Finding a voice: Supporting ESL nursing students’ communication in clinical placement
This project sought to identify the factors most likely to support effective communication in clinical placements for undergraduate nursing students in New Zealand for whom English is a second language (ESL students).
Author - Jan Eyre, MPhil (Distinction), PGDipSLT, B Ed, Literacy and Numeracy Advisor, Universal College of Learning (UCOL)
Date - August 2010
This report outlines the key findings of a project that sought to identify the factors most likely to support effective communication in clinical placements for undergraduate nursing students in New Zealand for whom English is a second language (ESL students). The experiences of ESL students as they completed a clinical placement were examined and compared with those of the students’ clinical lecturers and preceptors.
Data for the study were collected through semi-structured interviews with seven individual students before, during and after their final clinical placement. Semi-structured interviews were also held with preceptors, and a focus group was conducted with clinical lecturers. These interviews and the focus group were supplemented by paper-based exercises designed to focus and stimulate the discussion, and to collect data on students’ level of confidence in communicating. Information from the interviews and exercises was coded and grouped to produce four major themes or factors influencing effective communication on placement. The findings from the study point to the importance of facilitating students’ entry to the placement community of practice, and their access to its interactions. The four major factors identified acted either to support or inhibit students’ participation in the placement community, and therefore influenced their learning, including mastery of effective communication skills.
The study identified two critical factors intrinsic to the student, and two factors that could be considered as extrinsic to the student. The first intrinsic factor was the student’s proficiency with English language. Of particular importance was the student’s ability to use the sophisticated sociopragmatic language skills that are integral to effective nursing, and that enable the development of therapeutic relationships with clients and working relationships with colleagues. The student’s use of learning strategies, including the ability to adopt the proactive approach best suited to learning on placement, was the second intrinsic factor. Extrinsic factors likely to support the student’s integration within the community of practice were the quality of the preceptor and the tone of the placement environment. The preceptor’s attitude to and training for the role were critical in either facilitating or blocking the student’s entry to the interactions of the placement; of similar importance was the atmosphere of the placement environment, especially as it related to an inclusive or exclusive attitude towards the student.
The major outcomes of this project point to the critical importance of providing direct and specialised instruction for ESL nursing students in the communication required for placement, for example through a communication-for-placement programme that includes a focus on sociopragmatic aspects of English. Such a programme should be developed jointly by ESL specialists and nursing faculty. It is also important that ESL students are given appropriate and direct instruction and practice to enable them to develop the active learning styles most suitable for placement. Further implications focus on the necessity to ensure that preceptors are adequately trained for their role, and on identifying appropriate clinical placement environments for ESL students. The report concludes with a series of practical recommendations for undergraduate nursing programmes, and a proposed model of ‘best practice’ in supporting ESL students to develop effective communication skills for placement.
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