Year

2019

Degree Name

Master of Philosophy

Department

School of Nursing

Abstract

Background Clinical placement (also known as workplace experience) is an integral part of nursing education training programs worldwide. The successful completion of stipulated hours of clinical placement under the direct supervision of a registered nurse is a requirement for students to be eligible for nursing registration. To ensure students have an optimal clinical experience and are ready to practice when they enter the workforce, they should be supervised by nurses who have the appropriate clinical supervision knowledge and skill set for the role. There are no clear criteria for choosing who should be assigned to supervise students. It is expected that every registered nurse is able to supervise students during their shift, as clinical supervision is considered an inherent role of the nurses’ Standard of Practice. However, evidence from the available literature suggests that some registered nurses who supervise nursing students during clinical placements do not have the appropriate knowledge or skills to undertake the role. Most of the available evidence is based on students’ evaluations of their clinical placement experience, with few studies focusing on bedside nurses, the majority of whom undertake this important role. Aim The aim of this study was to investigate registered nurses’ perceptions of their knowledge and skills towards supervising students, during clinical placement in a hospital setting and identify the association between their knowledge and skills and professional characteristics. Methods A descriptive cross-sectional self-administered survey was administered to registered Nurses working at a metropolitan tertiary referral and teaching hospital in NSW. The modified Clinical Supervision Self-Assessment Tool (mCSAT) comprising of 30 mCSAT–knowledge items and 30 mCSAT–skill items was used to collect data. Each item was scored on a 5-point likert scale from strongly agree to strongly disagree, and the minimum and maximum scores obtainable for knowledge and skills were 30 to 150 respectively. SPSS software version 22 was used for data analysis. Data were summarised using descriptive statistics. A one-way analysis of variance was used to identify the association between professional characteristics and knowledge and skills for clinical supervision. Results A total of 232 registered nurses participated in this study for a response rate of 58%. The mean age of the participants was 38.5 years (SD± 11.3) and 77.7% (n=178), were female. Approximately 36.6% of the nurses (n=85) had not completed any formal clinical supervision training. The mean scores for overall knowledge was 116.59 (SD ±20.49) and for skills was 115.60 (SD± 22.19). The mean scores on the subscale of facilitating was 36.21 (SD ±5.47) for knowledge and 35.90 (SD± 5.74) for skill. The mean scores for the subscale of problem-solving was 39.28 (SD± 6.57) for knowledge and 39.29 (SD± 6.85) for skill. The mean scores on the subscale of evaluating learning was 41.62 (SD± 8.62) for knowledge and 41.62 (SD± 8.76) for skill. A one-way analysis of variance yielded significant differences in mCSAT–knowledge and mCSAT–skill based on the type of clinical supervision training. Nurses who had completed a hospital-based in-service program (M = 119.86 ± 18.95, 95% CI [116.16, 123.57]) had significantly higher mCSAT–knowledge scores than those who had no previous training in clinical supervision (M = 110.15 ± 19.80, 95% CI [105.86, 114.45]), p < 0 001. Similarly, participants who had completed a hospital-based in-service clinical supervision training program (M = 119. 60 ± 20.00, 95% CI [115. 67, 123.53]) had significantly higher mCSAT–skill scores than those who had no previous training in clinical supervision (M = 109.12 ± 21.73, 95% CI [104.35, 113.89]), p < 0 001. No other professional characteristics yielded any significant association with nurses’ knowledge or skills of clinical supervision Conclusion The study results demonstrated that having clinical supervision training was a significant factor for gaining knowledge and for the development of skills relating to clinical supervision. Given that 36% of the nurses did not have any clinical supervision training it is important that universities and health service providers develop collaborative strategies and opportunities for ongoing professional development in relation to knowledge and skills for clinical supervision for nurses. Further multicentre studies across various settings using larger samples are warranted to substantiate the results of this study.

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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.