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Exploring student nurses' and their link lecturers' experiences of reasonable adjustments in clinical placement

26 September 2019
Volume 28 · Issue 17



student nurses who attend preregistration nursing programmes in the UK are assessed on their academic work and their performance in clinical placement. Some of them require reasonable adjustments to be made in order to support their learning. Although there is national guidance on making reasonable adjustments for academic work, information on this associated with clinical placement is limited. The nursing literature reports varying levels of success in facilitating reasonable adjustments in clinical placement.


to explore the experiences of student nurses who require reasonable adjustments and their link lecturers associated with the facilitation of this support in clinical placement.


a descriptive phenomenological methodology was adopted. Data were collected using semistructured interviews with seven student nurses and three link lecturers from three fields of nursing (adult, child and mental health). Audiorecorded interview data were transcribed, coded and thematically analysed. Phenomena were identified and discussed, viewed through relevant educational theoretical lenses and in conjunction with nursing research literature.


three main themes emerged: defining reasonable adjustments, supporting students, and being professional.


all study participants could define reasonable adjustments and described a variety of experiences of these being facilitated in clinical placement. The process could be complex and depended on many factors that could promote or hinder the provision of support.

Student nurses who attend preregistration nursing programmes in the UK are assessed on their academic work and their performance in clinical placement. Some of these require reasonable adjustments to support their learning. Storr et al (2011) suggested examples of conditions requiring reasonable adjustments include dyslexia and dyscalculia (intellectual disabilities), mental health issues and long-term health conditions. According to the Equality Act 2010, part 2, section 6 (1b), such an ‘impairment has a substantial and long-term adverse effect on P's ability to carry out normal day-to-day activities'.

National guidance sets out the reasonable adjustments available for academic work, which include access to disability tutors and computer software aids, and allowing extra time for assessments (Equality Challenge Unit, 2010). However, the information available for reasonable adjustments associated with clinical placement is limited.

The Nursing and Midwifery Council (NMC) provides guidance on this in preregistration nursing programmes, which includes defining who is responsible for supporting student nurses while they are on clinical placement. This is primarily the nurse mentor (supervisor) and the link lecturer (a nurse lecturer from the university who visits clinical placement areas regularly), who ensure that student nurses have the most effective learning experience (NMC, 2008). However, only limited guidance is provided by the NMC regarding reasonable adjustments for student nurses on clinical placement. More detailed and helpful guidance has been produced by the Royal College of Nursing (2010; 2017), which suggests that student nurses are given access to coloured paper or screens as aids to reading medical paperwork, are allowed extra time to read patient notes and can use other technology in the clinical placement setting. Although useful, this guidance is brief and does not address how the suggested reasonable adjustments can be facilitated.

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