Nurse Preceptors Research Articles

Understanding the needs of nurse preceptors in acute hospital care setting: A mixed-method study

Nurse preceptors play an important role in supporting newly qualified nurses during transition periods. However, limited attention is given to the needs and experience of nurse preceptors with expected responsibilities. This study aimed to examine the perceived needs of nurse preceptors in three public acute hospitals by using a sequential mixed method approach conducted between March and August 2017. A questionnaire that comprised socio-demographic data, Clinical Teaching Behaviour Inventory (CTBI), and RN Preceptor Learning Needs Assessment, was distributed to all nurse preceptors. Semi-structured qualitative interviews were conducted with a purposive sample of 10 informants to complement the quantitative findings. We received 260 completed questionnaires, giving a response rate of 78.8%. The highest mean CTBI domain score was “Using appropriate teaching strategies” (Mean = 3.65, SD = 0.56), whereas the lowest was “Providing feedback and evaluation” (Mean = 3.51, SD = 0.60). The top five topics identified as the most important in nurse preceptor training were critical thinking, prioritising, teaching techniques, conflict management and teamwork. Qualitative findings revealed that the informants experienced tension with their dual roles and strained relationships with co-workers. The expectations of the informants for support were recognition from management level and highlighting coaching tactics, reciprocal learning and collegiate support.

Implementing a Tailored Educational Program for Nursing Preceptors about Selected Clinical Measurements that Improve their Role Effectiveness

Background: Preceptor ship is a clinical teaching model through which undergraduate nursing students are facilitated to acquire beginning competencies that enable them to function effectively in the complex workplace environment upon graduation. The aims of the current study were to evaluate the effect of tailored educational program about selected clinical measurements regard learning process on nursing preceptors (knowledge) and evaluate the preceptor abilities by their perceptee before the educational program. Quasi-experimental (pre-posttest) research design was used. The study was conducted at Faculty of Nursing and Institute of Nursing which affiliated to Minia University and Institute of Nursing which affiliated to Beni Suef University. Purposive study sample included Sixty one (61) preceptors recruited from previous mentioned settings as following: Group I (n=31) & Group II (n=30) respectively, Two tools was utilized, the first one was a structured self-administered questionnaire: to collect personal data of the preceptor and their knowledge regarding selected clinical measurements, the second one: were used to evaluate the preceptor‘s abilities which collected from the preceptees before the educational program. Results: revealed that Mean ±SD age regarding study participant (group1) equal 28.1+-4.7, about three quarter of participant (74.2%) have baccalaureate of nursing , the Mean ±SD related to the years of experiences was 6.7+-4.9. The majority of them (96.8%) hadn't receiving any staff developmental training program. Lastly the study cleared that total participant (100%) haven’t ongoing any educational program. There are a highly statically significant differences in knowledge between pre and posttest regarding selected clinical measurements that improving nursing preceptor's role among both studied groups p-value= .001**. Conclusion there are improvement in knowledge about selected clinical measurements that improving nursing preceptor's role among both studied groups and the precepts evaluation regarding highest abilities for their preceptor were according to they mentioned as their preceptor available when need help, provide feedback about program, actively sought educational opportunities….ect. Recommendation: the recent study recommended that it is important to design a Preceptorship programs or academy that develop a courses as the best starting point to increase the effectiveness preceptor role and which will reflect on the development of specific skills in their perceptee students

Nurse Preceptor Role in New Graduate Nurses' Transition to Practice.

The transition to practice period is a challenging and demanding time for new graduate nurses. Leaving the structured environment of nursing school and entering professional practice can cause reality and transition shock for the new nurse resulting in unsafe patient care, as well as intention to leave their position or the profession. Successful transition to practice depends on the new nurse building confidence and gaining essential clinical reasoning abilities while orienting to their role. In critical care settings, patient care is more complex and fast-paced, which adds another dimension of overall stress to the new graduate. Structured orientation programs with trained preceptors have been found to be the most successful means of preparing new graduate nurses for clinical practice. Ensuring preceptors are provided with education related to the development of clinical reasoning is essential to successfully assist new nurses in their transition to practice. Safe and effective patient care, especially in the critical care unit, is dependent upon having nurses who are well prepared for their role through being provided guidance and support from trained preceptors.

Teaching Basic Nursing Care: Nurse Preceptors' Perceptions about Changing the Teaching Context from the Clinical Setting to a School Simulation Lab.

Research demonstrates that basic nursing care receives less attention in clinical settings and has become visually less prominent in nursing education curriculums. While much is known about the importance of preceptorship in clinical settings, little is known about how preceptors teach basic nursing care to students in a school simulation lab. This study explores the preceptors' perceptions of teaching basic nursing care to nursing students in the school simulation lab compared to clinical settings. Data were collected through focus group interviews and participant observation and analyzed by using qualitative content analysis. Three main categories emerged: (i) Perceived advantages and disadvantages, (ii) Positive attitudes - remembering being a student, and (iii) Knowing what to do and showing how to do it. Awareness of the importance of having knowledge about basic nursing care may contribute to counterbalancing the devaluation of basic nursing care among nursing students.

Nurse Preceptor Perceptions of Nursing Student Progress Toward Readiness for Practice.

New nurses are often perceived as not meeting expectations for safe nursing practice. Nurse educators need to identify student learning and professional development needs as students progress toward practice. The purpose of the study was to determine the strengths and weaknesses of senior-level nursing students related to readiness for practice before graduation. Using a descriptive, exploratory design, nurse preceptors evaluated the degree to which their assigned senior nursing student was meeting expectations for readiness for nursing practice. Survey items were organized into affective, cognitive, and psychomotor domains and general readiness. This evaluation occurred at the beginning of the final practicum to assess student progress toward readiness for practice. Students scored highest in professional attributes but lowest in time management, prioritization, management of multiple patients, and pharmacology knowledge. Results can be used to inform teaching strategies, strengthen academic-clinical partnerships, and promote readiness for entry-level practice.

The CNO US Healthcare Immersion Program, Part 2: Expanding the Footprint of Professional Nursing.

As global leaders, US nurses will have an increasingly recognized role and responsibility in shaping health care in all countries. They should be at the forefront of changing and improving health systems to achieve universal health. Currently, a major health care reform is underway that requires a shift in the professional nursing footprint of China's nurse leaders. These leaders must garner knowledge capital to reinforce ethics, regulations, and standards; use current best practices; implement a comprehensive performance evaluation process; and capture the spirit of caring within their health care environments. Therefore, China is seeking US immersion opportunities for their emerging nurse leaders. Although US Immersion Programs exist, there is scant literature related to international precepting and how transformational learning occurs within this experience. This article introduces a transformational learning experience between US International Nurse Preceptors and a Chief Nursing Officer from Yinchuan, China.

Validity and Reliability of the Clinical Teaching Behavior Inventory (CTBI) for Nurse Preceptors in Korea

The aim of this study was to evaluate the validity and reliability of the Korean version of the Clinical Teaching Behavior Inventory (CTBI). The English CTBI-23 was translated into Korean with forward and backward translation. Survey data were collected from 280 nurses' preceptors at five acute-care hospitals in Korea. Content validity, construct validity, and criterion-related validity were evaluated. Cronbach's α was used to assess reliability. SPSS 24.0 and AMOS 22.0 software was used for data analysis. The CTBI Korean version consists of 22 items in six domains, including being committed to teaching, building a learning atmosphere, using appropriate teaching strategies, guiding inter-professional communication, providing feedback and evaluation, and showing concern and support. One of the items in the CTBI was excluded with a standardized factor loading of less than .05. The confirmatory factor analysis supported good fit and reliable scores for the Korean version of the CTBI model. A six-factor structure was validated (χ²=366.30, p<.001, CMIN/df=2.0, RMSEA=.06, RMR=.03, SRMR=.05, GFI=.90, IFI=.94, TLI=.92, CFI=.94). The criterion validity of the core competency evaluation tool for preceptors was .77 (p<.001). The Cronbach's α for the overall scale was .93, and the six subscales ranged from .72 to .85. The Korean version CTBI-22 is a valid and reliable instrument for identifying the clinical teaching behaviors of preceptors in Korea. The CTBI-22 also could be used as a guide for the effective teaching behavior of preceptors, which can help new nurses adapt to the practicalities of nursing.

Living With Moral Distress: The Perspectives and Experiences of Iranian Nurse Preceptors.

Background and Purpose: Preceptors play a key role in the transition experience of new nurses. Preceptorship is a stressful role and is influenced by contextual factors. There is a lack of sufficient understandings of the perspectives and lived experiences of Iranian nurse preceptors of preceptorship. The aim of this study was to explore the perspective and lived experiences of Iranian nurse preceptors of preceptorship. Methods: A qualitative design using a hermeneutic phenomenological approach was used. Six Iranian nurse preceptors were chosen using a purposeful sampling method from a large paediatric teaching hospital in an urban area of Iran. Data was collected using in-depth semi-structured interviews and was analysed using the Diekelmann et al.'s method of hermeneutic phenomenological analysis. Results: The data analysis resulted in the development of a constitutive pattern of 'living with moral distress', which was constituted of two major themes: 'asking for and being unable' and 'the experience of conflict'. Implications for Practice: The findings of this study can improve nurses' understandings of the preceptor's role and associated factors influencing the implementation of the preceptorship programme. 'Moral distress' caused by the preceptor role can influence nurse preceptors' mental health and also the patient care outcomes. More studies are required to explore this phenomenon in different contexts and cultures and design strategies for reducing the burden of taking this role on nurse preceptors. Also, policies are needed for developing a formal preceptor support system to help preceptors take this stressful and demanding role in healthcare settings.

Nurse Preceptor Experience in Preceptorship Program: A Systematic Literature Review of Qualitative Studies

This systematic literature review describes the experiences of the nurse preceptor in the preceptorship program in health care services. Data was collected from three databases: EBSCO, ScienceDirect, and Scopus. Qualitative, peer-reviewed, original studies published in English from 2013 until 2017 and exploring preceptor experiences of the preceptorship program were involved. The manuscripts were selected by screening titles, abstracts and full papers and the quality of the studies was measured. Data were analysed using content analysis.Ten studies were chosen for the review. Nurse preceptor experiences were divided into four main categories: experiences related to the preparation; experiences related to the preceptee; experiences preceptor role during the program; and experiences related to work environment. The findings establish that the nurse preceptor has a great impact to determine the quality of nursing services to the new graduate nurses, but many challenges face during the program.

The Clinical Supervision Process of Nurse Preceptors in Thailand: A Meta-Ethnography Research

The purpose of this study was to synthesize five graduate theses on nurse preceptors by using the Meta-Ethnography research method. The research findings fell into three steps, as follows: Step 1- Preparing for teaching. Nurse preceptors prepared for their clinical supervision with four sub-steps, 1) preparing for readiness, 2) studying and reviewing the clinical practice and clinical supervision guidelines of the organization, 3) planning and designing a clinical supervision model, and 4) making clinical supervision plans; Step 2- Teaching. This step consisted of seven sub-steps, 1) creating familiarity with the learners, 2) clinical practice orientation, 3) clarifying the performance evaluation criteria, 4) pre-conference, 5) clinical teaching from real situations, 6) post- conference, and 7) improving clinical teaching skills; Step 3- Teaching evaluation. This step consisted of three sub-steps, as follows. 1) self-evaluation by learners, 2) reflection-evaluation by nurse preceptors, and 3) documentation of evaluation by nurse preceptors. Therefore, nursing administrators can implement the results of this research as a process for clinical supervision and develop supervision systems in the nursing organizations to be more effective.

Review of State Boards of Nursing Rules and Regulations for Nurse Preceptors.

The clinical education of undergraduate nursing students relies heavily on the use of staff nurses who assume the preceptor role. The best and most efficient utilization of preceptors is unknown. This study reviewed Board of Nursing rules and regulations for all 50 states, the District of Columbia, and the U.S. territories for their published requirements regarding preceptors. Specifically, this review focused on preceptor-student and faculty-student ratios, role responsibilities, and requirements of preceptors and faculty in undergraduate precepted clinical experiences. Although some commonalities were noted, such as eligibility (RN licensure), degree requirements (baccalaureate), and years of experience (1 to 3), 11 states had no documented regulations. The existing documents appear to lack depth, specificity, and consistency. Because preceptors are utilized to such a great extent, the eligibility, selection, preparation, and expectations of preceptors and faculty who work with them should be more explicit. [J Nurs Educ. 2018;57(3):134-141.].

Nurse preceptors self-reported teaching skills competencies: Training preparation survey

Clinical Nurse preceptors are a vital part in facilitating knowledge application and acquiring of clinical nursing skills. Nurse preceptors come from various background of training for the role and may encounter challenges with orienting nursing students and novice nurses. Nurse preceptors’ orientation challenges may interfere nursing students’ and new nurses’ learning opportunities, which may lead to less than optimum learning environment. Understanding nurse preceptors’ self-reported role preparation may shed light to the preceptor-oriented learning process. The purpose of the study was to compare self-reported feedback of nurse preceptors who received formal training and that of nurse preceptors without formal training.

Enhancement of Professional Development of Front-Line Nurse Preceptors in a Dedicated Education Unit.

Dedicated education units (DEUs) have been well established throughout the country as a means of developing clinical skills in nursing students. In a DEU, maintaining an adequate number of well-prepared clinical nurse preceptors is essential for unit sustainability and effective student perception. This study was a quasi-experimental design using self-reported survey data. A comparison analysis was conducted using the initial results of the Revised Professional Practice Environment (RPPE) survey (i.e., pre-participation and no orientation) after completion of an orientation program and participation as preceptor in a DEU. Front-line nurses who participated as preceptors for one semester in a DEU demonstrated statistically significant improvement in two of the eight components of professional practice measured by the RPPE. This study lends support to the notion that preceptors do experience improvement in professional practice as a result of participation in a DEU. J Contin Educ Nurs. 2017;48(1):40-46.

Interventions Used by Nurse Preceptors to Develop Critical Thinking of New Graduate Nurses: A Systematic Review.

Healthcare complexity and patient acuity necessitate competent nurses with critical thinking abilities. However, these skill sets are less developed among newly hired graduate nurses. The overall purpose of this systematic review was to examine interventions/strategies implemented by preceptors in healthcare organizations to promote critical thinking of new graduate nurses. A systematic search of the literature resulted in 602 citations, with nine studies meeting the inclusion criteria. Educational interventions were varied and will be described in this article. Preceptor education was a key component in the studies reviewed.

A framework to support preceptors’ evaluation and development of new nurses’ clinical judgment

In today’s complex, fast-paced world of hospital nursing, new graduate nurses do not have well-developed clinical judgment skills. Nurse preceptors are charged with bridging the gap between new graduates’ learning in school and their autonomous practice as RNs. In one large, urban medical center in the U.S., a clinical judgment model and rubric were used as a framework for a new evaluation and orientation process. Preceptors of new graduate nurses who had used the former and new processes described their experiences using the framework. The findings indicated that having a structured framework provided objective ways to evaluate and help develop new graduate nurses’ clinical judgment. It is hypothesized that academic clinical supervisors may find such a framework useful to prepare students for transition to practice.

Enrolled Nurses’ experiences learning the nurse preceptor role: A qualitative evaluation

Summary Background Preceptors are crucial to the provision of effective clinical learning experiences for nursing students however many are insufficiently trained and lack support in the role. Within Australia, preceptors may work with students preparing to become Registered Nurses or Enrolled Nurses. An intervention was designed specifically to engage Enrolled Nurse preceptors because they are particularly overlooked. Methodology A qualitative evaluation of the educational experience was undertaken using semi-structured group interviews. Findings Four themes were identified: (a) feelings of disempowerment hinder a desire to do the job, (b) open to embracing opportunities to learn about clinical teaching, (c) barriers to engagement and (d) preceptoring across nursing divisions. Conclusion The study identified that the learning experience was valuable. In particular participants enjoyed the challenge of engaging with digital stories where other experienced educators shared the way they responded to learning problems and developed solutions, and the facilitated discussions. Recommendations to further improve the online resource included development of stories that are relevant to the unique challenges Enrolled Nurse preceptors face.

Mixed Method Research Investigating Evidence-Based Practice Self-efficacy, Course Needs, Barriers, and Facilitators: From the Academic Faculty and Clinical Nurse Preceptors

The current challenges faced by nurses in providing high quality and evidence-based practice (EBP) supported care require profound changes in nursing education. To understand the changes needed to strengthen EBP education, the researchers examined EBP self-efficacy, course needs, barriers, and facilitators for academic faculty and clinical nurse preceptors to teach EBP in undergraduate nursing curricula. For this study, mixed-method approach was used with survey data collected from 73 academic faculty members from 54 universities. Further, 17 clinical nurse preceptors in three academic hospitals provided qualitative data for exploration of barriers and facilitators to teaching EBP. Data analysis used SPSS/WIN 21.0 and content analysis. Quantitative data showed that although the overall level of self-efficacy among faculty was moderate, the implementation levels were relatively low. Most faculty members agreed with the need to integrate EBP courses into undergraduate nursing curricula. The qualitative data showed that the barriers to teaching EBP were lack of knowledge, skill, and initial investment for teaching EBP; hierarchical, rules-oriented nursing culture; potential learner overloads in processing EBP; limited research dissemination and application. Facilitators were identified as the importance of EBP to the profession of nursing; collaboration in schools and hospitals; and continuing education in teaching/utilizing EBP. The findings indicate that for successful integration of EBP ni nursing education there is a need for faculty training and integrated EBP courses.

The development and validation of the Clinical Teaching Behavior Inventory (CTBI-23): Nurse preceptors' and new graduate nurses' perceptions of precepting

Few studies have examined the perceptions of clinical teaching behaviors among both nurse preceptors and preceptees. To develop a Clinical Teaching Behavior Inventory (CTBI) for nurse preceptors' self-evaluation, and for new graduate nurse preceptee evaluation of preceptor clinical teaching behaviors and to test the validity and reliability of the CTBI. This study used mixed research techniques in five phases. Phase I: based on a literature review, the researchers developed an instrument to measure clinical teaching behaviors. Phase II: 17 focus group interviews were conducted with 63 preceptors and 24 new graduate nurses from five hospitals across Taiwan. Clinical teaching behavior themes were extracted from the focus group data and integrated into the domains and items of the CTBI. Phase III: two rounds of an expert Delphi study were conducted to determine the content validity of the instrument. Phase IV: a total of 290 nurse preceptors and 260 new graduate nurses were recruited voluntarily in the same five hospitals in Taiwan. Of these, 521 completed questionnaires to test the construct validity of CTBI by using confirmatory factory analysis. Phase V: the internal consistency and reliability of the instrument were tested. CTBI consists of 23 items in six domains: (1) 'Committing to Teaching'; (2) 'Building a Learning Atmosphere'; (3) 'Using Appropriate Teaching Strategies'; (4) 'Guiding Inter-professional Communication'; (5) 'Providing Feedback and Evaluation'; and (6) 'Showing Concern and Support'. The confirmatory factor analysis yielded a good fit and reliable scores for the CTBI-23 model. The CTBI-23 is a valid and reliable instrument for identifying the clinical teaching behaviors of a preceptor as perceived by preceptors and new graduate preceptees. The CTBI-23 depicts clinical teaching behaviors of nurse preceptors in Taiwan.

Reflection on Nurse Preceptor Training Courses: The Experiences of Nurse Preceptors and Preceptees

The Taiwan Joint Commission on Hospital Accreditation established a nurse preceptor training program in 2012. However, there has been minimal assessment of the nurse preceptor training program from the respective perspectives of nurse preceptors and preceptees. This study explores the teaching experiences of nurse preceptors and the learning experiences of new nurses, and reflects on the nurse preceptor training program. Investigators used a qualitative method to conduct 5 focus group interviews with 15 nurse preceptors and 14 new nurses in a medical center in northern Taiwan. Interview data was analyzed using content analysis. Eight themes were categorized from the teaching experiences of preceptors and two themes were categorized from the learning experiences of preceptees. The analysis of the data shows that this nurse preceptor training program focused on enhancing teaching skills and assessment skills and lacked instruction in teaching affection, guidance skills, and emotion management. This study may be used as a reference for developing training courses for nurse preceptors in Taiwan.

Attributes and Qualifications of Successful Rural Nurse Preceptors: Preceptors’ Perspectives

Nurse preceptors are integral to retaining new nurses. Given the challenges associated with attracting and retaining rural nurses (Trossman, 2001), the importance of preceptors in the retention of new nurses and the dearth of studies explicitly examining the attributes and qualifications of successful rural nurse preceptors, the purpose of this study was to unearth attributes and qualifications of successful rural nurse preceptors. In this basic qualitative study, 19 participants completed 1-2 hour in-depth interviews. Data was analyzed using the constant comparative method (Glaser &amp; Strauss, 1967). Major themes included a sense of honor, professionalism, self-efficacy, and the ability to learn. In addition to confirming previous research, the findings demonstrated the importance of emotion in the teaching/learning process and the influence of observational learning on preceptors’ present-day instruction. Practical implications included acknowledging emotion in the teaching/learning process, the need for new and experienced preceptors to share information and the importance of creating opportunities for critical reflection in preceptor education programs.