The changing landscape of pre-registration nursing, both in relation to increasing student numbers and the move towards care closer to home (NHS England, 2017; NHS England/NHS Improvement, 2019), as well as community management, require student nurse placements that offer a greater opportunity to develop understanding of care outside the hospital setting. This is reflected in the academic curriculum within the Future Nurse framework (Nursing and Midwifery Council (NMC), 2018a), in particular regarding population health and preventing ill health (Department of Health and Social Care, 2018); and as set out in the NHS Long Term Plan (NHS England/NHS Improvement, 2019).
A placement innovation aimed to address the need for greater community engagement, offering the students an opportunity to explore areas of third-sector health and social care, in order to develop their understanding of the nurse's role outside of statutory services. The wider remit allowed students to pursue particular interests and look more broadly at population- or family-based health. Students had the opportunity to develop their autonomy and communication skills outside of the traditional student nurse experience, while maintaining the required professionalism of a student nurse (NMC, 2018b). These placements were different to traditional placements as there was a greater focus on non-statutory or third-sector community organisations—and there were not necessarily nurses present.
The child health nursing pre-registration students were chosen for the pilot of this project because they were the smallest cohort in the university, aiding interaction and communication. The traditional practice components of their course involve placements within hospital areas or statutory services such as health visiting, due to the criteria required to meet NMC (2018c) standards.
To encourage, support and enhance more expansive learning, it was decided there would be no formal assessment of the volunteer placement. This was informed by Dyson et al's (2017) study into community engagement placements for student nurses, enabling them to engage with a wider range of experiences, allowing greater exploration and reflection. The student feedback suggests this change of focus was welcomed.
For this project, students were asked to arrange this one placement themselves. For all other placements the organisation was undertaken as usual by the university. Students were able to choose a placement and take responsibility for their own learning, thus taking an active role in their education.
A robust and clear risk-assessment strategy was vital. The first cohort feedback recommended an earlier and modified module introduction and risk assessment, informing the process for the second cohort. It was useful to manage expectations for students and researchers; practical challenges encountered by the students were initially underestimated by the researchers.
Background
A literature review used the search terms ‘Nurse students’ ‘Volunteering’ ‘Student volunteering’ and ‘Student nurse volunteering’ in the search engines PubMed, CINAHL and The King's Fund between June and September 2019. Criteria were articles published in English that related to student volunteering off campus and relevant to community engagement.
There has long been an association between undergraduates and volunteering/community engagement (Ellison and Kerr, 2014). In the UK, this was strengthened by the Dearing report (National Committee of Inquiry into Higher Education, 1997), which explicitly outlined the wider role of universities within their communities. Darwen and Rannard (2011) commented that student volunteering ‘can be aligned with key institutional and national objectives’, while Williamson et al (2018) suggested that volunteering is an increasing part of the zeitgeist in higher education. Engaging with the local community is one of the priorities of the university where this research was undertaken (Middlesex University, 2017) and also of many others involved in the Healthy Universities initiative (Healthy Universities, 2020). Vetitnev et al (2015) also highlighted the strategic goals of universities to train competent individuals who can function effectively outside of the university realm.
Nursing students must meet the requirements of their professional body, in England the NMC (2018a), to join the nursing register at the point of qualification. Community engagement offers an opportunity for expansive learning (Fuller and Unwin, 2004), developing a holistic view of wellbeing (Dyson et al, 2017) matching new Future Nurse standards (NMC, 2018a) and with greater focus on population health.
The authors used a working definition of community engagement for the students, guided by the National Council for Voluntary Organisations (NCVO):
‘Any activity that involves spending time, unpaid, doing something that aims to benefit someone (individuals or groups) other than, or in addition to, close relatives.’
Darwen and Rannard (2011) reported growing use of this approach in the curriculum and accreditation as part of university courses. The students were asked to undertake 75 practice hours in an area of their choice. The term ‘community engagement’ was used to reflect the proposal more accurately and to take the mandatory nature of the initiative into consideration.
Holdsworth and Brewis (2014) explored this ‘contradiction between coercion and choice’ that is intrinsic to higher education institutions, and considered the ‘blurring’ of educational practice with everyday life, including volunteering, now co-opted into education. In other countries, several studies focused on the ‘directional volunteering’ (Holdsworth and Brewis, 2014) and ‘compulsory volunteerism’ (Yang, 2017) within some university programmes. These were not specifically nursing courses, but highlighted the different motivations to volunteer if mandated; Yang (2017) found altruism did not increase and Grönlund et al (2011) questioned the authenticity of the experience of students formally required to attend, or informally expected to undertake, community engagement to enhance their CV.
The students in the authors' study were not undertaking this activity to enhance their CV, but instead to take a lead role in an aspect of their learning and explore an area of personal interest, relevant to their pre-registration nursing course. Dyson et al (2017) found more students would take part in community engagement if it were explicitly linked to their curriculum.
Volunteering/community engagement opportunities for university students have traditionally been organised by the students' union, university faculty or individual students. The literature highlights that the needs of the community organisations should be the focus. A flexible approach can be difficult to undertake around course commitments (Darwen and Rannard, 2011) and home-life balance (Williamson et al, 2018); however, the main barrier to volunteering is ‘awareness of and securing access to projects’ (Cloke et al, 2007).
There is a small body of literature regarding the specifics of nursing or midwifery students undertaking community engagement or volunteering (Dyson et al, 2017). However, there are many more articles relating to elective placements (Bradshaw et al, 2018). Often these experiences require no summative assessment, mirroring the suggestion of Dyson et al (2017), who recommended formative assessment of such experiences to enhance engagement with wider learning.
Such placements have led to an enhanced sense of confidence, (Sparrow, 2015), including the ability of students to better manage their compulsory placements (Bradshaw et al, 2018). Vetitnev et al (2015) found volunteering/community engagement can contribute towards the development of personality traits including self-confidence. Brewis et al (2010) described this as breaking out of the ‘student bubble’.
Hustinx et al (2010) suggested that volunteering/community engagement can demonstrate characteristics difficult to discern. These could include self-awareness, being responsible or showing greater autonomy (Kent-Wilkinson et al, 2015; Paull et al, 2017; Marshall, 2017). The development of resilience was reported in Williamson et al's (2018) study, and Grönlund et al (2011) highlighted the opportunity to enhance and develop the students' cultural awareness. As well as specific clinical skills (Sparrow, 2015), key aspects of team-working, communication and leadership have been reported (Darwen and Rannard, 2011), including conflict resolution skills essential in team-working and leadership roles (Vetitnev et al, 2015). Charlesworth et al (2017) noted that feedback from those who found volunteering unhelpful is often missed in research.
To facilitate a good volunteering/community engagement experience and successful learning, support is essential (Williamson et al, 2018). Paull et al (2017) discussed the need for different types of preparation, eg between higher education institutions and community organisations to develop partnerships with those organisations that are involved repeatedly, and to prepare learners. Dyson et al (2017) and Bradshaw et al (2018) found student preparation essential to support learners to plan volunteering roles and make sense of the learning opportunities once in the community, echoing Kay and Bradbury (2009) who also advocated for training for all those involved. Essential preparation for all parties was expectation management (Paull et al, 2017; Williamson et al, 2018) to ensure that all were clear from the start about what could and could not be achieved.
All of the previous research was taken into consideration when planning and developing the initiative. In order to develop a sense of personal autonomy, the students involved were asked towards the end of the first year of their nursing course to think about the opportunity of undertaking a placement of their choice as a volunteer in the second year. They were given the dates for the second year of the programme, to prepare to arrange the placement, either in one 75-hour block or, if they wished, they could undertake the 75 hours throughout the year. Students were able to choose whether or not to engage with this placement. Students who did not engage had the 75 hours deducted from their course total and alternative traditional placements were arranged later in their programme to ensure the required 2300 course practice hours were met.
It was each student's responsibility to choose the type of community engagement, contact the organisation, and to make all the arrangements. All students were asked to complete a risk assessment form before starting the community engagement and submit this to the university. They were advised that there would be no summative assessment but that they would either have to complete a reflection or a poster based on their experience. The poster was to be shown to more junior students in order to promote the initiative and encourage participation of students in the following year. The decision to formatively assess was informed by Dyson et al (2017).
Thirty-one students took part in the study. The areas chosen by the students for their community engagement are shown in Figure 1.
Figure 1. Placement areas chosen by participants (n=31)
Aim
The aim of this study was to evaluate child health student nurses' experience of participating in a community engagement placement during the second year of their course.
Method
This study used descriptive and interpretative methods of data collection using a cross-sectional data analysis. Qualitative data sets were gathered via focus groups and a review of written student reflections. The reflections followed the NMC revalidation reflective framework (NMC, 2021), and were up to 1000 words in length.
Ethical considerations
The research study was reviewed and approved by the Middlesex University Health and Education Ethics Committee (reference 6861). Participants were provided with a participant information sheet (PIS). Informed consent was obtained and all participants were informed, verbally and in the PIS, that they could withdraw consent at any time during the study. Students were informed that confidentiality was assured. No students withdrew.
To address the possible power imbalance, two members of the research team who were not known to the students prior to the start of the pilot project and did not teach on the course, facilitated the focus groups. The third researcher was well known to the students and able to contextualise the research within the child health curriculum.
Participants
A purposive sampling approach was used to recruit participants, who were all student nurses studying for a BSc (Hons) Nursing degree (child field). Students from the second and third year of training were invited to participate in the study; all students undertake their community engagement during the second year of their course. Initial contact was made for the study after the first year of the pilot had been completed, when the first group of second-year students had progressed to the third year of the course. All participants were assured of anonymity.
Data collection
Part 1. Focus group interviews
Semi-structured questions were developed by the researchers to guide and prompt the discussion (Joyce, 2008) (Box 1). The data in part 1 was collected in December 2019. Eleven third-year students took part in the focus groups. This small number allowed an increased opportunity for everyone to contribute to the overall discussion (Joyce, 2008). Two researchers, members of the Practice Based Learning Unit, organised and managed the focus groups and collected the students' reflections.
Box 1.Focus group indicative questions
- How did you find organising your own practice placement? (What influenced you when choosing an area to complete your community engagement experience?)
- What do you feel that you gained from undertaking this practice placement? (Thinking about your course overall, how would you relate your community experience to your previous and consequent placement experiences?)
- What were the challenges?
- What were the benefits?
- Is there anything you think now you would have done differently?
- Anything else you would like to discuss?
- What would you tell the first years to help prepare them for this experience?
Two focus groups were held, each lasting between 45 and 60 minutes. The semi-structured questions were used to prompt or encourage students to explore an issue in greater detail. The discussions were audio recorded and transcribed.
Thematic analysis was used to review the data and the researchers followed the principles proposed by Braun and Clarke (2006) (Table 1). Each researcher reviewed the material independently and then together until overarching themes had been decided. These four themes and their sub-themes are listed in Table 2.
Table 1. Braun and Clarke thematic analysis model
| Phase 1 | Familiarising yourself with your data |
| Phase 2 | Generating initial codes |
| Phase 3 | Searching for themes |
| Phase 4 | Reviewing themes |
| Phase 5 | Defining and naming themes |
| Phase 6 | Producing the report |
Table 2. Themes and sub-themes
| Themes | Sub-themes |
|---|---|
| Developing as a person | Including communication skills and emotional responses |
| Developing as a professional | Professional behaviour, understanding, and skills |
| Community engagement | Population health and wider experiences |
| Expansive learning | The wider learning, including challenges and benefits |
Although the content of the focus groups has been presented under specific themes, there was often a crossover between personal and professional concerns. Data from the focus groups and reflections will be used to illustrate the findings.
The transcribed interviews were reviewed by three focus group participants who agreed that the transcripts and excerpts used for publication were an accurate representation of the discussion.
Reflections
The students' reflections of their experiences of the community engagement project were analysed and the same process was followed as for the review of the focus group data. Findings from the focus groups and reflections were compared.
Reflections were initially reviewed and analysed separately by two members of the research team and then discussed with the third member of the team in order to agree themes.
Validity
Validity was achieved by means of triangulation. The study used two data collection methods to reduce error and bias during the collection process—focus groups and written reflections. The reflections were analysed individually and then collectively by the researchers, adding inter-rater reliability and enhancing the rigour. Student confirmation that the thematic analysis reflected their experience added to the validity and rigour.
Results
An invitation was sent by email to all second-year (n=41) and third-year (n=48) students on the course (n=89) to ask if they wished to participate in the focus groups. Only the third-year students took part, giving a participation rate of 23% (n=11). No second-year students attended the focus groups, in part due to the COVID-19 pandemic. Five reflective accounts from the second-year students and 14 reflective accounts from the third-year students were received.
Thematic analysis
At the point of initial theme generation, the researchers identified six themes: knowledge, criticism, expansive learning, emotion, communication, and professionalism. As the analysis proceeded these were developed into the four final overlapping themes (Table 2).
Focus group analysis
Eleven third-year students participated in the focus groups. They took part in the community engagement during academic year 2017-2018 and took part in the study in 2018-2019. Analysis revealed the following four themes.
Theme 1. Developing as a person
‘I really liked the … shall I call it autonomy?’
Focus group participant 3 (F3)
One of the participants' focuses was the extent of self-reliance that was needed in both organising and undertaking this experience. Participants commented on how this differed from their experience of the university arranging placements and how this meant the learners had to take more responsibility. This was not always a smooth journey and time management skills were highlighted as important, otherwise, ‘not having enough time’ (F1) became an issue.
The role definition as a volunteer was reported as helpful to build confidence because ‘I knew what was expected’ (F6). Building confidence was repeatedly stated as an outcome of taking part. Most participants felt they had:
‘A good experience and a different experience and you learn a whole lot of other things and how you deal with every day.’
F6
Some of the students reported a sense of satisfaction:
‘Being able to help them a little bit is really nice.’
F5
Theme 2. Developing as a professional
The students were able to use their professional training to help guide their community experience. Many spoke of professional requirements, including maintaining ‘confidentiality’ (F2), consideration of risk assessment in non-clinical areas as part of their learning, and an understanding of the need to:
‘Build trust and promote professionalism [as many] vulnerable people … rely mostly on professionals.’
F2
Clinical skills were also required, for example medication management in the homeless population, or diabetes management outside of hospital. There was evidence of reflection on the need to be non-judgemental, from experience gained with homeless people, for example:
‘We judge like how could they end up there, but when I sit … and talk with them … the people are real people.’
F2
Having time to spend with people and observe them was valued as an opportunity to:
‘Sit back and reflect and see things almost from two pairs of eyes.’
F1
Students had become more socially informed by participating in the work of community organisations.
Theme 3. Community engagement
The students reported a greater understanding of the resources available in the community and some of the health activities provided for different populations, such as:
‘Events and campaigns going on for young people.’
F3
Many students returned to previous university organised placements in the community and were able to:
‘See the service with a fresh pair of eyes.’
F1
Or students were able to reflect on their experiences:
‘A year and a half later … it was good to see the difference.’
F10
This led to students realising that they were also:
‘Part of the community and be able to help in a different way, not only as a nurse.’
F2
The differences across communities were also mentioned by a student who volunteered abroad:
‘It kind of opened our eyes to like the small things in this country [UK] and how they're really, really important.’
F5
Another student who worked with homeless people commented that she now:
‘Had a different view of the homeless after I went there.’
F2
Gaining a perspective was identified as important:
‘There's loads of stuff going on in other places and other countries, and I think it just opens your mind.’
F4
Theme 4. Expansive learning
The shift of focus from a ‘nursing’ outlook was noted by many of the participants:
‘It was actually really nice to see the other side … forget about your skills and just get to know the children.’
F4
‘On this one, you can just actually take in and learn whilst having fun.’
F6
One student commented that before the experience:
‘I think your whole world becomes “uni” and your world gets quite small.’
F8
The shift into wider learning opportunities was welcomed, with some students choosing areas of particular interest. For others, it provided an opportunity to see:
‘… well kids … we're so used to seeing unwell kids, it was nice to see that change.’
F8
The learning, although mostly positive, also highlighted the challenges of organising this experience, with repeated concern noted that the ‘procedure was taking so long’ (F4). The need to apply early in the year was highlighted, with many students not obtaining their first choice, and advising other students to ‘have a back-up plan’ (F6). One student commented:
‘There's so much other stress going on in the year, this is just an unnecessary stress.’
F10
It was also reported that the time allowed for this module, 75 hours, was not easy to match with the needs of the community organisations, which often needed longer commitments to obtain full value.
Third-year student reflections
Fourteen third-year students submitted written reflections. Analysis again revealed four main themes.
Developing as a person
The students identified that, although the prospect of arranging and undertaking this module was ‘overwhelming’ (third-year student reflection, participant 8 (3R8)) and ‘difficult to begin with’ (3R12), it was recognised to be a ‘great opportunity’(3R3); all the reflective accounts noted that their experiences ‘build confidence’ (3R10). Some reported that the motivation to undertake this module was important, with one student describing herself as ‘proud’ (3R7) that she had been able to plan, arrange and undertake this placement. Many of the students described their learning process as ‘fun’ or ‘enjoyable’ and attributed this to the ‘support for staff’ (3R3) in the area or not having a formal assessment in the area.
Improved or enhanced communication was highlighted in the majority of the reflections reviewed. Specific skills learnt were ‘learning to listen’ (3R2), ‘use of feedback’ (3R4), ‘be patient’ (3R13) and the ‘use of precise questions’ (3R10). The learners also considered ‘how it can be incorporated into clinical practice’ (3R6) and using initiatives observed to enhance their ‘[multidisciplinary team] communication’ (3R9). One student also commented on the ‘communication challenges’ (3R6) and how these could be managed with children with sensory impairment. This personal development and having a ‘chance to think for ourselves’ (3R1) was valued and its transferability into clinical practice was recognised.
Theme 2. Developing as a professional
The reflective accounts all focused on the professional skills gained or enhanced during this experience. Some of these related to professional values, linked to parts of the NMC Code (NMC, 2018b), for example, being ‘non-judgemental’ (3R13) and ensuring consent within the specific environment. Others were concerned with health and safety-related issues, working in different settings and learning the protocols in that specific area, including risk assessment and management, and considering their ‘accountability’ (3R6) outside of traditional clinical practice. One student spoke of the ‘real examples’ (3R11) of health and safety in practice outside of a hospital setting.
Aspects of caring generally were discussed with reference especially to ‘individualised care’ (3R11), ‘prioritising the child’ (3R13) and setting ‘boundaries’ (3R3 and 3R13). The latter was commented on by many students, who reflected upon their ‘working within limits’(3R6) and awareness of ‘knowing [my] limitations and when to refer on’ (3R10).
Theme 3. Community engagement
A few of the participants had undertaken placements with other health professionals in order to develop a deeper knowledge of those areas, such as the role of a community pharmacist or working with children with special educational needs. This learning was viewed in terms of ‘integration’ (3R13) in the community and the participants commented on how this could ‘improve discharge planning’ (3R4) by enabling them to be more aware of community resources. Several of the participants used this placement to work not only with children, but with families. Working with a ‘variety of ages’ (3R14) was reported as helpful when considering family-centred practices.
Theme 4. Expansive learning
Wider learning opportunities were reported as useful to enhance knowledge in a range of areas, including ‘learning through play’ (3R9), ‘working with children of different ages and abilities’ (3R14) and ‘different environments’ (3R14), and on working with both well and unwell children.
In some areas it was identified that there were ‘opportunities to expand knowledge quickly due to repetition’ (3R10). The participants described both ‘linking to previous knowledge’ (3R4) and then being able to utilise their ‘experience … in the next placement’ (3R13) and described ‘feed forward learning’ (3R4).
Many participants reported enhanced team-working, discussing ‘bonding’ (3R9), their ‘advocacy role’ (3R4), ‘collaboration’ (3R6) and ‘building relationships’ (3R12), seeing themselves as part of a team. Other students reflected on the experience as a way to demonstrate ‘leadership skills’ (3R1) and to consider ‘future career opportunities’ (3R4).
Second-year student reflections
Five second-year student reflections were also thematically analysed. This group undertook their community engagement placements during academic year 2019-2020. Some of the cohort had difficulties in relation to COVID-19, which accounts for the small number. These reflections demonstrated similarities and contrasts with the third-year reflections.
Theme 1. Developing as a person
The group identified how they had developed as people, with a focus on relationship building, effective team-working and the associated social skills and confidence. Increasing confidence and communication was reported by all the participants. The communication skills were considered both as verbal when working with different cultures and people ‘from all walks of life’(second-year student reflection, participant 4 (2R4)), but also with regard to social media and with children across different age ranges. Role modelling was highlighted as a way to learn from the regular volunteers—for example, beforehand one student had been worried ‘to say the wrong thing’ (2R4).
Theme 2. Developing as a professional
The second-year students also reported wider problem-solving skills to support an increasing number of people in some of their chosen placement areas. The age ranges of the children led to specific reflections on, for example, observations being vital, ‘as toddlers cannot express in words’ (2R5). Cultural awareness and adjusting the service to meet individual needs were focused on by several students, including the role of advocacy.
The students also highlighted their accountability and linked this with the NMC Code (2018b) and duty of care when considering safeguarding.
Theme 3. Community engagement
Many students focused on this placement as being an opportunity to ‘give back to the community’ (2R3) and mentioned ‘community spirit’ (2R4) in their reflections. The differences between community and hospital services were explored in the reflections. One student commented that it was an:
‘Eye-opening experience of being able to care for people in a community setting through different means.’
2R2
Theme 4. Expansive learning
The social factors involved in family experiences of hardship and distress were reported in many of the reflections, with reference to the wider determinants of health and family-centred care. Some reflected on the transferability of new skills learnt and increasing understanding of different groups, relating these to their future careers and the NMC Code (NMC, 2018b).
Discussion
The role of a volunteer can be more targeted than that of a student on a traditional clinical placement where there may be multiple competing demands, especially as the student's course progresses. The community engagement module offered an ‘enjoyable’ and ‘fun’ way to gain learning, beyond the usual confines of a professional course. Participants wrote of the children ‘learning through play’ (3R9), yet did not overtly see the similarities to their own learning without the usual pressures of clinical placement or any formal assessment. The lack of summative assessment was welcomed by participants.
There were differences in the thematic analysis of the data sets. Interestingly, in the reflective accounts, all participants mentioned enhanced or improved communication-related skills as a result of undertaking this module. However, the focus group attendees did not directly discuss communication, beyond the role of the university providing ideas of whom to contact, and information available from previous learners' experience. The focus group questions may have influenced the responses, for example, the challenges of this module were highlighted in the focus groups, something those who submitted reflections did not directly address beyond initial feelings of being overwhelmed.
The richness of the data collected came in part from the timing. All the participating students undertook the module in year 2. The reflective accounts were written shortly after the experience and the year 3 focus group participants were able to reflect on their longitudinal learning and experiences.
Students reported logistical challenges when securing placements, which concur with Cloke et al's (2007) findings and students had competing demands from their existing studies (Darwen and Rannard, 2011). The 75 hours set by the university is to be reviewed to support longer placements and this will increase the opportunities for future students. Participants provided advice for the next students to combat some of the difficulties they had encountered, advising future students to choose placements that are easy and inexpensive to travel to (F3).
These research findings concur with those of Vetitnev et al (2015) who reported that community engagement can facilitate both personal and professional development. The participants reported increasing their autonomy and developing a wider understanding and knowledge of the community.
Many of the students reported that this experience had changed their understanding of the wider health care and community systems, including recognising the social and environmental factors that influence population health and wellbeing. One student summed this up as:
‘You tend to have a different perspective, because you see them in a different light.’
F7
The caring role of the nurse was evident in much of the data, with one student's comment being typical:
‘This was my chance to make a difference when someone else needed it.’
2R3
The students who took part in this study were volunteers, but also nurses in training, and reflected upon the experience as such.
Study strengths and limitations
A strength of this work was having three researchers with different nursing registrations: one with adult, one with mental health and one researcher with child, adult, and mental health registrations. This added to inter-reliability and the questioning of assumptions along the way. The focus group transcript and themes were subsequently shown to a sample of the participants (n=3) and the themes were agreed as representative, thereby ensuring the analysis was valid and reducing any researcher bias.
The COVID-19 pandemic impacted upon the research. Some of the students were not able to complete their experiences. The university ‘lockdown’ also affected the attendance at the planned year 2 focus group, which changed to online, and was thus less accessible and students did not attend. Students have now adapted to working virtually and may be more likely to engage in virtual sessions in the future.
If this research were repeated, it would be helpful to know whether prior experience of volunteering made a difference to the value of completing this module and associated reflections and to know whether any students continued to volunteer after their placement was over.
There is also a need to carry out further research to identify if these placement opportunities benefit the organisations concerned and what they would want to achieve from such participation. The placement areas, for example, identified that 75 hours was too short a time to obtain full value.
Conclusion
The findings from this research illustrate how enjoyable the volunteer experience was for the student nurses, many of whom reported a wider appreciation of care delivery and welcomed the autonomy to choose their community engagement experience, especially in combination with the removal of formal assessment.
Traditionally, student nurse courses are not conducive to volunteering due to the requirements of the professional body, with short holidays and both academic and practice components. Professionalism, leadership and self-confidence were developed as students actively negotiated their placements. This autonomy also afforded an opportunity to think about future career opportunities they might not have considered, beyond hospital and closer to home.
Traditional pedagogy was altered, with students deciding upon and taking control of their learning experience. The reciprocal learning this generated via feedback was valuable to support future students undertaking such experiences and manage the expectations of both researchers and students.
This project was undertaken with child health students only. It has been shared widely within the faculty and this innovative model has now been adopted as part of the expansive learning module available for all fields of nursing students within the university. The main challenges, beyond COVID-19 restrictions, in rolling out this placement include the need for discussions with students to start early in the programme to support the logistical challenges of securing placements, including regular opportunities to discuss progress and good administrator support to manage larger cohort numbers.
There is the potential to also develop this experience into a full 6-week formative placement, reflecting the opportunity of working with diverse populations beyond the acute and statutory sectors using the findings from this research and that of Paull et al (2017), who advocated for longer, regular placements in partnership with community organisations. This would overcome barriers in relation to community organisations understandably not willing to take students for only 2 weeks. It is hoped that the next students will also find the voluntary experience ‘refreshing and enjoyable.’ (2R1).
KEY POINTS
- Student nurses require increased opportunities to engage with care provided closer to service users' homes
- The university successfully changed its pedagogical approach, enabling students to select their own community-based placements
- This innovative placement model led to a more expansive understanding of community care
- Students gained self-confidence and knowledge necessary for ‘Future Nurses’
CPD reflective questions
- How can we support more expansive practice learning to better prepare student nurses for community roles?
- Reflect on your understanding of where care is delivered and by whom
- Do you think all placements should be formally assessed?
- Is there a place for the type of voluntary community engagement placements described in this article for the students in your place of work? Think about how this might be organised