In pursuit of an optimal model of undergraduate nurse clinical education: An integrative review

Abstract

Clinical learning experiences are an essential part of nurse education programs. Numerous approaches to clinical education and student supervision exist. The aim of this integrative review was to explore how studies have compared or contrasted different models of undergraduate nurse clinical education. A search of eight databases was undertaken to identify peer-reviewed literature published between 2006 and 2015. Eighteen studies met the inclusion criteria. A diverse range of methodologies and data collection methods were represented, which primarily explored student experiences or perceptions. The main models of undergraduate nurse clinical education identified were: traditional or clinical facilitator model; the preceptorship or mentoring model; and the collaborative education unit model in addition to several novel alternatives. Various limitations and strengths were identified for each model with no single optimal model evident. Thematic synthesis identified four common elements across the models: the centrality of relationships; the need for consistency and continuity; the potential for variety of models; and the viability/sustainability of the model. The results indicate that effective implementation and key elements within a model may be more important than the overarching concept of any given model. Further research is warranted to achieve an agreed taxonomy and relate model elements to professional competence.

Preceptors’ perspectives of an integrated clinical learning model in a mental health environment

“…However, their effectiveness is often determined by the model under which they must conduct their preceptorship (Forber et al . ). Despite its potential benefits, most participants agreed that an ICLM brought several major disadvantages or challenges to their roles as preceptors.

It [an ICLM] gives more flexibility, but from the study point of view, or the practical point of view, I think that flexi model is not really working properly.

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“…; Forber et al . ; McCarthy & Murphy ). Ideally, the rosters of preceptors and students should be matched, to support the continuity of the learning experience (Butler et al .…”

“…; Ward & McComb ), the traditional block placement is the main model for clinical placements (Forber et al . ). Under the block model, students may be ‘buddied’ with a registered nurse for each shift, while a clinical supervisor serves as the primary instructor for a small group of students across different wards or units (Courtney‐Pratt et al .…”

“…Alternatively, a one‐to‐one supervisory relationship may be established between a student and registered nurse (the preceptorship or mentorship model) (Forber et al . ). The student attends a placement on a full‐time basis for several weeks, either during the study period or in semester breaks (Kevin et al .…”

“…; Forber et al . ; Hardy et al . ; Ward & McComb ), the traditional block placement is the main model for clinical placements (Forber et al .…”