Nursing Student Experiences of Clinical Practice - Assignment Example

? Qualitative Critique on Nursing Clinical Practice Sharif, Farkhondeh and Masoumi, S. (2005). A qualitative study of nursing experiences of Clinical Practice, Open Access, US: BMC Nursing , pp 1-7. Name of the Student University Name of Professor Date of Submission Number of words 2,977 Abstract This is a critic of the research conducted by Farkhondeh Sharif and Masoumi, S. in 2005 which was titled as A qualitative study of nursing student experiences of Clinical Practice. In the study, the researchers provided, in its abstract, brief disclosure of the background, methodology undertaken in the study, the outcome of research and the conclusion derived thereof. They explicated that the study was basically delving about the knowledge generated from the experiences the nursing students learned from the academe as instrumental in the application of the theories in their clinical practices that could help in the developing an effective clinical teaching strategies for nursing education (Sharif et al., 2005, p. 1-7). Thus, the researchers perceived that delving into the empirical experiences of the nurses could contribute in the development in the theoretical formations that could enhance the nursing curricula (Sharif et al., 2005, p. 1-7). However, at the outset, the researcher clarified that they are limited to 90 respondents only from a university and only their responses were used in categorically qualifying the answers for data analysis. The answers were categorized using themes (Sharif et al., 2005, p. 1-7). These are (a) point of view, (b) initial clinical anxiety, (c) theory-practice, (d) clinical supervision, and ( e ) professional roles (Sharif et al., 2005, p. 1-7). Introduction In this study, which is subject of my critical review, the researchers extensively defined clinical experience in nursing education. The theory provided clinical principles, critical thinking in resolving healthcare issues, including the stresses and brunt affecting them in the workplace and in healthcare management. Such included their anxieties (Sharif & Masoumi, 2005, p. 1-7). I choose this article for critical review because I work as a Nurse and Clinical instructor at the same time. As a medical professional, I believe that it is important to improve and develop new approaches towards better education outcomes, especially for nursing education whose graduates are tasked to provide sensitive healthcare. I share the purview that the article will lead me to explore the necessity about understanding nursing-students’ feelings in order to obtain good outcomes. The review is aimed at gaining knowledge and understanding the major approaches in research and to sight example of research studies pertaining to nursing clinical practice (Ingham-Broomfield, 2013, p. 102). It will analyse evidences on professional clinical care and correlate this in ethical professional healthcare as well as to the standard of the profession (Ingham-Broomfield, 2013, p. 102). The document was lifted from Biomedcentral.com (2013), an online site for research studies devoted for nursing research, training, education and practice. The site claimed to have adhered on a policy which is coherent to scientific knowledge but have less emphasis on interest levels as long as the research conducted contributed to the enrichment of healthcare literatures (BMC, 2013). The site is an open access site and although it has specified formats and prescribed (BMC, 2013). Documents are publicly available without subscription charges although for researchers, it has specific amount as charges for publication (BMC, 2013). The site is also automatically indexed by 17 prominent webs that offer indexing services (BMC, 2013). All published materials are subject to editorial policies and reviews. The title of the article I have chosen to review is A qualitative study of nursing student experiences of Clinical Practice. Though the title expressly noted that the research used qualitative method of study and therefore the analysis are confined from narratives and descriptive statements from primary sources, but it’s too broad that it provided an idea that the research might have considered a global perspective instead of specifically identifying the location of respondents were the study took its roots. I am however recognizing the competence of the researchers or authors of document as qualified to undertake studies relating to nursing since Sharif and Masoumi are bonafide nursing professionals that are either into psychiatric nursing and midwifery studies. Their tandem in undertaking this study is excellently attuned to their interests on clinical nursing behaviours. This critique used the framework of reflecting on its content; delve into the credibility of authors; the summation of abstract if it pointed key points; and, the rationale of the conduct of research. It will also check the comprehensiveness of the document; the purpose and aims of the research; the ethical issues; the methods utilized; and if the conclusion could be something that could be generalized, comprehensively accurate; and if these are transferable. Statement of the Problem- The research has no explicit problem mentioned in except that the researchers were clear about their aim of using the knowledge and reflection of the respondents in the formulation of additional educational materials that could enhance the nursing clinical practices (Sharif & Masoumi, 2005, p. 1-7). Research Questions – There were 9 questions raised by the researchers that are basically sifted from the, feelings, knowledge and experiences of the respondents. They were also asked about their recommendations on how to improve the clinical practices through their respective experiences and reflection (Sharif & Masoumi, 2005, p. 1-7). As this is a qualitative research, questions are not limited but are obviously open-ended and allow participants to further explicate their claims and statements. Literature Review Although there was an extensive definition of clinical nursing practice but the researchers have not extensively discussed literatures on the correlation of clinical nursing and about the nursing curriculum for schools to produce competent nurses. These could have helped explicate well about seeing the need of improving nursing curriculum and will also provide an in-depth impetus about what changes that should be targeted that could help medical institutions too. Applied theories on medical taxonomy can also be used as backbone for the investigation to ensure that standards and goals are equally attained by the researchers for metacognitive concerns (Anderson, Krathwohl, Airasian, Cruikshank, Mayer, Pintrich, Raths, & Wittrock, 2001, pp. 1-6; Howkins & Bray, 2008, p. 1). Bloom (1956) explained that the metacognitive knowledge is also the cognition about oneself in relation to variegated matters that underpin knowledge, comprehension, application, analysis, synthesis, and evaluation. As such, that provided an integrated approach on ideas, information, models, and principles (Bloom et al., 1956) toward deeper comprehension, understanding, translation and interpretation of experiences (Bloom, Englehart, Furst, Hill, & Krathwohlet, 1956, pp. 10-25). At the onset, with many respondents used, there are variant experiences that are open for different interpretation and perspectives that were consolidated under thematic theories (Loxley, 1997, p. 1-8; Reeves, Goldman, & Oandasan, 2007, p. 231). This correlates the fact that respondents have different sense of values, styles, and ways of appreciating their experiences. There distinct personalities and responses are also influenced by their persona, families, cultures, and interests (Loxley, 1997, p. 8). Their cognitive abilities will also resonate their respective level of expertise although they may have common understanding of patient care management (Pearson, Field, & Jordan, 2007, p. 9). They also relate with patients with differing multicultural backgrounds (Beyerlein, Johnson & Beyerlein, 2004, p. 1). It can be gleaned therefor that respondents in this study should have been appreciated in the literature as persons with varying level of cohesiveness in accomplishing their tasks and in contributing to the general goals and that their ability for professional interaction could help provide avenues for cooperation. There are maybe inane moments when the ideal and effective teamwork is impossible to realize but that only happens when there is less investment of passion to pursue the accomplishment of tasks. But then again, that will go back to performance management and evaluation to encourage or motivate practitioners to pursue team-based system and of open collaboration (Pollard, Thomas, & Miers, 2010, p. 8; Whitehead, Austin, & Hodges, 2011, p. 681). It is very significant therefor that roles are clarified to ensure differences are contextualized on common interests and goals (Barrett , Sellman & Thomas, 2005, 1-224). This is not non-conventional because medical institutions have known the significance of diversity in expertise and this is supported with open communication to maintain inter-professional learning processes (Pollard, et al, 2012, p. 8). In a Systematic Review of Studies of Nursing Education Outcomes: An Evolving Review done by Nancy Spector in 2006, researcher endeavoured to integrate evidence-based health management system sourced from respondents that were considered as expert in clinical healthcare. The research review underwent several random trials to ascertain that the values and needs of the learners for clinical nursing practice would be improved. Researchers also opted to undertake critical analysis via systematic review of evidences, whether these are supported or not, of nursing education strategies and learning environments. Employing mixed methodology, researcher used grading or rating system from 1 to V where level 1 used randomized control trials (RCT), level 2 has 5o or lesser subjects, level 3 has smaller cohorts or case-control, level 4 are evidences sourced from reports, studies, and low-level case-control or cohorts studies, and level 5 is based on expert evidences based on respondents experiential, physiological and biological principles. The process seemed complex but these was offset when they also adopted the theory of Gallager (2003), Pollit and Beck (2004) who utilized a system of rating research in accordance to the level of evidences in making decisions. Thus, the findings of the study earned a systemic meta-analysis with supporting evidences from quasi-experimental, correlational, descriptive, survey, assessment and qualitative data. Methodology The study conducted is a designed in a qualitative manner although and researchers used focus group discussion as an approach in generating responses. FGD is helpful in collectively getting insights and reflections but are also focused on the words used and their observations of the reality they have experienced (Sharif et al., 2005, p. 1-7). The method is helpful in descriptive and narrative studies that could help explicate an experience or phenomenon and the questions are actually raised in an open-ended fashion to allow the permeability of thoughts and further elucidation of claims (Sharif et al., 2005, p. 1-7). Like any studies, researchers clearly outlined the ethical considerations in the conduct in the study. They were careful that free, prior and informed consent are generated from respondents that are mostly 18-25 years old and are mostly females (Sharif et al., 2005, p. 1-7). Respondents were qualified as practitioners who have undertaken clinical works in a medical institution (Sharif et al., 2005, p. 1-7). The researcher however could have chosen an option of using a mixed research design to substantiate statistical information from their 90 respondents. Mixed research design can illustrate the statistical probabilities of the responses of the respondents that can help draw quantitative explication that could substantiate further the philosophical assumptions of the researchers. It can also deepen the analysis and provide a deeper approach in the investigation. As such, all of the answers of the respondents would have been subjected into deeper analysis instead of just simply integrating them in a thematic explication. The mixed method could of research, if utilized in this study, could have persuasively explain the result of the study on clinical nursing , taking into account the quantitative information with an underpinnings on qualitative information. It could have sensible data from its 90 respondents by exploring further the voices of the respondents; delve into the complexity of situations by integrating statistics, perspectives and explanations including secondary information. The variables of the research, inspired by the number of questions raised could have been elaborated in quantitative and qualitative manners, detailing their perspectives in descriptive and figurative information. While we recognize the narrative account as helpful in the understanding the issues and concern of clinical nursing, experts opined that quantitative analysis further the analysis and generalization with better examination and limitations inherent in descriptive analysis will be offset by additional information. It could also illustrate figures about the numbers of nurses under clinical nursing profession who underwent psychological and emotional stresses and those who are able to transcend the pressures inherent in the medical profession. Figurative details strengthen the findings and evidences will be able to provide complete understanding of the issue under investigation using the mixed method of research. It will also adequately nourish the research with more information Data analysis The analysis was drawn from the result of the focus group discussion. Respondents were recorded, documented and words were literally contextualized for deeper understanding. Respondents were also observed in their non-verbal communication, gestures and behaviours (Sharif et al., 2005, p. 1-7). The latter is inclusive of their confidence, knowledge, anxiety, their observations of the hospital environment, their fears, competence, pressures, the procedures they passed through and the clinical anxiety they felt (Sharif et al., 2005, p. 1-7). These responses were coded. The coding is mentioned in the earlier discussion. However, as can be gleaned from the studies which claimed to have 90+ respondents, there were less 10 reflection that was reflected in the discussion (Sharif et al., 2005, p. 1-7). It’s unclear though if these are the only best experiences from the respondents that could have been used in deepening the thesis. It is however appreciated that the researchers observed the ethical rules in conducting research by sourcing free prior and informed consents from respondents. Like nurses who have Hippocratic Oath as golden rule in their professional conduct, researchers too have professional ethical practices to observe. Exacting consent and treating responses with utmost confidentiality is a must, except in special cases when respondents agree that his or her identities can be bared. Ethics is an integral norm in research; not just ubiquitous conduct that can be regarded obliviously (Asch, Shea, Jedrziewski, Kathryn & Bosk, 1997, p. 1661). The ideas, thoughts, experiences and reflections of respondents are originally theirs and hence, sourcing these from them and publishing this as body of research require moral and ethical care (Gordo, 1986, p. 953). Such was clearly articulated by the researchers and as can be gleaned from their reports, the respondents’ answers were treated with utmost confidentiality although these are verbally articulated as part of the literature or discussion. The researchers evidently upheld these matters within the legal and ethical realms. Therefore, they are able to provide justice to research ethical practice. Moreover, the avenue where respondents share their insights and experiences (via FGD) also provided a space for them to informally and creatively share their experiences for them to see where they can improve their competences as health practitioners and revisit the strategies of the health curriculum to re-appreciate a patient-centered service (Hamilton & Manias, 2007, pp. 331-343). Informally, they can create a bond from the sessions and make it as a new bulwark for inter-professional networking for open communication and dialogues. The exchange and discourse could certainly also help improve organizational relations and conflicts. From their experiences, discourses will also help open an avenue for them to revisit their vision, mission, goals, programs and standards. Such correlate to the fact that the medical professionals are performing their responsibilities in accord to hierarchies of structures and power that provide directions to their norms and work ethics (Morison, Johnson, & Stevenson, 2010, pp. 412-421). They perform tasks under formal organizational structures that have plans and targeted desired outcome (Mizrachi & Shuval, 2005, pp. 1649-1660). It should be reckon that a lot of healthcare and organizational decision-makings and management are reliant on human resources performances to fully serve the interests of the clients. Nursing and healthcare providers are also into business operational management and therefore have serious interest on serving their clients (or patients) for their benefits and satisfaction. Such is a professional and corporate impetus for inter-professional collaboration and partnership that have intrinsic values for medical facility and for clients. Understanding how they operate to balance all the needs of the health institution is a great learning process for them to appreciate teambuilding, collaboration, and to strengthen their commitment for healthcare services. As such, the process also provided an avenue to appreciate too their professional contribution to health institution and to the academe in professional development and in working to contribute for the protection of lives (Lloyd, 2007, pp. 485-494). Thus, the nature of the discussion of the FGD are not simply limited to the questions presented by the researchers but is also enhance by making it as an open-ended queries to deepen the appreciation of their feelings, knowledge and experiences as practitioners. Conclusion The conclusion was derived from the themes generated from the experiments. Nursing experiences are indeed very unique experiences that can be utilized curricula development. In the study, the researcher affirmed that the themes generated from discussions helped in deepening the study. Their experiences, feelings, experiential reflections, and their anxieties offer points of reflection to improve nursing curricula to enhance the learning processes and in enlivening the integration of competence and skills if the lessons learned are integrated in the instruction. Experts assailed that experiential learning is a construct that generates the significance of reflection and pedagogical processes as additional knowledge for module development that can enhance teaching experiences. This will contribute therefore for progressive development of clinical theories and practice on manners that involve psychoanalytic perspectives, lessons derived from theoretical applications, the respondents’ appreciation of their professional culture and objects of knowledge, and how they cope with the pressures inherent in their undertakings. All of these provide certain interest for the enrichment of an institution for academic excellence. There may have been variants and conflicting experiences but these can be categorized to thematic sub-issues to effectively acculturate and share best practices and good coping mechanism for practitioners. It also provide an impetus of understanding further the persons who went into experiential reflection and their behaviours using verbal logic, visualizing realities, noting challenges, and differentiation of opportunities and strengths in the practice. In the end, the researchers affirmed that their literatures and the need to rethink about the imperative of improving the clinical skills training in nursing education to ensure that graduates are able to meet the demands and pressures of their profession. It will also help them appreciate the values and standards of clinical practice to ensure that practitioners are able to perform their oath in accord to standard of nursing practice (Robin & Manias, 2006, p. 1541). They further affirmed that the themes indicated in research are important factors to consider and to learn about. Moreover, they also affirmed that the study have similar import to earlier research conducted and thus therefor can be replicated in other institutions that are interested of improving their instructional capacity for nursing students (Robin et al., 2006, p. 1541). The universality of the themes and its application warrant such reliability for those who are interested to undertake similar study that would also touch anxieties sourced from clinical practice, the theoretical and praxis gaps, their professional roles and the need to improve to clinical supervision (Delamaire & Lafortune, 2010, pp. 1-5; Hadley, Blum, Mujaddid, & Parveen, Nuremowla, & Haque, & Ullah, 2007, p. 1166). These will contribute too in improving the core competence of practitioners and supervisory management over nurse and patient relation. Nursing is a multi-disciplinary profession. It has challenges to perpetually improve its services noting that contemporary medical care require practitioners to possess knowledge on composite courses of psychology, history, sociology, administration, customer-care, and social analysis aside from diagnostic and prescriptive skills (Kelly, 2008, p. 3). References Asch, D.A. & Shea, J.A., Jedrziewski, M. Kathryn & Bosk, C. L., (1997). 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