Listening to Preceptors: Part B

Preceptors training need assessment for medical laboratory professional clinical education programs in Ethiopia

Background

Health Workforce Improvement Program and professional associations recognized the need for a formalized method of providing academic education that would improve how preceptors teach and assess student. Thus, this study aimed to assess training needs of preceptors for Medical Laboratory Science clinical practicum education programs in Ethiopia.

Methods

A cross-sectional survey design was implemented in targeted health facility throughout the country to assess academic educational needs of preceptors for Medical Laboratory clinical practicum education programs. The study participants were conveniently selected practicing health professionals who formally or informally nominated as a clinical trainer or acts as clinical trainer giving practical training to the student in the targeted practice setting. An adapted structured questionnaire modified to local context was used to conduct the survey and the perceived competency assessment used five scale of measurement (Not capable, Beginner, Advanced beginner, Competent, Proficient). The frequency was presented using tables and figures.

Results

A total of 304 laboratory professionals participated in this study. More than half (52.6%) of the study participants were in the age group of 21 to 30 years and 264/304 (86.8%) were male. The majority (43.0%) of study participants had 6 to 10 years of experience and 212 (68.8%) did not receive clinical teaching skills training in the past two years. Regarding applying different hands-on teaching methods, the majority 38/304(12.5%) were not capable for role play and community based training, 49/304(16.1%) reported being Beginners, 85/304 (28%) said that they are advanced beginners in the competency. In this study, most study participants 98/304(32.2%) and 130/304(42.8%) perceived that they are competent and proficient in applying laboratory practice teaching methods respectively.

Conclusion

The average cumulative level of competency from level 1 (not capable) to level 3 (advanced beginner), we found: learning in the practical teaching area 45.4%, clinical practicum teaching quality improvement and advocacy 42.9%, student assessment methods 42.7%, communication, collaboration and partnership 40.9%. Overall competence of preceptors (proportion of preceptors reported competent) was 57%. We recommend designing the performance interventions in the form of training by including communication skills for effective preceptor ship, students assessment and feedback, teaching and instruction strategies, planning for clinical practicum learning and principles of learning and teaching in practical areas.

Quality improvement project: An online discussion forum for the support of nurse preceptors orienting newly hired nurses

Preceptorship in nursing is a complex responsibility that is often performed without any formal preparation. In nursing literature, there is consensus that nurse preceptors should be better supported and receive education regarding this role. There is however scarcity of evaluative evidence on educational strategies for preceptors of newly hired nurses transitioning to a new role. A structured online discussion forum (ODF) was developed and implemented to provide support and continuing education to a group of nurse preceptors (N = 25) in an accessible and low-cost manner; it was evaluated for the depth of knowledge co-construction. The results of this quality improvement (QI) project reveal that with sustained online and offline support and a structured learning activity, an ODF can encourage deep learning. Nurse preceptors who took part in this ODF reported feeling supported in their role of preceptor and desired to continue their participation.

Effective academic-practice partnership models in nursing students' clinical placement: A systematic literature review

OBJECTIVES

This systematic review examines the effectiveness of academic-practice partnership models which include clinical faculty and clinical mentor roles in improving nursing students' clinical learning when compared with traditional models.

REVIEW METHODS

PubMed, CINAHL, PsycINFO and Cochrane Library were searched to locate Randomized Control Trials and quasi-experimental studies published from 1999 to 2020. The Joanna Briggs Institute critical appraisal tools were used to ensure methodological quality.

RESULTS

Fourteen studies were included in the review. The Collaborative Teaching Model and the Dedicated Education Unit model were tested in randomized controlled trials. Dedicated Education Unit, Dedicated Education Centre, Clinical Education Units, Education Partnership model, Collaborative educational-practice model and Collaborative clinical practicum model were evaluated in four experimental studies and ten quasi-experimental studies. Studies did not include patient participation, and staff and faculty had anecdotal presence.

CONCLUSION

There is limited evidence on the effectiveness of academic-practice partnership models. However, the complementary roles of clinical faculty and clinical mentor, in addition to education and health institutions managers commitment could successfully facilitate students' clinical learning.

Challenges of the preceptors working with new nurses: A phenomenological research study

INTRODUCTION

Preceptors play an important role in the transition of new nurses to the practice setting, however, preceptorship experience has been perceived as stressful by preceptors. This study aimed to explore the lived experiences of nurse preceptors working with new nurses.

METHOD

This qualitative study used the hermeneutic phenomenological design to explore the experiences of six nurse preceptors working with new nurses in a tertiary pediatric teaching hospital in Northwest of Iran, who were recruited by purposive sampling. Data were collected using in-depth semi-structured individual interviews between July 2014 and March 2015, and analyzed using the Diekelmann's seven-stage method.

RESULTS

Data analysis revealed three themes: 1) preceptorship as a challenging and stressful role; 2) lack of support; and 3) lack of appreciation. Preceptorship as 'a challenging and stressful role' was the constitutive pattern that unified the themes.

CONCLUSION

The preceptorship of new nurses is challenging and stressful. Preceptors endure several roles concurrently, thus, their workload should be balanced appropriately in order not to compromise with one another and evade burnout. The preceptors need to be well supported and their contribution be appropriately recognized. Setting clear objectives and realistic expectations, and having clear policies and guidelines in place should help develop a preceptorship program that is more likely to bring about positive outcomes for both preceptors and new nurses.

Evaluating, understanding and improving the quality of clinical placements for undergraduate nurses: A practice development approach

Supervision and support is central to sustainability of clinical placement experiences of undergraduate nurses, but open to influences that impact nurses' capacity to undertake the role. Whilst supervision of learners is integral to the role of health care professionals, the primary responsibility is to deliver safe and effective care. Supervision of learners in practice is impacted by low levels of organisational support, variable individual preparedness, and lack of feedback and recognition for the role from education and industry partners. Over a period of five years the Quality Clinical Placement Evaluation research team, consisting of a partnership between health care and tertiary sectors have developed, and utilised a practice development approach to understand and support the quality of clinical placement for undergraduates and supervising ward nurses involved in Tasmanian clinical placement programs. Importantly, the approach evolved over time to be a flexible three step program supporting the translation of findings to practice, comprised of an education session related to supervision support; survey distribution to undergraduates and supervising ward nurses following clinical placement; and workshops where stakeholders come together to consider findings of the survey, their experience and the local context, with resultant actions for change. This paper reports on findings from the program after successful implementation in urban tertiary hospitals as it was implemented in non-traditional clinical placement settings, including community, aged care and rural settings. Feedback from clinicians identifies the utility of the three step program across these settings. The unique partnerships and approach to evaluating, understanding and improving quality of clinical placements has potential for transferability to other areas, with the value of findings established for all stakeholders.

Are preceptors adequately prepared for their role in supporting newly qualified staff?

OBJECTIVE

The purpose of this UK based study is to ascertain the support provided to preceptors and the qualities they require to carry out their role supporting newly qualified professionals.

DESIGN

A qualitative descriptive approach was adopted to elicit the experiences and perceptions of the preceptors in practice.

SAMPLE AND METHODS

A cross-section of 30 preceptors were randomised across 3 hospital sites within one acute Trust. Questionnaires were distributed with a response rate of 37% (n=11). Five preceptors participated in a semi-structured interview (n=5).

FINDINGS AND DISCUSSION

The themes that emerged from the analysis were lack of preparation for their role, expectations of the preceptors and how they perceive the role and the limitations and difficulties associated with being a preceptor.

CONCLUSIONS

Preceptor attributes and programme approaches have been discussed in the existing literature although guidance concerning preparation and training for the role in the UK is less well documented. The findings of this small scale study may be useful in planning and developing preceptorship programmes in the future to provide sustainable support to develop the preceptor as well as the preceptee.

Evaluating Preceptor Perception of Support Using Educational Podcasts

After their initial training, preceptors report a lack of ongoing support specifically in dealing with preceptor-identified areas of unsafe practice: the inability to demonstrate knowledge and skills, attitude problems, unprofessional behavior, and poor communication skills. The purpose of this staff development study was to test the use of educational technology in the form of podcasts, demonstrating how a preceptor could constructively approach difficult situations using caring behaviors to engage novice nurses and to examine the relationship between preceptor support and role commitment. A correlational research design was used to examine the effects of the podcasts, continuously available through common web sites. Findings include a significant increase in the preceptor’s perception of support especially among participants who had less training or experience with precepting. A strong correlation between the preceptor’s perception of support and commitment to their role was also demonstrated. Preceptors suggest development of additional podcasts for ongoing educational support.

Development of an online orientation course for preceptors in a dedicated education unit program

The dedicated education unit (DEU) is an emerging model of nursing education. Instead of an instructor-led clinical group, students are partnered with a unit staff nurse for precepted learning. These experiences in learning typically begin with early clinical courses. Precepting nursing students in a DEU is different from precepting newly hired staff nurses and traditional clinical students. This article describes the DEU model implemented at one university, the challenges associated with preparing staff nurses to precept nursing students, the development of a face-to-face DEU preceptor orientation, and progression to an innovative online orientation course.

A student evaluation workshop with rural nursing preceptors

Increasingly, clinicians and faculty members are motivated to provide students quality preceptorship placements in rural areas, particularly in light of the potential for recruitment of new graduates to underserved areas. Invariably, student performance evaluation is an onerous task for many preceptors and one in which they often feel ill-prepared. Rural preceptors may face additional challenges given the lesser availability of educational resources and professional development. In this article, the authors detail the development, pilot testing, and evaluation of a workshop on student evaluation that was created in collaboration with rural nurse preceptors.

Preceptorship placements can be a burden for students

Fourth year baccalaureate nursing students were surveyed to determine their perceptions of the preceptorship experience. Results indicated that students highly valued and enjoyed their preceptorship experiences. However, issues related to choice, finances, and role of the administration were identified. There is a need (a) to reexamine the organization and coordination of placements, (b) to understand the potential personal and financial burden on students during placements, and (c) to develop mechanisms to reduce obstacles for students that may compromise successful and meaningful preceptorship placements.

Lived experiences of clinical preceptors: a phenomenological study

The aim of this study is to explore the clinical preceptors' experiences and the meanings of their lives in clinical teaching. A phenomenological approach was adopted, and a 'snowballing' sampling method was used to recruit 20 clinical preceptors. Data were collected using audio-taped individual interviews. A content analysis was conducted and the results were clustered into four themes, which are (a) 'teaching is learning', (b) 'being unable to do what one would like to do', (c) 'experiencing bittersweet moments', and (d) 'being a role model and acting as a mother'. These findings demonstrate that the clinical preceptors are experiencing diverse feelings, both positive and negative. Strategies that address the needs of clinical preceptors must be developed in order to foster the positive experiences, and to retain experienced clinical preceptors.

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

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