BackgroundNursing education necessitates vigilance for clinical safety, a daunting challenge given the complex interchanges between students, patients and educators. As active learners, students offer a subjective understanding concerning safety in the practice milieu that merits further study. This study describes the viewpoints of senior undergraduate nursing students about compromised safety in the clinical learning environment.MethodsQ methodology was used to systematically elicit multiple viewpoints about unsafe clinical learning from the perspective of senior students enrolled in a baccalaureate nursing program offered at multiple sites in Ontario, Canada. Across two program sites, 59 fourth year students sorted 43 theoretical statement cards, descriptive of unsafe clinical practice. Q-analysis identified similarities and differences among participant viewpoints yielding discrete and consensus perspectives.ResultsA total of six discrete viewpoints and two consensus perspectives were identified. The discrete viewpoints at one site were Endorsement of Uncritical Knowledge Transfer, Non-student Centered Program and Overt Patterns of Unsatisfactory Clinical Performance. In addition, a consensus perspective, labelled Contravening Practices was identified as responsible for compromised clinical safety at this site. At the other site, the discrete viewpoints were Premature and Inappropriate Clinical Progression, Non-patient Centered Practice and Negating Purposeful Interactions for Experiential Learning. There was consensus that Eroding Conventions compromised clinical safety from the perspective of students at this second site.ConclusionsSenior nursing students perceive that deficits in knowledge, patient-centered practice, professional morality and authenticity threaten safety in the clinical learning environment. In an effort to eradicate compromised safety associated with learning in the clinical milieu, students and educators must embody the ontological, epistemological and praxis fundamentals of nursing.

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Nurse preceptors fulfill a primary role in the success of preceptorship experiences during the education of student nurses in their final year of study. Evidence suggests that this success depends greatly on adequate preceptor role preparation and support. The purposes of this qualitative, descriptive study were to explore and describe preceptor role support and development within the context of a rural and northern mid-sized Canadian community. More specifically, in this study the following are described: preceptors' (a) perception of past role preparation and current role support; (b) use and evaluation of the existing print-based fourth-year Preceptor Resource Manual (PRM); (c) perception of role support facilitators and barriers; and (d) recommendations for improvements to preceptor role preparation and support. Data were collected through individual and group interviews. Through content analysis four major themes emerged: accessible resources, role complexity, partners in precepting, and role development.

Title.  Representations of disability in nursing and healthcare literature: an integrative review Aim.  This paper is a report of an integrative review to explore the way in which disability has been considered in the multidisciplinary health and nursing literature. Background.  In the multidisciplinary health and nursing literature, two ways are presented in which disability can be understood: the traditional, functional perspective and a more contemporary, social perspective. Data sources.  Computerized databases of the CINAHL, Proquest Nursing and Allied Health Sources, EBSCO and Evidence Based Medicine Reviews Multifile and Cochrane databases were conducted for papers published in English in the period 1963–2007 using the keywords ‘models of disability’, ‘disability and nursing research’ and ‘theories of disability’. Methods.  An integrative review was performed and, of the 11,578 papers identified, 65 were included. Results.  The concept of functional disability refers to an individual who is physically ‘disabled’ and unable to perform expected roles. The concepts of social stigmatization and normalcy are associated with functional disability. In contrast, social disability concerns functional limitations within an individual’s experience of living with disability, examining how socially constructed barriers actually ‘disable’ people. Conventionally, disability research has been conducted from an etic perspective. Researchers contend that a shift towards an understanding from the emic perspective is needed for disability research to be emancipatory. Conclusion.  Adoption of a social perspective is necessary to inform an understanding of disability that addresses stigmatization and oppression. Research‐informed nursing practice, complemented by supportive health and social policies, could transform the experience of living with disability.

Background: Experiential learning within clinical practice settings is a substantial component of undergraduate nursing education. This study described baccalaureate nursing students' perception of how their belongingness evolves in clinical learning environments through partnerships with their clinical educator and unit-based nurses. Methods: The design of this study was constructivist grounded theory. The setting was a single four year baccalaureate nursing program located in Ontario, Canada. Eighteen students enrolled in third or fourth year of the program participated in a total of 22 semi-structured one-to-one interviews. Comparative methods were used to analyze the data. Results: The students' described positioning for belongingness, persevering for belongingness, and ultimately, entering into belongingness. Belongingness was depicted as gaining entry into the nursing "atmosphere", a privileged space unique to each clinical placement. In this space, students were granted access to rich learning and socialization opportunities in alliance with the unit-based nurses. For students unable to secure belongingness, learning within the clinical setting occurred as outsiders, exterior to the nursing atmosphere. Conclusion: Students described belongingness as possible when their demonstrated competencies were validated by others who had the capacity to optimize their professional socialization and development within the clinical setting.