Perceptions of nurse preceptors of students and new graduates with learning difficulties and their willingness to precept them in clinical practice (Part 2)

Preceptor perspectives on disability-related accommodations in pharmacy experiential education

INTRODUCTION

Accreditation Council for Pharmacy Education Standards require reasonable accommodation for students with disabilities in an educational setting. There is limited information regarding preceptor experiences and perspectives associated with accommodations in the pharmacy experiential learning environment. This study examined preceptor experiences and viewpoints and explored opportunities for schools/colleges of pharmacy (S/COP) to provide support and education for preceptors when meeting access needs.

METHODS

A collaborative team from seven S/COP experiential programs developed, pilot tested, and electronically distributed a questionnaire. The questionnaire collected information on preceptor demographics, experiences with disability-related accommodations, concerns and confidence in implementation, support from the academic institution, and additional needs. An open-ended question was analyzed using thematic analysis, and quantitative responses were described using descriptive statistics.

RESULTS

A total of 294 respondents consented to participate, met inclusion criteria, and submitted a questionnaire response (∼5 % response rate). Many respondents had not experienced requests for accommodation. The most common challenges related to implementation of accommodations were lack of clarity regarding the accommodation request (22 %) and uncertainty regarding how to apply the accommodation within the preceptor's practice (23 %). Most respondents (76 %) felt they would benefit from professional development in this area. Thematic analysis of free-text responses indicated a desire for resources, education, and for advanced notice when accommodation is needed.

CONCLUSION

While many preceptors may not have received requests for accommodation, opportunities exist for S/COP related to preceptor education, provision of resources, and transparent and proactive communication between the academic institution and the preceptor to support students with disabilities.

CONTRIBUTION TO THE LITERATURE

Requests for accommodations in the experiential education setting are an increasingly important topic for those involved in pharmacy experiential education, including directors, preceptors, and sites. The current body of literature published to date provides guidance, resources, strategies, and reviews of legal implications to consider when developing accommodations for experiential education. Additional literature provides insights from schools and colleges of pharmacy. However, there is limited information available regarding preceptor experiences and perspectives associated with accommodations in the pharmacy experiential learning environment. This manuscript outlines a study examining preceptor experiences and viewpoints. The results provide insight into preceptor perspectives as well as potential future opportunities for schools and colleges of pharmacy to support students with disabilities and implementation of accommodations.

Work Environment and Socio-Demographic Factors of Psychiatric Nurses: A Cross-Sectional Study in Hospitals of Eastern Saudi Arabia

The work environment in healthcare institutions, especially in psychiatric hospitals, plays a crucial role in shaping the experiences and efficacy of nurses' performance. This environment is influenced by various factors such as facility design, resource availability, workplace culture, support systems, and interpersonal dynamics. Understanding the intricate dynamics of the work environment in psychiatric hospitals is essential for ensuring the provision of high-quality mental healthcare services and enhancing the overall quality of life for both patients and healthcare providers, including nurses. However, the work environment of psychiatric nurses in the eastern region of Saudi Arabia is still inadequately understood. Objective: This study aimed to examine the work environment of nurses working in psychiatric hospitals in the eastern region of Saudi Arabia. Method: A cross-sectional research design was employed on a sample of 346 nurses using a non-probability convenience sampling technique. The survey method was adopted with the Practice Environment Scale of the Nursing Work Index (revised, Arabic version). Results: The study found a significant association between psychiatric nurses' work environment and their socio-demographic characteristics. Demographic factors, such as age and years of experience, were identified as influencing factors of nurses' perceptions of their work environment. Younger nurses and those with fewer years of experience reported greater job satisfaction when their work environment was positive. Conclusions: This study underscores the critical importance of maintaining a supportive work environment for psychiatric nurses due to its possible direct influence on their job satisfaction, work performance, quality of life, and overall well-being. Tailoring interventions to address demographic variations in perceptions of the work environment can enhance the well-being of nurses and improve the quality of care provided to psychiatric patients. These findings contribute to the body of knowledge on psychiatric nursing and have clinical implications for healthcare institutions that aim to optimize their work environments and retain a skilled and satisfied nursing workforce.

"Because people don't know what it is, they don't really know it exists": a qualitative study of postgraduate medical educators' perceptions of dyscalculia

BACKGROUND

Dyscalculia is defined as a specific learning difference or neurodiversity. Despite a move within postgraduate medical education (PGME) towards promoting inclusivity and addressing differential attainment, dyscalculia remains an unexplored area.

METHODS

Using an interpretivist, constructivist, qualitative methodology, this scoping study explores PGME educators' attitudes, understanding and perceived challenges of supporting doctors in training (DiT) with dyscalculia. Through purposive sampling, semi-structured interviews and reflexive thematic analysis, the stories of ten Wales-based PGME educators were explored.

RESULTS

Multiple themes emerged relating to lack of educator knowledge, experience and identification of learners with dyscalculia. Participants' roles as educators and clinicians were inextricably linked, with PGME seen as deeply embedded in social interactions. Overall, a positive attitude towards doctors with dyscalculia underpinned the strongly DiT-centred approach to supporting learning, tempered by uncertainty over potential patient safety-related risks. Perceiving themselves as learners, educators saw the educator-learner relationship as a major learning route given the lack of dyscalculia training available, with experience leading to confidence.

CONCLUSIONS

Overall, educators perceived a need for greater dyscalculia awareness, understanding and knowledge, pre-emptive training and evidence-based, feasible guidance introduction. Although methodological limitations are inherent, this study constructs novel, detailed understanding from educators relating to dyscalculia in PGME, providing a basis for future research.

Clinical nursing mentors' motivation, attitude, and practice for mentoring and factors associated with them

OBJECTIVE

To investigate the motivation, attitude, and practice toward mentoring and related factors among clinical nursing mentors.

METHODS

This cross-sectional study included clinical nursing mentors from 30 hospitals in Zhejiang Province between August and September 2023. Demographic information, motivation, attitude, and practice were collected through a self-administered questionnaire.

RESULTS

A total of 495 valid questionnaires were collected, and most of the participants were 30-39 years old (68.7%). Average motivation, attitude, and practice scores were 29 [26, 32] (possible range: 8-40), 87 (82, 94) (possible range: 22-110), and 41 (38, 45) (possible range: 11-55), respectively. Correlation analyses showed that the motivation scores were positively correlated with attitude scores (r = 0.498, P < 0.001) and practice scores (r = 0.408, P = 0.001), while attitude scores were positively correlated with practice scores (r = 0.554, P < 0.001). Multivariate logistic regression showed that intermediate and senior nursing mentors (OR = 0.638, 95% CI: [0.426-0.956], P = 0.030) and different hospitals (OR = 1.627, 95% CI: [1.054-2.511], P = 0.028) were independently associated with motivation. The hospital's frequency of psychological care was a significant factor associated with nursing mentoring motivation, attitude, and practice. Participation in training (OR = 2.908, 95% CI: [1.430, 5.913], P = 0.003) and lower frequency of job evaluation in hospital ("Often": OR = 0.416, 95% CI: [0.244-0.709], P = 0.001 and "Sometimes": OR = 0.346, 95% CI: [0.184-0.650], P = 0.001) were independently associated with practice.

CONCLUSION

Clinical nursing mentors had adequate motivation, positive attitude, and proactive practice towards mentoring and associated factors. Clinical nursing mentorship should be enhanced by prioritizing mentor training, fostering a supportive environment with consistent psychological care, and promoting structured mentorship activities.

A Cross-Sectional Study on Nursing Preceptors' Perspectives About Preceptorship and Organizational Support

Background

A skilled and experienced preceptor enhances nursing candidates' education. Students can acquire invaluable insights by observing and learning from the preceptor's professional nursing practice. Organizations must furnish sufficient support to guarantee the efficacy of preceptors in their responsibilities.

Objective

To evaluate preceptors' perceptions of the preceptorship and the relationship between organizational support and preceptor perspective of preceptorship.

Methods

A cross-sectional correlational design was deployed using purposive sampling of 90 nurses in the UAE. Between August 2023 and December 2023, a self-reported questionnaire with 40 items on preceptor perspectives of preceptorship (PPP) was distributed to nurses. The student's t-test, Chi-square, Monte Carlo, Fisher Exact, and Pearson coefficient were used.

Results

The results revealed that most participants were female (71.1%), with 48.9% between 36 and 45 years old. The mean score for the PPP was high (73.81 ± 10.92). There was a significant association between age, years of nursing experience, work area, and overall PPP. A strong correlation was found between self-preparation (r = .675), preceptorship perception commitment (r = .762), and the benefits of preceptorship (r = .830), along with organizational support.

Conclusion

The preceptors in this study had a positive perspective about preceptorship. Their acknowledgment of preceptorship's benefits to the organization shows their optimism and dedication. Future studies should analyze preceptor training programs and devise initiatives to improve clinical teaching.

Nurse Preceptors' Experiences of an Online Strength-Based Nursing Course in Clinical Teaching

Background: Online educational programs for nurse preceptors have been created based on various theoretical frameworks; however, no programs using a Strengths-Based Nursing (SBN) approach could be located. Purpose: This qualitative descriptive study explored the nurse preceptors' experiences in using a SBN approach to provide clinical teaching to nursing students after completing an online SBN clinical teaching course. Methods: Semi-structured interviews were conducted with six nurses. Data was thematically analyzed. Findings: Although their levels of familiarity with SBN varied, all preceptors acknowledged that using a SBN approach in clinical teaching benefits both students and educators. They reported that it empowered students and that it allowed them to discover their strengths. Getting to know their students helped the preceptors provide tailored learning experiences and feedback. Using the SBN approach simultaneously enhanced the preceptors' self-confidence and created opportunities for shared learning. Conclusion: Using a strengths' approach offers nurse preceptors a powerful tool to facilitate student learning and skills development in clinical practice.

Distress of Educators Teaching Nursing Students with Potential Learning Disabilities: A Qualitative Analysis

Clinical training at Japanese nursing universities has an increasing need for individualized learning support for students with potential learning disabilities. Despite a high interest in student support, educators' difficulties are neglected. This study clarified the difficulties encountered by practical training instructors in delivering clinical training to nursing students with potential learning disabilities. In this descriptive, qualitative study, online focus group interviews were conducted. Participants were nine Japanese nursing university graduates with over five years of clinical education experience. A total of five categories were extracted: searching for measures tailored to students in a short period of time during training; resistance to individualized responses that significantly differ from traditional Japanese collectivist education; conflict over support being perceived as favoring a particular student; hesitation to identify students' limits; and barriers in the process of supporting difficulties due to the nature of learning disabilities. Practical training instructors experience difficulties and hesitation when teaching students with potential learning disabilities. The practical training instructors need support and educational opportunities as well as students who need help. To overcome these difficulties, university educational staff, as well as students and families, must be educated on the existence and value of support tailored to the characteristics of an individual's learning disability.

Investigating the challenges of clinical education from the viewpoint of nursing educators and students: A cross-sectional study

Objective

Nursing clinical education is an important part of education in nursing in which students obtain the necessary skills to care for patients. The aim of this study was to investigate the challenges of clinical education from the viewpoint of nursing educators and students.

Methods

In this cross-sectional study, the required information was collected in the form of a census from nursing educators and students. Based on the census method, the research samples consisted of 163 nursing educators and students. The data collection tool is a researcher-made questionnaire. The data were analyzed using descriptive statistics and an independent t-test.

Results

The findings showed in the view of students the factors such as incongruity between educator's expertise and internship, lack of qualified educators, student's disinclination to study, lack of cooperation of health professionals, students' unawareness of their strengths and weaknesses. Lack of skilled clinical educators in the educational planning section.

Conclusion

According to the current challenges, identifying and then modifying clinical education challenges lead to achieving the educational goals and consequently, educating skillful personnel and supplying high-quality care services.

Supporting health professional educators in the workplace: A scoping review

PURPOSE

Clinical educators frequently request additional support for educating pre-qualification health professions students despite having access to professional development programs to build education knowledge and skills. The breadth of 'additional support' options remains unclear. The aim of this review is to explore what is known about support options for health professional educators in the workplace through the lens of learning organisations.

MATERIALS AND METHODS

A scoping review was conducted searching Ovid Medline, CINAHL, ProQuest and PsycINFO electronic databases from 1 January 2005 up to 21 October 2020 for studies that identified support strategies for clinical educators of pre-qualification students in the workplace. Relevant data were charted, summarised thematically and synthesised with reference to support type and implementation level.

RESULTS

Fifty relevant records related to medicine, nursing and allied health clinical education were included. Twelve support themes and five cross-cutting support categories were identified across four implementation levels of healthcare systems.

CONCLUSIONS

A diversity of support for clinical educators beyond professional development was identified. Future research combined with leadership and commitment from the healthcare and education sectors is needed to better understand the applicability, efficacy and resourcing of any newly integrated support to ensure it is sustainable and improves clinical educator capability.

Supporting nursing students with dyslexia: The situation in France in 2022 and outlook

Introduction

The number of students with disabilities in higher education is increasing. Dyslexia is the most common form of disability. Few reports on this subject focus on health-sector education in France.

Objectives

The survey sought to characterize and understand the support provided in nursing training institutes with regard to dyslexia.

Methods

A mixed survey was carried out in 2022, mainly involving disability referents in nursing institutes. A national questionnaire collected 113 responses from metropolitan and overseas France, then three focus groups brought together twenty-eight participants from ten different regions.

Results

In 2022, the most frequent measures were related to assessments and institutional communication. However, they lacked structure. There were still gaps, especially in the area of work placement.

Discussion

In addition to the disability referents, all stakeholders must be made aware of the needs of students with dyslexia. Greater visibility of disability could also change attitudes in the health care sector.

Conclusion

Specific support for dyslexia has been introduced in nursing training institutes. Its development requires a change in the attitudes of the stakeholders. It could then be extended to other health training courses.

Nurse preceptors' orientation competence and associated factors-A cross-sectional study

AIMS

To identify distinct orientation competence profiles amongst nurse preceptors and explain the associated factors.

DESIGN

A cross-sectional study design.

METHODS

The data were collected during the winter of 2020-2021 from registered nurses (N = 8279, n = 844) at one university hospital in Finland through an online questionnaire that included a self-administered electronic version of the Preceptors' Orientation Competence Instrument. K-means clustering was then used to identify nurse preceptor profiles. Chi-square, Fisher's exact test, Kruskal-Wallis and Mann-Whitney tests were used to analyse factors associated with competence profiles. The results were reported as frequencies, percentages, mean and standard deviation.

RESULTS

A total of three distinct orientation competence profiles (A, B, C) were identified. Profile A nurses evaluated their orientation competence at the highest level, whereas profile C nurses evaluated their competence at the lowest level. Sufficient clinical and theoretical experience, a motivation to work, willingness to orient new employees and participation in orientation and/or mentoring education were found to be associated with competence profiles.

CONCLUSION

The findings expand the current knowledge base of nurse preceptors' orientation competence. Health care organizations should recognize different orientation competence profiles amongst the nursing staff since the selection of a preceptor should always be based on possessing the necessary orientation competence rather than availability. The results indicate that preceptors (who reported taking on various tasks and covering multiple roles) need support from co-workers to sufficiently concentrate on employee orientation tasks. The results also indicate that preceptors need further orientation education, which should-for example-outline the learning goals for new employees and how preceptors can assess employee performance.

IMPACT

What problem did the study address? Prior research has not applied a robust theoretical framework covering all aspects relevant to a preceptor's competence. What were the main findings? A nurse's clinical and theoretical experience, motivation to work, willingness to orient new employees, and prior participation in orientation and/or student mentoring education were found to influence their level of orientation competence. Where and on whom will the research have an impact? Healthcare organizations can use the results of this study to make the selection of preceptors competency-based rather than their availability. Nurse leaders can use the results of this study to pinpoint which areas of nurses' orientation competence and associated factors need to be improved. Increased orientation competence will enable clinical nurses to provide high-quality orientation to new employees, which is crucial to the retention of nursing staff and the quality of patient care.

Difference between perceptions of preceptors and newly graduated nurses regarding delay in professional growth: a thematic analysis

BACKGROUND

Smooth reciprocal relationships enable a preceptee's growth, and it has been suggested that without such relationships, the preceptee may not be able to grow successfully. This study explored the differences in perceptions by matching the perspectives of both the preceptees who did not make progress in workplace adjustment and their preceptors. Identifying the differences in perceptions between the two groups is important for improving nursing education and the relationship between preceptees and preceptors.

METHODS

A pair of nurses who had been with the company for less than 3 years and who had previously been transferred or had resigned due to poor workplace adjustment were designated as preceptees, and those who had directly supervised the preceptee during their first year of employment were included as preceptors in the study. A 50-minute semi-structured interview was conducted separately to examine the perceptions of the preceptee and preceptor. A thematic analysis was used to analyse the interview data.

RESULTS

This study explored the differences in perceptions regarding the clinical practice of nursing between preceptors and their preceptees who did not make progress in workplace adjustment during nursing education; six themes were identified. After interviewing both sides, it became clear that the same event was interpreted differently depending on their positions, perspectives, and contexts. As the preceptees were nurses who had left or had been transferred, the existence of these differences in perceptions suggests that these factors may impact their departure or transfer. However, we do not aim to place blame on one side or the other for the preceptee's turnover or transfer and would like to consider effective support, not only for the preceptee, but also for the preceptor.

CONCLUSIONS

It is necessary to examine nursing education on the premise that differences may occur depending on the position and role of nurses in the workplace and to look at curricular framework changes to bring in a systemic influence towards the training of young nurses.

An empirical model of social and healthcare educators' continuing professional development in Finland

The objective of this work was to develop and test an empirical model of social and healthcare educators' continuing professional development. A cross-sectional survey study design was adopted, and a total of 422 part-time and full-time social and healthcare educators from 28 universities of applied sciences and vocational schools in different regions of Finland participated. Data were collected from October to December in 2018. The participants taught in the fields of healthcare, social services, and rehabilitation. The questionnaire included the EduProDe scale and background questions. Confirmatory factor analysis and structural equation modelling were used to develop the model, and its quality was assessed by computing goodness of fit indexes. The main finding was that when educators understand the benefits of continuing professional development, they will recognise their developmental needs and proactively seek support from their superiors. The results obtained provide insight into the preconditions for professional development and offer guidance for the design of future shared development programmes or activities for social and healthcare educators.

Associations of Preceptors' Training Needs With Clinical Teaching Experience and Training Received

Background Although training can improve the quality of clinical teaching for nurse preceptors, research on the training needs of junior versus senior preceptors is limited. This study sought to examine the differences in their needs by comparing their clinical teaching experience and the training they received. Method A secondary analysis of a cross-sectional survey was conducted in three hospitals using the Clinical Teaching Behavior Inventory (CTBI). Survey data were analyzed using the chi-square test, the independent t test, and multiple regression analysis. Results The differences (N = 252) in the subscales of building a learning atmosphere and committing to teaching were not statistically significant (p > .05). Generally, the mean CTBI scores of trained junior preceptors were significantly higher than those of untrained senior preceptors (p < .001). Conclusion Training yields more significant improvements in self-perceived clinical teaching behavior than clinical teaching experience. [J Contin Educ Nurs. 2022;53(4):165-170.].

Accommodating and supporting students with disability in the context of nursing clinical placements: A collaborative action research

AIM/OBJECTIVE

To examine issues and challenges encountered by university and clinical milieus in addressing the needs of students with disability during their clinical placements; and to identify existing or potential accommodation and support measures to address the challenges encountered.

BACKGROUND

The influx of students with learning disabilities, attention deficit disorder [with or without hyperactivity], mental health disorders or on the autism spectrum has caused an increase in the number of students with disabilities of more than 900% in universities in the past decade. This increase is causing added pressures to both the academic services providing student assistance and the personnel responsible for these students' clinical placements. While several studies have focused on measures designed to accommodate students with disabilities during their theoretical courses, only a small number worldwide have focused on student accommodation and support in the context of clinical placements. In the current paper, strategies highlighted in these studies were grouped under three categories: prior, during and post clinical placements.

DESIGN

Collaborative action research conducted amidst three learning communities.

METHODS

The larger study included learning communities from three disciplines: education, social work and nursing. Three tools helped guide the discussions: 1) brainstorming and classification tool; 2) contribution and feasibility tool; and 3) carrousel tool. The current study focusses solely on the findings from the five meetings of the nursing learning community (n = 14 participants).

RESULTS

Six categories of challenges were documented: 1) Poor writing skills; 2) Difficulty adapting to clinical milieus; 3) Difficulty linking theory with practice and setting priorities; 4) Difficulty managing specific and situational needs; 5) Issues with interpersonal skills and overall attitude; and 6) Challenges pertaining to students' professional responsibility to disclose their condition. Several accommodation and support measures were identified for each set of challenges and were also grouped under three categories: prior, during and post clinical placements.

CONCLUSIONS

Our study revealed that the issues identified could in fact be faced by any students, albeit their impact and complexity increased considerably when dealing with students with disability. It brought to light that the implementation of some of the measures identified will require changes to the structure of nursing programs. It also highlighted the ever-growing complexity of the clinical instructor role and the fact that clinical instructors do not always feel adequately prepared to support students with disability.

Effect of Nurses' Preceptorship Experience in Educating New Graduate Nurses and Preceptor Training Courses on Clinical Teaching Behavior

Only few studies have examined the preceptor training courses and their effects on clinical teaching behaviors (CTBs) of preceptors. This study investigated preceptors' experiences in educating new graduate nurses and the effect they had on clinical teaching behavior (CTB) based on whether they participated in a preceptor training program. A descriptive online survey method was used, and the participants included 180 registered nurses who were preceptors. The Clinical Teaching Behavior Inventory (CTBI-22) was used, and perceptions of teaching experiences were measured by six items. Data were analyzed using multiple linear regression. Preceptors working at general hospitals or hospitals were less likely to have participated in a preceptor training program than those working at tertiary hospitals. The overall mean score of CTB was 89.30, and "guiding inter-professional communication" showed the lowest mean score. Positive perceptions of preceptorship experiences were positively related with CTB, and the number of precepting experiences affected CTB only for nurses having undergone preceptor training courses. The use of role-playing as a method in training courses positively affected preceptors' CTB. These findings suggest that preceptors need support from nurse managers and colleagues, and preceptor training programs should be developed.

Should we use preceptorships in undergraduate nursing education?

BACKGROUND

Clinical learning experiences are the cornerstone of undergraduate nursing education as they allow students to apply theory to practice and help them develop as competent practitioners who are prepared for the realities of diverse, complex, and ever-changing practice environments.

PROBLEM

The traditional clinical teaching model, where small groups of students work with educators who are on-site facilitating learning, has numerous issues and thus there have been calls for reform. This Creative Controversy focuses on one reform option, the alternative clinical teaching model of preceptorships, which has gained popularity in recent years.

APPROACH

Current evidence surrounding preceptorships in undergraduate education was examined and critiqued.

CONCLUSION

Despite their popularity, there is a lack of robust evidence surrounding preceptorships and the motivations for using this model remain questionable. Future study is needed so preceptorships are implemented according to evidence-based teaching practices and not clouded by inappropriate motivations. The author challenges readers to question their practices and work to positively contribute to the science and practice of nursing education.