Background of Study
Nursing requires a multitude of medical knowledge, experience, and sufficient communicative skills. Two studies have been conducted exploring the issue of students’ challenges in clinical practice. The first one is “Theory and practice in the construction of professional identity in nursing students: A qualitative study” by Jamshidi et al. The second one is “The challenges of nursing students in the clinical learning environment: A qualitative study” by Marañón and Isla Pera. Both articles research the problem of nursing students’ adaptation in the clinical setting.
The studies are significant to nursing because they underline the importance of clinical expertise and have suggestions for an easier transition of a student to a nurse practitioner. The purpose is to find qualitative data that could be used to help the nurse students quickly and efficiently acquire patient care skills. The objective is to pinpoint specific changes that could be implemented for successful clinical experience. The research question is by what means the students’ nursing practice can be improved.
Relation of the Articles to the Nurse Practice Issue
Both articles provide the written account of research into the obstacles in students’ practice. Marañón and Isla Pera’s (2015) study will prove useful in ascertaining the prerequisites of successful clinical practice. Jamshidi et al. (2016) explore the psychological nature of nursing, which is beneficial in understanding what factors have a positive effect on students’ progress. Using both sources, it is possible to combine their findings into constructive ideas to be implemented in students’ learning.
In both cases, the articles research nursing students who have challenges with undergoing a smooth clinical practice. Marañón and Isla Pera (2015) chose participants with insufficient skills in patient care, thus proving the importance of nursing practice. At the same time, Jamshidi et al. (2016) focus on students and clinical placement mentors, exploring how their relations influence the learning progress. As a result, the participants of both researchers directly relate to the control group of the study.
Method of Study
The study by Marañón and Isla Pera (2015) uses ethnographic research as the primary method for conducting research. As the authors state, “A qualitative research study was conducted within a constructivist paradigm and with ethnography as the most appropriate methodological strategy to approach the study aim” (Marañón & Isla Pera, 2015, p. 860). The major benefit of this method is incorporation of the first-hand student experiences via observing them engage in direct patient care. It allows to analyze the immediate challenges in the application of their knowledge without the blurred perception of their recounts. The drawback of ethnography is the lack of literature delving into issues surrounding students’ transition into clinical practitioners, which complicates the relation of the findings to existing theories.
While Marañón and Isla Pera (2015) relied on observations for collecting data, Jamshidi et al. (2016) gathered information from interviews with students and instructors. The authors declare that “content analysis was used in this qualitative research so that rich and deep information could be obtained from the phenomenon under study” (Jamshidi et al., 2016, p. 2). The advantage of interviews is that the respondents explain the emotional reactions to challenges, which allows assessing the effect of stress on clinical practice. However, students’ memories are flawed and do not provide an objective record of cases, which constitutes the limitation of this method.
Results of Study
Based on the results of their study, Marañón and Isla Pera (2015) identified three main points. Firstly, “Clinical placements are the main element, as they provide an exceptional opportunity to experience professional reality and to be able to contrast it with that transmitted in other teaching settings or more theoretical strategies” (Marañón & Isla Pera, 2015, p. 862). As an example, the study mentions the words of a participant Joel who recollects how due to the clinical placement, she generated more professional knowledge than nursing school had been able to give. Secondly, the study stresses the importance of a clinic placement mentor, who facilitates students’ progress and increases their confidence. Thirdly, the more knowledgeable a graduate is, the more confident they will be in nursing, but this does not imply that nurse school theories supplant clinical practice. In summary, in order to achieve patient care expertise, clinical placement is necessary, which can be streamlined by a nurse mentor.
The research of Jamshidi et al. (2016) features psychological issues of students. As the authors claim, “The findings obtained from the study demonstrated that ineffective communication, inadequate preparation, and emotional reactions are Iranian nursing students’ challenges in the clinical learning environment” (Jamshidi et al. 2016, p. 4). The majority of concerns stem from interaction with instructors who are not satisfied with the students’ competence, causing further pressure on their sense of confidence. For instance, numerous interviewees reported the instructors voicing their displeasure in the presence of patients, which undermined the trust in the students’ skills. Therefore, instructors’ attitude encourages the atmosphere of tension, hinging the progress of learning. Furthermore, the lack of adequate teacher support manifests itself in poor communication with patients, in which students’ inferiority is evident. Overall, inconsiderate mentor behavior can undermine learning and adaptation to the clinical environment.
Altogether, the studies have two implications for nursing practice – the necessity of clinical practice and appropriate behavior of clinical mentors. Clinical placement is essential in nurse education since it exposes students to real-life scenarios, where psychological and social variables are present, including dealing with unsatisfied patients. Healthcare does not presuppose strictly set procedures of treating, as each case is individual and nurse training cannot take into account the entire diversity of possible complications. Moreover, students can get knowledge in the clinic that nursing school is not able to provide. However, the acquisition of clinical skills transpires easier, when facilitated by an encouraging mentor, who considers the inexperience of students. In support of this, Jones (2017) points out that “mentoring has been an effective strategy for nurturing nurses in the increasingly stressful and challenging health care work environment” (p. 76). As a result, nursing practice should incorporate teachers’ condescension in supervising nursing students.
As both studies involved the use of recorders to sample data, the confidentiality of respondents was put in question. Jamshidi et al. (2016) guaranteed the protection of respondents’ identity stating that “the recorded interviews were kept in a safe place and were only accessible by the researcher” (p. 3). Marañón and Isla Pera (2015) were also aware of privacy issues, claiming to have destroyed the recordings after completing the study. As a result, volunteers’ concerns of violations of their confidentiality were properly addressed in both studies.
Each study potentially exposed students’ fears and challenges to public knowledge, which created the ambiguity surrounding the possible disclosure of personal information. Marañón and Isla Pera (2015) stated that “participation was voluntary at all times and written informed consent was obtained from participants and the management of the distinct institutions” (p. 860). In a similar manner, Jamshidi et al. (2016) assured the research group of maintaining their privacy while obtaining consent for each interview. Therefore, by acquiring permission from the students, the researchers prevented uninformed disclosure that could implicate the participants.
Jamshidi, N., Molazem, Z., Sharif, F., Torabizadeh, C., & Najafi Kalyani, M. (2016). The challenges of nursing students in the clinical learning environment: A qualitative study. The Scientific World Journal, 2016, 1-7. Web.
Jones, S. J. (2017). Establishing a nurse mentor program to improve nurse satisfaction and intent to stay. Journal for Nurses in Professional Development, 33(2), 76-78. Web.
Marañón, A. A., & Isla Pera, M. P. (2015). Theory and practice in the construction of professional identity in nursing students: A qualitative study. Nurse Education Today, 35(7), 859-863. Web.