The role of the clinical preceptor: an integrative literature review

Experiences of preceptorship in Singapore: A qualitative exploratory study of preceptors' experience in precepting nursing students during pre-registration of clinical placement in an acute hospital

BACKGROUND

Preceptors play an important role in teaching and guiding nursing students to transit to the role of registered nurses. Nursing students are trained to acquire the skills and knowledge in providing good quality care to patients. However, the preceptors in the clinical area may face challenges in providing care to their patients in addition to their preceptor role. It is vital to explore and gain insights on the preceptorship experience to better understand their challenges and facilitate their preceptorships and the learning experience of the nursing students.

AIMS

This study explored the preceptors' experience to understand their challenges and support received in the facilitation of the preceptorship and learning experience of the nursing students in an acute care hospital in Singapore.

METHODS

Semi-structured interviews were conducted from June to October 2021 with ten registered nurses working in an acute hospital. Thematic analysis was conducted.

RESULTS

Three main themes emerged from the thematic analysis: (1) preceptor-student relationship; (2) barriers and challenges to successful preceptorship; and (3) outcomes of successful preceptorship.

CONCLUSIONS

This study provided valuable insights in the experience of the preceptors in Singapore. Recommendation for nursing management and leaders to establish support system in promoting recognition of preceptors, establish dialog sessions between stakeholders. Nursing education to provide support and to review the efficacy of the current preceptorship program to identify correlation with successful precepting experience for both preceptors and nursing students. Despite challenges faced by the preceptors, their experience had been positive and they are committed in precepting the nursing students.

The perspectives of pharmacy student preceptors on a service-learning program in primary health care: A qualitative study

Background

There are a few studies about preceptorship in primary health care settings, but they didn't assess all possible contributions of this experience, such as preceptor behavioral changes and impact on health services.

Objective

This study aimed to analyze the perspective of pharmacy student preceptors on a service-learning program carried out in a primary health care setting.

Methods

This was a qualitative descriptive study, with semi-structured interviews and thematic analysis. The themes were defined deductively, according to levels of Kirkpatrick's theory about the impact of educational activities.

Results

The preceptors showed positive and negative reactions to the structure of the service-learning program, developed their knowledge, changed behaviors such as collaborative interprofessional practice, and reported improvements in the health units.

Conclusions

From the perspective of pharmacy student preceptor preceptors, the service-learning program had an impact on all levels expected for an educational activity according to Kirkpatrick's theory: reaction, learning, behavior, and results. These findings may inform the design of service-learning programs.

The mediating effect of clinical teaching behavior on transition shock and career identity among new nurses: A cross-sectional study

BACKGROUND

New nurse attrition is a worldwide problem. Because of the gap between theory and practice in their work, new nurses may experience transition shock, which can have a negative impact on their career identity. Clinical teaching behavior is an important component in reducing the impact of new nurse transition, stabilizing the hospital nursing workforce, and cultivating high-quality nursing talents.

OBJECTIVES

Based on the New Nurse Transition Model, to explore the mediating role of clinical teaching behavior in the relationship between transition shock and career identity in the new nurse population of Gansu Province.

DESIGN

A cross-sectional study.

SETTING

Seventeen hospitals in Gansu province of China.

PARTICIPANTS

A total of 1684 new nurses (1590 female and 94 male) were recruited from seventeen hospitals in Gansu province.

METHODS

Three questionnaires include: The Clinical Teaching Behavior Inventory (CTBI-23), the Transition shock of Newly Graduated Nurses Scale (TSNGNS), and the Nurse's Career Identity Scale (NCIS). Structural equation modeling was used to deal with the relationships among clinical teaching behavior, transition shock, and career identity.

RESULTS

Transition shock was found to be negatively related to both career identity and clinical teaching behavior, with clinical teaching behavior mediates the relationship between transition shock and career identity.

CONCLUSIONS

The clinical teaching behavior of the teaching staff plays a role in mediating the relationship between new nurses' sense of career identity and transition shock. Accordingly, the teaching behavior of clinical teaching should be improved and the quality of clinical teaching behavior should be improved to increase the career identity of new nurses and reduce the turnover rate of new nurses.

Tracks to Postgraduate Rural Practice: Longitudinal Qualitative Follow-Up of Nursing Students Who Undertook a Rural Placement in Western Australia

The nursing workforce is the backbone of healthcare provision in rural and remote Australia. Introducing student nurses to rural clinical placements is one strategy used to address the shortfall of healthcare workers outside of major cities, with the goal of improving the training, recruitment and retention of nurses in rural areas. The aim of this qualitative, longitudinal study was to better understand personal and professional decision-making around rural nursing practice intentions and subsequent rural employment and retention. The study methodology consisted of repeated semi-structured interviews with student nurses who had completed at least one rural placement and following them on their journey to becoming graduate nurses over a 6-year period. Thematic longitudinal analysis was undertaken, with three main themes developing, each with further subthemes: (1) participants' satisfaction with rural placements; (2) their challenges with gaining employment; and (3) considerations regarding 'going rural' for work. The participants engaged in both prospective and retrospective reflection around several professional, personal, and wider systemic barriers and enablers to rural practice, which are discussed in detail in this paper. The insights from this longitudinal study have the potential to assist the development of a sustainable rural nursing workforce through informing rural workforce programs, strategies and policies.

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

BACKGROUND

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

AIM

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

METHODS

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

RESULTS

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

CONCLUSION

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

A scoping review of clinical skill development of preregistration registered nurses in Australia and five other English-speaking countries

AIM

The aim of this scoping review is to synthesise current evidence around the clinical skill development of preregistration registered nurses (RNs) in Australia, United Kingdom (UK), Ireland, United States (US), Canada and New Zealand, to inform nurse education, policy and clinical practice.

BACKGROUND

Nursing is a practical profession, and registered nurses require specific skills, knowledge and attributes in order to care for patients safely. The context for health care delivery is shifting, and the education of nurses must adapt to effectively equip the registered nurse of the future.

DESIGN

A scoping review was conducted of clinical skill development in preregistration nurses. CINAHL Plus, MEDLINE, Health Source (Nursing/Academic edition) and Scopus were searched. Included studies were primary Australian studies and international literature reviews, which focussed on preregistration nursing education. Papers were written in the English language and focussed on clinical skill development. Results were synthesised narratively. The review is reported here in accordance with the Preferred Reporting Items for Systematic Review and Meta-analyses Scoping Review extension (PRISMA-ScR) guidelines.

RESULTS

One hundred fifty-five Australia studies and 89 international reviews were included in the review. Six key themes were identified, namely clinical skills, approaches to teaching and learning, interprofessional education, assessment of learning, clinical placement and simulation.

CONCLUSION

There is substantial variation in strategies and programmes to facilitate clinical skill development both within Australia and internationally, indicating a genuine shift away from traditional didactic pedagogy. New graduate registered nurses were expected to be "work-ready," albeit at a novice level, when they enter the workplace. Future research should consider measures of impact on actual clinical practice and focus on developing work-ready graduates for the range of clinical settings in which they may practice. Educators, policymakers and educational institutions can use these findings to inform curriculum developments to ensure that clinical skill development is evidence-based.

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.

Caring ability of nursing students pre- and post-internship: a longitudinal study

Background

Nursing students’ internship experiences may significantly impact their caring ability. However, there is a lack of comprehensive evaluation of undergraduate nursing students' caring ability pre-and post-internship in China. This study aimed to explore the differences in the caring ability of undergraduate nursing students before and after internship.

Methods

The sample comprised 305 undergraduate nursing students who had undergone internships during 2018–2020 in three hospitals in Changsha, China. Caring Ability Inventory was used to measure and compare nursing students' caring ability before and after internship. Descriptive statistics and paired t-test were employed to analyze data in SPSS software (version 22.0).

Results

A total of 300 students completed the survey (response rate = 98.37%). The overall score of caring ability and scores of cognitive and patience dimensions were higher after internship than before internship (P < 0.05). There was no significant improvement in the courage dimension (P > 0.05).

Conclusions

Caring ability of undergraduate nursing students in China was at a low level, their overall caring ability significantly improved after the internship, indicating a positive relationship between internship and caring ability. Nursing educators and clinical nurses should emphasize the importance of caring ability development in internship planning and encourage nursing students to engage more with patients.

Supplementary information

The online version contains supplementary material available at 10.1186/s12912-022-00921-2.

A National Survey of Collaboration Between Nurse Faculty Members and Staff Nurses in the Clinical Learning Environment

AIM

The purpose of this study was to measure collaboration in the clinical learning environment.

BACKGROUND

Clinical learning, which is essential for nursing education, allows students to integrate what they have learned in the classroom in a complex social context with an interactive network of forces. Stakeholders are nursing students, nursing faculty, and staff nurses who must collaborate in providing an effective learning environment for students.

METHOD

Quantitative data were collected via the Collaboration in the Clinical Learning Environment tool, an author-developed 24-item Likert scale designed to measure the amount of collaboration between staff nurses and nursing faculty members in the clinical learning environment.

RESULTS

Three groups (n = 882) were surveyed: staff nurses, nurse faculty, and nurses who worked concurrently in academia and practice.

CONCLUSION

This study adds to the literature on collaboration between nursing faculty members and staff nurses. It also highlights areas for improvement for both parties.

Testing the measurement invariance of the Korean clinical learning environment, supervision and nurse teacher (CLES+t) scale

BACKGROUND

In 2018, the Korean version of the Clinical Learning Environment, Supervision, and Nurse Teacher scale was evaluated for validity and reliability.

OBJECTIVES

This study aimed to test the instrument's measurement invariance and to compare the latent means of groups.

DESIGN

This was a cross-sectional study.

SETTINGS

Nursing departments in four metropolitan cities and five regions of Korea. The study sample comprised 507 nursing students.

PARTICIPANTS

Bachelor's-level nursing students in their third and fourth years who have experienced clinical practicum.

METHODS

Data were collected from November 11 to December 24, 2018 using the Korean Clinical Learning Environment, Supervision, and Nurse Teacher scale. Confirmatory factor analysis and multi-group confirmatory factor analysis were conducted. Measurement invariance of the Korean Clinical Learning Environment, Supervision, and Nurse Teacher scale was tested in the following order: configural invariance, factor-loading invariance, intercept invariance, factor variance/covariance invariance, and residual invariance, by student year, hospital grade (tertiary or general hospital) and assignment of a nurse instructor (or not).

RESULTS

The measurement invariance of the Korean Clinical Learning Environment, Supervision, and Nurse Teacher scale by student year and hospital grade were confirmed by configural invariance, factor-loading invariance, intercept invariance, factor variance/covariance invariance, and residual invariance. The measurement invariance of the scale by assignment of a nurse instructor (or not) was also confirmed for configural invariance, factor-loading invariance, partial intercept invariance, partial factor variance/covariance invariance, and partial residual invariance. Comparing latent mean values, there was a statistically significant difference in the mean of the sub-dimensions of the Korean Clinical Learning Environment, Supervision, and Nurse Teacher scale by student year, hospital grade, and nurse assignment (or not).

CONCLUSIONS

The Korean Clinical Learning Environment, Supervision, and Nurse Teacher scale is an appropriate instrument for measuring the clinical learning environment regardless of student year, hospital grade, or nurse assignment.

Characteristics and processes of the dedicated education unit practice education model for undergraduate nursing students: a scoping review

OBJECTIVE

The objective was to review literature related to the dedicated education unit practice education model for undergraduate nursing students, and identify common characteristics and processes for implementing and sustaining this model.

INTRODUCTION

Although practice education is central to undergraduate nursing education, evidence-informed practices for learning in the clinical setting remain elusive. Changes to health care over the past decades related to the role and scope of practice for nurses, gradual shifts to community- and population-based care delivery, and expectations for interprofessional practice require forward-looking education models. The dedicated education unit model was developed in 1997 as a potential solution to globally recognized challenges in nursing education amidst discourses of nursing resource scarcity. Despite more than two decades of innovation and expansion, there is still limited understanding of the effectiveness of the dedicated education unit as a solution to those challenges, or for the anticipated benefits for students and patients, through enhanced evidence-informed health care. This analysis of the characteristics and processes of the model is timely for evaluating and sustaining implementation of the dedicated education unit across nursing practice and education settings.

INCLUSION CRITERIA

English-only publications related to the dedicated education unit practice education model for undergraduate nursing students in baccalaureate and associate degree programs using qualitative, quantitative, or mixed methods research, and quality improvement, program evaluation, and opinion publications were included.

METHODS

Using selected keywords including "dedicated education unit," we searched CINAHL, Google Scholar, MEDLINE, Academic Premier Search, ERIC, Cochrane Database of Systematic Reviews, JBI EBP Database, and ProQuest Dissertations and Theses. Two independent reviewers screened titles and abstracts against inclusion criteria. We reviewed reference lists for gray literature and additional references. Data were extracted from the included articles and categorized for characteristics and processes. Eighty-two publications from January 1997 to May 2020 were included. The findings were presented descriptively with tables and figures to support the data.

RESULTS

Dedicated education unit models were based on five characteristics and four processes. Characteristics of the dedicated education unit model included effective academic-practice partnership, adaptability to diverse contexts, unit culture of educational excellence, responsive and supportive unit leadership, and clarity of roles and responsibilities. Processes included building nurse and faculty capacity, facilitating student learning, communicating regularly at systems and unit levels, and evaluating and sustaining the model.

CONCLUSIONS

Evidence demonstrated that the dedicated education unit practice education model is well-established. However, there were existing gaps in this evidence, specifically evaluation and economic analyses. There was also limited attention to long-term sustainability of the model. The common characteristics and processes identified in this review may be used to support planning, implementation, and evaluation, including development and validation of evaluation tools. Although administrative infrastructure was noted as central to the dedicated education unit strategy, it was rarely acknowledged as part of management and thus also requires further study.

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.

The Importance of Peer Mentoring, Identity Work and Holding Environments: A Study of African American Leadership Development

Mentoring is well-known for its positive impact on diversity and inclusion across a wide variety of organizational contexts. Despite these demonstrated advantages, efforts to develop diverse leaders either through access to informal mentoring relationships or via formal mentoring programs are often complex, expensive, and frequently produce mixed results. We examine the unique impact of peer mentoring to support and develop African American leaders using a formalized program approach. Our findings show that peer mentoring is effective in providing a safe environment for the necessary work of identity to take place among African American leaders. This identity work takes the form of holding behaviors such as enabling perspectives, empathic acknowledgement and containment that are critical for the development, support and validation of diverse leaders. Our findings clearly show the benefit of external identity peer mentors for providing support and validation for African American leaders that can be absent within traditional hierarchical mentoring. By examining the outcomes of an actual leadership development program over time, we provide recommendations on how to enhance diverse leadership development by recognizing and cultivating the positive impact of identity-based peer mentoring.

Learning about user participation among nursing students: A qualitative study

BACKGROUND

User participation is an important aspect of nursing, especially within a rehabilitation setting where the emphasis is on the patient's ability to become as independent as possible. It is also decreed by law that students should learn about user participation. Furthermore, to achieve good nursing skills it is important for the students to understand "the what" and to reflect on "the how" regarding user participation.

OBJECTIVES

The aim of the study was to explore how students learn to apply user participation in a context of rehabilitation.

DESIGN AND METHOD

The design of the study is qualitative. Content analysis was adopted, and both inductive and deductive approaches were used. The informants were nursing students in the second and third years of the bachelor's degree at a university in Norway. Most of the students were in community health services, but some of them performed their internship at hospitals. Two focus groups with 11 students were conducted. In addition, the data also consist of 28 written reflections and 31 written work requirements in relation to rehabilitation. The students from the focus groups and the written work requirement were in practice in community health services. In the written reflections it was 14 students who had their internship at hospital and 14 students in community health services.

RESULTS

The main categories of the study are barriers to learning, dialogue as a tool and reflection as essential. The students learn to use check lists and focus on organizational planning, which might be a barrier to learning. Dialogue is important to improve the students' learning. Students need to reflect on user participation together with their supervisor to learn to be confident in encountering users, which indicates that reflection is essential.

CONCLUSION

The major findings indicate that students lack competence og user participation and that their supervisors seldom talk about it with them. Also, it should be compulsory reflection notes about user participation in the student's internships. Teachers at universities must inform supervisors and develop courses about mentorship and user participation. This may be a step forward to overcome theory-practice gap.

Preceptorship of Student Nurses in Ghana: A Descriptive Phenomenology Study

Background

Preceptorship plays an integral part in the clinical training of nursing and midwifery students, especially in high-income countries where it is a well-accepted concept. However, in Ghana, most nurses and midwives do not view preceptorship as part of their role.

Aim

The aim of this study was to explore the lived experiences of preceptorship of student nurses and the challenges confronting the preceptorship role.

Methods

A descriptive phenomenological study was conducted with 22 purposively selected preceptors aged 34 to 56 years from five clinical placement sites in the Cape Coast Metropolis in the Central Region of Ghana. Most of the participants had been preceptors for two to 18 years. In-depth interviews were conducted with the aid of a semistructured interview guide and analysed by qualitative thematic analysis inspired by Braun and Clarke's description of the method.

Results

The essence of the phenomenon has been captured in three main themes: (1) being excited about the role as it offered opportunities to learn and build relationship with students. (2) Encountering challenges including student's unwillingness to learn, absenteeism, and disrespect and also lack of interest of staff to assist students, time constraints, workload, burnout, parallel schedules of preceptors, and large student numbers, and (3) the need for effective collaboration between educational institutions and hospitals.

Conclusions

Though preceptors were excited about precepting student nurses, the challenges associated with it are multidimensional which requires effective collaboration between educational institutions and clinical placement sites.

A Multisite Study on Knowledge, Perceived Motivators, and Perceived Inhibitors to Precepting Nursing Students within the Clinical Environment in Ghana

Background

Preceptorship constitutes an important component of the educational process of training nursing students. The purpose of this study was to assess the knowledge, perceived motivators, and perceived inhibitors to precepting nursing students at the clinical placement sites in the Cape Coast Metropolis of the Central Region of Ghana.

Methods

A descriptive cross-sectional study was conducted among 442 nurses and midwives aged 27-56 years with at least three years of work experience. Data were collected with a questionnaire and analyzed using frequency counts, percentages, exploratory factor analysis, and point biserial correlation.

Results

The results indicate that the participants had a high knowledge of preceptorship of up to 91.2% (n = 404). A significant proportion of up to 88.2% (n = 390) had an intention to precept nursing students in the near future. The three important perceived motivational factors to precepting nursing students were the learning and professional needs of students, helping students to develop skills, and experience and formal recognition of the role of preceptorship. The main perceived inhibitors to engage in a preceptorship role were lack of preparation for the role, lack of support from faculty and nurse managers, and additional work burden. The results further indicate a significant strong positive correlation between experience and professional recognition of preceptorship and the intention to precept nursing students in the near future (r = 0.99, p=0.037).

Conclusions

The nurses and midwives who participated in the study are knowledgeable about preceptorship and have the intention to precept nursing students. Having enough experience on the job and being formally recognized as a preceptor may motivate these professionals to precept nursing students. However, there are critical perceived barriers that need to be addressed, to enable more nurses and midwives with the desire to precept students to engage in the preceptorship role.

Health TAPESTRY: Exploring the Potential of a Nursing Student Placement Within a Primary Care Intervention for Community-Dwelling Older Adults

The increasing prevalence of chronic diseases in aging places demands on primary care. Nurses are the major nonphysician primary care workforce. Baccalaureate nursing programs should expose students to primary care and older adults to support these demands and help recruit new graduates to this setting. However, many baccalaureate nursing programs focus on acute care and placements aimed at older adults are viewed negatively. To address these curriculum challenges, third-year Canadian baccalaureate nursing students were placed in an innovative primary care program—Health TAPESTRY—for community-dwelling older adults. Health TAPESTRY involves an interprofessional primary care team, trained lay volunteers conducting home visits, system navigation, and an online software application. The goal of this study was to explore third-year baccalaureate nursing students’ perceptions of this unique clinical primary care placement. This qualitative descriptive study explored students’ perceptions of this placement’s strengths, weaknesses, opportunities, threats (SWOT), and outcomes. Nursing students participated in focus groups (n = 14) or an interview (n = 1) and five completed narrative summaries following visits. Qualitative content analysis was supported by NVivo 10. Strengths of the clinical placement included training for the intervention; new insights about older adults; and experience with home visiting, interprofessional team functions, and community resources. Weaknesses included limited exposure to older adult clients, lack of role clarity, lack of registered nurse role models, and technology challenges. Opportunities included more exposure to primary care, interprofessional teams, and community resources. No threats were described. Nursing students’ clinical experiences can be enhanced through engagement in innovative primary care programs. Adequate exposure to clients, including older adults; interprofessional teams; mentoring by registered nurses or advanced practice nurse preceptors; and role clarity for students in the primary care team should be considered in supporting baccalaureate nursing students in primary care clinical placements.

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.

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.

Student dignity during work-integrated learning: a qualitative study exploring student and supervisors' perspectives

While University students increasingly participate in work-integrated learning (WIL), their dignity is often violated during WIL. The current literature is limited in so far as it typically focuses on student perspectives within healthcare contexts and does not use the concept of 'dignity'. Instead, this study explored student and supervisor perspectives on student dignity during WIL across healthcare and non-healthcare disciplines. Research questions included: What are: (1) types of student dignity experiences and patterns by groups; (2) factors contributing to experiences; (3) consequences of experiences? Sixty-five semi-structured interviews were conducted using narrative interviewing techniques with 30 supervisors and 46 students from healthcare (medicine, nursing and counselling) and non-healthcare (business, law and education) disciplines. Data were analyzed using framework analysis. Nine common narrative types were identified within 344 stories: verbal abuse, right for learning opportunities, care, inclusion, reasonable expectations, right for appropriate feedback, equality, trust, and right to be informed. Factors contributing to dignity experiences and consequences were often at the individual level (e.g. student/supervisor characteristics). We found some salient differences in perceptions of experiences between students and supervisors, but few differences between healthcare and non-healthcare disciplines. This study extends WIL research based on student perspectives in healthcare, and provides practice and further research guidance to enhance student dignity during WIL.

A longitudinal study on caring behaviors of Italian nursing students

AIM AND OBJECTIVE

The aim of this study was to analyze the caring behavioral differences taking place over the nursing academic period.

BACKGROUND

Caring is a core value in nursing education and many of its features can be measured as specific behaviors. The Italian Caring Behaviors Inventory is a tested psychometric questionnaire, useful to this aim. The use of the questionnaire facilitates the student's self-reflection and awareness.

DESIGN

Descriptive longitudinal study.

METHOD

The Italian Caring Behaviors Inventory questionnaire was filled out by 103 undergraduate nursing students at two Italian universities from May 2016 to May 2018 both during the second and the third year course. The questionnaire features 24 items with four caring factors: Factor 1 'Being with', Factor 2 'Doing with competence', Factor 3 'Responding to individual needs', Factor 4 'Providing effective care'. The Wilcoxon signed-rank test was used to assess differences between factors. Multiple regression analyses were conducted in order to evaluate variables associated with the increase or decrease of factors over time.

RESULTS

Results show a significant increase in Factor 2 during the selected period, which is positively associated with delta-Factor 1 and delta-Factor 3 and negatively associated with surgery clerkship during the third year of their course. Moreover, there is a significant decrease in Factor 3 between the second and third academic year and the variable positively associated to this decrease is the delta-Factor 4.

CONCLUSIONS

One of the main risks of nursing education is an asymmetric impact in favour of doing at the expense of being. In this study, we demonstrated that nursing students reported an increase in instrumental caring and a decrease in expressive caring. These results suggest that a specific training in expressive caring in the third term could be a viable answer to this unmet need in nursing education.

Preceptors' experiences of using structured learning activities as part of the peer learning model: A qualitative study

The clinical environment is a vital component of nurse education, constantly changing due to constraints of the current health care systems such as increasing number of students and a limited number of preceptors. Peer learning, is gaining momentum as an educational model highly suitable for clinical placements. The peer learning model incorporates structured learning activities that support student activity, but little is reported of the actual structure and content of those activities. Thereby, the aim of this study was to explore precepting nurses' experience of using structured learning activities as part of the peer learning model during clinical placement. We used a qualitative research approach, using two open self-administered global questions. The result is based on the analysis of the written responses from 62 preceptors. Four categories followed the analysis: An opportunity for collaboration, An occasion for reflection, A new educational structure, and Recommendations for development. The preceptors perceived the structured learning activities as beneficial for increased collaboration and reflection among students. Moreover, utilizing the structured learning activities was perceived to be time saving for the preceptors, however this is an area where further research is needed.

Characteristics of the collaborative learning unit practice education model for undergraduate nursing students: a scoping review protocol

What evidence on characteristics and processes of the collaborative learning unit practice education model for undergraduate nursing students is available?

Evaluation of Clinical Nursing Practice Programme with Preceptorship Supervision (Stake’s Countenance Evaluation Model)

Introduction: Preceptorship is clinical education for nursing students by conducting constructive partnerships between nurse educators and practitioners. Therefore, the purpose of this study was to find out the effectiveness of the preceptorship programme using the Stake Model Evaluation Programme in terms of aspects antecedents, transactions, outcomes and behaviours.Methods: This study uses descriptive design with quantitative and qualitative approaches. The sample consists of 131 students, 22 clinical preceptors and 22 academic preceptors. The quantitative data were collected using questionnaires, observation and document studies. Qualitative study was conducted using an interview. Descriptive analysis uses mean, standard deviation, percentage, frequency distribution and qualitative analysis using a content analysis.Results: The study evaluation found that at antecedent stage. About 68.2% to 90.9% clinical preceptors had a good preparation on the student preparation stages as perceived by the academic preceptor and preceptee. While in the stage of transaction, preceptors are able to teach nursing care and students to perform nursing care from simple to complex in accordance with the competencies achieved.  Only less than half (45.5%) of students had good implementation of nursing care, including assessment, diagnosis, planning, implementation and evaluation.  However, more than 68% of them showed good professional attitudes and communication. The outcome phase obtained consistency in the result of the practice phase with the national competency test with value from 76.2% to 97.4%.Conclusion: The majority of the antecedent, transaction stage, and outcome showed an average condition which requires an improvement in order to provide a good quality education programme. Future studies may also need to design an alternative approach for students’ supervision in clinic.

Factors developing nursing students and novice nurses' ability to provide care in acute situations

Nurses play an important role in detecting, interpreting and deciding appropriate actions to take in order to care for patients in acute situations. Nevertheless, novice nurses are reported as feeling unprepared to provide appropriate care in acute situations. In order to address this issue, it is important to describe factors in nursing education and first year of practice that enable nurses to provide appropriate care in acute situations. 17 novice nurses were interviewed in this qualitative study. A phenomenographic analysis was applied and four categories were discovered: Integrating theory into practice, access to adequate support, experience-based knowledge and personality traits. Results suggest that a variety of factors contribute to novice nurses' ability to provide appropriate care in acute situations. Experience of acute situations and the integration of theory and practice are pivotal in acquiring skills to provide appropriate care. To accomplish this, reflection, practice and/or applied training with a patient perspective is recommended.

The Effects of Preceptor Training on New Graduate Registered Nurse Transition Experiences and Organizational Outcomes

BACKGROUND

New graduate RNs (NGRNs) may experience difficulties in their transition to independent practice. The main role of preceptors is to guide, validate, and supervise the care that NGRNs provide. However, preceptors may not receive training to serve in the role.

METHOD

A literature review of the past 5 years was conducted, with 10 articles meeting the inclusion criteria to analyze the effects of preceptor training on NGRN outcomes.

RESULTS

Ten studies indicated a range of positive effects of preceptor training on NGRN transition experiences and organizational outcomes, including critical thinking and retention. Findings on NGRNs' stress levels are contradictory and ambiguous.

CONCLUSION

A variety of positive outcomes can be realized for NGRNs who partner with formally trained preceptors. J Contin Educ Nurs. 2018;49(5):216-220.

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.

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

BACKGROUND

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

OBJECTIVES

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

DESIGN

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

SETTINGS

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

PARTICIPANTS

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

METHODS

Data was collected using an online questionnaire.

RESULTS

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

CONCLUSIONS

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

Learning Situations in Nursing Education: A Concept Analysis

Background and purpose:

The nursing student requires opportunities to learn within authentic contexts so as to enable safe and competent practice. One strategy to facilitate such learning is the creation of learning situations. A lack of studies on the learning situation in nursing and other health care fields has resulted in insufficient knowledge of the characteristics of the learning situation, its antecedents, and consequences. Nurse educators need to have comprehensive and practical knowledge of the definition and characteristics of the learning situation so as to enable their students to achieve enhanced learning outcomes. The aim of this study was to clarify the concept of the learning situation as it relates to the education of nurses and improve understanding of its characteristics, antecedents, and consequences.

Methods:

The Bonis method of concept analysis, as derived from the Rodgers’ evolutionary method, provided the framework for analysis. Data collection and analysis were undertaken in two phases: “interdisciplinary” and “intra-disciplinary.” The data source was a search of the literature, encompassing nursing and allied health care professions, published from 1975 to 2016.

Results:

No agreement on the conceptual phenomenon was discovered in the international literature. The concept of a learning situation was used generally in two ways and thus classified into the themes of: “formal/informal learning situation” and “biologic/nonbiologic learning situation.” Antecedents to the creation of a learning situation included personal and environmental factors. The characteristics of a learning situation were described in terms of being complex, dynamic, and offering potential and effective learning opportunities. Consequences of the learning situation included enhancement of the students’ learning, professionalization, and socialization into the professional role.

Implication for Practice:

The nurse educator, when considering the application of the concept of a learning situation in their educational planning, must acknowledge that the application of this concept will include the student’s clinical learning experiences. More studies are required to determine factors influencing the creation of a successful learning situation from the perspectives of nurse educators and nursing students, clinical nurses and patients.

Italian version of Nursing Students' Perception of Instructor Caring (I-NSPIC): assessment of reliability and validity

BACKGROUND

Clinical experience is an essential component of nursing education since it provides students with the opportunity to construct and develop clinical competencies. Instructor caring is a pivotal facilitator at the forefront of clinical education, playing a key and complex educating role in clinical sectors. For these reasons the aims of this study was to assess the validity and reliability of the Italian version of NSPIC (I-NSPIC).

METHODS

A validation multicentre study was conducted in three different Italian universities. A total of 333 nursing students were enrolled in the 2014/2015 academic year. Exploratory factor analysis (EFA) with oblique rotation was performed to test the construct validity of I-NSPIC. The Cronbach's alpha coefficient and test retest via Intraclass Correlation Coefficient (ICC) analyses were done to assess the internal consistency and stability of the scale. A Spearman's correlation with another scale (CLES-T) was used to examine the concurrent validities.

RESULTS

Four factors (control versus flexibility, supportive learning climate, confidence through caring, appreciation of life meaning and respectful sharing) were identified in EFA. The Cronbach's alpha value showed that I-NSPIC was a reliable instrument (α = 0.94) and the ICC coefficient was satisfactory.

CONCLUSION

The I-NSPIC is a valid instrument for assessing the perception of instructor caring in Italian nursing students. It may also prove helpful in promoting the caring ability of nursing students and in increasing the caring interactions in the relationship between instructor and nursing students. The knowledge emerged from this study provide important insight in developing effective training strategies in the clinical training of undergraduate nursing students.

Pursuing Improvement in Clinical Reasoning: Development of the Clinical Coaching Interactions Inventory

BACKGROUND

Clinical coaching has been identified as a signature pedagogy in nursing education. Recent findings indicate that clinical coaching interactions in the clinical learning environment fail to engage students in the higher order thinking skills believed to promote clinical reasoning.

METHOD

The Clinical Coaching Interactions Inventory (CCII) was based on evidence of supervisor questioning techniques, the Tanner clinical judgment model, Bloom's Taxonomy, and simulation evaluation tools. Content validity was established with expert assessment, student testing for clarity, and calculation of scale-content validity index/average (S-CVI/Ave). Reliability was established with Kuder-Richardson Formula 20 (KR-20).

RESULTS

CVI (S-CVI/Ave) was .91, and KR-20 was .70. The CCII identified differences in clinical coaching behaviors in university faculty supervisors and staff nurse preceptor supervisors.

CONCLUSION

The CCII advances the measurement of clinical coaching interactions from qualitative to quantitative. Ultimately, results from use of this inventory may facilitate the design of prelicensure clinical coaching strategies that promote the improvement of students' clinical reasoning skill. [J Nurs Educ. 2016;55(9):495-504.].

The art of preceptorship. A qualitative study

In the clinical nursing practice preceptorship is a widespread method to improve patient care by assisting nurses in developing the right clinical skills. However, little is known about how preceptorship should be practiced to achieve a positive learning outcome. The aim of the study was to investigate how preceptorship can be used in clinical practice to create learning and facilitate competence development. A qualitative study guided by a hermeneutic phenomenological approach and inspired by ethnographic fieldwork included 28 participant observations and 58 interviews. Data were analysed according to Steinar Kvale's three interpretation contexts. The findings showed three themes: Being together: Preceptee and preceptor were physically present in the same room optimising the learning situation with focus on complexity, use of senses and patient safety. Doing together: Preceptee and preceptor performed nursing together to obtain skills focusing on independence, practical skills and communication. Getting along together: Preceptee and preceptor together focused on the patient, relation, comfort and managing how to keep the balance between a professional and a personal relation. Precepetorship is situated learning where knowledge and skills are generated through participation in clinical practice. In this way, nurses develop clinical judgement and independence.

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.