Looking beneath the surface of a preceptor-training programme through a realist evaluation

Abstract

South Africa’s department of health devoted themselves to the clinical nursing education and training model, which indorses preceptors as essential stakeholders to promote competence in students. A preceptor-training programme was developed that build on this model and implemented through an intervention. The initial programme theory hypothesised that trained preceptors would promote support and develop competence in students in comparison to untrained preceptors. Results showed a poor outcome because few preceptors participated and a high student attrition rates. The authors then posed the question “Why did the preceptorship training programme not work?” This article offers insight into the context, mechanism, and outcome of the preceptor-training programme through a realist evaluation. Reflective field notes, gathered during the intervention, were used and gave insight regarding how, for whom, and under which circumstances the programme could work and offered a refined programme theory for preceptorship. The main conclusion drawn showed that a preceptor-training programme alone is not the sole determining factor to ensure preceptors’ motivation to transfer their learning; a systems approach, ensuring the effectiveness of the programme, should be followed. Reflection on findings indicated the implementation context as a major determining factor of the training programme.