practice educators in the united kingdom: a national job description

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Practice educators in the United Kingdom: A national job description John Rowe * Open University, Health and Social Care, Horlock, Walton Hall, Milton Keynes, Buckinghamshire MK7 6AA, United Kingdom Accepted 11 May 2008 KEYWORDS Practice educator; Obligations and rights; Joint appointments Summary Much is known about the purpose of practice educators in the United Kingdom, but how their role is implemented is subject to conflicting expectations, partly created by the structure in which they work. Joint appointments between universities and practice are an opportunity for both organisations to collaborate in a partnership to enhance practice learning and fulfill one of the main aims of the practice educator role: to narrow the theory-practice gap. However tensions exist. This paper advocates a national (UK) job description for practice educators to reduce some of the tensions and conflict between the expectations of collaborating partners in practice learning. This would enable practice educators to concentrate on their obligations while employers concentrate on enabling practice educators to fulfill their obligations by upholding their rights to proper preparation, support and career structure. c 2008 Elsevier Ltd. All rights reserved. DEBATE In a recent paper Jowett and McMullan described an evaluation of a new practice educator role sup- porting pre-qualifying nursing students across three counties in the UK (Jowett and McMullan, 2007). They reported that the practice educator was per- ceived as an important link between practice and the University and supportive to both mentors and students. They also identified some of the dif- ficulties practice educators experienced; lack of a common understanding over promoting clinical competence, and tensions that have arisen out of being a joint appointment between the NHS and HEI. This paper aims to stimulate debate about how practice educators fulfill their obligations whilst exploring their role further. It illuminates the prac- tice educator role in terms of their obligations and their rights, and discusses the merits of being a 1471-5953/$ - see front matter c 2008 Elsevier Ltd. All rights reserved. doi:10.1016/j.nepr.2008.05.004 * Corresponding author. Tel.: +44 01235 522085; fax: +44 01908 858158. E-mail address: [email protected] Nurse Education in Practice (2008) 8, 369–372 www.elsevier.com/nepr Nurse Education in Practice

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Page 1: Practice educators in the United Kingdom: A national job description

Nurse Education in Practice (2008) 8, 369–372

Nurse

www.elsevier.com/nepr

Educationin Practice

Practice educators in the United Kingdom:A national job description

John Rowe *

Open University, Health and Social Care, Horlock, Walton Hall, Milton Keynes, Buckinghamshire MK7 6AA,United Kingdom

Accepted 11 May 2008

14do

01

KEYWORDSPractice educator;Obligations and rights;Joint appointments

71-5953/$ - see front mattei:10.1016/j.nepr.2008.05.00

* Corresponding author. Te908 858158.E-mail address: j.m.rowe@

r �c 2004

l.: +44

open.ac

Summary Much is known about the purpose of practice educators in the UnitedKingdom, but how their role is implemented is subject to conflicting expectations,partly created by the structure in which they work. Joint appointments betweenuniversities and practice are an opportunity for both organisations to collaboratein a partnership to enhance practice learning and fulfill one of the main aims ofthe practice educator role: to narrow the theory-practice gap. However tensionsexist.This paper advocates a national (UK) job description for practice educators to

reduce some of the tensions and conflict between the expectations of collaboratingpartners in practice learning. This would enable practice educators to concentrateon their obligations while employers concentrate on enabling practice educators tofulfill their obligations by upholding their rights to proper preparation, support andcareer structure.

�c 2008 Elsevier Ltd. All rights reserved.

DEBATE

In a recent paper Jowett and McMullan describedan evaluation of a new practice educator role sup-porting pre-qualifying nursing students across threecounties in the UK (Jowett and McMullan, 2007).They reported that the practice educator was per-ceived as an important link between practice and

8 Elsevier Ltd. All rights rese

01235 522085; fax: +44

.uk

the University and supportive to both mentorsand students. They also identified some of the dif-ficulties practice educators experienced; lack of acommon understanding over promoting clinicalcompetence, and tensions that have arisen out ofbeing a joint appointment between the NHS andHEI.

This paper aims to stimulate debate about howpractice educators fulfill their obligations whilstexploring their role further. It illuminates the prac-tice educator role in terms of their obligations andtheir rights, and discusses the merits of being a

rved.

Page 2: Practice educators in the United Kingdom: A national job description

370 J. Rowe

joint appointment between service and educationproviders. It concludes by proposing that thereshould be a single national (UK) job descriptionfor practice educators.

Roles refer to a position in a social structure,and can be defined as sets of rights and obligations(Banton, 1965). Practice educators have obliga-tions to the public, their employer, professionalbody and their colleagues, as well as their stu-dents. They also have particular obligations whichare synonymous with duties described on theirjob description. Alongside these obligations theyalso have certain rights associated with theiremployment. Rights refer to the means by whichpractice educators are enabled to fulfill their obli-gations and might consist of, for example, prepara-tion and training.

A review of primary research was conducted intoa number of practice educator roles which pro-vided support to student nurses in practice set-tings. Three electronic databases were selectedbecause they held records on health services, edu-cation and nursing: CINAHL, ASSIA and the BNI. To-gether these databases provided access to a widerange of professional journals containing detailsof research reports on nursing practice and educa-tion. The key words chosen were selected to iden-tify a wide range of papers about nurse education:‘student nurse’, ‘education’, ‘placements’, ‘rolesof practice educator’, ‘student support in prac-tice’, ‘practice teaching support’, ‘learning inpractice’, ‘personal tutor’, ‘practice teacher’,‘lecturer practitioner’, ‘practice facilitator’ and‘link teacher’.

A huge amount of literature is available aboutnursing and students’ experience of practice andlearning support for students in practice, but asGidman (2001) observed few research studies couldbe identified in the literature, and none specificallyaddressed practice educator roles in terms of obli-gations and rights. It was apparent that there wasno overarching strategy for evaluating the impactor implementation of these roles, and a lack of re-search into the development of lecturer–practitio-ners following their establishment (Williamson etal., 2004). Inferences could be made, though, fromthe viewed research about what obligations wereexpected and whether they were fulfilled or not.Likewise the reviewed research illuminated therights practice educators could expect, and if andhow they were upheld.

One of the purposes of the introduction of prac-tice educators was to address the theory practicegap that had emerged with teachers based awayfrom the practice setting, and often at a distancefrom the students they supported in clinical areas.

Aston et al. (2000) conducted a multi-site studyinto the role of teachers and lecturers in practicebecause of problems with practice education. Theyconcluded the role needed to be clarified as theresponsibility for both theoretical and practice ele-ments was placed with the universities.

Previously Fairbrother and Ford (1998) reviewedthe multifaceted aspects of the lecturer–practi-tioner role, and identified that there were local dis-crepancies. They were ill-defined in differenthealth settings, and with no universal job descrip-tion or method of implementation. This suggestedthat expectations of the role lecturer–practitio-ners were supposed to perform were not clear forthose who were implementing them, and that therewas no overall strategy for their introduction.

The reviewed literature illuminated practiceeducator obligations. Although there were differ-ences between job titles and the structures inwhich practice educators worked, there were sim-ilarities between their obligations. Paramount ofthese was practice educators’ visibility in practice,credibility, and ability to narrow the theory prac-tice divide for students. The presence of the lec-turer in the practice setting was very important(Aston et al., 2000). Brown and Pollock (1998)) as-serted that trained nurses judged the effectivenessof nurse teachers in clinical areas in relation totheir ability to assist students to manage the realityof clinical practice, with an obligation to narrowthe theory-practice gap (Driver and Campbell,2000) by finding the most effective way for stu-dents to achieve their objectives (Davies et al.,1996). Aston et al. (2000) identified aspects ofthe practice educator role as student support andthe development of the learning environmentincluding practitioner support and development.They were a link between the university and prac-tice (Williamson, 2004) as well as students andpractitioners (Newton and Smith, 1998).

The reviewed literature also illuminated some ofthe rights practice educators could expect to en-able them to fulfill their obligations. They could ex-pect to be well prepared for their role, but in manycases preparation for their role had been lacking(Aston et al., 2000). Where formal induction proce-dures had been available they were unhelpful (Wil-liamson et al., 2004). Aston et al. (2000) noted aperceived lack of guidance, and where guidancewas available it was vague, unachievable and opento individual interpretation. Even though practiceeducators were perceived to have had obligationsin the practice setting their actual role there wasnot clearly defined (Davies et al., 1996), with un-clear expectations, no universal job descriptionor method of implementing the role. The rights

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Practice educators in the United Kingdom: A national job description 371

practice educators might have expected; adequatepreparation, induction and guidance, clear expec-tations and job description seemed to have notbeen fully upheld.

There is a growing understanding of practiceeducators’ obligations, but much less clarity abouthow these expectations can be met. Lathlean(2007) proposed that there were challenges whenimplementing a complex role such as that of apractice educator. These included: role ambiguity,difficulties of role definition and role overload.There has been lack of clarity with the roles (Carn-well et al., 2007) with no common denominator forthe level of responsibility (Salvoni, 2001). Althoughit has not been apparent from the evaluations,there is a danger that in the absence of clearexpectations the role could be ineffective in botheducation and practice (Hancock et al., 2007). Be-cause there has been no overarching definition fora practice educator formal evaluation of the rolehas been more difficult (Leigh et al., 2005).

Jowett and McMullan (2007) concluded the prac-tice educator was a link between practice and theuniversity. This link is borne out by the literatureespecially regarding the structure of joint appoint-ments between education and practice. Jointappointments created an alliance (Salvoni, 2001),with practice educators having a ‘foot in bothcamps’ (Carson and Carnwell, 2007) with potentialrewards of having the ‘best of both worlds’ (Salvoni,2001).

But joint appointments can also bring tensions.One of the participants in Jowett and McMullan’sstudy felt like ‘piggy in the middle’ (2007: 269)due to conflicting expectations from the universityand practice, and another wanted support fromeither practice or the university. Conflict arosefrom serving two masters at the same time (Carn-well et al., 2007). Tensions were noticed by othersas well, with one participant in Hancock et al.,2007 study stating it was hard to know if he (thepractice educator), was representing the universityor the trust. Practitioners and students recognisedthe difficulties of educators being responsible toboth service and education (Carson and Carnwell,2007).

Not only do these tensions create dissonance,but they also bring professional disadvantages.One of the frequently discussed problems for prac-tice educator was career progression. As a jointappointment there was a need for a clearer careerpathway (Leigh et al., 2005) with a structure andappropriate salary (Salvoni, 2001). Often choiceswere between staying in practice, remaining apractice lecturer or taking up a temporary second-ment to the university. Problems for practice en-

sued where specialist knowledge and skills heldby the joint appointee practice educator were lost,and high caliber personnel on short-term contractswere hard to recruit.

Jowett and McMullan (2007: 270) concluded that‘there is a need to recognise that learning in and frompractice requires support, resourcing and prioritis-ing.’ Practice educators have been received posi-tively; they are seen as a link between practice andthe university and they are visible and supportive topractitioners and the learning environment. Thechallenge to support learning in practice is not con-fined to isolated pockets of nurse education, butaccording to the empirical evidence are widespread,and need to be addressed on a national scale.

A potential resolution to the tension created byconflicting expectations is to develop a single na-tional (UK) job description for practice educatorswith a common language that explains preciselywhat the role obligations are, and with clearly ex-pressed rights. Practice educators could concen-trate on their obligations while employersconcentrate on enabling practice educators to fulfilltheir obligations by upholding their rights to properpreparation and guidance, support and career struc-ture. Much of the lack of clarity and problems be-tween education and practice resulting from jointappointments could be reduced. Local initiativescould concentrate on preparing post-holders forthe role rather than the conflicting demands fromwithin and between services and education aboutthe focus of the role (Hancock et al., 2007).

References

Aston, L., Mallik, M., Day, C., Fraser, D., 2000. An explorationinto the role of the teacher/lecturer in practice: findingsfrom a case study in adult nursing. Nurse Education Today 20(3), 178–188.

Banton, M., 1965. Roles: An Introduction to the Study of SocialRelations. Tavistock Publications, London.

Brown, N., Pollock, L.C., 1998. The ideal role of the nurseteacher in the clinical area: a comparison of the perceptionsof the perspectives of mental health, learning difficulties andgeneral nurses. Journal of Psychiatric and Mental HealthNursing 5, 11–19.

Carnwell, R., Baker, S.A., Bellis, M., Murray, R., 2007. Manage-rial perceptions of mentor, lecturer practitioner and linktutor roles. Nurse Education Today. (8), 923–932.

Carson, A., Carnwell, R., 2007. Working in the theory practicegap: the lecturer practitioner’s story. Learning in Health andSocial Care 6 (4), 220–230.

Davies, S., White, E., Riley, E., Twinn, S., 1996. How can nurseteachers be more effective in practice settings? NurseEducation Today 16 (1), 19–27.

Driver, J., Campbell, J., 2000. An evaluation of the impact oflecturer practitioners on learning. British Journal of Nursing9 (5), 292–300.

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Fairbrother, P., Ford, S., 1998. Lecturer–practitioners: aliterature review. Journal of Advanced Nursing 27, 274–279.

Gidman, J., 2001. The role of the personal tutor: a literaturereview. Nurse Education Today 21 (5), 359–365.

Hancock, H., Lloyd, H., Campbell, S., Turnock, C., Craig, S.,2007. Exploring the challenges and successes of the lecturerpractitioner role using a stakeholder evaluation approach.Journal of Evaluation in Clinical Practice 13, 758–764.

Jowett, R., McMullan, M., 2007. Learning in practice – practiceeducator role. Nurse Education in Practice 7, 266–271.

Lathlean, J., 2007. Researching the implementation of pioneer-ing roles in nursing and midwifery: empirical insights aboutlecturer practitioners, consultant nurses and nurse regis-trars. Journal of Research in Nursing 12 (1), 29–42.

Leigh, J., Howarth, M., Devitt, P., 2005. The role of the lecturerpractitioner: an exploration of the stakeholders and practitio-ners perspective. Nurse Education in Practice 5 (5), 258–265.

Newton, A., Smith, L.N., 1998. Practice placement supervision:the role of the personal tutor. Nurse Education Today 18 (6),496–504.

Salvoni, M., 2001. Joint appointments: another dimension tobuilding bridges. Nurse Education Today. 21, 65–70.

Williamson, G.R., 2004. Lecturer practitioners in UK nursing andmidwifery: what is the evidence? A systematic review of theliterature. Journal of Clinical Nursing 13 (7), 787–795.

Williamson, G.R., Webb, C., Abelson-Mitchell, N., 2004. Devel-oping lecturer practitioner roles using action research.Journal of Advanced Nursing 47 (2), 153–164.

Available online at www.sciencedirect.com