Student nurses in transition : Generating an evidence base for final placement learning-facilitation best practice

The recent review of United Kingdom pre-registration nursing education has prompted local evaluation studies of nursing curricula, in readiness for the introduction of new standards for pre-registration nursing education. This three-phased, mixed methods study, set out to determine whether the final practice placement learning experiences could better meet student nurses’ learning needs in readiness for their first Registered Nurse post. The findings contribute alongside other projects towards an evidence base that supports change.The origins and learning experience of the final placement are examined amongst several reviews of nursing education since the early 1960s, in the context of the professional Fitness for Practice and Fitness for Purpose debate. Evidence suggests that final placement learning needs to develop independence and ensure the student feels valued and supported to build confidence. Students are more willing to take up a first post in a placement which has provided support. An exploratory, interpretive design, targeting an entire cohort of 278 students, triangulated pre- and post-placement survey data with data from eight in-depth individual interviews. The research investigated the students’ final placement learning experiences to ascertain their perceived needs, actual and desired experiences, and preferences for final placement allocation. Findings demonstrated a strong perception of the final placement as a role development transition. Students’ perceived needs reflected the NMC (2007) Essential Skills Clusters, as well as specialty-specific Fitness for Purpose learning needs. Learning experiences reflected the extant literature and included facilitative, gate-keeping and restrictive practices, against which students balanced their own agency for learning, recommending improved mentoring practices. A four part model, of final placement learning-facilitation best-practice, recommends development of the learning environments in balance with the personal learning needs and qualities of the transition student and a changed final placement allocations system