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Everything Matters: Exposing the Complexity of Stakeholder Collaboration in Clinical Education for Undergraduate Nursing Students

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Thesis(2.86 MB)

Date

2022

Authors

Supervisor

Gilkison, Andrea
Morgan, Jane
Spence, Deb

Item type

Thesis

Degree name

Doctor of Health Science

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Publisher

Auckland University of Technology

Abstract

The question asked in this study is how do stakeholders collaborate to support the development of clinical competence in undergraduate nursing students in the acute care setting? In 2015, a Bachelor of Health Science (Nursing) programme underwent two audits. The first audit carried out by Janice Muller, an independent auditor from a private consulting company, focused on the clinical model being used within the programme. The second audit was carried out by the Nursing Council of New Zealand in accordance with the regular accreditation and monitoring of AUTs pre-registration programme. Both audits questioned the effectiveness of stakeholder collaboration in relation to student learning in the clinical setting. Feedback from clinical partners highlighted a desire to be more actively involved with student learning experiences. The study explored the complexity of values and beliefs along with contextual factors that enable and constrain stakeholder collaboration between student nurses, registered nurses in clinical practice, and academic clinical educators. Gaining insight into this complexity helps to explain how stakeholders collaborate. Using interpretive description (ID) underpinned by complexity theory (CT), data were collected through focus groups and individual interviews, and analysed using a Complex Adaptive System (CAS) principle framework. Interpretative analysis identified collaboration occurs on a contextually influenced continuum comprised of five interrelated dimensions: ‘the individual(s)’, ‘the relationship’, ‘clinical practice’, ‘acute care environment’, and ‘clinical education’. Within these interrelated dimensions are notions related to values and beliefs, as well as other factors that both enable and constrain collaboration. Findings show that student nurses are usually positioned on the peripheries of collaboration, even though they are central to the purpose of interaction between stakeholders. Valuing stakeholder relationships and the registered nurses’ clinical responsibilities will enable organisations to invest in collaboration by providing protected time for both patient care and student learning. Teaching students how to collaborate with other stakeholders will empower them to meet their learning needs within this complex system. Helping students to develop both confidence and competence is key to creating a safe learning and practice environment for all stakeholders, including patients. Attending to these recommendations early in the students’ programme of study will improve outcomes for students as they progress through their nursing programme and become registered nurses.

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https://hdl.handle.net/10292/15603

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