Crossing the “Ascent to Competence” Borders Into Privileged Belongingness Space: Practical Nursing Students’ Experiences in Clinical Practice

Background There is substantial evidence that students’ sense of belonging in clinical practice influence their motivation, learning, and acquisition of skills. Despite the importance of belongingness in clinical education, not many studies have been done in the Canadian context in general and practical nurse education in particular. Purpose The main objective of this study was to explore practical nursing students’ experiences in clinical education with regard to their sense of belongingness. In addition, we also examined clinical instructors’ experiences in fostering a sense of belongingness to students in clinical settings. Methods Ascent to competence conceptual framework was used as an analytic lens in this study. Students enrolled in a two-year diploma in practical nursing and their instructors participated in the study. A total of 12 students and 4 clinical instructors participated in the in-depth semistructured one-on-one interviews. Inductive and deductive thematic analysis was used to analyze the data. Deductive analysis used predetermined themes as per ascent to competence framework. Inductive thematic analysis allowed us to provide additional themes on concepts that could not be effectively explained by the predetermined themes. Results Students described the uniqueness of their instructors and clinical sites as important attributes that enable them to cross various “borders” as they gain access to a “belongingness space” of acceptance, respect, and competency. Productive learning experiences were achieved by students who felt supported and “granted permission” to enter the belongingness space. The instructors highlighted their perceived roles in providing scaffolding supports they thought would help students feel a sense of belonging. Conclusions Students cross several borders as they persevere to gain access to the revered belongingness space. Clinical instructors play a major role in assisting students to enter the belongingness space where meaningful learning occurs.

A comparison of degree and diploma nursing students confidence of patient safety competency in Ontario, Canada

In Ontario, Canada, Registered Nurses and Practical Nurses practice autonomously and safely in the healthcare system. Students who are aiming to become a Registered Nurse are enrolled in a four-year university baccalaureate degree program while students pursuing a practical nursing diploma are registered in a two or three-year college program. Exploring differences in confidence levels could provide insight into whether one type of nursing educational program is assisting students to develop higher confidence levels on patient safety topics. The Health Professional Education in Patient Survey was used for data collection in this research study. In total, 206 practical nursing students and 458 degree nursing students participated in this study from four different academic settings in Ontario, Canada. Overall, students in both types of educational programs expressed similar levels of confidence on the seven patient safety subscales. Practical nursing students feel errors are viewed as individual mistakes and they fear repercussions when they make a mistake more so than degree students. Although the categories of students receive different education in terms of length of program, setting, and depth of content, students within either type of program appear to develop confidence levels that are similar for the most part.