Assessing the Effectiveness Between Nurse Educator and Clinical Coach Critical Care Training Programs for New Graduate Nurses in the ICU

OBJECTIVE

The aim of this study was to assess the differences in effectiveness between nurse educator-led and clinical coach-led intensive care unit (ICU) training programs for new graduate nurses.

BACKGROUND

New graduate ICU nurses require substantial clinical training, which is often provided by peers serving as clinical coaches who have not been formally trained for an educator role. Our medical center successfully transitioned from a nurse educator-led to clinical coach-led model for initial ICU education after formally training the clinical coaches.

METHODS

Nurses enrolled in nurse educator-led (n = 114) or clinical coach-led (n = 166) ICU clinical training programs were compared on program pass rate, satisfaction, preparedness, turnover, and competence.

RESULTS

There were no statistically significant differences between the groups on any of the identified measures of program effectiveness.

CONCLUSIONS

Both educator-led and clinical coach-led models, with appropriate training, effectively prepared ICU nurses in this setting. Implementing a clinical coaching model for ICU training of new graduate nurses could assuage common resource issues, such as a shortage of nurse educators, as well as address the increasing demand for well-trained ICU nurses.

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.

A Nordic model for learning compassionate care in clinical education

BACKGROUND

Preceptorship is one model of supporting student nurses' learning and development during their clinical education. However, little is known about what there is in preceptorship that promotes or hinders learning. Earlier studies found that there were ethical dimensions to students' encounters with preceptors.

AIM

The overall purpose of this Nordic follow-up study was to develop a model for learning compassionate care among student nurses during their clinical education - first, to deeper understand the learning of student nurses, and second, to investigate the phenomenon of preceptorship from the preceptors´ point of view.

METHOD

This study used a mixed methods design. Undergraduate student nurses (n = 139) from three universities in Finland and Sweden were shadowed for a period of three years. Quantitative data were collected through a questionnaire and were analysed using statistical methods. To better understand the learning acquired by the student nurses, focus group interviews (n = 70) were conducted. The phenomenological-hermeneutical approach was adopted. To capture the preceptors' point of view, narrative interviews were held with them (n = 88) in western Finland and northern Sweden. A hermeneutical approach was used when analysing the data.

FINDINGS

According to both student nurses and preceptors, a caring student-preceptor relationship, imbued with commitment, reverence and responsibility, is fundamental and serves as the basis for students' learning and development more than pedagogical methods used. Three main themes emerged: a caring student-preceptor relationship; a caring manner of being-the conduct; and a caring culture-the tone of the learning space.

CONCLUSIONS

This study shows the importance of preceptorship on student nurses in their quest of becoming compassionate and caring nurses. Therefore, based on earlier findings and the findings in this study, there is a need to facilitate and support the students' transformation, that is, the process of becoming, from student to a professional nurse.

Clinical supervisors' experience of giving feedback to students during clinical integrated learning

Background: For students within health-care education, clinical integrated learning has an important role in combining theory and practice. Constructive feedback is a cornerstone of effective clinical teaching, even though it can be a challenging task for both students and supervisors. There are limited studies on clinical physiotherapists' experience of giving feedback to students.Purpose: To explore clinical physiotherapy supervisors' experience of giving feedback to students during clinical integrated learning.Method: Twelve physiotherapists were interviewed in focus groups about their experiences of giving feedback to students. The interviews were analyzed using qualitative content analysis. Results: One latent, overarching theme was identified, which was continuous development and support within the social network at the workplace facilitates the work of giving feedback to students and three manifest main themes: (1) constructive dialog; (2) professionalism; and (3) enabling strategies.Conclusion: The current study focuses on supervisors' experiences of giving feedback to students in a clinical setting. The findings showed that giving feedback to students was a part of continuous development, facilitated by the social network at the workplace, and that the supervisors aimed to be professional while handling emotions in social interactions between supervisors and students.

Formalising the precepting process: A concept analysis of preceptorship

AIMS AND OBJECTIVES

To elucidate the terminology associated with preceptorships, articulate an operational description of preceptorship that may be useful in formalising the precepting process and provide guidance for constructing a clinical environment where precepting can thrive.

BACKGROUND

Precepting facilitates the transition of nurses into new roles. Precepting may improve patient outcomes and safety, as well as enhance nursing satisfaction. Most research focuses on preceptor preparation and perceptions. A comprehensive operational description of what is required to formalise the precepting process is missing from the literature.

DESIGN

This concept analysis was completed using a combination of Walker and Avant's and Rodger's methods.

METHODS

Existing literature relating to preceptorship was reviewed. Critical attributes, antecedents, consequences and empirical referents were identified. Model, contrary, related and borderline cases were developed.

RESULTS

Preceptorships have the specific attributes of being (i) one-on-one relationships, (ii) embedded within formalised programmes, (iii) that evolve over set amounts of time, (iv) to systematically facilitate practical experiences. Antecedents include how precepting is triggered and organisational supporting activities that may facilitate effective precepting. Consequences include new hire preparedness, confidence and increased retention. Empirical referents are provided for assessing hands-on clinical expertise, individualisation of precepting programmes and the preceptor-preceptee relationship.

CONCLUSIONS

This concept analysis provides a holistic view of the precepting process that shifts the focus from the people or checklist to formalised preceptorships.

RELEVANCE TO CLINICAL PRACTICE

Continuity throughout an organisation's system streamlines the process of hiring new employees and transitioning nursing students to practice. Organisational policies, dedicated resources and engagement in systematically improving the precepting process are critical. Nurse managers must promote and support formalised preceptorships by providing preceptors and preceptees the time and space needed and fostering a culture that supports preceptorships.

Predictor of Self-Perceived Nursing Competency Among New Nurses in Taiwan

The aim of this article is to identify the factors that predict self-perceived nursing competency among new nurses in Taiwan. This quantitative cross-sectional survey was performed with a convenience sample of 105 new nurses. Data were collected with questionnaires. Multiple linear regression showed perceived benefit of preceptor policies to nursing capacity and age accounted for 21.1% of the variance in dependent variables for self-perceived nursing competency importance. Satisfaction with current preceptor, satisfaction with current nursing job, and participation in interprofessional education conferences accounted for 22% of the variance in dependent variables for self-perceived nursing competency adequacy. The results could be a reference to design nursing education curricula that improve clinical training and retention of new nurses. J Contin Educ Nurs. 2017;48(3):129-137.

Preparing Dedicated Education Unit Staff Nurses for the Role of Clinical Teacher

Dedicated Education Units optimize the expertise of staff nurses to provide clinical instruction to nursing students, thereby creating a need to prepare staff nurses for the teaching role and educate them about clinical teaching strategies. A curriculum to educate Dedicated Education Unit staff nurses in the art of clinical instruction was created to fill this gap in staff development. This article describes the development of an innovative, interactive, evidence-based curriculum to prepare Dedication Education Unit staff nurses and strengthen an academic-practice partnership.

A report on the development and implementation of a preceptorship training programme for registered nurses

BACKGROUND

Clinical supervision represents an important aspect in the development of nursing students’ clinical skills. At the School of Nursing (SoN) the clinical supervisors employed by the University of the Western Cape (UWC) have limited contact sessions with students in the clinical setting. However, with the increase in student numbers a need was identified to strengthen the support given to nursing students in the service setting.

OBJECTIVE

A preceptorship training programme for nurses was developed in 2009, aimed at improving the clinical teaching expertise of professional nurses. The planning phase, based on a preceptorship model, represents a collaborative undertaking by the higher education institution and the nursing directorate of the Provincial Government Western Cape.

METHOD

A two-week, eight credit, short course was approved by the university structures and presented by staff members of the school. The teaching and learning strategies included interactive lectures, small group activities and preceptor-student encounters in simulated and real service settings. Some of the course outcomes were: applying the principles of clinical teaching and learning within the context of adult education, understanding the preceptor role and managing

RESULTS

To date, fifty-four participants have attended the course. Following an internal review of the pilot programme in 2010, relevant adjustments to the programme were made.

CONCLUSION

It is recommended that all the stakeholders be involved in the development and implementation of a contextually relevant preceptorship training programme. It is further recommended that the school embarks on an extensive programme evaluation.

Multiagency Online Preceptor Education: Design, Implementation, and Outcomes

This article describes the design, implementation, feedback, problems, and solutions of a fully online Preceptor Development Program designed to help nurses acquire knowledge, attitudes, and skills key to the preceptor role. This program uses a variety of active learning experiences that support preceptor development.

The commitment of Israeli nursing preceptors to the role of preceptor

BACKGROUND

Despite the professional importance of the preceptorship role and the rise in participation of nurses in training courses for the position, a significant number of nurses are not committed to this role. The reasons for this trend globally, and in Israel in particular, are not clear.

OBJECTIVES

The aim of this study is to explore the connections between characteristics of preceptorship, supports, benefits and rewards, and commitment to the preceptor role in Israel.

METHODS

The present study is a quantitative correlational study. A questionnaire survey was given to a convenience sample of 200 Israeli registered nurses working as preceptors in hospitals and community settings in the northern part of Israel.

RESULTS

Respondents showed a moderate commitment to the role of preceptor. Support within nurses' employment framework, intrinsic benefits and rewards, and to a lesser degree, extrinsic benefits and rewards, were found to be related to nurses' level of commitment to the role of preceptor. No correlation was found between support received from outside the workplace and commitment to the role of preceptor. Additionally, no correlation was found between the characteristics of preceptorship (the number of preceptees during the last six months or the average number of preceptees per session), and commitment to the role of preceptor. The most important factor contributing to commitment was support within the nurses' employment framework

CONCLUSIONS

The present study highlights the importance of support from within the nurses' employment framework, and also the role of intrinsic benefits and rewards, in relation to the level of commitment of Israeli preceptors to their role.

Clinical misconduct among South Korean nursing students

This study examines the extent and predictors of unethical clinical behaviors among nursing students in South Korea. From survey data of 345 undergraduate nursing students, unethical clinical behaviors were examined with respect to 11 individual characteristics, frequency and perceived seriousness of classroom cheating, two factors of individual attitude, and four contextual factors. Qualitative data from two focus group interviews were analyzed to explore reasons for and contexts of unethical clinical behaviors. About sixty-six percent of the participants engaged in one or more unethical clinical behaviors over a one-semester period. The prevalence of such behaviors varied widely from 1.7% to 40.9% and was related to the type of nursing program, the number of clinical practicum semesters completed, ethical attitudes toward cheating behaviors, the frequency of cheating on assignments, the frequency of cheating on exams, the perceived prevalence of cheating by peers, and prior knowledge of academic integrity. According to the regression analysis, the last four variables explained 29.4% of the variance in the prevalence of unethical clinical behaviors. In addition, multiple reasons and possible interventions for clinical misconduct were reported during the focus group interviews. Unlike cheating in the classroom, clinical misconduct was strongly induced by clinical nurses and poor clinical practice environments. In sum, unethical clinical behaviors were widespread among the participants and need to be corrected.

Exploring nurse preceptors’ perceptions of benefits and support of and commitment to the preceptor role in the Western Cape Province

Background: A preceptor is a specialised tutor who provides practical training to students in the practice setting. They are frequently used to orientate nursing students to prepare them for their duties as professional nurses. In the Western Cape Province professional nurses attend a training programme to prepare them for the role of preceptor. After completion of the training it is unclear how the trained nurse preceptors perceive their preparation for the role. The perceptions of preceptors may influence their commitment to their role.Objective: The purpose of this study was to explore nurse preceptors’ perceptions of benefits, support and commitment to the preceptor role. A conceptual framework guided the study which replicated previous studies that explored nurse preceptors’ perceptions.Method: A quantitative approach utilising a descriptive correlational design was used in this study to address the research questions. A convenience sample was drawn from preceptors (n = 60) who had completed a preceptor training programme at the University of the Western Cape. Instrumentation for the study included the following scales: preceptors’ perceptions of benefits and rewards, preceptors’ perceptions of support, and commitment to the preceptor role. Data analysis was performed using SPSS 20.0.Results: The findings indicate that nurse preceptors were committed to their role.Conclusion: The findings of this study are supported by Kanter’s model of structural determinants of behaviour in organisations, since preceptors who see themselves as having access to opportunity and support are likely to be committed to their role.

Evaluating the preceptor role for pre-registration nursing and midwifery student clinical education

AIM

The aim of this research is to evaluate the perceptions of the Registered Nurse (RN), Registered Midwife (RM) and Enrolled Nurse (EN) about their experience of preceptoring an undergraduate student within a large Local Health District in New South Wales (NSW) Australia.

BACKGROUND

In the current Health Workforce Australia (HWA) literature, the term 'Clinical Supervisor' has subsumed the role of mentor, preceptor, buddy and facilitator of clinical practice. Preceptor in this paper describes the supervisory, facilitating and teaching role of the registered nurse in the clinical practice undergraduate nursing and midwifery educational pairing.

DESIGN

A quantitative cross sectional design was used and data collected using the Clinical Preceptor Experience Evaluation Tool (CPEET), a previously validated and reliable survey tool.

METHOD

Nurses and Midwives across nine acute care facilities that preceptor undergraduate students were invited to complete the survey between March and May 2012.

RESULTS

There were 337 survey respondents across nine acute hospitals included in this study (22.5% response rate). Differences were observed between preceptors who had training in precepting in three of the subscales. Differences were observed in all four subscales between those preceptors with access to university facilitators in their location and those without immediate access.

CONCLUSION

The majority of preceptors score highly on all subscales indicating they are generally satisfied with the role of precepting. Significant differences on several items suggest that some aspects of the role are more challenging and less satisfying than others.

Intergenerational conflict in nursing preceptorship

BACKGROUND

Within the preceptorship model of clinical teaching/learning, the creation of a cohesive relationship between a preceptor and a nursing student highly influences the overall success of the experience. Invariably, preceptors and students tend to be of different generations and as such, there exists within this context the potential for generational misunderstandings and conflict.

DESIGN

A phenomenological study guided by van Manen's approach to human science research was conducted.

OBJECTIVE

The aim of this study is to explore the phenomenon of preceptorship in the intergenerational context.

PARTICIPANTS

A purposive sample of seven preceptors and seven nursing students was recruited from an undergraduate nursing program.

FINDINGS

The collective experience of all participants was illuminated through three key themes: being affirmed, being challenged, and being on a pedagogical journey. In this article we focus on encountering conflict, a key subtheme of being challenged, and one that emerged from the participants' narratives.

CONCLUSIONS

The study findings suggest that interpersonal conflict continues to be a reality in our profession, owing to which a collective effort must be made by nurse educators, practicing nurses, and nursing students to effect change and create a more cohesive culture. The findings have the potential to enhance generational understanding and foster a more cohesive culture in clinical practice settings.

The effect of preceptor behavior on the critical thinking skills of new graduate nurses in the intensive care unit

Little research has been conducted to examine the effect of preceptor behaviors on the critical thinking of new graduate nurses in the intensive care unit (ICU). This study explored the perceptions of new graduates on the effect of preceptor behaviors and strategies on the development of their critical thinking skills, using a qualitative exploratory descriptive design. Data were collected with demographic surveys and semistructured interviews. Data were analyzed with a qualitative content analysis approach. The study showed that relationships between new graduates and their preceptors played a key role in the development of critical thinking skills in new graduate nurses, and specific practical implications were suggested. The study data are useful for critical care nurses, preceptors, nurse educators, and clinical nurse specialists. The findings contribute to efforts to enhance the preceptor-preceptee relationship and develop critical thinking skills in new graduates.

Clinical nurses' perceptions and expectations of the role of doctorally-prepared nurses: a qualitative study in Iran

Nurses with doctorates are increasing in number throughout the world, yet the multitude of roles they play following graduation is unclear. The purpose of this study was to explore and describe clinical nurses' perceptions and expectations of the role of doctorally-prepared nurses in Iran. A qualitative study, using a content analysis approach was conducted with 43 clinical nurses chosen using a purposive sampling strategy. Oral, semi-structured and written interviews were used to generate data. During data analysis, three main themes emerged; "advantages of the doctoral degree", "clarification of doctorally-prepared nurses' role in clinical practice", and "unmet expectations of doctorally-prepared nurses". An understanding of the expectations of nurses on the role of doctorally-prepared nurses is needed to improve the collaboration between clinical nurses and doctorally-prepared nurses; remove misunderstandings on the abilities and skills of doctorally-prepared nurses; incorporate the expectations into doctoral education in order to facilitate their collaboration; and also remove the theory and practice gap through the utilisation of doctorally-prepared nurses' knowledge and skills in practice.

Using incentives to attract nurses to remote areas of Tanzania: a contingent valuation study

This article analyses (1) how financial incentives (salary top-ups) and non-financial incentives (housing and education) affect nurses' willingness to work in remote areas of Tanzania and (2) how the magnitude of the incentives needed to attract health workers varies with the nurses' geographic origin and their intrinsic motivation. A contingent valuation method was used to elicit the location preferences of 362 nursing students. Without any interventions, 19% of the nurses were willing to work in remote places. With the provision of free housing, this share increased by 15 percentage points. Better education opportunities increased the share by 28 percentage points from the baseline. For a salary top-up to have the same effect as provision of free housing, the top-up needs to be between 80 and 100% of the base salary. Similarly, for salary top-ups to have the same effect as provision of better education opportunities, the top-up should be between 120 and 140%. Our study confirms results from previous research, that those with a strong intrinsic motivation to provide health care are more motivated to work in a remote location. A more surprising finding is that students of older age are more prepared to take a job in remote areas. Several studies have found that individuals who grew up in a remote area are more willing to work in such locations. A novel finding of our analysis is that only nursing students with a 'very' remote origin (i.e. those who grew up farther from a district centre than the suggested remote working place) express a higher willingness to take the remote job. Although we do control for nursing school effects, our results could be biased due to omitted variables capturing individual characteristics.

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

BACKGROUND

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

METHOD

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

RESULTS

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

CONCLUSION

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

Preceptorship and affirmation in the intergenerational world of nursing practice

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

Nurse preceptors' views of precepting undergraduate nursing students

The nurse preceptor is an essential bridge between the classroom and the real world of human patients and clinical settings. The 26 experienced nurse preceptors who participated in this qualitative study shared stories and important perspectives on the nurse preceptor role in pre-licensure nursing education. Three consistent themes emerged: being engaged in the educational process, acknowledge my efforts, and it depends on the student. These findings have implications for schools of nursing and faculty working with undergraduate students in the clinical setting.

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.

Developing and validating a job description for internship preceptors

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