Support learning and development

The creation of an environment in which students are supported in the achievement of their learning outcomes is vitally important. In a study by Severinsson and Sand (2010:675) it was found that the unit manager is responsible for creating a ward culture in which the staff supports the students’ learning needs. However, the realities of the culture in the workplace must not be underestimated. Instances of negative interactions between staff and students, misunderstanding and conflict of work values and work ethics do occur. Resolution of misunderstandings will depend on the culture in the unit – an actively supporting attitude from the professional nurse and expert guidance will assist students in situations where they must make professional decisions. In such an environment students will have the frankness to request professional nurses to make time for them and to assist them in achieving their learning outcomes.

An important aspect for consideration is that feedback on clinical performance (assessment) and professional socialisation is essential for learning to take place in a unit. Students require constructive feedback to be able to learn from successes and mistakes. Dubi, Becker and Tekian (2015:534) reported on dissatisfaction of

examination. The staff did not consider feedback as part of the learning process. In this particular study (Dubi et al 2015:534) it was evident that the educational environment was not supportive, the morale of students was low and the absence of constructive feedback caused students to lack confidence in their competence and knowledge. The researchers held a workshop where the importance of constructive feedback was discussed and the importance of feedback explained. Feedback received after the workshop was that students’ satisfaction and motivation to perform improved and so their confidence and clinical skills. In the current study participants acknowledged that they would probably make mistakes from time to time but requested that confidentiality and privacy be considered when giving feedback, whether positive or negative as this would help them grow and correct their mistakes.

The working culture influences the students’ learning of professional practice which includes clinical reasoning skills, problem-solving skills and professional development. A knowledge-sharing culture (Hood et al 2014:117) where people share openly, where there is a willingness to teach, where ideas can be freely challenged and where knowledge gained from other sources used, is the ideal environment where learning will take place. Student nurses do not always understand the powerful influence the workplace culture has on learning, how the specific culture of learning established in a unit can enable them to adopt a critical and reflective attitude to the activities of their workplace and that can encourage and motivate them to be strategic in their learning and development. A unit in which the professional nurse has established an environment with an open and questioning attitude by the different role players promotes knowledge and eliminates the taken-for-granted assumptions of the workplace culture and this may lead to better informed decision-making. The hospitals in which participants in this study were placed were perceived as lacking in terms of an established learning culture, where staff work in isolation and where no learning takes place. They reported problematic experiences in achieving their clinical outcomes and that frequent requests from students for assistance to learn from their experiences in the unit they were ignored. Chuan et al (2012:192) reported that a supportive clinical learning environment and where a culture of learning is established, is important not only for the development of student nurses’ knowledge and skills but also for their professional socialisation into the nursing profession. Chuan et al (2012:193) refer to the appreciation of student nurses for the advice and “know how” of the more senior students to whom they can relate more easily. Junior students sometimes overlook the

importance and influence senior students can have on their training during their clinical placement. This highlighted the participants’ needs for professional nurses to assess their clinical learning needs, to assist them to set goals and to develop action plans to ensure that they are met.

To support student learning and development is to allocate tasks that are within their scope of practice for students to practice. In a study done by Williamson, Callaghan, Whittlesea and Heath (2010:832) the question was posed to the staff on the benefit of student placement in their unit where the feedback was positive from the unit staff in the sense of it being “tangible support to the staff but it also enhances the staffs’ knowledge”. While recognising the advantage of having students in a unit where a culture of learning can be established it is also important to consider that task allocation may be limited due to the stage of learning and that allocations can only be made in terms of the legal framework within which student nurses may practise. This will, however, enhance their sensitivities towards the requirement that they practise within their scope to achieve their programme outcomes (SANC 1991: Regulation R.2598, Section 2).

Professional nurses as role models are expected to promote the well-being of people entrusted to them. This makes teaching and learning in the clinical environment more than simply teaching physical nursing tasks. It is also concerned with students’ professional development. As the future of the nursing profession students need to have role models in practice that will not only teach nursing skills to ensure competence, problem-solving and critical thinking but also the skills that will allow professional socialisation, thereby enabling students to conduct themselves in the profession. They must learn the necessary skills to work within the multi-disciplinary team.

Struksnes, Engelien, Bogsti, Moen, Nordhagen, Solvik and Arvidsson (2012:83) are of the opinion that all professional nurses have a legal and professional responsibility to help and support nursing students in developing competencies in the clinical setting. They refer to the importance of a one-to-one relationship with students and professional nurses in the clinical environment to ensure students’ learning and professional development in clinical practice. Watkins, Roos and Van der Walt (2011:6) reported that professional nurses as role models are meant to motivate and guide the student nurses

taken place. If a culture of learning is instilled in unit staff, students would not have to request, as made evident in their notes – “take me with on doctors rounds even if I am busy – call me the experience may be lost forever”. This kind of support will be the norm when staff is aware of their collective responsibility towards students during clinical placement.