Nurse Practitioner Preceptors Research Articles

To precept or not to precept: Perspectives from nurse practitioners.

Nurse practitioner (NP) preceptors are crucial to clinical education. Recent increases in the required direct patient care hours for NP students may worsen the current preceptor shortage. However, most studies of preceptorship only include NPs who are current preceptors and are therefore missing vital information from nonpreceptors. It is imperative to understand facilitators and barriers to preceptorship from the perspective of NPs who have stopped being or have never been preceptors. The purpose of this study was to understand the factors influencing NPs' decisions whether to precept. This was a descriptive, phenomenological study. Semistructured interviews were recorded in Zoom, transcribed verbatim, deidentified, and analyzed using thematic analysis. Sixty NPs participated in the study: 23 current preceptors, 22 previous preceptors, and 15 who had never been preceptors. Facilitators to preceptorship included institutional support of preceptorship, positive student characteristics, clear expectations from the educational facility, and incentives. Barriers to preceptorship included time constraints, specialty, negative student characteristics, no institutional support, and being uncomfortable in the clinical role. Preceptors and nonpreceptors shared similar themes-positive student characteristics and clear expectations as facilitators to preceptorship, and time as a barrier. However, other themes were unique to one preceptorship group. This provides new evidence for practice and research. Nurse practitioner programs can facilitate preceptorship by ensuring that students are well prepared and providing clear expectations. Strategies should be developed to manage the time burden of preceptorship. In addition, support for preceptorship by health care organizations and systems should be studied.

An international telehealth experience in Guatemala.

An increase in competition for nurse practitioner preceptors and United States-based clinical practicum sites along with an increase in required direct patient care clinical hours demand innovative methods for gaining valuable nurse practitioner clinical experiences. Involving nurse practitioner students in medical mission trips to low-resource countries and follow-up telehealth clinics have been beneficial for all involved. Guatemala is a developing country in Latin America that has a high rate of poverty, malnutrition, and a lack of health care. Annual medical mission trips are beneficial in meeting the health care needs of Guatemalans but lack the frequent follow-up necessary to promote a more sustained impact. A monthly telehealth program was established in a rural area of Guatemala to promote the continuity of care for children with malnutrition. This article discusses associated barriers, strategies to overcome those barriers, and the inclusion of nurse practitioner students to meet the needs of the Guatemalan children with malnutrition using a telehealth program.

Preceptors’ preparedness to teach about substance and opioid use disorder: a qualitative study

Study aimLittle is known about preceptors’ comfort and readiness to teach clinical students about the care of patients with substance and opioid use disorder (SUD/OUD). This study explores preceptors’ views about caring for such patients, and their preparedness to teach about SUD/OUD management, to improve graduate competencies.MethodsParticipants were recruited by convenience and snowball sampling. Semi-structured interviews were conducted with physician, physician assistant, and nurse practitioner preceptors who taught medical and physician assistant students. Interviews were conducted via Zoom® videoconferencing. Transcripts were generated and independently analyzed for themes by 4 experienced coders using constant comparison and a grounded theory approach.ResultsFifteen interviews were conducted to theme saturation. We identified 3 major themes and 10 subthemes supported by exemplar quotes. The major themes were: education about SUD/OUD in primary care (subthemes include need for longitudinal curriculum, redefining ‘success’ in treatment, and precepting challenges), treatment of SUD/OUD in primary care (need for systemic support and care continuity), and medication-assisted therapy (MAT) training as a tool for teaching (preceptors’ own training, and need for clinical students to be trained).ConclusionsPreceptors agreed that treatment of SUD/OUD belongs in primary care and students should learn about SUD/OUD from the start of their medical education. Data analysis enabled the construction of an emerging conceptual framework reflecting a diversity of experiences and opinions of preceptor comfort and preparedness to teach about SUD/OUD, associated with various barriers and motivators. This framework can guide future strategies to address facilitators and obstacles to advance and promote preceptor preparedness to teach students about the care and management of patients with SUD/OUD.

Approach to advanced practice nursing student clinical during COVID-19.

Approach to advanced practice nursing student clinical during COVID-19.

Nurse practitioner preceptor education to increase role preparedness.

The public has become aware of the need for nurses and nurse practitioners in primary care with the widespread public health crisis. As the need for nurses and nurse practitioners grows, there is a need for the clinical educator and preceptor. However, preceptors have noted barriers to precepting such as time constraints, lack of preceptor role education, and role preparedness. Currently, neither preceptor role development nor education has been implemented within a local institution. Preceptor vocalization led the charge for preceptor role development education within the institution. This quality improvement project focused on the preceptor role preparedness and education. A convenience sample was recruited from a large, diverse academic institution. The modified Clinical Supervision Self-Assessment Tool-Skills was utilized to determine the effectiveness of online education in preceptor role preparedness. An online, self-directed, evidence-based preceptor education webpage with easily reproducible information related to collaborating with students and faculty situations. Literature, such as the One Minute Preceptor, Ask, Tell, Ask, and engaging student scenarios, was included from the literature review. A voice-recorded PowerPoint summarizing the webpage was included with a transcript for accessibility. A paired t-test was used to assess the mean differences between the preintervention and postintervention periods. The results indicated the online preceptor education was effective. Preparing nurse practitioner preceptors for their roles benefits the health care system. An online, self-directed, evidence-based preceptor education webpage can be beneficial in future preceptor education planning.

Nurse practitioner preceptor resource needs and perceptions of institutional support.

Nurse practitioner (NP) preceptors encounter stress when balancing clinical responsibilities with mentoring. Support can decrease role stress and promote preceptor resilience. Characterize NP preceptor resource needs and their perception of support for the clinical preceptor role. A cross-sectional, mixed-methods study used a web-based survey to identify preceptor resource needs. A convenience sample from a large, academic Midwestern university was recruited by email, with reminder emails 1 and 2 weeks after initial invitation. Survey tools included researcher-designed questions about preceptor-desired resources, an adapted Preceptor's Perception of Support Scale, and qualitative questions of preceptor needs. Data were analyzed using descriptive statistics and qualitative thematic analysis. Two hundred thirty-nine of 784 surveys (30.48%) were returned. Preceptors valued free mentoring resources, desired access by "smartphone app," and identified mentoring topics of interest. They perceived adequate role preparation, clearly defined roles, supportive and knowledgeable colleagues, committed supervisors, and appropriate workload. Respondents noted the following insufficiencies: time for normal duties while precepting, preceptor resources, opportunities to share with colleagues, faculty-student time, and faculty assistance to identify student's performance problems. Qualitative data highlighted faculty-preceptor communication and compensation as preceptor concerns. Preceptors feel a need for specific supports identified in this study. Preceptor insights inform strategies to build clinical preceptor resilience and well-being, strengthen the academic-practice partnership, and facilitate positive education outcomes. Faculty should increase communication-based support individualized to specific student needs. Resources should be developed that more fully support specific competencies and skills within NP student clinical education.

Design and outcomes of a nurse practitioner preceptor development program.

Nurse practitioners (NPs) are educated to provide high-quality patient- and family-centered care to underserved, culturally diverse, medically complex populations. Nurse practitioner faculty plan curricular activities that challenge NP students to critically assess individuals and populations with the goal of preparing NP students to be "practice-ready" upon graduation. Nurse practitioner clinical training occurs in practice settings with NP preceptors, with specific areas of clinical expertise. However, there is a lack of NP clinical preceptors educationally prepared to clinically teach and evaluate NP students. This article presents the design, implementation, evaluation, and outcomes from a 3-year grant funded by the United States Human Resources and Administration Services that featured a web-based Primary Care Nurse Practitioner Preceptor Development Program. Ninety percent of NPs who precepted NP students completed all web-based learning modules. Preceptors with educational preparation via online modules to guide NP student learning in clinical settings are a critical resource for faculty to prepare NP students to be practice-ready upon graduation. This web-based learning platform for online NP preceptor education may be a successful approach for expanding and improving the NP preceptor pool nationwide.

Nurse Practitioner Preceptor Plan: A Focus on Preceptor Rewards and Preferences.

Recruiting and retaining preceptors is a major challenge for nurse practitioner (NP) programs. The purpose of this project was to identify preceptor rewards that may foster NP preceptor recruitment and retention at one university. Seventy preceptors were surveyed regarding their reward preferences using rewards identified in the literature and among regional NP programs. The most preferred rewards included continuing education credits, professional growth opportunities, maintaining professional relationships with the university, and financial remuneration. To provide NP students with positive and effective clinical experiences, it is essential that NP program leaders understand preceptors' preferences and commit to preceptor support.

The Significance of the NP Preceptorship Shortage

Nurse practitioner (NP) students are often unaware of the difficulties they will face finding preceptors. Many graduate programs lack a network of preceptors, forcing students to reach out to anyone who will agree to precept. Nursing and other healthcare provider programs often compete for the same clinical sites and preceptors. In this article, we offer a comparison of clinical education models by provider and briefly discuss current concerns that impact NP students, such as opposition for practice autonomy and the COVID-19 pandemic, as they seek to complete the required clinical hours to graduate. Also included is general information about the NP preceptor, with a description of requirements and responsibilities of the role. Our discussion suggests several philosophical dilemmas of NP preceptorship, including pay for preceptors, and considers expectations for the future.

Insights on the Clinical Teaching Needs of Nurse Practitioner Preceptors

Preceptors for nurse practitioner (NP) students are vital in the educational process. Many preceptors have not had formal education regarding their teaching and learning responsibilities. A survey of NP preceptors was conducted at a national NP conference to identify specific development/training and resource needs and to determine the extent to which preceptors were using structured clinical teaching methods. The survey findings indicated that the overwhelming majority of preceptors had not attended preceptor development/training along with one third not feeling prepared to teach NP students. Preceptors identified and used unstructured teaching methods more commonly than structured methods that improve educational outcomes.

Web-Based Training Modules for Nurse Practitioner Preceptors

The 2016 National Task Force on Quality Nurse Practitioner Education described a preceptor as having the educational preparation or extensive clinical experience for clinical supervision. Preceptors are often unaware of teaching techniques, effective communication, and objective evaluation modes of student performance. Four 1-hour training modules for preceptors were developed to address these issues. Each illustrates communication and evaluation techniques to help nurse practitioner preceptors guide students as they learn to implement evidence-based practice. The online link to the continuing education training modules is provided for all interested schools of nursing, nurse practitioner preceptors, and other allied health professionals at no cost.

Improving Nurse Practitioner and Physician Assistant Preceptor Knowledge, Self-Efficacy, and Willingness in a Hospital Medicine Practice: An Online Experience.

A hospital medicine practice experienced an increased demand for additional nurse practitioner (NP) and physician assistant (PA) preceptors. An online preceptor education course was developed that included eight modules: communication and feedback, expectations for assessment and evaluation, pedagogy, time management and efficiency, goal setting and coaching, working with struggling or at-risk students, legal and ethical considerations, and teaching procedures. Knowledge, self-efficacy, and willingness to precept were examined in a precourse and postcourse format. Postcourse, knowledge improved from 69.4% to 90.6%. Self-efficacy improved by 35.2%, and willingness to precept also improved. Qualitative themes emerged, including excitement to precept, helpful course, and time constraints. An online NP and PA preceptor training program increased preceptor knowledge, self-efficacy, and willingness to serve as a preceptor. Additional research is needed to explore the time constraints to serving as an NP or a PA preceptor in the inpatient environment. [J Contin Educ Nurs. 2020;51(6):275-279.].

The One-Minute Preceptor: Evaluation of a Clinical Teaching Tool Training for Nurse Practitioner Preceptors

Health professionals cite a number of barriers to precepting nurse practitioner (NP) students, including lack of time and training. The primary aim of this study was to evaluate training of health professionals who teach NP students in a clinical teaching model, the One-Minute Preceptor (OMP). The OMP is a clinical teaching tool that has the potential to increase feedback to NP learners, improving their perceived clinical experience and learning opportunities. The secondary aim was to evaluate the impact of this training on perceived barriers to clinical teaching. The training included a 2-hour workshop on clinical teaching models within a community setting, with an emphasis on the OMP. The intervention was offered twice and included 57 participants from 4 different health professions. Data were collected before and after the intervention using an online survey. There were no differences between professions in outcomes, including barriers to teaching; however, an increase was found in providing positive and corrective feedback as well as overall teaching activities.

Precepting nurse practitioner students in the graduate nurse education demonstration: A cross-sectional analysis of the preceptor experience.

The Graduate Nurse Education (GNE) Demonstration seeks to increase the number of advanced practice registered nurses (APRNs) in clinical practice. With the overall increase in APRN programs and, particularly, enrollment in nurse practitioner (NP) programs, there is growing competition among students to secure quality clinical precepting experiences. This study describes NPs' and physicians' experiences with precepting APRN students within the Greater Philadelphia GNE Consortium. This was a cross-sectional descriptive survey of 1,021 NP and physician preceptors who provided clinical practicum experiences for at least one of the nine Greater Philadelphia GNE Consortium schools. Differences between NP and physician precepting experiences regarding the importance of various factors in their decisions to precept were explored. Both NP and physician preceptors provide clinical practicum experiences to APRN students because they enjoy doing so. However, they differ regarding what they find important in their decisions to precept such as having protected time to precept and educational opportunities. As universities work to recruit quality preceptors, they should consider tailoring their approach based on the preceptor's clinical role. In addition, schools located within the same region should consider streamlining administrative processes to form sustaining and productive clinical partnerships.

Tax incentives for preceptors of nurse practitioner students in Massachusetts: A potential solution.

With a growing population, there is an increasing need for nurse practitioners to improve access to health care. There is currently a shortage of nurse practitioner (NP) preceptors across Massachusetts, making clinical placements difficult and at times unachievable. The lack of NP preceptors has a direct impact on student outcomes, educational programs, and ultimately access to care. The authors explored lessons learned about the national scale of this problem and whether Massachusetts should entertain legislative initiatives similar to other states as a solution. Data were collected from the boards of nursing and the national and state chapters of the American Association of Nurse Practitioners regarding current and pending legislation. State and federal sources and the Massachusetts Association of Colleges of Nursing provided statistical and qualitative data on current and future needs for NP preceptors. States that have successfully passed legislation have awarded tax incentives to NP preceptors, although none of the existing regulations have assessed for their effectiveness in improving preceptor availability. Massachusetts may benefit from legislation to improve NP student access to preceptors; however, incentives related to geographical location may best serve both students and the greater population.

Traditional and Nontraditional Collaborations to Improve Population Health Using Geospatial Information System Maps: Analysis of the Opioid Crisis

IntroductionThe study aims were to analyze interprofessional practice collaborations among traditional and nontraditional health care providers and to educate nurse practitioner preceptors and students on population health, specifically, implementation of geospatial information system (GIS) maps and the correlation with the opioid crisis. MethodsA descriptive analysis was used to examine New York State data on the opioid crisis in comparison to outcome data from GIS maps of opioid use in two boroughs in New York City. Web-based modules were designed for analysis of GIS maps of opioid use near practice settings. ResultsNew York State data provided context for local opioid use, while GIS maps identified specific areas of the New York City boroughs that were most affected by the opioid epidemic. DiscussionThe importance of local GIS maps is that the information is available in real-time, and thus interventions can be designed, evaluated, and changed quickly to meet the immediate needs of the community.

The one-minute preceptor model: A systematic review.

Teaching models provide a systemic framework for didactic and clinical teaching. The One-Minute Preceptor (OMP) is one teaching model, providing five microskills to organize a learning experience for students in the clinical environment. This review aims to integrate the literature on the OMP model by highlighting potential use for nurse practitioners while identifying directions for future research. Electronic databases were searched from December 2017 to January 2018 for articles published in English. The databases included PubMed, CINAHL, and MEDLINE using terms including "preceptor," "clinical teaching," "time-efficient teaching," and "precepting." Of 32 articles in the final search, only 12 experimental quantitative studies were included in the synthesis and 20 descriptive studies in the discussion. The OMP model is supported by literature for its effectiveness as a teaching model and preference by students and preceptors. It has been shown to increase teaching techniques including feedback and assessment of students' clinical reasoning. The OMP model has the potential to overcome clinicians' barriers to precepting nurse practitioner students. Future research may evaluate the use of this model specific to nurse practitioner preceptors and students, perceived time benefits in clinical teaching, overall improvement in clinical teaching, and use in interprofessional precepting.

Supporting nurse practitioner education: Preceptorship recruitment and retention

ObjectivesClinical experience is an essential component of nurse practitioner (NP) education that relies heavily on preceptors. Recruitment and retention of preceptors is challenging due to many variables that can affect NP education and practice. We surveyed Canadian NP programs to understand their preceptorship structures, how they support preceptorship, and to identify gaps and challenges to recruitment and retention of preceptors. MethodsAn 18-item survey, developed by the NP Education Interest Group, was distributed to 24 universities across 10 Canadian provinces. Construct validity and reliability was assessed by experienced NPs and NP faculty. Data were analyzed using relative frequency statistics and thematic analysis. Participants consisted of administrative staff and/or faculty designated as responsible for recruitment and retention of NP preceptors. ResultsSeventeen returned surveys were analyzed and demonstrated more similarities than differences across Canada's NP programs, particularly related to barriers affecting recruitment and retention of preceptors. The findings identified NP programs have too many students for the number of available clinical sites/preceptors, resulting in overutilization, burnout, or refusal to take students. Competition with other health disciplines for clinical placements was identified as a challenge to placements. Respondents commented they lack time to recruit, provide follow-up, offer support, or seek preceptors' feedback due to competing work demands. They identified the need for standardized funding for preceptor remuneration and recognition across the country. ConclusionThe findings suggest the need for exploring a wider intraprofessional collaboration among graduate NP programs/faculty, clinical placement sites, and NPs to facilitate the recruitment and retention of preceptors.

Using Simulation to Improve Communication Skills in Nurse Practitioner Preceptors.

Role transitions in nursing may lead to stress and anxiety or the novice, which can be decreased with appropriate mentoring by preceptors. However, preceptors commonly describe having a lack of mentoring skills. This project focused on nurse practitioner preceptors and their gap in mentoring communication skills when handling difficult communications with novice nurse practitioners. The use of a simulation as a means for learning communication skills was evaluated for its effect on increasing preceptor skill level in mentoring.

Perceptions of Family Nurse Practitioner Clinical Preceptors About Usefulness of Onsite Clinical Site Visits.

Clinical site visits are important for evaluating graduate nursing students' clinical success. This descriptive study surveyed family nurse practitioner preceptors' perceptions of modalities for conducting site visits. Results indicated that preceptors believe faculty should make at least 1 face-to-face site visit to observe a student during the semester. No preference for telephone or mobile technology for conducting site visits was identified. The study provides important considerations when designing guidelines for faculty site visits.