Assessing and preparing students for distance preceptorship placements

A critique of the undergraduate nursing preceptorship model

The preceptorship model is a cornerstone of clinical undergraduate nursing education in Canadian nursing programs. Their extensive use means that nursing programs depend heavily on the availability and willingness of Registered Nurses to take on the preceptor role. However, both the health service and education industries are faced with challenges that seem to undermine the effectiveness of the preceptorship clinical model. Indeed, the unstable nature of the clinical setting as a learning environment in conjunction with faculty shortages and inadequate preparation for preceptors and supervising faculty calls us to question if the preceptorship model is able to meet student learning needs and program outcomes. In a critical analysis of preceptorship, we offer a deconstruction of the model to advance clinical nursing education discourse.

Preceptors' perspective on recruitment, support, and retention of preceptors

In this study, the researchers sought consensus among preceptors of senior nursing students about issues key to the preceptors' recruitment, support, and retention. A modified Delphi method with two rounds of questionnaires was used followed by a focus group to explore issues for which consensus was not reached. Preceptors agreed on the importance of personal satisfaction and on a number of tangible benefits of being a preceptors such as receiving information on a need-to-know basis. Topics such as how to help students think critically and how to provide constructive feedback also were considered important. Preceptors agreed that having students well prepared at the beginning of preceptored experiences was important as was receiving a personalized thank you letter to acknowledge their work a the end of the experience, two strategies that could help with retention.

Undergraduate nursing students' preparedness to "go rural"

This article reports on a theme emerging from a focused ethnography examining the professional socialization of undergraduate fourth year nursing students during a rural hospital preceptored clinical experience. Nursing students and preceptors geographically dispersed over a 640,000 square kilometer rural area participated in this study. Students report student preparedness for the rural hospital setting means to "know what you are getting into". Assisting nursing students to prepare for the rural hospital preceptorship facilitates a positive experience thus increasing the effectiveness of the preceptorship model of clinical teaching. Having a positive rural-based experience also has the potential for recruiting new staff. These preliminary findings suggest that student preparation for the rural hospital preceptorship includes cognitive and psychological preparation, as well as the acquisition of common advanced clinical skills.

International clinical placements for undergraduate students

This paper reports the findings of a study that sought to gain insight into the experiences of third year nursing students who participated in a 4-week clinical placement in an international setting. This study is different from many studies describing international placements for undergraduate nursing students as it concentrates on clinical experiences on placement. Students' reflective journals and face-to-face discussions were used to collect data, which were analysed by thematic content analysis. Categories were identified describing a focus on micro clinical-based issues that expanded over time to a focus on broader issues reflecting the "nursing culture" of the placement. Students described both positive and negative aspects of being placed in an international clinical setting, with the concept of "being different" emerging. Whilst the findings cannot be generalized beyond the sample, the study highlights the importance of adequate preparation and support for students on international clinical placements, with emphasis on attention to clinical detail.

Undergraduate nursing students' clinical experiences in rural and remote areas: recruitment implications

Providing rural and remote clinical experiences for undergraduate nursing students could help address future recruitment in these areas, but adequate financial support for students during clinical placements is also necessary. Strategies to address nursing shortages to date have emphasised funding for rural re-entry programs, or supporting students from rural backgrounds to attend university courses. Assisting current undergraduate nursing students, especially those from urban backgrounds, to experience living and working in rural areas has been overlooked as a potential recruitment strategy. Ongoing qualitative evaluation of a clinical placement program shows students respond positively and with increased interest in returning to rural nursing after graduation. Unfortunately, many are disadvantaged financially by the added expense of their rural clinical rotation. Finding ways to support students from both urban and non-urban backgrounds to undertake rural and remote clinical placements should be an important strategic and funding priority.

Student nurse stress in the preceptorship experience

Student nurses appear to experience significantly more stress during their academic preparation than they do during the first year of employment. Preceptorship is among the most stressful of student experiences. It is within the context of a challenging and at times daunting work environment that two complete strangers (preceptor and student) strive to accommodate one another within a professional capacity. If the relationship between preceptor and student is less than successful, not only can it be frustrating and disheartening, but it can result in student stress and disillusionment about nursing and an inability to integrate and learn. Using a hypothetical case, the authors discuss the importance of student assessment, close communication between faculty and preceptors, and quick responses to student stress as a means by which to circumvent the serious potential of student burnout in the practice setting.