An exploration of the role of the Academic Clinical Tutor (ACT) as a model of supporting nursing students in practice

In the United Kingdom nurse education has undergone a radical change over the last 30 years. The integration of nursing students within practice has evolved from apprenticeship style to bespoke mentoring support. In 2016 the Nursing and Midwifery Council (NMC) dictated that nursing programs must be comprised of 2300 hours of clinical practice and nursing students will spend varying lengths of time in a number of different clinical areas, depending on the field of practice nursing students are enrolled on. Clinical placements are specifically designed to facilitate authentic learning opportunities and are an integral component of undergraduate nursing programs (van der Riet et al., 2018). However, these may be fraught with problems that are multi-dimensional in nature. Currently, nurse education relies on Registered Nurses to act as mentors to educate, support, guide and assess the nursing student’s competency and knowledge in practice (Wilson, 2014). Despite mentors being required to undertake a robust mentorship programme in preparation for this role many barriers remain. Mentors report feelings of inadequacy, lack of educational knowledge, lack of time and lack of support in facilitating nursing students in their learning (Sandford, 2012). Students report lack of support, feelings of being ignored and no enthusiasm for teaching from mentors (Jack et al., 2017)

In May 2018, NMC launched Standards for Supervision and Assessment which will create the new roles of Practice Supervisor, Practice Assessor and Academic Assessor in clinical practice by 2020. It is envisaged that these roles will promote good quality student learning and achievement of practice lead student outcomes. (NMC 2018). This exploratory study is therefore timely as by examining how the different models of student supervision and assessment work in practice, we can explore how students will feel supported and empowered in their learning to develop the requisite qualities and skills of a registered nurse as outlined in the NMC standards Framework for nursing and midwifery education (2018)

In the USA, the Academic Clinical Tutor (ACT) is a bespoke clinical role, which is primarily an educator facilitating learning for nursing students in practice. They are equipped with the necessary skills to encourage critical thinking and questioning, enhance the learning experience, and develop evidence-based practice.
Through this Florence Nightingale Travel Scholarship, we have had the opportunity to visit the Faculty of Nursing, Kent State University, the world-renowned Cleveland Clinic, the University Hospital Medical centre and associated sites to observe a collaborative model of student supervision and assessment. The visits comprised of observation of the ACT in their role of supporting the nursing student in practice, followed by informal discussions with the ACT and Clinical Directors. This provided the opportunity to question and clarify aspects of the role and to explore if further observation was required. Informal discussions were also held with nursing staff and nursing students to identify the impact of the ACT role on the clinical environment, student learning and clinical experience. It also highlighted the value placed on the role of ACT in supporting students in practice.

Our observations concluded that the quality of the learning experience and the student’s sense of belonging that is fostered by the ACT, are worthy of further examination to enhance the student nurses’ learning experience in the clinical setting in the UK. A further comparative study between the two systems would be timely given the proposed changes to practice learning support and supervision to be implemented in 2020 (NMC, 2018)