临床学习环境中的促进因素和阻碍因素：注册护士学生的经历
Facilitative and obstructive factors in the clinical learning environment: Experiences of pupil enrolled nurses.
作者信息
Lekalakala-Mokgele Eucebious, Caka Ernestine M
机构信息
School of Health Care Sciences, University of Limpopo, Medunsa Sefako Makgatho Health Sciences University.
出版信息
Curationis. 2015 Mar 31;38(1):1263. doi: 10.4102/curationis.v38i1.1263.
BACKGROUND
The clinical learning environment is a complex social entity that influences student learning outcomes in the clinical setting. Students can experience the clinical learning environment as being both facilitative and obstructive to their learning. The clinical environment may be a source of stress, creating feelings of fear and anxiety which in turn affect the students' responses to learning. Equally, the environment can enhance learning if experienced positively.
OBJECTIVES
This study described pupil enrolled nurses' experiences of facilitative and obstructive factors in military and public health clinical learning settings.
METHOD
Using a qualitative, contextual, exploratory descriptive design, three focus group interviews were conducted until data saturation was reached amongst pupil enrolled nurses in a military School of Nursing.
RESULTS
Data analysed provided evidence that acceptance by clinical staff and affordance of self-directed learning facilitated learning. Students felt safe to practise when they were supported by the clinical staff. They felt a sense of belonging when the staff showed an interest in and welcomed them. Learning was obstructed when students were met with condescending comments. Wearing of a military uniform in the public hospital and horizontal violence obstructed learning in the clinical learning environment.
CONCLUSION
Students cannot have effective clinical preparation if the environment is not conducive to and supportive of clinical learning, The study shows that military nursing students experience unique challenges as they are trained in two professions that are hierarchical in nature. The students experienced both facilitating and obstructing factors to their learning during their clinical practice. Clinical staff should be made aware of factors which can impact on students' learning. Policies need to be developed for supporting students in the clinical learning environment.
背景
临床学习环境是一个复杂的社会实体，会影响学生在临床环境中的学习成果。学生在临床学习环境中可能会体验到对其学习既有促进作用又有阻碍作用的因素。临床环境可能是压力的来源，会产生恐惧和焦虑情绪，进而影响学生对学习的反应。同样，如果以积极的方式体验，该环境也可以促进学习。
目的
本研究描述了注册护士学生在军事和公共卫生临床学习环境中对促进因素和阻碍因素的体验。
方法
采用定性、情境、探索性描述性设计，进行了三次焦点小组访谈，直至一所军事护理学校的注册护士学生达到数据饱和。
结果
分析的数据表明，临床工作人员的接纳和自主学习的机会促进了学习。当得到临床工作人员的支持时，学生们会感到安全地进行实践。当工作人员表现出兴趣并欢迎他们时，他们会有归属感。当学生遇到 condescending 的评论时，学习就会受到阻碍。在公立医院穿着军装以及横向暴力行为阻碍了临床学习环境中的学习。
结论
如果环境不利于并支持临床学习，学生就无法进行有效的临床准备。该研究表明，军事护理学生在接受两种本质上具有等级制度的专业培训时会面临独特的挑战。学生们在临床实践中经历了对其学习既有促进作用又有阻碍作用的因素。临床工作人员应意识到可能影响学生学习的因素。需要制定政策以在临床学习环境中支持学生。
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