Background: In clinical practice, the responsibilities of frontline registered nurses (RNs) include providing patient care as well as precepting students and new staff nurses. The role has been acknowledged as demanding and challenging in acute healthcare settings and the importance of the preceptor role for the ease of the new nurses’ transition to clinical settings has been discussed in the literature. However, less is known about the nurses’ experiences as preceptors in the pediatric acute clinical setting. The purpose of this research was to explore and describe the experiences of RNs as preceptors when they precept newly hired registered nurses in pediatrics settings. Method: An interpretive descriptive design was used to guide the research process. Semi-structured one-on-one interviews, both in-person and virtual, were carried out with five preceptors who are registered nurses in an Ontario hospital. The real-life experiences of these participants are reported using their rich descriptions of events. Data collection and analysis were conducted concurrently and informed by the Braun and Clark (2006) framework. Results: Findings were grouped under the following three themes: the duality role of pediatric nurses; experiences of preceptor pediatrics nurses; and pediatric nurse preceptors’ needs. Implications: This study demonstrates that the role of the registered nurse as a preceptor is diverse and demanding, and that preceptors need to be supported by various stakeholders to ensure that they can carry out their role effectively. Recommendations are made for future practice, education, and research. Keywords: Preceptor, preceptorship, precepting, registered nurses, newly hired registered nurses, newly graduated nurses, acute healthcare, pediatrics / Thesis / Master of Science (MSc) / In clinical practice, registered nurses play not only the bedside healthcare provider role but also, they play the preceptor role. This role can be both difficult and challenging. Therefore, it is important to understand registered nurses’ experiences as preceptors in clinical settings. The goal of this study was to gain an understanding of the registered nurses’ experiences as preceptors for newly hired registered nurses in pediatric healthcare settings. This study showed that preceptors were aware of their dual role, shared experiences of feeling awarded, and discussed challenges they encountered when precepting. Finally, they identified some of their needs that they believed may assist them when being involved in the preceptor-preceptee relationship. It is important to acknowledge the challenges that preceptors encounter when precepting new nurses into the clinical area. Furthermore, it is imperative to prepare nurses for the preceptor role to ensure effective preceptor-preceptee relationships and improve preceptees retention and competence in their role.

Bakgrund: På vägen från novis till kompetent sjuksköterska finns det många faktorer som påverkartransitionen. Detta beror på att det finns ett tydligt glapp mellan teori och praktik förnyutexaminerade sjuksköterskor, vilket leder till att känslan av att vara redo inför denprofessionella yrkesrollen saknas när det efter examen är dags att börja arbeta somsjuksköterska. Genom att stötta de nyutexaminerade sjuksköterskorna under transitionenfrån novis till kompetent kan man förutom att ge de novisa sjuksköterskorna bättreförutsättningar för att lyckas i yrkesrollen, även främja patientsäkerheten. Syfte: Syftet var att beskriva vad som påverkar den nyutexaminerade sjuksköterskans transitionfrån novis till kompetent i sjukhusmiljö. Metod: Arbetets metod var en icke-systematisk litteraturöversikt. Datainsamlingen utfördes genomdatabassökningar i CINAHL och PubMed och totalt 15 vetenskapliga artiklar inkluderadesi resultatet. Samtliga inkluderade artiklar granskades utifrån Sophiahemmet högskolasbedömningsunderlag för vetenskaplig klassificering avseende studier med kvantitativ ochkvalitativ metodansats. Dataanalysen skedde genom en integrerad analysmetod där deinkluderade artiklarnas resultatdel jämfördes och kategorier togs fram. Resultat: Resultatet visade att det fanns fyra huvudkategorier vilka beskriver hur man kundeunderlätta transitionen från novis till kompetent sjuksköterska i sjukhusmiljö. Kategoriernavar utvecklande och hämmande faktorer, simulationsövningar, kliniska stödprogram ochhandledning. Slutsats: Utvecklande och hämmande faktorer påverkade transitionen till kompetent sjuksköterska.Kliniska stödprogram visade sig vara en stor tillgång för de nyutexamineradesjuksköterskorna. Det kan vara rimligt att öka antalet platser på dessa program som finns ilandet för att alla ska få de bästa förutsättningarna att utvecklas inom yrkesrollen. Ävensimulationsövningar hade en positiv inverkan på de novisa sjuksköterskornaskompetensutveckling. Handledning är också en tillgång men kan däremot behövautvecklas för att uppnå sin fulla potential som stöd i de novisa sjuksköterskornaskompetensutveckling. / Background Many factors affect the transition from novice to competent nurse. This is because there isa gap between theory and practice which leads to a feeling of being unprepared for theprofessional role. By supporting newly graduated nurses during their transition fromnovice to competent nurse, it is possible to give them better conditions to develop theirskills and promote patient safety. Aim The aim was to describe what affects the newly graduated nurse's transition from novice tocompetent in a hospital environment. Method This was a non-systematic literature review. Data collection was performed throughdatabase searches in CINAHL and PubMed. A total of 15 scientific articles were includedin the results. Included articles were reviewed on the basis of Sophiahemmet University'sassessment for scientific classification for quantitative and qualitative method approaches.An integrated data analysis was used where the results part of the included articles wascompared to form categories. Results Four main categories described how to facilitate the transition from novice to competentnurse in a hospital environment. The categories were: developing and inhibiting factors,simulation practice, clinical support programs and preceptorship. Conclusions Developing and inhibiting factors influenced the transition to a competent nurse. Clinicalsupport programs proved to be a great asset for the newly graduated nurses. It may bereasonable to increase the number of places on these programs available in the country sothat everyone has the best conditions to develop in the professional role. Simulationpractice also had a positive impact on their competence development. Preceptorship is alsoan asset but needs to be developed to achieve its full potential as support in the novicenurses' competence development.

A non-experimental, explorative, descriptive, quantitative study was undertaken. The purpose was to explore and describe the views of preceptors and preceptees regarding the fulfillment of the role of the preceptor in selected clinical nursing practice settings in the Botswana context. The study included 72 preceptors and 200 nursing students/preceptees who voluntarily agreed to participate in the study. A questionnaire was used to collect data. Data was analysed by using descriptive and inferential statistics. The findings of this study indicated that there were numerous constraints that interfered with the preceptor role in accompaniment of the preceptee. These constraints included the lack of desirable characteristics and time to plan learning opportunities, inadequate use of teaching strategies and inadequate knowledge on preceptee evaluation. Recommendations were stated for improvements in the future role of the preceptor in clinical practice settings Limitations of this study were also highlighted. / Health Studies / M.A.(Health studies)

A non-experimental, explorative, descriptive, quantitative study was undertaken. The purpose was to explore and describe the views of preceptors and preceptees regarding the fulfillment of the role of the preceptor in selected clinical nursing practice settings in the Botswana context. The study included 72 preceptors and 200 nursing students/preceptees who voluntarily agreed to participate in the study. A questionnaire was used to collect data. Data was analysed by using descriptive and inferential statistics. The findings of this study indicated that there were numerous constraints that interfered with the preceptor role in accompaniment of the preceptee. These constraints included the lack of desirable characteristics and time to plan learning opportunities, inadequate use of teaching strategies and inadequate knowledge on preceptee evaluation. Recommendations were stated for improvements in the future role of the preceptor in clinical practice settings Limitations of this study were also highlighted. / Health Studies / M.A.(Health studies)

Research has shown that, worldwide the nursing profession is faced with image-related challenges impacting on its status, prestige, power and the ability to attract more young and suitably qualified students to nursing. There is adequate evidence of a link between the image of nursing and the number of young people entering and leaving the profession. A positive image of nursing attracts applicants and the intention to leave nursing correlates positively with holding a negative image of nursing. There is also evidence of poor perception of the image of nursing among student nurses. The study aimed at exploring the potential of appreciative inquiry (AI) as a teaching strategy to transform the image of nursing among 3rd and 4th year, college and university student nurses in the Gauteng province of South Africa. The second aim was to describe student nurses’ experiences regarding their participation in the process of AI. A qualitatively dominant, sequentially embedded, mixed methods design with explorative-descriptive and quasi-experimental features was utilised. Sequential data collection and analysis were conducted during five stages comprising: a pre-test survey, intervention (appreciative inquiry), a post-test, description of the experiences of student nurses of AI and an integration stage. The pre-test results showed more positive than negative perceptions of the image of nursing among student nurses. The negative perceptions of the image of nursing among student nurses that needed intervention included the working conditions of nurses and the perception of nursing as a profession that was not respected and appreciated. The student nurses who took part in appreciative inquiry showed a significant and positive change in their perception of the image of nursing as a respected and appreciated profession. From the individual interviews on the student nurses’ experiences of AI, the themes “experience of positive emotions” and “experiential learning” emerged. The student nurses experiences described their engagement in AI as a positive and enjoyable experience from which multidimensional learning resulted. / Health Studies / Ph. D. (Health Studies)

New graduate nurses (NGNs) at bedside are faced with numerous challenges, which prompt them to leave jobs in their first year. The transition from being a student to competent nurse requires a NGN to have the necessary skills and experience. Subsequently, hospitals continue to face shortages of staff because of high turnover and low retention levels. Nonetheless, evidence from reviewed literature has indicated that the use of residency programs can increase NGNs' stay at bedside, improve retention, reduce costs of operations, and return employees' turnover. The purpose of this quality improvement project was to identify the likelihood of NGNs remaining at bedside after participating in a 52 week NGN residency program in the critical care units at Palmetto Health hospital. When a hospital recruits and retains NGNs at the bedside, the quality of life among patients is improved. Benner's theory of novice to expert was utilized to understand professional growth of nurses. Data were collected from the human resource department of the 18 nurses who initially participated in the residency program to compare retention rates before and after its implementation. The project initiative was based on a quantitative non-experimental comparison design. Based on the evidence from the human resource department, there was a 14% improvement in nurse retention 3 months after the implementation of the NGN residency program. A statewide adoption of NGN residency programs was recommended to help improve retention and enhance NGNs' professional improvement and quality of care. The implementation of NGN residency program also demonstrated implications for social change through increasing retention, building nurse competency, and enhancing quality of care delivered.

Research has shown that, worldwide the nursing profession is faced with image-related challenges impacting on its status, prestige, power and the ability to attract more young and suitably qualified students to nursing. There is adequate evidence of a link between the image of nursing and the number of young people entering and leaving the profession. A positive image of nursing attracts applicants and the intention to leave nursing correlates positively with holding a negative image of nursing. There is also evidence of poor perception of the image of nursing among student nurses. The study aimed at exploring the potential of appreciative inquiry (AI) as a teaching strategy to transform the image of nursing among 3rd and 4th year, college and university student nurses in the Gauteng province of South Africa. The second aim was to describe student nurses’ experiences regarding their participation in the process of AI. A qualitatively dominant, sequentially embedded, mixed methods design with explorative-descriptive and quasi-experimental features was utilised. Sequential data collection and analysis were conducted during five stages comprising: a pre-test survey, intervention (appreciative inquiry), a post-test, description of the experiences of student nurses of AI and an integration stage. The pre-test results showed more positive than negative perceptions of the image of nursing among student nurses. The negative perceptions of the image of nursing among student nurses that needed intervention included the working conditions of nurses and the perception of nursing as a profession that was not respected and appreciated. The student nurses who took part in appreciative inquiry showed a significant and positive change in their perception of the image of nursing as a respected and appreciated profession. From the individual interviews on the student nurses’ experiences of AI, the themes “experience of positive emotions” and “experiential learning” emerged. The student nurses experiences described their engagement in AI as a positive and enjoyable experience from which multidimensional learning resulted. / Health Studies / Ph. D. (Health Studies)

Peer learning är en handledningsmetod, som tydliggör anknytningen mellan teoretisk och praktisk kunskap samtidigt som ett större antal studenter kan erbjudas verksamhetsförlagd utbildning. Därför vore det av intresse att undersöka om det är en tillämpar metod i specialistsjuksköterskeutbildningen mot intensivvård. Syftet med studien var att undersöka peer learning som handledningsmetod inom specialistsjuksköterskeutbildningen mot intensivvård utifrån handledares perspektiv. Studien utfördes genom fokusgruppsintervju med en beskrivande design med induktiv ansats där data analyserades med manifest kvalitativ innehållsanalys. I studien framkom sex kategorier och fyra underkategorier. Interaktionen mellan studenterna ansågs utveckla förmågan till kommunikation och samarbete. Studenterna kunde fortsätta att bygga på befintlig kunskap, betraktades mer som jämbördiga och frångick en hämmande studentroll. Patient och anhöriga upplevdes inte misstycka till studenternas resonemang utan uttryckte snarare att de tog lärdom av det. Det unika sättet att tillvarata studenternas kunskaper och färdigheter på ledde till en tidig vidareutveckling av deras befintliga kunskaper. Den tidiga träningen i kommunikation och samarbete kan ses fördelaktigt eftersom brister i dessa genererar flest avvikelser idag. Slutsatsen är att peer learning är lämplig som handledningsmetod inom specialistsjuksköterskeutbildningen mot intensivvård. Fortsatt forskning om peer learning inom specialistsjuksköterskeutbildningar samt patienters och anhörigas upplevelser av studenternas resonemang är av stort intresse. / Peer learning is a precepting method that clarifies the link between theoretical knowledge and practical skills, and at the same time enables more students to be offered placement for clinical education. Therefore, it would be of interest to explore if the precepting strategy can be appropriate in the postgraduate nursing education in critical care. The purpose of the study was to explore peer learning as a precepting method in the postgraduate nursing education in critical care in preceptors’ point of view. The study was conducted by a focus group interview with a descriptive design with an inductive approach and data was analysed with manifest content analysis. The study revealed six categories and four subcategories. The interaction between the students was considered to develop the ability of communication and cooperation. The students could build on their former knowledge, considered as equals, and went from an inhibitive role as students. The patient and the relatives were not perceived to resent the student reasoning, they rather expressed they learned from it. The unique way to preserve students' knowledge and skills led to an early development of their already existing knowledge. The early training in communication and cooperation can be considered beneficial because deficiencies in these areas generate the most common incidents in healthcare today. The conclusion is that peer learning can be applied as a precepting method in the postgraduate nursing education in critical care. Further research of peer learning in postgraduate nursing educations is needed and also how the patient and family members experience the students' reasoning, are of great interest.

Collaborative academic-practice partnership (CAPP) positions make it possible for nursing educators to stay current with evolving practice issues and enable nursing practitioners to stay in touch with trends in contemporary nursing education. The purpose of this qualitative, collective case study was to explore the experience of registered nurses who occupy collaborative academic-practice partnership positions within a Canadian nursing context. Study sample consisted of registered nurses (n=10) employed in type of collaborative partnership between a health care agency and academic institution. Triangulation of data was achieved through interviews (two per participant) over several months, review of archival documents, and researcher‟s reflective fieldnotes. Findings revealed three emergent themes: Foundations, Actualization, Challenges and Benefits of the CAPP position. This study supports development of future CAPP positions to provide opportunities for growth, professional development, and career paths for nurses, while addressing university and agency requirements and quality patient care. These findings can play an important role in influencing change by way of strategic alliances in nursing education and practice. / xi, 155 leaves : ill. ; 29 cm

Evidensbaserat förhållningssätt har varit högt prioriterat i svensk sjuksköterskeutbildning de senaste decennierna. Trots det är det endast en låg andel av nyutexaminerade sjuksköterskor som uppger att de använder forskning i sin vardag. Avsaknaden av ett evidensbaserat förhållningssätt i den verksamhetsförlagda utbildningen har på senare år visat sig vara en av anledningarna till att sjuksköterskestudenter inte upplever sig utveckla ett evidensbaserat förhållningssätt. Syftet var att beskriva sjuksköterskors uppfattning av att handleda studenter i evidensbaserat förhållningssätt inom kommunal hälso- och sjukvård. Fenomenografisk ansats användes till analys av två fokusgruppsintervjuer med sjuksköterskor från två olika kommunala sjuksköterskeenheter. Det framkom fyra huvuduppfattningar som resulterade i beskrivningskategorier; 1) vetenskaplig kommunikation, 2) vara med, 3) bygga av erfarenhet och 4) begränsas av tid. Det gemensamma temat som framkom var att förstå kontexten. Med hjälp av handledarledd reflektion kunde studentens kliniska kompetens och helhetsyn utvecklas, vilket möjliggjorde en förståelse för kontexten. Först då var det möjligt för studenten att sammanfoga de tre delarna i evidensbaserat förhållningssätt: klinisk kompetens, bästa tillgängliga kunskap och patientens situation och önskemål. Resultatet visar på ett behov av samarbete mellan det kliniska och det teoretiska i sjuksköterskeutbildningen. För att möjliggöra en god handledning i evidensbaserat förhållningsätt skulle det vara värdefullt att utforska hur samarbetet mellan högskolan och den kliniska verksamheten kan stärkas. / Evidence-based practice has been highly prioritized in Swedish nursing education in recent decades. Nevertheless, only a low percentage of newly graduated nurses report that they use research in their daily work. The lack of evidence-based practice in the clinical education has been proven to be one of the reasons that nursing students’ did not develop competence in evidence-based practice. The purpose was to describe nurses' perceptions as preceptors teaching evidence-based practice in municipal health care. Phenomenological approach was used to analyze two focus group interviews at two municipal health care units. The data analysis resulted in four description categories; 1) scientific communication 2) be involved, 3) build through experience and 4) limited by time. Understanding of the context emerged as the common theme. With the help of preceptor-led reflection, the student's clinical skills and holistic view of the patient could be developed, which enabled an understanding of the context. Only then it was possible for the student to merge the three parts of evidence-based practice; clinical expertise, best available knowledge and patient's situation and preference. The result shows a need for cooperation between the clinical and theoretical part of nursing education. To develop a good preceptorship in teaching evidence based care it would be valuable to explore how cooperation between the university and the clinical settings can be improved.