Acknowledging Preceptors: Not an Easy Task

Preceptors' perspective on recruitment, support, and retention of preceptors

In this study, the researchers sought consensus among preceptors of senior nursing students about issues key to the preceptors' recruitment, support, and retention. A modified Delphi method with two rounds of questionnaires was used followed by a focus group to explore issues for which consensus was not reached. Preceptors agreed on the importance of personal satisfaction and on a number of tangible benefits of being a preceptors such as receiving information on a need-to-know basis. Topics such as how to help students think critically and how to provide constructive feedback also were considered important. Preceptors agreed that having students well prepared at the beginning of preceptored experiences was important as was receiving a personalized thank you letter to acknowledge their work a the end of the experience, two strategies that could help with retention.

The CCARE model of clinical supervision: bridging the theory-practice gap

Clinical supervision of nursing students is a key component of nursing education. The clinical setting provides students with an opportunity to develop a professional identity, knowledge base, and the ability to transfer classroom knowledge to the clinical setting. This paper suggests a model of clinical supervision that will address how to bridge the pre-existing theory-practice gap in nursing education through an attitude of caring and the utilization of caring behaviours based on Leininger's theory of culture care. Key concepts included in this model are: communication, collaboration, application, reflection and evaluation, these concepts comprise the CCARE model of clinical supervision.

Supporting preceptors

For effective teaching of nursing students and management of stress of increased workloads, preceptors require a great deal of support from nursing faculty, peers, and administrative personnel. Through a mailed survey, 295 preceptors reported that they would have appreciated more support. The best support is the continued and visible presence and involvement of instructors, which can be provided in person, by telephone, or via fax. This is best achieved if nurse educators, directors, and deans view themselves as copreceptors.

Being a preceptor is stressful!

Results of a mail survey of 295 preceptors indicated preceptoring nursing students can be a stressful experience, with overwork identified as the main source of stress. Overwork resulted from unsuitability of students for the clinical area, lack of time, and insufficient feedback and guidance. The findings suggest that both students and preceptors require proper readiness assessment and preceptorship preparation. Preceptorship stress needs to be acknowledged; it can be addressed through workload adjustments and by providing feedback and support from nurse educators, peers, and managers.

Self-efficacy of preceptors in the community: a partnership between service and education

Developing partnerships between service and education is one strategy to enhance student learning. A pre-test-post-test design was used to compare changes in perceptions of self-efficacy expectations in the supervision of a team of four senior nursing students. A convenience sample of eight community practitioners completed the Community Advisor Self-Efficacy (CASE) questionnaire prior to and following a 13 week community health practicum. Following the community practicum, the preceptors were also invited to attend a focus group to discuss their experience. No significant differences were found between the pre- and post-self-efficacy scores. Community practitioners felt reasonably confident in assuming the preceptor role. They felt most efficacious in encouraging students to use agency personnel and in providing student feedback, but somewhat less confident in areas such as selecting learning experience congruent with course objectives, and trusting the students' readiness to work with communities. All strategies to assist the preceptors in assuming their role were considered helpful. Evidence of the preceptors and faculty advisors working in partnerships with the students was not clearly evident. Findings are being used to refine strategies for preparing and supporting agency personnel for their role in working with students.

A centralized, computerized, and relational data base for student clinical placements

Quality clinical experiences are a critical component of advanced practice nursing (APN) curricula. Historically, nursing instructors coordinated both the didactic and clinical components of a course. Increasingly, course coordinators organize the didactic component, and external preceptors working in the clinical setting function as practicum teachers. Both scenarios involve labor-intensive processes, and neither facilitate the scheduling of clinical experiences that build on progressive learning across the student's curriculum. A centralized, computerized, relational data base for efficient management of APN preceptors and students across the curriculum was designed. One master's-prepared clinical coordinator maintains the data base and performs all related functions. This system offers numerous benefits to students, preceptors, ] faculty, and nursing school, including balanced and progressively complex clinical learning experiences for students from competent preceptors: consistent interface with students and preceptors; faculty relief from time-consuming tasks; rapid generation of a variety of tables, rosters, and reports; consistent tracking of preceptor evaluations; timely acknowledgment of preceptor assistance; and efficient communication among students, preceptors, faculty, and school administration.

New Graduates' Perceptions of Clinical Practice

This study describes the stresses and challenges experienced by graduate nurses in clinical practice during their initial orientation period and examines the relationship of social support to these stresses. Thirty-five graduate nurses completed a modified Pagana Clinical Stress Questionnaire and social support measure during their orientation period. The graduates experienced a moderate degree of stress in their orientation. Stresses identified most frequently were: lack of experience as a nurse, interactions with physicians, lack of organizational skills and new situations and procedures. Although orientation was stressful, when describing emotions experienced during this period, graduates reported positive emotions most frequently. Pearson correlation revealed no significant relationship between social support and stress. Significant correlations were found, however, between social support and stimulation in clinical practice (r = 57, p = .001) and development of self-confidence (r = 39, p = .029). Findings highlighted the important role of the preceptor during orientation.