A place for learning : a study of how nursing students learn and are supported while on clinical placement
This study investigated the teaching, learning and support of pre-registration nursing students in medical and surgical wards of two Scottish hospitals. The research was qualitative in nature and used a grounded theory approach, as described by Glaser and Strauss. Data were collected using non-participant observation of the students and their preceptors as they went about their daily ward routines and semi-structured interviews with subjects. The sample population comprised twenty-one students, twenty-one preceptors, six mentors, six mentees and two link teachers. Students and preceptors were a purposive sample though mentors, mentees and link teachers were identified using the theoretical sampling techniques of grounded theory research. Analysis of the data revealed two major descriptive categories called "relationships" and "environment", and six sub-categories labelled "student relationships with preceptors and supervisors", "mentoring relationships", "theory-practice relationships", "learning and teaching", " 'good', 'bad' and 'poor' learning and teaching experiences" and "preceptor-student interactions". From these the following three conceptual themes emerged: "control of learning opportunities", "mentoring and preceptoring" and "the theory-practice interface". The findings showed that control over the use of student learning opportunities was limited and that students learned specific aspects of ward work and patient care more often by chance than by planned experiences. It was also evident that students sought help from nurses other than those appointed to be their supervisors on any particular placement. They did this by identifying someone who they believed would be most able to answer their questions or understand their concerns. In comparison with studies conducted in the 1980s, the critical influence of the ward sister on the ward learning environment generally and on individual student learning opportunities was found to be much less significant. Evidence of different types of theory-practice gap is presented and it is suggested that generally students deal well with these when they encounter them.