Abstract
Interactions between nurses and patients are unique and personalized and often described as privileged encounters. The holistic nature of nursing practice centered on a health-based platform differs from the medicalized (disease-based) model of healthcare. These foundational aspects of nursing practice influence learning and teaching encounters at the bedside. In this chapter, a teacher-learner-patient triad is presented as it represents the interrelatedness and fluidity of the roles, which should always be considered within the broader contexts of safety and quality (patient care) and privacy and respect.
In this chapter, the increasing resolve from safety and quality organizations globally to enable health consumer involvement in their own and others’ care is acknowledged in relation to their engagement in learning and teaching encounters at the bedside.
Communication, modelling practice, health literacy, and the broader arrangements for how undergraduate nursing students attain clinical practice experience form a large part of discussions. However, focus is also given to postgraduate nursing students who concurrently work in addition to studying. This chapter seeks to offer an international perspective, while recognizing that the context of the authors’ practice in Australia is a strong influence on this work.
Similar content being viewed by others
References
Agency for Healthcare Research and Quality: Engaging patients and their families in their health care. https://www.ahrq.gov/patient-safety/resources/patient-family-engagement/index.html (2020). Accessed 16 Feb 2020.
Albert JS, Younas A, Sana S. Nursing students’ ethical dilemmas regarding patient care: an integrative review. Nurse Educ Today. 2020;88 https://doi.org/10.1016/j.nedt.2020.104389.
Andrews CE, Ford K. Clinical facilitator learning and development needs: exploring the why, what and how. Nurse Educ Pract. 2013;13(5):413–7. https://doi.org/10.1016/j.nepr.2013.01.002.
Australian Commission on Safety and Quality in Health Care. National Safety and Quality Health Service Standards guide for hospitals. In: ACSQHC, editor. 2nd ed. Sydney: ACSQHC; 2017.
Australian Commission on Safety and Quality in Health Care (ASQHS). Communicating for Safety standard. National Safety and Quality Health Service Standards. 2nd ed. Sydney: Australian Commission on Safety and Quality in Health Care 2017; 2017. p. 47–54.
Australian Nursing and Midwifery Accreditation Council.: https://www.anmac.org.au/. Accessed 2020.
Benner P. From novice to expert: excellence and power in clinical nursing practice. Menlo Park: Addison-Wesley Pub; 1984.
Benner P, Tanner C, Chesla CA. Expertise in nursing practice: caring, clinical judgment and ethics. 2nd ed. New York: Springer; 2009.
Billett S. Readiness and learning in health care education. Clin Teach. 2015;12:367–72.
Brooks LA, Manias E, Bloomer MJ. Culturally sensitive communication in healthcare: a concept analysis. Collegian. 2019;26(3):383–91. https://doi.org/10.1016/j.colegn.2018.09.007.
Chan D. Associations between student learning outcomes from their clinical placement and their perceptions of the social climate of the clinical learning environment. Int J Nurs Stud. 2002;39:517–24.
Cooper J, Courtney-Pratt H, Fitzgerald M. Key influences identified by first year undergraduate nursing students as impacting on the quality of clinical placement: a qualitative study. Nurse Educ Today. 2015;35(9):1004–8. https://doi.org/10.1016/j.nedt.2015.03.009.
Currie K, Strachan PH, Spaling M, Harkness K, Barber D, Clark AM. The importance of interactions between patients and healthcare professionals for heart failure self-care: a systematic review of qualitative research into patient perspectives. Eur J Cardiovasc Nurs. 2015;14(6):525–35. https://doi.org/10.1177/1474515114547648.
Dahlke S, Hunter KF. How nurses’ use of language creates meaning about healthcare users and nursing practice. Nursing Inquiry. 2020;27(3) https://doi.org/10.1111/nin.12346.
Doyle K, Sainsbury K, Cleary S, Parkinson L, Vindigni D, McGrath I, et al. Happy to help/happy to be here: identifying components of successful clinical placements for undergraduate nursing students. Nurse Educ Today. 2017;49:27–32. https://doi.org/10.1016/j.nedt.2016.11.001.
Edgecombe K, Bowden M, editors. Clinical learning and teaching innovations in nursing: dedicated education units building a better future. Dordrecht: Springer; 2014.
Fagerström L. Caring, health, holism and person-centred ethos – common denominators for health sciences? Scand J Caring Sci. 2019;33(2):253–4. https://doi.org/10.1111/scs.12732.
Forber J, DiGiacomo M, Carter B, Davidson P, Phillips J, Jackson D. In pursuit of an optimal model of undergraduate nurse clinical education: an integrative review. Nurse Educ Pract. 2016;21:83–92. https://doi.org/10.1016/j.nepr.2016.09.007.
Gonda J. Voices from the coalface: the impact of dedicated education units in nursing. In: Edgecombe K, Bowden M, editors. Clinical learning and teaching innovations in nursing: dedicated education unitsbBuilding a better future. Dordrecht: Springer; 2014.
Gopal G, Suter-Crazzolara C, Toldo L, Eberhardt W. Digital transformation in healthcare – architectures of present and future information technologies. J Clin Chem Lab Med. 2019;57(3):328–35. https://doi.org/10.1515/cclm-2018-0658.
Gregory LR, Hopwood N, Boud D. Interprofessional learning at work: what spatial theory can tell us about workplace learning in an acute care ward. J Interprof Care. 2014;28(3):200–5. https://doi.org/10.3109/13561820.2013.873774.
Gustafsson M, Kullen Engstrom A, Ohlsson U, Sundler AJ, Bisholt B. Nurse teacher models in clinical education from the perspective of student nurses-a mixed method study. Nurse Educ Today. 2015;35(12):1289–94. https://doi.org/10.1016/j.nedt.2015.03.008.
Hager P. New approaches in the philosophy of learning. Educ Philos Theory. 2005;37(5):633–4.
Hartin P, Birks M, Lindsay D. Bullying and the nursing profession in Australia: an integrative review of the literature. Collegian. 2018;25(6):613–9. https://doi.org/10.1016/j.colegn.2018.06.004.
Havery C. The effects of clinical facilitators’ pedagogic practices on learning opportunities for students who speak English as an additional language: an ethnographic study. Nurse Educ Today. 2019;74:1–6. https://doi.org/10.1016/j.nedt.2018.12.004.
Health Literacy Hub. (2018). https://healthliteracyhub.org.au/. Accessed 2020.
Hill R, Woodward M, Arthur A. Collaborative learning in practice (CLIP): evaluation of a new approach to clinical learning. Nurse Educ Today. 2020;85:104295. https://doi.org/10.1016/j.nedt.2019.104295.
Hong SJ. Gendered cultural identities: the influences of family and privacy boundaries, subjective norms, and stigma beliefs on family health history communication. Health Commun. 2018;33(8):927–38. https://doi.org/10.1080/10410236.2017.1322480.
Jack K, Hamshire C, Chambers A. The influence of role models in undergraduate nurse education. J Clin Nurs. 2017:n/a–n/a. https://doi.org/10.1111/jocn.13822.
James A, Chapman Y. Preceptors and patients – the power of two: nursing student experiences on their first acute clinical placement. Contemp Nurse. 2009;34(1):34–47. https://doi.org/10.5172/conu.2009.34.1.034.
Kelly M, Hager P. Informal learning: relevance and application to health care simulation. Clin Simul Nurs. 2015;11(8):376–82. https://doi.org/10.1016/j.ecns.2015.05.006.
Kolb D. Experiential learning: experience as the source of learning and development. Englewood Cliffs: Pearson Education; 1984.
Lave J, Wenger E. Situated learning: legitimate peripheral participation. Cambridge: Cambridge University Press; 1991.
Levett-Jones T, Lathlean J. Belongingness: a prerequisite for nursing students’ clinical learning. Nurse Educ Pract. 2008;8(2):103–11. https://doi.org/10.1016/j.nepr.2007.04.003.
Marc M, Bartosiewicz A, Burzynska J, Chmiel Z, Januszewicz P. A nursing shortage – a prospect of global and local policies. Int Nurs Rev. 2019;66:9–16.
Materne M, Henderson A, Eaton E. Building workplace social capital: a longitudinal study of student nurses’ clinical placement experiences. Nurse Educ Pract. 2017;26:109–14. https://doi.org/10.1016/j.nepr.2017.07.007.
McKenna L. Hidden, informal, and formal curricula in health professions education. In: Clinical education for the health professions. Cham: Springer; 2020. p. 1–13.
McMahon-Parkes K, Chapman L, James J. The views of patients, mentors and adult field nursing students on patients’ participation in student nurse assessment in practice. Nurse Educ Pract. 2016;16(1):202–8. https://doi.org/10.1016/j.nepr.2015.08.007.
Mikkonen K, Elo S, Kuivila H-M, Tuomikoski A-M, Kääriäinen M. Culturally and linguistically diverse healthcare students’ experiences of learning in a clinical environment: a systematic review of qualitative studies. Int J Nurs Stud. 2016;54:173–87. https://doi.org/10.1016/j.ijnurstu.2015.06.004.
Mikkonen K, Merilainen M, Tomietto M. Empirical model of clinical learning environment and mentoring of culturally and linguistically diverse nursing students. J Clin Nurs. 2020;29(3–4):653–61. https://doi.org/10.1111/jocn.15112.
Moscato SR, Miller J, Logsdon K, Weinberg S, Chorpenning L. Dedicated education unit: an innovative clinical partner education model. Nurs Outlook. 2007;55(1):31–7. https://doi.org/10.1016/j.outlook.2006.11.001.
National Institute for Health and Care Excellence: Patient and public involvement. https://www.nice.org.uk/about/nice-communities/nice-and-the-public/public-involvement/public-involvement-programme/patient-public-involvement-policy (2013). Accessed 16 Feb 2020.
Needham J, McMurray A, Shaban RZ. Best practice in clinical facilitation of undergraduate nursing students. Nurse Educ Pract. 2016;20:131–8. https://doi.org/10.1016/j.nepr.2016.08.003.
Nestel D, Bearman M, editors. Simulated patient methodology: theory, evidence and practice. Chichester: Wiley Blackwell; 2015.
Nestel D, Kelly M, Jolly B, Watson M, editors. Healthcare simulation education: evidence, theory and practice. West Sussex: John Wiley & Sons; 2018.
Newton JM, Billett S, Ockerby CM. Journeying through clinical placements – an examination of six student cases. Nurse Educ Today. 2009a;29(6):630–4. https://doi.org/10.1016/j.nedt.2009.01.009.
Newton JM, Billett S, Jolly B, Ockerby CM. Lost in translation: barriers to learning in health professional clinical education. Learn Health Soc Care. 2009b;8(4):315–27. https://doi.org/10.1111/j.1473-6861.2009.00229.x.
Newton JM, Henderson A, Jolly B, Greaves J. A contemporary examination of workplace learning culture: an ethnomethodology study. Nurse Educ Today. 2015;35(1):91–6. https://doi.org/10.1016/j.nedt.2014.07.001.
Nursing and Midwifery Council: Standards for student supervision and assessment. https://www.nmc.org.uk/standards-for-education-and-training/standards-for-student-supervision-and-assessment/. (2018). Accessed 2020.
Nursing Council of New Zealand: Requirements for registration as a registered nurse. https://www.nursingcouncil.org.nz/Public/Nursing/How_to_become_a_nurse/NCNZ/nursing-section/How_to_become_a_nurse.aspx (2017). Accessed 5 March 2021.
Papastavrou E, Dimitriadou M, Tsangari H, Andreou C. Nursing students’ satisfaction of the clinical learning environment: a research study. BMC Nurs. 2016;15(44):1–10.
Perry C, Henderson A, Grealish L. The behaviours of nurses that increase student accountability for learning in clinical practice: an integrative review. Nurse Educ Today. 2018;65:177–86. https://doi.org/10.1016/j.nedt.2018.02.029.
Philibert I, Elsey E, Fleming S, Razack S. Learning and professional acculturation through work: examining the clinical learning environment through the sociocultural lens. Med Teach. 2019;41(4):398–402. https://doi.org/10.1080/0142159X.2019.1567912.
Ratta C. The art of balance: preceptors’ experiences of caring for deteriorating patients. J Clin Nurs. 2018;27:3497–509. https://doi.org/10.1111/jocn.14579.
Roxburgh M, Conlon M, Banks D. Evaluating hub and spoke models of practice learning in Scotland, UK: a multiple case study approach. Nurse Educ Today. 2012;32(7):782–9. https://doi.org/10.1016/j.nedt.2012.05.004.
Saarikoskia M, Leino-Kilpib H. The clinical learning environment and supervision by staff nurses: developing the instrument. Int J Nurs Stud. 2002;39:259–67.
Salamonson Y, Ramjan L, Lombardo L, Lanser L, Fernandez R, Griffiths R. Diversity and demographic heterogeneity of Australian nursing students: a closer look. Int Nurs Rev. 2012;59:59–65.
Seidlein A-H, Salloch S. Who cares about care? Family members as moral actors in treatment decision making. Am J Bioeth. 2020;20(6):80–2. https://doi.org/10.1080/15265161.2020.1754506.
Smith JH, Sweet L. Becoming a nurse preceptor, the challenges and rewards of novice registered nurses in high acuity hospital environments. Nurse Educ Pract. 2019;36:101–7. https://doi.org/10.1016/j.nepr.2019.03.001.
Smith MR, Grealish L, Henderson S. Shaping a valued learning journey: student satisfaction with learning in undergraduate nursing programs, a grounded theory study. Nurse Educ Today. 2018;64:175–9. https://doi.org/10.1016/j.nedt.2018.02.020.
Spence D, Zambas S, Mannix J, Jackson D, Neville S. Challenges to the provision of clinical education in nursing. Contemp Nurse. 2019;55(4–5):458–67. https://doi.org/10.1080/10376178.2019.1606722.
Stockhausen LJ. The patient as experience broker in clinical learning. Nurse Educ Pract. 2009;9(3):184–9. https://doi.org/10.1016/j.nepr.2008.06.006.
Suikkala A, Koskinen S, Leino-Kilpi H. Patients’ involvement in nursing students’ clinical education: a scoping review. Int J Nurs Stud. 2018;84:40–51. https://doi.org/10.1016/j.ijnurstu.2018.04.010.
Tanner C. Thinking like a nurse: a research-based model of clinical judgment in nursing. J Nurs Educ. 2006;45(6):204–21.
Tzouvara V, Papadopoulos C, Randhawa G. Systematic review of the prevalence of mental illness stigma within the Greek culture. Int J Soc Psychiatry. 2016;62(3):292–305. https://doi.org/10.1177/0020764016629699.
Vygotsky L. Mind and society: the development of higher mental processes. Cambridge: Cambridge University Press; 1978.
Wenger E. Communities of practice: learning, meaning and identity. Leaning in doing: social, cognitive, and computational perspectives. Cambridge: Cambridge University Press; 1998.
Williamson GR, Plowright H, Kane A, Bunce J, Clarke D, Jamison C. Collaborative learning in practice: a systematic review and narrative synthesis of the research evidence in nurse education. Nurse Educ Pract. 2020;43:102706. https://doi.org/10.1016/j.nepr.2020.102706.
Wong KK, Velasquez A, Powe NR, Tuot DS. Association between health literacy and self-care behaviors among patients with chronic kidney disease. BMC Nephrol. 2018;19:Article 196. https://doi.org/10.1186/s12882-018-0988-0.
World Health Organization: Europe: European Union Standards for Nursing and Midwifery: Information for Accession Countries https://www.euro.who.int/__data/assets/pdf_file/0005/102200/E92852.pdf (2009). Accessed.
Zolezzi M, Alamri M, Shaar S, Rainkie D. Stigma associated with mental illness and its treatment in the Arab culture: a systematic review. Int J Soc Psychiatry. 2018;64(6):597–609. https://doi.org/10.1177/0020764018789200.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 Springer Nature Singapore Pte Ltd.
About this entry
Cite this entry
Kelly, M.A., Forber, J. (2021). Learning and Teaching at the Bedside: Expert Commentary from a Nursing Perspective. In: Nestel, D., Reedy, G., McKenna, L., Gough, S. (eds) Clinical Education for the Health Professions. Springer, Singapore. https://doi.org/10.1007/978-981-13-6106-7_61-1
Download citation
DOI: https://doi.org/10.1007/978-981-13-6106-7_61-1
Received:
Accepted:
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-13-6106-7
Online ISBN: 978-981-13-6106-7
eBook Packages: Springer Reference EducationReference Module Humanities and Social SciencesReference Module Education