Preceptorship is a teaching-learning approach in which learners are individually assigned to expert practitioners in the practice setting. The purpose is to provide them with daily experience on a one-to-one basis with a role model and resource person who is immediately available to them. Currently, the literature is replete with research on various aspects of preceptorship, including the preceptor role, the evaluation process, professional socialization, the promotion of clinical competence, and the fostering of critical thinking in undergraduate and graduate education, to name a few. To date, however, no studies have specifically explored the process involved in promoting the education of nurse practitioner students in preceptorship. The purpose of this grounded theory study was to explore the process used in preceptorship to prepare nurse practitioner students for their future role in professional practice. To that end, the process in which preceptors, nurse practitioner students, and faculty engage was explored. The sample comprised nurse practitioner students, preceptors and faculty from a large university in western Canada. Findings from this study revealed that as students proceeded through the preceptorship program they worked through or navigated what could be described as the liminal space or an in-between place. As a result of the findings of this study, several crucial points have been recognized that have implications for the nurse practitioner student who engages in preceptorship. First, upon acceptance into an advanced practice nursing program it is important for students who are themselves experienced professionals in their own right, to understand the preceptorship process of transition, found in this study to be the liminal space, intrinsic to which are adjustments from the role of nurse, to that of student and finally to that of the nurse practitioner. Second, to adequately prepare students for their transition, faculty need to develop curricula that address the challenges involved with this phenomenon, specifically knowledge related to threshold concepts and troublesome knowledge. Third, support for these students from faculty, preceptors and fellow students was found to directly affect the ability of these learners to successfully navigate their transitional process in preceptorship.

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Background: Cardiology is but one of the many clinical foci available to certified Advanced Practice Registered Nurses (APRNs). In fact, more acute care APRNs choose cardiology as their focus than any other. With such strong interest in cardiac advanced practice nursing, it is imperative to assess the adequacy of preparation for those who wish to follow this career path. Known barriers exist in the educational and clinical preparation of this APRN population, however, there is little research detailing the specifics of those barriers. Purpose: This study describes the needs of APRNs who plan to specialize in cardiology. Method and Sampling: A qualitative design was used to describe the motivation of APRNs specializing in cardiology, tools they currently utilize to achieve their specialization, and their needs based on the current approach. I recruited participants, APRNs specializing in cardiology, through meetings at a local cardiology practice. Seven APRNs specializing in cardiology with experience ranging from 10 months to 15 years, and currently working in a cardiac setting, participated in the study. Structured interviews were conducted to describe the needs of APRNs who plan to specialize in cardiology. The interviews were audiotaped and analyzed to reveal commonalities. Findings: After analyzing the audio recordings three major commonalities emerged: APRNs specializing in cardiology must overcome limited educational opportunities, APRNs specializing in cardiology require a higher level of skill than their formal training and licensing requirements provide, and the need to validate APRNs specializing in cardiology knowledge. Additional commonalities included availability and the type of degree programs, and a lack of cardiac focus in educational preparation. Conclusion: The findings showed the needs of APRNs who plan to specialize in cardiology are rooted in their educational preparation. There is a vast amount of variability among degree programs and a severe lack of cardiac focus in their educational preparation. In order to achieve competency, 100% of study participants secured a mentorship with an expert cardiac clinician for a minimum of one year post-graduation and without assistance from their educational programs. Additionally, APRNs specializing in cardiology believe a national certification or examination requirement would be beneficial to their practice.

Indiana University-Purdue University Indianapolis (IUPUI) / Health care reform emphasizes prevention of chronic disease through the reduction of modifiable risk factors as a way to reduce health care costs, morbidity, and mortality. Motivational interviewing (MI) is an effective method of health behavior counseling. It has been used successfully applied in health related behavior change and self- management of chronic disease. The knowledge, skills, and attitude of MI are acquired through learning as other techniques used in the health professions. Nurse practitioner faculty need guidance on how to design instruction in MI that incorporates competencies and utilizes innovative strategies. Prescriptive instructional design theory utilizes knowledge from educational research to establish the steps in the design process. The purpose of this research was to apply prescriptive instructional theory to the design of effective, efficient, and engaging instruction in MI resulting in beginning proficiency in the NP students. A formative design was used for this study. The First Principles of Instruction served as the prescriptive design theory used in the design of instruction in MI. Data sources included the researcher’s design journal, observation during interaction with the instance, demographics of authentic users, authentic user reaction, and knowledge testing. Four cycles of design-redesign were completed. Results of the study point to improvements in the First Principles of Instruction. The instruction was effective, based on the improved scores from pretest to posttest on the Helpful Response Questionnaire. The improved scores also indicated an increase in knowledge of MI. Efficiency was not improved from pretest to posttest. The definition of efficiency as less time to completion of the task did not apply to MI communication skills. The First Principles of Instruction were useful in the design of the techniques of MI. However, there is little guidance for the affective component of MI such as empathy. The prescriptions of the First Principles of Instruction were useful in designing the instruction in MI. NP students indicated in post instruction interviews that engagement in the instruction was related to the relevance of the subject matter to practice and interactive exercises.

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