Understanding the needs of nurse preceptors in acute hospital care setting: A mixed-method study

Registered nurses' perceptions of nursing student preceptorship: Content analysis of open-ended survey questions

Nursing preceptors play a crucial role in supporting and educating clinical students. Understanding the perceptions and needs of nurse preceptors is essential to enhance their role as preceptors and to improve their teaching practices. This study aimed to explore preceptorship in diverse settings and specific contexts. Content analysis was performed to analyze open-ended responses from a questionnaire based on nurses' perceptions of preceptorship with undergraduate nursing students. Data were collected from two university hospitals, with different healthcare provision levels. Of the 370 responses, 295 (96%) were those of women, and 34.5% were in the age group of 41-50 years. Three main themes were identified: (1) the role of preceptorship as a key component in learning, (2) challenges in student preceptorship, and (3) personal recognition and compensation for teaching work. This study highlights the positive experiences and provides valuable insights into the challenges and opportunities faced by nurse preceptors in their teaching roles, and emphasizes the need for institutional support and educational programs to enhance their teaching responsibilities. Improving communication and collaboration among stakeholders is crucial for improving learning outcomes and satisfaction.

Nurses, midwives and students' reports of effective dedicated education units in five European countries: A qualitative study

AIM

To investigate nursing/midwifery students, Clinical Mentors, Link Teachers and Head Nurses experiences within "Dedicated Education Unit" model in 6 European clinical placements and analyse the necessary elements for a powerful clinical learning environment.

DESIGN

A multi-country, phenomenological, qualitative study.

METHODS

Focus group interviews were performed to identify the personal and organizational factors of importance for students and nurses/midwives.

RESULTS

Data analysis produced 4 main themes (1) Clinical placement organization, (2) students' clinical knowledge and skill acquisition, (3) students, and nurses/midwives' experiences within the DEU model and (4) factors for creating an effective learning environment.

CONCLUSIONS

A close educational-service collaboration, a realistic clinical placement planning, a focus on student learning process and an investment in professionals' education and development among others, are elements to set up a powerful clinical learning environment.

IMPLICATIONS FOR THE PROFESSION

It is considered advisable and urgent to improve the working conditions of nurses/midwives and the learning environments of students as a strategy to alleviate the global shortage of nurses and respond to the increasingly demanding health needs of the population.

IMPACT

Due to the close relationship between students' learning and features of the clinical environment nurse educators seek innovative models which allow students to manage patient care and their transition to professional practice. To implement new learning strategies, identifying students, nurses and midwives perceptions and suggestions is a powerful information to evaluate implementation process and outcomes.

PUBLIC CONTRIBUTION

Our findings could help academic and clinical managers to meet the human and organizational requirements to create a successful learning environment in every student placement.

The Impact of an Online Preceptorship Training Program on Preceptor Self-Efficacy among Nurse Case Managers Working in an Acute Care Setting

PURPOSE/OBJECTIVES

The U.S. health care system is experiencing a critical workforce shortage of nurse case managers exacerbated by an older workforce and looming retirements and the growth of this specialty. This quality improvement project aimed to develop an online case manager preceptor training program and examine its impact on the nurse case manager preceptors' self-efficacy.

PRACTICE SETTING

This project was implemented at a 395-bed acute care, community-based hospital in the northeast.

METHODOLOGY AND SAMPLE

The target population for the intervention included a convenience sample of 13 nurse case managers who were assigned a preceptor role. The intervention was an abbreviated version of an online preceptorship program by Lippincott. The Preceptor Self-Efficacy Questionnaire (PSEQ), with a Cronbach's alpha of 0.96, measured nurse preceptors' confidence in various skills including fostering critical thinking and providing feedback. Data from pre- and post-intervention PSEQ surveys were analyzed using a Wilcoxon rank sum test in SPSS version 28.

RESULTS

The Wilcoxon rank sum test revealed a statistically significant improvement in preceptor confidence scores ( p = .043) between pre- and post-intervention PSEQ results.

IMPLICATIONS FOR CASE MANAGEMENT PRACTICE

This project demonstrated feasibility of an online nurse case manager preceptor training program while also identifying improved preceptors' self-efficacy. Future research can include investigating the impact of a preceptor training program on the nurse case manager learners receiving role training from the trained case manager preceptor.

Nurse Preceptor Burnout: Contributing Factors

OBJECTIVE

The aim of this study was to assess nurse preceptor burnout and examine related factors.

BACKGROUND

Nurse preceptors are essential to the provision of optimal hospital-based care. Preceptors guide and support nurses' transition from professional training to practice as well as movement within practice roles.

METHODS

As a component of the DevelopYou database, nurse preceptors (N = 210) were surveyed electronically using the BHLex Preceptor Role Questionnaire. Data retrieved from this data set were analyzed.

RESULTS

Twenty-eight percent (n = 60) of participants experienced burnout. Most (n = 203, 96.7%) enjoyed their role. Reasons for becoming a preceptor included a love for teaching, a desire to help others, and feelings of responsibility to the profession and the institution. Strategies to enable perceived value of the role focused on activities involving person-to-person interactions.

CONCLUSIONS

On the basis of the results of this analysis, it is apparent that nurse preceptors want to feel valued and supported by administration and have opportunities to interact regularly with colleagues.

Teaching the Teacher: Implementing a Toolkit to Standardize Effective Preceptorship of Prelicensure Nursing Students

BACKGROUND

Faculty can support successful preceptor-led clinical experiences by providing registered nurses with educational resources to guide them in the preceptor role.

PURPOSE

To upgrade our institution's educational resources using an online platform that enables just-in-time access.

METHOD

This was a quality improvement project to create and implement an educational resource tool kit for prelicensure nursing preceptors.

RESULTS

Half of our preceptors (n = 46, 52%) had no formal preceptor education. The preceptors used all the resources and were satisfied with the tool kit's content and ease of use.

CONCLUSION

Implementing the tool kit was feasible. Further development includes ( a ) adding content regarding diverse students and trauma-informed nursing care, ( b ) incorporating interactive educational materials, ( c ) exploring avenues to reduce cognitive load, ( d ) creating a prelicensure preceptor preparation course, and ( e ) considering avenues for providing open access for nursing faculty of prelicensure programs.

The lived experiences of nurse preceptors in training new nurses in Qatar: qualitative study

BACKGROUND

The role of preceptors is vital in the successful integration of new graduate nurses in hospital settings. This study aimed to explore the experiences of nurse preceptors in training newly joined nurses in Qatar.

METHODS

Qualitative study was conducted between May 2022 and May 2023. Online semi-structured interviews were conducted through MS Teams with 13 nurse preceptors who had completed preceptorship training and trained at least one newly joined nurse. Participants were recruited until data saturation was obtained and data were analyzed using qualitative thematic analysis.

RESULTS

The results of the study revealed several main themes: teaching strategies and progressive skill development in preceptorship, challenges faced by the preceptor and preceptor better supported in training new nurses. The preceptors utilized different techniques to support new nurses including demonstration, discussion, use of technology, application of real-life clinical scenarios, simulations, and a gradual decrease in supervision to promote independence. However, a significant challenge was also reported including preceptors experienced high levels of exhaustion from the dual responsibilities of training new staff while also performing their regular care duties.

CONCLUSIONS

The study underscores the fundamental role preceptors play in the training and development of newly joined nurses. While the challenges are considerable, particularly related to managing workload, the sense of achievement following the successful completion of training a new nurse suggests a strong commitment to this role. Despite the challenges, preceptors demonstrated innovative strategies to ensure the successful development of their preceptees, highlighting the importance of preceptorship in nursing education and practice.

Content Analysis of Feedback Journals for New Nurses From Preceptor Nurses Using Text Network Analysis

This study aimed to identify keywords, core topic areas, and subthemes by analyzing feedback journals written by preceptor nurses to new nurses during the preceptorship period and to derive implications through word clustering. A total of 143 preceptor nurses' feedback journals for new nurses from March 2020 to January 2021 were converted into a database using Microsoft Office Excel. Text network analysis was performed using the NetMiner 4.4.3 program. After data preprocessing, simple frequency, degree centrality, closeness centrality, betweenness centrality, and community modularity were analyzed. In the feedback journals, the most central words were "study," "medication," "practice," "nursing," "method," "need," and "effort," whereas frustration, "new nurses" had low centrality. Five subthemes were derived: (1) learning necessity to strengthen new nurses' competency, (2) independence of new nurses, (3) emphasis on accuracy in nursing skills, (4) difficulties in understanding the nursing tasks expected of new nurses, and (5) basic competency of new nurses. The results of this study highlighted the experiences of new nurses and allowed for an assessment of journal feedback content provided by preceptor nurses. As such, the study provides basic data to develop a standardized education and competency empowerment program for preceptor nurses.

Nurses' perceptions of preceptorship of undergraduate students in clinical context

BACKGROUND

Nurses' perceptions of preceptorships for undergraduate nursing students are crucial for designing effective and tailor-made strategies to improve nurses' involvement, motivation, commitment, and satisfaction in preceptorships.

OBJECTIVES

The aim of this study was to determine nurses' perceptions of preceptorships for nursing students in two hospitals located in northern Spain.

SETTINGS

This study was conducted in two highly specialized, medium-large, university tertiary care hospitals, including one public and one private hospital, located in northern Spain.

PARTICIPANTS

The participants of this study were clinical nurses in private and public health centers who had been preceptors for at least one year.

METHODS

A descriptive cross-sectional study was carried out between October 2021 and April 2022, with a total sample of 307. The validated "Involvement, Motivation, Satisfaction, Obstacles and Commitment" (IMSOC) questionnaire was used. Descriptive statistics and bivariate analysis were carried out. The variables included sex, age, educational level, preceptorship training, professional experience, work sector, work setting, and type of contract.

RESULTS

The mean global questionnaire score was 115.25 ± 33.86 (95 % CI: 111.62-123), with the highest score obtained for the "Involvement" dimension (29.96; SD: 9.23; 95 % CI: 29.01-34.87). Age showed statistically significant negative correlations with the overall and dimension scores (p < 0.05). Comparisons by work sector and type of contract reflected that nurses working in the private sector and those with permanent contracts had higher motivation and commitment scores.

CONCLUSIONS

Preceptors had positive perceptions of their role in undergraduate nursing students' education. Age, work sector, type of contract and time allocation should be considered when designing strategies to enhance the involvement, motivation, commitment, and satisfaction of nurses in their experiences as preceptors for undergraduate nursing students. Improving the preceptorship experience will benefit both nurses and students by improving preparation, satisfaction, and retention.

Establishing the Need for Standardized Clinical Educator Training Programs for Medical Laboratory Professionals

BACKROUND

There is minimal, if any, training for clinical educators in medical laboratory professions. This leads to challenges with teaching, assessment and workload/training balance. Hence, the need for standardized clinical educator training.

METHOD

A survey was developed, validated and deployed to medical laboratory professionals. Responses were analyzed using SPSS. Responses from two open-ended questions-is clinical educators' training important and how is this training beneficial?-were analyzed using thematic analysis.

RESULTS

Most participants indicated that clinical educator training is important (99.4%). However, 72.4% received no formal training prior to training student. Themes from the importance of training include: Equip clinical educators, body of knowledge, standardize training and quality of training. Themes that emerged from the benefits of clinical educators training involve Training content, logistics, professional behavior and technical skills.

CONCLUSION

Clinical educators' training is crucial and valuable. Standardized training on pedagogy and other success strategies are warranted for successful clinical experiences.

Evidence-based practices in developing and maintaining clinical nurse preceptors: An integrative review

OBJECTIVES

This integrative review of literature explores the best practice for establishing and maintaining a hospital-based nurse preceptor program. The intent is to provide nurse leadership and educators with guidance for optimizing preceptor programs in order to improve patient, staff, and organizational outcomes.

DESIGN

The project team conducted an integrative review of literature to inform best practice using the Johns Hopkins Evidence-Based Practice Model and Guidelines.

DATA SOURCES

Data sources included the PubMed, CINAHL, and Cochrane databases.

REVIEW METHODS

Each applicable article underwent a rigorous review and appraisal by the project team. The team used the Johns Hopkins Evidence-Based Practice Model to guide the appraisal process and to synthesize results to generate a comprehensive list of recommendations.

RESULTS

The search yielded 115 unique articles that answered the evidence-based practice question. What are best practices for establishing and maintaining a hospital-based nursing preceptor program? Due to the abundance of data, the practice question was divided into three separate sub questions that explored preceptor development, continuous preceptor support, and essential competencies of preceptors. Relevant evidence included one level I article, seven level II articles, and one level IV article. Most of the evidence was found in articles ranking as level III (n = 54) and level V (n = 52).

CONCLUSIONS

Many preceptorship themes and recommendations resonate throughout multiple levels of evidence. Recommendations include implementing an evidence-based, standardized curriculum that features diverse teaching modalities, critical thinking, and clinical reasoning. Common themes in the literature echo that preceptors need ongoing education, training, and support to improve nursing satisfaction, retention, and the quality of nursing care.

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.

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.].

Enablers of the interpersonal relationship between registered nurses and students on clinical placement: A phenomenological study

AIM/OBJECTIVE

The aim of this qualitative study was to explore the lived experiences (nature and extent) of the interpersonal relationship between RNs and students during clinical placement.

BACKGROUND

In Australia, as elsewhere, nursing students' clinical placements are facilitated and supervised by registered nurses (RNs). There is evidence of positive teaching and learning interactions between RNs and students influencing student placement outcomes. Comparatively, little is known about the value of interpersonal relationships between RNs and students in the contribution to positive placement experiences.

DESIGN

A descriptive phenomenological approach was used to investigate the interpersonal relationship between RNs and students from the perspective of the lived experience of the RN.

METHOD

In depth, semi-structured interviews were conducted with ten RNs and analysed using Colaizzi's seven-step analytical approach.

RESULTS

Study findings revealed that RNs are committed to building positive interpersonal relationships with students to enhance learning and achieve successful clinical learning outcomes. Positive relationships are enabled through factors encompassing three overarching themes; Getting to know the student is essential; Effective communication is a reciprocal process, and Mutuality of engagement and commitment is critical. Vital to the relationship was the capacity to know the student, communicate with them openly and effectively, and have a mutually engaging, committed relationship with them.

CONCLUSIONS

The establishment of positive interpersonal relationships is important to the RNs who facilitate and supervise the clinical learning of nursing students for meaningful learning and successful student outcomes. Key findings included that getting to know the student is essential, effective communication is a reciprocal process, and mutuality of engagement and commitment is critical to building a positive relationship. Findings can be utilised to advise professional development for RNs who work with students on clinical placement with regard to the importance of developing positive interpersonal relationships with students and the characteristics that enable that to occur. The primacy of the relationship, brought about through RNs requirement to facilitate student clinical learning needs acknowledgement. Also, the importance of the interpersonal relationship for RNs and students needs recognition by both, to help them achieve success in clinical placements through effective interpersonal and professional relationships which promote good learning opportunities.

Transition shock, preceptor support and nursing competency among newly graduated registered nurses: A cross-sectional study

BACKGROUND

Transition shock is highly prevalent among newly graduated registered nurses in their early career. Preceptors are widely used to support them in acquiring clinical nursing competencies and to promote their successful transition to practice. However, the mechanism by which transition shock and preceptor support are linked to nursing competency among newly graduated registered nurses remains unknown.

OBJECTIVES

The aim of the study was to examine the relationship between transition shock, preceptor support, and nursing competency in a sample of newly graduated registered nurses.

DESIGN

A descriptive, cross-sectional design.

SETTINGS

Six tertiary hospitals in the southeast of mainland China.

PARTICIPANTS

Newly graduated registered nurses undertaking their professional role in the first year.

METHODS

Convenience sampling was used to recruit 215 newly graduated registered nurses [184 female, 31 male] from six hospitals. Data on transition shock, preceptor support, and nursing competency were collected using questionnaires from November to December 2019.

RESULTS

The nursing competency of critical thinking/research aptitude (mean = 2.68, SD = 0.63) was scored the lowest among participants. Transition shock (r = -0.21, p < .01) and perceptions of preceptor support (r = 0.56, p < .01) were statistically significantly correlated with nursing competency. Preceptor context, whether the assigned preceptor varied day by day, and the emotional challenges of transition shock were the main predictors of nursing competency (F = 36.86, p = .00), accounting for 34% of the variance in nursing competency.

CONCLUSIONS

Educational programs aimed at increasing critical thinking and research aptitude in the educational stage and the continuing educational stage can benefit newly graduated registered nurses. A well-organized transition program in hospitals including awareness and recognition of transition shock in newly graduated registered nurses is essential to enhance their competency in providing quality nursing. More support and assistance would be useful in promoting the preceptor's role in improving nursing competency of newly graduated registered nurses.

Understanding nurse preceptors' experiences in a primary health care setting: A descriptive qualitative study

AIM

This study sought to understand primary health care nurse preceptors' experiences of precepting junior nurses.

BACKGROUND

Nurse preceptors provide clinical teaching to nurses and pre-registration nurses and play a supervisory role in their work. The demand for preceptors in the primary health care setting is on the rise, and there is a huge responsibility placed on them on top of their routine workload.

METHODS

A descriptive qualitative approach was adopted, and purposive sampling was used to select the participants. 14 nursing preceptors across six polyclinics were interviewed. Thematic analysis was used to analyse the data.

RESULTS

The analysis revealed three themes: (1) a vessel for transferring knowledge; (2) building a therapeutic relationship; and (3) overcoming organisational barriers.

CONCLUSION

In light of the study's findings, strategies to address the insufficient knowledge of nurse preceptors, lack of recognition and preceptorship opportunities must be developed.

IMPLICATIONS FOR NURSING MANAGEMENT

More attention and opportunities for nurse preceptors' professional development such as courses to enhance their knowledge on educational and research developments as well as teaching seminars to maintain and build effective relationships with their preceptees. In addition, recognizing the role of nurse preceptors as a pillar of guiding the future generation of nurses and research to support nurse preceptors in their training cannot be undermined.

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.

Midwifery Education Institutions in Italy Creation and Validation of Clinical Preceptors’ Assessment Tool: Students’ and Expert Midwives’ Views

Background: The aim of the study is to create and validate a midwifery preceptor’s evaluation form to be used by midwifery students. The International Confederation of Midwives recommends that clinical placements need to be supervised by a preceptor in order to be efficient for students who, in this way, gain competence and proper practice within the midwifery practical area. Methods: This is an observational multi-center transversal study and leads to the validation of an evaluation questionnaire. Methodically, the following steps were followed: literature review, focus group with midwifery students, meeting between expert midwives, creation of the preceptor’s assessment form, filling in of the forms by midwifery students and expert midwives, and validation of the form. The study was carried out in eight Italian universities and included eighty-eight midwifery students and eight midwives. Results and Conclusion: A midwifery preceptor’s assessment questionnaire was created made up of four attribute areas which, as a total, included 33 items. Cronbach’s alpha score was calculated after examining the forms filled in by students and expert midwives. An alpha score of 0.97–0.85 was obtained. The result was Pearson Correlation Coefficient r = 0.78.