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ABSTRACT A structured literature review was conducted to un- derstand clinical instructors’ perceptions of their role and the factors that facilitate and constrain their teaching in undergraduate nursing programs. The literature published in English between 2000 and 2011 was searched, and data were extracted from 15 articles that met the inclusion crite- ria. The analysis identified four themes—characteristics of the role, characteristics of eff ective clinical teaching, influ- ence of the clinical context on the role, and influence of the academic context on the role. Clinical instructors are por- trayed as needing to be good educators, as well as excel- lent clinicians. However, they often lack formal education and professional development opportunities related to the role and must draw on their individual personal and profes- sional experiences to guide their teaching to meet the de- mands of both the clinical and academic contexts in which they simultaneously work. S ince Florence Nightingale’s day, the clinical instruction of nursing students has been recognized as a key component of nursing education (Brown, Nolan, Davies, Nolan, & Keady, 2008; Tanda & Denham, 2009). Ideas about what and how nursing students acquire knowledge and clinical skills dur- ing their clinical instruction have developed over time—from an apprentice–laborer role learning about the tasks of nursing, to a teacher-led experience, where students are meant to learn how to be critical thinkers in rapidly changing clinical environ- ments (Bell-Scriber & Morton 2009; Carr, 2007; Gillespie & McFetridge, 2006; Phillips & Vinten, 2010; Tanda & Denham, 2009). Scholars have identified that students’ clinical practice and their experiences with clinical instructors (CIs) play an important role in shaping their professional values (Addis & Karadag, 2003; Gillespie, 2002; Haigh & Johnson, 2007; Tan- ner, 2005). It seems apparent that modern day CIs, that is, the “teach- ers” who are with students in the clinical setting, need to be expert in both clinical and teaching skills. Yet, CIs are often hired based on their clinical expertise, and little support is pro- vided to develop their teaching skills (Ironside, Diekelmann, & Hirschmann, 2005). Scholars have noted that CIs often do not use a higher level of questioning that would stimulate students’ critical thinking (Hsu, 2006, 2007). Furthermore, the small body of literature about the CI’s role suggests that it is complex, requiring interpersonal skills to manage students, staff nurses, and patients’ needs, in addition to having clinical and teaching expertise (Gillespie & McFetridge, 2006; Ramage, 2004). Some research also examines the educational support needed for CIs (Bell-Scriber & Morton, 2009; Krautscheid, Kaakinen, & Warner, 2008; Phillips & Vinten, 2010; Wolf, Beitz, Petters, & Wieland, 2009). For example, Wolf et al. (2009) identified that student–faculty relationships are a critical area of learning for new CIs and that they need to know the education theory that is appropriate for both the classroom and clinical settings.
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  • Spring '14
  • KarieE.Feldman
  • Nursing, clinical instructor

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