Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Lessons Students and New Graduates Could Teach: A Phenomenological Study That Reveals Insights on the Essence of Building a Supportive Learning Culture through Preceptorship

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

Lessons Students and New Graduates Could Teach: A Phenomenological Study That Reveals Insights on the Essence of Building a Supportive Learning Culture through Preceptorship

Article excerpt

In Australia, nursing education has been located in higher education sectors for almost 30 years and student demand for undergraduate nursing continues to grow stronger. Universities consis- tently rely on nursing enrolments to feed their revenue requirements. However, student satis- faction with curricula has never been systemati- cally evaluated or reported and the quality of this learning and the evidence base to support it, have not been established (Gabb & Keating, 2005; Walker, 2009).

There is a large body of work in the lit- erature describing initiatives to teach students and nurses about evidence-based practice and implementation science (Aarons, Hurlburt, & Horwitz, 2011; Bowen & Zwi, 2005; Melnyk & Fineout-Overholt, 2005). Since the release of the statistics about preventable medical errors reported through authorities such as the Institute of Medicine (2000), the need for sci- entific evidence on which to base clinical prac- tice is now unquestioned. Economic factors, variability in service and the sheer amount of research into practice are key drivers (Salmond, 2007). As a consequence, in addition to the need for compliance with competency stan- dards, accountability, effectiveness and efficiency in practice are expected and demanded, of all clinicians (Australian Nursing and Midwifery Council, 2006).

These same drivers are compelling higher educa- tion institutions and all who work within them, to provide accountable, effective and efficient learn- ing (Commonwealth of Australia, 2009). Although many educators are engaged in clinical research, they are in the main overlooking their own practice of teaching (McAllister, 2012; Oermann, 2007), and not responding sufficiently to challenges expe- rienced by students, such as assessment overload, poor concept integration in courses such as anat- omy and pharmacology, inflexible faculty attitudes and cultural insensitivity (Clinton & Jackson, 2009). The impact of this, just as it is for all prac- tices that lack evidence, is that nursing education will become irrelevant, devalued or overlooked. Without evidence to guide education practice, tra- dition-based practice, intuition and expert opinion are what remain (Salmond, 2007).

In Australia, nurse educators have no compulsory requirement to be credentialed pre- ceptors (Australian Nurse Teachers' Society, 2011). Research and evaluations of clinical edu- cation innovations, such as models for student support, buddy systems and clinical coaches are rarely published. In order for the speciality to advance, clinical teachers and academics need to work together to demonstrate that they are will- ing to question and evaluate their current prac- tices, such as preceptorship effectiveness.

In undergraduate education the term precep- tor refers to students working one-on-one with a registered nurse for a designated period of time (Callaghan et ah, 2009; Henderson, Twentyman, Heel, & Lloyd, 2006). Similarly, new graduate preceptorship also refers to a period of support under the guidance of an experienced clinician to ease transition. The preceptor guides the gradu- ate as they develop skills, apply theory to practice and comprehend the scope of their responsibili- ties (Boon, Graham, Wainwright, & Warriner, 2005). This role is said to be pivotal in support- ing new graduates' socialisation into the role and culture of nursing (Haggerty, Holloway, & Wilson, 2012).

Preceptorship began to regularly appear in nursing literature in the late 1970's (Amos, 2001; Benner, 1984; Viar, Booth, & Tate-Patterson, 1988). The meaning of the term preceptor, which is a one-to-one, clinical learning experience between an experienced registered nurse and a novice, has not altered in decades (Amos, 2001). However, there is evidence to suggest that the role takes time to develop, is stressful and the train- ing inadequate (Eley, 2010; Haggerty et al., 2012; McCarthy & Murphy, 2010). …

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