Preceptorship and the Nurse Practitioner Student: Navigating the Liminal Space.

BACKGROUND: The purpose of this study was to explore the process occurring in preceptorship to prepare nurse practitioner students for their future role in professional practice. The researchers examined this process through the eyes of the preceptors, nurse practitioner students, and faculty. METHOD: A grounded theory method was used to explore the process involved in preceptorship to prepare nurse practitioner students in the clinical setting. RESULTS: The process of navigating the liminal space emerged from the data to explain what actually was occurring throughout the nurse practitioner student preceptorship. This process was reflected on three levels: (a) positioning in preceptorship, (b) repositioning on the threshold of nurse practitioner, and (c) embracing the new nurse practitioner role. CONCLUSION: As the data emerged, the researchers uncovered a multidimensional process that was occurring in preceptorship. This process was identified as navigating the liminal space.

Putting the evidence into preceptor preparation.

The term evidence-based practice refers to the utilization of knowledge derived from research. Nursing practice, however, is not limited to clinical practice but also encompasses nursing education. It is, therefore, equally important that teaching preparation is derived from evidence also. The purpose of this study was to examine whether an evidence-based approach to preceptor preparation influenced preceptors in a assuming that role. A qualitative method using semistructured interviews was used to collect data. A total of 29 preceptors were interviewed. Constant comparative analysis facilitated examination of the data. Findings indicate that preceptors were afforded an opportunity to participate in a preparatory process that was engaging, enriching, and critically reflective/reflexive. This study has generated empirical evidence that can (a) contribute substantively to effective preceptor preparation, (b) promote best teaching practices in the clinical setting, and (c) enhance the preceptorship experience for nursing students.

Preceptorship: shaping the art of nursing through practical wisdom.

With so much emphasis having been focused on the development of nursing science and most recently on evidence-based practice, little attention has been directed toward the art of nursing or the practical wisdom that constitutes the spirit of that art. Practical wisdom is the performance of actions intended to preserve and enhance the well-being of others regardless of the context or circumstances involved. Although technically and from a knowledge perspective, nurses consider the most effective and efficient way to administer care, it is through their use of practical wisdom that they actually engage in the art of nursing to provide that care. Because preceptorship is so pivotal to influencing students in the way they approach their nursing care, this approach to teaching-learning in the clinical environment provides an excellent modality by which to cultivate practical wisdom and ultimately to shape the art of nursing.

The one-to-one relationship: is it really key to an effective preceptorship experience? A review of the literature.

Currently, considerable focus is directed at improving clinical experiences for nursing students, with emphasis placed on adequate support and supervision for the purpose of creating competent and safe beginning practitioners. Preceptors play a vital role in supporting, teaching, supervising and assessing students in clinical settings as they transition to the graduate nurse role. Intrinsic to this model is the assumption that the one-to-one relationship provides the most effective mechanism for learning. With the current Registered Nurses (RN) shortage, among other factors, the one-to-one relationship may not be feasible or as advantageous to the student. Thus, nurse educators need to carefully assess how this relationship is configured and maintained to assist them in fostering its evolution. In this review of the literature, the authors explore the assumption that a one-to-one relationship in the preceptorship experience fosters a rich and successful learning environment, and implications for nursing education, practice and research are outlined.

Preceptorship and practical wisdom: A process of engaging in authentic nursing practice.

Preceptorship is a teaching/learning approach, in which learners are individually assigned to staff nurses in the practice setting. Practical wisdom is a discerning process of evaluating and applying ideals or principles often in a moral context. The nurse who is practically wise recognizes that actions are always constrained to some extent by chance or context and yet precisely under such circumstances, acts to preserve and enhance the wellbeing of the patient. The purpose of this study was to examine the process used in the preceptorship experience to nurture practical wisdom. A grounded theory study was conducted with fourth year undergraduate nursing students and their preceptors in an acute/tertiary care setting. Data collection comprised a series of semi-structured interviews, documentation of field notes and journaling. Findings reveal that preceptors who nurture practical wisdom in the practice setting do so by engaging in a process of authentic nursing practice.

Preceptorship: an integrative review of the literature.

The preceptorship model is as an effective teaching and learning strategy most frequently employed to educate undergraduate and graduate students in the practice setting. The purpose of this article is to discuss the current state of knowledge in preceptorship by way of an integrative review of the literature using [Ganong, L.H. 1987. Integrative reviews of nursing research. Research in Nursing & Health 10 (1), 1-11.] framework. The objectives of this article are threefold: (1) to discuss the evidence in the literature related to preceptorship, (2) to describe the framework used to conduct this integrative review [Ganong, L.H. 1987.], and (3) to present the results. Two questions guided this review: (1) how is preceptorship described in the allied health literature between 1994 and 2005, and (2) what new knowledge/information related to preceptorship has emerged in the literature between 1994 and 2005? Ten defining characteristics specific to preceptorship were used to guide the data search. These included such terms as attributes, characteristics, education, health, nurse, nurturing, preceptorship, preceptor, preceptors, and teaching and learning. The findings reveal a pervasive trend in professional education toward an emphasis on the role of preceptorship in preparing students for competent practice.

Preceptorship and mentorship: not merely a matter of semantics.

In academic writing on mentoring and preceptorship there is little consensus on the meaning or characteristics surrounding these terms. The writers of this paper contend that the correct usage of preceptorship and mentorship, which gives credence and respect to the very different concepts embedded in each, is a very important precursor to the evolution of these two concepts in nursing education, both academically and within practical application. Although language is continually changing, lack of clarity robs language of its richness and complexity and interferes with clear thinking about the issues. In professional terms, clarity demands that concepts, around which a body of knowledge is growing, be consistent in their meaning and characteristics. Such clarity between the related educational concepts of mentor(ship) and preceptor(ship) is lacking.

A pragmatic view of intuitive knowledge in nursing practice.

Examining and exploring the intuitive knowledge--ergo intuition--of nurses is a critical undertaking for the practice of nursing. Traditionally, as nurses, we have been conditioned to value empirical knowledge above all other forms of knowledge. Intuition is, however, a rich source of nursing knowledge and, the authors would suggest, integral to the practice of nursing. Explicit recognition and embracing of intuition, as being a legitimate form of knowledge in the practice arena, must be intentionally nurtured. The focus of this paper is to explore intuitive knowledge within the context of nursing practice. It will also address various influences on our understanding of intuition as an essential form of nursing knowledge.

Contributing to the theory development of preceptorship.

The purpose of the study was to clarify and analyze the concept of preceptorship as experienced by the preceptor. Preceptorship is a teaching method commonly used in many professions. The current study assists in the clarification and analysis of the concept of preceptorship as experienced by the preceptor. Regarding methodology, the literature was reviewed to compare the experience of clinical teaching with preceptorship. Literature was reviewed from the following fields/domains: nursing, medicine, education, social work, rehabilitation, dentistry, law, and pharmacy. Through application of the framework outlined by Walker, L.O., Avant, K.C., 1995. Strategies for Theory Construction in Nursing, third ed. Appleton & Lange, Norwalk, attributes, antecedents, consequences, and empirical referents were identified that help define preceptorship. There were three main findings: The nature of the relationship between the preceptor and preceptee is pivotal, evaluation is a challenge, and preceptorship is distinct from mentorship. The consequences of a preceptorship experience are better prepared and more confident preceptors, evolution into a mentorship relationship, and professional development of both the preceptor and the preceptee. This article concludes with numerous topics that could be addressed in future research: (a) screening tools for the preceptor; (b) evaluation of the preceptee; (c) the relationship between preceptee, preceptor, and faculty; (d) preparation of the preceptor, and (e) rewarding the preceptor.