Pages: 19

This book is related to the socio-cultural environment and clinical nursing skills learning. To begin with, I use an old Chinese story to start the introduction.

Pages: 36

This chapter provides an overview of clinical nursing skills education. I will describe the characteristics, background and trend of development of clinical skills education. Since the findings of this book were collected in Hong Kong, China, the book will mainly refer to the cases using the local examples in addition to other global literature. Hong Kong's unique trajectory gives us a glimpse of the overall transformation of clinical nursing skills education. From which, we can increase our understanding of the factors affecting the nurse teachers designing their strategies in clinical nursing skills teaching today.

Pages: 29

I have been a teaching staff in the University B since 2017. In 2021–2024, I worked with some teaching fellows from different teams to perform several projects. These were related to the collection of junior pre-qualified nursing students' perspectives towards receiving different instructional modalities. These modalities include in-person skills teaching, real-time online demonstration and immersive virtual reality simulation. Some instructional modalities were tested to be applied in my teaching course, Fundamental Nursing Practice. Fundamental Nursing Practice is a core course with ten credits over two semesters for first-year nursing students in the undergraduate nursing programme of the university. The ordinary instructional modality of this course includes regular lectures and face-to-face skills demonstrations. However, due to the COVID-19 pandemic in 2019–2021, the ordinary teaching pattern encountered disruptions for normal class delivery. For example, the suspension of regular face-to-face classes, the imposition of town lockdowns and crowd restriction policies. These changes have served as catalysts, inspiring the faculty to conduct the research for the new educational methodology interventions (Blevins, 2021).

Pages: 16

What is “socioculture”?

Pages: 26

The first letter from the EHCS Protocol is “E”. “E” stands for “environment-related factors”, the first socio-cultural factor of my Environment Socio-cultural Approach (ESA) for clinical nursing skills education. Among the four socio-cultural factors, I put the “environment-related factors” in the first position, which stands out in its importance. As one of the important socio-cultural factors, “environment-related factors” refers to the fundamental functions and inherited structures that are presented in the learning environment (Rusticus et al., 2022). It is like a house which contains the building structure, essential build-up, facilities, pipelines and refurbishment. The EHCS's four socio-cultural factors are interrelated and interinfluencing; however, overall, “environment-related factors” might be the key contributor affecting the rest of the three (i.e., the H, C, S). These factors are not static, and they maintain a continuous process of interaction in the skills teaching and learning over time. These four factors are emerged from the findings of my previous research (Wong, 2023) which based on the theoretical framework of Vygotsky's (1978) Sociocultural Theory (SCT).

Pages: 27

The second letter from my EHCS Protocol is “H”. “H” stands for “human-related factors”, which is the second socio-cultural factor from my Environment Socio-cultural Approach (ESA) for clinical nursing skills education. The human-related factors highlighted two important aspects: The “support from the management” and the “influences from different people”. “Support from the management” emphasises the important leadership roles of management personnel in the process of supporting the process in clinical education, whereas the “influences from different people” describes the functions and the interacting influence of different parties within the learning context, which includes nurse teachers, students and the surrounding parties. This aspect mentioned the intra-psychological (self) and extra-psychological (other) interplay and how they support the learner's cognitive development (Vygotsky, 1978). It also explained why “students” have been placed as one of the members inside this socio-cultural factor and are the interacting body.

Pages: 22

The third letter from my EHCS Protocol is “C”. “C” stands for “culture-related factors”. It is the third socio-cultural factor of my Environment Socio-cultural Approach (ESA) for clinical nursing skills education. This socio-cultural factor is informed by two important subthemes: “values, beliefs and attitudes” and “rituals and gaps in practice”. “Values, beliefs and attitudes” are regarded as the cornerstones of nursing training. They not only indicate the attributes of the place (i.e., ward) and population (i.e., nursing students), but also specifically indicate the virtues of nursing education and professional clinical practice (Akay & Dalcali, 2023). “Rituals and gaps in practice” uncovers the phenomenon happening in our skills education of the nursing profession. The element “rituals”, alongside the concept of “gaps in practice”, signifies the traditional and routinised practice in nursing. They contain a reciprocal relationship and may widen the theory and practice gap and the learners' transformation toward higher-order thinking in clinical nursing skills education. This socio-cultural factor emerged from the findings of my previous research (Wong, 2023), which is based on Vygotsky's (1978) Sociocultural Theory (SCT).

Pages: 22

The fourth letter from my EHCS Protocol is “S”. “S” stands for the fourth socio-cultural factor – “skills-teaching-related factors”. It is the fourth socio-cultural factor of my Environment Socio-cultural Approach (ESA) for clinical nursing skills education. This socio-cultural factor consists of two main items: “Social interaction and collaborative learning” and “scaffolding and zone of proximal development”. These factors are the emerged findings of my previous research (Wong, 2023), which is based on the theoretical framework of Vygotsky's (1978) Sociocultural Theory (SCT).

Pages: 36

In this chapter, I will introduce an approach by using a sociocultural perspective to conduct clinical education. The approach is named “Environment Socio-cultural Approach”, with a short form of “ESA”. Based on ESA, I developed the EHCS Protocol in which emphasizing the consideration of four socio-cultural factors when implementing clinical nursing skills education. EHCS represents: 1) environment-related factors, 2) human-related factors, 3) culture-related factors and 4) skills-teaching-related factors. They are the integrated findings from the research project of my doctoral thesis in 2023. To memorise easily, I develop a mnemonic of “Easy Have Clinical Skills”, acronymised as “EHCS”. The EHCS Protocol provides guidelines for nurse teachers about the conduction of clinical nursing skills education in different learning contexts. The contexts could be the skill laboratory, the clinical setting, classroom or the virtual ward environment when using an immersive virtual reality simulation methodology. The idea of ESA originated from the ideas of Vygotsky's Sociocultural Theory (1978), which is the underpinning framework for developing this instrument. Affiliated with the discussion, I also developed a checklist to facilitate the nurse teachers in using the EHCS Protocol.

Pages: 13

This book uses the Environment Socio-cultural Approach (ESA) for clinical nursing skills education. ESA employs a socio-cultural approach to assess the learning environment and carry out clinical nursing skills education. It developed from a psychology and education perspective and explains how students' behaviour and mental processes are shaped by the social and cultural elements of their lives and surroundings during clinical skills education. Based on the ESA, I developed the (EHCS) Protocol, which informs “users” (i.e., teachers or clinical nurses) on how to assess and integrate the four socio-cultural factors in clinical education. The four socio-cultural factors are: 1) environment-related factors, 2) human-related factors, 3) culture-related factors and 4) skills-teaching-related factors. To make the protocol easier to memorise, I use a mnemonic, “Easy Have Clinical Skills”, representing the four factors: “EHCS”.