Exploring the Desirable Attributes and Competencies of Pharmacy Clinical Preceptors: A Scoping Review

BACKGROUND

Experiential learning is a vital component of health-professional education. It provides students with the opportunity to apply their knowledge in real-life settings before becoming licensed practitioners. Preceptors (i.e., practice educators) play a crucial role in developing students' professional skills and competencies, as well as shaping their attitude during their clinical training. Ensuring preceptors' quality and preparedness is a key aspect in students' experiential learning due to the important impact of the provided training on the quality of the students' learning experience. There is a knowledge gap about the desired attributes of pharmacy preceptors in the Gulf region, specifically Qatar, highlighting the need to explore preceptors' views on this topic.

PURPOSE

The aim of this scoping review is to identify the available tools in the literature to explore the desirable attributes of pharmacy preceptors as clinical educators. The objectives are to explore the reported desirable attributes of clinical preceptors in the published literature and select and utilize an appropriate tool to identify the desirable attributes of pharmacy preceptors in Qatar.

METHODS

The scoping review was designed to identify the relevant original research articles, which were published in English language, utilizing CINAHL, ERIC, ProQuest, and PubMed databases. Key concepts were preceptorship, attributes, pharmacy, and tools. Quantitative and mixed-methods study designs were included. The included articles were summarized according to their design, setting, population, and outcomes. The validity of the used instruments in these studies was reported.

RESULTS

A total of six articles qualified for inclusion into the full screening and were used to inform the results of this review. Skills like being a role model, assessment, and feedback expertise were of the highly important attributes to different populations (i.e., students, graduates, and preceptors). The review revealed the need for more validated tools in pharmacy research to increase the knowledge about the desired qualities of preceptors. Finally, a list of the most reported attributes in the literature was created after grouping all the reported attributes into five categories: (1) knowledge, teaching, and presentation skills; (2) professionalism and development skills; (3) communication skills; (4) supportive mentoring; and (5) enthusiasm and interest.

CONCLUSIONS

the top three identified attributes were related to communication, assessment and feedback, and professionalism. The results of this review demonstrated a lack of well-designed and validated tools in pharmacy research that can be used to explore the desirable attributes of pharmacy preceptors. This necessitates further research to develop and validate a new appropriate tool to ultimately understand the perceptions of pharmacy preceptors on this topic. Including more databases in the research could have enriched the findings.

Establishing the Need for Standardized Clinical Educator Training Programs for Medical Laboratory Professionals

BACKROUND

There is minimal, if any, training for clinical educators in medical laboratory professions. This leads to challenges with teaching, assessment and workload/training balance. Hence, the need for standardized clinical educator training.

METHOD

A survey was developed, validated and deployed to medical laboratory professionals. Responses were analyzed using SPSS. Responses from two open-ended questions-is clinical educators' training important and how is this training beneficial?-were analyzed using thematic analysis.

RESULTS

Most participants indicated that clinical educator training is important (99.4%). However, 72.4% received no formal training prior to training student. Themes from the importance of training include: Equip clinical educators, body of knowledge, standardize training and quality of training. Themes that emerged from the benefits of clinical educators training involve Training content, logistics, professional behavior and technical skills.

CONCLUSION

Clinical educators' training is crucial and valuable. Standardized training on pedagogy and other success strategies are warranted for successful clinical experiences.

Systematic review of tools to measure preceptors' perceptions of their role in undergraduate health clinical education

OBJECTIVE

Evaluate tools used to measure preceptors' perceptions of their role in the clinical education of health undergraduate students.

BACKGROUND

Measurement of preceptors' perceptions of their role in students' learning in practice lacks consistency. The preceptor role makes an important contribution to quality clinical education.

DESIGN

A systematic literature review informed by PRISMA Guidelines.

DATA SOURCES

Major databases CINAHL, ProQuest, Nursing and Allied Health, Medline, Health Reference Centre, Joanna Briggs Institute, PsychInfo and Google Scholar were searched.

REVIEW METHODS

The search strategy yielded a total of 166 papers. Screening for inclusion resulted in 28 papers for critical appraisal and review.

RESULTS

Twenty-two individual tools were identified. Fourteen were named. Nine tools were new, study-specific and untitled. Eight tools were informed by previous research. A third of studies were appraised as being of good quality. A lack of consistency in measures, use of small convenience samples and reliance on self-reported outcomes limited the generalisability of findings.

CONCLUSIONS

Two tools were suitable measures of preceptors' perceptions of their role or an appropriate measure for preceptor effectiveness in students' learning in practice. These tools were tested on the nursing profession only. Ensuring quality in clinical education requires consideration of experiences of key stakeholders and standard measurement of perspectives, effectiveness and preparedness to achieve quality clinical learning outcomes for students.

Preceptor Criteria Revisited

BACKGROUND

Preceptor selection criteria based on demographic data has been shown to yield inconsistent degrees of success in the role. The purpose of this mixed-methods study was to determine if preceptors with different levels of innovativeness identified different benefits and challenges when implementing the preceptor role.

METHOD

A mixed-methods study was conducted using online surveys to determine each participants' individual level of innovativeness. Interviews were conducted with preceptors from each innovator category to identify benefits and challenges in implementing the preceptor role.

RESULTS

Preceptors who scored lower in innovativeness identified challenges that were not discussed by preceptors who scored higher in innovativeness. Conversely, preceptors who scored higher in innovativeness identified benefits that were not common to preceptors with lower levels of innovativeness.

CONCLUSION

Opportunities for nurse educators and facility nurse leaders were presented to meet the diverse needs of the preceptor and provide for more consistent implementation of the preceptor role. [J Contin Educ Nurs. 2020;51(9):425-432.].

Changing preceptorship to achieve better quality training and less attrition in newly qualified nurses

The preceptorship period is of great importance in the career of a nurse, as he or she moves from being a student to a competent, accountable professional. Problems with the current preceptorship system for preceptors include not receiving adequate training—particularly in providing constructive feedback to preceptees. In addition, when a small number of nurses are repeatedly assigned preceptees to mentor, this can lead to burnout. Preceptees can feel overwhelmed by their first months as a newly qualified nurse (NQN) and can feel unsupported if a preceptor's teaching style or personality is unsuited to them. This can lead to attrition in the nursing workforce, a current problem. This article suggests a new way of organising preceptorship, by allowing preceptors to opt in to the scheme, providing a pool of energised and enthusiastic preceptors. In turn, NQNs could initially work with the pool of nurses before being given the choice of which preceptor to work with individually.

The effectiveness of partnership models in clinical nursing education - A scoping review

OBJECTIVES

To examine the effectiveness of partnership models in clinical nursing education with regards to cost effectiveness; student employability, work-readiness, confidence, and competence; and stakeholders' satisfaction.

DESIGN

Scoping review.

DATA SOURCES

Research studies published in English were searched electronically through EbscoHost (CINAHL and ERIC), Scopus, Medline (via Ovid), ProQuest Central, and Web of Science databases. Criteria were developed to guide the selection of original studies published in English before 2019 for review.

REVIEW METHODS

Arksey and Malley's framework (2005) and relevant enhancements guided the conduct of the review. An informal appraisal of selected studies was applied.

RESULTS

Two theses and 31 articles with a variation in methodologies, methods, sample sizes, research populations and quality of evidence were included for review. Four themes were identified: (i) Description of partnership models in clinical education, (ii) length of model implementation prior to evaluation, (iii) positive qualitative findings, and (iv) quantitative findings limited by data collection periods and methods.

CONCLUSIONS

Shared among the reviewed studies is stakeholder view of the positive impacts of partnership models on the clinical learning environment, and the increased level of support and individualised instruction for students. However, the use of not fully validated survey instruments and the lack of description about the implementation period before evaluation in many reviewed studies limit the interpretation of quantifiable effect of the partnership models. This review identifies a lack of attention on student employability, work-readiness, cost evaluation, patient perspective, and partnership models in low-income countries. Future research to address these knowledge gaps using high quality data collection methods and rigorous research design is warranted.

Becoming a nurse preceptor, the challenges and rewards of novice registered nurses in high acuity hospital environments

Precepting is a common and expected role of nurses in clinical settings worldwide. This research explored novice nurse's experiences of precepting undergraduate nursing students in high-acuity hospital environments. An interpretive study was undertaken with 12 novice nurses (<3-years of post-registration clinical experience), who were precepting nursing students. Data was collected through focus groups and thematically analysed. The zone of proximal development theory was applied to understand the relationship of learning that occurs between students and nurses. Three themes were identified. Firstly, participants established that precepting students enhanced their own self-development, and was a rewarding role, that not only developed the student into a nurse, but provided opportunities for the novice nurse to learn. Second, precepting was both challenging and rewarding. The challenges involved the student, the context, and the preceptors' own teaching and learning skills, resulting in feelings of frustration and conflict between nursing care and preceptor roles. Third, precepting was an expectation of both the nursing role and from senior nurses. At times, the participants felt overwhelmed and drained, particularly when having students that challenged them on multiple consecutive shifts. Participants identified the need for guidance and support from more capable peers to develop confidence while precepting nursing students.

Validation of Mentors' Behavior Scale among mentors

BACKGROUND

The Mentors' Behavior Scale was developed and validated initially among nursing students by assessing the importance of mentors' behavior, showing satisfactory psychometrics and the potential to match mentors with students according to students' expectation.

OBJECTIVES

This study aims to test the discriminant validity and the structure of the Mentor's Behavior Scale among mentors to assess mentors' performance.

DESIGN

A cross-sectional survey was applied in the study.

SETTING

Data were collected from mentors in seven hospitals in north, south, southwest China in 2016 and 2017.

PARTICIPANT

871 mentors participated in this study.

METHODS

Purposeful sampling and online survey was used.

RESULTS

Three factors (to guide personal growth, promote professional development, and provide psychosocial support) were identified by exploratory factor analysis. The cumulative contribution of variance was 61.03%. The Cronbach's alpha coefficient of the scale was 0.85, and those of the three subscale's were 0.84, 0.72, and 0.74. The results of discriminant validity showed that mentors who received training and who liked mentoring students scored higher in mentoring behavior.

CONCLUSION

Mentors considered that mentoring behavior were to guide students' personal growth, promote professional development and provide them with psychosocial support. It will be useful to apply The Mentors' Behavior Scale among mentors to guide and evaluate their behaviors.

Preceptor Knowledge on Preceptorship in an Academic Hospital in Kenya

BACKGROUND

Clinical preceptorship is critical for the acquisition of knowledge, skills, and attitudes in nursing care. Cardinal to the development of these competences is the preceptor's knowledge on preceptorship. In low-income countries, the responsibility of preceptorship rests with staff nurses whose knowledge on preceptorship is largely unknown.

METHOD

A survey was conducted among 254 nurses using a 3-point Likert scale questionnaire. Mean scale scores were computed for knowledge score. Association between training on preceptorship and level of knowledge was explored using chi square.

RESULTS

The mean knowledge score was 1.71 (SD ± 0.41). Few had undergone training on preceptorship; knowledge on preceptorship had been acquired experientially or through role modeling. More nurses who had undergone training agreed that preceptor-trainee roles should be clearly defined at the beginning of clinical placement, χ²(1) = 15.54, p = .016.

CONCLUSION

Although nurses were knowledgeable about preceptorship, few had been trained. A formal training program on preceptorship is warranted. J Contin Educ Nurs. 2017;48(11):496-500.

National preceptor development program (PDP): Influential evidence and theory. The first of a 3-part series

INTRODUCTION

Priority #3 of the Canadian Experiential Education Project for Pharmacy provided evidence-based guidance for the design and implementation of a national approach to preceptor development. In this first article (of three), findings from the project and recommendations to achieve a high-quality preceptor development program (PDP) are presented.

METHODS

A multi-method approach including detailed semi-structured interviews, classic literature review, and advisory committee feedback was employed. The research team performed an integrated analysis of all data to achieve the objectives of Priority #3.

RESULTS

Fifteen formal interviews, 167 articles and two stakeholder meetings informed findings. Experiential Education programs exhibited commonality in content and usually delivered programs online using modules or live lectures. Not all programs required preceptor education despite it being mandated by academic accreditors. Academics' perceptions varied regarding pharmacists' baseline knowledge, skills and attitudes prior to engaging in the preceptor role. A national approach to a PDP was desired if jurisdictional content was accommodated. Copious interprofessional literature of generally fair quality did not identify superior preceptor development approaches although there were numerous descriptions of interventions. Only 29 articles measured educational outcomes. Outcomes included satisfaction rates, self-efficacy and perceived knowledge, skill retention, skill implementation and participation rates.

DISCUSSION AND CONCLUSIONS

Twelve recommendations were identified to guide successful development of a national PDP. In the absence of good evidence, adult educational theory provided a basis for an effective PDP. Findings from Priority #3 may be relevant not only to pharmacy in Canada but other health professions and counterparts in other western nations with similar approaches to professional education.

The impact of an online learning platform about nursing education on enrolled nurse preceptor teaching capabilities: a pre-post-test evaluation

BACKGROUND

Enrolled nurses (ENs) across Australia precept nursing students in the clinical field. Yet learning about the preceptoring role is not widely available to ENs. Educational innovation: EN's in this study participated in a professional development project that utilised the material of an online learning resource, originally designed to inspire clinical registered nurses (RNs), and RN teachers, to develop teaching innovations in their role.

AIM

The aim of this paper is to report the results of a pre-post-test questionnaire designed to evaluate the impact of the professional development intervention.

RESULTS

The analysis showed high scoring means with many items in the questionnaire statistically significant (p < .05, CI 95%).

CONCLUSION

Results indicated positive differences in a number of teaching capabilities between pre- and post-test scores. This suggests ENs appreciate education that extends beyond clinical skills and that professional development should include the nursing education role.

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.

What Influences Home Care Nurses to Accept or Reject Precepting Opportunities? A Pilot Study

Nurse managers and nursing faculty report, anecdotally, on their difficulty identifying nurses willing to precept new staff or students. To understand more about this topic, we queried home care nurses at a small agency on their perceived incentives and barriers to precepting, their preceptor status, generation of birth, and birth order. The purpose of this pilot study was to identify home care nurses' perceived incentives and barriers to becoming a preceptor. We also sought to examine possible relationships between preceptor status, generation of birth, and ordinal position of birth.

Perceptions of preceptorship in clinical practice after completion of a continuous professional development course- a qualitative study Part II

Background

For health care professionals, clinical practice is a vital part of education, and in several countries, teaching is a regulated part of the role of nurses and health care staff. The added responsibility of taking on the teaching of students during clinical practice; thus, balancing clinical and educational demands, might lead to feelings of stress and burnout. Being a skilled and experienced professional is not automatically linked to being a skilled educator as teaching of a subject is a completely different story. Preceptors who participate in educational initiatives are better prepared to address challenges and are more satisfied with the preceptor role. The aim of the current study was to evaluate preceptors’ experiences of preceptorship in clinical practice after completion of a credit bearing continuous professional development course on advanced level.

Methods

This was a small-scale interpretative qualitative study drawing data from focus group interviews and written accounts from reflective journals. Data were analysed through the process of naturalistic inquiry.

Results

Our findings show that the participants, who took part in and completed the CPD course, had developed skills and competences they believed to be necessary to drive pedagogical development at their respective workplaces. This is illustrated by the main category Leading educational development and explained by four sub-categories: 1/ increased ability to give collegial support; 2/ increased trust in one’s abilities; 3/ increased emphasis on reflection; and 4/ increased professional status.

Conclusions

A well-structured program based on the needs of preceptors and developed in partnership between educational and clinical settings seems to be successful in terms of preceptors’ perceived increase of their competence, abilities and professional status. What seems to be missing, not only from the current study but also from previous research, is to what extent properly prepared preceptors impact on student learning and this needs to be further investigated.

Perceptions and experiences of nurse preceptors regarding their training courses: a mixed method study

BACKGROUND

Although the benefits of preceptor training programs on the performance of nurse preceptors have been reported, research related to nurse preceptors' perceptions of and experiences with preceptor training courses is relatively limited.

OBJECTIVES

To explore nurse preceptors' perceptions of preceptor training courses and obtain information on their experiences in working as preceptors.

DESIGN

A mixed method design was conducted.

PARTICIPANTS AND SETTINGS

Nurse preceptors who currently work at one of eight hospitals in northern Taiwan were recruited to participate in this study.

METHODS

A questionnaire survey and focus group interviews were conducted. A training course perception scale was developed and generated based on the current nurse preceptor training programs offered in eight hospitals. Focus group interviews were conducted to obtain additional information on nurse preceptors' experiences in working as preceptors. The survey data were analyzed using descriptive statistics. Interview data were transcribed and analyzed using a qualitative content analysis approach.

RESULTS

The results from the surveys of 386 nurse preceptors revealed that most courses included in the current preceptor training programs did not fulfill the learning needs of nurse preceptors and were clinically impractical. The most necessary and clinically useful course was the communication skills course, whereas the least useful course was the adult learning theory and principles course. Three themes were identified as problems based on the three focus group interviews conducted with 36 nurse preceptors: inadequate training was received before nurses were appointed as nurse preceptors, the courses were more theoretical rather than practical, and the preceptors experienced stress from multiple sources.

CONCLUSIONS

The results revealed that the current preceptor training courses are impractical; therefore, the content of preceptor training courses must be altered to fulfill nurse preceptors' training needs. Furthermore, problems identified through the focus group interviews reinforce the survey results.

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.

Empowering nursing preceptors to mentoring undergraduate senior students in acute care settings

Nurse preceptors play an important role in the transition of nursing students from classroom to clinical practice not only in the United States but also internationally. However, many preceptors feel a lack of confidence in their role as mentors to nursing students rather than experienced nurses because of inadequate preparation or formal training. A study looking at the educational needs of nurse preceptors would be invaluable to academic educators because they choose strategies and develop content for a handbook to serve as a quick reference. Thus, the mentorship experience for preceptors would be enhanced by incorporating the needs and preferences of the preceptors into their training and resource materials. The purposes of this study were to identify the needs of the nurses who precept students rather than nurses who mentor other nurses and to evaluate if the current handbook was a useful reference for preceptors during a practicum in acute care settings.

METHOD

A multiprocedural mixed method study was used. Data were collected through a questionnaire that was adapted with the permission of the author. Descriptive statistics and a chi-square test were used to compare differences in the means. The preceptorship handbook helped preceptors mentor undergraduate senior nursing students. In addition, the currently developed preceptorship handbook was recognized as a useful reference in mentoring nursing students by 100% of the participants.

Development and reliability testing of the quality clinical placement evaluation tool

AIMS AND OBJECTIVES

To develop and test the content and face validity, and reliability of the quality clinical placement evaluation tool.

BACKGROUND

The importance of clinical experience during undergraduate nursing degrees is undisputed. To date, tools available to measure quality of clinical placements have focused on single perspectives, that of the undergraduate or that of the supervising nurse. The quality clinical placement evaluation tool was proposed to provide an assessment of clinical placement experiences informed by supervising ward nurses and undergraduate stakeholders.

DESIGN

The study employed a cross-sectional design.

METHODS

The internal validity of an existing instrument was evaluated by an expert panel and modified for use in the acute care sector. Surveys were completed by undergraduate students (n = 48) and supervising ward nurses (n = 47). Factor analysis was used to identify themes drawn from the literature and explore redundancy of items. Reliability was assessed using Cronbach's alpha for internal consistency and test-retest (five to seven days apart).

RESULTS

Reliability testing showed good internal consistency for the tool; test-retest reliability testing results were moderate to good for students and fair to moderate for nurses. Factor analysis identified three core themes related to supervising ward nurse responses that could also be applied to undergraduate nurses. The domains identified were the following: welcome and belonging; support to meet learning needs; and confidence and competence: reflections on learning.

CONCLUSIONS

The quality clinical placement evaluation has shown statistically acceptable levels of reliability and validity for measuring the quality of clinical placement from perspectives of undergraduates and supervising ward nurses.

RELEVANCE TO CLINICAL PRACTICE

The tool provides tertiary institutions, acute care facilities, wards and individuals with the means to capture views of the quality of clinical placement which can also be used to undertake comparisons over time and between sites.

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.

A critique of the undergraduate nursing preceptorship model

The preceptorship model is a cornerstone of clinical undergraduate nursing education in Canadian nursing programs. Their extensive use means that nursing programs depend heavily on the availability and willingness of Registered Nurses to take on the preceptor role. However, both the health service and education industries are faced with challenges that seem to undermine the effectiveness of the preceptorship clinical model. Indeed, the unstable nature of the clinical setting as a learning environment in conjunction with faculty shortages and inadequate preparation for preceptors and supervising faculty calls us to question if the preceptorship model is able to meet student learning needs and program outcomes. In a critical analysis of preceptorship, we offer a deconstruction of the model to advance clinical nursing education discourse.

Quality clinical placements for undergraduate nursing students: a cross-sectional survey of undergraduates and supervising nurses

AIM

  This article is a report of a mixed method study of the quality of clinical placements for second year undergraduate nursing students in an acute care hospital.

BACKGROUND

  In response to the current and predicted workforce shortages, greater numbers of nursing undergraduate places are being offered at tertiary institutions. This means that requests for clinical places in hospitals to support undergraduate students has risen. Little is known about the impact of increased numbers on the quality of clinical placement as a learning experience and this is of concern as demand grows and the means of assessing capacity is still unknown.

METHODS

  A 5-point Likert Scale questionnaire, including free text fields, was administered to undergraduates (n = 178), clinical facilitators (n = 22) and supervising ward nurses (n = 163) at two time points in 2009. The survey targeted the quality of the clinical placement in four domains: welcoming and belongingness; teaching and learning; feedback; confidence and competence. Findings.  The findings demonstrated consistently high scoring of the clinical placement experience by both undergraduates and registered nurses. There were higher ratings of levels of support from clinical facilitators compared to supervising ward nurses evident in data associated with the items on the questionnaire relating to teaching and learning.

CONCLUSION

  The results are indicative of the professional commitment of nursing staff to support the next generation of nurses. The findings also give a mechanism to communicate outcomes of undergraduate support to nurses in practice, and highlight steps which can be taken to ensure high quality clinical placement continues.