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Abstract Schools of Nursing have witnessed an increase in the number of nursing students who struggle with learning difficulties. Support and accommodations are available in academic settings. Because nursing is a practice profession students also learn in clinical settings, which may not have similar support and accommodations. The compatibility of the clinical setting for the education of students with learning difficulties has not been studied. Staff nurses responsible for the clinical education of students and new nurses receive little preparation for their role as educator, and may not feel supported to meet the needs of those with learning difficulties. This is part one in a series of articles about the clinical education of nursing students with learning difficulties. This paper provides a framework and literature review for the development of a study (part 2) exploring the issue from the perspective of the nurse preceptors who educate students and new graduates with learning difficulties. Highlights • There is an increase in the number of students in school of nursing with learning difficulties. • The literature on nursing students with learning difficulties can be understood from the perspectives of nursing schools, faculty, and students. • Nurse educators have a role in preparing the learning environments for students with learning difficulties. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore Irish preceptors' experience of using a competence tool to assess undergraduate nursing students' clinical competence. This study used a mixed methods design. This study was conducted in two phases, the qualitative phase involved six focus group interviews to ascertain preceptors' experiences of using an assessment tool to assess clinical competence. The quantitative phase involved a descriptive survey measuring preceptors (N = 843) attitudes linked with the use of the assessment tool. The key themes that emerged from qualitative analysis were challenges of using the assessment tool, recognising competence and valuing adult learners. The challenges of using the tool included negotiating complex language and time constraints in completing assessments. Recognising competence revealed the use of intuition and subjectivity. While valuing adult learners acknowledged the reciprocal learning process between the preceptor and the learner. These findings reveal the inherent skills of preceptors to intuitively and subjectively recognise competence. The quantitative findings revealed merits and challenges for the preceptors using the assessment tool. In particular the complexity of the language was highlighted as an issue. A key recommendation from this research is the need to revise the assessment tool to support objective and subjective measurement of competence. [ABSTRACT FROM AUTHOR]

Background: Assessment of clinical practice is a core component of midwifery education. Clinical assessment is challenging and affected by a number of factors. Preceptor midwives are reported to be reluctant to fail students in clinical assessments. This is worrying as preceptor midwives are gatekeepers to the profession of midwifery and need to ensure midwifery students are safe and competent practitioners of midwifery on completion of their programmes., Methods: This qualitative descriptive study explores preceptor midwives experiences of clinical assessment of midwifery students in four maternity units in the Republic of Ireland. Following ethical approval, twenty-nine preceptor midwives were interviewed. Content analysis was used to analyse the data and two themes with associated subthemes identified., Findings: Competency assessment in practice was supported by a robust, clearly delineated process, considered vital to ensure effective and fair assessment of midwifery students. The process in place had many advantages but attracted some criticism too, most notably language, documentation and lack of continuity of the preceptor. The challenges of clinical assessment were multifaceted but the most pressing concern was dealing with students who were struggling in practice where the outcome of an assessment was potentially a fail. Preceptor midwives expressed reluctance to fail students but balanced this with ensuring safety for women and their babies. A number of other challenges hampered decisions in clinical assessments. These included the confidence of the preceptor, juggling the competing demands of clinical practice with effective assessment in an increasingly complex and fiscally challenging environment, operationalising the competency assessment process and the emotional toll associated with failing a student., Conclusion: Preceptors' primary focus is on ensuring that graduate midwives are safe and competent practitioners and it is this which guides their decision making on the outcome of clinical assessments. However, more support is required for the onerous responsibility of clinical assessment, particularly for less experienced midwives but also when failure of clinical assessment is a potential outcome. Preceptorship needs to be valued more at a strategic level., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: Facilitating and supporting clinical learning for student nurses and midwives are essential within their practice environments. Clinical placements provide unique opportunities in preparation for future roles. Understanding the experiences of first year student nurses and midwives following clinical exposures and examining the clinical facilitators and barriers can assist in maintaining and developing clinical supports., Methods: The study used a structured group feedback approach with a convenience sample of 223 first year nursing and midwifery students in one Irish university in April 2011 to ascertain feedback on the clinical aspects of their degree programme., Results: Approximately 200 students participated in the process. Two key clinical issues were identified by students: facilitating clinical learning and learning experiences and needs. Positive learning environments, supportive staff and increased opportunities for reflection were important issues for first year students., Conclusions: The role of supportive mentoring staff in clinical practice is essential to enhance student learning. Students value reflection in practice and require more opportunities to engage during placements. More collaborative approaches are required to ensure evolving and adapting practice environments can accommodate student learning., (Copyright © 2014 Elsevier Ltd. All rights reserved.)