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This thesis reports on a study of the lived experience of clinical nurses as mentors of student nurses in the workplace. Pre-registration nurse education, in which students must spend fifty percent of their time in practice, relies on a partnership between universities and health care providers and, crucially, the availability of practice mentors, able to support and assess practice learning. Within a hermeneutic phenomenological research methodology, twelve nurses described their experiences of mentoring through conversational interviews and event diaries which included ‘rich pictures’. The mixed methods provided openings for participants to talk about the harder-to-access elements of experience and generated multiple layers of rich data. Analysis of the data involved the application of different interpretive lenses: existentials in the care structure of Heidegger’s (1962) Dasein and the four lifeworld existentials (van Manen, 1997). For these respondents, the mentoring experience was rewarding, satisfying, frustrating, and even distressing at times. Being a mentor meant existing in worlds of ‘high stakes’, ‘hope for the nursing profession’ and ‘fragments’, governed by resource constraints, contextual demands and concern for others. Educational purposes dominated their being, revealing an essence, interpretively coined as ‘the educational use of self’, which meant that they were individually and authentically engaged in supporting and assessing learning. This study promotes greater understanding of mentoring practice and workplace learning, which can inform processes of recruitment, preparation and support of both students and mentors. Key insights are that mentors need support to work with complex and often hidden knowledge, including situations involving their intuitions.

This study explores the experiences of mentors who support pre-registration nursing students in clinical practice. The research was conducted in a remote and rural Scottish Health Board area. It poses the question, 'What role do mentors play in facilitating learning in practice?' Sub-questions explore how mentors see their role in promoting students' professional development, how they support students across the four domains of practice identified by the NMC (2004), and what factors impact upon mentors' abilities to promote student learning. An interpretative approach was adopted, guided by the principles of grounded theory (Strauss and Corbin, 1998). The theoretical framework drew upon social learning theories in helping to explain how possibilities for learning are dependent upon the social situation, social practices and student admission to 'communities of practice' (Lave and Wenger, 1991). The key data collection method was that of interview. 10 mentor volunteers were interviewed on two occasions, 8 of these mentors also kept diaries of their mentoring activities and reflections over a 12 week period. Findings led to the development of a tentative theory 'Fostering student learning' in which mentors facilitated the learning and development of their mentees in a supportive atmosphere likened to that of a nurturing family. The quality of the personal relationship between mentor and mentee was important as mentors established on-going dialogue with their mentees and 'coached' them towards achieving proficiency, instilling in them the values of kindness, compassion and a pride in the profession. In clinical placements in remote settings the pastoral role of the mentor appeared heightened and this added to the pressure mentors experienced as they sometimes struggled to balance competing responsibilities. The role of mentor is vital to supporting student learning, it has significant impact upon those who undertake it. A number of recommendations are made concerned with strengthening the mentor role.

Preceptorship within clinical nurse teaching was introduced in Ireland in 2002. Little is known how this model has impacted upon the pedagogical practices of the preceptor or student learning in clinical practice. An international literature review highlighted the question of what constitutes effective teaching and learning in clinical practice which is the subject of this thesis. An exploratory qualitative design was used to examine the clinical teaching and learning within the Irish preceptorship model. The sample comprised 13 students and 13 preceptors working together on four clinical areas in one hospital. Data were collected using semi- structured interviews and documentary analysis relating to the teaching and assessment of BNSc (general) students. Main findings showed preceptors used strategies that fostered performance and understanding such as demonstration, coaching and scaffolding. Participants believed the key to effective learning was interactive dialogue and building the students' confidence within the confines of a consistent mutually respectful relationship where the preceptor had time to teach. Many variations in preceptors teaching practices were illuminated. Some preceptors' utilised teaching methods that had the potential to enhance problem solving and students' self-directed learning ability. However, many did not use or value these cognitive approaches. Yet all preceptors expected students to make appropriate judgements within the unpredictable environment of practice. The student role as learner in many preceptor- students' relationships was not well understood or valued. Some cases of good practice were elucidated where professional education was the focus of students learning. Conversely in many cases the findings suggest that the students' education was driven by service needs and values such as performance, team work and a work ethic. Other professional values such as patient empowerment and critical thinking were not a primary concern. A best practice clinical teaching and learning model is offered based on the evidence of this study; recommendations as to its further modification and development are discussed. The research demonstrated how concepts such as cognitive apprenticeship (Coli ins 2006), situated teaching and learning in communities of practice (Lave 2009, Wenger 2009), and scaffolding (Vygotsky 1978) can be helpful in understanding the processes entailed in preceptorship. Therefore the research should provide both pragmatic guidance for nurse education in Ireland and more widely, and the development of our understanding about nurse education. The latter will add to the relatively weak theoretical underpinnings of much of the existing literature in nurse education research.

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Workplace violence is a serious issue in health care with international surveys revealing disproportionate involvement in certain professional groups, for example, ambulance staff, nurse and student nurses, or settings, for example, mental health and learning disability, elderly care, and A&E units. Staff training is widely advocated as the appropriate organisational response but there are relatively few published evaluations, and so much remains unknown about training effects or effectiveness. Many published studies are flawed by use of small samples, poor control of extraneous, organisational variables, absence of pre-test or follow-up data, limited range of measures, and weak statistical analysis. This study examined an existing training programme for student nurses whilst attempting to avoid the limitations identified above. The effects of training on a number of learning domains, for example, knowledge, self confidence, beliefs and attitudes, and self –assessed skills was investigated using a repeated measures, variable baseline research design, in conjunction with a model of learning. The likelihood of student nurses involvement in violent incidents, and the power/ease of use of different change evaluation methods were also investigated. Repeated administration of a purpose -designed questionnaire at four time points to three consecutive cohorts of student nurses [N=243] provided information about pre-training stability, possible changes on immediate training completion, and at three-months follow-up, after two clinical placements. Statistical analysis revealed the Unit to have generally desirable effects on learning domains that were still detectable at three-month follow-up. It also highlighted differential involvement in violent incidents based on placement type, and important differences between evaluation methods in terms of ease of use.

The purpose of this study was to explore and describe the perceptions of registered nurses with regard to facilitating the learning of student nurses during clinical placement. Focus group interviews with fifteen registered nurses were done, followed by participant observations in two clinical areas, to gain a clearer picture of obstacles, as well as the strategies employed during placement of student nurses in the clinical area. The :findings indicate that facilitation of the learning of student nurses during clinical placement is achieved by guidance, involvement, assisting and supervision of student nurses in the clinical area by nurses of all categories, and medical and paramedical personnel. Many obstacles were identified which obstruct the employment of strategies that are suitable for facilitation in the clinical area. Guidelines for the facilitation of learning of student nurses were recommended, to improve facilitation in the clinical area. / Health Studies / M.A. (Nursing Science)

The purpose of this quantitative, descriptive study was to describe how registered nurses utilise teachable moments to enhance students' learning in the clinical setting. The research questions were: What are the problems faced by registered nurses when they teach students in the clinical setting? and How do registered nurses utilise teachable moments to teach students? A pilot study was conducted in the clinical setting involving the respondents who had similar characteristics than the population. The sample consisted of 45 registered nurses who provided direct patient care in the clinical setting. A self­ administered, structured questionnaire was used to collect data. Data analysis was done by using descriptive statistical tests. The findings brought to light strengths and weaknesses with regard to the utilisation of teachable moments by registered nurses, and problems faced by registered nurses with regard to clinical accompaniment in general. Recommendations to improve clinical accompaniment by registered nurses through effective utilisation of teachable moments were made. Further research was recommended to explore some problematic areas that emerged from this study. / Health Studies / M.A. (Nursing Science)

The purpose of the study was to explore the perceptions of professional nurses on student mentorship. A qualitative, explorative, hermeneutic phenomenological research was conducted to determine the meaning of mentoring as perceived by professional nurses and to identify the successes and challenges encountered by professional nurses with regard to student mentorship during clinical practice. A face-to-face semi-structured interviews were done to collect data from operational managers (n=16) who were managing all unit activities, student mentoring included. Each interview lasted for ± 45 minutes. A hermeneutic data analysis (hermeneutic circle) was followed for data analysis. Four (4) themes and 15 sub-themes emerged from data collected from operational managers. The findings revealed that mentoring was perceived as a valuable phenomenon to apply in the preparation of student nurses for future professional role. In the process of mentoring, the caring attitude is revealed. Factors found to drive mentoring process successful was amongst other commitment, interest and partnership which guarantee the mutual efforts to the process. Though it is beneficial to mentor, mentee and the organisation as according to findings, challenges were also seen impacting on this process limiting its intentions / Health Studies / M.A. (Health Studies)

The purpose of this quantitative, descriptive study was to describe how registered nurses utilise teachable moments to enhance students' learning in the clinical setting. The research questions were: What are the problems faced by registered nurses when they teach students in the clinical setting? and How do registered nurses utilise teachable moments to teach students? A pilot study was conducted in the clinical setting involving the respondents who had similar characteristics than the population. The sample consisted of 45 registered nurses who provided direct patient care in the clinical setting. A self­ administered, structured questionnaire was used to collect data. Data analysis was done by using descriptive statistical tests. The findings brought to light strengths and weaknesses with regard to the utilisation of teachable moments by registered nurses, and problems faced by registered nurses with regard to clinical accompaniment in general. Recommendations to improve clinical accompaniment by registered nurses through effective utilisation of teachable moments were made. Further research was recommended to explore some problematic areas that emerged from this study. / Health Studies / M.A. (Nursing Science)