An examination of block and integrated practice learning models within employer sponsored pre-registration nursing programmes

Abstract

United Kingdom [UK] pre-registration nursing programmes [PRNPs] allocate half their curriculum learning hours to practice-based education which predominantly involves supervised workplace experience based on a block and/or integrated practicum model. Nevertheless, remarkably little robust research investigates the relative effectiveness and strengths/shortcomings of these models. This mixed-methods study examines block and integrated placements within employersponsored BSc (Hons) PRNPs provided by a UK-based distance learning university. Beliefs/experiences of the two practicum designs shared by 37 respondents from four stakeholder groups were acquired via semi-structured interviews. Quantitative analysis involving a sample of 460 nursing students was also undertaken to ascertain whether exclusive exposure to one placement type affected withdrawal/achievement rates. The research question for this investigation was: ‘What effect does a sponsor’s decision to adopt an integrated or block model of practice learning for those PRNP students whom they employ as non-registrant carers have on the student learning experience and retention/achievement?’. Qualitative content analysis of the interviews yielded five common themes. Most importantly, respondents perceived the block model as more effective in promoting affinity, facilitating role transition, and mitigating against perceived difference, although the integrated framework was deemed preferable for services releasing students from their non-registrant carer work. Based on these results, critical situational factors requiring consideration when selecting the most appropriate practicum model are identified. Subsequent crosstabulation and multinomial logistic regression analyses failed to demonstrate any statistically significant relationship between placement structure and student retention/degree classification. Finally, qualitative study data were re-analysed against the theory of human relatedness [THR]. It is argued that stakeholders may form their view of specific placement models by implicitly evaluating them against criteria akin to the key THR propositions. Improving practicum experiences might, therefore, also necessitate revising learning environment audit tools, challenging stakeholder practicum design prejudices and changing emphasis within PRNP curricula to better address these propositions.