Education and Ethics In Nursing ISSN: 2322-5300

تبیین چالش‌های آموزش بالینی پرستاری از دیدگاه اساتید: یک مطالعۀ تحلیل محتوا

دوره 14، شماره 1
فروردین 1404
صفحه 71-84

نوع مقاله : مقاله پژوهشی اصیل

نویسندگان

1 استادیار، مرکز تحقیقات مراقبت های پرستاری و مامایی، گروه پرستاری مراقبت ویژه ، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 کارشناس ارشد، مرکز تحقیقات مراقبت های پرستاری و مامایی، گروه پرستاری سلامت بزرگسالان ، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده
مقدمه: با توجه به اهمیت آموزش بالینی در شکل­دهی مهارت‌های اساسی و توانمندی‌های حرفه‌ای دانشجویان پرستاری، اولین قدم جهت ارتقای کیفیت آموزش بالینی، بررسی دیدگاه اساتید پرستاری بوده است؛ بنابراین پژوهش حاضر، با هدف تببین چالش‌های آموزش بالینی، از دیدگاه اساتید پرستاری دانشگاه علوم پزشکی اصفهان طراحی شد.
روش کار: پژوهش حاضر، از نوع کیفی و با رویکرد تحلیل محتوا، به روش گرانهایم و لوندمن، در فاصلۀ زمانی 11 دی ماه 1402 تا 9 مرداد 1403 ، انجام شد. مشارکت‌کنندگان مشتمل بر 30 نفر اساتید پرستاری دانشگاه علوم پزشکی اصفهان بودند که به ‌صورت نمونه‌گیری هدفمند، با حداکثر تنوع، وارد مطالعه شدند. روش جمع‌آوری داده‌ها شامل مصاحبۀ نیمه­ساختارمند بود. همۀ داده‌ها پس از ضبط و پیاده‌سازی از طریق تحلیل محتوای کیفی و با استفاده از نرم‌افزار مکس کیودا نسخۀ 2020 ، مورد تجزیه‌ و تحلیل قرار گرفت. به‌ منظور اطمینان از صحت یافته‌های پژوهش، چهار معیار اعتبار(Credability) یا مقبولیت، قابلیت اعتماد(Dependability) یا همسان بودن، قابلیت انتقال(Transferability) و تأییدپذیری(Confirmability) که توسط گوبا و لینکلن، برای استحکام تحقیقات کیفی پیشنهادشده، استفاده گردید.
یافته‌ها: در راستای تبیین «چالش‌های آموزش بالینی از دیدگاه اساتید پرستاری» ، با تجزیه ‌و تحلیل داده‌ها، 846 کد اولیه، 14 طبقۀ فرعی و سرانجام، 4 طبقۀ اصلی (موانع مربوط به محیط یادگیری، موانع مربوط به اساتید، موانع مربوط به دانشجویان و موانع مدیریتی و سازمانی) پدیدار شد که عبارت­اند از:1. طبقۀ اصلی موانع مربوط به محیط یادگیری:  از 4 طبقۀ فرعی (کمبود امکانات و فضاهای آموزشی و تجهیزات، ارتباط نامناسب تیم درمان با دانشجویان، تعصب و تبعیض، تنش و تعارض بین اساتید، سرپرستاران و پرستاران در محیط بالینی)؛ 2. طبقۀ اصلی موانع مربوط به دانشجویان: از 3 طبقۀ فرعی (عدم علاقه و بی­ انگیزگی، چالش­ های شخصیتی و روانشناختی و آمادگی ناکافی دانشجو برای ورود به کارآموزی)؛ 3. طبقۀ موانع مربوط به اساتید:  از 3 طبقۀ فرعی (عدم علاقه و عدم تسلط در بالین، عدم آشنایی با استراتژی‌های جدید تدریس بالینی و نداشتن مهارت‌های ارتباطی مؤثر)؛ 4. طبقه اصلی موانع مدیریتی و سازمانی: از 4 طبقۀ فرعی ( نامناسب بودن رویه‌های جذب اعضای هیئت علمی، نظارت ناکافی مدیران گروه‌های آموزشی، کمبود مربیان بالینی مجرب و نداشتن رویه‌های مشخص برای ارزشیابی اساتید )
نتیجه‌گیری: چالش‌های آموزش بالینی در پرستاری، چند بُعدی و نیازمند اقدامات هماهنگ در سطوح مختلف هستند. بهبود زیرساخت‌ها، تقویت توانمندی‌های اساتید، حمایت از دانشجویان و اصلاح رویه‌های مدیریتی می‌تواند، به حل این چالش‌ها کمک کند.

کلیدواژه‌ها

موضوعات

عنوان مقاله English

Explaining the challenges of nursing clinical education from professors' point of view: a content analysis study

نویسندگان English

Maryam Hashemi 1
Peghah Maghzi 2
1 Assistant Professor, Nursing & Midwifery Care Research Center, Department of critical care, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
2 Msc , Nursing & Midwifery Care Research Center, Department of adult health Nursing , Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
چکیده English

Introduction: Considering the importance of clinical education in shaping the basic skills and professional abilities of nursing students, the first step to improve the quality of clinical education has been to examine the views of nursing professors; Therefore, the present study was designed with the aim of explaining the challenges of clinical education from the perspective of nursing professors of Isfahan University of Medical Sciences.
Materials and Methods: The current research was conducted qualitatively and with the content analysis approach, using the Granheim and Lundman method, between January 1, 2023 and August 9, 2024. The participants consisted of 30 nursing professors of Isfahan University of Medical Sciences, who were included in the study in the form of targeted sampling, with maximum diversity. The data collection method included a semi-structured interview. After recording and implementing, all data were analyzed through qualitative content analysis using the 2020 version of Max Kyoda software. In order to ensure the validity of the research findings, four criteria of validity or acceptability, reliability or similarity, transferability and verifiability suggested by Goba and Lincoln for the strength of qualitative research were used.
Results: In order to explain the "challenges of clinical education from the point of view of nursing professors", by analyzing the data, 846 primary codes, 14 subcategories, and finally, 4 main categories (barriers related to the learning environment, barriers related to professors, barriers related to students, and managerial and organizational barriers) emerged, which are: 1. The main level of obstacles related to the learning environment: from 4 sub-levels (lack of educational facilities and spaces and equipment, inappropriate communication between the treatment team and students, prejudice and discrimination, tension and conflict between professors, supervisors and nurses in the clinical environment); 2. The main class of obstacles related to students: from 3 sub-classes (lack of interest and lack of motivation, personality and psychological challenges and insufficient preparation of students to enter internship); 3. The category of obstacles related to professors: from 3 sub-categories (lack of interest and lack of mastery in the clinic, lack of familiarity with new clinical teaching strategies and lack of effective communication skills); 4. The main class of managerial and organizational obstacles: from 4 sub-classes (improper procedures for recruiting faculty members, insufficient supervision of educational group managers, lack of experienced clinical trainers and lack of specific procedures for evaluating professors)
Conclusion: The challenges of clinical education in nursing are multidimensional and require coordinated measures at different levels. Improving the infrastructure, strengthening the capabilities of professors, supporting students and modifying management procedures can help to solve these challenges.

کلیدواژه‌ها English

  • N0ursing Professors
  • Clinical Education
  • Nursing Students
  • Content Analysis
  1. Htay M, Whitehead D. The effectiveness of the role of advanced nurse practitioners compared to physician-led or usual care: A systematic review. International Journal of Nursing Studies Advances. 2021;3:100034.
  2. Woo BFY, Lee JXY, Tam WWS. The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: a systematic review. Human resources for health. 2017;15:1-22.
  3. Smith J, & Brown, T. Clinical Education in Nursing: Challenges and Innovations. Springer.; 2023.
  4. Farsi Z, Nasiri M, Sajadi SA, Khavasi M. Comparison of Iran’s nursing education with developed and developing countries: a review on descriptive-comparative studies. Bmc Nursing. 2022;21(1):105-106.
  5. Chegini Z, Arab‐Zozani M, Kakemam E, Lotfi M, Nobakht A, Aziz Karkan H. Disaster preparedness and core competencies among emergency nurses: A cross‐sectional study. Nursing open. 2022;9(2):1294-302.
  6. Zaitoun RA, Said NB, de Tantillo L. Clinical nurse competence and its effect on patient safety culture: a systematic review. Bmc Nursing. 2023;22(1):173.
  7. Gaeeni M, Rezaei M, Khoramirad A, Parizad A. The challenges of clinical education in nursing: a qualitative analysis of nursing students and clinical instructors’ perspectives. J nurs midwifery sci. 2021;8(4):260.
  8. Kirca N, Ozgonul ML, Bademli K. The relationship between the competence of nurses and their attitudes in medical errors: a cross‐sectional survey. Journal of nursing management. 2020;28(5):1144-52.
  9. Rahmani A, et al. The Role of Faculty Supervision in the Quality of Clinical Education. Journal of Educational Management. 2022;14(2):31-32.
    1. Soroush A, Andaieshgar B, Vahdat A, Khatony A. The characteristics of an effective clinical instructor from the perspective of nursing students: a qualitative descriptive study in Iran. BMC nursing. 2021;20:1-9.
    2. Asadi M, Noorian S, Motefakker S, Heydari F, Shahsavari N, Senmar M. The state of clinical education and factors affecting effective clinical education: the point of view of nursing and midwifery students. BMC medical education. 2023;23(1):967..
    3. Hadian Jazi Z, Gheybi K, Zare Z, Shahsavari H. Nursing students’ experiences of educational discrimination: a qualitative study. BMC nursing. 2022;15(1):22.
    4. Ahmady S, Minouei MS. Explanation of medical students' experiences of educational clinical supervision: A qualitative study. Journal of Education and Health Promotion. 2021;10(1):12.
    5. Stolic S, Ng L, Southern J, Sheridan G. Medication errors by nursing students on clinical practice: An integrative review. Nurse Education Today. 2022;112:105325.
    6. Mwita K. Factors influencing data saturation in qualitative studies. Available at SSRN 4889752. 2022.
    7. Yang L, QI L, Zhang B. Concepts and evaluation of saturation in qualitative research. Advances in Psychological Science. 2022;30(3):511.
    8. Dyar KL, editor. Qualitative inquiry in nursing: Creating rigor. Nursing Forum; 2022: Wiley Online Library.
    9. Dossett LA, Kaji AH, Cochran A. SRQR and COREQ reporting guidelines for qualitative studies. JAMA surgery. 2021;156(9):875-6.
    10. CohenMiller A, Saban GA, Bayeta R. Rigor in Qualitative Research. The SAGE Handbook of Qualitative Research in the Asian Context Los Angeles, London, New Delhi, Singapore, Washington DC, Melbourne: SAGE Publications. 2022:327-43.
    11. LaDonna KA, Artino Jr AR, Balmer DF. Beyond the guise of saturation: rigor and qualitative interview data. The Accreditation Council for Graduate Medical Education; 2021. p. 607-11.
    12. Cant R, Ryan C, Cooper S. Nursing students' evaluation of clinical practice placements using the Clinical Learning Environment, Supervision and Nurse Teacher scale–A systematic review. Nurse Education Today. 2021;104:104983.
    13. Panda S, Dash M, John J, Rath K, Debata A, Swain D, et al. Challenges faced by student nurses and midwives in clinical learning environment–A systematic review and meta-synthesis. Nurse Education Today. 2021;101:104875.
    14. Rodríguez‐García MC, Gutiérrez‐Puertas L, Granados‐Gámez G, Aguilera‐Manrique G, Márquez‐Hernández VV. The connection of the clinical learning environment and supervision of nursing students with student satisfaction and future intention to work in clinical placement hospitals. Journal of Clinical Nursing. 2021;30(7-8):986-94.
    15. K. The theory of educational space: Integrating physical, social, and emotional dimensions.. J Educ Environ. 1991;45(3):123-30.
    16. Firmansyah D, Saepuloh D. Social learning theory: Cognitive and behavioral approaches. Jurnal Ilmiah Pendidikan Holistik (JIPH). 2022;1(3):297-324.
    17. Al-Khasawneh F, Al-Khasawneh MA, Al-Khawaldeh MA. Research Production at King Khalid University: Perceptions, Challenges, and Suggestions for Improvement. Indonesian Journal of Educational Research and Review. 2021;4(1):91-6.
    18. Nau DP, Shields KM. Student-to-faculty ratios and NAPLEX pass rates. Currents in Pharmacy Teaching and Learning. 2025;17(2):102237.
    19. Dhari S, Slemon A, Handlovsky I. A Mixed Method Study of Nursing Students' Experiences of Discrimination Within Their Programs. Journal of Advanced Nursing. 2025.
    20. Lazarus RS FS.. Stress, appraisal, and coping.. New York:: Springer; 1984.
    21. McKinney-Thompson C. Teacher stress and burnout and principals' leadership styles: A relational study: The University of Alabama; 2015.
    22. Tolsgaard MG, Kulasegaram KM, Ringsted CV. Collaborative learning of clinical skills in health professions education: the why, how, when and for whom. Medical Education. 2016;50(1):69-78.
    23. Kaufman DM. Teaching and learning in medical education: how theory can inform practice. Understanding medical education: evidence, theory, and practice. 2018:37-69.
    24. Jayasekara R, Smith C, Hall C, Rankin E, Smith M, Visvanathan V, et al. The effectiveness of clinical education models for undergraduate nursing programs: A systematic review. Nurse Education in Practice. 2018;29:116-26.
    25. Hampton KB, Smeltzer SC, Ross JG. The transition from nursing student to practicing nurse: An integrative review of transition to practice programs. Nurse Education in Practice. 2021;52:103031.
    26. Brown R ea. Clinical Competency of Nursing Faculty: A Critical Analysis.Nurse Education Today. 2023;112:105-10.
    27. Taylor E ea. Innovative Teaching Methods in Clinical Nursing Education.Journal of Advanced Nursing. 2022;78(6):1567-74..
    28. Williams K ea. Stress and Anxiety Among Nursing Students in Clinical Settings.. 2023;55(2):234-40. Journal of Nursing Scholarship. 2023;55(2):234-40.
    29. Cannity KM, Banerjee SC, Hichenberg S, Leon-Nastasi AD, Howell F, Coyle N, et al. Acceptability and efficacy of a communication skills training for nursing students: Building empathy and discussing complex situations. Nurse Education in Practice. 2021;50:102928.
    30. Roberts T ea. Motivation and Engagement in Nursing Education.. Nursing Research 2021;70(3):198-205.
    31. Jafarian-Amiri SR ZA, Qalehsari MQ. The challenges of supporting nursing students in clinical education.. ournal of education and health promotion.9(1):216.
    32. Aloufi MA, Jarden RJ, Gerdtz MF, Kapp S. Reducing stress, anxiety and depression in undergraduate nursing students: Systematic review. Nurse education today. 2021;102:104877.
    33. Nurunnabi ASM, Rahim R, Alo D, Mamun AA, Kaiser AM, Mohammad T, et al. Experiential learning in clinical education guided by the Kolb’s experiential learning theory. Int J Hum Health Sci (IJHHS). 2022;6(2):155.
    34. Garcia M ea. Recruitment Policies for Nursing Faculty: Challenges and Solutions.. 2023;54(1):34-40. Nursing Management. 2023;54(1):34-40.
    35. Romena RA, Mushtaq S, Raza MA. The Role of Total Quality Management in Universities: Administrative and Teachers Staff: Role of Total Quality Management in Universities: Administrative and Teachers Staff. Journal of Tourism, Hospitality, and Services Industries Research (JTHS). 2024;4(01):64-78.
    36. Abbaszadeh abas bf ss. Nursing teachers' perception of the challenges of clinical education and solutions: a qualitative study.. Journal of qualitative research in health sciences 2013;2(2):134-45.
    37. Lewis GK, Williams B, Allen S, Goldfarb B, Lyall K, Kling R, et al. Developing an evaluation tool to provide a 360-degree reflection on work-integrated learning in accounting education. Accounting Education. 2021;30(6):601-20.
    38. Satoh M, Fujimura A, Sato N. Competency of academic nurse educators. SAGE open nursing. 2020;6:2377960820969389.