PREPARATION OF CLINICAL PRECEPTORS

The development of a framework for clinical education programme of undergraduate nursing students in Ghana

INTRODUCTION

Clinical education is an important aspect of the training of nursing students but it is faced with challenges in Ghana. The development of a framework will respond to the need for improvement in the quality of clinical nursing education. This study describes part of a larger study which culminated in the development of a framework for a clinical education programme for undergraduate nursing students in Ghana. The aim of the current study was to integrate findings from a scoping review and situational analysis to develop a framework for clinical education in nursing.

METHODS

A sequential multimethod design approach was used to conduct the study. A scoping review on the practices that facilitate clinical nursing education and situational analysis were first conducted. The lessons learnt from the scoping review and the situational analysis provided the data matrix that was triangulated to develop the framework. The framework was developed using the model for clinical education developed by South African Nursing Education Stakeholders in consultation with experts in nursing education. An implementation plan was developed from the framework and evaluated using a Delphi technique.

FINDINGS

The resulting framework indicates the need for effective communication and collaboration between nursing education institution and the service setting to ensure that there is a well-structured clinical placement, formal supervision system and effective clinical assessment of students. The framework also proposes that to ensure quality clinical nursing education there is the need for Nursing Education Institutions to implement innovative and cost-effective clinical teaching methods.

CONCLUSION

The framework spells out the functions of the various stakeholders in nursing education and how these can be integrated and implemented to enhance quality clinical nursing education. Effectiveness of the thematic areas of the framework will increase the quality of clinical nursing education.

The perceptions of newly qualified nurses on the guidance by preceptors towards becoming experts in nursing

Background

The new role as professional nurse can be a difficult transition for the new qualified nurses. During this time, factors such as not being well prepared, working without supervision and a lack of guidance can be the result of a difficult transition.

Objectives

The purpose of this study is to assess the perceptions of newly qualified nurses on the guidance given by their preceptors towards becoming experts in practice at a Level II regional hospital in the Western Cape.

Method

A non-experimental quantitative descriptive design was followed. Collection of data was done by means of a questionnaire, designed by the researcher, using a cross-sectional research method. Non-probability sampling produced a sample of 162 nurses comprising registered nurses (48.2%), enrolled nurses (32.7%), and enrolled nursing auxiliaries (19.1%). Statistical analysis was performed using the Statistical Analysis System (SAS), version 9.3.

Results

The results of the research study indicated that respondents had more positive experiences than negative ones. The respondents indicated that for the role and characteristics of the preceptor, expectations were met for knowledgeability, professionalism and contribution to team work. Furthermore, the results indicated that the respondents would recommend preceptorship.

Conclusion

Preceptorship is one of the major interventions available to support newly qualified nurses by easing the transition from student to practicing nurse and reducing the theory-practice gap. The findings emphasised the importance of ongoing support programmes for nurses after obtaining a new qualification or/and being a new nurse.

Preceptors' perceptions of assessing clinical associate students at district hospital sites

BACKGROUND

Preceptors are key stakeholders in distributed health professions' education. They supervise students in the clinical setting to enable them to have a practical experience with patients, and they assess students' skills at the highest tier of clinical assessment. The university where this study was done conducts a distributed Bachelor of Clinical Medical Practice course on a distributed platform which is dependent on preceptors at the training sites. Understanding the perceptions of preceptors, as major stakeholders, regarding the student assessment they do will assist the faculty to provide better support and development that might be needed and assist in maximising the benefits of distributed training.

AIM

The aim of this study was to explore the perceptions of preceptors regarding assessing clinical associate students at district hospitals in the Bachelor of Clinical Medical Practice programme.

SETTING

The study was conducted at a rural university in the Eastern Cape province of South Africa.

METHODS

This was a qualitative study involving nine preceptors who were purposively selected from three district hospital training sites based on their involvement in assessing clinical associate students. Semi-structured interviews were conducted, recorded, transcribed and thematically analysed.

RESULTS

Four themes emerged from thematic analysis: assessment issues, preceptor issues, student issues and university support issues. Preceptors are committed and enthusiastic in training and assessing the clinical associate students but require input from the university in terms of training and ongoing support.

CONCLUSION

Lack of training threatens the validity of preceptor assessment. Academic institutions should train and support preceptors to enable them better to fulfil their roles.

Deliberate teaching tools for clinical teaching encounters: A critical scoping review and thematic analysis to establish definitional clarity

PURPOSE AND METHOD

We conducted a scoping review of tools designed to add structure to clinical teaching, with a thematic analysis to establish definitional clarity.

RESULTS

Six thousand and forty nine citations were screened, 434 reviewed for eligibility, and 230 identified as meeting study inclusion criteria. Eighty-nine names and 51 definitions were identified. Based on a post facto thematic analysis, we propose that these tools be named "deliberate teaching tools" (DTTs) and defined as "frameworks that enable clinicians to have a purposeful and considered approach to teaching encounters by incorporating elements identified with good teaching practice." We identified 46 DTTs in the literature, with 38 (82.6%) originally described for the medical setting. Forty justification articles consisted of 16 feedback surveys, 13 controlled trials, seven pre-post intervention studies with no control group, and four observation studies. Current evidence of efficacy is not entirely conclusive, and many studies contain methodology flaws. Forty-nine clarification articles comprised 12 systematic reviews and 37 narrative reviews. The most number of DTTs described by any review was four. A common design theme was identified in approximately three-quarters of DTTs.

CONCLUSIONS

Applicability of DTTs to specific alternate settings should be considered in context, and appropriately designed justification studies are warranted to demonstrate efficacy.