Staff nurses' experiences as preceptors and mentors: an integrative review

Process Mapping Midwifery Students' Clinical Placement in Sierra Leone: Identifying Facilitators and Barriers

Background: Improving midwifery education is critical to improving maternal and infant health outcomes in Sierra Leone. A significant priority within midwifery education is to strengthen the clinical teaching and students' hands-on experience in the clinical setting. Objectives: To identify facilitators and challenges within midwifery students' clinical placements and to highlight areas to strengthen the clinical midwifery education system as well as the role of preceptors. Methods: We conducted a participatory process mapping with two schools of midwifery in Sierra Leone to detail steps taken by practicing midwives and midwifery faculty when students are placed in clinical settings for midwifery rotations. Findings: There were 42 participants from the Bo and Makeni regions of Sierra Leone. Participants included midwifery faculty from the Schools of Midwifery in Makeni and Bo, clinical midwives from two regional government hospitals, clinical midwives from two affiliated community health centers, and midwives from the District Health Management Teams. Three recurring themes emerged in the process. First, there was always some element of preparing or teaching the student. Second, there were administrative tasks to coordinate between the schools, clinical sites, and students, before, during, and after clinical placements. And third, there were elements of communication and collaboration between schools and clinical sites/preceptors that could be improved through shared understanding and standardization. Additional themes were inconsistencies across activities before, during, and after students' clinical placement and limited opportunities and confusion around systems of evaluating all components of the clinical placement experience. Conclusions: This study provides insight into the process of midwifery students' clinical placement and highlights facilitators to be standardized and some modifiable barriers to be addressed. As Sierra Leone and many other similar countries in sub-Saharan Africa attempt to strengthen students' clinical education through educating and developing preceptors, processing mapping can be a useful tool.

Assessing the Competence of Nursing Students in Clinical Practice: The Clinical Preceptors' Perspective

Nursing students' integration of theoretical knowledge and practical abilities is facilitated by their practice of nursing skills in a clinical environment. A key role of preceptors is to assess the learning goals that nursing students must meet while participating in clinical practice. Consequently, the purpose of this study was to explore the current evidence in relation to competency assessment and assessment approaches, and the willingness of preceptors for assessing nursing students' competency in a clinical setting. The scoping review used the five-stage methodological framework that was developed by Arksey and O'Malley, as well as the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Relevant studies were searched by applying a comprehensive literature search strategy up to April 2024 across the following databases: CINAHL, OVID MEDLINE, EMBASE, and PUBMED. A total of 11,297 studies published between 2000 and April 2024 were revealed, and 38 were eligible for inclusion, which the research team categorised into three main themes: definitions of competence, tools for assessing competence and preceptors' and mentors' viewpoints in relation to the assessment of nursing students' competence. This review established that there are a multitude of quantitative instruments available to assess clinical competence; however, a lack of consistency among assessment instruments and approaches between countries and higher education institutions is prevalent. Existing research evidence suggests that the preceptors carried out the assessment process clinically and they found difficulties in documenting assessment. The assessing of nursing students' competency and the complexity of assessment is a concern for educators and mentors worldwide. The main concern centers around issues such as the interpretation of competence and complex measurement tools.

Student Nurse Anesthetists' and Supervisors' Perspectives of Learning in the Operating Room: An Integrative Review

PURPOSE

The purpose of this review was to identify supporting and hindering factors for student nurse anesthetists' (SNAs') learning in the operating room during clinical practice, from students' and supervisors' perspectives.

DESIGN

An integrative review.

METHODS

Systematic searches were conducted in Medline, Cinahl, PsycInfo, and ERIC. Search terms were related to nurse anesthetist, education, operating room context, and clinical setting. Searches were performed at three points in time and in total 1,530 unique articles were identified. After screening using Covidence and using Joanna Briggs Institute appraisal tools, 34 articles remained. These were analyzed inductively using a constant comparison method.

FINDINGS

Supporting factors include preparation before clinical practice, clearly stated expectations, a respectful relationship with the supervisor, daily planning and communication, and constructive feedback. Hindering factors include lack of time, disruptive behavior from supervisors or other team members, and environmental factors such as a high room temperature and noisy environment.

CONCLUSIONS

SNAs' learning situation in the operating room resembles undergraduate nurses' learning during clinical practice. Educators and supervisors can take several actions to promote SNAs' learning. Further research is warranted on the effect of teamwork on SNAs' learning.

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.

The impact of rural nursing and midwifery clinical placements from the perspective of health service staff

OBJECTIVE

To explore the impact of providing nursing and midwifery student placements from the perspective of regional, rural and remote health service staff involved in hosting students.

SETTING

Hospital and health services across regional, rural and remote southern Queensland.

PARTICIPANTS

Thirty-six nursing and midwifery staff working in clinical and/or management roles who were direct clinical supervisors of students or in leadership positions with responsibility for overseeing and supporting clinical placements.

DESIGN

Semi-structured interviews exploring the experiences and perspectives of nursing and midwifery health service staff who support student placements. Data were subject to thematic analysis.

RESULTS

Five key themes were identified as follows: (a) bringing new ideas and perspectives, (b) opportunities for development, (c) supporting the future rural workforce (d) impacts on workload and productivity and (e) strategies for balancing supervision.

CONCLUSION

The results indicate that there are a range of perceived benefits and challenges of providing nursing and midwifery student placements within regional, rural and remote settings. The findings also indicate that there are opportunities to further support rural health services to optimise the positive impacts and mitigate the challenges of providing placements. To do so requires collaboration between health services and education providers to allocate students appropriately to health services and support health service staff.

Nurse Preceptors' Experiences of an Online Strength-Based Nursing Course in Clinical Teaching

Background: Online educational programs for nurse preceptors have been created based on various theoretical frameworks; however, no programs using a Strengths-Based Nursing (SBN) approach could be located. Purpose: This qualitative descriptive study explored the nurse preceptors' experiences in using a SBN approach to provide clinical teaching to nursing students after completing an online SBN clinical teaching course. Methods: Semi-structured interviews were conducted with six nurses. Data was thematically analyzed. Findings: Although their levels of familiarity with SBN varied, all preceptors acknowledged that using a SBN approach in clinical teaching benefits both students and educators. They reported that it empowered students and that it allowed them to discover their strengths. Getting to know their students helped the preceptors provide tailored learning experiences and feedback. Using the SBN approach simultaneously enhanced the preceptors' self-confidence and created opportunities for shared learning. Conclusion: Using a strengths' approach offers nurse preceptors a powerful tool to facilitate student learning and skills development in clinical practice.

Impact of the COVID-19 Pandemic on Nurses Working in Intensive Care Units: A Scoping Review

BACKGROUND

The COVID-19 pandemic resulted in significant system strain, requiring rapid redeployment of nurses to intensive care units. Little is known about the impact of the COVID-19 pandemic and surge models on nurses.

OBJECTIVE

To identify the impact of the COVID-19 pandemic on nurses working in intensive care units.

METHODS

A scoping review was performed. Articles were excluded if they concerned nurses who were not caring for critically ill adult patients with COVID-19, did not describe impact on nurses, or solely examined workload or expansion of pediatric intensive care units.

RESULTS

This search identified 417 unique records, of which 55 met inclusion criteria (37 peer-reviewed and 18 grey literature sources). Within the peer-reviewed literature, 42.7% of participants were identified as intensive care unit nurses, 0.65% as redeployed nurses, and 72.4% as women. The predominant finding was the prevalence of negative psychological impacts on nurses, including stress, distress, anxiety, depression, fear, posttraumatic stress disorder, and burnout. Women and members of ethnic minority groups were at higher risk of experiencing negative consequences. Common qualitative themes included the presence of novel changes, negative impacts, and mitigators of harm during the pandemic.

CONCLUSIONS

Nurses working in intensive care units during the COVID-19 pandemic experienced adverse psychological outcomes, with unique stressors and challenges observed among both permanent intensive care unit and redeployed nurses. Further research is required to understand the impact of these outcomes over the full duration of the pandemic, among at-risk groups, and within the context of redeployment roles.

A complex and demanding situation - Midwifery preceptors and midwifery students' experiences of teaching and learning prevention of severe perineal trauma

BACKGROUND

Many high-income countries have seen an increase in severe perineal trauma. Teaching strategies and conditions for learning during the active second stage of labour are scarcely described.

AIM

To describe midwifery preceptors and midwifery students' experiences' of teaching and learning how to manage the second stage of labour, with the specific aim of preventing severe perineal trauma.

METHODS

A qualitative study with focus group discussions and individual in depth-interviews with preceptor midwives (n = 23) and student midwives (n = 10). Data were analysed by qualitative content analysis.

RESULTS

"A complex and demanding situation with mutual need for feedback, reflection and safety" was the overall theme describing the conditions. Three sub-themes were identified. "Adapting to a unique situation" refers to the difficulty of teaching and learning the aspects needed to prevent severe perineal trauma, and to provide care during this stage. "Hindering and limiting circumstances" describes teaching strategies that were perceived negatively, and how midwifery students tried to adapt to the preceptors rather than the birthing women. "A trustful and communicative relationship" describes the importance of the relationship between the student and the preceptor, where communication was a central, but not obvious part.

CONCLUSION

An increased awareness among preceptors is needed to optimize teaching strategies, enabling the students to focus on learning the art of the second stage of labour; supporting the woman, preventing severe perineal trauma and ensuring the safety of the unborn baby. Future research should address how existing prevention models can include training to increase preceptors' confidence in teaching.

The role of motivation in the intention of nurse clinical instructors to persevere in their role: A cross-sectional study

AIM

To examine factors related to clinical instructors' motivation to persevere in their role, such as motivation, benefits and support.

BACKGROUND

Clinical nursing education is mainly based on acquiring hands-on training provided by clinical instructors in various health environments. In recent years the number of nursing students in Israel has increased, resulting in a shortage of clinical instructors. One of the reasons is that many clinical instructors do not persevere in their role for long.

DESIGN

A quantitative cross-sectional study.

METHODS

Participants included 176 licensed clinical instructors. Data were collected between January 2020 and March 2020 using an online questionnaire. The questionnaire included five parts: personal details, job benefits, perceived support, motivation for serving as a clinical instructor (autonomous motivation, controlled motivation and amotivation) and the intention to persevere as a clinical instructor.

RESULTS

Findings showed clinical instructors' intention to persevere in their role was positively associated with the overall score for motivation, perceived support and job benefits and negatively associated with amotivation (defined as a state where people do not intend to perform a particular behavior or do not know why they are performing it). Two mediation models analyses indicated that autonomous motivation fully mediates the relationship between support and the intention to persevere as a clinical instructor and that amotivation partially mediates the relationship between job benefits and the intention to persevere as a clinical instructor. The findings also demonstrated a correlation between the nature of the benefits preferred by clinical instructors and their motivation to persevere in their role.

CONCLUSIONS

Motivation plays an important role in the intentions of clinical instructors to persevere in their role. Providing clinical instructors with support from various resources and adjusting the benefits offered according to their needs may also raise their motivation to persevere in their role. Moreover, health managers and educators should pay attention to and follow the professional training and guidance processes of new and existing clinical instructors to establish and strengthen their internal motivation so that they continue willingly in their positions.

Development and Evaluation of a Preceptor Education Program Based on the One-Minute Preceptor Model: Participatory Action Research

This participatory action research study was conducted to confirm the implementation process and effect of developing and applying a preceptor education program based on the One-Minute Preceptor Model to foster the competence of preceptor clinical nurses. The study was conducted for eight weeks from March 2020 on 30 preceptor nurses in South Korea. Nursing standards were developed for two weeks and six cycles (comprising four stages) were performed. Data collection was integrated using both quantitative and qualitative approaches. For quantitative data, the Clinical Core Competency of Preceptor (CCCP) and General Communication Competence Scale (GICC-15) results were collected from preceptor nurses through questionnaires. Reflection journals of nurses' experiences were also analyzed through content analysis and frequency of keywords using WordClouds. There was no significant change in CCCP or GICC-15 results among preceptor nurses. However, nurses' experiences were associated with the growth and development of competencies such as evidence-based practice, quality feedback, and self-reflection. The program was effective in developing nurse competencies. Therefore, it is necessary to encourage One-Minute Preceptor Model activities among preceptors through an action research approach and to actively support research and practice in clinical settings, as well as to provide organizational and systematic support.

Preceptorship of clinical learning in nursing homes - A qualitative study of influences of an interprofessional team intervention

This study aimed to explore the influences of an interprofessional preceptor-team intervention (IPPT) on interprofessional collaboration, preceptors' role, confidence, and motivation to precept health care students (nursing, physiotherapy) and apprentices in a Norwegian nursing home.

METHODS

Qualitative data were collected by two focus group discussions: possible gains and pitfalls of the IPPT-intervention were focused. The group-discussions were tape-recorded, transcribed verbatim and analysed by means of qualitative content analysis.

FINDINGS

The IPPT-intervention influenced positively on preceptors' confidence and motivation to work as a preceptor and facilitated interprofessional collaboration between the health professionals. The preceptors' role in the ward became clearer and more visible to the peers. Perceived lack of time, a heavy workload, the ward hierarchy, and lack of managerial support were key barriers for preceptorship.

CONCLUSIONS

To enhance preceptors' work and thus student's learning, the ward hierarchy should be limited and interprofessional collaboration further developed. Enhanced visibility and acknowledgement of the preceptors' role and increased managerial support can reduce barriers for preceptorship.

The Challenges of Precepting Undergraduate Nursing Students in Malawi

PURPOSE

Malawi trains registered nurses as clinical preceptors to facilitate quality clinical teaching to nursing students. The concept of preceptorship is new in Malawi, and as such data about its contribution and challenges are scanty. It is for this reason that this study was undertaken to explore the challenges that preceptors face as they teach students.

METHODS

This exploratory-descriptive qualitative study was conducted at Malawi's four major referral hospitals utilised by nursing training institutions as clinical sites. A sample of 12 participants was purposively selected to provide data regarding challenges encountered during preceptorship activities. In-depth interviews were conducted in order to collect data on challenges experienced by these facilitators. The data were later categorised and analysed into themes.

RESULTS

From the analysed data, three key themes emerged including preceptorship as time-consuming, lack of support from faculty members and lack of teamwork among preceptors.

CONCLUSION

The study concluded that preceptors face several challenges that affect the quality of clinical teaching. The study recommends that there should be an improvement in the working relationship among those involved in clinical teaching to enhance clinical learning experiences among student nurses. It also recommends that more registered nurses should be trained as preceptors to improve the student-preceptor ratio.

Contribution of students to nursing practice settings during clinical training: Design and validation of a questionnaire

BACKGROUND

A validated questionnaire to measure the contributions of nursing students to clinical settings could potentially assist in the improved management of students in healthcare institutions.

AIM

To develop and test the psychometric properties of the questionnaire 'Nursing Student Contributions to Clinical Settings' (CEEEC, Spanish acronym for 'Contribuciones de los Estudiantes de Enfermería a los Entornos Clínicos').

DESIGN

Instrument design and psychometric testing.

PARTICIPANTS/SETTINGS

A multicentre study involving 1,098 nursing professionals from three universities and five hospitals of Spain, between January 2019 and March 2020.

METHODS

The study was carried out in two phases. Phase 1 involved the questionnaire design by experts (n = 28), which required a review of the available literature, cognitive interviews and Delphi rounds, and a preliminary validity study, which included a pilot test with responses from a sample of nurses (n = 143). Phase 2 involved a formal validation with a wider sample of nurses (n = 927), including factor analysis and a study of convergent validity with the Practice Environment Scale-Nursing Work Index and Health Sciences-Evidence Based Practice.

RESULTS

Experts selected 42 items on student contributions. After cognitive interviews, three items were eliminated and seven failed to reach the minimum content validity index (78%). Based on the remaining 32 items, the discrimination index of each item was calculated, and those with <0.3, eight items were sequentially eliminated. The resulting questionnaire contained 24 items grouped into a single factor, which explained 41% of the variance. The internal consistency was excellent (Cronbach's alpha: 0.94), and the convergent validity was confirmed.

CONCLUSIONS

A 24-item questionnaire was designed and validated to measure the contributions of nursing students to clinical practice settings.

IMPACT

Most hospitals are also teaching centres where nursing students undergo clinical practice. The application of this test will provide insight into the nursing professionals' perception of the students' role.

Preceptorship as part of the recruitment and retention strategy for nurses? A qualitative interview study

AIM

To explore aspects that are important for the integration of preceptorship and processes for recruitment and retention of nurses.

BACKGROUND

The shortage of nurses is a global concern that has a major impact on health care systems around the world. However, earlier research has not considered whether preceptorship of nursing students can be an integral part of recruitment and retention of nurses.

METHOD

A descriptive design with a qualitative approach was used. Semi-structured interviews were conducted with ten preceptors and six ward managers in different health care specialties in Sweden.

RESULTS

Three aspects were found central for integrating preceptorship with recruitment and retention: perceptions of preceptorship, the organisation of preceptorship and the way preceptorship operates in relation to recruitment and retention strategies.

CONCLUSION

The findings suggest that preceptorship and recruitment strategies could both benefit from being integrated.

IMPLICATIONS FOR NURSING MANAGEMENT

It is central for nursing managers to develop organisational practices that enable the integration of preceptorship with recruitment and retention of nurses. This could increase the quality of both preceptorship and the work environment in general.

ICU nurse preceptors' perceptions of benefits, rewards, supports and commitment to the preceptor role: A mixed-methods study

This paper explores Intensive Care nurses' perceptions of benefits, rewards, supports and their commitment to the role of preceptor. A questionnaire, consisting of Likert-scales and open-ended questions was used to collect data during October 2018. Preceptors were committed to their role. Correlations were found between preceptors' perceptions of benefits or rewards and commitment to the role (p = 0.003, r² = 0.39) and perceptions of support and commitment to the role (p = .001, r² = 0.46). Altruistic benefits were perceived to be of the greatest importance. Participants who recognised the importance of preceptorship for the organisation were more likely to be committed to the role. Eighty-three percent of respondents reported a lack of consistency in allocation to work with their preceptee. Qualitative results elucidated themes of helping, personal professional development, the opportunity to teach, and organisational improvement. Supports as barriers and enablers to successful preceptorship were discussed in terms of peer and leadership support, role preparation, the logistics of the environment, role conflict, and consistency of allocation to work in a preceptorship dyad. Commitment to the preceptor role may be increased by highlighting organisational benefits of preceptorship, increasing consistency of contact between preceptorship dyads, and increasing access to supports and preparation.

Nurses and undergraduate student nurses' experiences in collaborative clinical placement programs in acute hospitals: An integrative literature review

OBJECTIVES

To identify, and critically review student, nurse clinician and clinical facilitator/educator experiences of collaborative clinical placement models in acute hospitals.

DESIGN

An integrative review that followed Whittemore and Knafl's (2005) framework.

DATA SOURCES

Studies published between 2009 and 2019 were identified via a comprehensive search of the following databases: CINAHL, OVID Medline, EMBASE, EMCARE, PsychINFO, Johanna Briggs Institute, ERIC and SCOPUS.

REVIEW METHODS

The initial search located 2309 Articles. After screening and checking for eligibility 14 articles were critically appraised using the Critical Appraisal Skills Program checklist for qualitative papers, the McMaster's Critical Review Form for quantitative papers and MMAT Appraisal tool for mixed method papers. The papers were then analysed thematically.

RESULTS

Thirteen studies met the inclusion criteria for the review (four quantitative, six mixed method, three qualitative). We identified an overarching central theme of sense of belonging and acceptance along with the following four sub themes: familiarity and continuity, confidence and competence, preparedness and lastly supervising relationships and faculty support.

CONCLUSION

This review indicates collaborative clinical placement programs have a positive impact on the student experience. Further research is needed regarding experiences of clinical nurses, health organisation leaders and Faculty to better understand what will improve support of students in collaborative clinical placement programs as there were few research findings found related to these non-student participant groups. Exploring student placement experiences that include both traditional and Collaborative models would provide greater insight into the value of these programs.

Do preceptorship and clinical supervision programmes support the retention of nurses?

BACKGROUND

The reasons for nurse shortages are the ageing healthcare workforce, increasing demand for services, employee dissatisfaction, life-work imbalance and burnout.

AIM

To review the literature to find out whether there is evidence to support preceptorship and clinical supervision programmes in retaining nurses, and particularly newly qualified nurses (NQNs), in clinical practice.

METHODS

A search of databases, as well as other sources, was carried out, with six studies selected for data analysis.

FINDINGS

Thematic analysis was used to synthesise the results and produced seven themes: increase satisfaction, gain competence and feel more confident; competencies of preceptors and supervisors; framework or model required; the challenge to the programmes; intention to stay and staff retention; voluntary withdrawal from the nursing profession; and further support for development.

CONCLUSION

Training (preceptorship and clinical supervision programmes) is effective in retaining NQNs, increasing satisfaction, improving skills and competency and staff engagement; however, more support for both preceptors/supervisors and NQNs is needed to maximise the success of these programmes in the future.

Development of the Preceptor Self-Assessment Tool and Use of the Content Validity Index

BACKGROUND

Competency of staff nurse preceptors is an essential factor that determines the success of preceptorship experiences. Competency assessment is complex, and no self-assessment tool exists.

METHOD

This article describes phase two of the development of the Preceptor Self-Assessment Tool (PSAT). A content validity index (CVI) survey was completed by 11 subject matter experts to determine relevance of items on the PSAT.

RESULTS

The Scale-Level CVI (S-CVI) for the instrument was 0.91, and the items CVI ranged from 0.45 to 1.0; most were above 0.78. One item was dropped and three were collapsed, leaving the final number of items at 64.

CONCLUSION

The items on the PSAT have undergone content validity and have been found to be highly relevant. Pilot testing in a large sample of preceptors is warranted to further refine the items on the tool. [J Contin Educ Nurs. 2020;51(10):469-476.].

Clinicians' ability, motivation, and opportunity to acquire and transfer knowledge: An age-driven perspective

BACKGROUND

Many countries are seeing a dramatic increase in the average age of their clinicians. The literature often highlights the challenges of high replacement costs and the need for strategies to retain older personnel. Less discussed are the potential pitfalls of knowledge acquisition and transfer that accompany this aging issue.

PURPOSE

We propose a conceptual framework for understanding how clinicians' age interact with ability, motivation, and opportunity to predict clinical knowledge transfer and acquisition in health care organizations.

APPROACH

This study integrates life-span development perspectives with the ability-motivation-opportunity framework to develop a number of testable propositions on the interaction between age and clinicians' ability, motivation, and opportunity to acquire and transfer clinical knowledge.

RESULTS

We posit that the interaction between ability (the knowledge and skills to acquire knowledge), motivation (the willingness to acquire and transfer knowledge), and opportunity (resources required for acquiring and transferring knowledge) is a determinant of successful knowledge management. We also suggest that clinicians' age-and more specifically, the cognitive and motivational changes that accompany aging-moderates these relationships.

CONCLUSION

This study contributes to existing research by offering a set of testable propositions for future research. These propositions will hopefully encourage empirical research into this important topic and lead to guidelines for reducing the risks of organizational knowledge loss due to aging.

PRACTICE IMPLICATIONS

We suggest several ways that health care organizations can tailor managerial practices in order to help capitalize on the knowledge-based resources held by their younger and older clinicians. Such initiatives may affect employees' ability (e.g., by providing specific training programs), motivation (e.g., by expanding subjective perceptions of future time at work), and opportunities (e.g., by providing mentoring, reverse mentoring, and coaching programs) to acquire and transfer knowledge.

Career mentoring in aged care: Not all it seems

Understanding the nature of career mentoring is important for improving the career experience of aged care workers. This study explores the career mentoring behaviours of sponsorship, coaching, advocacy, challenging assignments, exposure and visibility in the residential aged care context. Interviews were conducted with 32 aged workers from several occupations within the care context. It was found that career mentoring in the aged care context was limited. The mentor behaviours of coaching, sponsorship and advocacy were limited and there was no opportunity in aged care to provide challenging assignments or promote exposure and visibility. Organisations and managers can facilitate learning and personal development by providing inclusive training for all workers regardless of the need to meet professional registration requirements. Learning needs to be continuous as careers and clinical techniques evolve. Extension of existing mentoring programmes to include all care workers would improve overall quality of care in residential aged care facilities.

Nursing home staff experiences of implementing mentorship programmes: A systematic review and qualitative meta-synthesis

Aim

To determine nursing home staff experiences in mentorship programmes, and staff perceptions of the enablers and barriers to implement mentorship programmes.

Background

Mentorship programmes are perceived as playing an important role in improving the quality of care in nursing homes. However, little is known about research evidence across the global about staff's experiences in the programmes.

Methods

A search for studies published from the earliest available date to April 2019 was undertaken. Two reviewers performed data extraction and an appraisal of eight studies using tools from the Joanna Briggs Institute. A pragmatic meta‐aggregative approach was applied to synthesise the findings. The qualitative research that was included was analysed to identify 63 findings that were organised into 12 categories and combined into three syntheses.

Results

The implementation of effective mentorship programmes is influenced by three factors: mentor capability, opportunity in the mentorship programmes, and motivation in the mentorship programmes.

Conclusions

There are a number of studies of nursing home staff experiences of mentorship programmes. However, systematic reviews that synthesise findings in this field are lacking. It is crucial to tailor the programme design to suit each unique nursing home care setting. We identified barriers and enablers, and learned that no barriers are insurmountable.

Implications for Nursing Management

Findings will inform nurse managers of an ideal environment for the implementation of a successful mentorship programme. Nursing homes need to establish and sustain mentorship programmes to help improve workforce capacity in delivering high‐quality care for residents.

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.

Preceptors' Subjective Competency Ratings in Acute Care Hospitals in Taiwan

BACKGROUND

This study focused on developing a Subjective Competency Scale (SCS) in acute care hospitals and identified factors that affect preceptors' competency to precept new graduate nurses (NGNs).

METHOD

This study was conducted in two stages that included collecting information on preceptor training courses and conducting a cross-sectional questionnaire survey. A total of 350 preceptors completed the survey in 2011. The validity and reliability of the SCS were determined.

RESULTS

An SCS was developed using 22 items and five factors: teaching/assessment skills, interpersonal/communication skills, confidence/self-assurance, problem-solving/stress-coping skills, and self-reflection. These explained 69.73% of the variance. Cronbach's alpha for these five factors of scale ranged from .715 to .889. Preceptors' subjective competency was correlated positively with age, years as a nurse, years as a preceptor, willingness to be a preceptor, and self-rated relationship with NGNs (p < .001).

CONCLUSION

The SCS exhibited high validity and reliability; therefore, it can be used for future preceptors' subjective competency assessment and evaluation. [J Contin Educ Nurs. 2019;50(2):69-78.].

Understanding the needs of nurse preceptors in acute hospital care setting: A mixed-method study

Nurse preceptors play an important role in supporting newly qualified nurses during transition periods. However, limited attention is given to the needs and experience of nurse preceptors with expected responsibilities. This study aimed to examine the perceived needs of nurse preceptors in three public acute hospitals by using a sequential mixed method approach conducted between March and August 2017. A questionnaire that comprised socio-demographic data, Clinical Teaching Behaviour Inventory (CTBI), and RN Preceptor Learning Needs Assessment, was distributed to all nurse preceptors. Semi-structured qualitative interviews were conducted with a purposive sample of 10 informants to complement the quantitative findings. We received 260 completed questionnaires, giving a response rate of 78.8%. The highest mean CTBI domain score was "Using appropriate teaching strategies" (Mean = 3.65, SD = 0.56), whereas the lowest was "Providing feedback and evaluation" (Mean = 3.51, SD = 0.60). The top five topics identified as the most important in nurse preceptor training were critical thinking, prioritising, teaching techniques, conflict management and teamwork. Qualitative findings revealed that the informants experienced tension with their dual roles and strained relationships with co-workers. The expectations of the informants for support were recognition from management level and highlighting coaching tactics, reciprocal learning and collegiate support.

Aggression Management Training in Undergraduate Nursing Students: A Scoping Review

Recent events and media coverage have put aggression and violence toward healthcare workers on the agenda of many governments and healthcare providers. Shown to cause poor job satisfaction, attrition and higher rates of turnover, aggression and violence toward healthcare workers is a substantial problem in the provision of quality care. We aim to determine the feasibility of providing aggression management training to undergraduate nursing students to better prepare them for the workforce. This review found seven studies utilizing various methods of providing aggression management training to students. Delivery was diverse in terms of format, content and duration, and the efficacy of training was typically determined in a pre- and post-test fashion. The findings in reviewed studies indicate significant improvements in competence and attitudes, however some methodological caveats exist. We conclude that aggression management training for undergraduate nursing students is indeed feasible within certain constraints: methodological approaches to demonstrating efficacy need to evolve beyond pre- and post-test designs and changes in content delivery incorporating new and novel methods, such as simulation, need to be considered and incorporated. Aggression management training should be considered as essential in the nursing curriculum in order to provide neophyte nurses with the skills and capabilities to manage aggression and violence in their future workplaces.

Predictors to Private Practice Occupational Therapy Fieldwork Opportunities in Canada: New Evidence suggests New Solutions

The study examined predictors to increasing and enhancing fieldwork education opportunities provided by occupational therapists working in private practice. A cross-sectional design that used a self-administered questionnaire was provided to Canadian occupational therapists in private practice. Participants receiving funding from the workers' compensation sector, those with between 11 and 20 years of work experience, and therapists working full-time hours were more likely to accept a student in fieldwork placement. Respondents who indicated that physical space and resources were not barriers to taking students on placement were more likely to accept students. Therapists more comfortable with the criteria and methods for appropriate and effective student teaching and supervision were also more likely to accept a student for fieldwork placement. The study findings can inform academic programs on how best to support preceptorship and guide university fieldwork coordinators' strategies for outreach and education for private practitioners.

Preceptorship during health personnel students' clinical studies in nursing homes-An institutional perspective on an intervention

AIM

The recruitment and retention of preceptors to mentor health professional students and apprentices in their clinical studies are not easy. The aim of this study was to investigate factors that hindered the implementation of an intervention intended to improve the working conditions for preceptors in nursing homes. The preceptorship was related to clinical studies for health professional students and apprentices.

DESIGN

A qualitative, explorative design was applied.

METHODS

Qualitative data were collected in September 2014 by means of focus groups with preceptors and key informant interviews. The data were prepared by thematic analysis and interpreted in the light of institutional theory.

RESULTS

The intervention to improve the working conditions for preceptors was hampered by institutional traits involving rule-like perceptions of "want to," "ought to" and "have to." Precepting was preserved as an individual task of the preceptors and was not considered a daily activity in nursing homes.

CONCLUSIONS

To improve the working conditions for preceptors in nursing homes and thus improve recruitment and retention among preceptors, the nursing home leaders should address institutional traits related to preceptorship.

Clinical Nurses' Perceptions of a Senior Capstone Dedicated Educational Unit

Clinical nurses' perceptions of a senior capstone dedicated educational unit (DEU) model to transition to practice was evaluated in a pilot study. Nursing students were placed in the traditional capstone and the DEU senior capstone unit with clinical nurses. Staff nurses completed an online survey to compare and contrast satisfaction and effectiveness of the models. The results of the study revealed no perceived differences in the outcomes of a DEU experience as compared to the traditional preceptor model. However, nursing management reported an improved sense of leadership and teamwork on the unit with the DEU model.

The competence of nurse mentors in mentoring students in clinical practice - A cross-sectional study

BACKGROUND

Nurses play an important role in developing the competence of nursing students and acting as role models for students during clinical practice placements. Nurses need diverse competence to successfully mentor nursing student.

OBJECTIVES

This study aimed to describe and explain nurse mentor competence in mentoring nursing students in clinical practice settings based on self-evaluation, as well as identify different mentor profiles.

DESIGN

This study employed a cross-sectional, descriptive design involving a self-administered electronic version of the Mentor Competence Instrument.

SETTINGS

The study population included nurse mentors from all five university hospitals in Finland.

PARTICIPANTS

Through random sampling, 3355 nurse mentors were invited to take part in the study in 2016.

METHODS

Data was collected using Mentors Competence Instrument, which consists of 63 items structured in 10 mentoring competence categories.

RESULTS

Mentors (n = 576) evaluated their level of competence in various categories as middle- to high-level. They evaluated reflection during mentoring and identifying a student's need for mentoring the highest, whereas student-centered evaluation and supporting a student's learning process were rated lowest. Three distinct profiles of mentor competence were identified. These profiles differed in evaluation of mentoring competence level, previous participation in mentoring education, and time spent on reflective discussions with students.

CONCLUSIONS

According to their profiles, mentors have diverse needs for support in building their mentoring competence. We suggest that healthcare organizations should provide nursing mentors with education that is based on their individual levels of mentoring competence. Nurses should also be encouraged to use time for reflective discussion with students during clinical practice.

Adaptation and validation of the clinical supervision self-assessment tool among registered nurses

BACKGROUND

Clinical supervision of pre-registration nursing students has become an integral role of the registered nurse. The Clinical Supervision Self-assessment Tool relating to knowledge (CSAT-Knowledge) and the individual's skills (CSAT-Skills) of clinical supervision and comprising of 30 items each originally is widely used for nurses in Australia. However, the psychometric properties of this tool have not been previously reported.

OBJECTIVE

To adapt the Clinical Supervision Self-Assessment Tool for nurses and to investigate the psychometric properties of the modified tool to measure registered nurses' knowledge and skills regarding supervising pre-registration nursing students.

DESIGN

Instrument adaptation and psychometric testing.

PARTICIPANTS/SETTINGS

A convenience sample of 229 registered nurses in a tertiary teaching hospital in Australia.

METHOD

A two-phase prospective study was conducted. Phase 1 involved the modification of the Clinical supervision Self-Assessment Tool, content validity and pilot testing of the modified version. Phase 2 included the psychometric testing of the modified Clinical Supervision Self-Assessment Tool (mCSAT-Knowledge; mCSAT-Skills).

RESULTS

The mCSAT-Knowledge and mCSAT-Skills comprised of 30 items each. The content validity of the mCSAT was considered satisfactory based on the feedback from the expert panel. Results of the exploratory factor analysis supported a three-factor structure identified as: evaluating clinical learning; facilitating clinical learning and problem solving. The internal consistency was high with a Cronbach's alpha values >0.90. The construct validity was supported as nurses who had undertaken clinical supervision training demonstrated significantly higher clinical supervision knowledge and skills scores than those had no training.

CONCLUSIONS

The findings provide empirical support for the modified Clinical Supervision Self-Assessment Tool as a valid measure of registered nurses' knowledge and skills regarding the clinical supervision of pre-registration nursing students. The tool requires further psychometric testing in different samples of nurses to enable validation in other settings.

The influence of peer mentoring on critical care nursing students' learning outcomes

Purpose

The purpose of this paper is to explore the influence of peer mentoring on critical care nursing students' learning outcomes in critical care units.

Design/methodology/approach

A qualitative exploratory research design was used to conduct the study. Ten critical care nursing students were recruited from critical care units in the five private and two public hospitals. Descriptions of their experiences were gained through individual face-to-face interviews.

Findings

The study reinforces peer mentoring as a vital strategy in helping the critical care nursing students to attain their learning outcomes. However, peer mentoring was not consistent in all hospitals and there were no structured support systems to ensure that peer mentoring was formalized. Making peer mentoring a vital component in the registered nurses core competencies would enable efficiency and guarantee the viability of peer mentoring.

Research limitations/implications

Mentors for the critical care nursing students were not included in the study.

Practical implications

The study identified a need for incorporating a formalized mentorship programme into the core competencies of all qualified critical care nurses, the unit mentor to familiarise themselves with the prescribed learning objectives of the critical care nursing student and an allocation of supernumerary time for the critical care nursing student and mentors to allow for formal mentoring responsibilities to take place.

Originality/value

The study reinforces peer mentoring as a vital strategy in helping the critical care nursing students to attain their learning outcomes and conscietises registered nurses of their responsibility as mentors.

An exploration of peer-assisted learning in undergraduate nursing students in paediatric clinical settings: An ethnographic study

BACKGROUND

Peer-assisted leaning relates to the acquisition of knowledge and skills through shared learning of matched equals. The concept has been explored within the field of nurse education across a range of learning environments, but its impact in practice is still relatively unknown. This paper reports on findings when observing paediatric undergraduate nursing students who engage in PAL within the clinical practice setting.

OBJECTIVES

The aim of this paper is to report the findings of a study undertaken to explore peer-assisted learning in undergraduate nursing students, studying children's health, in the clinical practice setting.

DESIGN

A qualitative ethnographic study using non-participant observations.

SETTINGS

A range of inpatient paediatric clinical settings across two teaching hospitals.

PARTICIPANTS

First, second and third year paediatric student nurses enrolled on a Bachelor of Nursing Programme.

METHODS

Non-participant observations were used to observe a range of interactions between the participants when engaging in peer-assisted learning within the same clinical area. A total of 67 h of raw data collected across all observations was analysed using framework analysis to draw together key themes.

RESULTS

Of the 20 identified students across two hospitals, 17 agreed to take part in the study. Findings were aggregated into three key themes; 1. Peers as facilitators to develop learning when engaging in peer-assisted learning, 2. Working together to develop clinical practice and deliver care, 3. Positive support and interaction from peers to enhance networking and develop working structure.

CONCLUSIONS

Peer-assisted learning in undergraduate children's nursing students stimulates students in becoming engaged in their learning experiences in clinical practice and enhance collaborative support within the working environment. The benefits of peer-assisted learning in current clinical practice settings can be challenging. Therefore, education and practice need to be aware of the benefits and their contribution towards future strategies and models of learning.

Predictors of nurses' level of participation in student care: A multivariable analysis

OBJECTIVE

To determine the association and predictive nature of certain socio-demographic, education, work and research variables on nurses' participation level in the clinical care of students.

DESIGN

A cross-sectional analytical study using a validated questionnaire between February and June 2014.

SETTING AND PARTICIPANTS

A consecutive sample of 117 nurses who worked in public health centres in the province of Castellón (Spain) in 2014. The nurses who had never mentored students and the questionnaires that were <50% complete were excluded.

METHODS

A descriptive analysis of the sample and an association analysis between variables were performed. The questionnaire and its dimensions were performed with a logistic regression and the maximum likelihood method, which used a complementary log-log link method. The concordance index was calculated using contingency tables.

RESULTS

The mean age was 42.56 years, and the overall mean questionnaire score was 122.84 (SD = 18.69; 95% CI: 119.415-126.26). Across the sample, 58.1% (n = 68) of the nurses obtained an Excellent score, followed by Adequate in 41% (n = 48). Overall, the predictive variables were age, mentoring of students in the last 5 years and previous training to mentor students.

CONCLUSION

The main predictive variable for greater participation in the mentorship of students was previous training in mentoring. This study also reflected on other variables that could influence nurses' participation in student mentoring.

Mental health nurses' views and experiences of working with undergraduate nursing students: A descriptive exploratory study

BACKGROUND

The core of pre-registration nursing education is the learning that takes place during the clinical placement. However, despite the fact that registered nurse preceptors are key players in supporting students during their placements there is a lack of literature examining the views of preceptors working with nursing students in mental health settings.

OBJECTIVES

To explore mental health nurses' views and experiences of working with undergraduate nursing students and determine what factors influence this experience.

DESIGN

A descriptive exploratory study approach using an on-line questionnaire was adopted for this study.

SETTINGS

A specialist mental health service (SMHS) within one District Health Board in New Zealand.

PARTICIPANTS

89 registered nurses who had been involved in working with nursing students participated in this study.

METHODS

Data was collected using an online questionnaire.

RESULTS

The majority of the respondents in this study reported that they felt confident and well supported in the work they did with nursing students and had a positive perception of this role. However, one significant negative factor identified was the extra stress and workload pressure they reported when working with students, when no allowance was made for this. Another key finding was that engaging in some form of education related to the preceptorship role was positively correlated with nurses knowing what was required of them, feeling confident, the extent to which they planned clinical education, and feeling that they were sufficiently appreciated.

CONCLUSIONS

Ensuring nurses have access to education related to clinical teaching and learning increases their confidence in the work they do with nursing students and has also been shown to have a positive impact on how they view this role.

Conceptualizing the mentoring relationship: An appraisal of evidence

This paper appraises the conceptual development of mentoring in nursing and highlights the need for further research on mentoring that focuses on conceptual clarification and theoretical discovery. Despite an abundance of published articles on mentoring, a paucity of research studies on nurse-to-nurse mentoring exists. Nursing literature abounds with descriptive terminology about mentoring rather than explanatory research. Descriptive terminology does little to develop the concept of mentoring, leaving one to ponder how to implement mentoring relationships in nursing. Published research has primarily focused on two broad categories: mentor characteristics and mentoring relationship outcomes. Although numerous scholars have asserted the need to clearly conceptualize mentoring, limited research focus has contributed to an ambiguous understanding of mentoring. Research that clarifies mentoring as a concept and provides a theoretical explanation of the mentoring relationship will fill a long-standing gap in the literature.

'It's complicated': Staff nurse perceptions of their influence on nursing students' learning. A qualitative descriptive study

BACKGROUND

During both teacher-led clinical practica and precepted practica, students interact with, and learn from, staff nurses who work on the clinical units. It is understood that learning in clinical practice is enhanced by positive interactions between staff nurses and nursing students. While much is known about preceptors' experiences of working with nursing students, there is little evidence to date about staff nurses' perspectives of their interactions with students in teacher-led practica.

PURPOSE

To understand teacher-led clinical practica from the perspective of staff nurses.

METHOD

A qualitative descriptive approach answers the question: How do staff nurses perceive their contributions to nursing students' learning during teacher-led practica? Nine staff Registered Nurses (RNs) working within a regional acute care hospital in western Canada were interviewed using semi-structured interviews. Interview transcripts were analyzed using cross case analysis to discover themes and findings were checked by several experienced RNs.

RESULTS

Analysis showed that nurses' interactions with nursing students are complicated. Nurses want to "train up" their future colleagues but feel a heavy burden of responsibility for students on the wards. This sense of burden for the staff nurses is influenced by several factors: the practice environment, the clinical instructor, the students themselves, and the nurses' understanding of their own contributions to student learning.

CONCLUSIONS

Staff nurses remain willing to support student learning despite multiple factors that contribute to a sense of burden during teacher-led practica. Workplace environment, nursing program, and personal supports are needed to support their continuing engagement in student learning. Nurses need to know how important they are as role models, and the impact their casual interactions have on student nurses' socialization into the profession.

Participation of clinical nurses in the practical education of undergraduate nursing students

OBJECTIVE

To evaluate the level of participation of clinical nurses from Castellón where Universitat JaumeI nursing students do their clinical clerkship. To identify the variables that may influence clinical nurses' participation in students' clinical mentorship.

METHOD

This observational, cross-sectional and descriptive study was conducted by applying the validated Involvement, Motivation, Satisfaction, Obstacles and Commitment (IMSOC) questionnaire. The variables collected were: age, work environment and previous training. The study was conducted between January and December 2014.

RESULTS

The sample included 117 nurses. The overall mean questionnaire score was 122.838 (standard deviation: ±18.692; interquartile range 95%: 119.415-126.26). The variable "previous training for mentorship students" was statistically significant in the overall score and for all dimensions (P<.05). Primary care nurses obtained better scores in the dimension Implication than professionals working at other care levels.

CONCLUSIONS

The level of participation of the clinical nurses from Castellón is adequate. The previous training that professionals receive for mentoring students improves both their level of participation and primary care level. Extending this research to other national and international environments is recommended.

Role of clinical practice educators in an integrated community and mental health NHS foundation trust

Clinical practice educators (CPEs) aim to provide support and education to clinical staff and students to improve their professional practice. This article examines the work of a team of six CPEs, who were employed by one large integrated mental health and community health NHS foundation trust that incorporates both mental and physical health services. It explores how the role of the CPE can have positive effects on clinical settings, and can improve the provision of evidence-based care for clinical staff and students on placement in the trust. The article provides examples of the work undertaken by the CPE team and considers the plans for its future development.

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.