A collaborative preceptor model for clinical teaching of beginning nursing students

Dichotomy between theory and practice in chest radiography and its impact on students

Introduction

It is important that theory is synchronous with clinical practices that students engage in. Lack of congruence between theory and practice presents serious problems to students. This study was therefore conducted to determine if there was a theory–practice gap in chest radiography during clinical rotations, and any associated causes and effects on radiography students.

Method

A descriptive survey design was used to conduct this study from 2 February to 27 July 2014. A semi‐structured questionnaire consisting of open‐ and close‐ended questions was used to purposively collect data from 26 radiography students in Ghana who had completed theory lessons in chest radiography and had either completed or were undertaking clinical rotations in chest radiography.

Results

Twenty‐five (96%) respondents indicated the presence of theory–practice gap in chest radiography during clinical rotations, where differences between theory and clinical practice were observed. Lack of working materials 16 (62%), heavy workload 14 (54%), equipment breakdowns 14 (54%) and supervisory factors 11 (43%) were identified as the causes. Many students (81%) experienced diverse adverse effects such as confusion 10 (38%), poor performance during clinical examinations 6 (23%) and entire loss of interest in the professional training 1 (4%) of this dichotomy.

Conclusion

Dichotomy between theory and practice found in chest radiography has diverse adverse effects on students. Regular feedback on the quality of clinical practice received by students should be encouraged to determine the existence of any gaps between theory and practice in order to promote effective clinical rotation programmes in radiography.

A comparison of a traditional clinical experience to a precepted clinical experience for baccalaureate-seeking nursing students in their second semester

The shortage of nursing faculty has contributed greatly to the nursing workforce shortage, with many schools turning away qualified applicants because there are not enough faculty to teach. Despite the faculty shortage, schools are required to admit more students to alleviate the nursing shortage. Clinical groups in which preceptors are responsible for student learning extend faculty resources. Purpose. To determine the effectiveness of an alternative clinical experience (preceptorship). Methods. quasi-experimental, randomized, longitudinal design. Students were randomized to either the traditional or precepted clinical group. The clinical experience was a total of 12 weeks. Groups were compared according to several variables including second semester exam scores, HESI scores, and quality and timeliness of clinical paperwork. Sample. Over a two-year period, seventy-one undergraduate nursing students in the second semester medical-surgical nursing course participated. 36 were randomized to the experimental group. The preceptors were baccalaureate-prepared nurses who have been practicing for at least one year. Setting. Two hospitals located in the Texas Medical Center. Statistical Analysis. Descriptive statistics and independent t-test. Results. There was no difference between the groups on the variables of interest. Conclusion. Students in the precepted clinical group perform as well as those in a traditional clinical group.

Integrative review of graduate entry programs in nursing

In this integrative review, the authors report on, summarize, and analyze research conducted on non-nurse college graduates enrolled in master's degree programs in nursing in the United States and Canada, leading to preparation for advanced practice nurse roles. This review demonstrated that non-nurse college graduates successfully develop into registered nurses and advanced practice registered nurses (APRNs) or certified nurse-midwives (CNMs). What is conspicuously absent in the literature is articulation of the process whereby college graduates become nurses and APRNs or CNMs. Given the expansion of graduate entry programs for non-nurse college graduates, along with the recent clarion call to move advanced practice nursing to the postgraduate level, it is time to examine the process. Understanding the process will help faculty refine pedagogy and curricula to support students' transition from non-nurse to both nurse and APRN or CNM.

Team preceptorship model: a solution for students' clinical experience

There is a shortage of registered nurses in developed countries, and this shortage is due to the aging nursing workforce, demand for healthcare services, and shortage of nursing professors to teach students. In order to increase the number of clinical placements for nursing students, the authors developed and implemented a collaborative preceptorship model between a Canadian University and Public Health Department to facilitate the clinical experiences of Bachelor of Science of Nursing (BScN) students. This paper describes the Team Preceptorship Model which guided the clinical experience of nine students and 14 preceptors. It also highlights the model's evaluation, strengths, and limitations.

Development and testing of a Clinical Learning Environment Diagnostic Inventory for baccalaureate nursing students

Aim. This paper reports the development and testing of the psychometric properties of the Clinical Learning Environment Diagnostic Inventory for baccalaureate nursing students. Background. The quality of the clinical learning environment is an essential factor in determining the quality of nursing students' clinical experience. It is also well-recognized that the clinical setting can be a source of stress and anxiety for students. To design an optimal clinical learning environment for students, instruments based on the cognitive and socio-emotional aspects of the learning process are necessary. Method. The hypothetical construct of the clinical learning environment was derived from a comprehensive review of the literature, including experiential learning theory and the epistemology of practice. Developing the instrument involved the collection of items through semi-structured interviews, assessing content validity and determining the scaling. After a pilot study, the instrument was tested with 312 undergraduate students and 157 preceptors between September and December 2004. The factor structure was determined by exploratory factor analysis. Results. Exploratory factor analysis produced a five-factor solution that was similar to the hypothetical model. Cronbach's alpha internal consistency reliability coefficients ranged from 0.65 to 0.77 across the five factors. Three-week test-retest reliability coefficients ranged from 0.59 to 0.74. Criterion-related validity and construct validity were estimated by the correlation between the Clinical Learning Environment Diagnostic Inventory and appropriate other instruments and a set of comparison data obtained from the students and preceptors. Conclusion. The findings yielded acceptable estimates of reliability and validity of the Clinical Learning Environment Diagnostic Inventory. Therefore, this instrument is considered useful for assessing learning environments in clinical settings.

The CCARE model of clinical supervision: bridging the theory-practice gap

Clinical supervision of nursing students is a key component of nursing education. The clinical setting provides students with an opportunity to develop a professional identity, knowledge base, and the ability to transfer classroom knowledge to the clinical setting. This paper suggests a model of clinical supervision that will address how to bridge the pre-existing theory-practice gap in nursing education through an attitude of caring and the utilization of caring behaviours based on Leininger's theory of culture care. Key concepts included in this model are: communication, collaboration, application, reflection and evaluation, these concepts comprise the CCARE model of clinical supervision.

Discursive influences on clinical teaching in Australian undergraduate nursing programs

Clinical teaching is a vital, yet multidimensional component of Australian undergraduate nursing courses. Unlike other parts of curricula, clinical teaching relies on the both higher education and health care sectors to meet prescribed goals and for effective student learning to occur. As such it is influenced by discourses from within both education and health. Whilst there is considerable literature related to undergraduate nursing clinical teaching; it mainly deals with practical aspects such as effectiveness of clinical teaching or discussions of models employed. Only a small pool of literature exists that discusses the construction of clinical teaching including the factors that have influenced the development of practices both in the past and present. Using the work of Foucault, this paper examines dominant and competing discourses influencing clinical teaching through their constructions within the literature. These are discourses of academia, nursing, and economics. The discussion situates these discourses and discusses how some of the resultant issues surrounding clinical education remain largely unresolved.

Collaborative Testing to Promote Learning

This pilot study examined the adequacy of collaborative testing to test students' knowledge, as well as a teaching tool for critical thinking, collaboration, and test-taking ability. The results indicated students using collaborative testing for unit examinations scored equally well on a cumulative final examination as students who did not use collaborative testing. There were some indications that the test-taking skills of students using collaborative testing improved, producing more effective testing of knowledge. Finally, collaborative testing provided students with the opportunity to become more proficient with critical thinking and collaboration skills, and all students reported decreased test anxiety. Instructors desiring to provide more classroom opportunities for learning these valuable skills may want to consider using collaborative testing as a learning experience, as well as an effective testing method.

Hallmarks of the professional nursing practice environment

THE AMERICAN Association of Colleges of Nursing (AACN) is the national voice for university and 4-year college education programs in nursing. Representing more than 560 member schools of nursing at public and private institutions nationwide, AACN's educational, research, governmental advocacy, data collection, publications, and other programs work to establish quality standards for bachelor's-degree and graduate-degree nursing education, assist deans and directors to implement those standards, influence the nursing profession to improve health care, and promote public support of baccalaureate and graduate nursing education, research, and practice. Task forces are appointed by the AACN Board of Directors as issues arise that require study and action. This white paper was prepared by the AACN Task Force on Hallmarks of the Professional Practice Setting.

A collaborative model: twenty healthcare agencies and academic institutions share resources to educate preceptors

The Boston Collaborative Learning Group (BCLG), a 20-member consortium of healthcare agencies and academic institutions, originated in 1996 in response to a demand for innovative cost-effective measures. Directors of Staff Development and academicians collaborate and share resources in planning preceptor education programs. Over 750 Boston area nurses have attended 1 of 10 programs offered. This article provides an historical perspective on forming a consortium and the benefits of this collaborative model.

Breaking into orthopaedic nursing: preceptorship for novice nurses

Recalling feelings of reality shock and insecurity helps the staff nurse to truly understand the feelings that a nursing student experiences. Without a student preceptorship the new graduate may be unaware of all of the staff nurse responsibilities and have a problematic role transition to the work environment. The new graduate's adjustment to a staff nurse role is challenging, but if it is overwhelming the new nurse may eventually leave the profession (Coudret et al., 1994). Quick reference tables are designed to help plan and implement a preceptor experience. The precepted practicum has many benefits for both the nursing student and the RN preceptor.

Supporting preceptors

For effective teaching of nursing students and management of stress of increased workloads, preceptors require a great deal of support from nursing faculty, peers, and administrative personnel. Through a mailed survey, 295 preceptors reported that they would have appreciated more support. The best support is the continued and visible presence and involvement of instructors, which can be provided in person, by telephone, or via fax. This is best achieved if nurse educators, directors, and deans view themselves as copreceptors.

Nurses' use of tuition waivers: one university's experiences

Although the nursing literature documents the benefits of collaboration between academic and practice settings, the benefits of rewarding clinical preceptors and their organizations has not been examined. In Fall 1996, a large urban public university in New England implemented a program awarding tuition waivers to individual preceptors and clinical agencies who had made significant contributions to the education of nursing students. Three years after implementation, the program was evaluated to determine the extent nurse preceptors and clinical agencies used tuition waivers to assist nurses to enroll in a degree-granting program. Slightly more than one third (36.6 per cent) of the 82 vouchers awarded for a course waiver of tuition and fees were used by 24 nurses. Of the 24 nurses, 12 (50 per cent) were matriculating in the University degree-granting program when they used the voucher. Only one nurse, however, who took her first course on the campus with a voucher, subsequently enrolled in the graduate nursing program during the study period. J Prof Nurs 17:147-150, 2001.

Strategies for enhancing student learning by managing ambiguities in clinical settings

Have you ever watched as care providers, be they student nurses or staff nurses, display behaviors that seem to indicate that they are becoming overwhelmed by situations in the acute care setting? Have you also observed other providers who seem to thrive on the "challenges" presented by these same situations? The same situation stimulates responses that reflect opposite ends of a continuum, the continuum of tolerance of ambiguity. The nurse educator needs to develop a greater understanding of the elements in the clinical situation (the ambiguities) that have stimulated the behavioral responses, and how an individual's level of tolerance of ambiguity influences reactions to the ambiguous situations. These understandings provide the nurse educator with the foundation for developing teaching strategies to facilitate effective management of ambiguous situations in clinical settings.