from my experience with the hospitals as patient or co. patient, the following may be part of the challenges facing trainee nurses 

confidence

complying with  PPE

complying with The specific hospital protocols

awareness of the system i.e. admission, post-operation etc.  

Hi,

I think to have the direct supervision from expert clinical instructor to give the students the confidence in their training is very important. Assuming students have been trained in labs and get the theoretical introduction for what they may experience in the hospital.

I agree with  you that  the supervision is a key for confidence gaining  specially in training practice  

Having the ability to work with a group of professionals that are willing to take the time with students and engage them is key.  As a clinical supervisor, my students have had some great experiences and the staff are encouraged by their leadership to be friendly and become an extended educator to the students while they are there.  

Students make such comments as "staff were friendly and really wanted to help me to learn which made it a great learning environment".  

Hi Olajide,

There are several areas that challenge nursing students. One that I see in my practice is the correlation from theory to the clinical setting. Patient simulation can help to bridge this gap, but there's nothing that takes the place of 'on the job' training. High instructor-student ratio is an aspect that adversely affects student clinical experiences by decreasing learning opportunities and delaying clinical competence and student confidence. In most scenarios, clinical site employees are helpful, but workload and willingness to take time to assist and mentor students can be barriers to student learning. 

Student need a clinical mentor who inducts them into the clinical community of practice*. Student have a much better (happier, confidence enhancing, and learning enabled) clinical learning experience if they are welcomed, liked and treated with respect.  The clinical mentor who engages with the student and points them to and supports them in their learning is a key figure (sadly this does not always happen) . The university also must have systems, such as academic staff being available to give support to both student and mentors, that acknowledges the  three way partnership in student learning.

* Wenger, E. (1998) Communities of Practice:Learning, Meaning , and Identity.Cambridge. Cambridge University Press 

thank you Mr. Griffiths the point of three way partnership in student learning is an excellent consent for technical training   

Thank you all for the useful response. You have all made a valuable contribution to the discussion. I have taken note of the issues surrounding confidence, workload, time factor and so on.

I was also thinking about the potential impact of using a mobile application to coordinate the interactions between the clinical practitioners and the nursing trainees. I have also been toying with extending this to peer support from a particular trainee or fellow trainees to another if they require further information on any area of interest or help with care planning.

This, in my opinion, will also expose the quality of support being extended to the trainee since the platform will serve the purpose of capturing the feedback given and support structure that cuts across different clinical settings.

Is this really viable? What are the potential impacts from the trainees perspective, institution and from the clinical settings.

The accompaniment is important. Having trained nurses humanized and comprehensive student needs, facilitates personal growth. The experience is also required. I believe that should be the teaching-learning relationship with strengthening values.

I believe there are a number of challenges that nursing students face when on clinical placement. The first, which is perhaps the most challenging,is finding suitable clinical placements and meeting the demand for clinical placement is always a challenge. Secondly, the fact that despite most universities having a working partnership with industry service providers, the practicalities or perhaps reality of this 'working relationship' is that it can be quite limited. Universities may secure facilitators or mentors to 'facilitate' a students clinical placement experience, but this does not mean that this will be the person who actually works with the student while on clinical placement. It is more usual that the student will be placed with whoever is restored on duty that day on the ward so there are no guarantees, or ways of knowing just how experienced or good of a ‘mentor’ this person will be. In my experience most mentors in this scenario have little to no training in how to be a student nurse mentor/trainer, 2. have limited time, inclination and/ or belief that they have a professional responsibility to teach or be involved in training students through mentor-ship and finally; 3. are given limited consideration with respect to their workload responsibilities whilst on working with the student to allow spend time for teaching/mentoring/ demonstrating or discussing to unpack the clinical experiences for the student. This is perhaps one of the primary complaints/comment that I receive from students coming back to university from having had a clinical placement.

The designated facilitator may have several groups of students and essentially their role is reduced to a managerial role in terms of overseeing and coordinating the students placement for example, rosters, dealing with missed clinical days and ensure the student is budded up with someone on respective shifts. This by nature means, its the luck of the draw who the student is working with and likewise the luck of the draw with respect to the quality of that 'budding and teaching experience. If the student is unlucky enough to get someone who simply does not like the idea of having a student and was expected/forced to take them - mostly this does not end good for the student and this almost always is reflected back onto the student-  the issue was with them never the ‘mentor’ nursing staff on the ward or the context or environment which my have posed specific challenges. These are the sorts of challenges that seem to remain a challenge for ‘nursing trainees’ or student nurses while on clinical placement. . I honestly believe, that is we are serious about ensuring quality clinical experience and training for our students, greater emphases and responsibility needs to be placed on the development of a more 'collaborative' mentorship and training program for students. All personnel involved in a students clinical learning experience, this means lecturers, hospital nursing staff in clinical settings, not simply 'a' facilitator for a group of student nurses in a hospital setting need to be actively involved in the training program. Lecturers or tutors running the education program need to have a presence in the 'real world' clinical setting not simply a simulation room in a remote setting on some University campus.

In my experience, there is a number of challenges:

1. peer support - due to the nature of nursing, nursing students work different shifts and different hours to each other therefore supporting each other is often difficult.

2. Support from qualified staff - staffing levels often being as they are on wards and units; nursing students often feel quite unsupported and isolated.

3. Confidence - Especially in first year students; placements can be very daunting and those lacking an abundance of confidence often get lost in the crowd.

4. financial - due to the nature of the nursing training programme, and the requirements for placements, it is very difficult for student nurses to hold down a part time job whilst training due to the inflexibility of the course. This can have massive financial implications and in turn can cause challenges in the students home life.