Nurse preceptors' orientation competence and associated factors-A cross-sectional study

Competency domains for registered nurse preceptor professional development: Evidence from a modified e-Delphi study

AIM

To develop an evidence-based framework of nurse preceptor competency domains and competency descriptors for use in nurse preceptor professional development.

BACKGROUND

Nurse preceptors are registered nurses who coach, support and assess nursing students while simultaneously caring for patients. Working as both clinician and educator requires preceptors to develop additional skills. However, preceptor preparation is often overlooked and may not be evidence based.

DESIGN

A modified e-Delphi study.

METHODS

A three-phase e-Delphi method informed the study that was conducted between March and September 2023. In the first preparatory phase an expert group distilled the results of a previous literature review identifying seven preceptor competency domains and more than 200 competency descriptors. Two e-Delphi rounds followed. A 70% rater agreement response threshold was chosen as appropriate in this study. The CREDES reporting framework was followed.

RESULTS

In the preparatory phase, the expert group (n=6) reached consensus on six preceptor domains and 57 preceptor descriptors. In Round 1, nurse preceptors (n= 89) rated the domains and descriptors using a four-point Likert scale; from not important to very important. Six domains and 34 competency descriptors were ranked as very important'. Round 2 participants (n=30) who opted in from Round 1 indicated their 100% agreement with the Round 1 results. The results reveal that preceptors resonate intuitively with the six domains Role model, Facilitator, Leader, Evaluator, Teacher and Coach and the related descriptors.

CONCLUSION

The preceptor evidence-based competency framework offers registered nurse preceptors and their employers the opportunity to focus efforts in developing a nurse preceptor workforce. The framework can be used to design preceptor professional development and offers registered nurses a self-assessment tool to identify their preceptorship skills strengths and areas for development. If implemented in these ways the framework may benefit healthcare organisations to provide quality nurse preceptorship, thus enhancing the clinical learning experiences of nursing preceptees.

Registered nurses' cultural orientation competence for culturally and linguistically diverse nurses in the hospital setting: A cross-sectional study

AIMS

To explore registered nurses' cultural orientation competence profiles for providing culturally and linguistically diverse (CALD) nurses with orientation in the hospital setting, and to identify which factors are associated with cultural orientation competence profiles.

DESIGN

A descriptive, explorative cross-sectional study.

METHODS

Data were collected from December 2020 to January 2021 using the Preceptors' Orientation Competence Instrument (POCI) and Preceptors' Cultural Orientation Competence Instrument (POCCI). A total of 844 registered nurses from one university hospital district in Finland participated, reflecting a response rate of 10%. A K-means cluster algorithm was employed to identify different cultural orientation competence profiles.

RESULTS

The cluster analysis identified three cultural orientation competence profiles (A, B and C). Nurses in Profile A evaluated their cultural orientation competence the highest, with members of profiles B and C demonstrating the second highest and lowest, respectively, cultural orientation competence scores. Several factors were associated with cultural orientation competence profiles, namely, orientation education and student mentoring education, support from managers and colleagues, motivation, willingness to act as a preceptor, time to provide orientation, sufficient clinical and theoretical nursing skills and current work title.

CONCLUSION

Cultural diversity and acceptance of it can be enhanced by building accepting culture towards new incomers and offering continuing education to improve the cultural competence of staff, which can further benefit patient care of CALD patients. Orientation practices can be improved by rewarding staff and building collaborative teamwork culture.

IMPLICATIONS FOR PROFESSION AND/OR PATIENT CARE

Organizations can strengthen nurses' cultural orientation competence; for example, by providing adequate orientation education and allocating more time to the orientation process.

REPORTING METHOD

The STROBE criteria were used to report the results of the observations critically.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Nurse leaders' perceptions of competence-based management of culturally and linguistically diverse nurses: A descriptive qualitative study

AIM(S)

To describe nurse leaders' perceptions of culturally and linguistically diverse (CALD) nurses' competence-based management.

DESIGN

A descriptive qualitative study of the competence-based management of CALD nurses, from the perspectives of nurse leaders in three primary and specialised medical care organisations. This study followed the COREQ guidelines.

METHODS

Qualitative semi-structured individual interviews were conducted with 13 nurse leaders. Eligible interviewees were required to have management experience, and experience of working with or recruiting CALD nurses. Data were collected during November 2021-March 2022. The data were analysed using inductive content analysis.

RESULTS

Competence-based management was explored in terms of competence identification and assessment of CALD nurses, aspects which constrain and enable competence sharing with them, and aspects which support their continuous competence development. Competencies are identified during the recruitment process, and assessment is based primarily on feedback. Organisations' openness to external collaboration and work rotation supports competence sharing, as does mentoring. Nurse leaders have a key role in continuous competence development as they organise tailored induction and training, and can indirectly reinforce nurses' work commitment and wellbeing.

CONCLUSION(S)

Strategic competence-based management would enable all organisational competencies potential to be utilised more productively. Competence sharing is a key process for the successful integration of CALD nurses.

RELEVANCE TO CLINICAL PRACTICE

The results of this study can be utilised to develop and standardise competence-based management in healthcare organisations. For nursing management, it is important to recognise and value nurses' competence.

IMPACT

The role of CALD nurses in the healthcare workforce is growing, and there is little research into the competence-based management of such nurses.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

The Effect of the Application of the Team-STEPPS-Based Preceptorship Guidance Model on the Competence of Nursing Students

Objective

Student competence is an important topic of discussion during the implementation of counseling in the clinic. The purpose of this study was to analyze the effect of the Team-STEPPS-based preceptorship guidance model on student competency.

Methods

A comparative study was used to analyze the quantitative data. Participants were clinical practice students at "Ngudi Waluyo" Public Hospital with a total of 92 registered students divided into treatment and control groups. The Wilcoxon Signed Rank Test and the Mann-Whitney U-Test were used to assess differences between the intervention and control groups.

Results

There were post-test differences between the intervention group and the control group, namely clinical competence p-value (0.003), nursing management p (0.000), technical competence p (0.008), self-management p (0.000), and care-oriented patients p (0.000).

Conclusion

The Team-STEPPS-based preceptorship guidance model is very important in increasing student competency, not only in mastering clinical competence, but also in mastering technical skill competencies, nursing management, self-management, and patient-oriented care skills, and therefore, can increase student independence.

New graduate registered nurses' professional competence and the impact of preceptors' education intervention: a quasi-experimental longitudinal intervention study

AIMS AND OBJECTIVES

The aim of this quasi-experimental longitudinal intervention study was to investigate new graduate nurses' professional competence development after preceptors' participation in an education intervention.

BACKGROUND

New graduate registered nurses are expected to be competent in many areas of nursing. Expectations that are sometimes unrealistic may cause a sense of inadequacy and stress, and this may in turn prevent them from fully deploying their competencies. Competence development is related to practice environment, occupational commitment, empowerment, and work experience. Orientation or transition programs have been designed to ensure new graduate nurses' competence, and preceptors and preceptorship could also have significant influence on their competence development.

DESIGN

A quasi-experimental longitudinal intervention study.

METHODS

The data was collected from October 2015 to November 2017. Participating wards were randomized into intervention and control groups. The intervention group preceptors had an eight-hour education intervention that focused on new employees' orientation, particularly from new graduates' point of view. Wards in the control group continued to precept as before. The Nurse Competence Scale was used for new graduates' self-assessment at baseline and at three-month and nine-month follow-up. This study is reported in accordance with the TREND Statement Checklist.

RESULTS

The education intervention aimed at preceptors did not have impact on the intervention group NGRNs' competence development. There were no statistically significant differences between the groups and effect size remained small.

CONCLUSIONS

The preceptors' education intervention was not effective enough to develop new graduates' professional competence so that it would have differed from that of the graduates receiving conventional orientation at the university hospital. This study confirmed that competence development is a complex and multidimensional phenomenon and organizations should invest in new graduate registered nurses' competence development during their early career. Preceptors' education and development of preceptorship and transition programs are an important part of overall competence development in complex health care environments.

TRIAL REGISTRATION

Retrospectively registered.