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Leadership in Clinical Education

Nursing Leadership 2013

Tara Green

on 11 April 2017

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Transcript of Leadership in Clinical Education

support & behaviour modelling
Growth & Development

10 Qualities in Great Students
*self discipline *Respect *Perseverance *Citizenship *Compassion *Integrity *Responsibility *Trustworthiness *Fairness *Honesty (Mackay, 2006)
Early practical experiences and relationships with clinical supervisors can shape a student’s perceptions of the nursing profession.
(Lofmark & Wikblad, 2001 in Zilembo & Monterosso, 2008)
Nursing Leadership in the Clinical Education Environment
8 Traits of Great Nursing Instructors
*Appropriate education
*Teaching skills
*Ability to work with others
*Assessment skills
*Love of nursing
*Communication skills
*Skills beyond the clinical setting
(Parsh, 2010)
Initial Clinical Practicum:
It is important to provide students with a safe and healthy learning environment. The nursing culture needs to increase the value that is put upon the learning process.

*Education must be valued by the nursing staff.

*There must be a commitment to teaching, rather than it being seen as a burden or

*Educators must be valued!

*Appropriate recompense should be paid for teaching; time should be quarantined
for teaching; extra staff should also be provided to avoid overloading staff or
compromising patient care.

*Students must be valued!

*Education should be included in all aspects of planning.

*Use of facilities and resources should be optimized for all educational purposes.

(Moscaritolo, 2009)
Clinical Experience

*Nurse preceptors can fulfill their role effectively by supporting
students in their professional development and being responsive to
students’ needs.

*From an Australian study of nursing students' perceptions of
preceptor leadership skills, 96% of respondents felt that leadership
was an important role of the clinical preceptor.

*The highest rated desirable characteristics in the item relating to
leadership in nurse preceptors were clinical competence and
purposefulness, followed by support, motivation, approachability,
consistency, organization, and effective communication.

*The least desirable leadership characteristics included negotiation,
analytical, and reward and punishment.

*The data from this study suggests that students favour a
transformational approach to leadership style from their clinical

*"Transformational leaders can be persuasive, creative and
intuitive, so as to enhance these skills in others and to
nurture nursing leaders for the future." (p. 201)
(Zilembo & Monterosso, 2007)
*Students experience a great amount of anxiety prior to
their first clinical experience

*Head Nurses are seen as one of the best sources of
practical information on the floor

*Ward Nurses are not familiar enough with clinical
expectations to be able to adequately
mentor groups of new nursing students

*Clinical Instructors are perceived as "evaluators" more
so than as "educators"

*A good mentor "can play an important role in student
nurses' self-confidence, promote role socialization, and
encourage independence which leads to clinical
competency" (p. 5)

*There are many theory-practice gaps and
inconsistencies between what it taught and/or expected
in class versus what is taught and/or expected in
the clinical setting
(Sharif & Masoumi, 2005)
British Colombian Nurses Union. (2013). Make your work place a
bully free zone. Retrieved March 1, 2013 from https://www.bcnu.org/News/News.aspx?page=Bulletins_Feb%2017,%202012:search:lateral violence

Duteau, J. (2012). Making a difference: the value of preceptorship
programs in nursing education. Journal of Continuing Education in Nursing, 43(1), 37-43. doi: 10.3928/00220124-20110615-01

Elbing, C. (n.d.) Nurstoons. [Comics 36, 136,179]. Retrieved from

Ehrenberg, A & Häggblom, M. (2007). Problem-based learning in
clinical nursing education: integrating theory and practice. Nurse Education in Practice. 7(2), 67-74. Accessible at http://www.ncbi.nlm.nih.gov/pubmed/17689426

Juice Incorporated Intelligent Energy. (2010). Question and Answer
- Part 2.mov [Video file]. Retrieved from http://www.youtube .com/watch?v=q4qAjocpORo

Juice Incorporated Intelligent Energy. (2011). Trailer - Ending
Nurse-to-Nurse Hostility #1: Raising Awareness with Kathleen Bartholomew [Video file]. Retrieved from http://www.youtube .com/watch?v=40uIYiJRc8c

Lockwood-Rayermann, S. (2003). Preceptor leadership style and the
nursing practicum. Journal of Professional Nursing. 19(1), 32-27

Mackay, C. (2006). 10 Qualities You Find in Good Students and Good
Citizens. Retrieved February 27, 2013 from http://EzineArticles.com/?expert=Caroline_Mackay

Moscaritolo, L. (2009). Interventional strategies to decrease
nursing student anxiety in the clinical learning environment. Journal Of Nursing Education, 48 (1), 17-23. doi: 10.3928/01484834-20090101-08

Parsh, B. (2010). Eight traits make great nursing instructor.
Retrieved February 27, 2013 from http://journals.lww.com/nursingmanagement/Citation/2010/03000/8_traits_make_great_nursing_instructors.13.aspx

Rowell, P. (2010). Lateral violence: nurse against nurse. Retrieved
from http://www.tnaonline.org/Media/pdf/wkpl-viol-dec-10-abstract-rowell.pdf

Sharif, F., Masoumi, S. (2005). A qualitative study of nursing student
experiences of clinical practice. BMC Nursing, 4:6. Accessible at http://www.biomedcentral.com/1472-6955/4/6/prepub

Sinek, S. (2010). How great leaders inspire action. Retrieved March
1, 2013 from http://www.youtube .com/watch?v=qp0HIF3SfI4

Zilembo, M., & Monterosso, L. (2008). Nursing students' perceptions
of desirable leadership qualities in nurse preceptors: a descriptive survey. Contemporary Nurse: A Journal For The Australian Nursing Profession, 27(2), 194-206.

*Which qualities do good clinical
instructors possess?

*How does lateral violence affect the individual
and, subsequently, the learning environment?

*What could improve the clinical experience for
nursing students and preceptors?

*How do you think that political issues, such as nursing shortages, affect clinical experience?

*As a new grad, how can you improve the clinical
learning environment for future students through

*Do you think preceptors should be paid?



Links to
Extra Reading:
Lateral Violence

Lateral Violence
as a Result of Oppression
Dr. Martha Griffin, RN, an expert and educator on the topic of lateral violence in nursing, believes lateral violence results from feelings of oppression within the group. Also known as “oppressed group behavior”, which is a phenomenon that occurs when a group feels excluded from the power structure. She believes that nurses have very little control over their work environment, yet are held accountable which results in stress. Some members of the oppressed group become abusive to peers and those with lesser status such as students due to the stress and powerlessness affecting her or him.
(Rowell, 2004)
Bullying and horizontal violence is prevalent in healthcare. It can often have a negative affect on nursing students who are vulnerable due to the power differential.

* It is estimated that up to 40% of Canadians
have experienced workplace bullying.
* Studies show that 21% to 46% of nurses have
experienced or witnessed bullying.
* Workplace bullying is associated with nurses
leaving their job, or the nursing profession.
* Exposure to workplace bullying can negatively
affect the health of workers, their family,
team communication, job satisfaction,
motivation, morale and affect patient outcomes.
(BCNU, 2013).
"Student learning and clinical experience can be influenced directly by the leadership characteristics that a preceptor possesses."
-Suzy Lockwood-Rayermann, PhD, RN
Barriers to Clinical
Education Environment
* Shortage of clinical sites

* Sites not accepting many students

* Difficulties in recruiting or retaining preceptors

* Competition for access to clinical facilities

* Unrealistic expectations

* Lateral Violence

* Staffing shortage

* Limited resources
Benefits Found in the
Clinical Education Environment
* Critical thinking development

* Application of theory

* Hands on experience

* Experience working with healthcare team

* Experience in "real" working environment

* Patients as teachers

(Ehrenberg & Häggblom, 2007)

The benefits of clinical experience in nursing education cannot be overstated. It has been shown that quality clinical education experiences can enhance nursing practice by way of professional growth and development, with the opportunity to apply the theory learned in the classroom setting. Preceptorship has been shown as an effective technique in the development of quality nurses through clinical education. The role of a preceptor is multifaceted and not necessarily an appropriate role for all nurses. Understanding of the clinical environment, comprehension of learning styles, and effective conflict resolution skills need to be acquired by the nurse before participating in the role of preceptor.
(Duteau, 2012)
Exposure to workplace bullying can
negatively affect the health of workers,
students, their family, team communication,
job satisfaction, motivation, morale and affect patient outcomes. Leadership measures that can positively influence this issue include:

* Raising awareness about lateral violence
* Supporting the creation of unit-specific guidelines
* Promoting zero tolerance for violent and abusive behaviors
* Protecting victims from retribution if bullying is reported
* Supporting the use of employee assistance programs
* Interrupting the violence and standing up for others
* Discussing solutions to incidences and encouraging dialogue
Matching a preceptor's leadership style to a student's learning style can make for a more positive, beneficial clinical experience for everyone involved. (Lockwood-Rayermann, 2003)
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