An Examination of the Provision of Structure and Pre-Registration Nursing Students’ Clinical Experience: A Self-Determination Theory Perspective
Doctor of Philosophy
School of Education
Background Clinical placements are a mandatory learning resource for all nursing students enrolled in the Bachelor of Nursing program through Australian Universities (Courtney-Pratt et al., 2012; Henderson et al., 2012; Needham et al., 2016). Nursing students learn through the support, guidance, and supervision of registered and enrolled nurses employed to work within the clinical placement setting and clinical facilitators provided by the universities (Courtney-Pratt et al., 2012; Happell et al., 2015). Clinical placements allow nursing students to consolidate their knowledge, familiarise themselves with the clinical placement setting, and develop competencies beyond what can be offered solely in the theoretical learning environment. To date, there has been little research conducted on the social context (clinical placement) or the provision of structure (clinical facilitator) regarding their influence on the motivation and professional learning of nursing students. To examine the social context and provision of structure, this thesis utilised the lens of Self-Determination Theory, an organismic dialectical approach to understanding human behaviour (Ryan & Deci, 2017).
Aim The aim of this thesis was to examine the influence that the provision of structure has on the motivation and professional learning of nursing students working within a mental health clinical placement.
Method This study utilised a quasi-experimental research design. 114 nursing students were provided a battery of questionnaires pre and post their mental health clinical placement with a focus on understanding the nursing student’s perceptions of the social context, motivational responses, and perceived levels of professional learning. Examination of each research question utilized ten different (2 x 2) (Group X Time) repeated measure analysis of variance (RM ANOVA) calculations for motivational responses (autonomy, competence, relatedness, autonomous motivation, and controlled motivation) and professional learning Roles and Responsibilities in Recovery (RRR), Non-Linearity of the Recovery Process (NLRP), Roles of Self-Definition and Peers in Recovery (RSPR), Expectations Regarding Recovery (ERR) and Stigma. Any significant RM ANOVA (either main or interaction effect) was followed up with a post-hoc Bonferroni pairwise comparison and plotting of simple means to examine the location of the significant difference for each dependent variable.
Results The results of this thesis show that the provision of structure and social context influences the professional learning and motivation of nursing students attending the mandatory clinical placement component of their Bachelor of Nursing degree. Nursing students in the clinical placement setting with a high provision of structure, when compared with nursing students in the low provision of structure groups, reported significantly different levels of motivational response in terms of competence. Nursing students in the high provision of structure groups also reported a significant difference in terms of professional learning, as seen within the questionnaire responses for RRR, NLRP, and stigma.
Conclusion In conclusion, the social context and provision of structure can support or thwart the growth and learning development of nursing students attending their clinical placement. Nursing students are increasingly more likely to feel motivated to engage in professional learning opportunities to overcome professional barriers and challenges when provided nursing supervision by well-informed and experienced clinical facilitators dedicated to learning and developing nursing students on clinical placement. This study has demonstrated that the social context and provision of structure are influential to the motivation and professional learning of nursing students attending their clinical placement. This has been well demonstrated throughout this thesis. This study supports the need to develop and implement a structured learning program that supports clinical facilitators to motivate and enhance the learning opportunities for nursing students on clinical placement. Further research is required to understand the social context and provision of structure outside of the clinical placement environment of Recovery Camp following the implementation of a supported and structured learning program for clinical facilitators.
Cregan, Anita, An Examination of the Provision of Structure and Pre-Registration Nursing Students’ Clinical Experience: A Self-Determination Theory Perspective, Doctor of Philosophy thesis, School of Education, University of Wollongong, 2022. https://ro.uow.edu.au/theses1/1546
FoR codes (2020)
3901 Curriculum and pedagogy
Unless otherwise indicated, the views expressed in this thesis are those of the author and do not necessarily represent the views of the University of Wollongong.