Faculty of Health and Social Sciences, Department of Nursing and Health Sciences, University of South-Eastern Norway, Drammen, Norway.
Faculty of Medicine, Institute of Health and Society, Department of Nursing Science, University of Oslo, Oslo, Norway.
Int J Nurs Stud. 2022 Oct;134:104258. doi: 10.1016/j.ijnurstu.2022.104258. Epub 2022 Apr 20.
Research suggests that the interventions of practice education facilitators, who liaise between the higher education institution and the clinical placement sites, may strengthen the clinical learning environment for nursing students. However, there is a lack of evidence concerning the value of these roles in nursing education.
The objective of this study was to explore how, under what circumstances and why the practice education facilitator role can strengthen the clinical learning environment for nursing students.
A realist review was conducted to understand the contextual factors and mechanisms that support or hinder the capacity of the practice education facilitator to strengthen the clinical learning environment for nursing students.
The settings are clinical areas where nursing students are directly involved with patient care.
The participants comprised academic and clinical staff involved in clinical nursing education.
This realist review was conducted in three overlapping and iterative phases: (1) the development of an initial programme theory explaining how the practice education facilitator role is thought to strengthen the clinical learning environment; (2) structured searches, screening and data extraction; and (3) analysis and synthesis to develop and refine the programme theory.
The review included 27 research papers. Evidence from these studies led to the development of five context-mechanism-outcome configurations that explain how, under what circumstances and why practice education facilitators can (or can fail to) strengthen the clinical learning environment. Factors such as practice education facilitators' visibility and accessibility in the clinical area and their clinical credibility were found to influence whether clinical supervisors took the opportunity to seek support and guidance from them. Moreover, ward culture regarding student learning and opportunities to prepare for the role were found to influence clinical supervisors' motivation to carry out the functions of the role and develop professionally; this in turn further influenced whether they used the resources provided by the practice education facilitator.
Theory-based explanations of how, under what circumstances and why the practice education facilitator role may strengthen the clinical learning environment of nursing students may support further development of this role in the future.
研究表明，实践教育协调员在高等教育机构和临床实习场所之间进行联络，其干预措施可能会加强护理学生的临床学习环境。然而，关于这些角色在护理教育中的价值，目前还缺乏证据。
本研究旨在探讨实践教育协调员的角色如何、在何种情况下以及为何能够加强护理学生的临床学习环境。
进行了一项实际主义审查，以了解支持或阻碍实践教育协调员加强护理学生临床学习环境的能力的情境因素和机制。
设置是护理学生直接参与患者护理的临床区域。
参与者包括参与临床护理教育的学术和临床工作人员。
该实际主义审查分三个重叠和迭代阶段进行：（1）制定一个初步的方案理论，解释实践教育协调员的角色如何被认为能够加强临床学习环境；（2）进行结构化搜索、筛选和数据提取；（3）分析和综合以制定和完善方案理论。
本审查包括 27 篇研究论文。这些研究的证据导致了五个情境-机制-结果配置的发展，解释了实践教育协调员如何、在何种情况下以及为何能够（或未能）加强临床学习环境。实践教育协调员在临床区域的可见性和可及性及其临床可信度等因素被发现会影响临床主管是否有机会寻求他们的支持和指导。此外，病房文化对学生学习和为角色做准备的机会被发现会影响临床主管履行角色和专业发展的动机；这反过来又会影响他们是否利用实践教育协调员提供的资源。
基于理论的解释如何、在何种情况下以及为何实践教育协调员的角色可能会加强护理学生的临床学习环境，可以支持未来进一步发展这一角色。
