Impact of a learning circle intervention across academic and service contexts on developing a learning culture

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Summary

Partnerships between university schools of nursing and health services lead to successful learning experiences for students and staff. A purposive sample of academics and students from a university school of nursing and clinicians from three health institutions involved in clinical learning (n = 73) actively participated in a learning circles intervention conducted over 5 months in south east Queensland. Learning circle discussions resulted in enhanced communication and shared understanding regarding: (1) staff attitudes towards students, expectations and student assessment; (2) strategies enhancing preparation of students, mechanisms for greater support of and recognition of clinicians; (3) challenges faced by staff in the complex processes of leadership in clinical nursing education; (4) construction of learning, ideas for improving communication, networking and sharing; and (5) questioning routine practices that may not enhance student learning. Pre–post surveys of hospital staff (n = 310) revealed significant differences across three sub-scales of ‘accomplishment’ (t = −3.98, p < .001), ‘recognition’ (t = −2.22, p < .027) and ‘influence’ (t = −11.82, p < .001) but not ‘affiliation’. Learning circles can positively enhance organisational learning culture. The intervention enabled participants to recognise mutual goals. Further investigation around staff perception of their influence on their workplace is required.

Introduction

The preparation of nursing students for the real world of practice is a significant contemporary issue for health care and education institutions globally. Effective clinical learning experiences are strategic in assisting students to apply knowledge and skills learnt in the academic context. It is recognised that effective partnerships between university schools of nursing and health services lead to successful learning experiences for students and staff (Clare et al., 2003, Henderson et al., 2007, Department of Education Science and Training, 2001). These partnerships are crucial in the promotion of practice communities that enable student engagement in learning about professional behaviour, attitudes and practice (Lave and Wenger, 1991). Clinicians contribute directly to the development of students' clinical competency by creating learning opportunities (Kell and Jones, 2007), and while they are best positioned to facilitate student learning they may not be knowledgeable about students' learning needs and how to address them (Yonge et al., 2007). Previous research identified that registered nurses can be poorly prepared about what is expected of them and of students (Brammer, 2006, Dickson et al., 2006, Walker et al., 2008), resulting in the perception of students as a burden (Clarke and Henderson, 2005). The paper outlines the results of a learning circle intervention designed to build partnerships between university and health service staff to better understand the issues that both parties face when organising and supporting student learning in clinical practice. The intent of the study was to demonstrate an effective partnership could formulate solutions to effect positive change in clinical learning cultures.

Section snippets

Literature review

Inclusive behaviours by the clinical team can assist students to achieve their learning goals and assimilate into the ward culture (Levett-Jones and Lathlean, 2007, Twentyman et al., 2006). Positive connections between staff and students facilitate sharing of knowledge, critical thinking about practice and professional values (Henderson et al., 2006). Encouraging staff awareness and abilities when interacting with students are essential elements of a positive learning environment (Eraut, 2003).

Method

A quasi-experimental design was used to assess the impact of the learning circle intervention on the clinical learning environment. Ethical approval was gained from the participating university and hospitals' ethics committees prior to the commencement of the study.

Learning circle participants

Learning circle participants were a purposive sample of registered nurses, clinical facilitators and educators from across the three health organisations, as well as academic staff and students from the university (see Table 1).

Content from learning circle discussions

The first learning circle comprised the gatekeepers and discussed staff attitudes towards, and perceptions of students, expectations and student assessment. Assessment criteria for student performance were of interest to the nurse unit managers (NUMs), as many of them

Discussion

The learning circles intervention evaluated in this project contributed to perceptions of positive change in the clinical learning culture. Through shared discussion, participants from both academic and clinical settings recognised mutual goals and developed possible solutions to address identified concerns. There are, however, several limitations associated with this study. Participation of staff was not uniform across participating organisations. Similarly, it is largely unknown the extent to

Conclusion

This study implemented and evaluated a learning circle intervention with students and staff from different levels of the participating hospitals and university. This approach recognised that learning occurs within a community of practice, and accordingly attitudes and behaviours can best be affected through a collective approach. Learning circle participants explored learning practices in their clinical contexts, the extent to which these practices met students' needs, and a shared

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