Les Perceptions des Étudiants en Soins Infirmiers Pédiatriques en Milieu Communautaire

Over the last decade health care delivery has shifted from hospitals to the community resulting in a significant reduction of hospital-based clinical placements for nursing students to practice and learn. Studies have emerged describing this problem and outlining the ways in which Colleges and Universities have attempted to deal with the acute shortage of clinical areas in nursing and other health care programs. Several studies describe the development of community-based clinical experiences, and some of these examined students’ perceptions. One finding appears to be constant: student perceptions of community experiences have an effect on their learning outcomes. There is an increasing need to teach nursing students in community settings both to contend with the shortage of hospital-based placements and to prepare students for future practice. Pediatric hospitals are no longer able to provide as many clinical placements as they once did. This has created a problem for college nursing departments. Over the past five years, John Abbott College’s pediatric nursing teachers have attempted to deal with this problem in numerous ways; however, students and faculty were dissatisfied with the solutions as there was a lack of development of the pediatric community clinical component. The purpose of this study is to explore nursing students’ perceptions of pediatric community experiences both prior to the start of the clinical rotation and following the experience. Student perceptions of nursing in community settings are an important element in the level of student satisfaction and ultimately their learning in pediatric clinical settings. In order to explore the John Abbott College’s nursing students’ perceptions, data was collected from a small segment of the population. Students’ perceptions were explored quantitatively through the use of questionnaires using a Likert scale administered both prior to the clinical experience and following the experience; and qualitatively, using content analysis of reflective journals and focus group discussions. The results of the study demonstrated that prior to the community rotations; students did not know what the experience would involve. They felt apprehensive due to being inadequately prepared for the experience and questioned the actual learning they would acquire from a community setting. Following the pediatric community experience, students perceived benefits to their learning particularly in the development of their abilities to communicate with children, and to recognize and apply principles of growth and development to children of different age groups and with different health needs. In addition, students perceived an increase in their self- confidence when teaching children. They also developed an appreciation of the role of the nurse in health promotion for individuals’ in community settings. Furthermore, students described an increase in their awareness of resources that are available in the community. Overall, students were satisfied with their pediatric community clinical experience. The results of this study indicate that adequate student preparation is required prior to the community clinical experience. This preparation would include a clear description of the clinical objectives and associated learning activities, as well as an explicit explanation of the evaluation process. Finally, it is recommended that the pediatric nursing teachers continue to search for community clinical areas that can enhance student learning in pediatrics. This study contributes to the literature on community experiences for nursing students since it explored students’ perceptions before and after the community clinical rotation.

SWOT analysis of a pediatric rehabilitation programme : a participatory evaluation fostering quality improvement

Purpose. To present the results of a strengths, weaknesses, opportunities and threats (SWOT) analysis used as part of a process aimed at reorganising services provided within a pediatric rehabilitation programme (PRP) in Quebec, Canada and to report the perceptions of the planning committee members regarding the usefulness of the SWOT in this process. Method. Thirty-six service providers working in the PRP completed a SWOT questionnaire and reported what they felt worked and what did not work in the existing model of care. Their responses were used by a planning committee over a 12- month period to assist in the development of a new service delivery model. Committee members shared their thoughts about the usefulness of the SWOT. Results. Current programme strengths included favourable organisational climate and interdisciplinary work whereas weaknesses included lack of psychosocial support to families and long waiting times for children. Opportunities included working with community partners, whereas fear of losing professional autonomy with the new service model was a threat. The SWOT results helped the planning committee redefine the programme goals and make decisions to improve service coordination. SWOT analysis was deemed as a very useful tool to help guide service reorganisation. Conclusions. SWOT analysis appears to be an interesting evaluation tool to promote awareness among service providers regarding the current functioning of a rehabilitation programme. It fosters their active participation in the reorganisation of a new service delivery model for pediatric rehabilitation.

Development, implementation, and evaluation of the Apollo model of pediatric rehabilitation service delivery

This article presents the experience of a rehabilitation program that un- dertook the challenge to reorganize its services to address accessibility issues and im- prove service quality. The context in which the reorganization process occurred, along with the relevant literature justifying the need for a new service delivery model, and an historical perspective on the planning; implementation; and evaluation phases of the process are described. In the planning phase, the constitution of the working committee, the data collected, and the information found in the literature are presented. Apollo, the new service delivery model, is then described along with each of its components (e.g., community, group, and individual interventions). Actions and lessons learnt during the implementation of each component are presented. We hope by sharing our experiences that we can help others make informed decisions about service reorganization to im- prove the quality of services provided to children with disabilities, their families, and their communities.