Preceptorship Experience Research Articles

Improving the Precepting Experience in a Burn Intensive Care Unit.

Improving the Precepting Experience in a Burn Intensive Care Unit.

Nursing interns' perception of clinical competence upon completion of preceptorship experience in Saudi Arabia

BackgroundNursing interns are newly graduate students with limited real-life work experiences. These novices are in the process of enhancing their competencies in the delivery of quality nursing care with the guidance of the preceptors. Hence, it is relevant to examine the impact of preceptorship, as a teaching strategy, among nursing interns during their preceptorship years in clinical settings. ObjectiveThe aim of this study is to determine if the preceptorship program has provided the nursing interns the needed education in enhancing clinical competence. SettingThe study was conducted in one of the tertiary hospitals in Riyadh, Saudi Arabia. ParticipantsConvenience sampling was used to recruit 92 undergraduate nursing interns who have completed the five-years nursing education including preceptorship. MethodsThe nursing interns completely answered the survey questionnaires which covers Benner's Competencies, Knowles' Adult Learning Theory and the Nursing Process. DesignThe study followed a mixed-methods design wherein a descriptive cross-sectional approach was used to identify factors affecting the nursing interns' perception towards clinical competence. Two open-ended questions referring to the improvement of internship program and competency were concurrently collected which was the qualitative portion of the study. ResultsThe preceptorship program enhanced the preceptees competencies in the clinical setting primarily in priority-setting with acutely ill patients, multitasking and demonstrating complex nursing skills. The majority of the nursing interns perceived preceptorship as a constructive experience. The availability, approachable attitude, and trustworthiness of the preceptor were viewed as influential factors in improving the interns' clinical competence. Variations were significant with phases of internship and type of school. Furthermore, results showed positive correlation between the nursing interns' efficacy and clinical competencies in professional behavior, general performance, and core nursing skills. ConclusionPreceptorship program positively impacts nursing interns' skills in handling actual patients in clinical setting. Hence, the preceptorship program is an effective teaching strategy which advances the novice to the next stage of developing clinical competence.

Clinical education of nurse practitioner students: Identifying incentives, barriers, and working models to develop sustainable preceptorships

The purpose of this article is to discuss ongoing barriers nurse practitioner (NP) programs face securing clinical education opportunities, identify incentives to precept, and introduce working models to sustain quality placements. A comprehensive review of literature related to NP preceptorships was performed. Commonly identified barriers included lack of compensation and decreased productivity. Motivating factors included a desire to give back to the profession and credit toward recertification. Working models to establish academic practice partnerships, streamline patient schedules, and prepare preceptors were shown to positively impact the precepting experience. Novel approaches to NP clinical education are necessary to create robust and sustainable learning opportunities.

Preceptors Experiences of Clinical Nurse in the Integrated Nursing Practice: Waiting and Going Together with Burden to Take on Preceptee

Preceptors Experiences of Clinical Nurse in the Integrated Nursing Practice: Waiting and Going Together with Burden to Take on Preceptee

What a difference a year makes

Yvonne Nolan reflects on her experiences of preceptorship and why being a newly qualified health visitor has been very different to her preceptorship as a midwife.

Perfil de preceptores e metodologias empregadas na formação de médicos residentes de um Hospital de Ensino do Estado do Pará

In the current context of medicine, new demands around the full attention to the patient arise, thus requiring changes in the training of health professionals. Innovative methods of teaching and learning process in health courses in the world have already been used for over 30 years, although in Brazil only for more than a decade. In medical residency (MR), the learning process is based on the transmission of medical preceptor experience for the resident. Objective: so an improvement in this process requires significant changes in the training of preceptors. In order to know the methods and knowledge of the preceptors on methodologies and active references, in a teaching hospital, as well as their knowledge about active methods. Methods: it was developed an exploratory descriptive study with a qualitative nature, through semi-structured interviews. Three thematic axes were discussed: I- characterization of receptors; II- fields of work, III-knowledge and teaching methods praxis, with emphasis on the interest of these preceptors to participate in pedagogical training in active methodologies. The content analysis under the perspective of Bardinwas used to study the data in this research. Results: The demographic characteristics of the participants were: predominantly female and aged between 50 and 60 years in the eight Registration Units (RU) addressed. All participants verbalized the use of real clinical case discussion or simulated for the pursuit of knowledge and evaluation of medical residents, although eight RU report not knowing the active methods of teaching and learning. Twelve (12) RU report they meet these methodologies and eight have reported the use of any active method in their daily practice. Conclusion: analyzing these perceptions, one may conclude that all interviewed preceptors have already used any active method, but in a intuitive way, since there’s indents suggested to aquire theoretical knowledge aboutt he cases taken in the medical scenario in practice. All participants have mencioned the necessity of more pedagogical training and have also reported that the influence of this lake leads to a weakening of the right practice of receptorism. Moreover, this variable, all involved cited the institutional infrastructure, continuing education guarantee, job plans, career and compensation for preceptors with motivating strategies and promoting quality in the teaching and learning process. From the theoretical trajectory of this study It was proposed a pedagogical training project in active methodologies for preceptors of MR of FSCMPA.

Perceptions, practice, and “ownership:” experiences in continuity of the patient-doctor relationship in a family medicine residency

The objective of this mixed-methods study was to determine interpersonal continuity (the ongoing therapeutic relationship between patient and health care provider) experiences of family medicine residents and preceptors, and explore their perceptions of interpersonal continuity. Quantitative data on resident and preceptor encounters were extracted from the electronic medical record (EMR). Opportunities for developing interpersonal continuity were determined using the Usual Provider Continuity (UPC) Index. A qualitative descriptive research method was used for the qualitative portion. Semi-structured interviews were conducted and constant comparative analysis was used to determine emerging themes. Residents were found to have low UPC rates; preceptor rates were higher. Qualitative findings showed variable experiences with interpersonal continuity not apparent from UPC rates. Both preceptors and residents expressed perception of "ownership" of patients as a significant barrier to interpersonal continuity. This study suggests that a perceived lack of individual "ownership" of a patient panel was a significant barrier to developing interpersonal continuity. This might conflict with current changes towards team-based health care delivery. Understanding perceptions and changing them through a multi-faceted approach including resident teaching and faculty development might help improve interpersonal continuity which are core to both family medicine curricula and current models of health care delivery.

Preceptorship vs. clinical models of learning: The experiences of Bahraini nursing students

Background: Different models of teaching and learning are used to produce competent skilled clinical nurses. Some are traditional clinical teaching methods while others are grounded in preceptorship principles of mentoring. Knowledge regarding student nurses’ experiences of preceptorship and its meaning for them can enhance the understanding of stakeholders in academia and practice to the needs of senior nursing students’ and can offer them guidance to construct a more efficient approach to clinical teaching.Objective: The aim of the study was to explore the lived experiences of senior student nurses of preceptorship, while on clinical placements , with the objectives of describing their experiences and their relations with preceptors and also to illustrate the factors that facilitated or hindered the clinical learning process.Methods: A phenomenological hermeneutical inquiry was utilized. Data collection was conducted using semi-structured interviews with ten purposively chosen senior nursing students. Smith’s Interpretative Phenomenological Analysis (IPA) was used as a framework for data analysis.Results: Students’ lived experiences of preceptorship were mainly positive. Three main themes were identified: (1) Role Model Identification; (2) Team Integration; (3) Interpersonal Professional and Structural Challenges. The findings showed that preceptor relationships shaped the acquisition of skills and knowledge of student nurses’ during their clinical placements.Conclusions: The findings illustrate the importance of collaboration between the academy and practice in providing support for student nurses and their preceptors. In addition, careful selection, comprehensive training and rewards for preceptors can enhance and facilitate student nurses’ learning.

Transition From Education to Practice for New Nursing Graduates: A Literature Review.

New nurse turnover costs organizations in the United States an estimated $1.4 billion to $2.9 billion per year (Meyer, Shatto, Delicath, & von der Lancken, 2017; Ulrich et al., 2010). Retention of graduate nurses can decrease costs, combat nursing shortages, and improve patient outcomes. Despite the increase in prevalence of nurse residency programs, new nurses are leaving their first positions at alarming rates. The purpose of this literature review is to examine the factors that affect graduate nurse transition to practice. Findings indicate that a supportive environment free from bullying, a positive preceptor experience, and self-confidence were keys to retaining new graduate nurses.

Residents as preceptors and educators: What we can learn from a national survey to improve our residency programs

IntroductionDeveloping pharmacy residents into effective preceptors is essential to meet the demands of pharmacy education. A survey was created to assess the availability of resident precepting educational opportunities, identify common barriers associated with developing preceptors’ skills, and discover strategies to optimize programming. MethodsAn online survey focused on the development of residents as preceptors was e-mailed to all residency program directors (RPD) for American Society of Health-System Pharmacists accredited residencies in the United States. Information was collected on program demographics, level of support and precepting activities offered and resident employment outcomes. ResultsFive hundred thirty-eight responses were received. The majority were postgraduate year one RPDs and had less than six residents. Sixty-one percent of programs were affiliated with a college of pharmacy. Seventy-eight percent devoted 10hours or less per month in developing residents as preceptors with 33% providing less than five hours. Seventy-one percent of the residency programs did not offer a formal precepting rotation. However, 59% of respondents indicated that their residency graduates frequently accepted positions, which required teaching/precepting. The most common barriers to developing residents as preceptors included: lack of time for residents to precept within the residency structure (41%), availability of preceptors to mentor residents throughout experience (33%) and lack of preceptors’ availability to mentor residents’ precepting abilities over time (30%). Discussion and conclusionsRPDs should prioritize training of residents as preceptors. Requiring residents to serve as primary preceptors in rotations dedicated to teaching is important to prepare for future job responsibilities.

Development, Implementation, and Evaluation of a Certified Registered Nurse Anesthetist Preceptorship-Mentorship Program.

Little evidence exists to support the effects of a preceptor-mentor program for orienting newly hired certified registered nurse anesthetists (CRNAs). The literature suggests that participation in a preceptorship-mentorship program will increase the satisfaction, confidence, and comfort of both preceptors and newly hired orientees. The purpose of this project was to determine the effects of these outcomes. This program was developed based on best evidence and implemented as a quality improvement project. Three sessions were held to educate preceptors (N = 12) in the following areas: communication skills, providing constructive feedback, and assessing learner's styles and needs. The results suggested that participation significantly increased CRNA preceptor satisfaction and comfort in the precepting experience. The newly hired CRNAs answered that they were mostly or very much satisfied and confident at the completion of their orientation period. This program can be expanded to include additional preceptors and be sustained with future new hires. J Contin Educ Nurs. 2017;48(10):464-473.

A Case Study on Experiences of Clinical Preceptors in the Undergraduate Nursing Program

A Case Study on Experiences of Clinical Preceptors in the Undergraduate Nursing Program

The Preceptor Experience, Suggestions from the Literature

Participants will gain awareness of the common perceived barriers to precepting dietetic interns (DIs) and receive evidence-based suggestions to overcome these barriers based on a multi-disciplinary literature review.

Putting knowledge to work in clinical practice: Understanding experiences of preceptorship as outcomes of interconnected domains of learning.

To explore how preceptor support can assist newly qualified nurses to put knowledge to work across interconnected forms of knowledge when delegating to healthcare assistants. Current literature on preceptorship in nursing has failed to explore how competence is underpinned by knowledge frameworks in clinical practice. An ethnographic case study in three hospital sites in England (2011-2014). Data collection included participant observation, interviews with 33 newly qualified nurses, 10 healthcare assistants and 12 ward managers. Data were analysed using thematic analysis. A tool to assist newly qualified nurses to delegate and supervise newly qualified nurses during the preceptorship period was developed and piloted with thirteen newly qualified nurses in the same sites. A process evaluation was undertaken. Focusing on a key task for newly qualified nurses, delegation to healthcare assistants, we argue that preceptorship can support newly qualified nurses as they put knowledge to work in the transition from qualifying student to newly qualified nurses. In supportive ward cultures, limited access to formal preceptorship can be bolstered by team support. newly qualified nurses in less supportive ward cultures may have both a greater need for preceptorship and fewer compensatory mechanisms available to them when formal preceptorship is not available. We argue that organisational learning contexts and individual learning styles (interconnected domains of learning) are key to understanding effective preceptorship. We suggest that putting knowledge to work early in their careers with preceptorship support may assist newly qualified nurses to develop confidence and competence in delegation and supervision of healthcare assistants. Our findings suggest that newly qualified nurses need to be supported by effective preceptorship in their learning as they transition from undergraduate to post graduate. Preceptorship programmes at ward and organisational level need to recognise the intensity of the learning required during this transition phase.

Use of an Innovative Interprofessional Mini-Series Movie to Train Preceptors

Objectives: To evaluate the effectiveness of the innovative “Preceptor Mini-Series: Adventures in Interprofessional Precepting” movie program in training pharmacy preceptors on interprofessional competencies and to determine pharmacy preceptors’ perceptions of the effectiveness of the Mini-Series format.
 Methods: Chronicled by two preceptor experts, the Mini-Series movie follows the challenges of pharmacy, nursing, and medicine students and their preceptor during six-week experiential rotations. Pharmacy preceptors were invited to events held at movie theatres or local classrooms in three different cities. Participants were asked to provide basic demographic information and answer four “pre-program” and “post-program” survey questions focused on working in an interprofessional environment on a 5 point scale, 1=strongly disagree, 5=strongly agree. The post-program survey also included six additional questions to assess participant’s attitudes toward the effectiveness of this medium.
 Results: Fifty-eight (58) individuals attended the movie events. The majority had more than ten years of preceptor experience (n = 21, 36.2%), were female preceptors (n = 40, 69.0%), and practiced in an interprofessional environment (n = 48, 82.8%). The participants’ scores on all four interprofessional confidence level questions were significantly increased after viewing the Mini-Series movie and the overall mean increased from 4.47 (pre-confidence level) to 4.79 (post-confidence level, p < 0.001). There were no significant differences of confidence levels based on gender, location, or number of students a preceptor took on rotation each year. However, participants with fewer years of preceptor experience (0-10 years) had a significantly higher perceived learning score than those with more preceptor experience (>10 years) (4.89 vs. 4.63, p = 0.020). The mean for satisfaction (4.9, 3 questions) was slightly higher than the means for perceived learning (4.8, 1 question), and instructional approach (4.87, 3 questions).
 Implications: After program completion, pharmacy preceptors indicated an increase in confidence level for precepting in an interprofessional environment. The Mini-Series movie program also yielded positive feedback on its delivery format and suggests the medium may be effective to use for similar future training initiatives.
 Conflict of Interest
 The authors report no conflicts of interest or financial incentives to disclose related to this project. Dr. Craig D. Cox conceptualized, developed, and directed the Mini-Seriesprogram described in the manuscript. All funding for and all income generated by the program studied is the property of the Texas Tech University Health Sciences Center School of Pharmacy.
 
 Type: Original Research

Using Training Needs Assessment to Develop a Nurse Preceptor-Centered Training Program.

Studies reveal that most nurse preceptor preparation programs do not meet nurse preceptors' training needs. This study thus developed a nurse preceptor-centered training program (NPCTP) in Taiwan. The ADDIE model was used for the instructional design. On the basis of the nurse preceptors' training needs assessment, the research team developed the NPCTP. Content was adopted from the authentic experiences of preceptors and new graduate nurses (NGNs) using interview data to make 81 videos with computer avatars and 10 live actor films. Each course was taught as nine instructional events. The NPCTP was evaluated using reflection quizzes, preceptors' self-evaluations, NGNs' evaluations, and focus group interviews. The NPCTP enhanced preceptors' clinical teaching behaviors and had a positive influence on NGNs. The NGN evaluation was even better than the preceptors' self-evaluation. This article provides the what and how for an NPCTP in Taiwan. J Contin Nurs Educ. 2017;48(5):220-229.

Organizational readiness for change: Preceptor perceptions regarding early immersion of student pharmacists in health-system practice.

To examine preceptors' perceptions regarding readiness for change pre- and post-implementation of a pilot early immersion program engaging student pharmacists in direct patient care. Student pharmacists enrolled in the second professional year of a Doctor of Pharmacy degree program completed a four-week health-system introductory pharmacy practice experience (IPPE) which was modified to include direct patient care roles in operational (drug preparation and dispensing) and clinical (comprehensive medication management) pharmacy environments. Pharmacy preceptors with direct oversight for program implementation completed a pre/post Organizational Readiness for Implementing Change (ORIC) survey and a 50-min interview or focus group post-experience. The ORIC survey evaluates two dimensions of organizational readiness for change - change commitment and change efficacy. Additional items assessed included implementation needs, support, and perceived value of the change. ORIC survey constructs were compared before and after the experience. Interviews and focus groups were audio recorded, transcribed, and evaluated by constant comparative analysis. A mixed methods approach was used to triangulate findings and develop greater understanding of the ORIC survey results. Twenty pharmacy preceptors (37±8 years of age, 60% female, 65% clinical pharmacist position, 70% prior preceptor experience) participated in the study. There were no significant changes in pre/post survey constructs, except for a decline in the perception of organizational change commitment (p<0.001). Sub-analyses indicated the decline was associated with items assessing individual dedication and individual commitment to the change (p<0.05 for both). Primary emerging themes from interviews included concerns about implementation requirements, contextual factors of the experience that affected implementation, and varying perceptions about the value of early immersion across preceptor roles. As pharmacy curricula immerse student pharmacists in practice earlier in their education, pharmacy departments can utilize the ORIC survey to identify preceptors' commitment and concerns to support the necessary changes for student pharmacist engagement.

Rural Nursing Preceptorship: An Integrative Review

Introduction: Canadians living in rural and remote areas experience lower health outcomes and life expectancy than their urban counterparts. Registered nurses employed in rural and remote areas are often the sole health care provider and are crucial to the delivery of high quality health care. Adequate preparation of future nurses who will work in rural and remote communities is thus essential to ensure access to safe, competent nursing care. Nursing preceptorship is the vehicle through which nursing students become immersed in a particular setting over an extended period of time. The purpose of this literature review is to determine the state of knowledge regarding rural nursing preceptorship. Methods: An integrative review of the literature was conducted using the SPIDER Tool for analysis of qualitative evidence. From a limited pool of relevant articles, over 40 were retrieved published between 2004 and 2015. Of these, 19 articles met the inclusion criteria and were included in the review and analysis. Each article was evaluated for adherence to the criteria of ethics and rigor using the Research Appraisal Checklist (RAC) tool of appraisal. Results: Of the 19 articles reviewed, various definitions of rural practice were provided. Standard definitions of rurality and rural practice is currently lacking. Four main themes emerged from the review of the literature around the nature of the rural experience interprofessional collaboration , recruitment and retention of nurses to rural communities and student performance evaluation and feedback . Conclusions: Preparation of future nurses who are competent and confident to practice in rural settings is crucial. Support and preparation required by faculty advisors and preceptors to ensure successful preceptorship experiences is not clearly understood. Recruitment and retention strategies aimed at the shortage of the nursing workforce in rural settings should highlight the unique nature of rural practice. Future research should focus on the challenges experienced by nursing students that may prevent them from seeking employment in rural communities. Keywords : rural nursing, preceptorship, rural preceptorship, rurality DOI: http://dx.doi.org/10.14574/ojrnhc.v17i1.430

The Experiences of Preceptors with New Graduate Nurses in Inpatient Units

The Experiences of Preceptors with New Graduate Nurses in Inpatient Units

Student and Preceptor Experiences at an Inter-Professional Student-Run Clinic: A Physical Therapy Perspective.

Purpose: Student-run clinics (SRCs) provide a unique opportunity for inter-professional education; they prepare health care students for a collaborative future by enabling them to interact with other such students in a clinical setting focused on inter-professional learning and collaboration. Physical therapy (PT) students are increasingly being included in SRCs; however, most research on student experiences in SRCs has been carried out with medical students. This qualitative study explores the perceived benefits of the PT experience in an SRC through the lens of PT students and their preceptors. Method: A qualitative interpretive-descriptive approach consisting of face-to-face, semi-structured interviews was used. Interviews were audiotaped and transcribed verbatim. Data were analyzed using a constant comparative approach. Results: Seven PT students and eight preceptors who volunteered at the SRC between September 2013 and May 2015 participated in the study. Three themes emerged from the interviews: (1) exposure to marginalized patient populations, (2) learning through inter-professional interactions, and (3) experience with different patient care approaches. Conclusions: Participating in an SRC enhances PT students' understanding of their and other health care professionals' roles. Students gained an appreciation for the social determinants of health and improved their knowledge of inter-professional collaboration. The knowledge gained from this study has the potential to inform PT professional development, SRCs, and PT education.