Clinical practice is an essential and integral component of nursing education. The decision-making process involved in student selection of clinical placements is influenced by a range of factors which are internal or external to students. As there was little research that explored these factors and the influence they have on student decisions, I wanted to investigate this further. A mixed-method approach was used, using a questionnaire and focus group interview, to give breadth and depth to the research. This study found that students are particularly influenced by previous positive experiences, or an interest in a particular area of practice. Their personality will also influence their placement decisions. Nurse preceptors and clinical lecturers also provide a key support role to students in the clinical environment.

Magister Curationis - MCur / Nursing students’ clinical abilities are highly dependent on the quality of the clinical experience obtained, while placed in the clinical environment. The clinical environment has key role players, which include the clinical supervisor. The primary role of the clinical supervisor is to guide nursing students to become best practice nursing professionals. However, globally, literature alludes to the failure of educating institutions to deliver competent nursing professionals, to meet the needs of patients and deliver quality patient care. Anecdotal evidence at the participating university indicated the possibility that various factors such as high student supervisor ratio and increased workload for clinical supervisors may impact on the ability of the supervisors to function effectively in the clinical settings. At the participating university, this may have been due to various factors, such as large student numbers, as well as social and environmental challenges experienced by the clinical supervisors. The aim of this study was to explore and describe the lived experiences of clinical supervisors, who supervise nursing students at a higher education institution. The study employed a qualitative research approach, utilizing a descriptive phenomenological design. Purposive sampling was used to select eight (8) participants, who were all clinical supervisors of first and second-year nursing students at the HEI (Higher Education Institution) under study. Data was collected by means of in-depth interviews and analysed, using Tesch’s method of data analysis. The five (5) major themes identified, focused on the experiences of clinical supervisors regarding: time as a constraint to job productivity; the impact of the organisational culture on the fluidity of support; limited resources; interpersonal relationships as a dynamic communication process; and impact on the self. In this study, participants focused on their experience of clinical supervision as it related to time, the organisational culture, resources and the impact of the experience on the self. The researcher based on the findings concluded that clinical supervisors are generally satisfied with their jobs and they love the teaching role that they portray. They are unhappy with the circumstances, that they experiencing as challenging in which they must do their clinical supervisor job.

This thesis defines the time impact of precepting medical students on rural general practitioners and explains how and why they commit the time to precept. To answer this question, original research was undertaken within the context of the innovative community-based medical education program, the Parallel Rural Community Curriculum (PRCC), using the parallel consulting model. Chapters One to Three detail the context of this study, appraise the existing evidence in the literature, and establish the rigour of the study design. In line with the constructivist theoretical perspective presented by the author, a case study methodology was chosen for this study. The thesis is constructed in two parts. Results from a prospective cohort study of GPs� videotaped consulting, with and without students, are described in Chapters Four and Five. No increase in consultation time or non-consulting time was found when precepting medical students. GPs� activities changed, suggesting they adapted their behaviour when students were present. An interpretive study, using a grounded theory approach, was used to explain the �how� and �why� of the research question. Interview data from GP preceptors, practice managers and students was used to construct a transferable explanatory theory as it emerged from the data. These results are presented in Chapters Six and Seven. The majority of GPs considered precepting more time consuming than consulting alone. This finding was not consistent with the videotaped data. GPs consistently experienced time pressure in their roles due to constant intrusion of competing priorities. This increased when precepting students. Frequent descision making by GPs as a response to their drive to remain on time was found to be a significant contributing factor to the changes found in consultation activities. Although many types of professional enrichment were identified by GP preceptors as adding value to precepting, the doctor-student relationship was clearly defined as the most important motivator for precepting in this study. The case study analysis explains how and why this occurred, and documents the maturation of the doctor-student repationship over time in the year long PRCC attachments. Through a grounded theory analysis of the data, four precepting consultation models emerged: student observer, teacher-healer, doctor orchestrator and doctor advisor. In Chapter Eight, the study defines these models in the context of legitimate peripheral participation of a novice member of the rural GP community of practice. The corroborative evidence from the literature suggests that these models may be applicable to other settings, particularly other community-based medical education sites.