The meaning of preceptorship: nurses' lived experience of being a preceptor

Experiences of preceptorship in Singapore: A qualitative exploratory study of preceptors' experience in precepting nursing students during pre-registration of clinical placement in an acute hospital

BACKGROUND

Preceptors play an important role in teaching and guiding nursing students to transit to the role of registered nurses. Nursing students are trained to acquire the skills and knowledge in providing good quality care to patients. However, the preceptors in the clinical area may face challenges in providing care to their patients in addition to their preceptor role. It is vital to explore and gain insights on the preceptorship experience to better understand their challenges and facilitate their preceptorships and the learning experience of the nursing students.

AIMS

This study explored the preceptors' experience to understand their challenges and support received in the facilitation of the preceptorship and learning experience of the nursing students in an acute care hospital in Singapore.

METHODS

Semi-structured interviews were conducted from June to October 2021 with ten registered nurses working in an acute hospital. Thematic analysis was conducted.

RESULTS

Three main themes emerged from the thematic analysis: (1) preceptor-student relationship; (2) barriers and challenges to successful preceptorship; and (3) outcomes of successful preceptorship.

CONCLUSIONS

This study provided valuable insights in the experience of the preceptors in Singapore. Recommendation for nursing management and leaders to establish support system in promoting recognition of preceptors, establish dialog sessions between stakeholders. Nursing education to provide support and to review the efficacy of the current preceptorship program to identify correlation with successful precepting experience for both preceptors and nursing students. Despite challenges faced by the preceptors, their experience had been positive and they are committed in precepting the nursing students.

Clinical teaching practices of nurse educators: An integrative literature review

Clinical teaching practice of nurse educators is important in the development of clinical competence of undergraduate nursing students, but it is often not done according to best practice standards. This study aimed to summarise the best clinical teaching practices of nurse educators teaching undergraduate nursing programmes. An integrative literature review was conducted according to Whittemore and Knafl’s adapted stages. A systematic search of electronic databases, including EBSCOhost and ScienceDirect, for applicable papers from January 2001 to June 2021, was followed by a manual search. The review resulted in selection of 67 papers, and critical appraisal had been completed by two independent reviewers using relevant critical appraisal tools. Papers that were selected revealed six main themes, with sub-themes, outlining best practices for clinical teaching, namely: (1) planning for clinical teaching practice: self-preparation and planning for clinical placement; (2) facilitation of students’ clinical learning: orientation of students, planning for clinical teaching and the clinical teaching process; (3) evaluation of students’ clinical skills: reflection by the nursing student and feedback; (4) modelling professional clinical teaching practice: emotional intelligence, self-evaluation, role modelling and continuous professional development; (5) work-based assessment in the clinical environment: clinical assessment process and clinical assessment tools and (6) clinical teaching in the simulation laboratory. The six identified best practices could assist nurse educators to provide comprehensive clinical teaching.

The systems psychodynamic role identity of nursing students during their preceptorship

BACKGROUND

Existing research on nursing students' preceptorship experiences focusses mainly on conscious and rational behaviour, evidencing experiences of personal and professional development. This study argues that the exploration of their unconscious experiences could add important information towards an in-depth understanding of their role identity during this experience.

OBJECTIVE

The research objective was to describe the unconscious role identity of nursing students during their preceptorship from a systems psychodynamic stance.

DESIGN

A qualitative design, a collective case study and hermeneutic phenomenology were utilised as methodologies.

SETTING

Set in the School of Nursing of a Canadian University, the research focussed on students in the fourth year Consolidation in Nursing Practice Course.

PARTICIPANTS

The sample included 41 nursing students, 37 females, 22-28 years of age.

FINDINGS

The manifesting themes were high levels of anxiety, defensive structures, boundary and authority matters, and role dynamics. The nursing students experienced high levels and different kinds of anxiety, which they defended against using introjections, projections and regression to their child ego state. They experienced the preceptorship as being in a middle position between past and future as well as between knowing and not knowing. The discussion was presented in relation to the macro (organisational), meso (group), and micro (individual) levels.

CONCLUSIONS

Unconsciously, the nursing students experienced difficulty in effectively taking up their professional role. They defended against their discomfort by splitting their experiences into what they introjected and projected. They introjected incompetence in coping with the emotional demands of the role and projected their anger onto authority figures. Their professional role identity got stuck in a de-authorised position where they could survive but not develop their selves in their new role. These experiences inhibited their authenticity and learning ability.

Nurses' experiences of their competence at mentoring nursing students during clinical practice: A systematic review of qualitative studies

Aim To identify and synthesize the best available evidence on nurse mentors' experiences of their competence in mentoring nursing students during clinical practice.

DESIGN

The research employed a systematic literature review that followed the guidelines of the Joanna Briggs Institute (JBI).

DATA SOURCES

The databases CINAHL, Medline Ovid, Scopus, Eric, Web of Science, Medic, and OATD were systemically searched from 2000 to 2017.

REVIEW METHODS

The identified studies were screened by title, abstract (n = 3080) and full-text (n = 91) using the following inclusion criteria: registered nurses, nurses' experiences of competence in mentoring nursing students, acute and primary care organizations providing clinical practice for nursing students, qualitative study. Quality appraisal was performed, data extracted and findings from the included studies (n = 21) were pooled using meta-aggregation with the Qualitative Assessment and Review Instrument (JBI-QARI).

RESULTS

A total of 92 extracted findings were aggregated into 21 categories and then further grouped into five synthesized findings: 1) creating an interactive relationship with the student; 2) developing mentor's characteristics and cooperation with stakeholders; 3) providing goal-oriented mentoring; 4) supporting students' development to nurse profession; 5) supporting the student's learning process.

CONCLUSIONS

This review demonstrated that multifaceted mentoring competence is essential to supporting students' learning processes and helping them become confident professionals. For this reason, the findings suggest that healthcare organizations which provide clinical practice for students should emphasize developing the mentoring competence of nurses by offering nurse mentors adequate education, ensuring that the organizational structure affords them sufficient support, and creating a receptive learning atmosphere.

Work role transitions – expert nurses to novice preceptors

Purpose

Several issues are reported in the literature regarding the preparation and training of nurses for the preceptor role. The purpose of this study is to explore the experiences, growth and development of nurses transitioning to the preceptor role in allied health contexts.

Design/methodology/approach

A basic interpretive qualitative research method was used for this study. In total, 20 preceptors who were practicing in a variety of healthcare settings participated in in-depth interviews.

Findings

The preceptors of this study found meaning through their teaching and learning encounters with novice nurses. Their meaning making led to identity development and new perspectives on both the nursing and preceptor roles.

Research limitations/implications

This study extends the literature on informal learning and training by focusing on the unique work role of nurse precepting. Conclusions of this study call for additional research that examines other occupational areas in which workers have transitioned from expert to novice again, and how training can enhance these transitions

Practical implications

Participants described several areas of improvement for preceptorships: additional administrative support, guidelines and standards for preceptor training and preparation and additional time and support for transitioning to the preceptor role

Originality/value

Work role transition theory was used in this study to examine the preparation and training of preceptors. This study features the voices of nursing preceptors who have experienced changes in their employment status and major shifts in their work roles transitioning from expert to novice to expert again.

Preceptors' conceptions of a peer learning model: A phenomenographic study

BACKGROUND

During the past few years nurses precepting undergraduate nursing students have been put under greater pressure because of increased number of students admitted to the universities combined with a shortage of clinical placements. One solution is the preceptor model peer learning where two students are tutored by the same preceptor simultaneously.

OBJECTIVES

The aim of this study was to describe the variation of registered nurses' conceptions of preceptorship in a peer learning model for undergraduate nursing students.

DESIGN

The study used a qualitative descriptive design and a phenomenographic approach.

SETTINGS

The interviews took place at somatic and psychiatric units at two different hospitals in southern Sweden.

PARTICIPANTS

Twelve informants participated who had worked as registered nurses between 1-17years and acted as peer learning preceptors between 2month and 6years.

METHODS

Each nurse was interviewed individually using a semi structured interview guide. Follow up questions were used to make the informants develop and deepen their answers.

RESULTS

Four different descriptive categories emerged in the study: 1) Preceptorship in peer learning generates development and new perspectives 2) Preceptorship in peer learning enables student reflection and independence 3) Preceptorship in peer learning engenders insufficiency and stress 4) Preceptorship in peer learning requires education and support.

CONCLUSIONS

The result of this study showed that preceptors conceived that peer learning enabled them to take a step back which gave them a new role and perspectives. The consequence was that the students could be more independent which saved time for some of the preceptors. However, some preceptors perceived insufficiency and stress while working with two students. It is also important to educate both students and preceptors to optimise the use of peer learning.

Precepting a Student? Here are the Job Descriptions

Often a community health nurse is asked to precept a nursing student. Having a student accompany a nurse into patients' homes and clinics provides valuable learning experiences for the student. In this one-to-one, apprentice-type relationship with a community-skilled nurse, the student synthesizes clinical knowledge by learning skills, roles, responsibilities, and standards of care outside the acute care setting and enhances assessment, decision-making, and communication skills. In addition, preceptor experiences are opportunities to ignite professional enthusiasm, as well as serve as recruitment and retention modalities. To assist in implementing and/or continuing preceptor practicums with nursing schools, this article lists the job descriptions for all those involved in preceptorships.

Competencies to enable learning-focused clinical supervision: a thematic analysis of the literature

CONTEXT

Clinical supervision is essential for development of health professional students and widely recognised as a significant factor influencing student learning. Although considered important, delivery is often founded on personal experience or a series of predetermined steps that offer standardised behavioural approaches. Such a view may limit the capacity to promote individualised student learning in complex clinical environments. The objective of this review was to develop a comprehensive understanding of what is considered 'good' clinical supervision, within health student education. The literature provides many perspectives, so collation and interpretation were needed to aid development and understanding for all clinicians required to perform clinical supervision within their daily practice.

METHOD

A comprehensive thematic literature review was carried out, which included a variety of health disciplines and geographical environments.

RESULTS

Literature addressing 'good' clinical supervision consists primarily of descriptive qualitative research comprising mostly small studies that repeated descriptions of student and supervisor opinions of 'good' supervision. Synthesis and thematic analysis of the literature resulted in four 'competency' domains perceived to inform delivery of learning-focused or 'good' clinical supervision. Domains understood to promote student learning are co-dependent and include 'to partner', 'to nurture', 'to engage' and 'to facilitate meaning'.

CONCLUSIONS

Clinical supervision is a complex phenomenon and establishing a comprehensive understanding across health disciplines can influence the future health workforce. The learning-focused clinical supervision domains presented here provide an alternative perspective of clinical supervision of health students. This paper is the first step in establishing a more comprehensive understanding of learning-focused clinical supervision, which may lead to development of competencies for clinical supervision.

Clinical supervision in primary health care; experiences of district nurses as clinical supervisors - a qualitative study

BACKGROUND

Learning in the clinical environment is an important part of nursing education. Several recent studies focusing on clinical learning have been based on hospital settings. Little is known about primary health care (PHC) as clinical environment where district nurses (DNs) or nurses supervise students. It is important to understand more about opportunities and difficulties in supervising in this area in order to develop PHC as an optimal learning environment for nursing students. The main objective of this study was to gain an understanding of supervisors' experiences of supervising undergraduate students at PHC units.

METHODS

A qualitative research approach was used to collect data and analyse supervisors' experiences. Six focus groups were carried out with 24 supervisors. Focus group data were audio-taped. The data were analysed using an inductive content analysis.

RESULTS

Three themes illustrated supervisors' experiences: abandonment, ambivalence and sharing the holistic approach. Supervisors felt abandoned by their managers, colleagues and nurse teachers from universities. They experienced ambivalence due to simultaneously being supervisors for students and carrying out their daily work with patients. At the same time, they were proud to be DNs and willing to share their unique role to apply a holistic approach and continuity in patient care with students.

CONCLUSION

When supervising students in PHC, social support and communication between supervisors and their colleagues and management as well as nurse teachers need to be taken into consideration both at universities and at primary health care units.

Assessing the impact of academic-practice partnerships on nursing staff

Background

The ‘spillover effect’ of academic-practice partnerships on hospital nursing staff has received limited attention. In 2007, the Department of Veterans Affairs (VA) created the VA Nursing Academy (VANA) to fund fifteen partnerships between schools of nursing and local VA healthcare facilities. In this paper, we examine the experiences of the VA staff nurses who worked on the units used for VANA clinical training.

Methods

We used survey methods to collect information from staff nurses at all active VANA sites on their characteristics, exposure to the program’s clinical training activities, satisfaction with program components, and perspectives of the impact on their work and their own plans for education (N = 314). Our analyses utilized descriptive statistics and bivariate and multivariate regression.

Results

Results show that staff nurses working on VANA units had moderately high levels of exposure to the program’s clinical education activities, and most reported positive experiences with those activities. The vast majority (80 %) did not perceive the presence of students as making their work more difficult. Among those who were enrolled or considering enrolling in a higher education program, over a quarter (28 %) said that their VA’s participation in VANA had an influence on this decision.

The majority of staff nurses were generally satisfied with their experience with the students. Their satisfaction with the program was related to the level or dose of their exposure to it. Those who were more involved were more satisfied. Greater interaction with the students, more information on the program, and a preceptor role were all independently associated with greater program satisfaction.

Conclusions

Our study suggests that academic-practice partnerships may have positive spillover effects on staff nurses who work on clinical education units. Further, partnerships may be able to foster positive experiences for their unit nurses by focusing on informing and engaging them in clinical training activities. In particular, our results suggest that academic-practice partnerships should keep unit nurses well informed about program content and learning objectives, encourage frequent interaction with students, involve them in partnership-related unit-based activities, and urge them to become preceptors for the students.

Electronic supplementary material

The online version of this article (doi:10.1186/s12912-015-0085-7) contains supplementary material, which is available to authorized users.

Establishing and maintaining the clinical learning environment for nursing students: a qualitative study

BACKGROUND

Experience in the clinical setting is viewed as a crucial aspect of nursing education. Evidence suggests that students experience acceptance to alienation on the clinical unit. Little is known about preceptor beliefs underlying their approach with students, and the perspective of unit management is absent.

OBJECTIVES

To provide a description of the beliefs and processes that emerge at the unit level regarding the clinical learning environment for nursing students.

DESIGN

Multiple case study design.

SETTING

Four units from across an urban university health center who have a demonstrated ability to accept students.

PARTICIPANTS

A purposive sample of four nurse managers, four assistant nurse managers, three advanced practice nurses, and six staff nurses with recent and recurrent precepting experience were recruited from across four units.

METHODS

Semi-structured focus group interviews were conducted with all participants from each unit. Content analysis was used to identify major themes and categories in the interview data.

RESULTS

Two overarching themes were revealed: (1) Influencing factors included cultural factors and contextual factors that either inform units' beliefs about the ideal learning environment, or affect their ability to provide it. (2) Willingness refers to a willingness to invest in students and the forms that investment takes. It includes openness, taking them under wing, and structuring to meet goals. The influencing factors provide the foundation upon which the unit's work to accommodate students is built.

CONCLUSIONS

The degree to which a unit is able to manage the contextual factors determines how well they can shape the students' environment. The sturdiness of their culture with regard to hosting students determines the pervasiveness of their approach by staff on the unit.

Identifying clinical learning needs using structured group feedback: first year evaluation of pre-registration nursing and midwifery degree programmes

BACKGROUND

Facilitating and supporting clinical learning for student nurses and midwives are essential within their practice environments. Clinical placements provide unique opportunities in preparation for future roles. Understanding the experiences of first year student nurses and midwives following clinical exposures and examining the clinical facilitators and barriers can assist in maintaining and developing clinical supports.

METHODS

The study used a structured group feedback approach with a convenience sample of 223 first year nursing and midwifery students in one Irish university in April 2011 to ascertain feedback on the clinical aspects of their degree programme.

RESULTS

Approximately 200 students participated in the process. Two key clinical issues were identified by students: facilitating clinical learning and learning experiences and needs. Positive learning environments, supportive staff and increased opportunities for reflection were important issues for first year students.

CONCLUSIONS

The role of supportive mentoring staff in clinical practice is essential to enhance student learning. Students value reflection in practice and require more opportunities to engage during placements. More collaborative approaches are required to ensure evolving and adapting practice environments can accommodate student learning.

Preferred Thinking Style, Symptom Recognition, and Response by Nursing Students During Simulation

A better understanding of the relationships between symptom recognition, nursing response, and preferred thinking style is needed to improve nursing education practices. Final semester nursing students ( N = 29) completed a high fidelity patient simulation (HFPS) scenario; recognized symptoms (i.e., dyspnea) and responses (i.e., apply oxygen) were recorded, and compared with students’ preferred thinking style using the Rational-Experiential Inventory–40. Relationships between concepts were explored. Significant relationships were noted between preference for Rational thinking styles and symptom recognition ( p < .05). Preferred thinking style was not related to numbers of therapeutic responses. Thirty percent of students delayed application of oxygen until directed to do so by members of the health care team. Students having a stronger preference for rational thinking demonstrate greater accuracy in cue recognition. More nursing research is needed to explore the cognitive processing during simulation .

Text messaging to support off-campus clinical nursing facilitators: a descriptive survey

BACKGROUND

Managing large student cohorts can be a challenge for university academics, coordinating these units. Bachelor of Nursing programmes have the added challenge of managing multiple groups of students and clinical facilitators whilst completing clinical placement. Clear, time efficient and effective communication between coordinating academics and clinical facilitators is needed to ensure consistency between student and teaching groups and prompt management of emerging issues.

METHODS

This study used a descriptive survey to explore the use of text messaging via a mobile phone, sent from coordinating academics to off-campus clinical facilitators, as an approach to providing direction and support.

RESULTS

The response rate was 47.8% (n=22). Correlations were found between the approachability of the coordinating academic and clinical facilitator perception that, a) the coordinating academic understood issues on clinical placement (r=0.785, p<0.001), and b) being part of the teaching team (r=0.768, p<0.001). Analysis of responses to qualitative questions revealed three themes: connection, approachability and collaboration.

CONCLUSIONS

This study demonstrates that use of regular text messages improves communication between coordinating academics and clinical facilitators. Findings suggest improved connection, approachability and collaboration between the coordinating academic and clinical facilitation staff.

Importance of public health nurses precepting students in clinical practice: a qualitative study

BACKGROUND

Preceptors' working environment, support and competence affect how they perform the preceptor role, are therefore important for developing students and can influence students' roles as students and future professionals. Previous research has focused on precepting student nurses and not so much on public health nurses or other postgraduate students. Knowledge in this field is therefore lacking.

OBJECTIVE

The article aims to present a grounded theory of the role of public health nurses as student preceptors in Norway.

DESIGN

We conducted 20 interviews with public health nurses in addition to a focus group with four participants. We used classical grounded theory method to gather and analyze data.

FINDINGS

The preceptors were strongly concerned about invisibility and lack of recognition of the preceptor role. This main concern was resolved by the strategy of being obligated and included three patterns: optimistic, ambivalent and reluctant performance, all with differing motivation for being obligated. All stakeholders involved in clinical practice seem to contribute to making the preceptors' role invisible and thereby contribute to the lack of recognition, support and reward, which again seem to self-reinforce invisibility.

CONCLUSION

The study highlights the obligation of public health nurses in precepting students and increases the understanding of the challenges of this role. Ensuring education of a high academic standard requires paying more attention to developing effective support for the people involved.

Group supervision to strengthen nurses in their preceptor role in the bachelor nursing education--perceptions before and after participation

BACKGROUND

A collaborative project was carried out at four bachelor nursing colleges in Sweden and Norway, to support preceptors in the clinical fields by means of group supervision. The aim of this study was to investigate the preceptors' views on their own ability and satisfaction in the role before and after taking part in group supervision during one year and to describe their perception of the supervision model used.

METHOD

Forty-five preceptors participated in the study. Baseline and endpoint questionnaires were used for data collection.

RESULTS

Before taking part in group supervision most preceptors expressed that they were content with their ability and knowledge with regards to the preceptor role. Despite this most of them considered that the participation had increased their ability to supervise students, and more than half of them considered that it also had promoted to their personal development. At the end of the project a majority of them had positive experiences of group supervision. Most of the structure and climate factors in the supervision model were considered important and almost all were highly realised.

CONCLUSION

The study showed that group supervision could be a valuable tool to provide support to clinical preceptors in bachelor nursing education.

Preceptorship and affirmation in the intergenerational world of nursing practice

Research has shown that while preceptorship offers a reality-oriented learning environment and facilitates competence of students, there are inherent rewards and stressors associated with the experience. Students and preceptors can be from different generations, and as such, they may often come to the learning space with differing values and expectations. The nature of the preceptorship experience in this intergenerational context was explored in a recent phenomenological study with seven preceptors and seven nursing students in an undergraduate nursing program in Eastern Canada. Overall the experience was found to be inclusive of three main themes: being affirmed, being challenged, and being on a pedagogical journey. In this paper we explore the first of these themes, being affirmed. Highlighting the positive aspects of the preceptorship experience in the intergenerational context is necessary to promote a culture of openness and respect for generational differences within clinical nursing practice settings and to improving the overall quality of the educational experience.

Implementation of the Clinical Facilitation Model within an Australian rural setting: the role of the Clinical Facilitator

Education providers globally use various models for undergraduate nurse clinical education. This paper presents the major findings of a research project conducted by a rural university in Australia that aimed to explore the Clinical Facilitation Model of undergraduate nursing education from a rural perspective. In particular how the Clinical Facilitators enacted their role within the rural environment and to identify any barriers to the provision of effective clinical learning during facilitated clinical experience within this context. This qualitative study used a phenomenological approach to explore the experiences of Clinical Facilitators. Individual in-depth interviews were conducted with eight Clinical Facilitators. Data was analysed using thematic analysis and several themes emerged from the study. This paper will report two of the major findings which are based on how Clinical Facilitators enacted their role within the rural environment. Whilst this study has a rural focus the findings will add to the limited body of knowledge internationally regarding the Clinical Facilitation model used as a result of balancing educational needs of the student with the care needs of the patients in the current health policy climate. The findings will be useful for informing undergraduate curricula, and will assist faculty and health services in planning and implementation of models of clinical education that meet the needs of the student and that are specific to the rural environment. In addition, the findings will provide insight into strategies that the rural Clinical Facilitator can utilise to assist in fulfilling their teaching role.

Quality clinical placements for undergraduate nursing students: a cross-sectional survey of undergraduates and supervising nurses

AIM

  This article is a report of a mixed method study of the quality of clinical placements for second year undergraduate nursing students in an acute care hospital.

BACKGROUND

  In response to the current and predicted workforce shortages, greater numbers of nursing undergraduate places are being offered at tertiary institutions. This means that requests for clinical places in hospitals to support undergraduate students has risen. Little is known about the impact of increased numbers on the quality of clinical placement as a learning experience and this is of concern as demand grows and the means of assessing capacity is still unknown.

METHODS

  A 5-point Likert Scale questionnaire, including free text fields, was administered to undergraduates (n = 178), clinical facilitators (n = 22) and supervising ward nurses (n = 163) at two time points in 2009. The survey targeted the quality of the clinical placement in four domains: welcoming and belongingness; teaching and learning; feedback; confidence and competence. Findings.  The findings demonstrated consistently high scoring of the clinical placement experience by both undergraduates and registered nurses. There were higher ratings of levels of support from clinical facilitators compared to supervising ward nurses evident in data associated with the items on the questionnaire relating to teaching and learning.

CONCLUSION

  The results are indicative of the professional commitment of nursing staff to support the next generation of nurses. The findings also give a mechanism to communicate outcomes of undergraduate support to nurses in practice, and highlight steps which can be taken to ensure high quality clinical placement continues.

Making a difference: the value of preceptorship programs in nursing education

The benefits of clinical nursing experience in nursing education cannot be overemphasized. Literature has shown that proficient clinical nursing education enhances nursing practice through the development of professional growth with opportunities for the application of theoretical knowledge. Clinical preceptorship has been shown to be an effective method in the development of professional nurses through clinical education. The role of a clinical nursing preceptor is complex and not necessarily applicable to all nurses. Understanding the clinical environment, comprehending individual learning styles, and dealing effectively with conflict are skills that an effective preceptor needs to acquire before participating in the role. This article describes the origin of the preceptor role in clinical nursing education and discusses how the role can be enhanced through a proficient and well-planned preceptorship education program.

Improving student supervision in a Norwegian intensive care unit: a qualitative study

The purpose of the study was to investigate intensive and critical care nurses' experiences of an empowerment program in the context of their role as student supervisors. Multistage focus group interviews were carried out and qualitative content analysis was performed in several steps. The overall results highlighted the need for strategies aimed at ensuring quality. The emerging themes were time, leadership and shared responsibility. Enough time promoted motivation, learning and reflection. Obligations to the student limited their leisure time and family life, and imposed some limitations during working hours. Leadership was perceived as crucial and leaders should act as strategic managers of development. The balance between "shared responsibility" and one supervisor in charge of one student was highlighted. There is a need to strengthen and improve the system of student supervision. There is a need to allocate time for learning and reflection. Who is responsible for the students must be clearly defined in the hospital, the university and in the intensive care unit, and it must be communicated.

Preceptors' experiences of clinically educating and assessing undergraduate nursing students: an Irish context

AIM

To explore preceptors' views and experiences of preceptoring undergraduate nursing students.

BACKGROUND

Undertaking a preceptoring role is acknowledged internationally as complex and challenging. With the introduction of the undergraduate degree programme in Ireland (2002), preceptors were assigned a more formal role in the teaching and assessing of students. As this was a new programme for students and an additional responsibility for preceptors, it was important to investigate how preceptors found this new experience.

METHODS

Data were collected using a mixed methods descriptive approach.

RESULTS

Many preceptors wanted to become a preceptor and enjoyed the role. The majority of preceptors found the role stressful and burdensome and did not feel adequately supported by their clinical managers. Preceptors expressed the need for protected time, support, feedback and recognition from management for undertaking this role.

CONCLUSION

Findings validate problems experienced with preceptoring in other English-speaking countries and contribute further to building a case for vital change in this component of nursing education and nursing practice.

IMPLICATIONS FOR NURSING MANAGEMENT

Managers should focus on the challenges expressed by preceptors in this study and identify appropriate strategies to carefully select, monitor and support preceptors in this complex role.

Preceptoring nursing students: registered nurses' perceptions of nursing students' preparation and study approaches in clinical education

Preceptorship influences Registered Nurses' (RNs) daily work to different degrees depending on nursing students' knowledge, and willingness to learn. Consequently, it is of the utmost importance to investigate how RNs assess nursing students in clinical education. The aim of this study was to describe RNs' perceptions of nursing students' preparation and study approaches at hospital workplaces, and to explore relationships between RNs' perceptions and their personal/clinical characteristics. A cross-sectional design was used. In 2006, 142 of 196 RNs at a Swedish hospital answered a questionnaire (response rate 72.5%). The majority of RNs (63-84%) rated students' study approaches highly and thought students comprehended the outcomes of learning. Fewer (45-49%), rated students as having adequate theoretical knowledge highly and were of the opinion that they had acquired knowledge about the unit. Statistically, non specialist nurses rated significantly higher compared with specialist nurses. Significant positive correlations were found between the RNs' perceptions of nursing students and their interest in preceptoring. The extent to which preparation programmes, established in collaboration between a university and a hospital, had improved preceptors and nursing students was not graded. Further descriptive and intervention studies are therefore needed.

Developing and validating a job description for internship preceptors

A job description is a contract between the employer and the employee, which should outline duties, responsibilities, and reporting relationships. In this study, the author designed a job description for internship preceptors working at Alexandria and El-Mansoura university hospitals and examined its validity. The study sample included all available internship preceptors in the university hospitals and their supervisors. The results of study revealed the various components of the job description. Most of the respondents preferred the job title to be internship preceptor.

Teaching during clinical practice: strategies and techniques used by preceptors in nursing education

The preceptor is a nurse who teaches and supports the student and is seen as pivotal to student learning within the clinical setting. Earlier studies have shown that preceptors' pedagogical competence is significant for facilitating learning during clinical practice. However, studies describing pedagogical competence, especially in terms of teaching strategies, seem to be scarce. The aim of this study was to describe which strategies and techniques preceptors use to teach undergraduate nursing students during clinical practice. The study had an ethnographic approach; methods used were participant observations and focus group interviews with nurses who were experienced in precepting undergraduate nursing students. Findings illustrated how preceptors used different strategies and techniques in a continuous process of adjusting, performing and evaluating precepting. Increased knowledge on how the preceptors actually teach student nurses during clinical practice will help facilitate educational programmes for preceptors, which will enhance their pedagogical skills and competences.

Factors influencing student nurses' career choices after preceptorship in a five-year junior nursing college in Taiwan

This study was conducted to explore the influence factors of a preceptorship in career choices following student nurses' graduations. A total number of 326 student nurses in their fifth year of junior nursing college were selected as participants. A validated and reliable questionnaire was used in this study. Data were analyzed by the Statistical Package for the Social Science (SPSS) for windows for percentage, mean, standard deviation, and Pearson's correlation. The results showed that: (1) the first five factors influencing student nurses' career choices were good unit environment, nurse's professional role, self-professional knowledge deficiency, nurse's professional knowledge, and patient's and family's good feedback; (2) the correlation between the chosen field of practice and willingness to work after graduation showed a strong relationship in all areas. Notably, the preceptorship had an impact on student nurses selecting a nursing career. These results can give nurse educators guidance in preparing student nurses as they enter the work force.

Precepting student nurses in the intensive care unit

Nurses in critical care units are often asked to precept a student nurse. To make this a valuable learning experience, careful planning should be done. The preceptor and the nursing faculty member need to collaborate to plan and carry out the nursing experience.

Preceptoring a student in the final clinical placement: reflections from nurses in a Canadian Hospital

AIM

To capture personal reflections on being a preceptor and to identify the supports and challenges to enacting the role.

BACKGROUND

Prior to graduation from a nursing programme, students begin the transition in roles from student to practicing health-care professional. To ease this transition, preceptorship programmes have been implemented to foster professional socialization and help students achieve confidence in their practice during their final clinical placement (consolidation experience). Preparation for the preceptor role is dependent upon the information offered by the agency as well as by the educational institution. Nursing staff are requested for much of the calendar year to work with increasing numbers of undergraduate students at various levels, function as preceptors in the final clinical experience (consolidation) as well as be involved in the orientation of newly hired nurses.

METHODS

This qualitative study used one-on-one tape recorded interviews with nurses who had previous experience as a preceptor. Thematic analysis of the transcribed data resulted in the emergence of an overall theme and categories.

RESULTS

Eight nurses were interviewed from a variety of units including medical surgical as well as critical care. The overriding theme from the analysis was 'safe passage'. This safe passage was for the patient and the student and was accomplished through the process of teaching and a clear view of the preceptor role. Challenges to the role were lack of recognition by other nursing staff as well as limited support from some faculty advisors. Supports for the role were the visible presence and ongoing support by faculty advisors as well as the hospital workshop.

CONCLUSION

This study highlighted the importance of support from nursing faculty as well as recognition by fellow nurses of the workload involved when being a preceptor.

RELEVANCE TO CLINICAL PRACTICE

Preceptors play an important role with students prior to graduation. Both the hospital and educational institutions need to ensure that nurses are given the necessary support, recognition and resources.