Clinical preceptors (CPs) play an integral role to prepare skilled, competent and caring student nurses to perform their future roles as members of the health care team. The aim of this study was to explore processes and effectiveness of the new role of clinical preceptors (CPs) in a low income country. A case study using Tellis (1997) approach was used. Data was collected from different viewpoints including, nursing administration, nursing services, co-faculty and students. The findings of the study will contribute to an in-depth understanding about the emerging role of CPs and operationalization of this role within the undergraduate nursing programme in Pakistan. The study findings endorse that CPs support clinical education of the nursing students' provided there is mentorship and a program for teaching and learning. Through this case study the authors demonstrated the complexities and challenges of introducing a new role. Additionally, factors like institutional support, resources and mentorship are vital elements to support the new emerging role of CPs. It is envisioned that this new role can be replicated in other health care disciplines locally and regionally.
Background:
Providing end of life (EOL) care is a component of palliative care but dealing with dying patients and their family members is stressful for the healthcare providers. To prepare them for providing EOL care, the high-fidelity simulation could be used as a pedagogy in which real-life scenarios are used on the computerized manikins mimicking the real patients.
Aims:
The aim of this study was to measure the effectiveness of high-fidelity simulation to teach EOL care in the palliative nursing course in the undergraduate nursing education program at the School of Nursing and Midwifery at Aga Khan University which is private university in Karachi, Pakistan.
Methods:
This study was approved by the ethics review committee of Aga Khan University. It was hypothesized that exposure to high-fidelity simulation will lead to an increased positive attitude in participants towards the care of dying. A quasi-experimental design was used. In line with the design, there was no control group. The same group of students (
n
= 42) were assessed through Frommelt Attitudes Toward Care of the Dying (FATCOD) Part B assessment tool. Permission for using this tool was obtained from Dr. Katherine Frommelt, the author of this tool. Research participants filled this tool before and after the intervention, i.e., providing EOL care to a patient in a high-fidelity simulation lab.
Results:
Out of 30-FATCOD items, significant attitude change was detected on 11-items of which 8 were positively worded statements and 3 were negatively worded statements. As per the hypothesis, it was expected for the positively worded statements that the mean score for the posttest would be significantly greater than the pretest mean score (pretest score < posttest score). The hypothesis was proved for items 1, 4, 10, 18, 22, 25, 27, and 30 as their
t
-value was significant at 0.05 alpha value (one-tailed). For the negatively worded statements, it was expected that the mean score for the posttest would be significantly lower than the pretest (pretest score > posttest score). The hypothesis was proved for items 5, 6, and 11 as their
t
-value was significant at 0.05 alpha value (one-tailed).
Conclusion:
In this research teaching, EOL care through high-fidelity simulation had improved the attitudes of students toward providing care. This pedagogy also provided the participants with a learning opportunity to deal with their own emotions. These findings provide a way forward for teaching EOL and other complex skills of clinical practice.
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