Elsevier

Nurse Education Today

Volume 61, February 2018, Pages 43-48
Nurse Education Today

Effects of a service learning experience on confidence and clinical skills in baccalaureate nursing students

https://doi.org/10.1016/j.nedt.2017.11.009Get rights and content

Highlights

  • Service learning bridges the chasm between the classroom and “real life” clinical.

  • Diabetes camp illustrates the daily challenges for children with and without diabetes.

  • Teaching beyond the classroom fostered critical thinking and community engagement.

  • Reflection analysis found that clinical, leadership, and personal attributes improved.

Abstract

Background

Camp programs yield positive and lasting benefits for children. Integrating a summer camp into a nurse course with a service learning design fosters learning beyond the classroom and enhances community engagement.

Objective

The purpose of this study is to describe the nursing students' experience and perceived confidence after completing a service learning nursing course.

Design

This is a descriptive, qualitative research study that used reflection and a perceived confidence questionnaire.

Setting

The study was conducted in a school of nursing and surrounding university campus facilities during the diabetes camp.

Participants

The participants (n = 23) were nursing students who enrolled in the nursing course.

Methods

As part of the course requirements, students completed an eight item question confidence survey before and after the diabetes camp related to diabetes and camp management, and interpersonal abilities with patients, families, and healthcare professionals. Within 48–72 h after diabetes camp, the students completed the reflection paper. The pre and post Confidence Surveys were analyzed using a t-test and thematic analysis was used to analyze the reflection paper.

Results

Overall, perceived confidence levels increased after completing the service learning course (t =  9.91, p = 0.001). Four themes emerged from the qualitative analysis: pre-camp assumptions and fears, growth in confidence, understanding diabetes management in the community, and appreciation for learning beyond the classroom and hospital setting.

Conclusions

This service learning course provided nursing students the ability to not only develop diabetes clinical skills and perceived confidence, but also life skills including teamwork, leadership, and conflict resolution.

Introduction

In the United States, more than 14 million children and adolescents attend summer camp each year (American Camp Association, 2017). Currently, camp programs are available based on interest, location, and different populations. For children with chronic illness, the camp experience has shown to have a lasting effect on psychosocial development, including significant effects on self-esteem, peer relationships, independence, leadership, values, and willingness to experience new things (American Academy of Pediatrics [AAP], 2011; Bultas et al., 2015). For children with Type 1 diabetes (T1D) experiencing a summer camp specialized for a child with T1D facilitates positive experiences as well as a traditional camp, but in a medically safe environment (AAP, 2011; American Diabetes Association [ADA], 2012). An equally important goal is to enable children with T1D to meet and share their experiences with one another while they learn to be more responsible for their condition. For this to occur, medically trained camping staff must be available to ensure optimal safety as well as an integrated camping/educational experience (American Academy of Pediatrics, 2011, American Diabetes Association, 2012). Camp for children with T1D, therefore, provides vital education in a setting that gives each child the best chance of seeing an improvement in knowledge and self-management of the disease (American Academy of Pediatrics, 2011, Bultas et al., 2015). For the nursing students, experientially, a summer camp provides hands on involvement with diabetic management in a more relaxed “real world” setting.

Diabetes and You: Kamp for Kids (K4K) provides education, camaraderie, and support to children with T1D. K4K typically has 65–85 campers between the ages of 4 and 17 that attend each year, 50–60% of whom have T1D. Unique to this summer camp is the incorporation of the concept of service learning, which has various definitions. Service learning is a well-established andragogy, with the primary purpose of translating information presented in didactic courses to real-world situations (Dewey, 1938). The Corporation for National Service (1990) defines service learning as a “method under which students learn and develop through active participation in thoughtfully organized service experiences that meet actual community needs, that [are] integrated into the students' academic curriculum or provide structured time for [reflection, and] that enhance what is taught in school by extending student learning beyond the classroom and into the community…” According to Kazemi and colleagues, service learning can provide nursing students the opportunity to participate in a learning environment pertaining to a specific population (Adegbola, 2013, Kazemi et al., 2011, Helms et al., 2016). When integrated into the nursing curriculum, service learning not only reinforces academic coursework, but also strengthens critical thinking, responsibility, and personal development (Savage et al., 2015, Waterman, 2013). In developing a three-phased model for service learning course design for faculty, Coleman et al. (2014) found that a concentrated learning experience increased confidence as students learned about their own skills. Other researchers found that service learning fostered personal development (Bamber and Hankin, 2011, Helms et al., 2016, Wilson, 2011).

The nursing elective course NURS411: “Topics in Healthcare Delivery: Teaching Wellness to Children” provides students opportunity to expand their knowledge of diabetes management beyond the classroom or hospital. This course has an on campus classroom and clinical component, K4K. The purpose of this study then is to describe the nursing students' experience and perceived confidence in their nursing skills after completing a service learning nursing course. Also, overviewed will be the importance of service learning and its integration into the nursing curriculum.

Section snippets

Course Classroom Component

The college classroom component occurs six weeks before the clinical component, K4K, of the course. During the classroom portion of the course, students attend five instructional classes centered on the care and management of children with T1D and also develop and implement K4K. The students are randomly assigned into five groups and each group organizes and manages K4K for one day. Students not only learn concepts to manage a group event such as a camp, but also the translation of these

Research Design

This descriptive qualitative research study used open ended questions to describe nursing students' experience and perceived confidence in their nursing skills after completing a service learning nursing course.

Participants

Using a purposeful sample, a total of 23 students enrolled in the summer 2016 course; all completed the on campus classroom and camp successfully. The majority of the students (87%) in this study are in a second degree nursing program, which requires completion of a baccalaureate degree

Analysis

The pre- and post-Perceived Confidence Surveys were analyzed using IBM Statistical Package for the Social Sciences (SPSS) version 23, Chicago IL. Paired t-test was used to analyze analyzed each question of the pre- and post-Perceived Confidence Survey with significance determines at p < 0.05. Two authors experienced in qualitative research used Braun and Clarke's six phase process of thematic analysis to analyze the reflection analysis papers (Braun and Clarke, 2006). After de-identifying the

Results

A paired t-test analysis resulted in a significant difference between the between the pre- and post-perceived confidence survey (t =  9.91, p = .001). The largest difference between the mean among the eight questions was related to the students' confidence in insulin pump therapy with a pre-camp mean of 2.35 (± 0.71) compared to a post-camp mean of 3.48 (± 0.59). The paired t-test demonstrated statistically significant differences in mean scores of perceived confidence in working with children with

Discussion

This unique service learning course allows college students to not only learn diabetes education and managerial concepts in a classroom environment, but also to translate the learned information into a real-world experience during the week of K4K. This is consistent with Dewey's definition of service learning (1938) as well as the Corporation for National and Community Service (1990) and nurse researchers' definition (Kazemi et al., 2011) who defines service learning as an enhance education by

Limitations

This study has some limitations that warrant discussion. This study used a purposeful sample from second degree nursing students from one university, thus has limited generalizability. The participants recently completed a clinical experience in the in-patient hospital setting that may have elevated their perceived confidence prior to K4K. Another limitation is that there was no control group to compare the perceived confidence survey with the study sample. Despite these limitations, this

Conclusion

For children with T1D a camp experience focused on healthy living and diabetes management is such a positive experience as they meet other children with T1D and maybe help others without T1D understand it more (AAP, 2011). This course provides an unparalleled opportunity to immerse the student nurse into diabetes education and management skills not usually gained in a hospital setting. Also, it provides a heightened sense of community engagement and responsibility not only to the campers and

Funding

This research study did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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