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Preceptors’ experiences of student supervision in the emergency medical services: a qualitative interview study
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. (Centre of Interprofessional Collaboration within Emergency care (CICE))ORCID iD: 0000-0001-9818-2591
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.ORCID iD: 0000-0002-8115-5359
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.ORCID iD: 0000-0003-2606-6289
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. (Centre of Interprofessional Collaboration within Emergency care (CICE))ORCID iD: 0000-0001-8376-8805
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2020 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 84, p. 1-8, article id 104223Article in journal (Refereed) Published
Abstract [en]

Background

Clinical placements play a central part in the education of future emergency medical services (EMS) staff and their development of clinical skills and competence. A key aspect of students' integration of theory and praxis and development into an independent clinician is a supportive mentorship with the preceptor. However, students report barriers for learning within the EMS, while the preceptors' experiences of their role have received scant attention in research.

Objectives

To describe preceptors' experiences of student supervision in the EMS during clinical placements.

Design

A descriptive qualitative design was used.

Participants and setting

Twenty specialist nurses were recruited among EMS staff from all parts of Sweden.

Methods

Data were collected using individual interviews and analyzed with latent qualitative content analysis.

Findings

EMS preceptors develop a competence in combining caring and learning adapted to individual student needs when facing students with varying needs in an ever-changing healthcare setting. A trustful relationship between student and preceptor is fundamental when coping with a dual responsibility for student and patient needs. However, several aspects in the EMS setting hinders the preceptors' ability to support the development of the students' independence. Surrounding support structures are important if the preceptors are to feel safe and secure in their role as assessor, teacher and ambulance nurse.

Conclusions

Preceptors need to develop a didactic flexibility through preceptor courses adapted to the complex premises found in the EMS. Ambulance services and universities should recognize the importance of preceptors´ colleagues, student continuity, university support and cooperation for improving quality and clarity in supervision during clinical placements.

Place, publisher, year, edition, pages
Elsevier, 2020. Vol. 84, p. 1-8, article id 104223
Keywords [en]
Ambulance nurse, Clinical placement, Emergency medical services, Learning environment, Preceptor, Specialist nurse, Supervision
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
URN: urn:nbn:se:lnu:diva-89785DOI: 10.1016/j.nedt.2019.104223ISI: 000501643800031PubMedID: 31726285Scopus ID: 2-s2.0-85074754376OAI: oai:DiVA.org:lnu-89785DiVA, id: diva2:1365232
Available from: 2019-10-24 Created: 2019-10-24 Last updated: 2022-11-21Bibliographically approved
In thesis
1. Balancing structure and flexibility in the ambulance service: the pursuit of professional judgement in caring and learning
Open this publication in new window or tab >>Balancing structure and flexibility in the ambulance service: the pursuit of professional judgement in caring and learning
2022 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to describe the conditions for learning inthe ambulance service during clinical practice, and to develop an understanding of how to support the professional development of caring in this context.

The findings of this thesis are based on four qualitative interview studies.The study group consisted of 28 specialist ambulance nursing students (I), 20 preceptors (II), 27 preceptors (III), and 16 specialist ambulance nursingstudents (IV), from all parts of Sweden. The data were collected by individual, dyadic, and focus group interviews. The study designs and analytical approach were guided by the critical incident technique, latent content analysis, reflexive thematic analysis, and a phenomenographic approach.

The findings indicate that the contextual complexities of ambulance care contradict the students’ fundamental need to independently care for the patients in their development of all domains of knowledge. Caring and learning in the ambulance service requires a structured approach in medical, technical, and practical aspects to create a basic security for preceptors and students in dealing with the diversity in care situations, patient needs, and student needs. However, this structured approach may hinder an individualized and situationally adapted approach unless the preceptors and students develop a flexible and reflective questioning approach in the phronetic domains of knowledge. The support, educational strategies, and learning objectives needed for enhancing educational clarity and quality during clinical practice in ambulance care are presented at an organizational, environmental, situational, and interpersonal level.

It is proposed in the conclusions that a reflective questioning approach and an embodied understanding of ambulance service work supported by critical reflections are fundamental to support professional development in this field. Higher education institutions and the ambulance departments should address the professional development as a mutual concern, where supporting the development of a caring competence should be viewed as a lifelong continuum of learning. The expanding scope of ambulance care requires professional judgement to manage the ethical complexities of clinical decision-making to safeguard the patient perspective in ambulance care.

Place, publisher, year, edition, pages
Växjö: Linnaeus University Press, 2022. p. 125
Series
Linnaeus University Dissertations ; 471
Keywords
Ambulance service, caring, clinical practice, further education, learning, registered nurses, phronesis, preceptor, professional development, professional judgement, students, supervision.
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-117626 (URN)10.15626/LUD.471.2022 (DOI)9789189709645 (ISBN)9789189709652 (ISBN)
Public defence
2022-12-15, Wiksell, Växjö, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2022-11-21 Created: 2022-11-21 Last updated: 2024-03-13Bibliographically approved

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Wallin, KimHörberg, UlricaWerkander Harstäde, CarinaElmqvist, CarinaBremer, Anders

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