归属与否：护理专业学生与临床学习环境的互动——一项观察性研究
To belong or not to belong: nursing students' interactions with clinical learning environments - an observational study.
作者信息
Liljedahl Matilda, Björck Erik, Kalén Susanne, Ponzer Sari, Bolander Laksov Klara
机构信息
Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
Clinical Genetics, Karolinska University Hospital, SE-171 76, Stockholm, Sweden.
出版信息
BMC Med Educ. 2016 Aug 5;16:197. doi: 10.1186/s12909-016-0721-2.
BACKGROUND
Belongingness has been argued to be a prerequisite for students' learning in the clinical setting but making students feel like they belong to the workplace is a challenge. From a sociocultural perspective, workplace participatory practices is a framework that views clinical learning environments to be created in interaction between students and the workplace and hence, are dependent on them both. The aim of this study was to explore the interdependence between affordances and engagement in clinical learning environments. The research question was: How are nursing students influenced in their interactions with clinical learning environments?
METHODS
An observational study with field observations and follow-up interviews was performed. The study setting comprised three academic teaching hospitals. Field observations included shadowing undergraduate nursing students during entire shifts. Fifty-five hours of field observations and ten follow-up interviews with students, supervisors and clinical managers formed the study data. A thematic approach to the analysis was taken and performed iteratively with the data collection.
RESULTS
The results revealed that students strived to fill out the role they were offered in an aspirational way but that they became overwhelmed when given the responsibility of care. When students' basic values did not align with those enacted by the workplace, they were not willing to compromise their own values. Workplaces succeeded in inviting students into the community of nurses and the practice of care. Students demonstrated hesitance regarding their desire to belong to the workplace community.
CONCLUSION
The results imply that the challenge for clinical education is not to increase the experience of belongingness but to maintain students' critical and reflective approach to health care practice. Additionally, results suggest students to be included as an important stakeholder in creating clinical learning environments rather than being viewed as consumer of clinical education.
背景
归属感被认为是学生在临床环境中学习的先决条件，但让学生感觉自己属于工作场所是一项挑战。从社会文化角度来看，工作场所参与式实践是一种框架，它认为临床学习环境是在学生与工作场所的互动中创建的，因此，依赖于两者。本研究的目的是探讨临床学习环境中可供性与参与度之间的相互依存关系。研究问题是：护理专业学生在与临床学习环境的互动中是如何受到影响的？
方法
进行了一项包括实地观察和后续访谈的观察性研究。研究地点包括三家学术教学医院。实地观察包括在整个轮班期间跟随本科护理专业学生。五十五小时的实地观察以及与学生、主管和临床管理人员的十次后续访谈构成了研究数据。采用主题分析法对数据进行分析，并在数据收集过程中反复进行。
结果
结果显示，学生们努力以一种有抱负的方式履行所赋予他们的角色，但当赋予他们护理责任时，他们会不堪重负。当学生的基本价值观与工作场所所践行的价值观不一致时，他们不愿意妥协自己的价值观。工作场所成功地邀请学生融入护士群体和护理实践。学生们对于自己想要归属工作场所群体的愿望表现出犹豫。
结论
结果表明，临床教育面临的挑战不是增加归属感体验，而是保持学生对医疗保健实践的批判性和反思性态度。此外，结果表明学生应被视为创建临床学习环境的重要利益相关者，而不是被视为临床教育的消费者。
Zotero 插件