The Role of the Lecturer in Clinical Practice: A Systematic Review

1
The Role of the Lecturer in Clinical Practice A
Systematic Review

• Maria J Grant
• Information Scientist, School of Nursing
• Michelle L Howarth
• Lecturer, School of Nursing
• Jackie Leigh
• Lecturer, School of Nursing
• Cyril Murray
• Senior Lecturer, School of Nursing
• NET2006. Education in Healthcare, 17th Annual
  International Participative Conference, Durham.
• 5th to 7th September 2006.

2
Background

• Role of nurse educationalist in practice a long
  history
• Roles have evolved
• Academic-in-Practice role created within Salford
  (May 2003)
• Explore similarities with other institutions
• A plethora of research but limited synthesis
• Ambiguous guidance from professional bodies (e.g.
  ENB 1993 NMC August 2006)

3
Aims and Objectives

• Aim
• To investigate the role of the academic in
  clinical practice
• Objectives
• To systematically review the research literature
  which describes
• The activities of the lecturer in clinical
  practice (what they actually do!)
• The robustness of research used to evaluate the
  role

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Methodology

• Iterative search strategy (Grant et al, 2000)
• Scope, refine and confirm
• Calls for grey literature
• Endnote reference management software
• Abstracts reviewed
• Include, exclude, ambiguous
• Documents appraised
• Appraisal 1 (University of Salford, 2005)
• Appraisal 2 (inter-rater reliability)
• Key themes
• 18 months!!!

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Databases Searched
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Key Words

• Academic in practice
• Clinical facilitator
• Clinical instructor
• Clinical practice facilitator
• Clinical teacher
• Clinical tutor
• Fieldwork educator
• Generic teacher
• Home sister
• Lecturer practitioner
• Link lecturer

• Long arm practice tutor
• Nurse educator
• Nurse lecturer
• Nurse teacher
• Nurse tutor
• Off-site practice tutor
• Practice educator
• Practice link educator
• Practitioner lecturer
• Practitioner teacher
• Theoretical consultant

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Inclusion Exclusion Criteria
Inclusion Exclusion Criteria
8
(No Transcript)
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Critical Appraisal

• Appraisal 1 (University of Salford, 2005)
• Qualitative, quantitative, mixed-methods
• Research design, robustness of methodology,
  applicability and relevance to practice
• Appraisal 2 (25 sample)
• Discussions within group high level of
  agreement (inter-rater reliability)
• Three key themes emerged
• Lecturer Practitioner role to be reported
  separately

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Types of Research

• Broad mix of research methodologies
• Variable quality limited transparency of
  process
• Tendency towards concept analysis and opinion
  based discursive papers

11
Three Key Themes
Self development
Student support
Staff support
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Authorship 23 papers/17 first authors
Staff Aston et al, 2000 Camiah, 1998 Clifford,
1993 Clifford, 1995 Clifford, 1999 Crotty,
1993a Crotty, 1993b Crotty, 1993c Elcock,
1998 Ferguson et al, 2003 Fisher, 2005 Hardiman,
1993 Jowett, 1994 McElroy, 1997 Murphy,
2000 Owen, 1993 Smith et al, 2001
Student related Aston et al, 2000 Camiah,
1998 Clifford, 1993 Clifford, 1995 Clifford,
1999 Crotty, 1993a Crotty, 1993b Crotty,
1993c Day et al, 1998 Elcock, 1998 Ferguson et
al, 2003 Forrest et al, 1994 Jowett, 1994 Luker
et al, 1995 McElroy, 1997 Murphy, 2000 Ramage,
2004 Smith, 1992 Smith et al, 2001 White et al,
1994
Self Aston et al, 2000 Camiah, 1998 Clifford
1993 Clifford, 1995 Clifford, 1999 Crotty,
1993a Crotty, 1993b Day et al, 1998 Ferguson et
al, 2003 Fisher, 2005 Forrest et al,
1994 McElroy, 1997 Murphy, 2000
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Theme 1 Student Related Activities

• Teaching
• One-to-one supervision
• Clinical teaching working alongside
• Teaching with caseload
• Dichotomy of views (nurse role vs. role as a
  teacher)
• Liaison and Support
• Supporting students via visits
• Liaison role
• Assessment
• Students assessment undertaken by teachers

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Theme 2 Staff Related Activities

• Education
• Practice Development
• Staff Development
• Communication and Liaison

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Theme 3 Activities Related to Developing Oneself

• Hands on care
• Working in clinical practice
• Therapeutic role
• Keeping up to date
• Updating knowledge and skills
• Reading research
• Clinical credibility

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Summary of Themes

• No focus on specific aspects of actual role
  activity
• No clear definitions
• Activities identified in the themes could be
  undertaken separately/in isolation
• Context bound to clinical area
• Limited quality research

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Closing Thoughts

• The answer is 42!
• Disparate publishing often with similar
  authorship
• Generated theory but still to be tested
• Further collaborative research required

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Forthcoming Activities

• Writing the report
• Local and national dissemination
• Publishing papers
• Take a rest!

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References

• Hardiman, R. H. (1993). "Teachers' experiences of
  their role following the implementation of
  Project 2000 a qualitative approach." Journal of
  Advanced Nursing 18(7) 1023-32.
• Jowett, S., I. Walton, et al. (1994). Challenges
  and changes in nurse education. Slough, National
  Foundation for Educational Research.
• Luker, K. A., C. Carlisle, et al. (1995). The
  evolving role of the nurse teacher in the light
  of educational reforms. London, ENB 249.
• McElroy, A. (1997). "Developing the nurse
  teacher's role." Nurse Education Today 17(2)
  145-149.
• Murphy, F. A. (2000). "Collaborating with
  practitioners in teaching and research." Journal
  of Advanced Nursing 31(3) 704-714.
• Nursing and Midwifery Council (August 2006)
  Standard To Support Learning and Assessment in
  Practice. London, NMC.
• Owen, S. (1993). "Identifying a role for the
  nurse teacher in the clinical area." Journal of
  Advanced Nursing 18(5) 816-25.
• Ramage, C. (2004). "Negotiating multiple roles
  link teachers in clinical nursing practice."
  Journal of Advanced Nursing 45(3) 287-296.
• Smith, P. and B. Gray (2001). "Reassessing the
  concept of emotional labour in student nurse
  education role of link lecturers and mentors in
  a time of change." Nurse Education Today 21(3)
  230 - 237.
• University of Salford. HCPRDU tools. 2005. Web
  site http//www.fhsc.salford.ac.uk/hcprdu/tools.h
  tm
• White, E., E. Riley, et al. (1994). A detailed
  study of the relationship between teaching,
  support and supervision and role modelling in
  clinical areas within the context of project 2000
  courses. London, ENB.

• Aston, L., M. Mallik, et al. (2000). "An
  exploration into the role of the teacher/lecturer
  in practice Findings from a case study in adult
  nursing." Nurse Education Today 20(3) 178-188.
• Camiah, S. (1998). "Current educational reforms
  in nursing in the UK and their impact on the role
  of nursing lecturers in practice a case study
  approach." Nurse Education Today 18(5) 368 -
  379.
• Clifford, C. (1993). "The clinical role of the
  nurse teacher in the United Kingdom." Journal of
  Advanced Nursing 18(2) 281-9.
• Clifford, C. (1995). "The role of the nurse
  teachers concerns, conflicts and challenges."
  Nurse Education Today 15(1) 11-16.
• Clifford, C. (1999). "The clinical role of the
  nurse teacher a conceptual framework." Journal
  of Advanced Nursing 30(1) 179-185.
• Crotty, M. (1993a). "The changing role of the
  nurse teacher." Nurse Education Today 13(6)
  415-20.
• Crotty, M. (1993b). "Clinical role activities of
  nurse teachers in Project 2000 programmes."
  Journal of Advanced Nursing 18(3) 460-4.
• Crotty, M. (1993c). "The emerging role of the
  British nurse teacher in Project 2000 programmes
  a Delphi survey." Journal of Advanced Nursing
  18(1) 150-7.
• Day, C., D. Fraser, et al. (1998). The role of
  teacher/lecturer in practice researching
  professional education. London, ENB.
• Elcock, K. (1998). "Lecturer practitioner a
  concept analysis." Journal of Advanced Nursing
  28(5) 1092-8.
• ENB (1993) Standards for approval of higher
  education institutions and programmes. London,
  ENB.
• Ferguson, K., S. Owen, et al. (2003). The
  clinical activity of mental health lecturers in
  higher education institutions, Trent NHS WDC.
• Fisher, M. T. (2004). "Exploring how nurse
  lecturers maintain clinical credibility." Nurse
  Education in Practice 5(1) 21-9.
• Grant, M.J., and A. Brettle, Developing a review
  question. 3rd Symposium on Systematic Reviews,
  Oxford. 3-5 July 2000 .

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Contact Details

• Maria J Grant
• Information Scientist, School of Nursing
• University of Salford, Allerton Building, Salford
  M6 6PU
• Email m.j.grant_at_salford.ac.uk
• Tel [phone]
• Michelle Howarth
• Lecturer, School of Nursing
• University of Salford, Allerton Building, Salford
  M6 6PU
• Email m.l.howarth2_at_salford.ac.uk
• Tel [phone]