Reflection on actions: Identifying facilitators of and barriers to using physical assessment in clinical practice

Byermoen, Kirsten Røland; Brembo, Espen Andreas; Egilsdottir, H Ösp; Heyn, Lena Günterberg; Moen, Anne; Eide, Hilde

doi:10.1016/j.nepr.2020.102913

Cited by 13 publications

(30 citation statements)

References 24 publications

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“…Compared to our ndings in the rst study (19) the students in this study used fewer physical assessment skills; moreover, their assessments were more targeted to the patients' condition and the students acted on cue recognition. Three factors helped the students determine which assessments to use during the patient encounter: 1) increased integration of knowledge within human bioscience; 2) increased clinical reasoning skills; and 3) increased ability to transfer knowledge from prior experiences.…”

Section: Internalization Of Physical Assessment In Clinical Nursing Practicementioning

confidence: 74%

“…Which learning strategies do the students apply during clinical rotation to integrate physical assessment as a routine? Design This is a follow-up study, utilizing the same data collection method and student sample from a previous study (19). The study has an explorative qualitative design and uses a triangulation of data collection methods, as illustrated in Fig.…”

Section: Aim and Research Questionsmentioning

confidence: 99%

“…Factors that hindered practice were lack of support in the learning environment and preceptors not using physical assessment skills. We also performed an observation study combined with a stimulated recall interview (SRI) to gain more in-depth knowledge about how third-year nursing students learn and practise speci c physical assessment skillsand to explore facilitators and barriers in the learning process (19). Facilitating factors included peer learning; students' ability to transform experiences from prior clinical encounters; their ability to articulate reasoning in relation to human bioscience; and engaged role models who expected students to perform physical assessment.…”

Section: Introductionmentioning

confidence: 99%

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Nursing students’ development of using physical assessment in clinical rotation—a stimulated recall study

Byermoen¹,

Eide²,

Egilsdottir³

et al. 2021

Preprint

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Background The overall aim of this study was to explore third-year bachelor nursing students’ stimulated recall reflections on their physical assessment competence development. The choice of learning strategies in nursing education seems to have great impact on nursing students’ use of physical assessment skills while in clinical rotation. There is a need to explore nursing students’ learning processes related to the use of physical assessments. Methods Explorative qualitative design using a triangulation of data collection methods. Nine final-year nursing students’ physical assessment performances during patient encounters were audio-taped and observed. Shortly after, an individual stimulated recall interview based on the audio-recorded patient encounter and observation notes was conducted. A two-fold analysis was conducted: 1) analysis of students’ performed assessments, and 2) a meaning condensation analysis of the stimulated recall interviews. Results 1) Students’ assessments shifted from a checklist approach to a symptom-based approach, and they emphasized conversation as part of their assessments. 2) Through the stimulated recall interviews, students described reasons for using physical assessments in patient encounters, how the learning environment facilitated or hindered their use of physical assessments, and their own learning strategies. Conclusions Findings contribute a novel, in-depth description of what influenced nursing students’ learning processes of using physical assessment during clinical rotation. This study reveals the importance of designing and implementing learning activities in practical and theoretical courses to support and strengthen students’ learning processes. Further, findings suggest that stimulated recall as a reflective practice should be used systematically to enhance clinical reasoning skills and thus provide deep learning. A more targeted course design for physical assessment— building on and emphasizing nursing students’ prior knowledge and competence—may lead to more confident registered nurses and promote patient safety in different health care contexts.

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Section: Internalization Of Physical Assessment In Clinical Nursing Practicementioning

confidence: 74%

Section: Aim and Research Questionsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Nursing students’ development of using physical assessment in clinical rotation—a stimulated recall study

Byermoen¹,

Eide²,

Egilsdottir³

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…Factors that hindered practice were lack of support in the learning environment and preceptors not using physical assessment skills. We also performed an observation study combined with a stimulated recall interview (SRI) to gain more in-depth knowledge about how third-year nursing students learn and practise specific physical assessment skills—and to explore facilitators and barriers in the learning process [ 17 ]. Facilitating factors included peer learning; students’ ability to transform experiences from prior clinical encounters; their ability to articulate reasoning in relation to human bioscience; and engaged role models who expected students to perform physical assessment.…”

Section: Introductionmentioning

confidence: 99%

Nursing students’ development of using physical assessment in clinical rotation—a stimulated recall study

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background The overall aim of this study was to explore third-year bachelor nursing students’ stimulated recall reflections on their physical assessment competence development. The choice of learning strategies in nursing education seems to have great impact on nursing students’ use of physical assessment skills while in clinical rotation. There is a need to explore nursing students’ learning processes related to the use of physical assessments. Methods Explorative qualitative design using a triangulation of data collection methods. Nine final-year nursing students’ physical assessment performances during patient encounters were audio-taped and observed. Shortly after, an individual stimulated recall interview based on the audio-recorded patient encounter and observation notes was conducted. A two-fold analysis was conducted: 1) analysis of students’ performed assessments, and 2) phenomenological hermeneutical analysis of the stimulated recall interviews. Results Nursing students assessments shifted from a checklist approach to a symptom-based, more holistic and person-centred approach, emphasizing conversation as part of their assessments. The nursing students also reported that a safe and stimulating learning environment was a prominent feature for their continuing development. Learning from skilled role models with expectations to them using physical assessment skills facilitated their continuing skills appliance, interprofessional communication and reflective practice. Conclusions This study contribute with a novel, comprehensive and in-depth description of what influenced nursing students’ learning processes experiences of using physical assessment skills during clinical rotation. The results reveal the need for targeted course designs by implementing scaffolded learning activities in practical and theoretical courses aimed at strengthening students’ learning of physical assessment skills—building upon and emphasizing their prior knowledge and competence, which may lead to more confident registered nurses and promote patient safety in different health care contexts. We propose using stimulated recall systematically as a novel reflective learning activity in nursing education to foster clinical reasoning and metacognition skills and achieve deep learning.

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“…However, those skills are underutilized because they are covered mainly by elective courses, which some universities do not offer (Çalışkan et al, 2020;Dougles et al, 2015). Students believe that physical assessments are necessary but occasionally perform them in clinical settings (Byermoen et al, 2021). What is more, Giddens and Eddy (2009) argue that there is a difference between the physical assessment skills students learn at college and the ones they observe nurses practice in real-life clinical settings, causing considerable inconvenience.…”

Section: Introductionmentioning

confidence: 99%

Barriers to physical assessment skills in nurses and nursing students: a comparative-descriptive cross-sectional study

2022

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Research Problem/Aim: Physical assessment is an integral part of nursing interventions and an important learning outcome of nurse training programs. This paper investigated impediments preventing nurses and nursing students from putting physical assessment skills into practice. Method: This was a comparative-descriptive and cross-sectional study. The sample consisted of 118 nurses and 95 nursing students. Data were gathered using a Demographic Characteristics Questionnaire, a Physical Assessment Knowledge and Practice Questionnaire, and the Barriers to Nurses’ Use of Physical Assessment Scale. Findings: Nurses and students had a mean age of 30.53±7.14 and 21.80 ±0.77, respectively. Most nurses (82.3%) and students (95.8%) stated that they used physical assessment skills in clinical settings. Nurses had a mean Barriers to Nurses’ Use of Physical Assessment Scale “lack of time and interruptions,” “lack of influence on patient care,” subscale score of 3.30±0.69, 3.77±0.79, respectively. Students had a mean the Barriers to Nurses’ Use of Physical Assessment Scale “lack of time and interruptions” and “lack of influence on patient care,” subscale score of 3.36±0.65, and 3.96±0.75, respectively. Students had a higher mean Barriers to Nurses’ Use of Physical Assessment Scale “ward culture” subscale score than nurses (p=0.001). Conclusion: Students had a significantly higher Barriers to Nurses' Use of Physical Assessment Scale "ward culture" subscale score than nurses. The barriers preventing participants from using physical assessment skills mainly were the “lack of influence on patient care," "lack of time and interruptions," and "specialty area." Educators should encourage nursing students to develop physical assessment skills and put them into practice in laboratories. Hospital administrators should provide nurses with in-service training to execute their physical assessment skills in real-life clinical settings.

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Reflection on actions: Identifying facilitators of and barriers to using physical assessment in clinical practice

Cited by 13 publications

References 24 publications

Nursing students’ development of using physical assessment in clinical rotation—a stimulated recall study

Nursing students’ development of using physical assessment in clinical rotation—a stimulated recall study

Nursing students’ development of using physical assessment in clinical rotation—a stimulated recall study

Barriers to physical assessment skills in nurses and nursing students: a comparative-descriptive cross-sectional study

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