Developing a Preceptorship/Mentorship Model for Home Health Care Nurses

Preceptorship and mentorship programs are used in the health care sector to educate nurses, enhance their leadership skills, and improve their quality of work life. Recognizing the importance of these initiatives, Saint Elizabeth Health Care sought funding to create an innovative model of preceptorship/mentorship that meets the unique needs of home health care nurses. The methods utilized included focus groups, key informant interviews, and a workflow analysis. Factors that influence preceptorship such as nursing workload, preceptor training and remuneration were examined to develop a new model that offers career enhancement and leadership opportunities for preceptors and mentors, and promotes a welcoming environment for preceptees. Reward and recognition programs were created for preceptors to acknowledge their leadership contribution at the front line. This study demonstrates how evidence and innovation were used to create a preceptorship/mentorship model to develop community nursing leaders of the future.     

Preceptor/mentor education: a world of possibilities through e-learning technology

Preceptorship/mentorship is designed to socialize students into the nursing profession, promote their confidence/competence and foster their critical thinking ability. In today's global context, opportunities exist for local, rural, national and international student placements which provide exciting and mutually rewarding preceptorship experiences. Despite the recognized value of those involved in preceptorship/mentorship, however, little progress has been made regarding the development of an infrastructure that effectively supports their ongoing education. This project, piloted from October 2008 to February 2009, leveraged our established research and teaching experience in preceptorship with technologies that allowed us to create an accessible and engaging e-learning space designed to support preceptors in a seamless fashion, improve the quality of the student preceptorship and enhance professional teaching capacity. A purposive sample of 25 preceptors was selected with a total of 18 preceptors successfully completing the five month program. Upon completion, participants were surveyed and individually interviewed. Data analysis revealed the program to be informative, supportive and highly valued. Knowledge derived from this study can: a) further enrich the substantive nature and infrastructure of online preceptor education; and b) contribute to clarifying best practices for preceptor support, facilitation, and ongoing professional development with a view to enhancing the preceptorship experience.     

Positioning mentorship within Australian nursing contexts: a literature review

There are a variety of structured and unstructured supportive relationships available to nurses. Internationally, nurses commonly use preceptorship, clinical supervision, and mentorship to meet distinct needs and provide differing levels of commitment, intensity, and enabling functions. Of particular interest to the nursing profession is the use of mentoring relationships to support nurses in achieving leadership positions. In Australia, preceptorship and clinical supervision are freely used and understood by nurses however, mentoring relationships are less readily applied, and agreed meanings and understanding are lacking. This paper will explore the range of supportive relationships available to nurses. The terms used to define and describe these relationships, and how these relationships are contextualised, will be explored in order to better understand the position of mentorship for nurses in Australia. The potential value of mentorship in developing nursing leadership in Australia will also be identified.     

Challenges of the preceptors working with new nurses: A phenomenological research study

IntroductionPreceptors play an important role in the transition of new nurses to the practice setting, however, preceptorship experience has been perceived as stressful by preceptors. This study aimed to explore the lived experiences of nurse preceptors working with new nurses.MethodThis qualitative study used the hermeneutic phenomenological design to explore the experiences of six nurse preceptors working with new nurses in a tertiary pediatric teaching hospital in Northwest of Iran, who were recruited by purposive sampling. Data were collected using in-depth semi-structured individual interviews between July 2014 and March 2015, and analyzed using the Diekelmann's seven-stage method.ResultsData analysis revealed three themes: 1) preceptorship as a challenging and stressful role; 2) lack of support; and 3) lack of appreciation. Preceptorship as ‘a challenging and stressful role’ was the constitutive pattern that unified the themes.ConclusionThe preceptorship of new nurses is challenging and stressful. Preceptors endure several roles concurrently, thus, their workload should be balanced appropriately in order not to compromise with one another and evade burnout. The preceptors need to be well supported and their contribution be appropriately recognized. Setting clear objectives and realistic expectations, and having clear policies and guidelines in place should help develop a preceptorship program that is more likely to bring about positive outcomes for both preceptors and new nurses.     

Nursing preceptorship experiences in rural settings: “I would work here for free”

AimsThe primary aim was to capture the experience of preceptorship in a rural setting, via photographic narrative. It is hoped that this narrative will highlight areas that require greater support; communicate the experience of rural preceptorship for students, educators and policymakers; and emphasize the benefits of this experience for these current and future stakeholders.MethodsIn a photovoice study, preceptors (n = 4) and students (n = 4) in rural, Western Canadian health care settings were given digital cameras and asked to provide images and commentary about the experience of preceptorship. Participants selected the photographs to be included as data, and participated in thematic data analysis, through facilitated group discussions during and following the preceptorships.FindingsThis article explores the category of teaching and learning, encompassing three themes: confidence, conscientiousness, and mutual growth. Preceptors emphasized the importance of students bringing sufficient knowledge to the rural preceptorship, pertaining not only to the nature of care but also to the predominant health care issues in the community.ImplicationsThe implications were generated in part by the participants, who indicated a need for more student practica in rural settings; curricular changes to incorporate knowledge about rural health care and communities; post-graduation rural mentorship programs; and site/community-specific preparation.     

Effects of a preceptorship programme on turnover rate,cost, quality and professional development

Aim and objectives. The purpose of the present study was to design a preceptorship programme and to evaluate its effects on turnover rate, turnover cost, quality of care and professional development. Background. A high turnover rate of nurses is a common global problem. How to improve nurses’ willingness to stay in their jobs and reduce the high turnover rate has become a focus. Well‐designed preceptorship programmes could possibly decrease turnover rates and improve professional development. Design. A quasi‐experimental research design was used. Methods. First, a preceptorship programme was designed to establish the role and responsibilities of preceptors in instructing new nurses. Second, a quasi‐experimental design was used to evaluate the preceptorship programme. Data on new nurses’ turnover rate, turnover cost, quality of nursing care, satisfaction of preceptor’s teaching and preceptor’s perception were measured. Results. After conducting the preceptorship programme, the turnover rate was 46·5% less than the previous year. The turnover cost was decreased by US$186,102. Additionally, medication error rates made by new nurses dropped from 50–0% and incident rates of adverse events and falls decreased. All new nurses were satisfied with preceptor guidance. Conclusions. The preceptorship programme effectively lowered the turnover rate of new nurses, reduced turnover costs and enhanced the quality of nursing care, especially by reducing medication error incidents. Positive feedback about the programme was received from new nurses. Relevance to clinical practice. Study findings may offer healthcare administrators another option for retaining new nurses, controlling costs, improving quality and fostering professional development. In addition, incentives and effective support from the organisation must be considered when preceptors perform preceptorship responsibilities.     

A Nordic model for learning compassionate care in clinical education

BackgroundPreceptorship 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.AimThe 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.MethodThis 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.FindingsAccording 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.ConclusionsThis 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.     

Australia’s first Transition to Professional Practice in Primary Care Program: Qualitative findings from a mixed-method evaluation

Background

In Australia, there is an increasing demand for registered nurses in primary health care. Registered nurses graduating from university typically enter the workforce via supported transition to professional practice programs in acute-care hospital settings. A prospective strategy to create a sustainable primary health care workforce is to develop comparable transition programs in primary health care settings, such as general practice. We developed, implemented, and evaluated Australia’s first transition to professional practice in primary care program.

Supporting preceptors of distance nurse practitioner students

Preceptors play an important role in facilitating clinical competency development of nursing students. Support of preceptors is essential to ensure optimal student learning as well as preceptor satisfaction, recruitment and retention. Distance education programs face a unique barrier in supporting preceptors due to lack of physical proximity to preceptors and students. This quality improvement initiative explored current supports available to preceptors of students in distance nurse practitioner programs and the importance preceptors place on these supports. Findings revealed individual, institutional and external factors must be jointly considered to optimally support preceptorship. The study provides a Canadian perspective to a growing body of global research on nurse practitioner student preceptorship, contributing to development of best practices for supporting preceptors and students in distance health education programs.     

An evaluative study of clinical preceptorship

Clinical preceptorships, in collaboration between clinical agencies and educational institutions have been documented as an effective and innovative means of facilitating student learning, providing advantages for both the clinical and educational settings. A preceptorship programme of 100 hours duration was developed and delivered by the nurse education institute, in consultation with a health care organization. The objectives of the preceptorship programme were to help registered nurses, in partnership with clinical nurse educators, to effectively integrate, support and assist the development of clinical competence in the undergraduate nursing student. Following the implementation of the preceptorship programme a research study was conducted to evaluate programme effectiveness. The purpose of the study was to examine preceptors, preceptees, and nurse managers' preceptions of the preceptor role and factors which influenced the performance of preceptors. The methods used in this study included those commonly found in evaluation research. That is, participants were drawn from those who were involved, either directly or indirectly, in the preceptorship programme, namely preceptors, preceptees and nurse managers. Using focus groups, they were each asked to identify the outcomes of the programme in practice. Study findings highlighted the importance of formal preceptor preparation, which was shown to enhance teaching and learning opportunities for student preceptees, personal and professional development of the preceptors, and the promotion of positive partnerships between nurse educators and nurse practitioners. The need for formal recognition of the preceptor role in practice, particularly in relation to the provision of adequate time and resources, emerged from the study. The research findings enabled the development of an evaluative model of preceptorship, which highlights the intrinsic and extrinsic factors impacting on the preceptor role.     

Get the most from your preceptorship program

Carefully designed, systematically implemented, and comprehensively evaluated clinical preceptorship programs can expand and enhance the educational experience of baccalaureate nursing students. In addition, such programs can increase the satisfaction and vitalize the teaching and leadership roles of staff nurse preceptors. Such programs may attract faculty and new graduates to a particular practice setting, as well as attract staff to a particular academic program for further education. In an era of increased professional accountability and demands for cost containment, collaboration between academic programs and practice settings can ensure more efficient and effective use of resources to ease the transition of new nurses from the world of education to the world of clinical practice.     

An evaluation of a strategy to improve the support of orthopaedic nurses through a team preceptorship programme

Transition to a new work area is often stressful for both experienced and new graduate nurses. It is essential that the new graduate be supported through this transition period to enable them to adjust to the environment itself, refine knowledge, and develop skills specific to their chosen clinical stream. In past years, several strategies have been designed with varying levels of success.This study evaluates an Australian transition support model, where the fundamental difference is that the management of the program is facilitated by a nurse possessing refined leadership, communication, clinical and organisational skills.The model has been evaluated on its effectiveness in meeting specific outcomes. The findings revealed that this coordinated team approach provided increased support for the new graduate, reduced the stress and workloads on the preceptors, whilst promoting confidence in the new starters and preventing conflict between preceptors and preceptees. The Coordinator’s role was shown to be an effective and crucial component in the Coordinated Team Preceptorship Model (CTPM) and findings illustrated that a team preceptorship model is not sustainable without a Coordinator.     

Are preceptors for orientation of new nurses effective?

The intent of this secondary analysis of a large data set was to provide empirical data on the benefits of preceptorship programs for orientation. Do nurses with preceptors have more satisfaction, social integration, and professionalism; less turnover; and better performance? The subjects were newly employed nurses, 177 were assigned to preceptors, and 98 did not have preceptors. The subjects completed questionnaires at three time periods: during the first few weeks on the job and at 6 and 12 months after employment. Data were analyzed by student's t test and chi square analysis. On average, nurses with preceptors and less education and experience and were more involved with family. They worked on units with sicker patients. Nurses with preceptors were more satisfied with social and psychological rewards initially and had more of a feeling of self-regulation. Previously employed nurses with preceptors reported more social integration at 6 and 12 months. The study provides beginning evidence that preceptors are beneficial for nurses who have limited education and experience.     

Partnering to Lead Change: Nurses’ Role in the Redesign of Health Care

Health care has a long-held perception of perioperative nurses as providers who advocate for patients and who carry out physician orders. According to the Institute of Medicine’s 2010 report on the future of nursing, not only must that view evolve, but nurses also must play a leading role, in partnership with physicians and other health care colleagues, if health care reform is to succeed. Several factors will prepare nurses for this new role of partnering to advance health, including advancing their formal education, developing leadership as a core competency, acquiring leadership skills, and being active in new models of leadership (ie, mentorship, volunteering, advocacy).     

Peers and partners: working together to strengthen preceptorship in mental health nursing

The Sussex Education Consortium commissioned a development project to identify the education and training needs of community mental health nurses (CMHNs). The project also afforded an opportunity to examine the CMHNs' perception of their role of preceptor with pre-registration diploma nursing (PRDN) students following the mental health branch. Utilizing a 'responsive evaluation' methodology, stakeholders' views were captured. As a consequence of the issues and concerns raised, the Consortium commissioned a second project, following a similar methodolgy, to explore preceptorship in greater depth. This paper reports stakeholders' views on preceptorship arrangements expressed in semi-structured interviews, focused group discussions and other fora during the two projects. Preceptor preparation and support arrangements did not meet the needs of preceptors. Many preceptors felt their role was neither valued nor acknowledged. The link lecturer role was perceived as important by preceptors; but lecturers were often unable to meet the expectations placed upon them. The volume of students and allocation arrangements caused problems for placement areas. Finding time to carry out the roles of the preceptor was a challenge for practitioners. Recommendations for improving preceptorship are discussed and developments described, illustrating how locally commissioned research may influence both education and practice in mental health nursing.     

Preceptorship and critical thinking in nursing education

Although preceptorship is being used increasingly by nursing faculty in the practice setting, little is known about how preceptors teach and even less is known about how critical thinking is being fostered in that relationship. The purpose of this study was to examine the process used in preceptorship to develop and promote the critical thinking ability of baccalaureate nursing students. Using the grounded theory method, this study was conducted in a large tertiary care hospital. Participants included fourth-year baccalaureate nursing students (preceptees) and their staff nurse preceptors. Data collection was composed of semistructured interviews and observations of the preceptors and preceptees as they worked together in the practice setting. Secondary data sources included documents considered appropriate to the study (e.g., nurse notes, student journals). By constant comparative analysis of the data, the findings of this study revealed a process that reflects the enabling of students by preceptors to develop and promote their critical thinking ability in the practice setting.     

Developing a collaborative preceptor program involving registered nurses, student nurses and faculty.

This paper addresses a collaborative preceptorship program involving a group of undergraduate nursing students, their registered nurse preceptors employed on the paediatric ward of an acute care hospital, and academic staff from a university school of nursing. The project utilised a fourth generation evaluation model, adapted from action research methods, which comprised a series of parallel focussed group discussions with a registered nurse preceptor group and a student nurse group. During the project, members of the two groups explored the issues around the supervision of students in practice in an acute paediatric context. This resulted in the development of innovative approaches to the supervisory practices utilised by preceptors. It also highlighted the benefits of collaboration between universities and hospital staff in developing preceptorship programs which respond appropriately to the needs of both preceptors and students.