Exploring the Decision-Making Process Behind the Loss of a Clinical Placement: Second-Year Nursing Students in the Special Care Nursery
Notice bibliographique
Résumé
The purpose of this study was to explore how a Special Care Nursery (SCN) in a southern Ontario hospital decided to stop taking second-year nursing students for clinical placement. A qualitative intrinsic case study approach was utilized to guide and analyze twelve participant interviews. Participants were recruited using both purposeful and snowball sampling. Sharan Merriam (1998) was utilized as a theorist for the methodology and framework of this case study. Additionally, Leah Curtin’s (2014) six-questions for ethical decision-making in nursing management were used to develop the semi-structured interview guide. An overarching theme of Conflicting Messages was found, with three subsequent themes of 1) Contributing Factors, 2) Level that Decisions Happen, and 3) Outcomes of Decision-Making. Findings of this study indicated that the decision to cease placements in the SCN was likely made due to a culmination of factors, but a defined cause and process for decision-making was not found. Factors that were identified by participants as being influential in the loss of this placement included clinical instructors not supporting students, high unit acuity, negative attitudes towards students, uncertainty with the student scope of practice, nurse burnout, and systems issues. There was uncertainty surrounding who was involved in making this decision, which was attributed by participants to a lack of communication and collegiality between frontline staff and those in management positions. This led to unilateral decision-making, and a lack of departmental cohesion. Additionally, preferential placement opportunities were found to be offered to medical learners over nursing students. Implications were identified as wide reaching, including unit recruitment concerns, lack of exposure to the specialty of neonatal nursing, and the inability of nurses to fulfill their professional obligations of knowledge sharing. Ultimately, it was identified that the use of Curtin’s (2014) decision-making model alone lacked a formal process to guide how decisions in nursing management should be made, although it raises context specific questions that aid in understanding an issue at hand. The development of a comprehensive model for decision-making in nursing leadership would be beneficial to provide structure for how important choices are made in healthcare and improve transparency in decision-making.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,016 | 0,022 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,011 | 0,010 |
| Communication savante | 0,011 | 0,005 |
| Science ouverte | 0,003 | 0,006 |
| Intégrité de la recherche | 0,003 | 0,006 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».