What is the influence of clinical experience on the nursing student’s understanding of patient centered care?

This qualitative study investigated the student nurse experience of clinical placement and the effect the environment and existing culture had on their ability to deliver patient centred care using critical social theory. The central aim of the research was to understand the social and contextual influences of clinical placement that may impact on the student’s ability to bridge the theory to practice gap and provide holistic and patient centered care. The term “patient centred care” has now become central to nursing dialogue and teaching. To be patient centred means that nurses need to engage with the patient and their family taking into account their beliefs, values & feelings. In addition to this, they must share the decision making with the patient and provide the physical needs essential to promoting a healthy outcome. This level of engagement is a significant expectation for nurses entering the workforce. However, evidence suggests that many nursing students are still required by the workplace to focus on the completion of tasks rather than spending time engaging with patients as central to their care. Using critical social theory as the theoretical framework, focus group discussions involving three groups of third year nursing students (n=31) were conducted. The participants provided a rich source of data that detailed their experiences of clinical placement over the three years of their Bachelor of Nursing degree. The value of this research came from the comparisons made between the environments that students considered as either enhancing or eroding the level of patient engagement. It was through a reflective process that the major themes emerged from this study: • The importance of belonging • Socialisation and the influence of experience • Being valued. In undergraduate nursing programs today it is important to develop nurses who have caring and holistic practice at the forefront of their role. To do this effectively we as educators must know and understand the effect socialisation has on students attending clinical placement and to set about a process of change with our colleagues in the clinical work environment that shifts their assumptions on the role of the student nurse from a task orientated add-on to a developing practitioner who is valued as part of the health care team.Thesis (M.Clin.Sc.) -- University of Adelaide, Adelaide Nursing School, 2017