Supporting the transition to practice: preceptor behaviors that foster a positive student preceptorship experience.

OBJECTIVES: Preceptors support nursing students when transitioning to the professional nursing role. This study explored student perceptions of preceptor characteristics that promoted or hindered learning. METHODS: A Likert-scale survey including two open-ended questions was sent to 571 nursing students completing a preceptorship experience. Descriptive statistics were used to analyze responses to the Likert-scale items. Qualitative analysis was completed on the two exploratory questions to extract themes. RESULTS: Students rated the preceptor between 4=Very Good and 5=Outstanding for all items. No significant differences in scores were found when comparing results between programs. Themes assisting in learning included: increasing independence gradually and pushing out of comfort zone. Themes identified that hindered learning included: doubting self and being pushed aside. CONCLUSIONS: Future implications include communicating preceptorship objectives and providing ways to apply research to practice. These findings can guide collaboration between academic and practice partners to assist with transition to practice.

Assessing Student Performance in a Dedicated Education Unit: Validity of the Creighton Competency Evaluation Instrument.

ABSTRACT: In dedicated education units (DEUs), nurses serving as clinical teaching partners (CTPs) provide formative feedback about student performance. The Creighton Competency Evaluation Instrument (C-CEI) has demonstrated validity and reliability by faculty in both the simulated and clinical environments. The purpose of this pilot study was to determine the content validity of the C-CEI in the direct patient care environment when used by staff nurses functioning as CTPs in the DEU setting. Results indicate that the items of the C-CEI demonstrated necessity, fittingness, and understanding. CTPs reported the C-CEI is a valid instrument for use in the DEU setting.

Addressing the Perioperative Nursing Shortage Via a Perioperative Nursing Preceptorship for Baccalaureate Nursing Students.

A growing demand for perioperative nurses, insufficient interest in the perioperative nursing specialty, and nurse retirements have resulted in a perioperative nursing workforce shortage. Undergraduate nursing students' limited exposure to perioperative content, along with facility hiring practices that exclude recently graduated nurses, further contribute to this shortage. To address these concerns, a large health care system in the midwestern United States partnered with a college of nursing to institute a perioperative preceptorship for baccalaureate nursing students during their final semester. After completing the preceptorship, students reported increased understanding of perioperative nursing roles and responsibilities, time management, and patient safety skills; ability to work effectively as a part of an interdisciplinary team; and independence in the perioperative setting. Future study is needed to examine rates of matriculation among program graduates into perioperative nursing positions and the program's effect on the length of orientation for recently graduated nurses and nurse retention.

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.

Impact of the dedicated education unit teaching model on the perceived competencies and professional attributes of nursing students.

The Dedicated Education Unit clinical teaching model is a strategy designed to create optimal teaching and learning environments. Evidence is lacking regarding the influence of the Dedicated Education Unit model on students' specific nursing competencies and professional attributes. This descriptive, comparative study took place in a private baccalaureate nursing program in the United States. The researchers compared evaluations of student competencies and attributes who participated in a Dedicated Education Unit model (n = 163) to students who participated in a traditional clinical teaching model (n = 147) immediately following the practicum in which the Dedicated Education Unit model was used. The Dedicated Education Unit group scored significantly higher in 26 of 33 specific competencies and professional attributes compared to students who participated in the traditional clinical teaching model. These data suggest that the Dedicated Education Unit model promotes knowledge, competency, and professional attribute development more effectively than the traditional clinical teaching model.

The development of an instrument to evaluate interprofessional student team competency.

Healthcare institutions, accreditation agencies for higher learning, and organizations such as the National Academy of Medicine in the United States, support interprofessional education (IPE) opportunities. However, incorporating IPE opportunities into academic settings remains difficult. One challenge is assessing IPE learning and practice outcomes, especially at the level of student performance to ensure graduates are "collaboration-ready". The Creighton-Interprofessional Collaborative Evaluation (C-ICE) instrument was developed to address the need for a measurement tool for interprofessional student team performance. Four interprofessional competency domains provide the framework for the C-ICE instrument. Twenty-six items were identified as essential to include in the C-ICE instrument. This instrument was found to be both a reliable and a valid instrument to measure interprofessional interactions of student teams. Inter-rater reliability as measured by Krippendorff's nominal alpha (nKALPHA) ranged from .558 to .887; with four of the five independent assessments achieving nKALPHA greater than or equal to 0.796. The findings indicated that the instrument is understandable (Gwet's alpha coefficient (gAC) 0.63), comprehensive (gAC = 0.62), useful and applicable (gAC = 0.54) in a variety of educational settings. The C-ICE instrument provides educators a comprehensive evaluation tool for assessing student team behaviors, skills, and performance.

Defining Roles and Expectations for Faculty, Nurses, and Students in a Dedicated Education Unit.

The dedicated education unit (DEU) model of clinical nursing education is an innovative, evidence-based model for creating a more effective learning environment. Although nursing programs have used this model for years, the literature provides minimal direction to assist faculty in transitioning from traditional clinical teaching to the DEU model. This article reports the development and evaluation of 2 resources to help all involved understand teaching roles and desired learning outcomes in the DEU model.

Reliability and internal consistency findings from the C-SEI.

Human patient simulation (HPS) is increasingly being used as both a teaching and an evaluation strategy in nursing education. To meaningfully evaluate student performance in HPS activities, nurse educators must be equipped with valid and reliable instruments for measuring student performance. This study used a novel method, including leveled, video-archived simulation scenarios, a virtual classroom, and webinar and e-mail communication, to assess the reliability and internal consistency of data produced using the Creighton Simulation Evaluation Instrument. The interrater reliability, calculated using intraclass correlation (2,1) and 95% confidence interval, was 0.952 (0.697, 0.993). The intrarater reliability, calculated using intraclass correlation (3,1) and 95% confidence interval, was 0.883 (-0.001, 0.992), and the internal consistency, calculated using Cronbach's alpha, was α = 0.979. This article includes a sample of the instrument and provides valuable resources and reliability data for nurse educators and researchers interested in measuring student performance in HPS activities.

The development of a quantitative evaluation tool for simulations in nursing education.

In a complex healthcare environment, educating nursing students to safely care for clients is a challenging endeavor. As the use of high fidelity simulations increases, the ability to evaluate students is essential. A review of the literature identified a lack of tested simulation evaluation instruments to accurately measure student performance. A simulation evaluation tool was developed and tested with senior nursing students. Content validity was established from the literature and from the review of the tool by an expert panel. Reliability was established using sixteen simulation sessions, with two trained evaluators at each session. Percent agreement by evaluators ranged from 84.4% to 89.1%. Additional research needs to verify these results with different evaluators, varying levels of students, and additional scenarios. A valid, reliable tool to evaluate simulation experiences improves student assessment skills and ultimately clinical performance.

A unique simulation teaching method.

Simulation is an excellent venue for students to learn experientially and provides opportunities for students to practice problem solving and psychomotor skills in a safe, controlled environment. Through the use of a specifically designed format, faculty at Creighton University School of Nursing have developed a unique method of implementing high-fidelity simulation that allows a more comprehensive learning experience. This innovative teaching strategy incorporates not just skill acquisition, but also care management concepts into the scenario, while requiring only one faculty member. Students simultaneously take one of two paths through the components of this method to achieve the same learning outcomes.