Date of Award


Degree Name

Doctor of Philosophy (College of Nursing)

Schools and Centres

Nursing and Midwifery

First Supervisor

Associate Professor Kylie Russell

Second Supervisor

Associate Professor Caroline Bulsara


The literature suggests that the need to belong to a community influences health and wellbeing, which in turn affects behavioural, and cognitive responses. However, student nurses are often in a vulnerable position of being excluded intentionally or otherwise from ward/unit activities. This can lead to feelings of isolation and poor achievement.

The aim of this project was to design and develop a toolkit for nurses in an e-learning format using reflective learning to promote a sense of belonging and inclusion of student nurses in the clinical team. Upon completion of the development of the e-learning program, distribution commenced to selected clinical areas for use by nurses before periods of clinical practicum for students. The e-learning program can be accessed at (see Appendix 12 for e-learning instructions to register).

A sequential mixed method design was used, which employed the results of the initial qualitative phase to inform the following quantitative phase. The qualitative phase consisted of three rounds of open questionnaires using the Delphi panel method with 18 participants. Themes emerged and were expanded upon during the process to inform the design of the framework for the toolkit. The quantitative data that were subsequently collected reported on the evaluation of the toolkit’s applicability, usefulness and sustainability.

An e-learning package entitled WANTED was subsequently developed to address the major themes of Welcome, Attitude, Nurture, Team, Encourage (autonomy) and Delight (in success of student inclusion). The interactive program, which included pre- and xiii post-questionnaires based on Stagg’s attitude survey (1992), was offered to a random selection of nurses in Western Australia to participate in the activity and comment on the usability of the tool. Twenty-three completed programs identified that attitude change towards student nurses could be improved and that the e-learning format gave excellent information that reflected and supported traditional training.

Addressing issues of student integration into the nursing team and creating a belongingness environment with the use of practical tools will encourage and enable a fundamental shift in attitude towards students. This project has considered individual personal values and characteristics, the effect of the direct environment and the need to belong in order to create a learning environment.

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