Helen Dugmore

Aim
The aim of this study was to explore how final semester undergraduate nursing students engage with reflective practice, by comparing their preferences towards digital storytelling or written reflections.

Background
Reflective practice is an essential component of professional nursing practice. Reflection is embedded as both a learning and an assessment tool in undergraduate nursing curriculum, however it may not come easily to some students. Digital storytelling was integrated into the final semester of a Bachelor of Nursing program, as an innovative way to engage students in reflective practice.

Design
A descriptive survey design was used in this study.

Methods
An online survey was used to explore nursing student experiences using both digital storytelling and written forms of reflection. Descriptive statistics were used to analyse student preferences, and content analysis was used to analyse open ended responses.

Results
A total of 147 responses were received across two cohorts (response rate of 24 %). Preferences were mixed between the two methods. Digital Storytelling provided an opportunity for students to share their stories with their peers leading to reflective learning, whilst written reflection provided an avenue to enhance clinical confidence and identify areas for development. Both methods had challenges including the timing of reflective activities within their units, expressing and sharing emotion, and working with technology and assessment restrictions to complete reflections.

Conclusion
Students need to be introduced to different methods of reflection throughout their undergraduate studies, so they can engage in reflective practices that work for them. Nursing educators need to recognise the importance of students sharing their stories to derive meaning from their experiences and transform their learning.

Developing reflective practice in undergraduate nursing students is an important outcome of any Bachelor of Nursing (BN) program. Integrating reflection helps students: understand their values and expectations; link theory to practice; improve professional competence; and manage the stress and anxiety of transitioning to practice. Undergraduate students often engage with reflective practice at a descriptive level, and for reflection to be effective it must be purposeful and linked to practice. A Digital Storytelling Workshop was integrated into a final semester nursing unit to provide students with a creative way to reflect on their experiences and motivations across the degree.

Final Semester BN students completed an online survey (n = 117) evaluating their experience with reflection, including a depth of reflection questionnaire. Additionally, three students participated in interviews exploring their experiences with reflection across the curriculum. Findings suggest that students used reflection, and even critical reflection, to help them understand their practice. Offering alternate methods to develop reflective practice early in the BN curriculum may allow more students to engage with the reflective process and achieve a deeper level of reflection. The timing of the reflective activities in their final semester provided an opportunity for enhancing confidence prior to transition into professional practice.

Background: Interprofessional practice amongst health care professionals can facilitate effective collaboration and can improve health outcomes for patients. Interprofessional clinical placements have mainly been established within inpatient settings; however, ambulatory care settings can also provide interprofessional education. This study evaluates an interprofessional placement in ambulatory care for medical and nursing students. Methods: Medical and nursing students undertook a 2-week interprofessional placement in respiratory, diabetes and chronic pain clinics, as well as within the patient's home. An electronic post-placement survey including 14 fixed-response and five open-ended questions was conducted to evaluate the students' experiences. Results: Ninety-two students undertook the interprofessional placement: 74% were medical students and 26% were nursing students. The overall response rate was 81%. Students strongly supported the model of clinical supervision with the nurse educator and teaching registrar working collaboratively to facilitate the placement. Both medical and nursing students felt that the placement facilitated the development of interprofessional principles, with 78.7% agreeing or strongly agreeing with the statement 'the clinical placement allowed me to reflect on interprofessional learning and practice'. In terms of future practice, 67% of medical students and 81% of nursing students agreed that 'this placement has altered how [they] will practice as a professional in the future'. Interprofessional practice can facilitate effective collaboration and can improve health outcomes for patients. Discussion: Medical and nursing students found that the ambulatory care setting facilitated a mix of learning opportunities that complemented learning from the inpatient setting, and the interactions with other health professionals provided a valuable learning experience that contributed to their understanding of interprofessional practice.

Aim and objectives To examine students’ beliefs, behaviours and attitudes in relation to interprofessional socialisation, and their expectations and experience, before and after a 2‐week clinical placement in ambulatory care. Background Interprofessional clinical placements for students are important for developing an understanding of interprofessional collaboration and identity, for the benefit of patient care. Ambulatory care environment involves collaborative management of complex chronic problems. This educator supported placement that enabled final‐year nursing and medical students to work together. Design A descriptive matched before‐after study was conducted. Methods Students’ completed an online questionnaire before and after their clinical placement. The questionnaire comprised of three sections: demographic information, the Interprofessional Socialisation and Valuing Scale and open‐ended questions. Descriptive analysis and paired t‐tests were conducted for the three subscales, and thematic analysis of qualitative responses was conducted. Results Sixty‐two of the 151 students between 2011–2014 completed both surveys. There was a significant increase after placement in the overall Interprofessional Socialisation and Valuing Scale scores. The change was greater for nursing students compared with medical students, although for both groups the change was small. The majority had a good‐to‐very good experience learning each other's and their own professions and identified the nurse educator and teaching registrar as key to success. Conclusion A clinical placement in an ambulatory setting for nursing and medical students resulted in an increase in self‐perceived ability to work with others and in valuing working with others. Relevance to clinical practice Interprofessional clinical placements are essential for students to understand interprofessional practice for better patient outcomes and developing their own perspective of future work within an interprofessional team. Ambulatory care is an ideal environment for nursing and other health professional students to engage in interprofessional clinical placements.

BACKGROUND:
Residential aged care environments can provide valuable learning opportunities for health professional education. An aged care community-university partnership developed the Beyond the Teaching Nursing Home: Community Partnership of Learning and Care (BTTNH: CPLC) programme, where older adults volunteer in learning activities with health professional students. This article describes medical students' experience of participating in a clinical learning activity as part of the broader programme.

METHOD:
Fourth-year medical students (enrolled in a 6-year medical degree) on geriatric medicine rotation participated in a half-day clinical visit as part of the BTTNH: CPLC programme. Medical students participated in an interview activity with an older adult from the aged care facility. A survey was administered to evaluate medical students' experience of the structured clinical visit to a residential aged care facility. Residential aged care environments can provide valuable learning opportunities for health professional education RESULTS: Medical students valued the learning experience of interacting with older adults, observation of the residential aged care environment and learning about the needs of older adults living in residential aged care.

CONCLUSIONS:
Providing meaningful learning opportunities for medical students in residential aged care environments may contribute to a better understanding of residents, aged care environments, development of communication skills, professional role and clinical decision-making skills that are relevant for the care of older adults not only in aged care but also in other care settings.

In changing higher education environments, health profession’s educators have been increasingly challenged to prepare future health professionals to care for aging populations. This article reports on an exploratory, mixed-method research study that used an innovative photo-elicitation technique and interprofessional small-group work in the classroom to enhance the reflective learning experience of medical and nursing students. Data were collected from pre- and postquestionnaires and focus groups to explore shifts in perceptions toward older persons following the reflective learning session. The qualitative data revealed how using visual images of older persons provides a valuable learning space for reflection. Students found meaning in their own learning by creating shared storylines that challenged their perceptions of older people and themselves as future health professionals. These data support the use of visual methodologies to enhance engagement, reflection, and challenge students to explore and deepen their understanding in gerontology.

Reflection has been identified as key to interprofessional education as it facilitates a focus on interprofessional communication, collaborative practice and professional roles, while contributing to debunking ingrained understandings of roles and behaviours. The aim of this study is to explore the written reflections of nursing students following an interprofessional placement in ambulatory care. A deductive analysis of nursing student reflective journal entries mapped against the university interprofessional framework was conducted. A purposeful sample of 19 graduate entry Master of Nursing Science students participating in a two-week interprofessional educational placement completed a reflective journal relating to an interprofessional placement in ambulatory care. The analysis of the journals found that all students were able to reflect on their interprofessional clinical experience, but the ability to reflect varied between students. Despite the challenges that some nursing students experienced in achieving deep levels of reflection, the study demonstrated the usefulness of incorporating reflective journals into nursing curriculums and as part of interprofessional practicums.

The learning landscape of the higher education environment is changing, with an increased focus over the past decade on how educators might begin to cultivate reflective skills in health professions students. In addition, changing professional requirements demand that health professionals are adequately prepared to practise in today's complex healthcare systems, including responding to changing demographics of population ageing. In this educational case study, we will share how we (a group of education, medical and nursing academics) developed Depth of Field: Exploring Ageing' a digital, consumer-driven, interprofessional reflective learning resource that uses photographs, narrative and small-group work to strengthen reflective capacity in current and/or future health professionals.