Aim
The aim of this study was to explore students' experiences of structured learning activities using forms for unit-specific learning outcomes and targeted reflection during clinical placements in outpatient units.
Methods
The study has a qualitative explorative design. Conventional content analysis following Hsieh and Shannon [19], also described as inductive category development [20], was used.
Settings and accession to the field
The study was conducted in a hospital in the eastern part of Norway. Written permission was obtained from the head of the hospital nursing department and the head of the outpatient department before the study was conducted. The second-year students undergoing clinical placement were informed by two instructors in the upcoming program that a study would take place in the outpatient units and that some of them would be contacted and asked if they wanted to participate in the study. Students could decline to be further contacted.
Informants
Inclusion criteria for joining the study were: second-year students, undergoing clinical placement at the cardiology or neurology units. Nine students were asked to participate in the study, but only seven ultimately participated in the interviews. The time scheduled for the interviews was changed shortly before they were due to take place and two students failed to notice the change. The age of the informants, six women and one man, ranged between 20 and 41 years (mean 28, median 22). Four of them undertook clinical placement at the cardiology unit and three of them at the neurology unit.
Data collection
Data were collected by means of focus group interviews during spring 2015. The first group consisted of five informants. The second group consisted of only two informants, as two informants did not show up for interview. An interview guide, with themes concerning the informants’ experiences with the forms’ unit-specific learning outcomes and targeted reflection in the outpatient unit, was used. The questions were inspired by the content of these forms. The interviews started by obtaining biographical data and with open dialogue during which the informants were encouraged to talk freely about their experiences (e.g. asking about their experiences of the use of unit-specific learning outcomes). The interview guide was used as a reminder to the researchers to ensure that the themes were covered. In order to obtain rich and meaningful data, probing questions were sometimes asked by both researchers to extend or narrow the field of interest (e.g. ‘could you please elaborate on this?’).
The interviews took place in a quiet room at the hospital, and, with the exception of a phone call, they were conducted without interruption. They took place at the end of the informants’ clinical placements. As author2 was also a nurse educator for the informants, author1, who was unknown to the informants, was in charge of the interviews. During the final 30 min approximately, author2 left the room so that her presence did not hinder the informants from talking freely about their experiences. At the very end of the interviews, which were each 50 min long, a verbal summary of the content was presented to the informants to ensure that their experiences had been correctly understood.
Analysis
Immediately after the interviews, notes were made by author1 to capture the setting and reflections in respect of the informants’ emotional responses. The interviews without any biographical details of the informants were transcribed verbatim by a secretary and delivered to the three authors. The authors read the interviews right through each by themselves in order to obtain a sense of the whole. Thereafter the interviews were read word by word. Words which were interpreted to capture key experiences of the informants were highlighted in the text and assigned preliminary codes [19]. In the next step of the process, the research team met and compared their codes and sorted them into categories and subcategories. Quotations were selected to support each description and to secure the trustworthiness of the data.