Evidence-based practices in mentoring student nurses in clinical placement : a systematic review and meta-analysis / Mark Job G. Bascos

Dissertation (Doctor of Philosophy in Nursing) -- Saint Louis University, January 2018.

Mentoring is an important variable in the learning process of student nurses during
clinical placement. Mentoring practices have been reported across the international literature to
be essential in the personal and professional development of students. Despite the benefits, the
gap created by the variations and limited studies in mentoring in clinical placement may create
confusion in terms of selecting and implementing effective mentoring practices.
To identify effective mentoring practices in the clinical placement of student nurses
to be integrated in developing a mentoring program.
A systematic review and meta-analysis was conducted. Included studies identified
mentoring practices involving clinical instructors, nurse educators, staff nurses, mentors, or peer
students and examined the effectiveness of improving the knowledge, skills, and learning
outcomes of student nurses in the clinical area. Study designs included randomized controlled
trials and quasi-experimental studies.
The search included electronic databases and manual searching of published and
unpublished literature. Major databases include PubMed, Cochrane Central Register of
Controlled Trials, Joanna Briggs Institute Database of Systematic Reviews and Implementation
Reports, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Medline.
Reference lists of retrieved articles were reviewed to identify any further studies, including grey
literature databases. The search was restricted to articles available in the English language. Two
reviewers independently assessed for risk of bias and performed data extraction. The data were
summarized and statistically analyzed using the Comprehensive Meta-Analysis version 3.0
software.
Of the 17,946 records screened, six studies met the inclusion criteria Mentoring
practices that have shown positive outcomes in the clinical placement of student nurses involve
orientation, goal setting, supervision, psychosocial support, self-reflection, and feedback. The
studies reported the positive outcomes of mentoring in the knowledge, skills, self-concept, stress,
anxiety, confidence, satisfaction, support, and in a welcoming environment. Meta-analyses
revealed a statistically significant effect of mentoring practices in the clinical placement of
students (Standardized Mean Difference [SMD] 0.357, 95% Confidence Interval [CI] 0.038,
0.677,=69.26%, p = 0.028). A subgroup analysis resulted to a statistically significant effect of
mentoring by nurses and peers in the improvement of knowledge and skills of student nurses
(SMD =0.426, 95% CI, 0.202, 0.650, P = 0%, p=0.000).
This meta-analysis suggests that student nurses can benefit from mentoring in their
clinical placement particularly in improving knowledge and skills. The findings further suggest
that mentoring may be able to influence an interaction of a conducive clinical learning
environment and positive learning outcomes. This study recommends the integration of the
results in the development of a student mentoring program. Future research on the impact of
mentors' characteristics and other mentoring practices in non- clinical settings is also
recommended to enhance the development of mentoring programs.