The presence of nursing students and its influence on the quality of care provided by staff nurses

Background: Research on the field practice of nursing students has focused mainly on the effects of this experience for the students. Although it has been suggested that the presence of students may influence the behavior of practitioners, this has yet to be empirically validated. Purpose: The purpose of the study was to test the hypothesis claiming the presence of students in hospital wards will improve the quality of care given by the nurses. The theoretical model supporting this was based on 2 main concepts: self-focus and social role. Method: Systematic observations were carried out in 15 hospital wards in a medical center in Israel. Observations were conducted according to a strict protocol based on the Israeli Standard Nursing Procedures. Observers graded nursing activities on a specially designed quality of care scale, which allowed for the computing of "quality of care" indices. A within-subject design was used, in which each subject was compared with his or her own performance (with/without students). Results: The results were consistent with the hypothesis. In the presence of students, nurses provided higher quality care when compared with their own performance in the absence of students. Conclusions: The presence of students seemed to have a beneficial effect on nurses' performance and quality of care. Data analysis supported the hypothesized theoretical model. Implications for further research and practice are discussed.