The use of block and integrated practicum structures within employer-sponsored pre-registration nursing programmes: A Critical Realist study

This study, underpinned by Critical Realism, explores the use of block and integrated placement frameworks within employer-sponsored pre-registration nursing programmes at a United Kingdom university. Digitally recorded, commercially transcribed semi-structured interviews involving four stakeholder groups (employers, students, mentors, and practice tutors), were exposed to qualitative content analysis, and yielded four common themes; connectedness, role transition, carer work and difference. Most respondents perceived the block model as being more effective in promoting connectedness, facilitating role transition, and mitigating against perceived difference; although use of the integrated model was considered more desirable for services having to release these students from carer work. Results also highlight various factors which may influence the most appropriate choice of practicum model, including individual student characteristics, the service in which learners undertake their non-registrant care work, the nature of the placement and mentor autonomy within their clinical role. Congruent with the principles of Critical Realism, efforts to establish potential underlying causative mechanisms associated with practicum experiences are underway and currently involves scrutiny of these results against key features of the Theory of Human Relatedness. Furthermore, a regression analysis to identify the statistical relationship between the placement model completed by two national cohorts and retention rates/degree classifications is in progress. This combined work contributes to the extremely limited body of knowledge in an important area of curriculum design within nurse education.