NURBN3031: Critical analysis of learning and leading in clinical practice Assessment Answer

Introduction

Clinical nurse leaders have a crucial role in sustaining the cost-efficient and cost-effectiveness of nursing nurses. They have the skills to empower nurses and provide direct care and support to the patients and the nursing team. They motivate towards goal-directed behaviour through their communication and problem-solving skills. They use different sets of competencies to create a positive learning environment and promote the translation of knowledge into practice (Guibert‐Lacasa & Vázquez‐Calatayud, 2022). The essay aims to reflect on my learning as a clinical leader and teacher of others while completing the courses. The essay will provide insight into the key responsibilities of a clinical leader and the strategies that they can use to lead others in practice. The essay will review the end-of-module activities and discuss strategies to meet learning needs, learning in clinical practice and ways to lead in clinical practice. It will provide a brief understanding of the qualities and competencies needed to create a positive learning environment and lead a team. Such knowledge and awareness have implications for professional development and preparation for practice for aspiring nurses.

Meeting your Learning Needs

At the end of the module 3 activity, I was involved in discussing my learning characteristics, preferences and my preferred learning style. As a child, I started with formal and informal ways of learning. I relied on traditional systems such as lectures and tests to increase my knowledge level. During adulthood, I started learning by dealing with problematic situations. I am an active learner and I like to take initiative during the learning process. My learning style is visual and auditory indicating that I prefer both visual sources as well as audio or lecture notes to learn. Based on my learning characteristics, three of my learning needs are knowledge in teamwork, the ability to acquire knowledge through observation in daily practice and engaging in discussions to comprehend lessons.

A visual learner absorbs information by observing real-life situations and actively engaging in practical lessons. Such learners depend on visual information to acquire information and learn new things. One evidence-based strategy that is important to meet this need to strengthen observation skills. It is an essential skill that allows student nurses to move from making assumptions and critically examining patient situations. It is an important skill that can enable nurses to make better decisions in nursing practice. The study by Nanavary (2018) gave the insight that the use of visual thinking strategy is useful in developing observation skills and self-reflection. The visual learning theory uses the sense of seeing to interpret information and create meaning from that information. The study narrated that exposing students to artwork can improve their communication and observation skills. Thus, visual arts can be used as a learning tool to improve observation skills, communication skills and empathy among nursing students. It can enable actively detecting changes in patients over time and implementing interventions to reduce them.

An auditory learner learns through verbal lessons such as discussion and listening to recorded notes. One evidence-based strategy that can support learning in auditory learners is group discussion. Group discussion is an appropriate strategy for team-based learning. It facilitates gaining a deeper understanding of a topic and leads to long-term retention of information. It can allow nursing students to discuss ideas together and gain clear ideas about the concepts. Such discussion can take place with peers as well as educators. Such discussion can allow nursing students to be partners in the learning process and build consensus in a group. Such learning experiences can improve communication skills as well as the ability of the learner to cooperate with others (Roshni & Rahim, 2020). Group discussion is also an effective means to clarify doubts. In future practice as a registered nurse, group discussions can help in discussing a patient situation or any clinical procedure with the medical team. It can also help nurses to educate patients living with chronic disease conditions and provide them with self-care and self-management education. It can help in the empowerment of individuals in the community (Barros et al., 2018).

The third strategy by which I can meet my learning need is to engage in self-reflection through the use of reflective journaling. It is a strategy by which nursing students can correlate their theoretical knowledge with that clinical learning situations. It can help them to expand their clinical knowledge and engage in professional behaviours and practices. Writing reflective journals can promote contextual awareness and lead to a connection with self and theirs. It can also allow nursing students to evaluate their actions and understand ways to increase their capacity for sound clinical judgments (Mahlanze & Sibiya, 2017). The study by Matshaka (2021) further supports those self-reflection enables students to acknowledge that they may have vulnerabilities and self-reflection can help them achieve qualities to meet patient needs. It can make them an authentic practitioners in the future

Learning in Clinical Practice

In clinical practice, preceptor plays a critical role in bridging the gap between classroom and clinical practice for new graduate nurses. They play a role in creating a conducive environment for learning (Hong & Yoon, 2021). At the end of the module 8 activity, I focused on narrating about a preceptor who was good at supporting me in my learning. The three qualities that I found effective about the preceptor were excellent communication skills, supportive nature and active listening skills. She used to spend adequate time with nursing students and actively listen to their concerns regarding nursing practice. The first supportive strategy that the preceptor used was the use of active communication skills to promote positive learning for nurses. The scope of a preceptor’s role is wide and they are involved in coaching, guiding and inspiring nursing staff. They create an effective learning environment for their students through their communication strategies (Bengtsson & Carlson, 2015). The study by Hardie et al. (2022) shows that interpersonal and communication skills are important components of nursing preceptorship. They can use this skill to develop positive relationships with nursing students and provide them with constructive feedback. By using appropriate communication skills, they can critique positively and strengthen students’ self-confidence in different clinical situations.

In addition, empathy is also an important supportive strategy that the preceptor can use. Active listening skills paired with empathy can help in developing effective interpersonal relationships with preceptee and provide an effective teaching environment. Empathy is a factor that allows viewing problems from the perspective of student nurses and giving them solutions accordingly. Such a form of empathy and compassion towards the student helps in providing emotional support to new graduate nurse and create an opportunity for debriefing of students. It is a form of facilitation technique that support students to learn and work on their competence level. Preceptors use their clinical skills to guide nurses on ways to interpret patient information and reflect on their care (Hugo-Van Dyk et al., 2022).

In the clinical scenario, the preceptor was committed to providing support to resolve the issues of the student. They can do this through the use of effective teaching and learning strategies. They evoke the interest of nursing students by putting forward a clinical situation and encouraging them to use their clinical judgment to decide the best course of action. However, evidence shows that many preceptors struggle to fully support their students. Such preceptors have expressed the need to gain knowledge about adult learning principles to understand the capabilities of each student and support them accordingly. The use of such principles can enhance the teaching strategies of preceptors (Bengtsson & Carlson, 2015). Apart from teaching strategies, the preceptor’s attitudes have a huge impact on the learning of nursing students. For instance, Phuma-Ngaiyaye, Bvumbwe and Chipeta (2017) gave the argument that preceptors who are friendly and receptive have more followers. Nursing students feel free to approach such mentors and an active learning environment is created. This strategy can support in easy orientation to the ward environment and create appropriate learning opportunities for students. A trained preceptor has a positive attitude towards students compared to a non-trained preceptor. Trained preceptors encourage students to identify their learning needs and give guidance on ways to address those needs. Thus, apart from teaching and communication skills, effective preceptor attitude or behaviour can have a significant impact on the clinical learning environment for students. It gives the implication to clinical managers actively implementing preceptorship programs in the ward.

Leading in Clinical Practice

If I am given the responsibility to use team nursing to lead a team, then I will have to use a team-based approach to ensure that I can delegate work effectively and provide high-quality care to patients. The concept of team nursing is the provision of providing health services to individuals and family members by working collaboratively with patients and the multi-professional team to accomplish shared goals. The team nursing model is based on the philosophy that a group of professional and non-professional healthcare professionals work together to identify, plan and implement client-centred care. The pre-requisite of leading such a team is extensive team communication practices. I will use communication skills to encourage my team members to perform and promote continuity of care. The most important points of communication at the beginning would be to share the vision of the organization with the team, then engage in clarification of roles and responsibilities and establish different communication channels for interaction between the team. Good communication can foster teamwork and help in preventing errors (Foronda, MacWilliams & McArthur, 2016). The study by Arnold and Boggs (2019) revealed that through effective communication styles, leaders can motivate team members to perform and establish a culture of safety.

The second strategy that I will use to promote quality care is to engage in effective delegation. Delegating is a complex decision-making process where nurses utilize leadership and change management skills to delegate tasks and ensure that activities are effectively executed. I will do this by following the five rights to delegation namely the right task, right person, right circumstances and right communication. Through this approach, it can be possible to understand the key activities in the settings and allocate tasks as per the expertise of team members (Crevacore et al., 2023). According to Beckett et al. (2021), delegation is a concept that is synonymous with team nursing. To prepare the team for a team nursing model of care, focusing on delegation is important. Using the five rights of delegation, nurses may delegate tasks based on the education, experience and skills of the team members. Improvement in delegation can be associated with the prevention of adverse events, decreasing fall risk and improving patient satisfaction with care (Wagner, 2018). Thus, with effective transfer of responsibilities between the team, delegation can ensure development team cohesion.

The third strategy to achieve the goal of team nursing and provide high-quality care is to arrange daily team huddles. Huddles are short debrief sessions with the multi-professional team that can be arranged daily to share problems and identify solutions. The advantage of such team meeting is that they can ensure that each members= stay informed, review events and develop a plan for well-coordinated patient care. The implementation of huddles in clinical settings is associated with improvement in medical safety, problem identification, situational awareness and teamwork. It fosters collaboration between different departments (Aase, Tjoflåt & Hjorthaug Urstad, 2021). The study by Lin et al. (2022) shows that daily huddles can maximise the process needed to reduce clinical mistakes and near misses in nursing care. It can facilitate the development of a safety culture and achieve the goal of high-quality care. Moreover, daily huddle has been found to contribute to knowledge creation and quality of care. This is possible because discussions on managing patient load or complexities help in identifying solutions to address special needs and improve the provision of preventive services. For this reason, the huddle is a part of nursing education as it is an important learning tool. It will allow nursing students to understand the importance of interacting and speaking up during team meetings (Aase, Tjoflåt & Hjorthaug Urstad, 2021).

The fourth and most important strategy in team nursing is the use of an effective leadership style. It is a critical factor that creates the pathway for high-quality care. I plan to use a transformational leadership style to motivate my team members to deliver high-quality care. The study by Stanfou et al. (2017) gives the argument that there are many identified leadership styles in healthcare settings. The transformational leadership style is linked with developing relationships and improving the motivation level of staff members. Such leaders can use their communication skills to inspire confidence among staff and communicate loyalty through a shared vision. This approach results in better cooperation from staff members, an increase in team morale and job satisfaction levels. The task-oriented leadership style is also suitable for leading a team as it allows for planning work activities, clarifying roles and setting work objectives. Effective leaders can direct nursing practice to its highest level by supporting evidence-based practice. Based on the work environment, nurse leaders can modify their leadership styles. When creating a new team, building team motivation is the most important task for leaders. In such cases, the transformational leadership style has a strong positive influence on the motivation level and patient safety outcomes of staff (Smama’h et al., 2023).

Conclusion

The essay provided a summary of my learning journey and my understanding of the course lessons related to clinical leadership in nursing. As a student nurse, each individual has a different style of learning and different learning needs. In the essay, I discuss my learning style and characteristics. By completing the end of the module 3 activity, I identified three learning needs for myself which were observation skills, group discussion and self-reflection. All these are evidence-based practices that can allow nursing students to actively engage in the process of learning and interlink theoretical lessons with that of real-world practice. The strategies discussed can be useful during the transition to registered nurse practice in the future. In addition, the impact of positive preceptorship was explored and three supportive strategies were discussed which could lead to positive learning in the clinical practice context. These strategies included active communication skills, empathy and providing support through effective teaching strategies. Lastly, the four strategies were discussed that could help in leading a team. It included effective communication skills, delegation, team huddles and an effective leadership style. 

References

Aase, I., Tjoflåt, I., & Hjorthaug Urstad, K. (2021). Using the ‘huddle’to enhance interprofessional teamwork among nursing students through a podcast: a qualitative and exploratory pilot study. BMC nursing , 20 , 1-8.

Arnold, E. C., & Boggs, K. U. (2019). Interpersonal relationships e-book: professional communication skills for nurses . Elsevier Health Sciences.

Barros, L. M., Brandão, M. G. S. A., Barbosa, A. D. O., Nascimento, L. A. D., Ximenes, L. B., & Caetano, J. Á. (2018). Use of group discussion as an educational strategy during nursing appointments for patient undergoing bariatric surgery.

Beckett, C. D., Zadvinskis, I. M., Dean, J., Iseler, J., Powell, J. M., & Buck‐Maxwell, B. (2021). An integrative review of team nursing and delegation: Implications for nurse staffing during COVID‐19. Worldviews on Evidence‐Based Nursing , 18 (4), 251-260.

Bengtsson, M., & Carlson, E. (2015). Knowledge and skills needed to improve as preceptor: development of a continuous professional development course–a qualitative study part I. BMC nursing , 14 (1), 1-7.

Crevacore, C., Jacob, E., Coventry, L. L., & Duffield, C. (2023). Integrative review: Factors impacting effective delegation practices by registered nurses to assistants in nursing. Journal of Advanced Nursing , 79 (3), 885-895.

Foronda, C., MacWilliams, B., & McArthur, E. (2016). Interprofessional communication in healthcare: An integrative review. Nurse education in practice , 19 , 36-40.

Guibert‐Lacasa, C., & Vázquez‐Calatayud, M. (2022). Nurses' clinical leadership in the hospital setting: A systematic review. Journal of Nursing Management , 30 (4), 913-925.

Hardie, P., Darley, A., Langan, L., Lafferty, A., Jarvis, S., & Redmond, C. (2022). Interpersonal and Communication Skills Development in General Nursing Preceptorship Education and Training Programmes: A Scoping Review. Nurse Education in Practice , 103482.

Hong, K. J., & Yoon, H. J. (2021). Effect of nurses’ preceptorship experience in educating new graduate nurses and preceptor training courses on clinical teaching behavior. International Journal of Environmental Research and Public Health , 18 (3), 975.

Hugo-Van Dyk, L., Nyoni, C. N., Williams, M., & Botha, B. S. (2022). Preceptor support during the COVID-19 pandemic: Recommendations for continuing development. curationis , 45 (1), 2370.

Lin, S. P., Chang, C. W., Wu, C. Y., Chin, C. S., Lin, C. H., Shiu, S. I., ... & Chen, H. H. (2022). The Effectiveness of Multidisciplinary Team Huddles in Healthcare Hospital-Based Setting. Journal of Multidisciplinary Healthcare , 2241-2247.

Mahlanze, H. T., & Sibiya, M. N. (2017). Perceptions of student nurses on the writing of reflective journals as a means for personal, professional and clinical learning development. Health SA Gesondheid , 22 , 79-86.

Matshaka, L. (2021). Self-reflection: A tool to enhance student nurses’ authenticity in caring in a clinical setting in South Africa. International Journal of Africa Nursing Sciences , 15 , 100324.

Nanavaty, J. (2018). Using visual thinking strategies with nursing students to enhance nursing assessment skills: A qualitative design. Nurse Education Today , 62 , 39-42.

Phuma-Ngaiyaye, E., Bvumbwe, T., & Chipeta, M. C. (2017). Using preceptors to improve nursing students' clinical learning outcomes: a Malawian students' perspective. International journal of nursing sciences , 4 (2), 164-168.

Roshni, M., & Rahim, A. (2020). Small group discussions as an effective teaching-learning methodology for learning the principles of family medicine among 2nd-year MBBS students. Journal of Family Medicine and Primary Care , 9 (5), 2248.

Sfantou, D. F., Laliotis, A., Patelarou, A. E., Sifaki-Pistolla, D., Matalliotakis, M., & Patelarou, E. (2017, October). Importance of leadership style towards quality of care measures in healthcare settings: a systematic review. In Healthcare (Vol. 5, No. 4, p. 73). MDPI.

Smama’h, Y., Eshah, N. F., Al-Oweidat, I. A., Rayan, A., & Nashwan, A. J. (2023). The Impact of Leadership Styles of Nurse Managers on Nurses’ Motivation and Turnover Intention Among Jordanian Nurses. Journal of Healthcare Leadership , 19-29.

Wagner, E. A. (2018). Improving patient care outcomes through better delegation-communication between nurses and assistive personnel. Journal of Nursing Care Quality , 33 (2), 187-193.

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