Posted: August 30th, 2023

The Optimal Clinical Environment

Creating the Optimal Clinical Environment

Nurse educators are responsible for both didactic and clinical education. Much thought and planning goes into determining clinical content and clinical placements. Before you can negotiate clinical partnerships, you must decide on the type of clinical experiences students need and where they can get them. After completing this week’s reading, and reflecting on your experiences as a student, consider how an educator should go about making these kinds of decisions.

Initial Post: Use these prompts to think about the topic and share your ideas.

How would things like active learning, action and reflection, and higher level thinking influence your decisions about student placement (i.e. where would you place new students vs. senior students and why)?
Scheduling students on the same floor for longer periods of time allows students to adjust and feel comfortable in the learning environment. On the other hand, more frequent changes may provide a greater variety of clinical experiences. As an educator, how do you choose? Which do you prefer? Which do you think students prefer? Support your answers with information about best practices.
What balance of clinical observation vs. hands on care is optimal and why?
Who should have the greater role in guiding and supervising students on a clinical floor, the instructor or staff nurses/preceptors? How might this be negotiated/configured.

Creating the Optimal Clinical Environment: Balancing Factors for Effective Nurse Education

Nurse educators play a pivotal role in shaping the learning experiences of nursing students, both in didactic and clinical settings. Crafting an optimal clinical environment requires careful consideration of various factors that can influence students’ learning outcomes and overall experience. In this article, we delve into the key elements that nurse educators should contemplate while designing clinical placements and experiences, backed by recent insights from scholarly sources.

1. Tailoring Learning through Active Learning, Action, and Reflection

Active learning methodologies engage students in the learning process, promoting critical thinking and practical skill application. When deciding student placements, educators should consider the balance between active learning, action, and reflection. Junior students might benefit from more structured and supervised environments, allowing them to focus on foundational skills and grasp essential concepts.

On the other hand, senior students could be placed in more complex settings that demand higher-level thinking, decision-making, and autonomy. This progressive approach aligns with the experiential learning cycle, where action and reflection refine skills and judgment. Research by Prince (2004) emphasizes the effectiveness of active learning strategies in enhancing student engagement and knowledge retention.

2. Finding the Sweet Spot: Stability vs. Variety in Clinical Placements

Striking a balance between extended placements on the same floor and frequent rotations can significantly impact students’ learning experiences. Longer placements offer familiarity and comfort, enabling students to integrate into the clinical environment more effectively. Conversely, shorter rotations expose students to a diverse range of cases and care settings, broadening their skill set.

In making this choice, educators should consider the learning objectives of the curriculum and the desired learning outcomes. A study by Oermann et al. (2017) underscores the importance of aligning clinical experiences with course objectives to optimize learning outcomes.

3. The Clinical Observation vs. Hands-On Care Dilemma

Determining the right balance between clinical observation and hands-on care is crucial. While observation provides insights into patient care dynamics and allows students to learn from experienced professionals, hands-on care fosters the development of technical and interpersonal skills. Striking this balance depends on the students’ level of competence, the clinical setting, and the specific learning goals.

Recent research by Lahti et al. (2016) highlights the significance of hands-on experiences in building students’ self-confidence and clinical proficiency. Thus, educators should ensure a progressive increase in hands-on opportunities as students advance through their clinical journey.

4. Guiding and Supervising: Educators vs. Staff Nurses/Preceptors

The question of who should take a more active role in guiding and supervising students on clinical floors—educators or staff nurses/preceptors—is multifaceted. Educators bring pedagogical expertise and can provide a comprehensive learning framework. On the other hand, staff nurses and preceptors offer real-world insights and practical wisdom from their clinical experience.

The optimal approach often involves collaboration. Educators can set the overarching learning objectives, while preceptors offer day-to-day guidance and mentorship. A study by Myrick and Yonge (2017) underscores the importance of clear communication and mutual understanding between educators and preceptors to enhance students’ clinical learning experiences.

In conclusion, creating the optimal clinical environment necessitates a thoughtful interplay of various factors. Nurse educators must consider active learning strategies, balance between stability and variety, optimal hands-on experiences, and collaborative guidance from educators and preceptors. By aligning these elements with educational goals and student needs, nurse educators can shape effective and enriching clinical learning experiences.

References:

Prince, M. (2004). Does Active Learning Work? A Review of the Research. Journal of Engineering Education, 93(3), 223-231.
Oermann, M. H., et al. (2017). Assessment of nursing students’ clinical performance. Nurse Educator, 42(5), 244-247.
Lahti, M., et al. (2016). Nursing students’ opportunities to participate in clinical practice: An integrative literature review. Nurse Education in Practice, 16(1), 257-263.
Myrick, F., & Yonge, O. (2017). Preceptorship and critical pedagogy: A natural pairing. Journal of Professional Nursing, 33(2), 88-92.

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