The effects of clinical facilitators' pedagogic practices on learning opportunities for students who speak English as an additional language: An ethnographic study.

BACKGROUND: Increasing numbers of undergraduate nursing students speak English as an additional language. Clinical placements can be difficult for many of these students and their clinical facilitators. The causes of challenges are often reported to be students' lack of English language ability or, for some students, learning styles that are not suited to Western style education.

OBJECTIVE: The purpose of this research was to investigate how clinical facilitators' pedagogic practices in hospital settings enabled or constrained the learning of students for whom English was an additional language.

METHOD: This research used an ethnographic design to observe the interactions of twenty-one first year students for whom English is an additional language, and their three facilitators. Observations occurred during three two-week clinical placement blocks, in three large metropolitan hospitals in Australia. Written ethnographic field notes were made during the observations. Field notes were analysed in two stages: firstly, to identify major themes, and secondly, to map the spaces and activities where facilitators and students interacted.

RESULTS: The study found that there were multiple learning spaces in the hospitals, each of which was associated with particular learning activities between facilitators and students. These activities provided access to opportunities for learning core nursing skills, as well as for socialisation into the language of nursing. However, not all students had access to these opportunities. The pedagogic practices facilitators used created or constrained learning opportunities for students.

CONCLUSION: This paper proposes a new way of thinking about the supervision of students for whom English is an additional language in clinical settings. Rather than focusing on a lack of English language proficiency or cultural heritage factors, it proposes that a guided approach to using spaces and activities can maximise students' opportunities for learning.