Nursing Students’ Errors in Clinical Learning. Qualitative Outcomes in a Mixed Methods Research
Introduction: To err is human. Although this is a common phrase, when it comes to health professional in general and to nursing in particular, not only errors can be dangerous but they are not well accepted nor comfortable. Even so, going through professional life without an error might be exception and not rule. There should not be complacency and to face the issue with the dignity that being a nurse demands, errors must be acknowledged, not hidden, as a way of professional and personal development in order to assure a safe and ethic professional practice (Disch, Barnsteiner, Connor, & Brogren, 2017; Gorini, Miglioretti, Pravettoni, 2012; Espada, 2016). These occurrences can be a way of constructive learning by replacing blame for prevention (Drach-Zahavy., Somech., Admi, Peterfreund, Peker, & Priente, 2014; Zieber & Williams, 2015).
1 - Objectives: To analyze factors associated with nursing students’ errors during clinical learning, and their perceptions regarding these events and the opportunity for learning and development provided by them.
2 - Method: Convergent Mixed Method design according Creswell and Clark (2011). Qualitative dimension included face to face and internet interviews. Data analysis followed Miles and Huberman (1994) method. Authorization from Director of the Nursing School was obtained. Belmont Report Ethics guidelines was the ethics foundation for this study.
3 - Results: Nursing student’s errors were revealed according to their perceptions. The participants' perception of what is an error was not unanimous. They occurred in all phases of the nursing process and in transversal skills. Implementing phase of nursing care was the one with more errors, following medication errors, errors in needs identification, errors in transversal (soft) skills, errors in care planning, and, at last, errors in care evaluation. Only 2nd year students reported transversal skills. Errors were acknowledged as learning and developmental opportunities. Second-year students considered more than 4th year that errors contributed to their learning. Errors as an impediment to learn and development was more mentioned by 4th year participants. Students acknowledge that errors has contributed to their learning and development because they have recognized that there has been further development and awareness.
4 - Final Considerations: Students acknowledged their errors and ascribe to themselves reasons and what could have prevented what happened. Mixed Method was a very adequate design to study phenomena. Qualitative dimension was essential to reveal and achieve the objectives. Outcomes from qualitative methods informed and completed quantitative data on this research. Therefore, Mixed Methods research is a very important path to study sensitive issues as errors committed in health care.
There were findings only possible by qualitative methods of collecting and analyzing data. Qualitative dimension of this research allowed entering in a problem that is not easy to present. Suggestions founded on the findings are presented.