The purpose of this study was to explore the experiences and impact of peer-to-peer shadowing as a technique to develop nurse middle managers’ clinical leadership practices. A qualitative descriptive study was conducted to gain insight into the experiences of nurse middle managers using semi-structured interviews. Data were analysed into codes using constant comparison and similar codes were grouped under sub-themes and then into four broader themes. Peer-to-peer shadowing facilitates collective reflection-in-action and enhances an “investigate stance” while acting. Nurse middle managers begin to curb the caring disposition that unreflectively urges them to act, to answer the call for help in the here and now, focus on ad hoc “doings”, and make quick judgements. Seeing a shadowee act produces, via a process of social comparison, a behavioural repertoire of postponing reactions and refraining from judging. Balancing the act of stepping in and doing something or just observing as well as giving or withholding feedback are important practices that are difficult to develop.
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Novice nurses currently feel unprepared for the social dynamics of the workplace, due to a lack of assertiveness. Although clinical placements in nursing curricula should prepare student nurses for the demanding work environment, they do not seem to meet these expectations. Our study looked into Dutch students’ experiences of clinical placements as a learning environment for assertiveness. Twelve semistructured interviews were conducted and thematically analyzed, revealing three themes and four subthemes. Clinical placements varied greatly in their capability to stimulate assertiveness development. The team's supportiveness toward students and the didactical skill of the coach mainly influenced this capability. In general, students lacked a clear professional role with regards to their colleagues, stifling assertive behavior with the fear of failing the clinical placement. Our findings indicate that future-proof nursing curricula should support the development of assertive interprofessional conduct in students both before and during clinical placement.
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One challenge novice nurses face at the start of their career is coming to grips with the tumultuous working environment and its social dynamics. Assertive behavior and interprofessional communication play a key role in maintaining one’s health throughout this process: skills which novice nurses feel they lacked in their education. Within their education, clinical placements providea true-to-life working environment to train these skills. However, studies show that assertive behavior and interprofessional communication skills are not structurally addressed within this learning environment. To alleviate this theory-practice gap, our study focused on developing a digital tool together with nursing students that helps them structurally reflect upon and monitor these skills. Our main question was: How do students want to reflect upon their assertive behavior and interprofessional communication during their clinical placement using a digital tool?
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