Building bridges: evaluation of a practice-based foundation course

Introduction Successful transition into busy, acute clinical areas such as the Emergency Department and Medical Admissions is influenced by the provision of appropriate support for newly-qualified or inexperienced nurses. This paper presents the collaborative development, implementation and evaluation of an innovative practice-based, accredited foundation course situated across five acute hospitals in south-west London, UK. Methods The aims of this two-phase case study evaluation included identifying how the course influenced participants‘ development, to what extent and why. Phase one was a longitudinal exploratory study which used a phenomenological approach and involved all nurses (n=20) enrolled on the first run of the course. Data collection included focus group interviews and questionnaires at the beginning, middle and end of the course. Phase two employed a mixed-methods design and focused upon stakeholder evaluation. Mentors, senior nurses, practice educators and managers participated in semi-structured interviews individually and in small groups. Further data were collected from the second cohort via questionnaires; analysis of the nurses‘ portfolios; and employers‘ recruitment and retention figures. Results Phase one results were conceptualised as a theoretical model. Participants described a developmental journey involving increasing confidence, job satisfaction, knowledge and skills. The course had a positive influence; in particular providing a 'bridge‘ to support the transition into practice for newly-qualified staff. Practice had both positive and negative influences, with staff from some areas reporting a significant lack of support for the work-based learning activities. Stakeholder evaluation echoed the positive influence of the course on professional and academic development and also recruitment and retention of staff. Discussion Whilst the results of this study are not generalisable, evaluation of this course has demonstrated the value of providing structured development for junior staff in demanding clinical environments. The theoretical model generated may inform the development of similar courses elsewhere.