This research has focused on a detailed exploration of undergraduate nursing students' development for registration and their future employability potential. There has been a particular emphasis on probing whether there is value in being a nursing graduate, within this. In the study employability refers to graduating students' preparedness to contribute to their immediate and longer term working lives, using the combination of operational and academic competence, self-efficacy and potential for further development through reflection and lifelong learning. A review of literature has revealed that there is a general paucity of any type of related published research from the within the UK and elsewhere, especially qualitatively-based research. In particular, no research could be found which has explored in-depth, as its primary aim, what nursing graduateness constitutes at the point of graduation and registration as a nurse and, whether it contributes to the employability potential of graduate nurses for both basic and advanced practice. A qualitative, instrumental case study was applied as the research design to achieve depth of focus for this inquiry, in order to meet the aims of the research. Findings from the study have uncovered a wide range of graduate attributes which were identified within participating students' development and perceived employability potential. From this a model of nursing graduateness has been proposed. Findings also indicated that changing healthcare needs within society coupled with the recent reforms in healthcare, NHS policy and the nursing role have placed greater emphasis than ever before on such graduate attributes within nursing as higher order thinking for effective nursing practice. Recommendations have been put forward for nursing education practice and research.

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The preparation of newly qualified nurses has raised many professional debates and yet the ‘end product’ of nurse education, the qualified nurse continues to demonstrate knowledge and skill deficits in areas considered essential to patient care. Technological advances in an ever-changing and complex clinical environment mean that certain acute clinical skills have become routine for the qualified nurse and yet few educational institutions and NHS Trusts in the UK have seen the need to address this within the pre-registration nursing curricula. This study, questions whether the pre-registration nursing curricula is failing newly qualified nurses by not adequately preparing them to cope with the complexities of practical skills within the clinical environment. This skill deficit is rectified on qualifying when nurses rapidly equip themselves with skills that are considered essential for practice. Using a constructivist paradigm and a mixed methods research approach, the opinion of key stakeholders in pre-registration nurse education was sought. Focus groups and surveys were conducted with skills teachers to ascertain essential skills. Constructive alignment theory (Biggs 1999) was tested with two student cohorts from a pre-registration nursing programme (n=58). Comparisons were made between an experimental group who acquired certain skills during their pre-registration programme and a control group who had not acquired those additional skills. The programme was evaluated using Stake’s (1967) countenance model of evaluation. Data were analysed using SPSS, constant comparative analysis and triangulation. The findings confirmed that nurses should acquire the skills investigated in this study, but differences of opinion were found as to when this was acceptable. Favourable results for the experimental group were demonstrated indicating the need to provide nurses with the additional skills prior to qualifying. The study also identified other like-minded UK nurse educators who had been innovative with their skills’ curricula. Nursing curricula can be successfully underpinned by an educational theory such as constructive alignment providing added value to the learner and enablingnurses to enter the profession fit for practice and purpose. To further enhance the quality and standard of provision, the following are recommended: strengthening the collaborative relationships between the key stakeholders for nurse education, as well as promoting interprofessional learning and skills development. This will help improve the international credibility for the UK skills curricula.

Background: Following the MPharm degree, the pre-registration training year is a critical time where the values, attitudes and behaviours of qualified pharmacists are inculcated. Given the paucity of research, a programme of work was undertaken to explore the process of professional socialisation and development of professionalism in trainees during the pre-registration year. Method: The programme of work, the first of its kind in pharmacy, explored the process of professional socialisation and development of professionalism in trainees prospectively during the 2011/12 pre-registration year. A purposive sample of 20 pre-registration trainee-tutor pairs - 14 from community and 6 from hospital pharmacy – were recruited across North West England. Semi-structured interviews and behavioural professionalism questionnaires were used longitudinally in four rounds of data collection during the training year and with newly qualified pharmacists (NQPs; formerly trainees). A cross-sectional survey was administered to 1706 trainees towards the end of the training year to examine areas explored in the longitudinal study, including behavioural professionalism, supervision and ‘patient mattering’. Interviews were analysed thematically using template and framework analyses, and the critical incident technique. Quantitative data was analysed using descriptive and multivariate analyses. Results: Findings demonstrated that many of trainees’ attitudes and values appeared to be fostered during their upbringing and were further shaped by the MPharm degree, laying out professional expectations for pharmacists. At the beginning of training, sector differences were apparent with more formalised inductions in place in hospital than community pharmacies, particularly independents. Previous pharmacy work experience, which all 20 trainees had undertaken during MPharm studies, facilitated the transition into training. Early on in the year, as trainees familiarised themselves with the organisation and working processes they were often supported by pharmacy technicians and other support staff and trainees worked effectively and in a professional manner with them throughout training. The application of clinical knowledge acquired from the MPharm degree was challenging, as recognised by trainees and tutors. With continued practice experience and increased responsibility and patient contact, abilities in applying clinical knowledge and communicating with patients improved, as did trainees’ confidence. Longitudinal ratings of behavioural professionalism increased significantly during training, as assessed by trainees and their tutors, and this was confirmed in the analysis of a representative sample of 347 trainees that were surveyed (response rate = 24.2%). Survey findings showed how elements of behavioural professionalism such as communication skills were more prone to development compared to, for example, appearance and interpersonal skills. Perceptions of supervision received during the training year were generally positive. The pre-registration tutor was a key source of support, as well as role model, throughout the year, particularly in community pharmacy. Hospital tutors had a more distant relationship with their trainees and relied on other pharmacists to supervise their trainees. Tutors were often considered to have the largest impact on the development of professionalism in trainees, particularly in community. When considering aspects of their supervision, hospital trainees rated their tutors significantly higher than those in community in ‘articulation’ and ‘exploration’, relating to asking trainees for rationale of actions and encouraging them to pursue learning goals, respectively. Differences between training sites, such as the pharmacy services being delivered and patient mix, were found as were trainees’ beliefs that they mattered to patients: community trainees believed they mattered more (e.g. were more helpful) to their patients than hospital trainees. Conclusions: The multiple methods employed in this programme of work revealed experiences trainees faced and contributing factors associated with their professional socialisation and development of professionalism. The findings led to recommendations for pharmacy education and training including: integrating university-based and work-based learning more closely, ensuring consistency in training experiences in different settings and sectors, improving training and support for staff involved in training and setting explicit standards relating to elements of professionalism. These are considered in the context of anticipated changes to the MPharm into a more integrated 5-year degree programme.

In 2007 the Nursing and Midwifery Council (NMC) endorsed the use of simulation to replace up to three hundred hours of practice learning in the pre-registration nursing programme (NMC, 2007a). This decision was the impetus for this study as it raised questions regarding whether simulation could replace practice and whether simulated learning transferred to the practice setting. For the first time, the NMC proposal to replace practice hours with simulation has been critically analysed and the implications of this decision explored. A literature review demonstrated a lack of robust evidence to support the use of simulation in this way. This informed the development of this study’s research question and aims. A qualitative collective case study was chosen as the optimum research design to facilitate in-depth exploration of the use of simulation at a selected university in the North West of England. The in-depth qualitative case study incorporated multiple models of simulation, student cohorts, nurse educators and key informants which provided the most comprehensive analysis of viewpoints in any published research in the UK to date. Deeper understanding of the case arose from the use of multiple data collection methods: documentary analysis, participant observation and interviews which enabled findings to be triangulated and corroborated. Most importantly, because the simulation models used were comparable to those used by other education providers in the UK; there is a possibility of the transferability of findings which could be used to inform the development of simulation in the under-graduate nursing curriculum. This thesis develops an argument that there were three key assumptions made by the NMC when they endorsed the replacement of practice hours with simulation. The first is that there is a shared understanding in nursing regarding what simulation is. Secondly; that simulation is delivered in a ‘safe environment’ and finally that competence demonstrated in simulation transfers seamlessly to practice. This thesis has presented new knowledge and developed an argument for caution regarding the use of simulation in pre-registration nurse education. These findings challenge the assumptions made by the NMC and highlight issues for further consideration and exploration namely: the ambiguity regarding the concept of simulation, student safety during simulation, student perceptions of authenticity and finally the transfer of simulated learning to practice.

Thesis (MCur (Interdisciplinary Health Sciences. Nursing Science))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: A nurse has to develop certain concepts, attitudes, knowledge and skills in nursing. For the purpose of this study the researcher explored a private nursing school in the Southern Cape with the focus on their personal-professional developmental (PPD) programme. The researcher explored the feasibility of this programme by describing the pre-registration nurses’ perceptions on the value and contribution of the programme to their personal and professional development. In particular, the exploration addressed the nurses from a multicultural setting who found it difficult to adapt to the nursing norms, values or working culture. This was done in order to make a difference in the nature of the above-mentioned programme so that it would suit the nurses from different cultures and also set up a programme which will ensure quality nursepatient care through enhanced communication skills, empathy and critical thinking abilities. The objectives set for this study were to explore the perceptions of pre-registration nurses from a multicultural setting who were involved in this programme in order to determine whether the PPD programme contributed to their life enrichment and level of knowledge and to explore the perceptions of the professional nurses supervising the pre-registration nurses with regard to additional knowledge, skills and attitudes gained after the completion of the PPD programme. A quantitative research approach with a smaller qualitative component and a descriptive design was selected. The population for this study comprised all the pre-registration nurses of the abovementioned school (N=120) and all the professional nurses who worked closely with the preregistration nurses (N=27). A structured questionnaire and semi-structured interviews were used to collect the data. The sample of pre-registration nurses who took part included the entire population (n=120). The non-probability purposive sampling of the professional nurses who took part in this study comprised 14 participants. Reliability and validity were assured by means of a pre-test of the questionnaire and the use of experts in nursing education, research methodology and statistics. Data were collected personally by the researcher. Ethical approval was obtained from Stellenbosch University and the head of the particular private hospital. Informed written consent was obtained from the participants. It seemed that the multicultural pre-registration nurses felt the PPD programme was effective and contributed to the skills they needed to be passionate and knowledgeable nurses. On completion of the study key recommendations were made regarding the improvement of communication between pre-registration nurses and management at ward level, the implementation of a structured programme with measurable, accessible outcomes, and the provision of classes in computer literacy as well as basic research skills. / AFRIKAANSE OPSOMMING: ʼn Verpleegster moet sekere konsepte, houdings, kennis en vaardighede in die verpleegkultuur ontwikkel. Vir die doel van die studie het die navorser ’n privaat verpleegskool in die Suid-Kaap ondersoek wat hul toespits op ’n unieke persoonlike professionele ontwikkelingsprogram (PPO). Die lewensvatbaarheid van hierdie program, asook die vlak van kennis wat die voorgraadse verpleegsters bereik het en ná voltooiing van die program op pasiënte toepas, is deur die navorser ondersoek. Hierdie program het ten doel om voorgraadse verpleegsters bevoeg te verklaar t.o.v. lewensverryking betreffende kommunikasievaardighede, empatie en kritiese denke. Die doel van die studie was om die persepsies van multikulturele voorgraadse verpleegsters ten opsigte van die genoemde program vas te stel ten einde te bepaal of hierdie program wel bygedra het tot hul lewensverryking en vlak van kennis. Persepsies van professionele verpleegkundiges onder wie se toesig hierdie genoemde verpleegsters werksaam was, is ondersoek om vas te stel of voorgraadse verpleegsters addisionele kennis, vaardighede, empatie en kritiese denke met behulp van die program bekom het. ’n Kwantitatiewe studie met ʼn kleiner kwalitatiewe komponent en ʼn beskrywende ontwerp is gekies. Die populasie het bestaan uit al die voorgraadse verpleegsters van die genoemde skool (N=120) en al die professionele verpleegkundiges wat betrokke is by bogenoemde verpleegsters (N=27). ’n Gestruktureerde vraelys en semi-gestruktureerde onderhoude is gebruik om data in te samel. Die totale populasie verpleegsters is ingesluit in die studie (n=120). ’n Nie-waarskynlikheids- doelgerigte steekproef van professionele verpleegkundiges wat deelgeneem het was 14. Geldigheid en betroubaarheid is verseker deur die uitvoer van ʼn vooraf toetsing van die vraelys, asook deur kenners in verpleegonderrig, navorsingsmetodologie en statistiek te konsulteer. Data is persoonlik deur die navorser ingesamel. Etiese goedkeuring is van die Universiteit Stellenbosch en die hoof van die spesifieke privaat hospitaal verkry. Geskrewe ingeligte toestemming is van al die deelnemers verkry. Dit wil voorkom asof die voorgraadse verpleegsters in die multikulturele werksomgewing van mening was dat die PPO-program effektief bygedra het tot hul passie vir verpleging en hulle verryk het met kennis. Ná afloop van die studie is die hoof-aanbevelings gedoen ten opsigte van verbeterde kommunikasievaardighede tussen voorgraadse verpleegsters en bestuur op grondvlak, die instelling van ’n gestruktureerde program met meetbare, bereikbare uitkomste, asook die aanbieding van rekenaarklasse en basiese navorsingsklasse.

Occupational Therapy is a client centred, holistic allied health profession in which the quality of a supportive, empowering therapist-client relationship is seen as having a key and central role in effective therapy. A minimum of a 1000 hours of practice placement education (PPE) must be successfully completed in pre-registration programmes, which are charged with ensuring graduates are fit for practice and purpose. This Work Based Project focussed on how pre-registration education can best equip students for a first PPE in terms of sufficient inter-personal communication skills. Primary data collection was conducted between November 2008 and March 2010. The project firstly employed thematic content analysis of data elicited from two rounds of focus group surveys of practice placement educators (PPEds) to identify a baseline of inter-personal communication skills required prior to embarking on a first PPE. This data was used to formulate an objective structured clinical examination (OSCE) checklist of inter-personal communication skills, which was then utilised as a formative assessment and in role play scenarios in taught sessions with one first year pre-registration occupational therapy cohort. This cohort was surveyed via a questionnaire and in addition five students were interviewed. Subsequently a group of third year students, who role played clients for the OSCE, participated in a facilitated discussion on their perceptions of the OSCE. The data on students’ perceptions and an analysis and comparison of staff and student ratings of performance in the formative OSCE, were utilised in a critical evaluation of the use of this OSCE as a teaching and assessment tool. The findings indicate a level of agreement on the content of the OSCE checklist, providing content validity to this particular assessment. PPEds, and first and third year students are positive about the use of an OSCE when it is used as a formative experience. Students recommend that if used as a summative assessment the OSCE is combined with a reflective piece. Objective structured clinical examinations have long been established in other health care professions such as medicine and nursing. This project has provided evidence indicating that an OSCE of inter-personal communication skills is a valid assessment tool for occupational therapy pre-registration students, and that it can also facilitate student reflection, self-awareness and learning. It has also identified profession specific inter-personal communication skills required for embarking on a first PPE.

This thesis examines the perceptions and experiences of pre-registration nursing students with dyslexia in one university in relation to one specific assessment: the Objective Structured Clinical Examination (OSCE). In September 2013, all United Kingdom pre-registration nursing training moved to degree level university programmes. Universities must also ensure that all nursing students meet the fitness to practise criteria laid down by the Nursing and Midwifery Council (NMC, 2015). Current national higher education policy aims to widen participation; this includes those with disabilities. Statistics show that 10% of students attending university in England have a declared disability, the main one being dyslexia. The study university has its own widening participation policy, with 19% of its children’s nursing students currently registered as having dyslexia. The Nursing and Midwifery Council (2010) states that all pre-registration nursing programmes should contain a variety of assessment strategies, to ensure students meet the academic and clinical standards required by the professional nursing and midwifery register. One of the final assessments at the study university, as with many other medical and nursing degrees, is the Objective Structured Clinical Examination, a method of assessment that requires students to perform clinical assessments and answer questions within standardised conditions, within a set time limit. This study aims to explore the ways in which nursing students with dyslexia perceive and experience the OSCE as an assessment method, and to draw conclusions on ways to develop it further. Using a two-phase mixed methods approach, a purposive sample of 24 nursing students in year 3 of their course, was approached to participate in an online questionnaire, with 12 responding. Six students participated further in object elicitation interviews, which were analysed using a ‘Framework’ method. The findings highlight the unique OSCE journeys of study participants, the impact of dyslexia on the individual and the OSCE assessment process. The thesis offers discussion and recommendations around the OSCE as an ‘inclusive’ teaching and assessment method, considering how the design of curricula and assessments assists in recognising students’ individualism and in reducing potential issues. It is the first study to consider the OSCE with regard to such students and offers an opening for future studies focussing on learning difficulties and OSCE assessments within nursing.

The purpose of this thesis is to examine the problem of gazumping, to consider the various factors which give rise to it, to examine the adequacy of existing legal doctrine in redressing it, to explore statutory provisions designed to reduce gazumping and to propose reform of the law to address the problem. The term gazumping refers to a practice by which a vendor accepts a purchaser's offer to purchase land or property, and before exchanging contracts, withdraws from the existing agreement in order to accept a higher price from another purchaser. This thesis proceeds on the assumption that gazumping is an undesirable practice, particularly from the prospective purchaser' perspective. The practice of gazumping initially boomed in a volatile property market with constantly rising house prices and where demand exceeded supply. A purchaser who believes he or she has secured the purchase of his or her desired property may suffer emotional stress and significant costs which cannot be recovered when the vendor reneges on his or her agreement. The thesis notes that gazumping occurs at the pre-contractual stage in the sale of property because there is no legally binding relationship before the formal exchange of contracts. The thesis posits that the existing law in various Australian jurisdictions offers inadequate protection to prospective purchasers of property. The thesis examines the inadequacy of existing legal doctrines and remedies in addressing the problem of gazumping at the pre-contractual stage and arrives at the conclusion that existing legal doctrine is inadequate. The thesis notes legislative and other measures in response to gazumping in Australia and other common law jurisdictions and concludes that these too were inadequate in not going far enough to eliminate or reduce gazumping. The competing merits of these approaches are considered. The thesis establishes that the solution to gazumping lies in an early protection of the purchaser�s interest in land. This is because as soon as an agreement is enforceable the purchaser acquires an equitable interest and in the event of any breach of the agreement by the vendor, the purchaser, as a general rule, can obtain either damages or specific performance. The thesis raises seven key recommendations for law reform aimed to minimise the occurrence of gazumping and to provide the purchaser with tools against the practice of gazumping. It considers that the recommendations can minimise the undesirable practice of gazumping where the current law is inadequate and also achieve several other objectives.

No / This study explores the impact of the process of socialisation on pre-registration student nurses views about care, and their personal ability to cope with becoming a nurse. Objectives: It aims to identify the effect time has on participants attitudes and views of care and becoming a nurse, during pre-registration nurse training, by using a descriptive longitudinal qualitative design. Setting: Data collection took place within the School of Health or on student's clinical placement areas, using a random sample of 16 pre-registration student nurses obtained from a convenience sample of 52 volunteers. Methods: Participants were involved in two semi-structured in depth interviews, the first 6-9 months after entering nurse training and the second 6-9 months prior to completion. Interviews were tape recorded, transcribed verbatim and analysed using Morse and Field's (1996) four stages of analysis. Results: Identified changes between data collection stages suggest socialisation results in a loss of idealism about care within nursing, as well as the identification of negative aspects of care. Loss of care is linked to increased abilities to cope with the nursing role, although this is not uniform and some participants clearly discriminate and reject negative exposures. In conclusion this study identifies an under recognised dichotomy between the caring ethos of professional nursing and the professional socialisation processes student nurses are subject to, which directly mitigate against the individual nurses abilities to care.