Nursing supervisors’ perspectives on student preparedness before clinical placements- a focus group study

Ann-Chatrin L. Leonardsen; Siri E. Brynhildsen; Mette T. Hansen; Vigdis A. Grøndahl

doi:10.1371/journal.pone.0252483

Peer Review History

Original SubmissionFebruary 3, 2021
22 Mar 2021 Decision Letter - Mojtaba Vaismoradi, Editor PONE-D-21-03784 Nursing supervisors’ perspectives on student preparedness before clinical placements- a focus group study PLOS ONE Dear Dr. Leonardsen, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please submit your revised manuscript by May 03 2021 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. 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Please include a copy of the interview guide used in the study, in both the original language and English, as Supporting Information, or include a citation if it has been published previously. 3. We note that you have indicated that data from this study are available upon request. PLOS only allows data to be available upon request if there are legal or ethical restrictions on sharing data publicly. For information on unacceptable data access restrictions, please see http://journals.plos.org/plosone/s/data-availability#loc-unacceptable-data-access-restrictions. In your revised cover letter, please address the following prompts: a) If there are ethical or legal restrictions on sharing a de-identified data set, please explain them in detail (e.g., data contain potentially identifying or sensitive patient information) and who has imposed them (e.g., an ethics committee). Please also provide contact information for a data access committee, ethics committee, or other institutional body to which data requests may be sent. b) If there are no restrictions, please upload the minimal anonymized data set necessary to replicate your study findings as either Supporting Information files or to a stable, public repository and provide us with the relevant URLs, DOIs, or accession numbers. Please see http://www.bmj.com/content/340/bmj.c181.long for guidelines on how to de-identify and prepare clinical data for publication. For a list of acceptable repositories, please see http://journals.plos.org/plosone/s/data-availability#loc-recommended-repositories. We will update your Data Availability statement on your behalf to reflect the information you provide. 4. Thank you for submitting the above manuscript to PLOS ONE. During our internal evaluation of the manuscript, we found significant text overlap between your submission and the following previously published works, some of which you are an author. https://bmcmededuc.biomedcentral.com/track/pdf/10.1186/1472-6920-12-112.pdf https://link.springer.com/article/10.1186/s12909-017-0966-4?code=3b519ef9-c50c-49a5-94ee-5ab75637dc44&error=cookies_not_supported We would like to make you aware that copying extracts from previous publications, especially outside the methods section, word-for-word is unacceptable. In addition, the reproduction of text from published reports has implications for the copyright that may apply to the publications. Please revise the manuscript to rephrase the duplicated text, cite your sources, and provide details as to how the current manuscript advances on previous work. Please note that further consideration is dependent on the submission of a manuscript that addresses these concerns about the overlap in text with published work. We will carefully review your manuscript upon resubmission, so please ensure that your revision is thorough. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer #1: Thank you so much for the opportunity to review your paper. First of all, this topic is very practical and the information is meaningful to the nurse supervisors, educators, and nurse students as well. Following recommendations may help improve the paper quality: 1. This paper did not indicate that the observations were charted during the interview and therefore, they were not included in the analysis. For interviews, verbal expressions are important, but the non-verbal information is equally important to the study. Thus, the results might be affected when the non-verbal information is missed. 2. Some spelling errors: such as Ln 102, "purposeful", it is better to use the word " purposive". Ln 301, Fidnings-findings. Reviewer #2: This is a qualitative study aims at exploring supervisors’ perspectives on student preparedness for clinical placements. The manuscript is well-written and explains the research clearly. The findings provide useful information for the readers. I enjoyed reading this and I have one minor comment: 1. sample (lines 102 -109): i would suggest not to use first person such as "we" Reviewer #3: I was very interested in the topic of focus group interviews on supervisors' perspectives of students in practice. From my experience managing practitioners, I don't think the results of this study's interviews are new to the nurses currently working in hospitals. However, when it is read by nursing students or professors leading students, it seems to be helpful to some extent. The overall regret about the result is that the concept derived from the interview that lasted for 5 months is small. Interviews must have been conducted with 34 people for 5 months, but there is no information on how many interviews the data was saturated. I wonder if the concept has been sufficiently drawn from the interview data. Although it has been suggested as a limitation of the study, it is regrettable that there is no mention of IDN. Thank you. Reviewer #4: 1. The paper has grammatical and needs grammar editing to improve its quality 2. The introduction needs to be improved to bring out the problem 3. The paper should also highlight the policy implications of the findings. 4. What do the authors mean by ‘piloting within the research group’? Sounds confusing to the reader. 5. How did the interviewers relate to the participants? What was their positioning within the study? Reviewer #5: The authors have explored an area which required research. Findings are genuine. It would have been really nice if results were more clearly depicted. Conclusions are sound and upto the mark. Kindly publish, if possible. Reviewer #6: Thanks for giving me the opportunity to review the manuscript It is a good study and authors have selected an important topic. However there is a scope to improve this manuscript and some of my suggestions are given below: The introduction needs to provide a better background on the existing opportunities for nursing students preparedness before clinical placement and the role of nursing supervisors in the selected setting in order for larger global readers to understand the context and need of the study. Method section: Total population of nursing supervisors in the selected setting needs to be mentioned. Mention the sample size in the sample section and the basis on which sample size is calculated for the study also needs to be justified . Line no 110-111 not very clear what do you mean by saying that they were asked to participate by their manager? Since the cadre and nomenclature related to different nursing posts differ worldwide so clearly mention who is a manager in these health care setting Although you have mentioned some of the questions of the semi structured interview guide but it would be good if you attach interview guide as a supplementary file. Mention and justify how many focus group discussions were done. Write few lines to summarize the result and the discussion section at the end Add the recommendations and also comment on the generalizability of the study results. ********** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. Attachments Attachment Submitted filename: PONE-D-21-03784_reviewer.pdf https://doi.org/10.1371/journal.pone.0252483.r001
Revision 1
6 Apr 2021 Author Response PLOS ONEE Prof, Mojtaba Vaismoradi, PhD, MScN, BScN Academic Editor Re-submission of manuscript: PONE-D-21-03784 Nursing supervisors’ perspectives on student preparedness before clinical placements- a focus group study Dear Editor We would like to thank the editors and reviewers for their comments on our manuscript. Below You will find the issues raised, followed by our response to these remarks. Comments from the editor Comment 1: a) If there are ethical or legal restrictions on sharing a de-identified data set, please explain them in detail (e.g., data contain potentially identifying or sensitive patient information) and who has imposed them (e.g., an ethics committee). Please also provide contact information for a data access committee, ethics committee, or other institutional body to which data requests may be sent. b) If there are no restrictions, please upload the minimal anonymized data set necessary to replicate your study findings as either Supporting Information files or to a stable, public repository and provide us with the relevant URLs, DOIs, or accession numbers. Please see http://www.bmj.com/content/340/bmj.c181.long for guidelines on how to de-identify and prepare clinical data for publication. For a list of acceptable repositories, please see http://journals.plos.org/plosone/s/data-availability#loc-recommended-repositories. We will update your Data Availability statement on your behalf to reflect the information you provide. Response: When including transcript from the focus group interviews, there is a risk that the discussions themselves, or references to actions, patients, places or challenges, may identify specific wards/locations and hereby patients. Therefore, we did not include this as supporting information. Moreover, the transcripts of the interviews are in Norwegian, and therefore not accessible to an international audience. Hence, we wish to keep our statement- if possible. Comment: 4. Thank you for submitting the above manuscript to PLOS ONE. During our internal evaluation of the manuscript, we found significant text overlap between your submission and the following previously published works, some of which you are an author. https://bmcmededuc.biomedcentral.com/track/pdf/10.1186/1472-6920-12-112.pdf https://link.springer.com/article/10.1186/s12909-017-0966-4?code=3b519ef9-c50c-49a5-94ee-5ab75637dc44&error=cookies_not_supported We would like to make you aware that copying extracts from previous publications, especially outside the methods section, word-for-word is unacceptable. In addition, the reproduction of text from published reports has implications for the copyright that may apply to the publications. Please revise the manuscript to rephrase the duplicated text, cite your sources, and provide details as to how the current manuscript advances on previous work. Please note that further consideration is dependent on the submission of a manuscript that addresses these concerns about the overlap in text with published work. We will carefully review your manuscript upon resubmission, so please ensure that your revision is thorough. Response: We have revised the manuscript thoroughly, and hope that our revisions now are deemed not-overlapping with present publications. Reviewers' comments Reviewer #1 Comment 1: Thank you so much for the opportunity to review your paper. First of all, this topic is very practical and the information is meaningful to the nurse supervisors, educators, and nurse students as well. Following recommendations may help improve the paper quality: 1. This paper did not indicate that the observations were charted during the interview and therefore, they were not included in the analysis. For interviews, verbal expressions are important, but the non-verbal information is equally important to the study. Thus, the results might be affected when the non-verbal information is missed. Response: We appreciate this input. Due to several researchers conducing the interview, as well as the large number of interviews, non-verbal information was not included in the analysis. We have added this as a further limitation to the study. Please see manuscript with track changes. Comment 2: 2. Some spelling errors: such as Ln 102, "purposeful", it is better to use the word " purposive". Ln 301, Fidnings-findings. Response: We thank the reviwer for this comment, and have consequently revised the manuscript accordingly. Please see manuscript with track changes. Reviewer #2 Comment 1: This is a qualitative study aims at exploring supervisors’ perspectives on student preparedness for clinical placements. The manuscript is well-written and explains the research clearly. The findings provide useful information for the readers. I enjoyed reading this and I have one minor comment: 1. sample (lines 102 -109): i would suggest not to use first person such as "we" Response: We thank the reviewer for positive inputs. The first person has been deleted in the revised manuscript. Reviewer #3 Comment 1: I was very interested in the topic of focus group interviews on supervisors' perspectives of students in practice. From my experience managing practitioners, I don't think the results of this study's interviews are new to the nurses currently working in hospitals. However, when it is read by nursing students or professors leading students, it seems to be helpful to some extent. The overall regret about the result is that the concept derived from the interview that lasted for 5 months is small. Interviews must have been conducted with 34 people for 5 months, but there is no information on how many interviews the data was saturated. I wonder if the concept has been sufficiently drawn from the interview data. Response: We thank the reviewer for this input. Saturation is a discussed term in qualitative research, and there is no consensus of whether it is appropriate to refer to. Our experience was that some themes were repeated across interviews, but repeated interviews also added new information/themes. Hence, we can not claim that saturation has been reached. Comment 2: Although it has been suggested as a limitation of the study, it is regrettable that there is no mention of IDN. Thank you. Response: We are also sorry that we were not able to recruit more IDNs to this study. Some places in the results section, we specify that IDNs also related to statements or discussions. In the revised manuscript, we have included some more information about IDNs’ statements. Unfortunately, research on IDNs’ supervision or practice is lacking, so we have not been able to identify studies to include in the discussion section. Reviewer #4: Comment 1: The paper has grammatical and needs grammar editing to improve its quality Response: We have revised the manuscript for grammatical errors. Please see manuscript with track changes. Comment 2: The introduction needs to be improved to bring out the problem Response: We have tried to highlight «the problem» further- please see manuscript with track changes. Comment 3: The paper should also highlight the policy implications of the findings. Response: In the revised manuscript we have added policy implications, under the «Relevance to clinical practice» section. Please see manuscript with track changes. Comment 4: What do the authors mean by ‘piloting within the research group’? Sounds confusing to the reader. Response: The study was initiated in a research group consisting of a total of 12 participants. The interview guide was piloted in this group. In the revised manuscript, we have tried to clarify this. Comment 5: How did the interviewers relate to the participants? What was their positioning within the study? Response: The interviewers were not familiar to the participants. The interviewers were participants in the research group initiating the study. We have tried to clarify this in the revised manuscript. Please see manuscript with track changes. Reviewer #5 Comment:The authors have explored an area which required research. Findings are genuine. It would have been really nice if results were more clearly depicted. Conclusions are sound and upto the mark. Kindly publish, if possible. Response: We thank the reviewer for appreciating our study. Reviewer #6 Comment 1: Thanks for giving me the opportunity to review the manuscript It is a good study and authors have selected an important topic. However there is a scope to improve this manuscript and some of my suggestions are given below: The introduction needs to provide a better background on the existing opportunities for nursing students preparedness before clinical placement and the role of nursing supervisors in the selected setting in order for larger global readers to understand the context and need of the study. Response: We thank the reviewer for this input, and have revised the background. Please see manuscript with track changes. Comment 2: Method section: Total population of nursing supervisors in the selected setting needs to be mentioned. Response: Unfortunately, we do not have any overview of the number of supervisors in the selected setting. The RNs/IDNs circulate the supervisory role, and there are no statistics presenting the number of employed healthcare personnel. In fact, this is a national problem, stated by the gouvernment. Comment 3: Mention the sample size in the sample section and the basis on which sample size is calculated for the study also needs to be justified . Response: We are not familiar with sample size calculations in qualitative studies. Hence, we did not perform any sample size calculations. Comment 4: Line no 110-111 not very clear what do you mean by saying that they were asked to participate by their manager? Since the cadre and nomenclature related to different nursing posts differ worldwide so clearly mention who is a manager in these health care setting Response: We thank the reviewer for pointing this out. We have revised the methods section, and we hope that this now is more clear. Please see manuscript with track changes. Comment 5: Although you have mentioned some of the questions of the semi structured interview guide but it would be good if you attach interview guide as a supplementary file. Response: The interview guide has been attached as a supplementary file. Comment 6: Mention and justify how many focus group discussions were done. Response: We chose the number of groups pragmatically, as stated in the manuscript. In qualitative research environments, there are no consensus on the number of participants in interviews, or the number of focus groups in such discussions. Hence, we aimed at including participants from two surgical and two medical hospital wards, and a variety of primary healthcare wards (n=4). Comment 7: Write few lines to summarize the result and the discussion section at the end Response: The results section has been summarized in the beginning of the discussion section, We have added a summary of the discussion section as recommended. Comment 8: Add the recommendations and also comment on the generalizability of the study results. Response: We have added recommendations, and have commented on the generalizability of the study results. Please see manuscript with track changes. Concluding remarks The comments provided here are submitted in adition to a manuscript with track changes, as well as a clean copy. We hope our revisions are deemed sufficient, and that the paper will be accepted for publication in PLOS One. Thank You for considering our revised manuscript for publication. Yours sincerely Ann-Chatrin Linqvist Leonardsen ________________________________________ https://doi.org/10.1371/journal.pone.0252483.r002
17 May 2021 Decision Letter - Mojtaba Vaismoradi, Editor Nursing supervisors’ perspectives on student preparedness before clinical placements- a focus group study PONE-D-21-03784R1 Dear Dr. Leonardsen, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Prof Mojtaba Vaismoradi, PhD, MScN, BScN Academic Editor PLOS ONE, & Nord Universitet, Norge https://doi.org/10.1371/journal.pone.0252483.r003
Formally Accepted
19 May 2021 Acceptance Letter - Mojtaba Vaismoradi, Editor PONE-D-21-03784R1 Nursing supervisors’ perspectives on student preparedness before clinical placements- a focus group study Dear Dr. Leonardsen: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Professor Mojtaba Vaismoradi Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0252483.r004

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