Collaborative Learning in Practice

Coaching to Support Student Learners in Healthcare

Charlene Lobo, Rachel Paul, Kenda Crozier

• Éditeur: Wiley-Blackwell
• Année: 2021
• ISBN:
  9781119695424
• Édition: 1
• Sujet: Medicine
• Sous-sujet: Nursing Skills

Cited in the 2015 Willis review on nurse education as an exemplary system-wide approach for supporting learning in practice, Collaborative Learning in Practice (CLiP) is an innovative coaching model that empowers students to take the lead in their practice through creating positive learning cultures.

Collaborative Learning in Practice provides a detailed description of the CLiP model and explains how coaching can be integrated into a range of learning conversations. Written by an experienced team of practitioners, this unique text describes the theoretical basis of the CLiPmodel, highlights potential pitfalls and successes, and offers practical guidance on implementation. A wealth of real-world case studies demonstrates how the CLiPmodel works in a range of professional and practice settings, considering healthcare education, research and leadership. This authoritative book:

• Provides an overview of the innovative CLiP model of practice-based learning, linked to the NMC standards for student supervision and assessment
• Offers numerous real-life examples of how to implement and evaluate CLIP in practice
• Explores the use of reverse mentoring to update and share knowledge collaboratively
• Discusses how coaching approaches such as GROW and OSCAR can enhance learning experiences
• Includes access to online learning tools including self-assessment tests, additional practical scenarios and case studies, and links to further reading

Developing practitioner knowledge and skill through an accessible, reader-friendly approach, Collaborative Learning in Practice is an essential resource for nursing and allied healthcare educators, nursing and healthcare students, and practice mentors, supervisors, and assessors in clinical environments.

Part I
Evolution of CLiP™

1
Changes in Practice Learning

Kenda Crozierand Charlene Lobo

Regulation of Nurse and Midwifery Education

The World Health Organization declared 2020 the year of the Nurse and Midwife and in December 2019 the Nursing and Midwifery Council (NMC) acknowledged 100 years of nursing registration in the United Kingdom. The model of hospital based ‘training’ of nursing, and the instigation of a register for qualified nurses in the 1919 Nurses Act, may have been the beginning of the professionalisation of nurses, but according to Davies (1977) it was also responsible for nursing shortages by restricting training places. In the century that followed we have seen changes to the Nurses and Midwives Act, the ‘training’ evolving from hospital control into higher education, and the registration of nurses moving from the responsibility of the General Nursing Council to the United Kingdom Central Council (with four country boards) to the current Nursing and Midwifery Council. The 1902 Midwives Act (England and Wales) established the Central Midwives Board to oversee the education and practice of midwives, thus beginning the route to professionalisation of midwifery. Today, nurses and midwives in UK practice under rules laid down in government legislation in the Health Act 1999 (UK) and Nursing and Midwifery Order 2001 (UK)¹ and subsequent amendments as statutory instruments. The need to educate more nurses to replace an ageing workforce and the requirement for clinical practice experience to support this poses a difficult problem for educators to reconcile.

Throughout the early part of the twentieth century, nursing education was in the control of hospital matrons and followed the principles of Florence Nightingale. Nursing tasks were repeated throughout the period of training to demonstrate competence and to ensure that nurses understood the servitude required of their role. In the 1940s, the Wood Committee Report sought to change nurse training by recommending recognition of the student status of nurses in training. It recommended larger nursing schools and a more academic syllabus. Both the General Nursing Council and the Royal College of Nursing were concerned over the continued ability of students to contribute to the staffing of hospitals during their training (Davies 1977) and resisted the recommendations. This concern was heightened with the introduction of free healthcare via the National Health Service in 1948 which increased demand on service. From the 1940s until the 1990s, a second tier nursing qualification known as the enrolled nurse existed in support of the registered nurse (RN). The enrolled nurse training was two years long as opposed the three year RN training (Seccombe et al. 1997).

In many ways the process of practice education in clinical and care settings is a means of socialising students into the ‘ways of being’ a nurse, midwife, or other health professional. This phenomenon was described in the 1950s by Williams and Williams (1959) in the USA. They described three processes for socialising students including: selfless service, scientific knowledge, and authoritarian control to produce nurses. This process of behaviour modification to achieve the required social norms largely served as the means to train nurses throughout much of the first part of the twentieth century. In the second half of the twentieth century, nursing students were still expected to work alongside qualified practitioners adapting to the required behaviour and attitudes to meet the outcomes of programmes; however, there was increased emphasis on scientific knowledge and research and rather less concern with emulating and modelling selfless service.

The 1972 Briggs (Department of Health and Social Security 1972) Report made major recommendations for the separation of nurse education from service, advocating an academic degree route into nursing. There was a distinction made between the caring role of nursing and the curing role of medicine. Nurses were deemed responsible for the physical, psychological, and social health of the patient. The model of nurse education changed following the Nurses, Midwives and Health Visitors Act of 1979, from apprenticeship to education with a two part programme: an 18 month foundation followed by a further 18 months of practical training leading to registration. The disease focused, theoretical education was supported by time in the clinical environment on hospital wards where students could practise their nursing skills under the supervision of ward staff. The programme was no longer controlled by hospital matrons and clinical teachers began to appear on the wards to support student learning.

In 1983, the United Kingdom Central Council for Nursing, Midwifery and Health Visiting was created, and nurses were enabled to register in four branches as registered general nurses (RGN), registered mental health nurses (RMN), registered learning disability nurses, or registered sick children's nurses. The intention was to streamline a very unwieldy register with many different parts.

Throughout the 1980s, concern was growing about nursing shortages, the low numbers of qualified nurses being produced in the UK, and the need to recruit nurses from overseas to fill vacancies. The Royal College of Nursing identified concern about high rates of attrition from nursing programmes and recommended Project 2000 as a way forward in which students would be supernumerary in the clinical environment and the emphasis was on learning and development of skills and knowledge (Rye 1985; United Kingdom Central Council 1986). Nursing schools moved from hospitals into higher education institutions, thus emphasising the separation from service. In 1999, the Department of Health (DH) reported on further changes for nurse education in a review of the role of nurses promising a growth in recruitment, better quality placements, and better support for students in practice (Department of Health, 1999).

The training of second level enrolled nurses was phased out during the 1980s and 1990s. Seccombe et al. (1997) reported to the United Kingdom Central Council (UKCC) on confusion over role boundaries between enrolled nurses and RNs and the difficulties for those who wished to convert to RN status. Over 80% of employers reported that where nurses did convert to RN, their grade and role did not change. The phasing out of enrolled nurses saw the more widespread introduction of healthcare assistants who received varying degrees of training for their role. The Willis Report (2015) identified that there were approximately 1 million healthcare assistants in the NHS supporting the work of around 330 000 RNs.

Globally, there has been a move to prepare nurses for the workforce through degree‐level education. This is true for UK, Ireland and other European Union countries, USA, Australia and New ...