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A pathway into the profession: The use, feasibility and outcomes of a peer learning intervention for nursing students and newly graduated nurses
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
2020 (English)Doctoral thesis, comprehensive summary (Other academic)
Description
Abstract [en]

The overall aim of present thesis was to study the use, feasibility and outcomes of a peer learning intervention for nursing students and new graduates, including studies using a quasi-experimental (Study I and III), descriptive (Study II) and mixed-methods (Study IV) design. Data were collected using questionnaires, observations, checklists for intervention fidelity, individual interviews and group interviews. When studying peer learning outcomes among nursing students, peer learning seems to have a significant interaction effect on self-efficacy, based on a comparison of changes over time between the intervention (n=42) and comparison (n=28) groups. Studying each group separately over time, significant improvements were found in the intervention group on thirteen of the twenty variables, whereas the comparison group improved on four (Study I). Observations of how nursing students (n=16) used peer learning revealed that the student pairs collaborated to different extents and in different ways. All students were observed practicing several competencies together (Study II). Testing the peer learning model in new graduates’ workplace introduction (n=10) revealed that new graduates’ descriptions of peer learning were consistent with the theoretical description (Study III). Feasibility was tested in relation to compliance and acceptability, and lessons were learned. In Study IV, fidelity to the intervention was generally good. When first-line managers (n=8) described their perception of using the peer learning intervention with new graduates, predominantly positive outcomes were expressed. When examining the effect of peer learning in workplace introduction for newly graduated nurses (n=35), it was difficult to draw any conclusions due to recruitment problems (Study IV). The conclusions is that peer learning is a useful model for nursing students’ that seems to improve self-efficacy more than traditional supervision does. The model gives nursing students opportunities to practice several competencies on each other, and these competencies, e.g., leadership and organizational skills are useful in their future profession. The students practice teaching and supervision skills on each other, which seems to be a natural part of the peer relationship. Peer learning in the context of new graduates’ workplace introduction describes in a way consistent with the theoretical description of peer learning outcomes thus, also here it seems as a useful model. When developing and testing new interventions such as peer learning, it is important to do so systematically to minimize problems when conducting an evaluation, where the MRC framework can be useful. First-line managers generally expressed a positive attitude toward the peer learning model.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2020. , p. 82
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1623
Keywords [en]
Clinical practice education, Intervention, Newly graduated nurses, Nursing students, Peer learning, Workplace introduction.
National Category
Nursing
Identifiers
URN: urn:nbn:se:uu:diva-398698ISBN: 978-91-513-0837-1 (print)OAI: oai:DiVA.org:uu-398698DiVA, id: diva2:1379255
Public defence
2020-02-18, Universitetshuset, Biskopsgatan 3, Uppsala, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2020-01-24 Created: 2019-12-16 Last updated: 2020-01-24
List of papers
1. A peer learning intervention for nursing students in clinical practice education: A quasi-experimental study
Open this publication in new window or tab >>A peer learning intervention for nursing students in clinical practice education: A quasi-experimental study
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2017 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 51, p. 81-87Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Studies of peer learning indicate that the model enables students to practice skills useful in their future profession, such as communication, cooperation, reflection and independence. However, so far most studies have used a qualitative approach and none have used a quasi-experimental design to study effects of nursing students' peer learning in clinical practice.

OBJECTIVES: To investigate the effects of peer learning in clinical practice education on nursing students' self-rated performance.

DESIGN: Quasi-experimental.

SETTING: The study was conducted during nursing students' clinical practice.

PARTICIPANTS: All undergraduate nursing students (n=87) attending their first clinical practice were approached. Seventy students out of 87 answered the questionnaires at both baseline and follow-up (42 of 46 in the intervention group and 28 of 39 in the comparison group).

METHODS: During the first two weeks of the clinical practice period, all students were supervised traditionally. Thereafter, the intervention group received peer learning the last two weeks, and the comparison group received traditional supervision. Questionnaire data were collected on nursing students' self-rated performance during the second (baseline) and last (follow-up) week of their clinical practice.

RESULTS: Self-efficacy was improved in the intervention group and a significant interaction effect was found for changes over time between the two groups. For the other self-rated variables/tests, there were no differences in changes over time between the groups. Studying each group separately, the intervention group significantly improved on thirteen of the twenty variables/tests over time and the comparison group improved on four.

CONCLUSIONS: The results indicate that peer learning is a useful method which improves nursing students' self-efficacy to a greater degree than traditional supervision does. Regarding the other self-rated performance variables, no interaction effects were found.

Keywords
Intervention, Nursing students, Clinical practice education, Peer learning, Quasi-experimental
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-314364 (URN)10.1016/j.nedt.2017.01.011 (DOI)000396957900012 ()28142097 (PubMedID)
Available from: 2017-02-01 Created: 2017-02-01 Last updated: 2019-12-16Bibliographically approved
2. FIRST-YEAR NURSING STUDENTS’ COLLABORATION USING PEER LEARNING DURING CLINICAL PRACTICE EDUCATION: AN OBSERVATIONAL STUDY
Open this publication in new window or tab >>FIRST-YEAR NURSING STUDENTS’ COLLABORATION USING PEER LEARNING DURING CLINICAL PRACTICE EDUCATION: AN OBSERVATIONAL STUDY
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(English)Manuscript (preprint) (Other academic)
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-398692 (URN)
Available from: 2019-12-09 Created: 2019-12-09 Last updated: 2019-12-16
3. A peer learning intervention targeting newly graduated nurses: A feasibility study with a descriptive design based on the Medical Research Council framework
Open this publication in new window or tab >>A peer learning intervention targeting newly graduated nurses: A feasibility study with a descriptive design based on the Medical Research Council framework
2018 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 74, no 5, p. 1127-1138Article in journal (Refereed) Published
Abstract [en]

Aims: The aim of this study was to describe the feasibility of a peer learning intervention targeting newly graduated nurses. Feasibility was tested concerning consistency of the theoretical description of peer learning with empirical findings in a new context, compliance and acceptability, as well as usability of a questionnaire measuring the intended future outcome variables.

Background: Newly graduated nurses who meet, socialize and share experiences have described supporting each other's ability to cope with stress. Peer learning involves individuals in a similar situation learning from and with each other through interaction. When implementing new interventions, feasibility studies are used to minimize problems in future evaluation studies.

Design: Quasi‐experimental design with an intervention group, followed over time using descriptive methods. The study was based on the Medical Research Council framework.

Methods: Repeated semi‐structured interviews, a checklist for fidelity and a questionnaire were conducted with 10 newly graduated nurses from January to March 2015. The intervention's main component included pairs of newly graduated nurses working the same shift and having joint responsibility for a group of patients for a period of 3 weeks. The intervention also included 3 months of regular reflection by the pair.

Findings: Using deductive analysis, the peer learning intervention was found to be consistent with the theoretical description. Due to the compliance and acceptability, there were lessons learnt. The tested questionnaire was found to be useful.

Conclusions: This peer learning intervention seems to be feasible in this context. This study will serve as the basis for a future full‐scale evaluation study.

Keywords
acceptability, compliance, feasibility, intervention, newly graduated nurses, peer learning, process evaluation
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-342752 (URN)10.1111/jan.13513 (DOI)000430121900015 ()29193242 (PubMedID)
Available from: 2018-02-23 Created: 2018-02-23 Last updated: 2019-12-16Bibliographically approved
4. A PEER LEARNING INTERVENTION IN WORKPLACE INTRODUCTION - FIRST-LINE MANAGERS’ AND NEWLY GRADUATED NURSES’ PERSPECTIVES: A MIXED-METHODS STUDY GUIDED BY THE MEDICAL RESEARCH COUNCIL FRAMEWORK.
Open this publication in new window or tab >>A PEER LEARNING INTERVENTION IN WORKPLACE INTRODUCTION - FIRST-LINE MANAGERS’ AND NEWLY GRADUATED NURSES’ PERSPECTIVES: A MIXED-METHODS STUDY GUIDED BY THE MEDICAL RESEARCH COUNCIL FRAMEWORK.
(English)Manuscript (preprint) (Other academic)
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-398695 (URN)
Available from: 2019-12-09 Created: 2019-12-09 Last updated: 2019-12-16

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