Teaching the Teacher: Implementing a Tool kit to Standardize Effective Preceptorship of Prelicensure Nursing Students

BACKGROUND

Faculty can support successful preceptor-led clinical experiences by providing registered nurses with educational resources to guide them in the preceptor role.

PURPOSE

To upgrade our institution's educational resources using an online platform that enables just-in-time access.

METHOD

This was a quality improvement project to create and implement an educational resource tool kit for prelicensure nursing preceptors.

RESULTS

Half of our preceptors (n = 46, 52%) had no formal preceptor education. The preceptors used all the resources and were satisfied with the tool kit's content and ease of use.

CONCLUSION

Implementing the tool kit was feasible. Further development includes ( a ) adding content regarding diverse students and trauma-informed nursing care, ( b ) incorporating interactive educational materials, ( c ) exploring avenues to reduce cognitive load, ( d ) creating a prelicensure preceptor preparation course, and ( e ) considering avenues for providing open access for nursing faculty of prelicensure programs.

A qualitative analysis investigating competence assessment of undergraduate nursing students

BACKGROUND

This study reports on the process of competence assessment in undergraduate nursing programmes in New Zealand.

AIM

To identify current competence assessment practice and determine how competence assessment is constructed in order to reflect student development.

DESIGN

This research utilised a qualitative exploratory-descriptive design.

PARTICIPANTS

Nurse educators from nine tertiary institutions opted to participate in the research.

METHODS

Semi-structured interviews were conducted and data were analysed using a thematic analysis approach.

RESULTS

Three themes are reported in this article; clinical assessment pedagogy, measure of competence, and relational assessment practice. There was significant variation between and within institutions in conducting competence assessment while scaffolding competence assessment throughout the degree programme was highlighted as a challenge.

CONCLUSIONS

This study highlights the need for an assessment process that allows for the developing competence of nursing students and competencies that are designed to adequately assess students in each year of the nursing programme.

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.

A Multimodal Project to Assess Preceptor Burnout: Implications for Professional Development Practitioners

This article describes the assessment of contributing factors to preceptor burnout and strategies to address them. A review of the literature, surveys, and focus groups were conducted, and no single solution to address burnout was found. Findings did not show significant differences related to the number of preceptors, the experience of preceptors, or the experience of new hires. Preceptors expressed the need for ongoing professional development, formalized feedback, resource materials, operational policies, and meaningful recognition.

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

Background

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

Methods

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

Results

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

Conclusion

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

Evidence-based practices in developing and maintaining clinical nurse preceptors: An integrative review

OBJECTIVES

This integrative review of literature explores the best practice for establishing and maintaining a hospital-based nurse preceptor program. The intent is to provide nurse leadership and educators with guidance for optimizing preceptor programs in order to improve patient, staff, and organizational outcomes.

DESIGN

The project team conducted an integrative review of literature to inform best practice using the Johns Hopkins Evidence-Based Practice Model and Guidelines.

DATA SOURCES

Data sources included the PubMed, CINAHL, and Cochrane databases.

REVIEW METHODS

Each applicable article underwent a rigorous review and appraisal by the project team. The team used the Johns Hopkins Evidence-Based Practice Model to guide the appraisal process and to synthesize results to generate a comprehensive list of recommendations.

RESULTS

The search yielded 115 unique articles that answered the evidence-based practice question. What are best practices for establishing and maintaining a hospital-based nursing preceptor program? Due to the abundance of data, the practice question was divided into three separate sub questions that explored preceptor development, continuous preceptor support, and essential competencies of preceptors. Relevant evidence included one level I article, seven level II articles, and one level IV article. Most of the evidence was found in articles ranking as level III (n = 54) and level V (n = 52).

CONCLUSIONS

Many preceptorship themes and recommendations resonate throughout multiple levels of evidence. Recommendations include implementing an evidence-based, standardized curriculum that features diverse teaching modalities, critical thinking, and clinical reasoning. Common themes in the literature echo that preceptors need ongoing education, training, and support to improve nursing satisfaction, retention, and the quality of nursing care.

Exploring core competencies of clinical nurse preceptors: A nominal group technique study

AIM

The aim of this study was to explore core competencies of nurse preceptors based on the perspectives of postgraduate-year nurses, nurse preceptors and head nurses.

BACKGROUND

Perspectives of core competencies of nurse preceptors are varied among postgraduate-year nurses, nurse preceptors and head nurses, which makes it difficult to establish preceptor training programs and develop evaluation instruments.

DESIGN

A nominal group technique study.

METHODS

A nominal group technique procedure was applied to small-group and large-group discussion. The participants were recruited from the inpatient units at five nonprofit hospitals, each having over 1000 patient beds, in Taiwan. A total of 101 participants were involved in this study: 32 postgraduate-year nurses, 42 nurse preceptors and 27 head nurses, who were respectively sorted into five, six and four small groups with six to eight members in each group. After applying nominal group technique procedure, the core competencies were scored and ranked. Based on the final scores and ranking, the core competencies that the participants felt to be most important for nurse preceptors were identified. The expert panel then integrated these core competencies and derived a consensus.

RESULTS

Seven core competencies of nurse preceptors were derived, in order of declining importance: teaching traits, clinical nursing profession, communication and collaboration, teaching pedagogy, reaction of contingency, critical thinking and reflection and consultation on academic writing. All participants perceived that teaching traits (198 points) and clinical nursing profession (161 points) were the most important. Consultation of academic writing is unique, which may be due to the clinical ladder system still being implemented in Taiwan.

CONCLUSIONS

The nominal group technique is an efficient and proper method to conduct a consensus for specific issues or values among individuals and groups. The results of this study can facilitate the development of evaluation indicators or instruments as well as provide a direction of continuing education program for preceptor training.

Factors that influence the preceptor role: a comparative study of Saudi and expatriate nurses

OBJECTIVES

The aim of this study was to compare expatriate and Saudi nursing staff's perceptions of factors that influence their role as preceptors of nursing students.

METHODS

Descriptive comparative study using a self-administered survey was completed by a convenience sample of eligible nurses (n=285). It was conducted in five different hospitals within the Ministry of Health in the Kingdom of Saudi Arabia.

RESULTS

Most preceptors were expatriate nurses (70.5%), while Saudi preceptors represented only 29.5%. The findings show that there is a difference between Saudi and expatriate nurses in their perception of the role, that cultural factors influence the role of expatriate preceptors and that organisational factors influence both groups.

CONCLUSIONS

Expatriate preceptors felt that there were cultural obstacles that hindered their role. These findings will contribute to the development of a more contemporary and culturally sensitive preceptorship model.

A nationwide survey of the perception of the APPE by community pharmacy preceptors in South Korea

BACKGROUND

Considering that approximately 75% of active pharmacists work in a community pharmacy globally, experiential practice in community pharmacies is a crucial part of pharmacy education. Skilled preceptors and their perceptions are integral to experiential practice. However, the perception of community pharmacy preceptors on a nationwide level is rarely studied.

OBJECTIVES

To examine the perception of community pharmacy preceptors who had undertaken the newly implemented community pharmacy experiential practice in South Korea.

METHODS

This study was based on a self-administered, nationwide, online cross-sectional survey performed by the Korean Pharmaceutical Association in 2017. Active community pharmacy preceptors undertaking experiential practice in South Korea were enrolled. The preceptor's competence, satisfaction, stress, achievement, and the likelihood of continuing preceptorship were evaluated using a 4-point Likert scale. In addition, the determinants of perception were evaluated using multivariate logistic regression analysis.

RESULTS

Of the 681 active preceptors, 390 (response rate: 57.3%) participated in this study, and the data of 385 participants were used for the final analysis. The majority of the preceptors were satisfied (83.1%), felt high achievement (85.8%), and were likely to continue with the preceptorship (85.7%). However, 52.8% reported increased stress due to the increased workload and lack of personal time. Preceptors who participated voluntarily had higher competence (odds ratio [OR] 2.050, 1.265-3.322) and exhibited lower stress (OR 0.560, 0.368-0.852). The academic degrees of preceptors and the number of preceptees trained by them were significantly related to competence. Preceptor age (>50 years) was negatively associated with stress (OR 0.635, 0.419-0.962).

CONCLUSION

Because competence is a key element associated with community pharmacy preceptors, it is necessary to create an environment in which preceptors can consider themselves competent. This nationwide study with community pharmacy preceptors will provide a basis for improving the quality of training at community pharmacies and may aid experiential practice administrators in revising the current program.

Preceptor Practice: Initial Results of a National Association for Nursing Professional Development Study

In 2020, the Association for Nursing Professional Development commissioned a national preceptor practice analysis study using the Ulrich Precepting Model to identify the roles, knowledge, and activities essential to preceptor practice. In a survey of 3,623 preceptors, the model's seven preceptor roles and their associated domains of knowledge and practice were validated. Findings indicate that nursing professional development practitioners should provide preceptors with initial role preparation in addition to ongoing education.

Improving Nurse Preceptor Competence With Clinical Teaching on a Dedicated Education Unit

BACKGROUND

Nurse preceptors have varying backgrounds of teaching experience and often cite insufficient preparation as a common reason for difficulties transitioning from the role of clinician to educator. This project evaluated an online education program for nurse preceptors of prelicensure students.

METHOD

Nurse preceptors received online instruction and howto examples in the form of clinical teaching vignettes to improve the teaching component of their role. Pre- and postsurveys were used to help determine program effectiveness.

RESULTS

After the training, nurse preceptors indicated they felt more competent when teaching students, and likewise, students reported increased satisfaction with the quality of teaching.

CONCLUSION

There are numerous roles assumed by nurse preceptors. Although many nurse preceptors are expert clinicians, they may lack expertise in the teaching role. Preceptor preparation programs that provide practical examples through the use of vignettes can contribute to the development of teaching competencies. [J Contin Educ Nurs. 2021;52(5):226-231.].

Experience of burnout among pediatric inpatient nurse preceptors

BACKGROUND

There is a paucity of research describing burnout among nurses who work in the role of a preceptor, in the inpatient setting. In 2017, precepting nurses at an academic children's hospital were surveyed using the Oldenburg Burnout Inventory (OBI). Results of the survey inspired leadership to further explore this phenomenon using key informant interviews.

METHODS

Prospective qualitative description with individual interviews analyzed using conventional content analysis.

RESULTS

In regard to burnout, five themes illustrated the experiences of precepting nurses. "Feeling the Responsibility" reflected the cognitive stain of precepting. "An Obligation to the Role," reflected the dimensions of the OBI that addressed distancing and decreased interest in the work. However, preceptors described positive experiences "It Challenges Me Every Day," awareness of resources "Nursing Response," and insights for improving the preceptor program, "Future Strategies."

CONCLUSIONS

While elements of the OBI were salient in the data, three inductive themes highlighted the balance of positive challenges and learning opportunities that inspire preceptors.

Factors associated with teaching efficacy among nurse educators in hospital settings

AIMS AND OBJECTIVES

The objective of this study was to examine differences in personal characteristics, core practice competency and role stress according to levels of teaching efficacy among clinical nurse educators working in general hospitals.

BACKGROUND

In the clinical setting, successful adaptation to instruction among practicing clinical nurse educators is challenging.

DESIGN

Secondary analysis of data through a cross-sectional study design was adopted.

METHODS

Originally, 565 nurses were recruited from general hospitals; 364 were included in this study. Participants were nurses with more than 1 year of experience in various settings from 16 general hospitals wherein nursing students trained for clinical practicum in five cities in South Korea. Self-reported data were collected via the Teaching Efficacy, Core Practice Competency and Perceived Stress Scales assessing clinical education-related teaching efficacy, core practice competency and role stress. In the analyses, comparison between nurses with high and low teaching efficacy was conducted. We have followed through the EQUATOR (e.g. STROBE) research checklist for the preparation of this manuscript.

RESULTS

According to univariate analysis, levels of teaching efficacy were shown to be higher with age, longer clinical careers, in those undergoing a doctoral course or with a doctorate, previous experience in providing clinical education and enrolment in continuing education for clinical education. In the multivariate analysis, enrolment in continuing education for clinical education, assessment and intervention skills, critical thinking skills, teaching skills and role ambiguity were associated with level of teaching efficacy among nurse educators.

CONCLUSION

Based on the results of this study, we recommend that nursing administrators should foster the recognition of personal characteristics in potential clinical nurse educators or preceptors with high teaching efficacy.

RELEVANCE TO CLINICAL PRACTICE

Nurses should be supported by providing them with opportunities for professional development to enhance teaching efficacy.

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.].

Should we use preceptorships in undergraduate nursing education?

BACKGROUND

Clinical learning experiences are the cornerstone of undergraduate nursing education as they allow students to apply theory to practice and help them develop as competent practitioners who are prepared for the realities of diverse, complex, and ever-changing practice environments.

PROBLEM

The traditional clinical teaching model, where small groups of students work with educators who are on-site facilitating learning, has numerous issues and thus there have been calls for reform. This Creative Controversy focuses on one reform option, the alternative clinical teaching model of preceptorships, which has gained popularity in recent years.

APPROACH

Current evidence surrounding preceptorships in undergraduate education was examined and critiqued.

CONCLUSION

Despite their popularity, there is a lack of robust evidence surrounding preceptorships and the motivations for using this model remain questionable. Future study is needed so preceptorships are implemented according to evidence-based teaching practices and not clouded by inappropriate motivations. The author challenges readers to question their practices and work to positively contribute to the science and practice of nursing education.

Measuring and assessing the competencies of preceptors in health professions: a systematic scoping review

BACKGROUND

In healthcare, preceptors act as a role model and supervisor, thereby facilitating the socialisation and development of the preceptee into a professional fit to practice. To ensure a consistent approach to every preceptorship experience, preceptor competencies should be measured or assessed to ensure that the desired outcomes are achieved. Defining these would ensure quality management and could inform development of an preceptor competency framework. This review aimed to evaluate the evidence for preceptor competencies and assessment in health professions.

METHODS

This study followed the PRISMA ScR scoping review guidelines. A database search was conducted in Embase, Medline, CINAHL and IPA in 2019. Articles were included if they defined criteria for competency, measured or assessed competency, or described performance indicators of preceptors. A modified GRADE CERQual approach and CASP quality assessment were used to appraise identified competencies, performance indicators and confidence in evidence.

RESULTS

Forty one studies identified 17 evidence-based competencies, of which 11 had an associated performance indicator. The competency of preceptors was most commonly measured using a preceptee completed survey (moderate to high confidence as per CERQual), followed by preceptor self-assessment, and peer-assessment. Preceptee outcomes as a measure of preceptor performance had good but limited evidence.

CONCLUSIONS

Competencies with defined performance indicators allow for effective measurement and may be modifiable with training. To measure preceptor competency, the preceptor perspective, as well as peer and preceptee assessment is recommended. These findings can provide the basis for a common preceptor competency framework in health professions.

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.

Preceptors´ experiences of student supervision in the emergency medical services: A qualitative interview study

BACKGROUND

Clinical placements play a central part in the education of future emergency medical services (EMS) staff and their development of clinical skills and competence. A key aspect of students' integration of theory and praxis and development into an independent clinician is a supportive mentorship with the preceptor. However, students report barriers for learning within the EMS, while the preceptors' experiences of their role have received scant attention in research.

OBJECTIVES

To describe preceptors' experiences of student supervision in the EMS during clinical placements.

DESIGN

A descriptive qualitative design was used. Twenty specialist nurses were recruited among EMS staff from all parts of Sweden.

METHODS

Data were collected using individual interviews and analyzed with latent qualitative content analysis.

FINDINGS

EMS preceptors develop a competence in combining caring and learning adapted to individual student needs when facing students with varying needs in an ever-changing healthcare setting. A trustful relationship between student and preceptor is fundamental when coping with a dual responsibility for student and patient needs. However, several aspects in the EMS setting hinders the preceptors' ability to support the development of the students' independence. Surrounding support structures are important if the preceptors are to feel safe and secure in their role as assessor, teacher and ambulance nurse.

CONCLUSIONS

Preceptors need to develop a didactic flexibility through preceptor courses adapted to the complex premises found in the EMS. Ambulance services and universities should recognize the importance of preceptors´ colleagues, student continuity, university support and cooperation for improving quality and clarity in supervision during clinical placements.

Quantitative Analyses of the Effectiveness of a Newly Designed Preceptor Workshop

Educational preparation for nurse preceptors helps reduce anxiety and stress in precepting. A quality improvement project was initiated in a large U.S. West Coast federal healthcare system to evaluate an existing training program for preceptors. A new 2-day preceptor workshop was subsequently created to address identified gaps. Results demonstrated statistically significant gains in preceptors' essential knowledge and skills required in precepting, and room for improvement in faculty teaching techniques and course materials.