1. Support Structures as perceived by BSc. Children’s / General Integrated Nursing Students in a Paediatric Setting: The Transition from a Supernumerary to a Rostered Student Doris O’ Toole, CPC RGN, RCN, RNT, MSc., BSc., Dip Fiona Carney, CPC RGN, RCN, BSc., H. Dip

2. Background  Expert Group (DOHC, 2004) BSc. (Hons) Children’s & General Integrated Programme (2006) Introduction of CPC role (paediatric setting)

3. Aims / Objectives Explore the support structures (paediatric setting) Identify how effective the support structures were perceived Understand the possible changes experienced by students over the 4.5 years Generate data that will be valuable to clinical staff in the future

4. Sample Students undertaking the BSc. Integrated Programme (n=29 total cohort) Single university Non-probability sampling (volunteer) Programme Co-ordinator (recruited volunteers) Random selection Focus groups (n = 9)

5. Research Methodology Qualitative design Longitudinal approach Focus groups moderated (external facilitator) Ethical approval

6. Data Collection Krueger & Casey (2000) Framework Ice-breakerCourse IntroductoryExpectations TransitionExperiences / Concerns KeySupport / Ideals EndingRating Summary

7. Data Analysis Tapes transcribed verbatim (moderator) Moderator’s notes (flip chart) Transcripts verified (two student participants) Thematic Analysis: a) Course b) Expectations c) Experiences d) Difficulties / Concerns e) Support Personnel f) Ideal Support Structures

8. Key Findings: 1 st Year CPC’s – Key support: “They make this course, if you ever have a problem they are there for you”, “like our own age”, “know your name” Patient Contact -.Communicating: “Great talking to the children” Preceptor - Role models / Inspire: “You have one to one relationship with them. They make sure you are getting on ok” CNM – Interest: ‘ My CNM taught us things as well as the CPC. If they are interested in students they are going to help you out”

9. Key Findings: 2 nd Year CPC’s – Key Support: “Always there for you”, “you feel they are on your side all the time”, “they are like our big sisters” Peers / CEF – Peer support: “The people in your class are always there for you”, “the CEF was brilliant and if I wanted to do something she was always there” CNM’S – “The CNM kind of trusted me to do things’ Preceptor - Less contact time: “Own workload”, “have their own stress without us”

10. Key Findings : 3 rd Year CPC’s – Key support: “They are brilliant here (in CUH)” S/N – Team member: “We are doing nearly everything the nurses are doing” Preceptor - Approachable: “Has interest in student teaching, depends on who you get” HCA - Indirect support: “They know the layout of the ward”, “approachable”

11. Key Findings: 4 th Year CPC - Support: highlighted once again, “have other jobs other than supporting us students’ CEF - Increased support: “see us more as staff nurses” Staff Nurse - Increased independence: “Bring you along”, “give you a caseload” Preceptor - not as much direct contact ‘Give you pointers’ allow you to do your caseload’ Preceptor ‘Less contact time’(Different hours etc)

12. Key Findings : Internship S/N – Feedback: “They are always there making sure you are ok, “part of the team” Preceptors – Support: “she taught me loads”, “they are training us to be good nurses” CEF’s – Trust: “They trust you more this year” CNM – Inclusion: “Oversee that you are getting on ok” CPC’s – Change in role: “More emotional support”, “always there if you need to ask a question”

13. Students definitions of Support “If you are having a crap day”, “someone to have a chat to”, “open to you”, “not feeling stupid if you have a question” “To be there for you”, “to be positive for you”, “guide you through”

14. Key Support Personnel Key Findings: Support Personnel

15. Ideal Support Structures CEF on each ward Regular meetings /education sessions within the ward Change of duty roster ( ‘long days’) “If they keep going the way they are going” Increased visits by lecturers from the university to the hospital setting

16. Limitations Single university / site Non-probability sampling

17. Recommendations Replication study Increased sample size (multiple sites) Randomised sample / probability sampling

18. Implications to Nursing Practice Reinforces a quality clinical learning environment (ABA, 2003) Value of the multiple support roles Student satisfaction / clinical performance Integration within the healthcare team

19. Implications to Education & Management Positive student experiences (influence on retention & recruitment in Children’s Nursing) Future role models for other students Explore partnership link with the university (‘ideal support structures’)

20. Conclusion Identification of positive resources / support personnel available to students Perception of support roles - changeable Impact of support - positive learning experiences

21. Acknowledgements Colleague CPC Nursing students & affiliated university Children’s University Hospital, Temple Street for funding the research study References available on request from doris.o’toole@cuh.ie