PMID: 11111558

Issn Print: 0363-3624

Publication Date: 2000/05/01


Print

The Impact of Prior Nursing-Like Work Experience on a Student's Clinical Performance

Patricia E. Henry; Barbara L. Kramer; Rose Schecter; A. Sharon Summers

+ Author Information

Author Information: e-mail:

    loading  Checking for direct PDF access through Ovid

Excerpt

"Do you think it would help my nursing skills if I got a job in a hospital?" asked a Fundamentals nursing student. No doubt, this question has been posed to a host of nursing faculty. Unfortunately, the answer is not an easy one. Faculty experiences with students who work as nursing assistants vary; although some were outstanding in their clinical performance, others displayed behaviors in clear contrast to what was taught to them as Fundamentals students. When confronted with faculty observations about their deficiencies, students would often remark "that's what the nurses do where I work." The authors theorized that some students were emphasizing their work environment as a venue for learning more than their academic setting. To validate this, the authors set about to try to determine whether prior nursing-like work experience influenced a student's clinical performance.
The literature review produced several studies supporting student work experiences and internships as beneficial in increasing knowledge about particular populations or improving awareness or attitudes. However, the issue of clinical performance was not clearly addressed. Hence, a survey instrument was designed by the authors, titled Patient Care Critical Elements Tool (PCCET), measuring self-reported actions and decisions related to a variety of patient care situations. A 4-point Likert scale was used for response choices of always/yes, sometimes/maybe, never/no, and unsure. Patient care situations were categorized into three subscales, namely Safety, Respect & Confidentiality, and Infection Control. The topics addressed are encountered in the work environment of a nursing assistant and are taught in a Fundamentals clinical nursing course. Students with and without nursing-like work experience were identified. The authors anticipated that if students were incorporating incorrect behaviors from their work environment, it would be reflected in their responses to the PCCET survey. After approval of the (Molloy College) Institutional Review Board, 66 sophomore-level nursing students completed the PCCET before their first clinical course. A chi-square test showed no statistically significant differences between the correct responses for each item between the 2wo groups (P > 0.05). After reassessing content validity, the authors revised the tool and administered it to a sample of 10 students, 5 of whom had prior nursing-like experience. The results from this group again showed that workers and nonworkers answered questions similarly.
At this juncture, the authors determined that they needed to rethink the research project. Several explanations for the findings were discussed. Perhaps the survey asked questions that could be answered based on common knowledge. Perhaps students answered what should be done rather than what they actually did. After a consultation with an expert currently working at a subsidiary of Educational Testing Services, the authors have decided to explore the possibility of using observation to assess the student's clinical performance and its relationship to his or her work experience. Using observation to gather data is a method requiring specific guidelines, training of observers, and consideration as to the impact of "being observed" on student performance. The group is exploring all of these issues.
The authors would be interested in either tools with known reliability and validity or examples that support our anecdotal experiences. Thoughts on methods to validate this would be appreciated. We await the responses of our colleagues.
    loading  Loading Related Articles