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Summary
This article reviews the literature on primary care settings as learning environments, and examines how the learning opportunities available for nurses and students can be recognised and harnessed. The aim is to establish the effectiveness of primary care settings as learning environments. This article also discusses mentoring experiences of district nurses, school nurses and health visitors.
THE CURRENT ethos of multiprofessional and interprofessional learning, and notions such as work-based learning and learning organisations, are fuelling the development of continuing professional learning in clinical areas. It is, therefore, an ideal time to explore the nature of, and the extent to which, primary care clinical settings are effective learning environments for all involved. The learning ethos in primary care settings does not seem to have been examined adequately. Research findings, for example the study by Phillips et al (2000), suggest that the experience of some pre-registration students on placement is that the mentoring and assessment of students are often given low priority because of the heavy workloads of practitioners.
The research literature and guidelines focus on acute clinical settings as learning environments, but there is little information dealing with this in primary care areas. Clinical practitioners' experiences show that primary care clinical settings constitute a diverse and fertile source of learning for students, with practitioners engaged in substantial levels of autonomous practice that directly benefit patients or clients.
Rationale
Literature searches indicate that little has been documented in relation to primary care settings as clinical learning environments, and the literature that does exist focuses mainly on hospital-based practice settings (Chan 2001, Fretwell 1980, Hart and Rotem 1995, Neary 1997). However, the growing numbers of pre-registration students and the recognition that all individuals are lifelong learners (Gopee 2001, Tight 1998) have created a need to use all healthcare settings for student practice placements and professional development.
The English National Board (ENB) and the Department of Health (DoH) publication Placement in Focus (ENB/DoH 2001a), discusses a range of principles and guidance for good practice in relation to student clinical placements. The underlying principles and guidance are based on the need for a dynamic and proactive approach by the organisation in the provision and assessment of practice experience. Consequently, the document indicates that higher education institutions (HEIs) and...