This research explores how experienced nurses perceive their role as clinical teachers in an environment that is challenged not only with on-going changes in healthcare delivery, but also by the expectation that it will continue to provide positive clinical learning opportunities for undergraduate student nurses.
Schools of nursing in Australia have undergone rapid and far-reaching change as a consequence of the legislated transfer of nursing eduction to the tertiary sector. Expectations that nurse academics will possess higher degrees and be actively involved in research mean that faculty members have less time to be directly involved in their students’ learning during clinical practice placements. The literature indicates that the responsibility for moment to moment teaching and learning thus appears to have been implicitly given to clinical staff who may not possess any formal qualifications for teaching, yet are largely responsible for students’ learning through clinical placements. Indeed some clinicians report a worrying lack of knowledge of clinical supervision models giving cause for further concern about the nature of the clinical learning environment. Schools of nursing expect that clinical practica will provide opportunities for students to learn how to be a nurse through guided questioning, analysis and critical thinking. It is evident that in some settings, this represents an ideal situation and not the reality.
Critical reflection on these issues has informed the purpose of this research and helped to shape the following questions that focus the conduct of the study:
Research Question One
How do experienced nurses create positive clinical learning environments for student nurses?
Research Question Two
How do experienced nurses resolve the often-contradictory demands of nursing students and those of the practice setting?
Research Question Three
How do changes in the healthcare environment impact on the experienced nurse's role as a clinical teacher?
The theoretical framework for this study was underpinned by the interpretive philosophies of hermeneutic phenomenology and symbolic interactionism, because they acknowledge the personal experiences and meanings of the participants. A case study approach was utilised because it acknowledges the given context of the participants. Data were collected from six experienced nurses through a series of semi-structured interviews, informal interviews and periods of participant observation supported by field notes and the researcher’s diary.
Participants identified that their perception of their role as clinical teachers was constructed of three intersecting roles: that of facilitator of learning, assessor and socialiser. This study concludes that several factors influence these nurses’ perception of their role as clinical teachers. In particular, the positivist work culture of the clinical setting and nurses’ own past experiences and world view of nursing combine to shape these nurses’ perception of their role as clinical teachers.
The research concludes that the expectations that students will be supported in their endeavours to be critically thinking, problem solving and reflective practitioners may, in fact, be unrealistic in the current, economically constrained, clinical environment. It is evident that experienced nurses, despite being willing to be involved with clinical teaching, have to function in rapidly changing environments that do not always offer opportunities for nurses to reflect on their practice. However, the creation of positive clinical learning environments in these circumstances requires an increased understanding and appreciation by both schools of nursing and their students of the impact of change on these nurses and their clinical environment. This appreciation may result in more effective collaboration between nursing education and nursing service to assist student nurses to learn not merely through repetitive practice and busywork, but also through opportunities to observe, question and understand their nursing practice.