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Report on Evaluation of Undergraduate Intern Year at the UCD School of Nursing, Midwifery and Health Systems

1.1 Introduction

This document provides an overview of the results from an evaluation of the intern year at the UCD School of Nursing, Midwifery and Health Systems. The evaluation was completed in semester 1 of the academic year 2009-2010 and included both general and psychiatric programmes. The School developed the instrument used to evaluate the intern year.

1.2 Instrument

The evaluation of the students’ experiences of their clinical placement was measured using the Intern Year Evaluation Questionnaire (IYEQ). The IYEQ consists of 29 questions that measure students’ level of satisfaction with various aspects of their placement with three additional demographic questions. The purpose of the IYEQ is to evaluate students’ perceptions of the quality of their intern year, the core aspects of support and learning that students experienced during their internship year and the extent to which they were prepared for their placement. The value of the IYEQ is that it gives a broad perspective on outcomes by focusing on students’ perceptions of their overall experience rather than on students’ evaluations of particular lecturers or clinical staff. The IYEQ measures five distinct but interrelated areas including a

Preparation for Internship, Student Support, Learning and Assessment, Preparation for Practice and Overall Satisfaction.

1.3 Analysis and Interpretation of the CEQ

Students following completion of the intern year were asked to rate their level of agreement or disagreement on a five-point scale on the 29-items that comprised five areas of the IYEQ. The questionnaire also uses positively and negatively worded items; the rationale for this is to ensure that the respondent considered each item carefully before completion. To aid interpretation of findings on the scales that comprise the IYEQ were linear transformed. Positive values indicate students are in agreement, negative values indicate disagreement.

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1.4 Profile of Students Evaluated

A total of 115 students completed the survey. The profile of the students surveyed is outlined in table 1.

Table 1 Profile of Total Sample, General and Psychiatric

Characteristic Total

Sample

General Psychiatric

Gender % (n)

Female 90.4 (104) 90.8 83.3

Male 9.6 (11) 9.2 16.7

Hospital % (n)

St. Vincent’s University Hospital 39.1 (45) - -

Mater Misercordiae University Hospital 37.4 (33) - -

St. Michael’s Hospital 18.3 (21)

St. John of God Hospital 5.2 (6)

1.5 Students’ Evaluations of their Clinical Placement

To aid interpretation and standardise scores across the IYEQ the mean item scores in the tables and figures are based on a linear transformation where the 1 to 5 categories (strongly disagree to strongly agree) have been recoded from -100 to +100. Positive values indicate degrees of agreement with each of the items and negative values indicate degrees of disagreement each of the items. For further ease of interpretation overall agreement on each item is reported by combining strongly disagree/disagree and agree/strongly agree categories (no opinion responses are omitted).

1.5.1 Students’ Evaluation of their Preparation for Internship

Overall students identified that they were well prepared prior to commencing their internship with over eighty-four per cent in agreement with the statement ‘I was well prepared for placement’ (table 2). Students also reported high levels of satisfaction in relation to being orientated in semester one and knowing what was expected from students on internship. Although levels of satisfaction were somewhat lower for the items that measured the impact of DoCAT documentation and the management experience preparation exercise, between sixty to seventy per cent expressed satisfaction with these elements of preparation.

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1.5.2 Students’ Evaluation of Support Received during the Intern Year

Students reported that they received high levels of support from clinical staff during the intern year with the vast majority in agreement that clinical staff were helpful in assisting students learn on placement and that they were well supported during internship. Students were also in agreement that clinical staff had time to support them in the clinical area and that they were well supported by staff from the UCD School of Nursing, Midwifery and Health Systems. Students disagreed that there were too many students on placement for clinical staff to provide support. There was variability however in students’ responses to the statement ‘Clinical and patient commitments prevented clinical staff from supporting me on clinical placement’ with approximately forty-four percent in agreement and over a third in disagreement. The integration of students into the clinical team during their internship was evident in that over ninety per cent reported being part of the clinical team (no student disagreed with this statement). Students were also highly satisfied with the level of supervisory support they received as well as staff understanding the difficulties they faced while on clinical placement.

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1.5.3 Students’ Evaluation of their Experience of Learning and Assessment

Between ninety-five and ninety-nine per cent of students reported that they were able to both apply and relate theory to practice during their intern year. Students were also provided with helpful feedback on their progress during the intern year and approximately eighty per cent reported that they had access to appropriate learning experiences in the clinical area (only six per cent were in disagreement). Although sixty per cent agreed that ‘Clinical staff were responsible for student learning in the clinical area’ over a fifth disagreed with this statement. However just under ninety per cent of students reported that they had been fairly assessed during their intern year.

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1.5.4 Students’ Evaluation of Outcomes Achieved as a Consequence of the Intern Year

Outcomes achieved as a consequence of the intern year were the highest rated component of the evaluation. Approximately ninety-five per cent of students reported that the internship had helped them develop their practical clinical skills, had enabled them to practice safely and effectively, had increased their confidence as a nurse and had prepared them for practice following qualification. The vast majority also reported that they had the necessary skills and training to manage the clinical environment (it should be noted that ten per cent disagreed with this statement) and that they had received the necessary skills and training to fulfil their role as a nurse.

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1.5.5 Students’ Overall Evaluation of the Intern Year

The vast majority of students expressed high levels of satisfaction with the intern year. Ninety-three per cent were in agreement with the statement ‘overall I was satisfied with my internship’; just under two per cent were in disagreement with the statement.

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Table 2 Item Scores* and Percentage Agreement† on the CEQ – Undergraduate and Graduate Students

No. CEQ Scale/Item Item Scores Percentage

Disagreement† Percentage Agreement Mean* SD

Preparation for Internship

1 I was well prepared for internship 50.43 35.96 3.5 84.3 2 Orientation in Semester 1 prepared me for

internship

41.30 51.85 13.9 74.8

3 It was made clear right from the start what was

expected from students on internship 36.95 54.24 19.2 73.9 4 The DoCAT documentation provided clear

guidelines for my learning 24.34 57.11 14.3 60.9

5 The management experience exercise was effective in preparing me for my future role

37.39 56.13 14.9 69.6

Student Support

6 Clinical staff were helpful in assisting me to learn

on internship 59.56 34.97 2.6 93.3

7 I was well supported on internship 59.56 40.22 4.4 87.0 8 Clinical and patient commitments prevented

clinical staff from supporting me on clinical placement

8.26 57.70 36.5 43.5

9 There were too many students on placement for

clinical staff to provide support 20.61 57.91 61.7 21.7 10 Clinical staff had time to support me in the clinical

area 34.78 48.74 16.5 71.3

11 I was well supported on internship by the staff of the UCD School of Nursing, Midwifery and Health Systems

31.30 54.39 16.5 64.3

12 I felt part of a clinical team 64.34 28.68 0.0 93.9

13 I had good access to supervisory support during

my internship 49.13 39.72 3.5 77.4

14 Staff made a real effort to understand the

difficulties I faced on placement 32.60 50.88 13.9 60.9

Learning and Assessment

15 Clinical staff were responsible for student learning

in the clinical area 29.56 50.39 20.9 60.9

16 I had access to the appropriate learning

experiences in the clinical area 47.82 41.03 6.1 79.1

17 I was fairly assessed on internship 55.65 41.76 6.0 87.8 18 I was able to relate theory to practice on internship 69.56 25.38 0.0 99.1 19 I was able to apply theory to practice on internship 66.08 27.74 0.0 95.7 20 I was provided with helpful feedback on my

progress on internship 46.95 40.39 20.0 80.0

Preparation for Practice - Outcomes

21 Internship helped me develop my practical clinical

skills 80.43 29.39 0.9 96.9

22 I can now practice safely and effectively following

internship 70.00 30.92 0.9 94.9

23 My internship has increased my confidence as a nurse

78.69 32.48 2.6 96.5

24 My internship prepared me for practice following

qualification 70.43 33.04 2.6 95.7

25 I feel I have all the necessary skills and training to

fulfil my role as a nurse 51.30 42.12 7.9 84.3

26 I feel I have all the necessary skills and training to

manage the clinical environment 46.08 46.12 10.4 79.1

Overall Satisfaction

27 Overall I was satisfied with my internship 68.26 35.25 1.8 93.0 *Scores range from – 100 to + 100. Positive mean scores indicate levels of agreement, negative scores indicate levels of disagreement.

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Analysis of Item Scores

The mean item scores identified that the development of practical clinical skills (M = 80.43, SD = 29.39) was the highest outcome identified by students followed by the development of confidence as a nurse as a consequence of the intern year (M = 78.69, SD = 32.48). Students also reported high mean scores in relation to their ability to practice safely and effectively (M = 70.00, SD = 30.92) and being prepared for practice following qualification. High mean scores were also evident in relation to the support received by students from clinical staff in assisting them to learn on internship (M = 80.43, SD = 29.39) and being part of the clinical team (M = 59.56, SD = 34.97). Although still rated positively the lowest mean score related to students’ responses to the statement: ‘clinical and patient commitments prevented clinical staff from supporting me on clinical placement’ (M = 8.26, SD = 57.70) (see figure 1).

Figure 1 Item scores for each item on the IYEQ – Graduate and Undergraduate Students (Items to the left indicate a negative perception of the item, items to the right indicate a positive perception of the item). In this graphic all items are positively rated.

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Evaluation

Student Nurse Questionnaire

Please record your responses to the questions by ticking the appropriate box or filling in the spaces as requested. START HERE

A.. Please indicate below your level of agreement or

disagreement with the following statements in relation to your internship:

******* RESPONSE KEY FOR QUESTIONS BELOW *******

Strongly Strongly

Agree Agree no opinion Disagree Disagree

! " # $ %

1. I was able to relate theory to practice

on internship ! " # $ %

2. Clinical staff were helpful in assisting

me to learn on internship ! " # $ %

3. I was well supported

on internship ! " # $ %

4. I was well prepared for internship ! " # $ %

5. Orientation in Semester 1 prepared

me for internship ! " # $ %

6. Internship helped me develop my

practical clinical skills ! " # $ %

7. Clinical and patient commitments prevented clinical staff from

supporting me on placement ! " # $ %

8. Clinical staff were responsible for

student learning in the clinical area ! " # $ %

9. There were too many students on placement for clinical staff to

provide support ! " # $ %

10. Clinical staff had time to support

me in the clinical area ! " # $ %

13. I had acess to appropriate learning experiences

in the clinical area ! " # $ %

14. I was able to apply theory to

practice on internship ! " # $ %

15. I was fairly assessed on

internship ! " # $ %

16. I can now practice safely and effectively

following internship ! " # $ %

******* RESPONSE KEY FOR QUESTIONS BELOW *******

Strongly Strongly

Agree Agree no opinion Disagree Disagree

! " # $ %

17. My internship has increased my

confidence as a nurse ! " # $ %

18. My internship has prepared me

for practice following qualification ! " # $ %

19. I feel I have all the necessary skills and

training to fulfil my role as a nurse ! " # $ %

20. I feel I have all the necessary skills and

training to manage the clinical environment ! " # $ %

21. I was well supported on internship by the staff of the School of

Nursing, Midwifery & Health Systems at

UCD ! " # $ %

22. I felt part of the clinical team ! " # $ %

23. I had good access to the supervisory

support on internship ! " # $ %

24. It was made it clear right from the start what was expected from students on

inernship ! " # $ %

25. I was provided with helpful feedback

on my progress on internship ! " # $ %

26. Staff made a real effort to understand

the difficulties I faced on placement ! " # $ %

27. The management experience exercise was effective in preparing me for my

future role ! " # $ %

28. The DoCAT documentation provided

clear guidelines for my learning ! " # $ %

29. Overall I was satisfied with my

internship ! " # $ %

Please respond to the following questions about yourself: H. Gender:

!Male

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I. Please indicate the discipline in which you are undertaking your degree

!General Nursing

!Psychiatric Nursing

J. Please indicate the hospital in which you undertook your Internship:

!Mater Misercordiae University Hospital !St. Vincent’s University Hospital !St. Michael’s Hospital

!St. John of God Hospital

Thank you for taking the time to complete this questionnaire. Your assistance in providing this information is very much appreciated. If there is anything else you would like to tell us

about your experience in the clinical area please do so in the space provided below.

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_______________________________________________________ ______________________________________________________

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Figure

Table 1 Profile of Total Sample, General and Psychiatric

Table 1

Profile of Total Sample, General and Psychiatric p.3
Table 2 Item Scores* and Percentage Agreement †  on the CEQ – Undergraduate and Graduate Students

Table 2

Item Scores* and Percentage Agreement † on the CEQ – Undergraduate and Graduate Students p.8
Figure 1 Item scores for each item on the IYEQ – Graduate and Undergraduate Students (Items to the  left indicate a negative perception of the item, items to the right indicate a positive perception of the  item)

Figure 1

Item scores for each item on the IYEQ – Graduate and Undergraduate Students (Items to the left indicate a negative perception of the item, items to the right indicate a positive perception of the item) p.9

References

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