Perception of nursing students to two models of preceptorship in clinical training

The Effect of the Application of the Team-STEPPS-Based Preceptorship Guidance Model on the Competence of Nursing Students

Objective

Student competence is an important topic of discussion during the implementation of counseling in the clinic. The purpose of this study was to analyze the effect of the Team-STEPPS-based preceptorship guidance model on student competency.

Methods

A comparative study was used to analyze the quantitative data. Participants were clinical practice students at "Ngudi Waluyo" Public Hospital with a total of 92 registered students divided into treatment and control groups. The Wilcoxon Signed Rank Test and the Mann-Whitney U-Test were used to assess differences between the intervention and control groups.

Results

There were post-test differences between the intervention group and the control group, namely clinical competence p-value (0.003), nursing management p (0.000), technical competence p (0.008), self-management p (0.000), and care-oriented patients p (0.000).

Conclusion

The Team-STEPPS-based preceptorship guidance model is very important in increasing student competency, not only in mastering clinical competence, but also in mastering technical skill competencies, nursing management, self-management, and patient-oriented care skills, and therefore, can increase student independence.

Between challenges and support: Preceptors run clinical nursing training amidst unprecedented crisis

Aim

This study aimed to address challenges facing nurse preceptors related to multifaceted educational roles, academic and institutional support during the COVID-19 pandemic in the Kingdom of Bahrain.

Background

Clinical nurse preceptors have faced great challenges since the influx of the COVID-19 pandemic. At this unprecedented time, they are overwhelmed with additional responsibilities to follow the COVID-19 precautionary measures alongside their usual educational role. So, they require careful preparation and massive institutional support.

Design

A descriptive study was conducted in different clinical settings in the Kingdom of Bahrain.

Methods

A sample of 125 clinical nurse preceptors who participated in the students' training for at least one full clinical rotation during the COVID-19 pandemic responded to two questionnaires regarding the clinical nurse preceptor role, preparedness, and institutional support provided to them during the COVID-19 crisis.

Result

It is revealed that 40.8%, 51.0%, and 53.0% of the preceptors faced major challenges regarding the teacher, facilitator, and feedback provider/evaluator roles during the COVID-19 pandemic. Moreover, 71.2% of the preceptors were incredibly overwhelmed with additional instructions related to COVID-19 precautions alongside covering course learning objectives for the students. However, most of them did not perceive challenges concerning both academic and institutional support.

Conclusion

The clinical nurse preceptors declared they received adequate pedogeological preparation, academic and institutional support throughout the COVID-19 pandemic. They also encountered moderate and minor challenges while mentoring nursing students during such a critical era.

Predictors of effective clinical teaching - nursing educators' perspective

BACKGROUND

The clinical teaching is the core component of the nursing curriculum, the alarming pandemic rates brought uncertainty to clinical teaching, weighing the safety of patients, students, and faculty, which demanded essential modification in clinical teaching and resulted in challenges in relation to effective response to clinical teaching requirements. This study aimed to assess the effective clinical teaching from the nurse educators' perspective during the remote teaching that followed the COVID-19 pandemic.

METHODS

This study is a national Web-based descriptive study. Participants were recruited from five major Nursing Colleges in Oman. Descriptive and inferential as well as multiple linear regression analyses were conducted.

RESULTS

A total of 127 nurse educators completed the survey with mean age of 43.9 (SD = 6.9) years. The overall effective clinical teaching score was 54.4 (SD = 10.9) which is considered acceptable, although the nurse educators in Oman reported the highest score on the safety dimension of the effective clinical teaching. Furthermore, females, doctoral prepared nurse educators, and those who acted as preceptors reported higher effective clinical teaching levels compared to their counterparts. The regression analysis showed that age, gender, and attending infection control training are significant predictors of effective clinical teaching.

CONCLUSION

The paradigm shift in clinical teaching requires adequate measures including identification and appropriate training of clinical instructors and preceptors to meet clinical teaching demands in remote teaching. It is also important to take actions that promote and maintain the safety prioritization in bedside clinical teaching. These measures might positively impact on the nursing education process.

Are intensive care units good places for nursing students' learning compared to other settings? Findings from an Italian national study

OBJECTIVE

To explore students' perceived quality of the intensive care unit learning environment during their rotations; to compare these perceptions with that reported by students attending other settings and to assess correlations between the perceptions regarding the quality of the environment and the competences learned.

RESEARCH METHODOLOGY

A secondary analysis of data collected by a national cross-sectional study carried out in Italy. A total of 9607 nursing students participated; they ranked the intensive care units' quality, as assessed by the Clinical Learning Quality Evaluation Index; the perceived competences learned were also ranked with a Likert scale; from 0 = None to 3 = Very much.

RESULTS

A total of 323 (3.5%) participants attended their rotation in an intensive care unit. They perceived the quality of the environment to be significantly higher (n = 2.11 out of 3) than those rotating in non-intensive care unit wards (n = 1.91; p < 0.001). The competences learned by intensive care unit students were significantly higher than that reported by students attending non-intensive care unit wards (n = 2.31 out of 3 vs 2.06 out of 3; p < 0.001).

CONCLUSION

Intensive care units are highly appreciated by students, both in terms of their quality learning environment and their capacity to promote learning compared to other settings. Therefore, intensive care units should be considered as a place for clinical rotation to promote positive attitudes regarding critical care patients.

An evaluation of the current mentorship/preceptorship practices for newly qualified radiographers in Northern Ireland

INTRODUCTION

Mentorship/Preceptorship (M/P) has been utilised within the nursing profession since the early 1980's. Successful, structured M/P programmes can be hugely beneficial to Northern Ireland (NI) Trusts who recruit regularly and often rely on the fluidity of staff movement regionally. In the absence of standardised tools to accurately and universally measure the competency of newly qualified Radiographers (NQR) as they evolve, establishing the benchmark for effective practice within Radiology departments in NI is difficult and highly subjective at best. This study aimed to evaluate the current M/P strategies within NI as perceived by NQR and Radiology Managers (RM).

METHODS

A mix of both qualitative and quantitative data was obtained using questionnaires through a scoping exercise. Opinions were sought from a target audience of NQR, who began full-time employment following graduation in 2018, and RM involved in the delivery of current M/P programmes within the NI Trusts.

RESULTS

Responses were gained from all five NI trusts to achieve a representative regional sample, with final opinions of RM (n = 8, 54%) and NQR (n = 30, 67%) received. With the exception of one response, all NQRs confirmed receiving some form of M/P support within their inaugural post.

CONCLUSION

Significant variations were apparent in both the structure and delivery of Trust M/P induction programmes, calling into question the comparable competency of NQRs regionally.

IMPLICATIONS FOR PRACTICE

The disparity in approach towards M/P programmes across NI, and subsequent lack of comparability of NQR competence, endorses the development of a more robust and universal method for the regional assessment of NQRs, such as that of the 'Flying Start NHS®' programme utilised by National Health Service (NHS) Scotland, in combination with knowledge and skills framework (KSF) practices in supervision.

Development of an advanced practice preceptor evaluation tool

BACKGROUND

Preceptors are essential in advanced practice registered nurse (APRN) and physician assistant (PA) fellowships; however, no tools exist for fellows to evaluate their preceptor.

PURPOSE

The study's purpose was to examine the use of a modified preceptor evaluation tool (PET) in a new population APRNs and PAs who participated in a formalized postgraduate fellowship program.

METHODOLOGICAL ORIENTATION

A qualitative study involving cognitive interviewing methods was used to evaluate original and modified items of the PET as a means to determine face validity. Over a period of 19 months, five different focus groups were conducted. Study participants completed an independent analysis of the tool prior to engaging in a focus group discussion. Further testing of new items was performed using the last two focus group cohorts and achieved data saturation.

SAMPLE

The sample included 23 fellows who had completed an acute, ambulatory, or primary care yearlong fellowship. More than half of the fellows ranged in age from <30 to 40 years.

CONCLUSIONS

All original 19 items were retained, with the majority (79%) requiring slight modifications. Using feedback from fellows, 10 items were added to the final version, including two open-ended questions. The new items added a focus on preceptors' ability to foster domains of professional growth in the fellows' provider role.

IMPLICATIONS FOR PRACTICE

This newly developed tool with face validity provides a new mechanism for preceptor evaluation by APRN and PA fellows. Additional research is needed with larger groups of fellows as a means to establish the tool's psychometric properties.

Nursing students' experience of the mental health setting as a clinical learning environment: Findings from a national study

PURPOSE

To explore nursing students' perceptions of their clinical learning experiences in the mental health (MH) setting.

DESIGN AND METHODS

Secondary analysis of data collected within an Italian national cross-sectional study involving students (N = 9607) who were attending 95 3-year baccalaureate nursing programs.

FINDINGS

Students in MH settings scored the quality of the learning environment overall significantly higher (P = .008) compared to those who rotated in other clinical settings, specifically with respect to (a) the tutorial strategies' quality; (b) the learning opportunities; and (c) the learning environment's quality.

PRACTICE IMPLICATIONS

MH settings emerged as a worthy clinical environment where less pressing rhythms allow preceptors to provide students more learning opportunities that, in turn, affect the perceived degree of competence achieved and the desire to work in these contexts after graduation.

The "Ideal" Clinical Supervision Environment in Nursing and Allied Health

Background

The importance of effective clinical supervision for emerging clinicians is well recognised, not only for practice preparation, but also for reducing future attrition rates. Also recognised are the challenges faced by both students and supervisors during the supervision experience. This study aimed to identify the qualities of the “ideal” clinical supervision environment from the perspective of clinical supervisors from both nursing and allied health.

Design

A qualitative study using an interview method based on action research.

Methods

The convergent interview method was used with 20 clinical supervisors and educators from nursing and allied health across Victoria. Interviews were recorded and data analysis occurred at the end of each pair of interviews to develop deeper questions in line with the method.

Results

12 major themes emerged as “ideal” qualities with a range of suggestions on how these can be achieved.

Conclusion

The “ideal” qualities can be used in assessing and improving current contexts, as well as designing new clinical supervision processes, models, programs and guidelines or policies. The convergent interview method allowed for deeper level analysis than previous research.

Collaborative learning in practice: A systematic review and narrative synthesis of the research evidence in nurse education

Collaborative Learning in Practice is a model of placement learning for student nurses that is currently being implemented in the United Kingdom, apparently originating in Amsterdam. Potential benefits are reported to be increased placement capacity, reduced burdens on mentors as practice assessors, improvements in qualified nurses' job satisfaction, recruitment and retention, and better-developed preparedness for registrant practice amongst student nurses. We conducted a thorough, rigorous systematic review between October and December 2018 of the literature on Collaborative Learning in Practice to discover whether there was a research evidence base for these claims. We found nothing published in English in peer reviewed journals. We found 14 related papers, although these were about the Dedicated Education Unit concept, and we have conducted a narrative synthesis of them. Key findings support the assertions related to Collaborative Learning in Practice, albeit in different models of placement learning. Further research is necessary with Collaborative Learning in Practice stakeholders including staff and students, and regarding patient care metrics, to demonstrate benefits or otherwise and until that research takes place potential gains remain unproven.

Nursing interns' perception of clinical competence upon completion of preceptorship experience in Saudi Arabia

BACKGROUND

Nursing interns are newly graduate students with limited real-life work experiences. These novices are in the process of enhancing their competencies in the delivery of quality nursing care with the guidance of the preceptors. Hence, it is relevant to examine the impact of preceptorship, as a teaching strategy, among nursing interns during their preceptorship years in clinical settings.

OBJECTIVE

The aim of this study is to determine if the preceptorship program has provided the nursing interns the needed education in enhancing clinical competence.

SETTING

The study was conducted in one of the tertiary hospitals in Riyadh, Saudi Arabia.

PARTICIPANTS

Convenience sampling was used to recruit 92 undergraduate nursing interns who have completed the five-years nursing education including preceptorship.

METHODS

The nursing interns completely answered the survey questionnaires which covers Benner's Competencies, Knowles' Adult Learning Theory and the Nursing Process.

DESIGN

The study followed a mixed-methods design wherein a descriptive cross-sectional approach was used to identify factors affecting the nursing interns' perception towards clinical competence. Two open-ended questions referring to the improvement of internship program and competency were concurrently collected which was the qualitative portion of the study.

RESULTS

The preceptorship program enhanced the preceptees competencies in the clinical setting primarily in priority-setting with acutely ill patients, multitasking and demonstrating complex nursing skills. The majority of the nursing interns perceived preceptorship as a constructive experience. The availability, approachable attitude, and trustworthiness of the preceptor were viewed as influential factors in improving the interns' clinical competence. Variations were significant with phases of internship and type of school. Furthermore, results showed positive correlation between the nursing interns' efficacy and clinical competencies in professional behavior, general performance, and core nursing skills.

CONCLUSION

Preceptorship program positively impacts nursing interns' skills in handling actual patients in clinical setting. Hence, the preceptorship program is an effective teaching strategy which advances the novice to the next stage of developing clinical competence.

Monitoring preceptors' supportive role: A measuring instrument for increased accountability

PURPOSE

This article describes the development of a measuring instrument to monitor support offered by preceptors during their accompaniment of students in clinical facilities.

DESIGN

A quantitative methodological study design was used to develop the instrument.

METHODS

Data were collected by means of a self-completed questionnaire. Total sampling of 192 undergraduate nursing students was done. Descriptive data analysis was conducted regarding the biographical characteristics, Cronbach's alpha was computed to determine the reliability, and an exploratory factor analysis was done to describe the construct validity of the developed instrument.

RESULTS

The Cronbach's alpha of 0.98 indicates high reliability and high internal consistency. Three constructs regarding clinical support, namely cognitive-, emotional- and system support were identified by means of the exploratory factor analysis.

CONCLUSION

The new conceptualisation of support gives insight into the value of the preceptor's role. The instrument designed for this study could be used to assess and monitor the support offered by preceptors while they accompany students in clinical practice.

CLINICAL RELEVANCE

Considering the need to strengthen nursing and midwifery education systems, this instrument contributes to measuring and monitoring clinical accompaniment of students by preceptors.

Lifelong learning strategies in nursing: A systematic review

Background

Lifelong learning is an expectation in the professional performance of nurses, which is directly related to the success of students in nursing schools. In spite of the considerable attention paid to this issue, lifelong learning strategies are not fully understood.

Objective

The aim of this study was to clarify lifelong learning strategies of nursing students with respect to international experience.

Methods

In this systematic review, an extensive investigation was carried out using Persian and English studies in Pub Med, ProQuest, Cochrane, Ovid, Scopus, Web of Science, SID, and Iran Doc using the following keywords: lifelong learning, self-directed learning, lifelong learning model, continuing education, nursing education, and lifelong program. Finally, 22 articles published from 1994 to 2016 were selected for the final analysis. Data extracted from the selected articles was summarized and classified based on the research questions.

Results

In this study, 8 main themes, namely intellectual and practical independence, collaborative (cooperative) learning, researcher thinking, persistence in learning, need-based learning, learning management, suitable learning environment, and inclusive growth, were extracted from the article data.

Conclusion

Having identified and clarified lifelong learning strategies in nursing, it is recommended to use the research findings in the programs and teaching systems of nursing schools. Use of strategies of lifelong learning will led to increased quality of education, development of nursing competency and finally, increased quality of patient care.

The effects of nursing preceptorship on new nurses' competence, professional socialization, job satisfaction and retention: A systematic review

AIMS

The aim of this study was to determine the effects of nursing preceptorship on the competence, job satisfaction, professional socialization and retention of new nurses.

BACKGROUND

Although studies have focused on the effects of nursing preceptorship on new nurses' competence and retention, a systematic review of the overall effects is lacking.

DESIGN

A quantitative systematic review.

DATA SOURCES

Five English/Chinese databases were searched for original articles published before June 2015 and only six articles published between 2001-2014 were included in the final analysis.

REVIEW METHODS

Joanna Briggs Methodology was used to process one randomization control trial, one quasi-experimental study and four observational studies. Two appraisers independently reviewed each study using the standardized critical appraisal tools from the Joanna Briggs Institute.

RESULTS

The most adopted preceptorship was a fixed preceptor/preceptee model and one-on-one for 1-3-month duration. It showed that new nurses' overall competence increased significantly due to preceptorship. Only a few studies explored the effects of preceptorship on the job satisfaction and professional socialization of new nurses. Clear conclusions regarding the effect of preceptorship on nurses' retention rate could not be made because of inconsistent time points for calculation and a lack of control groups in the study design.

CONCLUSIONS

Preceptorship can improve new nurses' nursing competence; however, more studies are needed to ascertain its effects on new nurses' retention rates, job satisfaction and professional socialization to promote nursing care quality and resolve nursing shortages.

Using preceptors to improve nursing students' clinical learning outcomes: A Malawian students' perspective

Objective

Clinical environment remains an important aspect in the development of student's competence, confidence and fulfillment of their expected learning outcomes. Preceptors and clinical teachers play a significant role in preparing students to achieve their professional goals through continuous support and resource provision. This study explored the students' perception of using clinical preceptors to improve their clinical learning outcomes.

Methods

The researchers used semi structured interviews to collect qualitative data. A total of 48 students were purposively and conveniently sampled from 8 hospitals to participate in the study. Content analysis was used to analyse the data.

Findings

Two themes emerged from the study findings namely: creating a positive clinical learning environment and facilitating academic clinical collaboration.

Conclusions

The findings of the study revealed that students gained more confidence and competence in clinical practice when supported by preceptors as well as achieved clinical learning outcomes. These findings suggest the need to train more clinical preceptors for improvement of students' clinical learning outcomes.

In pursuit of an optimal model of undergraduate nurse clinical education: An integrative review

Clinical learning experiences are an essential part of nurse education programs. Numerous approaches to clinical education and student supervision exist. The aim of this integrative review was to explore how studies have compared or contrasted different models of undergraduate nurse clinical education. A search of eight databases was undertaken to identify peer-reviewed literature published between 2006 and 2015. Eighteen studies met the inclusion criteria. A diverse range of methodologies and data collection methods were represented, which primarily explored student experiences or perceptions. The main models of undergraduate nurse clinical education identified were: traditional or clinical facilitator model; the preceptorship or mentoring model; and the collaborative education unit model in addition to several novel alternatives. Various limitations and strengths were identified for each model with no single optimal model evident. Thematic synthesis identified four common elements across the models: the centrality of relationships; the need for consistency and continuity; the potential for variety of models; and the viability/sustainability of the model. The results indicate that effective implementation and key elements within a model may be more important than the overarching concept of any given model. Further research is warranted to achieve an agreed taxonomy and relate model elements to professional competence.

Midwifery Professional Relationships: Collaboration Across the Novice-to-Expert Continuum

This article describes the types of helpful and supportive interactions or communication strategies that characterize the collaborative relationships in which a midwife can engage across the novice-to-expert continuum of professional development. Similarities and distinctions are drawn between the various terms describing types of collaboration and discussed with respect to the added value that each relationship can have for the individual and for the health care team. A conceptual depiction of the essential components of effective teamwork or collaboration is presented. Emphasis is placed on the dynamic nature of the process of developing and sustaining these relationships across the midwife’s professional lifetime.