Nursing in rural communities offers opportunities for independent nursing practice and community participation. However, recruitment of nurses to rural settings can be difficult. In response to this challenge and the rising demand within nursing education for community clinical placements, intensive, short-term, rural community clinical placements are being developed by urban universities. As yet, little research has examined the use of these placements for undergraduate nursing education. The purpose of this qualitative research study was to examine the experiences of students, registered nurse mentors, and clinical instructors in rural health clinical placements, as part of a larger study examining alternative clinical placements. Through use of the interpretive descriptive method, the perspectives of participants were elicited from focus groups and interviews. The paradox of nursing student placements in rural health is that limitations of the rural site became the impetus for nursing student learning and partnership. An implication is that service learning partnerships be pursued for mutual benefit of students, communities, and rural nurses.
Ongoing restructuring within the health care system juxtaposed with mandated increased seats in nursing programs have taxed traditional clinical practice settings beyond their capacity. In the search for suitable clinical placements to meet learning objectives and fulfill required clinical hours, nursing program administrators are turning to various non-traditional settings. Yet limited research exists to describe the prevalence and types of 'innovative' clinical placements (ICPs) or the nature and quality of student learning in such settings. Described in this article are findings from a national survey of Canadian baccalaureate nursing programs completed by nurse educators and clinical placement coordinators regarding nursing student placements within ICPs. Participant survey responses provide a national snap-shot of ICPs, along with perspectives on pedagogy, strengths and weaknesses, capacity and sustainability issues, and ethical, legal and academic considerations associated with student placements in these settings.
The nursing profession has renewed its commitment to social and political mandates, resulting in increasing attention to issues pertaining to diversity, vulnerable populations, social determinants of health, advocacy and activism, and social justice in nursing curricula. Narratives from a qualitative study examining undergraduate nursing student learning in five innovative clinical settings (corrections, international, parish, rural, and aboriginal) resonate with these curricular emphases. Data were derived from focus groups and interviews with 65 undergraduate nursing students, clinical instructors, and RN mentors. Findings of this study reveal how students in innovative clinical placements bear witness to poverty, inequities, and marginalization (critical awareness), often resulting in dissonance and soul-searching (critical engagement), and a renewed commitment to social transformation (social change). These findings suggest the potential for transformative learning in these settings.
An urgent need to secure additional community health placements provided initial motivation to use alternate clinical settings. Subsequent student requests for placement in these settings, rather than the traditional community settings, drew attention to the sites' unique and far-reaching benefits. Presenting the findings of a qualitative study, the authors discuss the perspectives of students, instructors, and RNs regarding their experiences in these alternative clinical settings and provide recommendations for the use of alternative settings in nursing education.
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