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HELSEVEL-H-Gode og effektive helse-, omsorgs- og velferdstjenester

Aiming for quality in nursing home care: Rethinking clinical supervision and assessment of nursing students in clinical studies

Alternative title: Økt kvalitet i kliniske studier: Utvikle og teste innovative læringsverktøy i veiledning og vurdering av sykepleiestudenter

Awarded: NOK 14.0 mill.

The Improving quality in clinical placement studies in nursing homes (QUALinCLINstud) project addresses the urgent need for improved quality and efficiency in clinical supervision and assessment of student nurses in nursing home placements. This will be achieved through a novel, collaborative, co-productive, social innovation and learning process between the nurse education system, student nurses and clinical care institutions for older people. The aim of the QUALinCLINstud project is to develop and evaluate how a web-based program can optimize supervision, assessment and learning during nursing home placements. Given the multiple stakeholders and complexity of issues involved in clinical supervision and assessment practices, the web-based program will target three stakeholder groups: (1) nurse mentors, (2) first-year student nurses and (3) nurse educators. The web-based program aims to improve the following quality dimensions: (1) nurse mentors? supervision and assessment competence; (2) student nurses? learning experience; and (3) efficiency in supervision and assessment practices. The project (June 2018- December 2022) employs an explorative and descriptive multiple case study design using a mixed-method approach and incorporating the methodology of Participatory Design. The study settings are three higher educational institutions (HEIs) in Norway and nursing homes as clinical placement sites in a range of municipalities. A case consists of one HEI along with the nursing homes it engages with to provide clinical placements to its students. Three cases are selected to provide comparisons across geographical areas and differently ranked education institutions. The study is structured across four sequential work packages (WPs). WP1 (2018/2019), comprises an exploratory study of how the nurse education institution address quality in clinical education in nursing home placements and the challenges they experience. Data consists of fifteen in-depth interviews with program leaders of nurse bachelor programs (n=4), course leaders (n=6) and practice coordinators (n=5) across the case study sites. Findings suggest at least two key challenges in providing effective first-year student clinical placements in nursing homes: i) limited access for student placements; and ii) lack of qualified nurse teachers and available registered nurse mentors. Other challenges pertain to the reliability and validity of assessment practices and lack of process for improving quality of nursing student education from within the educational institutions. In WP2 (2019/2020), clinical supervision and assessment practices have been explored from a multiple stakeholder perspective. A qualitative approach has been applied in which data have been collected through observations (287 hours), individual in-depth and focus group interviews with key stakeholders (i.e. student nurses, nurse mentors, nurse teachers). WP2 involved data collection across the three case study sites (i.e. HEIs and associated nursing homes). A complete analysis of data from WP2 will be available in 2020/2021. WP3 (2020/2021) comprises developing the web-based supervision and assessment program targeting quality dimensions in nursing home placements. The process of program development will be informed and guided by a tentative synthesis of first impression findings from WP1 and WP2 and in close collaboration with key stakeholders and e-learning designers. The developmental process entails that the design, learning activities and content in the web- based program will be co-produced with students, teachers, nurse mentors, e-learning designers and researchers. The co-production process will try to ensure that the program meets stakeholders` needs, user interface, and provides benefits in use. Workshops and dialogue meetings have been conducted as the main co-creation activity. Thus far five workshops have been conducted with stakeholder groups. Additionally, the project is also concerned with mapping and appraising the co-production development process. To do this, observations have been conducted during the workshops to explore the degree of participation, involvement and group interactions. Furthermore, three focus group interviews with the key stakeholder participants have been conducted to explore their views and experiences concerning involvement. The aim of the project?s final stage (WP4 2021-2022) is to pilot-test, explore and describe the outcomes and usefulness of the web-based supervision and assessment program developed and validated in WPs 1-3. Overall, the project holds great potential for value creation and will contribute to expand the current knowledge base concerning supervision and assessment practices in nursing home placements, identify improvement measures and document the utility value of user involvement in developmental processes and the value of digital educational tools applied in clinical placements, which are currently lacking in Norway.

The QUALinCLINstud project addresses the urgent need for improved quality in clinical supervision and assessment of student nurses in nursing home studie through a novel, collaborative and co-productive partnership between the nursing education system and clinical care institutions for older people. The QUALinCLINstud project aims to explore and extend current knowledge on clinical supervision and assessment practices in nursing home placements. Furthermore, the study will develop, pilot test and evaluate an innovative web-based supervision and assessment program targeting quality improvements in clinical supervision and assessment in the nursing home context. The innovation will target three stakeholders groups (1) nurse mentors (2) first-year nursing students and (3) nurse teachers and aims to improve the following quality dimensions; a) nurse mentors supervision and assessment competence b) student nurses critical thinking skills and learning experience and c) nurse teachers assessment tools. Thus, this project entails testing of innovative tools (e-learning tools) to optimize efficiency in education and practice. The QUALinCLINstud project will employ a multiple case study design using a mixed- method approach organized in four work packages. WP 1 will explore how the nurse education system ensures high-quality in nursing home placements. In WP 2, we will explore clinical supervision and assessment practices from a multiple stakeholder perspective using a triangulation of qualitative methods. Based on a synthesizing of findings from WP 1-2 we will develop an innovative web-based supervision and assessment program in close collaboration with key stakeholders in WP3. In WP 4, we will test and evaluate the web-based program by using a mixed-method approach. Combined, this project holds great potential for value creation where tools to increase students learning experience and outcomes are seen as crucial for preparing students for the 21st century labor market.

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HELSEVEL-H-Gode og effektive helse-, omsorgs- og velferdstjenester