Student nurses exposure to Primary Health Care nursing: Issues and innovations
This project makes recommendations for processes and practices that will ensure learners are provided with quality clinical placements.
Karen Betony – Nurse Maude Association
Judy Yarwood – Christchurch Polytechnic Institute of Technology
Dr Chris Hendry – New Zealand Institute of Community Health Care
Dr Philippa Seaton – Christchurch Polytechnic Institute of Technology
Completed: June 2012
You can download an executive summary of this project from the link below. A copy of the full report is available on request from the project leader, Karen Betony or from Ako Aotearoa's Southern Hub Manager, Bridget O'Regan.
Background to the project
The provision of quality clinical placements for health care students is acknowledged as a major challenge for tertiary institutions. Clinical practice experience is an essential component of any undergraduate health professional education programme. Yet there appears to be a range of barriers both in New Zealand and internationally impacting on tertiary education institutions' abilities to provide quality placements.
In this collaborative project between Nurse Maude Association, Christchurch Polytechnic Institute of Technology (CPIT) and New Zealand Institute of Community Heath Care, Karen Betony and her team focused on clinical placements in primary healthcare settings.
The project goals were to:
- gather baseline information on the range of Primary Health Care (PHC) and community settings used in offering clinical experience to Bachelor of Nursing (BN) students
- identify barriers to providing quality PHC and community clinical placements
- identify areas of innovation in providing PHC and community placements
- make recommendations for ensuring BN students gain appropriate exposure to PHC and community based nursing.
The literature review provides an overview of key changes that have occurred worldwide, leading to policy changes and their impact on undergraduate health professional education programmes. The review highlights the role that clinical practice placement experience plays in the preparation of health professionals, to ensure there is a suitably prepared health workforce.
14 of the 17 New Zealand universities and polytechnics that offer BN programmes, responded to the SurveyMonkey questionnaire.
Issues and innovations
The 32 issues raised are easily summarised under the following topics:
- lack of placement availability
- placements in medical centres where medical students were given preference over nursing students
- payment for placements
- requirements for Registered Nurse supervision of students
- impact on clinical staff taking a student
- perceived value of the placement.
Despite these issues, some institutions have found innovative ways of ensuring students gain appropriate experience. These include:
- establishing a Dedicated Education Unit (DEU)
- looking for opportunities to integrate the Whanau Ora programme into PHC placements, enabling students to work with families.
- a revised curriculum to embed PHC concepts of health promotion and education throughout the programme, and incorporating rest homes in their year 3 PHC placement to increase placement capacity.
- offering a PHC placement for their “Transition to Practice” placement to third year students only.
The recommendations which follow are written with the focus on PHC. They are however applicable in all professions where clinical placements are a programme component.
- Establish regional clinical placement allocation groups to adopt a regional, rather than institutional approach to managing clinical placements.
- Review the funding regime for clinical placements for nursing students particularly in PHC settings.
- Increase inter-professional collaboration to reduce competition for placements and open up opportunities for inter-professional placements, such as nurses with physiotherapists, and medical students with nurses
- Take a team approach to student learning to include PHC teams such as dieticians, podiatrists and social workers, provided a Registered Nurse retains overall responsibility for supervising and assessing the student.
- Clarification from the Nursing Council of New Zealand of the core expectations of a 'primary health care and community experience'.
- Reduce inconsistencies across the country by undertaking further research to identify an appropriate exposure to theoretical, practical and clinical experience.
- Ongoing collaboration between tertiary and healthcare providers.
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