Job satisfaction in preceptorship and its effect on the clinical performance of the preceptee

Structural Relationships between Socio-Cognitive Mindfulness, Everyday Creativity, and Clinical Competence in Nursing Students: Mediating Effects of Everyday Creativity

BACKGROUND

Incorporating socio-cognitive mindfulness, which has not received much attention from nursing researchers, this study investigated the structural relationships between socio-cognitive mindfulness, everyday creativity, and clinical competence among nursing students. This study also explored the mediating effect of everyday creativity.

METHODS

A cross-sectional study was performed with 222 nursing students in South Korea. Students completed the questionnaire evaluating their own socio-cognitive mindfulness, everyday creativity, and clinical competence. Data were analyzed using structural equation modeling and path analysis.

RESULTS

Socio-cognitive mindfulness positively influenced everyday creativity (β = 0.791, p < 0.01), and everyday creativity also positively influenced clinical competence (β = 0.470, p < 0.01). However, the relationship between socio-cognitive mindfulness and clinical competence was not significant. Importantly, everyday creativity fully mediated the relationship between socio-cognitive mindfulness and clinical competence (a × b = 0.372, p < 0.01).

CONCLUSIONS

The results indicate that socio-cognitive mindfulness effectively enhances nursing students' clinical competence by improving their everyday creativity. The mediating result highlights the significance of everyday creativity in nursing education, underscoring the necessity for training programs aimed at cultivating creativity. This research offers a basis for developing programs that concentrate on socio-cognitive mindfulness and everyday creativity, with the goal of enhancing the clinical competence of nursing students.

Organizational determinants of information transfer in palliative care teams: A structural equation modeling approach

Several organizational factors facilitate or hinder information transfer in palliative care teams. According to past research, organizational factors that reduce information transfer include the inconsistent use of shared electronic patient files, frequent changes of healthcare staff, a lack of opportunities for personal exchange, and a lack of evaluation of collaborative processes. Insufficient information sharing between professionals can negatively impact patient safety, whereas studies have shown that some organizational factors improve collaboration between professionals and thus contribute to improved patient outcomes. The main purpose of this study is thus to investigate whether, and if so how, organizational factors contribute to successful information exchange in palliative care teams in Switzerland, while also accounting for the different care contexts of primary and specialized palliative care. A nationwide survey was aimed at medical professionals working in palliative care. In total, 379 participants (mean age = 49.8 years, SD = 10.3) were included in this study. Two main outcome variables were examined: healthcare providers' satisfaction with information transfer in their team and their overall satisfaction with communication in their team. Hypotheses were tested by employing structural equation modeling. Findings revealed that the strongest predictors for effective information transfer in palliative care teams were sufficient opportunities for face-to-face meetings and supervision alongside feedback tools to improve collaborative practices and the application of guidelines and standards for collaboration. Face-to-face meetings were an even greater contributor to information transfer in specialized settings, whereas sharing the same work-based values with colleagues was considered more important in primary settings. Results from this study contribute to the existing literature elucidating how information transfer is facilitated in the field of palliative care. If proposed measures are implemented, this could possibly improve patient outcomes in palliative care. Furthermore, the findings can be useful for healthcare organizations and associations to make more efficient resource allocation decisions with the aim to optimize information transfer within the workforce.

A Review for Concept Clarification of Critical Thinking, Clinical Reasoning, and Clinical Judgment in Nursing Education

Purpose: This article is a comprehensive review for concept clarification of critical thinking, clinical reasoning, and clinical judgment, which still lack a consensus and are of mixed use. Methods: Norris's method of concept clarification was used to review concepts that have no clear definition or conceptualization yet. Results: This review summarized literature from various disciplines, classified each concept based on similarities and differences, and provided hypothetic conceptual schema. Conclusion: Clinical reasoning and clinical judgment are clinical situation specific concepts, while critical thinking is a concept applied in general situations. Critical thinking is a broader concept and serves as a foundation for clinical reasoning and clinical judgment. Clinical reasoning precedes clinical judgment. Clinical judgement implies the end point or conclusion of clinical reasoning. Each of critical thinking, clinical reasoning, and clinical judgment is a cognitive and affective process not a psychomotor process. The concept of clinical competency involves action taken after the cognitive processes of clinical reasoning and clinical judgment.

Effects of a simulated emergency airway management education program on the self-efficacy and clinical performance of intensive care unit nurses

AIM

To examine the effects of a simulated emergency airway management education program on the self-efficacy and clinical performance among nurses in intensive care units.

METHODS

A one-group, pre- and post-test design was used. Thirty-five nurses who were working in adult intensive care units participated in this study. The simulation education program included lectures, skill demonstration, skill training, team-based practice, and debriefing. Self-efficacy and clinical performance questionnaires were completed before the program and 1 week after its completion. The data were analyzed by using descriptive statistics and the paired t-test to compare the mean differences between the pre-test and post-test. The scores before and after education were compared.

RESULTS

After education, there was a significant improvement in the nurses' self-efficacy and clinical performance in emergency airway management situations.

CONCLUSION

Simulation education effectively improved the self-efficacy and clinical performance of the nurses who were working in intensive care units. Based on the program for clinical nurses within a hospital, it will provide information that might advance clinical nursing education.

Pair Scanning: Integrating the Student Sonographer Without Impacting Patient Care

OBJECTIVES

Ultrasound departments in Canada frequently reduce patient bookings to support student training, which impacts not only patient care but also revenue generation. Therefore, physicians and employers are reluctant to host student sonographers, and educational programs struggle to find sufficient clinical placements for their students. Two research questions were investigated: (1) Can a pair scanning technique effectively integrate the student sonographer into the workplace without impacting patient volumes? (2) Does the pair scanning technique prepare the student sonographer for entry-level practice faster than traditional practice?

METHODS

This research project was divided into 2 phases. The first phase used action research to develop the pair scanning protocol at a single site with a single preceptor and student. The second phase used a mixed methods approach to test the transferability of the pair scanning protocol across multiple sites, preceptors, and students.

RESULTS

In phase 1, the student sonographer performed a greater number of total examinations than the rest of her cohort (who were at different placement sites), and the higher performance of independent examinations by the student sonographer under the pair scanning technique was statistically significant [H₍₄₎  = 36.297; P < .01]. In phase 2, the pair scanning group and the control group performed equally, with no statistically significant differences.

CONCLUSIONS

The pair scanning protocol is effective at integrating the student sonographer into the work flow without impacting patient care. It prepares the student sonographer for entry-level practice equally with traditional practice and may be most effective with the weak to average student.

General Satisfaction Among Healthcare Workers: Differences Between Employees in Medical and Mental Health Sector

Background:

General satisfaction is a personal experience and sources of satisfaction or dissatisfaction vary between professional groups. General satisfaction is usually related with work settings, work performance and mental health status.

Aim:

The purpose of this research study was to investigate the level of general satisfaction of health care workers and to examine whether there were any differences among employees of medical and mental health sector.

Methods:

The sample consisted of employees from the medical and mental health sector, who were all randomly selected. A two-part questionnaire was used to collect data. The first section involved demographic information and the second part was a General Satisfaction Questionnaire (GSQ). The statistical analysis of data was performed using the software package 19.0 for Windows. Descriptive statistics were initially generated for sample characteristics. All data exhibited normal distributions and thus the parametric t-test was used to compare mean scores between the two health sectors. P values < 0.05 were defined as reflecting the acceptable level of statistical significance.

Results:

457 healthcare workers completed the questionnaire. The mean age of the sample was 41.8 ± 7.9 years. The Cronbach alpha coefficient for GSQ was 0.79. The total mean score of general satisfaction for the employees in medical sector was 4.5 (5=very satisfied) and for the employees in mental health sector is 4.8. T-test showed that these results are statistical different (t=4.55, p<0.01) and therefore the two groups of healthcare workers feel different general satisfaction.

Conclusions:

Mental health employees appear to experience higher levels of general satisfaction and mainly they experience higher satisfaction from family roles, life and sexual life, emotional state and relations with patients.

Putting the evidence into preceptor preparation

The term evidence-based practice refers to the utilization of knowledge derived from research. Nursing practice, however, is not limited to clinical practice but also encompasses nursing education. It is, therefore, equally important that teaching preparation is derived from evidence also. The purpose of this study was to examine whether an evidence-based approach to preceptor preparation influenced preceptors in a assuming that role. A qualitative method using semistructured interviews was used to collect data. A total of 29 preceptors were interviewed. Constant comparative analysis facilitated examination of the data. Findings indicate that preceptors were afforded an opportunity to participate in a preparatory process that was engaging, enriching, and critically reflective/reflexive. This study has generated empirical evidence that can (a) contribute substantively to effective preceptor preparation, (b) promote best teaching practices in the clinical setting, and (c) enhance the preceptorship experience for nursing students.

Relationships between critical thinking ability and nursing competence in clinical nurses

AIM AND OBJECTIVE

To examine the relationships between critical thinking ability and nursing competence in clinical nurses.

BACKGROUND

There are few evidance-based data related to the relationship between critical thinking ability and nursing competence of clinical nurses.

DESIGN

A cross-sectional and correlation research design was used.

METHODS

A total of 570 clinical nurses at a medical centre in southern Taiwan were recruited into this study. Two self-report questionnaires, the Watson-Glaser Critical Thinking Appraisal (WGCTA) and the Nursing Competence Scale (NCS), were used to collect data.

RESULTS

The critical thinking ability of clinical nurses was at the middle level. The highest score for the subscales of the WGCTA was 'interpretation ability' and the lowest was 'inference ability'. The nursing competence of clinical nurses was at the middle level and above. The highest score for the subscales was 'caring ability' and the lowest was 'research ability'. Critical thinking ability had a significantly positive correlation with nursing competence. Critical thinking, working years, educational levels and position/title were the significant predictors of nursing competence, accounting for 32·9% of the variance.

CONCLUSIONS

Critical thinking ability had a significantly positive correlation with nursing competence. The critical thinking ability of clinical nurses with a master's degree was significantly better than those with a bachelor's degree or a diploma and nurses with over five working years was significantly better than those with under five years.

RELEVANCE TO CLINICAL PRACTICE

The findings of this study can further serve as a reference for nursing education to improve nursing curricula and teaching strategies for nurse preparation. It could also be a guideline for nursing administration personnel in on-the-job training and orientation programs for nursing staff.

Role strain in collegiate athletic training approved clinical instructors

CONTEXT

Certified athletic trainers who serve as Approved Clinical Instructors (ACIs) in the collegiate setting are balancing various roles (eg, patient care and related administrative tasks, clinical education). Whether this balancing act is associated with role strain in athletic trainers has not been examined.

OBJECTIVE

To examine the degree of, and contributing factors (eg, socialization experiences, professional and employment demographics, job congruency) to, role strain in collegiate ACIs.

DESIGN

Cross-sectional survey design.

SETTING

Geographically stratified random sample of ACIs affiliated with accredited athletic training education programs at National Collegiate Athletic Association (NCAA) Division I, II, and III institutions.

PATIENTS OR OTHER PARTICIPANTS

118 collegiate ACIs (47 head athletic trainers, 45 assistant athletic trainers, 26 graduate assistant athletic trainers).

MAIN OUTCOME MEASURE(S)

The Athletic Training ACI Role Strain Inventory, which measures total degree of role strain, 7 subscales of role strain, socialization experiences, professional and employment characteristics, and congruency in job responsibilities.

RESULTS

A total of 49% (n = 58) of the participants experienced a moderate to high degree of role strain. Role Overload was the highest contributing subscale to total role strain. No differences were noted between total role strain and role occupant groups, NCAA division, or sex. Graduate assistant athletic trainers experienced a greater degree of role incompetence than head athletic trainers did (P = .001). Division II ACIs reported a greater degree of inter-role conflict than those in Division I (P = .02). Female ACIs reported a greater degree of role incompetence than male ACIs (P = .01). Those ACIs who stated that the ACI training provided by their institution did not adequately prepare them for the role as an ACI experienced greater role strain (P < .001).

CONCLUSIONS

The ACIs in the collegiate setting are experiencing role strain in balancing their roles as health care providers, clinical educators, and administrators. Methods to reduce role strain need to be considered.

Relationship between organizational empowerment and job satisfaction perceived by nursing assistants at long-term care facilities

AIM

The purpose of this study was to understand the relationships between organizational empowerment and job satisfaction among nursing assistants at long-term care facilities in Taiwan.

BACKGROUND

Nursing assistants are the major manpower at long-term care facilities. The responsibilities of nursing assistants are complex and numerous and affect their job satisfaction. We assumed that a well-organized and pleasant work environment is an important characteristic of organizational empowerment and ought to enhance the nursing assistants' job satisfaction. However, little information exists that can be used by long-term care facilities managers when they strive to increase the nursing assistants' job satisfaction by modifying the regulations or interventions from an organizational perspective.

METHODS

We used a cross-sectional design with a descriptive correlation approach to understand the relationship between organizational empowerment and job satisfaction among nursing assistants at long-term care facilities in Taiwan. A total of 28 long-term care facilities and 114 nursing assistants participated in the study.

RESULTS

The results indicated that, where there was a moderate level of organizational empowerment, a higher level of job satisfaction was found. Organizational empowerment was significantly associated with total job satisfaction (r = 0.366, p < 0.01). The variables of nationality (Vietnamese), resources, opportunity and informal power were significant predictors of job satisfaction (R(2) = 0.318, F = 12.24, p < 0.001).

CONCLUSION

Organizational empowerment is significantly associated with job satisfaction among nursing assistants in this study.

RELEVANCE TO CLINICAL PRACTICE

Nursing assistants need to receive more assistance and resources from their co-workers to enhance their job satisfaction. The manager should initiate regular meetings and activities for staff who work in long-term care facilities that will allow sharing, communication and support among the staff in terms of ideas, information and feelings.

The experience of a good day: A phenomenological study to explain a good day as experienced by a newly qualified RN

The main aim of this study was to provide an explanation of the newly qualified nurse's experience and description of a good day. Secondly, it sought to provide an explanation of how a good day made them feel about nursing. By identifying the main components of a good day and what positively effects the experience of a working day for a newly qualified nurse, it may be possible to move towards an increase in the occurrence of the components and emulation of a good day. While there is evidence to suggest that positive experiences within nursing increase job satisfaction and aid retention to the profession, the experience of a good day and what constitutes a good day for a newly qualified nurse has not been explored. The main components of a good day have not been identified and no work has been carried out to ascertain how these days make nurses feel about their chosen career. The aims of the study lent themselves to a phenomenological descriptive approach to research, the objective of which is identification of the essence of behaviour. Eight newly qualified nurses agreed to take part in the research. Each participant was interviewed twice, and in addition one group interview was arranged to clarify themes. The interviews, which were audio taped, were informal allowing the participants to answer in an open and unstructured manner. Once completed, all the tapes were transcribed and immersion and analysis of the data led to 5 themes naturally emerging as the components of a good day. The identified themes were, doing something well, good relationships with patients, feeling that you've achieved something, getting the work done and you need team work. In addition, although not a theme of a good day but of great importance was the description of 'that wonderful feeling at the end of a good day'. These themes contributed to feelings of job satisfaction and the pleasure of nursing. More specifically the concept of knowing the patient both from a personal level and knowing about their care and condition has been identified as a main component of a good day. This knowing the patient had a knock on effect in that when this was part of the day it was easier to prioritize and get the work done. These nurses were striving to develop a level of care and competency and, unlike expert nurses, did not have vast experience and knowledge to underpin their actions. They need to ensure that all levels of knowledge are addressed before they can carry out care. Additionally, the team dynamics and the way the team work together had a significant effect on the day.

The experience of a good day: a phenomenological study to explain a good day as experienced by a newly qualified RN

The main aim of this study was to provide an explanation of the newly qualified nurse's experience and description of a good day. Secondly it sought to provide an explanation of how a good day made them feel about nursing. By identifying the main components of a good day and what positively effects the experience of a working day for a newly qualified nurse, it may be possible to move towards an increase in the occurrence of the components and emulation of a good day. While there is evidence to suggest that positive experiences within nursing increase job satisfaction and aid retention to the profession, the experience of a good day and what constitutes a good day for a newly qualified nurse has not been explored. The main components of a good day have not been identified and no work has been carried out to ascertain how these days make nurses feel about their chosen career. The aims of the study lent themselves to a phenomenological descriptive approach to research, the objective of which is identification of the essence of behaviour. Eight newly qualified nurses agreed to take part in the research. Each participant was interviewed twice, and in addition one group interview was arranged to clarify themes. The interviews, which were audio taped, were informal allowing the participants to answer in an open and unstructured manner. Once completed, all the tapes were transcribed and immersion and analysis of the data led to 5 themes naturally emerging as the components of a good day. The identified themes were, doing something well, good relationships with patients, feeling that you've achieved something, getting the work done and you need team work. In addition, although not a theme of a good day but of great importance was the description of 'that wonderful feeling at the end of a good day'. These themes contributed to feelings of job satisfaction and the pleasure of nursing. More specifically the concept of knowing the patient both from a personal level and knowing about their care and condition has been identified as a main component of a good day. This knowing the patient had a knock on effect in that when this was part of the day it was easier to prioritise and get the work done. These nurses were striving to develop a level of care and competency and, unlike expert nurses, did not have vast experience and knowledge to underpin their actions. They need to ensure that all levels of knowledge are addressed before they can carry out care. Additionally the team dynamics and the way the team work together had a significant effect on the day.

Keeping afloat: student nurses' experiences following assignment referral

The retention of nursing students is an ongoing problem, both within the United Kingdom (UK) and internationally. While there is a plethora of literature relating to student attrition, there is an absence of evidence in relation to the experiences of those students who are struggling to meet the demands of nursing programmes. Using an inductive sociological enquiry based approach, this study sought to examine the experiences of student nurses after referral on the first attempt of a summative assessment. Nursing students who had failed an assignment (n=20) were invited to participate. Data was collected using focus groups, with the emergent themes collapsed into a concise format using thematic content analysis. Four key themes were identified: desire to succeed; acceptance of personal failure; recognition of personal attributes required for success; and responsibility for personal success and failure. Students remained on the programme, despite struggling with financial and personal difficulties, because the desire to become a qualified nurse outweighed transient hardships. This paper will illustrate the benefits of understanding the students' experiences, in order to ensure the support students receive is appropriate to their needs. Understanding the support strategies as perceived by the students may prevent further wastage from nursing programmes.

Preceptor Preparation

Preceptor preparation is critical to the success of all orientation programs. This article focuses on the purposes of preceptor preparation and a series of programs developed for the staff of Surgical Services. The programs are leveled and focus on basic and advanced concepts. The advanced program is a means of reward and recognition for preceptors in the various surgical services areas. The programs are designed for nurses and other staff involved in precepting new employees.

Supernumerary status: definition, operationalisation and its effect in practice

This paper presents an evaluation of the implementation of supernumerary status in intensive care units in the Greater Belfast area. The evaluation focused on three questions, what did staff understand by the term supernumerary status. How was supernumerary status implemented in the Trusts? What effect did supernumerary status have on the staff/Trusts involved? The results of the evaluation are presented here and issues for further development identified. The study was qualitative in nature and used semi-structured interviews and focus group interviews to collect data. Participants were purposefully selected by virtue of their experience of supernumerary status. Interviews and focus groups were audiotaped and transcribed verbatim. These transcripts were then analysed line-by-line and coded. Data analysis described 10 common themes. In general, the concept of supernumerary status was well received and was supported by all involved who believed that its goal of producing adequately trained and skilled practitioners in an intensive care environment was a worthwhile exercise that benefited both staff and patients. Overall, exploring the operationalisation of a supernumerary status programme helps us to explore the challenges of supporting neophyte nurses in all areas of practice and challenges service providers to consider creative approaches to providing such support. However, whilst making a positive contribution to the recruitment and development of nurses new to the intensive care environment, further study is required to gauge the long-term effect of this programme on retention of staff.

Precepting in 2002

Preceptorships have been used to bridge the gap between nursing education and the reality of the workplace. The role of preceptors to prepare new or transitioning nurses to function more efficiently and earlier has become increasingly important in recent years. To foster positive attitudes in the experienced nurses toward accepting and functioning in the roles of preceptors, nursing administration and nursing education must collaborate. Preceptors have the ability to shape, nurture, influence, and support novice nurses. Experienced nurses hold the responsibility to encourage this commitment.

Clinical placements in mental health: are clinicians doing enough for undergraduate nursing students?

There are growing concerns identified in the literature about the lack of quality clinical placements in mental health for undergraduate nursing students. This study outlines an innovative student programme, designed and implemented by clinicians, committed to providing a quality clinical placement for students. The programme was evaluated by the use of an open-ended questionnaire administered to a sample of 10 undergraduate nursing students. Results of this evaluation suggested that the programme was able to provide a positive clinical experience in mental health for nursing students and is worthy of a more controlled investigation.

Enhancing staff development with a structured preceptor program

The unexpected expansion of a 14-bed medical intensive care unit exposed the need for a structured preceptor/orientation program. Staff feedback and a review of quality indicators further substantiated this finding and revealed a decrease in standards of practice and problems in staff development. A restructured preceptor/orientation program yielded improvements in communication and staff satisfaction. Preceptors and orientees now have a better understanding of their roles and expectations, and quality of care is improving in an environment that promotes personal and professional growth.

Peers and partners: working together to strengthen preceptorship in mental health nursing

The Sussex Education Consortium commissioned a development project to identify the education and training needs of community mental health nurses (CMHNs). The project also afforded an opportunity to examine the CMHNs' perception of their role of preceptor with pre-registration diploma nursing (PRDN) students following the mental health branch. Utilizing a 'responsive evaluation' methodology, stakeholders' views were captured. As a consequence of the issues and concerns raised, the Consortium commissioned a second project, following a similar methodolgy, to explore preceptorship in greater depth. This paper reports stakeholders' views on preceptorship arrangements expressed in semi-structured interviews, focused group discussions and other fora during the two projects. Preceptor preparation and support arrangements did not meet the needs of preceptors. Many preceptors felt their role was neither valued nor acknowledged. The link lecturer role was perceived as important by preceptors; but lecturers were often unable to meet the expectations placed upon them. The volume of students and allocation arrangements caused problems for placement areas. Finding time to carry out the roles of the preceptor was a challenge for practitioners. Recommendations for improving preceptorship are discussed and developments described, illustrating how locally commissioned research may influence both education and practice in mental health nursing.

Student nurses' lived experience of preceptorship. Part 1--in relation to learning

In this first part of a research project a phenomenological approach was applied to understanding student nurses' experience of preceptorship. The lived experience of seventeen student nurses learning within a preceptor-preceptee relationship on hospital wards formed the basis of the study. Tape-recorded interviews were conducted, transcribed and analysed. The phenomenological hermeneutic analysis revealed three themes of meaning central to the lived experience of learning. These were (a) directing learning; (b) learning in practical action and (c) feeling in learning. The themes included six sub-themes with internal variations. The results indicate that learning, as a phenomenon, could be understood as being in different modes of learning, including directing learning, learning in practical actions and feeling in learning. Each theme was also found to be inherent in the others in an ongoing changeable process. The findings were compared with Aristotle's five modes of learning and revealed that the student nurses' learning embraced scientific knowledge, technical skills, practical wisdom and limited intuition. The study may provide nurse educators with some insight into student nurses' learning by being in real-life situations and performing nursing actions within a preceptor-preceptee relationship.

Enhancing relationships between nursing faculty and clinical preceptors

Rapid changes in health care and nursing education have necessitated an increased need for educators and clinicians to build alliances. Historically, the economic demand has been placed on clinical agencies to provide quality educational experiences for students. However, clinical agencies are increasingly refusing to precept students because of cost and liability issues. To secure and maintain optimal clinical experiences for students, nurse educators must learn to develop positive relationships with practicing nurses, contribute to staff education, and share educational responsibility in evaluating student learning.