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Research

Increasing student involvement in a trust

Developing a student task group helped generate enthusiasm and provided valuable feedback and insight into how student experience could be improved

In this article…

  • The importance of student feedback in influencing practice
  • How a student task group was established
  • Evaluation of the group

 

Author

Sue Haines is assistant director of nursing; Rachel McGown is practice learning facilitator; both in nursing development at Nottingham University Trust. Student task group: Helen Conway, Nicola Fisher, Natasha McVey, Emily Gartshore, Vicky Lonsdale, Charlotte Merriman, Ed Randall, Catherine Spratt, Vicky Worricker; all student nurses at the University of Nottingham at the time of writing.

 

Abstract

Haines S, McGown R (2014) Increasing student involvement in a trust. Nursing Times; 110: 5, 16-18.

Effective partnership between universities and placement providers is an essential part of high-quality pre-registration nurse education. This article reports on work at one trust to build on working relationships with higher education colleagues; this included the establishment of a student task group to improve practice learning, communication and student involvement at the trust.

  • This article has been double-blind peer reviewed
  • Figures and tables can be seen in the attached print-friendly PDF file of the complete article in the ‘Files’ section of this page

 

 

5 key points

  1. The Keogh review notes that student nurses and medical students can provide valuable insights into clinical practice
  2. Practice placements and mentors provide 50% of student nurses’ training
  3. A welcome day is a good way of alleviating first-year students’ fears about starting placements
  4. A student task group can help trusts gain feedback about issues in daily practice and about learning needs
  5. It is useful for students to see a variety of areas while on placement; one-day exposure can help widen their experience

 

A number of recent reviews have highlighted the critical role of practice placements in developing the future nursing workforce and the importance of high-quality student placements and mentorship (Francis, 2013; Willis, 2012).

Ambition 7 of the Keogh review identifies the valuable insights that student nurses and medical students can provide and encourages directors of nursing to “think about how they can harness the loyalty and innovation of student nurses, who move from ward to ward so they become ambassadors for their hospital and for promoting innovative nursing practice” (Keogh, 2013).

Effective partnership working between universities and practice placement providers is essential for the provision of high-quality pre-registration nurse education. Nottingham University Hospitals Trust (NUH) aims to continually improve the practice learning experience and to take forward the above ambition from the Keogh review by engaging and involving student nurses as members of the trust nursing team and as ambassadors for the hospital.

To do this, we have developed a project to engage students in developing and delivering a trust welcome day led by the director of nursing for all new first-year student nurses. We have also established a “student task group” to give students a greater opportunity to provide feedback. The task group identifies issues for improvement from a student’s perspective and potential solutions, raising the profile and importance of learning in the practice setting.

The trust

NUH Trust is a large acute care provider with more than 1,600 beds, 85 wards and 4,000 nurses and midwives. We support large numbers of students in a wide range of clinical learning environments and to do this we need to work closely with higher education partners.

The new graduate nurse curriculum programme started in September 2012, and all University of Nottingham student nurses now undertake a direct entry three-year degree or four-year master’s-level programme. We identified a need to assess the impact this change might have on student nurses, and how clinical practice placements and mentors should respond to ensure they received effective support.

We used observations in clinical practice, questionnaires and interviews with students and their mentors to identify practices that had a positive impact on learning and areas for improvement.

Our findings suggested there was an opportunity to increase real-time student feedback and actively review how we involved students in influencing the trust’s nursing professional priorities and in identifying how the learning environment and practice can be improved.

Aim

In January 2013, we planned a welcome day for first-year students on their first day in clinical practice. Students starting their first clinical placement often do not know what to do or what is expected of them, and their experience can be hindered by a variety of stressors (Morgan, 2002).

We wanted to address this and involved existing students at the University of Nottingham to help facilitate the day and share their clinical experiences. Links were established with the university’s peer mentoring scheme and eight students in the second, third and fourth years of nursing programmes volunteered to be involved.

First-year welcome day

The trust education team worked with university practice learning colleagues and students to identify workshops that would be most beneficial to students before they started their first placements. These workshops aimed to build on and complement existing preparation for practice days delivered by the university.

On the day, the director of nursing welcomed students and outlined the trust’s values and behaviours as well as its professional nursing expectations and priorities. The 130 first-year students then had the opportunity to ask questions about their forthcoming clinical experiences. Current students supported clinical staff in facilitating workshops throughout the day to develop their own skills as well as giving first-year students the opportunity to meet existing students. The workshops focused on a variety of clinical skills with learning mapped to competencies.

Evaluations of the day were positive and showed it achieved the aim of alleviating some of the students’ fears around starting the placement part of their course.

The commitment and enthusiasm demonstrated by current students inspired us to look at ways to include students more in practice learning and the idea of a student task group was developed.

Establishment of the student task group

In February 2013, the assistant director of nursing and practice learning facilitator met with the students to discuss developing a student task group.

The scheme was piloted to assess its effectiveness at engaging students in influencing and developing practice learning at NUH and at providing a forum to improve mechanisms of communication and support between the trust and its student nurses.

Initial objectives

At the initial meeting, students identified a number of issues within their placements where they felt learning could be improved, and showed enthusiasm for improving communication and student involvement in the trust. Ideas included the following:

  • Promoting a positive and professional image of student nurses and nursing, working in partnership with the trust nursing team on professional nursing objectives;
  • Student involvement in trust activities planned for 2013 to celebrate achievements and promote a positive image of nursing within the local community;
  • Improving consistency in quality and content of orientation packs in placements areas;
  • Giving mentors further clarification on the clinical skills students are allowed to undertake in different placement areas, aligned with local learning opportunities;
  • Increasing access to critical care placements at different points in student training;
  • Increasing careers information - students felt they had a poor awareness of career opportunities available and a lack of insight into senior nursing roles.

Impact and achievements to date

International Nurses’ Day

For International Nurses’ Day in May 2013, the student task group presented a display stand at a celebration tea party for retired nurses and members of the Nottingham Nurses League.

This gave them the opportunity to share with both trust staff and retired nurses what nurse education is like today, including information about recent elective placements abroad, student portfolios and completed dissertations.

The event brought together nurses from all stages of their careers and beyond, from students to the oldest guest, a 92-year-old retired nurse.

Celebrating research and education

As part of the NUH annual Research and Education Festival held in June, students were invited to present their recently completed dissertations.

They also had the opportunity to attend workshops celebrating innovations in research and hear presentations from regional speakers on the future of nurse training and development.

The festival included a Celebrating Mentorship conference where students took part in facilitating workshops for mentors from healthcare providers throughout the region.

Increasing access

We have increased access to acute and critical care placements at various stages in training. Traditional allocations and capacity have been reviewed and work has also been carried out in critical care areas to develop new management placements in intensive care and high-dependency areas.

Careers day

A careers day was held in November for all second- and third-year student nurses. This was led by the senior nursing team in partnership with the university student nurse careers representative.

It involved workshops, a panel for questions and talks from band 5 staff nurses to show students potential career and job opportunities within acute care nursing, research and clinical teaching.

Benefits for students

The student task group has improved two-way communication between the trust as a placement provider and student nurses on placement. It provides another forum for increasing the student “voice” and involvement in the trust.

Because of the success of the pilot, the task group has been established as a formal nursing group within the trust. It is providing opportunities for leadership development and enabling students to develop key skills identified by the NMC code of practice, especially in areas of communication, collaborative team working and problem solving (NMC, 2008). Areas for improving the learning environment have been identified and students are involved in developing solutions.

Students have further benefited from an exchange of knowledge, creating an effective learning and development network and engaging with fellow staff and the wider public. By networking with staff, they have been able to improve the placement experience for both mentors and students, for example by coordinating insight visits to create more student opportunities. Insight visits give students the opportunity to see specialist roles within the healthcare team for a day or a shift. The group’s achievements and actions are disseminated to the students’ university forums, enabling other students to be aware of the feedback mechanisms in place and action being taken.

The next steps are for the task group

to be more widely publicised across the university and communication cascade mechanisms to be developed. Students are committed to developing consistent orientation guides and best practice guidelines, so that others can get the most out of placement areas and practise safely and competently.

Benefits for the trust

There are significant benefits of working in partnership with students. The task group gives further opportunity for us to gain real-time feedback from students about issues affecting them in daily clinical practice.

This gives the student voice formal standing so any concerns can be dealt with quickly and effectively. As part of the trust’s commitment to Nursing Times’ Speak Out Safely campaign, the senior nursing team has supported students in publicising good practice and discussing how best to raise concerns.

Students are an integral part of the nursing team, and an increased understanding of their interests has allowed the trust to open up a wider variety of insight visits and opportunities, reducing the pressures of high numbers of students in certain areas.

We hope that through widening opportunities and insight into nursing careers, we have encouraged students to aspire to work within the wide range of specialties available.

Plans

The student task group is established as a nursing group within the trust and reports to the director of nursing.

Welcome days for all first-year students are now an integral part of student induction. Partnership working with university colleagues aims to ensure representation across programmes and further promotion of the task group to recruit members. We are also incorporating students from associated health education institutions to encourage shared learning and experiences between students.

We are piloting a model of shared governance, involving staff nurses being actively engaged in leading decision making through staff-led councils (Luzinski, 2011). The councils take responsibility for evidence-based practice, aspects of decision making and leading improvement. Unit practice councils are providing opportunity for leadership development and greater staff involvement in decision making (Dinning, 2012).

Over the next year, the student task group is set to evolve into a student council, continuing to build on the achievements and set direction for further student leadership development and the student nurse ambassador role.

In addition, a clinical leadership module for students has been developed through the University of Nottingham Advantage award. This is an employability scheme to improve students’ personal and professional development, and will be promoted through the student task group. This includes the development of a student champion role to further enhance patient safety education.

Evaluation

The student task group has helped students to engage with wider trust initiatives and created a student-led channel of communication between the trust and the university.

Students participating in the group report having developed their leadership skills and improved collaborative practices. The trust has benefited from a greater understanding of students’ experiences and developing a more effective working relationship. The students have had opportunities to be involved in aspects of the nursing profession and nursing leadership in practice that are not directly covered in the course curriculum content.

Students involved in the task group are ambassadors for nursing; their enthusiasm and commitment to innovation and the delivery of excellence in patient care is inspiring.

The group has created opportunities for experienced nursing staff and students to work together to improve the quality of practice learning and promote a positive image of nursing within the local community.

 

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