Nursing Students' Perceptions of Learning Outcomes throughout Professional Simulation Experiences - Literature review Example

Professional Experience Placement Introduction Several aspects, including learning styles and clinical placement impact the learning process of nursing students. Reflecting on students’ learning experiences assists in promoting the quality of education. Integrating diversity in learning; helps in preparing diverse and cultural and sensitive practitioners in their future practice. Nursing profession is based on practice. Consequently, clinical education is a fundamental element of nursing curriculum. Clinical experience plays the most important part in nurse education. Students need effective clinical placements to enable them to apply theory into practice. The placement experiences are the key to preparing students to enter into workforce as competent and independent healthcare practitioners (Chen & Zhang, 2012). This paper will analyse the various learning experiences and take into account all modalities offered. The learning experiences will be identified and finally the paper will provide a reflection of the learning experiences. Description of Experiences Tutorials included small group learning activities that in most cases were led by the lecturer. They consolidated the knowledge conveyed in the previous lectures. Tutorials allowed elaboration, clarification, revision and follow up of lectures. They were less formal and offered a more understanding and application to daily life. Tutorials allow reflection of the learning information, and provide time to think and fill in any gaps from the lecturers (French et al, 2008). Through tutorials, it was easy to participate in learning and I expressed myself freely. It was easy to interact with fellow student during tutorials and hence this increased communication. During learning, cases were used where actual clinical situations were presented to solve them. Cases ranged from simple situations to complex scenarios. The various cases provoked critical thinking and thus allowed professional thinking and urged students to utilise theoretical concepts in highlighting practical problems. Cases were presented either to individual students but mostly to group of students and this enabled brainstorming of solutions to the presented case problems. This is because it facilitated critical thinking regarding various clinical situations and identification of potential solutions. Most important, the case world provided emotional preparation for the real world clinical practice. Basically, case world provide experience of solving clinical dilemmas, equip students with skills to come up with different strategies for problem solving and helped in problem identification and learning how to think professionally (Popil, 2011). Pods involved learning about nursing stations layout, into pod-like shapes. This included where the patient beds should be located, the location of clinical services and stationing of nurses where nurse can be able to spend more time with the patients. Nursing pods ensure that nurses have a specified number of patients at a given time to enable them spend more time at bedside and prevent wastage of time by nurses while walking for supplies and information Popil, 2011). Pods also involved learning about how a nursing station layout can be user-friendly to all healthcare providers, especially nurses. On the other hand, clinical intensive facilitated engagement in clinical decision making because it equipped me with the ability to use a multi-conceptual approach when delivering nursing care to patients. This learning therefore contributed to the personal and professional development, promoted lifelong learning and brought along skills required in pursuing excellence during patient care (Bambini et al, 2009). During clinical placement, I worked in diverse clinical settings which included acute care hospital, routine care, accident and emergency department, hospital operating rooms, among others. I came across various clinical situations and handled various patients with different types of diseases. I was also able to watch RNs, senior nurses, role models, physicians and other nurses deliver nursing and medical care to patients several times. Therefore, clinical placement provided an opportunity to practice, observe role models and develop nursing skills and problem solving capabilities (Jarvis, 2006). The clinical placement also facilitated integration of theoretical content with realities of nursing practice. Learning teams involved group sessions where students used group work as a way of learning. It also involved “peer tutoring” where students assisted each other in learning. As Stone et al (2013) explain, learning teams are vital in developing critical thinking skills, academic benefits as well as clinical skills. Learning teams enables students to have an experience of working together as a team, know each other weaknesses and strengths and thus students are able to support each other. This is important because through learning teams one gains experience of how to work together with team members and hence during practice collaboration with colleagues will be easier (Bambini et al, 2009). Clinical skill guidelines consisted of learning about what is expected of nursing within any healthcare setting. Accordingly, there was comprehensive coverage of nursing standards of care and the recommended suitable treatment and care of individuals with specific conditions and illnesses. This also covered the principles of nursing practice. Workshops consisted of various tutors, healthcare professionals and other students. This provided a platform to get advice regarding several nursing aspects. Workshops involved nursing student career preparation and thus they provided me with tips on how to be a better nurse, leadership, and teamwork as well. Influencing factors During PEP, some of the factors that promoted my learning include the supportive environment in the hospital. According to Papastavrou et al (2010), when healthcare providers including the RN, senior nurses and physicians are supportive, encouraging, friendly, approachable and understanding, this creates supportive environment for student nurses and hence they are able to learn and practice successfully. All staff members were friendly and treated me with respect and thus I was able to take part in communication to advance my learning goals. Another factor that promoted my learning was positive ward culture where I was welcomed, appreciated and integrated into the ward team. Chen & Zhang (2012) report that prevailing culture within the ward greatly influences learning experiences of nursing students. Papastavrou et al (2010) further emphasizes that the staff should view student as a less experienced colleague and treated them as so because this favors their learning. The staff had this perception and thus whenever I sought assistance; they would help me gladly and corrected me in a friendly manner whenever I made a mistake. However, there were few hindrances to my learning during PEP and they included staff shortages and increased workload. This kept all the healthcare providers including my role models and RN busy and hence I was not able to consult and seek clarification as much as possible. This is supported by Chen & Zhang (2012) who argue that the professional orientation of nursing staff has a significant influence on student learning within the clinical environment (Chen & Zhang, 2012). The learning outcome was achieved. This is because I developed skills, attributes and knowledge in nursing practice during the PEP. By the end PEP, I was able to practice as independently as possible, identify healthcare priorities for the assigned patient load, develop my own time plan, deliver care confidently, perform handover and document all my activities and actions; these are some roles a student nurse should be able to perform after clinical placement (Chen & Zhang, 2012). The main promoting factor in clinical skill guidelines was that during learning copies of the guidelines were provided and thus it was possible to refer to the guideline frequently until I became familiar with them. I achieved the learning outcome because after learning on clinical skill guidelines, I am can practice within the ethical, legal and regulatory frameworks of professional nursing practice and effectively utilise standards of nursing practice to perform and assess patient care within entry level practice. I am also able to make clinical decisions to ensure safe and accurate patient care (Royal College of Nursing, 2012). In learning teams, some factors that promoted learning included independence aspect of learning in teams, critical thinking and ability to brainstorm and solve problems easily when in teams. According to Stone et al (2013), learning teams are linked to increased levels of knowledge in aspects such as problem solving and communication. The hindrance in learning teams was that sometime I could develop anxiety which made me not to actively participate. A review study by Stone et al (2013) indicated that one negative feature associated with learning teams is increase in anxiety levels in some learners (Stone et al., 2013). I achieved the learning outcomes because I gained team work skills and can now collaborate with others during practice. As Bambini et al (2009) suggests, collaborative/teamwork practice is a higher level of nursing function that learning team allow students to practice. Factors that promoted learning in case world include that several cases were presented with different kinds of health problems and this enabled e to tackle diverse clinical conditions. Case world also came with multiple learning styles. The only hindrance is that some cases were too complex. I achieved the learning outcome because I believe that my critical thinking skills have greatly developed. According to Ravert (2012), case world is one of the best ways of assisting students in developing critical thinking. Case world enables students to think spontaneously and actively. Nurses are needed to make several decisions quickly and hence case world allows students to gain the critical thinking skills required in their practice. The most promoting factor during workshop is that advisors not only offered knowledge on nursing practice but they also presented effective strategies for studying, reading and how to practice professionally. I achieved the learning outcome because the workshops made me feel more comfortable and confident to attend clinical and also prepared me better for coursework and clinical experience. The most promoting factor in pods was the practicability and thus I achieved the learning outcome. Pods equip students with information and practical knowledge regarding how a good nursing layout should be to enable nurses to offer excellent nursing care and service (Jarvis, 2006). For tutorials, factors that promoted my learning are that tutorials involved group work, participation and there was active learning because tutorials offered learning activities other than listening to the tutor. The main hindrance is that sometimes the groups were too small which made tutorials boring. I achieved the learning outcome because through tutorials, I was able to understand classroom materials much better. According to French et al (2008) students report increased understanding of course materials after taking part in tutorials. Tutorials can be used to clarify and reinforce classroom materials. When students understand classroom work well, they are able to synthesize knowledge from other sources (French et al, 2008). Reflection The decision to participate in all learning modalities has played a big role in my nursing practice. I have gained enormous knowledge and practical experiences that helped e improving my nursing skills. However, I did not use any simulation during learning and I feel that simulations would have assisted in increasing and improving knowledge and understanding in nursing practice. According to (Fountain & Alfred (2009) simulation experiences facilitate learning. Simulations are beneficial to students with numerous learning styles and help in attaining educational objectives. The identified outcomes of simulation experiences include: improved communication, increased nursing skills, increased understanding of class work, development of critical thinking skills and facilitates team work (Broussard et al, 2009). The learning prepared me as a clinician to think critically when making nursing decisions, to safely deliver nursing care to the patients, adhere to the required ethical and legal nursing requirements, function as patient advocate, and carry out nursing practice within the legal scope of practice of the Registered Nurse. Accordingly, with the learning I can effectively apply concepts and skills gained during patient care, make clinical and nursing decisions to ensure accurate and safe patient care, practice within the ethical, legal and regulatory frameworks of professional nursing practice and utilise standards of nursing practice to deliver nursing care Broussard et al, 2009). This will definitely improve patients’ health outcome because during nursing care, I will endeavor ensure that accurate nursing decisions are made to ensure safe patient care, use critical thinking to be able to come up with the right nursing decisions quickly, collaborate with other healthcare providers and adhere to the required ethical and legal nursing obligations. Learning experiences such as case world and workshops engaged students and hence enabled me to apply theory to practice, practice decision making skill, utilise various viewpoints and also synthesize course content. Case world also promoted critical thinking and brainstorming and hence during PEP I was able to apply the critical thinking skills when I faced different clinical situations. Through tutorials, learning teams and workshops I was able to interact with students, share opinions and also it was possible to explore one’s own thoughts. This enabled me to collaborate well with other healthcare providers during PEP. According to Broussard et al (2009) students who in their learning tackle case studies, attend tutorials, workshops and also regularly use learning teams during their learning are able to collaborate with tea members which is train of an expert nurse. These learning experiences also promote the ability to communicate with healthcare members due to peer interactions involved and hence the experiences not only impacted collaboration during PEP also the experiences enabled me to communicate effectively with healthcare providers during PEP (Broussard et al, 2009). Additionally, through the learning experiences, I had opportunities to practice skills in clinical situations before my clinical placement. The practicing skills gained in learning experiences contributed to better skill performance and hence I was more confident during PEP. The learning prepared me as a clinician to think critically when making nursing decisions, to safely deliver nursing care to the patients, adhere to the required ethical and legal nursing requirements, function as patient advocate, and carry out nursing practice within the legal scope of practice of the Registered Nurse. Accordingly, with the learning I can effectively apply concepts and skills gained during patient care, make clinical and nursing decisions to ensure accurate and safe patient care, practice within the ethical, legal and regulatory frameworks of professional nursing practice and utilise standards of nursing practice to deliver nursing care. This will definitely improve patients’ health outcome because during nursing care, I will endeavor ensure that accurate nursing decisions are made to ensure safe patient care, use critical thinking to be able to come up with the right nursing decisions quickly, collaborate with other healthcare providers and adhere to the required ethical and legal nursing obligations. Moreover, through the learning as an RN I have greatly improved various skills required in nursing practice such as communication skills and collaboration. I can communicate effectively with both patients and other healthcare providers and thus the learning has played a role in enabling me to maintain good patient nurse relationships and good relations with healthcare providers because communication is the key to forming good relations during nursing practice. As a Learning This experience has changed my awareness for learning in that initially I was only accustomed to passive learning but through these experiences I have experienced active student participation and learning. The experiences brought along practical learning that addressed critical thinking, teamwork, collaboration, cognitive development, clinical skills as well as academic gains. I have learnt that learning can also involve active student participation where the student has the responsibility for their learning. Such learning experiences encourage independent learning, critical thinking, problem solving skills, and also equip students with the practical experiences in nursing practice (Lake & McHugh, 2010). I intend to take this information into third year and beyond by applying the skills and experience I have gained in my third year, beyond and even in future practice. These experiences have given me a sense of autonomy and thus in third year and beyond I will have full responsibility of my own education. Since I have had increased levels of knowledge in areas such as communication, problem solving, critical thinking, in third and beyond it will be easy to address all tasks and learning involved in future learning. Through these experiences, I now understand the role of RN across clinical contexts. The role of an RN encompasses assessing and managing using the acquired nursing knowledge and skills. RN is supposed to function autonomously and in collaborative relationships with other healthcare practitioners and hence experiences such as learning groups and workshops made me realize these roles. By reflecting on the learning experiences, I have learned that the RN has a role to reflect of their level of expertise, the intricacy of the clinical situations and the level of supervision. A Registered Nurse is personally responsible for his/her own practice and are supposed to maintain their competency and meet all professional standards. These are some of the roles of the RN that I learned during PEP because I could observe their accountability and how they maintained competency during practice. Clinical skill guidelines also made me learn regarding the professional standards an RN is supposed to meet (Nursing and Midwifery Board of Australia, 2013). RNs are supposed to apply critical thinking and good judgment in all decisions they make and thus experiences such as case world I was able to learn that it is important to have good critical thinking skills because problem solving and decision making are among the roles of RN and these roles require good critical thinking skills. RNs should perceive clinical situations as whole and recognize unexpected clinical responses and act accordingly. It is also the responsibility of an RN to supervise and enrolled nurses, graduate nurses and student nurses as well (Lake & McHugh, 2010). Bibliography Bambini, D., Washburn, J., & Perkins, R, 2009, Outcomes of clinical simulation for novice nursing students: Communication, confidence, clinical judgment, Nursing Education Perspectives, 30(2), 79-82. Broussard, L., Myers, R., & Lemoine, J, 2009, Preparing pediatric nurses: The role of simulation based learning. Issues in Comprehensive Pediatric Nursing, 32, 4-15. DOI:10.1080/01460860802610178 Chen Y & Zhang Q, 2012, Assisting undergraduate nursing students to learn evidence-based practice through self-directed learning and workshop strategies during clinical practicum, Nurse Education Today, 32(5):570-5. DOI: 10.1016/j.nedt.2011.05.018. 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