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Students’ Perceptions in the Nursing Clinical Workplace

Introduction

This paper is an article review of ten documents explaining student perception about effective preceptors in the nursing workplace environment. In locating the ten articles to be used in this paper, an online search strategy was used. To find the right articles, key words were used in an online search engine to locate article web addresses. Connector words were important in creating emphasis on the right type of articles. Filtering through the online search results was not easy. The articles’ titles were crucial in finding the most appropriate documents for analysis. However, before undertaking this process, a narrow research was done, to identify the right keywords to type into the online search engine (for correct results). This strategy was employed after noticing there were more than 20,000 pages to review in the initial search results (if the right keywords were not used). Since reviewing over 20,000 pages was going to be time-consuming and strenuous, a list of words was developed to narrow the search process to relevant articles (which would be found within the desired pages). These words acted as a guide to the online search process. However, this strategy was not perfect because some distracting pages were also obtained after the online search result. After experiencing this challenge, a list of words found in the recommended search pages was developed. The keywords used to find the right articles will however be discussed in subsequent sections of this study.

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Since some words occurred simultaneously and in a predicted manner, it was crucial to locate pages where words were arranged in the desired pattern. This strategy was fruitful when locating articles that had the proper names (but which had several names attached to them). Such articles included names of books and journals, but they also included names of places, people and the likes. Considering the fact that prior knowledge was used in the research process, there were some distinct phrases (from class studies) that could be included in the search process. It was therefore easy to locate articles that had unique phrases used in class.

Trimming the URL was also a useful search strategy that resulted in locating the right type of articles for the study. This strategy was used to locate articles that were deeply buried in volumes of literature. Articles which were thought to be found next to the recommended URLs were also located in this manner. To locate these articles, the appropriate URLs were trimmed. Though there were instances that the “Forbidden” message was encountered, there were times that, web pages with useful links were located. These links were used to locate more articles. This strategy was also used to locate missing articles (or links which sent a “404” error message). Here, it was easy to trace the start of the search process to establish if missing files could be located.

Finally, it was easy to find appropriate articles for this paper, by finding similar pages of the articles initially found. It was easy to find these articles by clicking on the links provided for articles which were recommended by the online search engine (as having the same contents as the preferred articles). This strategy was especially useful in instances where difficulty in trying to find the right type of keywords to key in the online search engine was experienced. The keywords used to confine the topic were students’, nursing, preceptors, clinical, institution and organization (Burns 2003, p. 1).

Inclusion and Exclusion Criteria

To determine which articles were to be selected for this research paper, the relevance of the articles was identified to establish how best they would satisfy the study’s objective. This strategy was pivotal in sorting articles to be included in the article database. This strategy means that, all articles to be included in the article database were first selected and reviewed to determine how best they explained students’ perceptions of the attributes of effective preceptors in the nursing clinical workplace. Specifically, any article that sought to explain the attributes of effective preceptors in the nursing clinical workplace, contents in any of the subfields of student perceptions of effective preceptors in the nursing clinical workplace, contents in related fields of nursing and student perceptions, and any unrelated areas of interest regarding student perceptions of the attributes of effective preceptors in the nursing clinical workplace, were included in the article database.

Types of Articles Selected

Inclusion Criteria

The article selection process was determined by the nature of the articles to be selected. The articles had to be original reports or replications of original research findings, literature reviews and reports done to investigate student perceptions of effective preceptors in the nursing clinical workplace. Other criteria for inclusion of the research articles were surveys, case studies and theoretical reviews. Articles which did not fall within the above criteria were not considered useful in this paper. Substantive comments (and replies to such comments) were also used as an inclusion criterion in the selection of research articles for this paper. This inclusion criterion provided a framework where insights into student perceptions of the attributes of effective preceptors in the nursing clinical workplace (which were not documented in mainstream research articles) could be factored in the paper.

Exclusion Criterion

Editorials focused on the research topics were not considered to be part of the framework for locating the right research articles. However, editorials which contained substantial articles and followed the nature of scholarly articles were considered an extension of the inclusion criterion for sourcing research articles. Letters written to editors were also not considered to be objective research materials to be included in this research paper. News items were also not considered a criterion for selecting health and medicine articles. The main motivation for using this exclusion criterion was that, news articles were not objective. Moreover, it was assumed that, some news items were meant to advance certain interests, which could be contrary to the objective of undertaking this research study. Papers or presentations used in research conferences and symposia were also not considered to be scholarly articles to be used in this paper. Most of these research articles were considered inappropriate for this paper because they were not published (and they did not conform to the rigorous publication process, evident in journal articles) (Hayes 2001, p. 111).

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Articles written to express personal views were also excluded from the list of selection criteria for this article. These articles included personal reminiscences and testimonials (Myrick and Yonge 2002). Like the previously mentioned exclusion criteria, these articles failed to meet the objective for scholarly articles. Moreover, they were biased, and were probably written without being objective about the research topic. Informal anecdotal reports and articles were also considered to be part of the exclusion criteria because they were not scholarly and professional. It was difficult to include informal information as part of an academic research project. Research articles written in form of poems or interviews were also not included as part of the research criteria.

Themes Trends and Research Data Present in the Articles

The main theme of the research articles sampled was student involvement (Myrick and Yonge 2001, p. 461). Student involvement was perceived a critical determinant of the perspectives students held regarding the attributes of effective preceptors in the nursing clinical workplace. Effective preceptors were identified to be those that encouraged student involvement because it was a critical part of the nursing profession. More so, its importance was manifested from the fact that, nursing is a practical-based profession and little theoretical application is needed. Moreover, student involvement predetermines the level of student growth and development. In addition, it was affirmed that, if preceptors encouraged student involvement, student attitudes about the topic of study were bound to improve (National Organization of Nurse Practitioner Faculty 2000). In other words, student participation was observed to prepare students for life in the nursing workplace. This affected their perceptions.

Humor was also identified to be a strong theme in the analysis of student perceptions about effective preceptors in the nursing workplace environment (National Organization of Nurse Practitioner Faculty 2000). Humor was especially identified to create an appropriate environment for learning because it “lightened up” the learning environment and mentally prepared students to comprehend what was being taught. Effective preceptors were therefore identified to be those that were crafty and creative in their teaching styles and more so, how they infused learning in their teaching approaches. Flexibility was also identified to be a desired characteristic of effective preceptors (Mamchur and Myrick 2003, p. 189). Clinical preceptors who were perceived to be flexible in the learning environment were identified to have a stronger and more effective impact on the learning process because they were able to divert from the pre-determined learning schedules to give students something more than they thought they would get. Effective preceptors were therefore observed to be those who found it easy to adapt to different learning contexts. This theme was also majorly advanced in the context of accommodating the varying student perceptions regarding the nursing workplace (Hayes 2001, p. 111).

Innovation was also a common theme discussed in the ten articles sampled. Innovation was deemed to be a necessary quality for effective preceptors in the clinical learning environment. Moreover, effective preceptors who were perceived to be innovators were rated highly in coming up with new ideas to provide better learning experiences to students (Hildebrandt 2001). In the context of assessing student attitudes and perceptions of the attributes of effective preceptors in the nursing clinical workplace, innovation was considered the determinant of student attitudes, regarding new ideas and change in the clinical learning environment (Hayes 2001, p. 111).

Research Synthesis

Comprehensively, the sampled research articles identified that, there was a significant difference in the manner students perceived effective nursing preceptors, based on their cultural origins. In certain cultures, specific nursing qualities such as humor were identified to be the most significant preceptor qualities. However, in other cultures, specific preceptor qualities such as thorough understanding of nursing knowledge were exemplified. Most of the articles also pointed out that there was a strong need for nursing preceptors to shift their teaching approaches to be supportive of the clinical learning goals (Hayes 2001, p. 111).

Most of the articles also pointed out that there was a strong need to merge the importance of personal attributes in effective learning, and the skills or academic requirements needed to teach nursing principles (Hayes 1994, p. 62). For instance, it was affirmed that, it was not only enough to equip nursing preceptors with effective skills and knowledge needed to deliver an effective teaching program (Hayes 1994, p. 62). It was equally important to personalize the learning process and make it more interesting for the students. This is where personal teaching skills were to be considered. The two teaching criteria were therefore identified to be pivotal in the learning process, but it was identified that there was a strong need to merge the two teaching criteria to realize the best learning outcomes (Hayes 2001, p. 111).

It was also identified that there was a strong need for nursing preceptors to factor student input in learning activities so that student needs could be effectively addressed. Throughout the ten articles studied, there was a consistent analysis of student perceptions about the clinical environment as a learning environment. It was noted that there was a strong reference to the concept of “consistency” (Hayes 2001, p. 111). The concept of “dependability” was also strongly cited in the studies, but the framework for delivering effective learning outcomes was cited as the most crucial for the nursing practice (Guberski 2000). Another strong area of agreement in most of the articles sampled was the strong assertion that, student input was not effectively addressed by the nursing preceptors. This omission was feared to affect the nursing workplace environment and equally affect the quality of most nursing practices. Finally, the sampled articles identified that, though nursing preceptors were mandated to improve the learning process, there was a low level of commitment among the nursing preceptors to accept new ideas, or accommodate new practices in the nursing workplace environment (Fay 2001, p. 14).

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Conclusion

This paper identifies ten scholarly articles, based on an online search strategy. The article refinement process was based on the use of keywords to find the appropriate articles for the study. Credible research sources including books and journals defined the main criteria for the article selection process. This paper observes that the articles sampled in this study identify unique student-centered qualities as crucial traits which effective preceptors should have. There was little reference to the traditional teaching approaches practiced by most preceptors. Nursing preceptors who adapted best to new teaching ideologies and included desirable personal qualities such as humor and consistency rated highly on the effectiveness scale.

References

Burns, C 2003, Preceptor Survey Report, Association of Faculties of PNPs, Cherry Hill.

Fay, V 2001, ‘Providing optimal hands-on experience: A guide for clinical preceptors’, Advance for Nurse Practitioners, vol.1, pp. 71.

Guberski, T 2000, New paradigms in advanced nursing practice: technical strategies for nurse practitioner education, National Organization of Nurse Practitioner Faculties, Washington.

Hayes, E 1994, ‘Helping preceptors mentor the next generation of nurse practitioners’, Nurse Practitioner, vol.19, pp. 62-66, viewed 30 July 2011, via JSTOR.

Hayes, EF 2001, ‘Factors that facilitate or hinder mentoring in the nurse practitioner preceptor/student relationship’, Clinical Excellence for Nurse Practitioners, vol.5, pp. 111-118.

Hildebrandt, E 2001, ‘Preceptors: A perspective of what works’, Clinical Excellence for Nurse Practitioners, vol.5, pp. 175-180.

Mamchur, C & Myrick, F 2003, ‘Preceptorship and interpersonal conflict: A multidisciplinary study’, Journal of Advanced Nursing, vol.43, pp. 188-96.

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Myrick, F & Yonge, O 2001, ‘Creating a climate for critical thinking in the preceptorship experience’, Nurse Educator Today, vol.21, pp. 461-467.

Myrick, F & Yonge, O 2002, ‘Preceptor behaviors integral to the promotion of student critical thinking’, Journal for Nurses in Staff Development, vol.18, pp. 127-133.

National Organization of Nurse Practitioner Faculty, 2000, Partners in Nurse Practitioner Education: Preceptor Manual for Nurse Practitioner Programs, Faculty, Preceptors and Students, National Organization of Nurse Practitioner Faculty, Washington.

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