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Background: The transition of nurse education in the Republic of Ireland (RoI) to third level higher education institutions (HEIs) in 2002 spurred many changes including provision of ‘protected time status’ for reflective... [ view full abstract ]

Background: The transition of nurse education in the Republic of Ireland (RoI) to third level higher education institutions (HEIs) in 2002 spurred many changes including provision of ‘protected time status’ for reflective practice and a work based clinical internship for pre-registration nursing and midwifery degree programmes.
Aim and objectives of the study: aim of the study was to evaluate students’ reflective thinking levels, approaches to learning and epistemological beliefs in an Irish undergraduate nursing and midwifery education context with three specific objectives.
Method: A concurrent, embedded mixed methods design was utilised using a cohort of undergraduates students registered at one large city university including midwifery and the four disciplines of nursing (i.e. general, mental health, intellectual disability and adult & children’s integrated). A purposive sample of 482 students post ethical approval (1st n=253 & 4th year students n=229). Three reliable valid questionnaires merged into one survey, measured three constructs: reflective thinking levels (RTQ), students’ approaches to learning (SAL) and epistemological beliefs (EBI). Semi-structured interviews were conducted with a sample of Fourth year students at starting (n=24) and exiting point of internship (n=21).
Findings: Findings revealed a statistically significant change in Final year with increases in constructs over the three time points used (pre, mid and end points of internship). First and final year students were compared with statistically significant results. Qualitative findings added depth and understanding with emergent themes which will be outlined. Integration of the qualitative findings supported the quantitative results.
Conclusions and Implications: Overall conclusion supports the continued use of the internship with ‘protected time status’ for reflective practice and mechanisms that foster self-directed learning in students including a structured model approach, facilitative trained staff and engagement of key stakeholders. Recommendations are presented for regulatory, academic and clinical stakeholders involved in nurse education.