Nurses’ experiences of supervising nursing students who demonstrate unsafe practice on clinical placements: A systematic review
thesis
posted on 2017-03-22, 00:26 authored by James Richard BonnamyBackground:
Nurses within the clinical environment have described difficulty evaluating
nursing student performance during clinical placements, particularly when
students demonstrate unsafe practice. This situation may result in an outcome
where students receive a grade incongruent with their actual performance. There
is a need to synthesise the findings of studies about the experience of nurses
who supervise students who demonstrate unsafe practice on clinical placements
so that recommendations can be made.
Aim: The aim of this systematic review was to evaluate qualitative studies that have explored the experience of nurses who have supervised students who demonstrate unsafe practice on clinical placements. Two specific review questions were addressed that considered the experience of nurses who have supervised students who demonstrate unsafe practice on clinical placements and the reasons why nurses award pass grades to these students.
Method: Qualitative studies that described the experience or the effects of the experience of supervising students who demonstrate unsafe practice on clinical placements were considered. Five databases were searched using a pre-defined search strategy and studies were assessed for inclusion and quality against set criteria. Data was extracted independently by two reviewers. A third reviewer facilitated resolution of any discrepancies. Data were similar enough to enable a meta-aggregation of findings into five categories from which two synthesised findings were developed.
Results: A total of 14 studies were included in the review. Whilst the quality of the studies varied, each provided rich data for analysis. A total of 59 findings were extracted from the included studies and aggregated into five categories culminating in two synthesised findings related to nurses’ experiences of supervising students who demonstrate unsafe practice on clinical placements.
Conclusions: This review demonstrated that nurses experienced a moral dilemma when supervising and assigning a grade to students who demonstrated unsafe practice on clinical placements. The dilemma caused significant moral distress when assigning a pass or fail grade at the end of the supervision experience. The distress was often overlooked due to a lack of debriefing for nurses who supervised these students. This lack of support resulted in nurses assigning pass grades despite having concerns about student performance. Further research is needed into the briefing and debriefing requirements of nurses who supervise students who demonstrate unsafe practice on clinical placements. This systematic review has contributed to our understanding of the experience of supervising students who demonstrate unsafe practice on clinical placements.
Aim: The aim of this systematic review was to evaluate qualitative studies that have explored the experience of nurses who have supervised students who demonstrate unsafe practice on clinical placements. Two specific review questions were addressed that considered the experience of nurses who have supervised students who demonstrate unsafe practice on clinical placements and the reasons why nurses award pass grades to these students.
Method: Qualitative studies that described the experience or the effects of the experience of supervising students who demonstrate unsafe practice on clinical placements were considered. Five databases were searched using a pre-defined search strategy and studies were assessed for inclusion and quality against set criteria. Data was extracted independently by two reviewers. A third reviewer facilitated resolution of any discrepancies. Data were similar enough to enable a meta-aggregation of findings into five categories from which two synthesised findings were developed.
Results: A total of 14 studies were included in the review. Whilst the quality of the studies varied, each provided rich data for analysis. A total of 59 findings were extracted from the included studies and aggregated into five categories culminating in two synthesised findings related to nurses’ experiences of supervising students who demonstrate unsafe practice on clinical placements.
Conclusions: This review demonstrated that nurses experienced a moral dilemma when supervising and assigning a grade to students who demonstrated unsafe practice on clinical placements. The dilemma caused significant moral distress when assigning a pass or fail grade at the end of the supervision experience. The distress was often overlooked due to a lack of debriefing for nurses who supervised these students. This lack of support resulted in nurses assigning pass grades despite having concerns about student performance. Further research is needed into the briefing and debriefing requirements of nurses who supervise students who demonstrate unsafe practice on clinical placements. This systematic review has contributed to our understanding of the experience of supervising students who demonstrate unsafe practice on clinical placements.
