Ewertsson Mona, Bagga-Gupta Sangeeta, Allvin Renée, Blomberg Karin
Faculty of Medicine and Health, School of Health Sciences, Örebro University, S-70182 Örebro, Sweden.
School of Education and Communication, Jönköping University, Jönköping, Sweden.
BMC Nurs. 2017 Aug 16;16:48. doi: 10.1186/s12912-017-0238-y. eCollection 2017.
Clinical practice is a pivotal part of nursing education. It provides students with the opportunity to put the knowledge and skills they have acquired from lectures into practice with real patients, under the guidance of registered nurses. Clinical experience is also essential for shaping the nursing students' identity as future professional nurses. There is a lack of knowledge and understanding of the ways in which students learn practical skills and apply knowledge within and across different contexts, i.e. how they apply clinical skills, learnt in the laboratory in university settings, in the clinical setting. The aim of this study was therefore to explore how nursing students describe, and use, their prior experiences related to practical skills during their clinical practice.
An ethnographic case study design was used. Fieldwork included participant observations (82 h), informal conversations, and interviews ( = 7) that were conducted during nursing students' ( = 17) clinical practice at an emergency department at a university hospital in Sweden.
The overarching theme identified was "Learning about professional identities with respect to situated power". This encompasses tensions in students' learning when they are socialized into practical skills in the nursing profession. This overarching theme consists of three sub-themes: "Embodied knowledge", "Divergent ways of assessing and evaluating knowledge" and "Balancing approaches".
Nursing students do not automatically possess the ability to transfer knowledge from one setting to another; rather, their development is shaped by their experiences and interactions with others when they meet real patients. The study revealed different ways in which students navigated tensions related to power differentials. Reflecting on actions is a prerequisite for developing and learning practical skills and professional identities. This highlights the importance of both educators' and the preceptors' roles for socializing students in this process.
临床实践是护理教育的关键部分。它为学生提供了将从讲座中学到的知识和技能在注册护士的指导下应用于真实患者的机会。临床经验对于塑造护理专业学生作为未来专业护士的身份也至关重要。目前缺乏对学生在不同情境中（即在临床环境中应用在大学实验室学到的临床技能）学习实践技能和应用知识方式的了解。因此，本研究的目的是探讨护理专业学生在临床实践中如何描述和运用他们与实践技能相关的先前经验。
采用人种志案例研究设计。实地考察包括在瑞典一家大学医院急诊科对17名护理专业学生的临床实践进行参与观察（82小时）、非正式交谈和访谈（n = 7）。
确定的总体主题是“关于情境权力的专业身份学习”。这包括学生在接受护理专业实践技能社会化过程中学习时的紧张关系。这个总体主题由三个子主题组成：“身体化知识”、“评估和评价知识的不同方式”以及“平衡方法”。
护理专业学生不会自动具备将知识从一种情境转移到另一种情境的能力；相反，他们的发展受到他们在接触真实患者时的经验以及与他人互动的影响。该研究揭示了学生应对与权力差异相关紧张关系的不同方式。反思行动是培养和学习实践技能及专业身份的先决条件。这凸显了教育者和带教老师在这个过程中使学生社会化方面的作用的重要性。
