Florence Luhanga

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.

Failure to assign failing grades: issues with grading the unsafe student

In a grounded theory study examining the process of precepting an unsafe student, it was found that preceptors assigned passing grades to students who in fact should not have passed. Although preceptors perceived their role as gatekeepers for the profession, by not assigning failing grades to students who should not have passed a course, essentially they were abdicating their responsibility. Indeed, the simple act of assuming responsibility for precepting a student implies professional as well as pedagogical accountability.

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.

Hallmarks of unsafe practice: what preceptors know.

During a preceptorship experience, certain students do not progress in their learning at the same rate as others and may engage in unsafe practice. Twenty-two preceptors working with fourth year baccalaureate nursing students for 340 hours in a final practicum were interviewed. This study reaffirmed that early identification and intervention of unsafe practice are critical and consist of red flags regarding knowledge, attitudes, skills, and professionalism.

Exploring the Issue of Failure to Fail in a Nursing Program

Abstract A study using a qualitative descriptive design was undertaken to explore the issue of “failure to fail” in a nursing program. Individual in-depth interviews were conducted with nursing university faculty members, preceptors, and faculty advisors (n=13). Content analysis was used to analyze the data. Results indicate that: (a) failing a student is a difficult process; (b) both academic and emotional support are required for students and preceptors and faculty advisors; (c) there are consequences for programs, faculty, and students when a student has failed a placement; (d) at times, personal, professional, and structural reasons exist for failing to fail a student; and (e) the reputation of the professional program can be diminished as a result of failing to fail a student. Recommendations for improving assessment, evaluation, and intervention with a failing student include documentation, communication, and support. These findings have implications for improving the quality of clinical experiences.

Strategies for Precepting the Unsafe Student

Precepting a student who is unsafe is distressing both for the preceptor and the student. This article derives from a grounded theory study that describes the careful thought reflected in strategies used by preceptors to teach students who are unsafe. Both preceptors of undergraduates and new employees may find these strategies useful, with the ultimate goal being patient safety. The findings have implications not only for preceptor preparation in the area of evaluation but also for faculty support and the need for evaluation guidelines.

Preceptorship: Using an Ethical Lens to Reflect on the Unsafe Student

Patient safety has become a worldwide health concern, and health care professionals have a moral and ethical responsibility to promote patient safety. The clinical education of many health care professionals often involves a preceptorship or field experience wherein students are assigned to work one-to-one with a preceptor or field educator so that they can be socialized into the profession and receive a reality-oriented experience. Health care professionals who accept the responsibility of being a preceptor face additional workload and stress, especially when the students to whom they are assigned are not meeting the expectations of safe, professional practice. Taking a stand against unsafe students is an important way for preceptors to promote patient safety. Given the nature of the stress and the inherent ethical issues associated with precepting an unsafe student, it is useful to examine this experience through an ethical lens. Included in this article is a brief overview of preceptorship as a model of clinical education, together with a discussion of the nature of the ethical decisions that preceptors face when precepting an unsafe student. Ethical theories, namely, virtue ethics and utilitarianism, are also explored and serve to provide the ethical lens through which preceptors can reflect upon their experiences with unsafe students.

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.

Preceptorship and Mentorship

Thirty years ago, there would not have been a special issue on preceptorship and mentorship. Given the rise and consequent research interest in these two practices in nursing, numerous scholarly papers are being published. This particular special edition will be highly relevant to those who participate in preceptorship or mentorship programs from those who coordinate them to the students or graduates who benefit from them.