Title : Clinical immersion of senior nursing students
Abstract:
Background information: Transitioning from nursing school to practice can be challenging for senior nursing students. Traditionally nursing students experience clinical rotations in fragmented clinical shifts. They may not have the opportunity to see the whole patient’s care from admission to discharge, to practice prioritization, time management, clinical decision-making and to experience the complete role of a registered nurse. Clinical immersion or extended periods of time spent in professional clinical practice can better prepare students for practice as a professional nurse.
Purpose: The purpose of this project is to assess the effect of a structured clinical immersion experience for senior level Bachelor of Science in Nursing (BSN) students perceived competence, confidence, clinical reasoning, and preparation for practice as a professional Registered Nurse (RN).
Methods: Senior Bachelor of Science in Nursing (BSN) students (n=45) from a private university in New York were studied utilizing a quasi-experimental, one-group pretest-posttest design. The BSN students participated in a three week clinical immersion experience. The extended clinical experience was set up to provide the students with 12 hour clinical shifts for six shifts over the three-week period. The 45 students from the senior-level undergraduate program were mentored by experienced Registered Nurses (RN) at three acute-care community hospitals during their clinical rotation. Prior to, as well as after the clinical immersion experience, students completed the CASEY fink readiness for practice survey (pre-intervention and post-intervention). A set of clinical assessments were administered on a weekly basis to monitor students clinical skills throughout the clinical experience.
Findings: Senior BSN students demonstrated significant improvements (p<.001) in all readiness domains after the completion of clinical immersion. Overall readiness for practice scores increased from 39.6 prior to the clinical experience to 46.9 after the experience. Similarly, scores for clinical skills increased from 56.8 prior to the experience to 70.6 after the experience. The findings from this study demonstrated positive change in students perception of readiness for and competence in practice after participating in the clinical immersion.
Senior nursing students can benefit from a clinical immersion experience that includes participation in 12-hour shifts of practice as a registered nurse. Such an experience can aid in strengthening their clinical skills as well as their ability to prioritize, make decisions and be confident in their practice of nursing. Incorporating full-shift clinical immersion into the undergraduate nursing education may help to bridge the academic-to-practice gap found in transition of new graduates to practice in the acute-care setting
