The nursing shortage in the United States is increasing and directly affects the turnover of staff in the adult burn center of the facility that is the focus of this project. In addition to the institution's traditional leadership education, which includes preceptor and charge nurse modules, a burn-focused supplemental preceptor preparation education program (SPPEP) was developed and delivered to address the expressed needs of the staff preceptors. The purpose of this quality improvement evidence-based project was to develop and deliver a program evaluation tool for the adult burn center leadership to assess the effectiveness of the SPPEP in this specialty area, including whether a supplemental preparation program for adult burn center preceptors would increase their confidence and competency, and lower attrition rates of nurse orientees. A preprogram survey was administered to all participating preceptors identifying perceived gaps in preparation to fulfill the expectations of the preceptor role. Benner's novice-to-expert and Knowles's adult learning theory concepts provided the framework for the SPPEP. The quality improvement program evaluation was based on reported confidence and the perception of competence of the preceptors who participated (N = 11). This research revealed that the SPPEP increased the preceptor's confidence and perceived competence level from 64.12% to 89.28% after the first SPPEP delivery. By systematically preparing the preceptors, the SPPEP can reduce overall orientation expenditure while improving patient outcomes, preceptor confidence, perceived competence, and the satisfaction of registered nurses.

The literature indicates that serving as a preceptor for new nurse graduates can be challenging and stressful without proper training in this role. Many organizations appoint preceptors without providing training and support for the role, which negatively impacts both the new nurse and the preceptor. Evidence shows that a preceptor workshop can cultivate the knowledge and skills needed to train and precept new nurse graduates. Further, there is evidence that preceptorship programs ease new graduates' transition to practice, increase employee satisfaction, and improve the quality of care provided to clients. The purpose of this developmental project was to develop a preceptor workshop to prepare registered nurses to serve in the capacity of preceptors within a local agency to ease the transition for new nurse graduates into practice, increase employee satisfaction, increase retention rates, and promote higher quality of care within organizations. The preceptor workshop proposed in this project incorporates Watson's caring theory, Benner's novice-to-expert model, and Wright's domain-specific competency assessment model. These theoretical frameworks served to guide the curriculum and design of an eight-module workshop. This workshop will be shared with the partnering organization with the recommendation for implementation and evaluation within the next year. Development of an effective training program for preceptors will result in positive social change by improving outcomes for preceptors, preceptees, the organization, and the clients. Implementing this workshop will have a positive impact on the quality of care provided to clients within the organization by the affects on retention rates, satisfaction, and transition to practice.

The transition from student to new graduate nurse is a difficult conversion. The challenges of the new graduate are the demanding workload, lack of clinical skills, and incivility from staff nurses and unfamiliar institutional cultures. More than 40% of new graduate nurses report making medication errors and feel unprepared to recognize and intervene in life-threatening complications that keep the patient safe from harm. Preceptorship is a clinical instructive model in which a professional relationship provides new graduate nurses with access to a clinical expert and role model within a preset time frame. The goal of the program was to evaluate the outcomes of a preceptorship program that individualized a teaching-learning method in which a new graduate nurse was assigned a clinical expert in order to experience the day-to-day practice with a role model and a resource in the clinical setting. At the conclusion of the orientation process, the graduate nurse identified confidence in their ability to complete assigned skills, they were more motivated to remain on staff in the facility, and the retention of the new graduate nurses increased from 40% to 100% at the 1 year mark. The graduate nurses evaluated the program, the preceptor and the assigned competencies and the facility and the probability of continuing on staff. The surveys were collected by management, and evaluated for rigor, which revealed encouraging results of the program. The facilitation and integration of the preceptor program for new graduate nurses changed the perception of competency within the facility as it relates to the discipline of nursing and moves the graduate toward professional growth, establishing a changing environment in the facility's community of healthcare.

Thirty percent of the doctor of pharmacy degree program, the sole degree recognized by the Accreditation Council for Pharmacy Education (APCE), is dedicated to experiential education. Experiential education is comprised of introductory pharmacy practice experiences (IPPE's), which are interwoven throughout the first three years of the professional curriculum, and advanced pharmacy practice experiences (APPE's), which serve as a capstone in the final year of the degree program. The majority of these experiences are supervised by external pharmacist practitioners or preceptors. Although ACPE mandates adequate preparation and development for preceptors, it does not define the content of such training. Little is understood regarding effective preceptor characteristics and behaviors. The pharmacy literature in this area is scant. <br>Studies in the medical, nursing, and other health-related professional literature suggest that students and preceptors do not always agree on preceptor characteristics and behaviors that are conducive to student learning. Other studies suggest that students who are more experienced may value preceptor characteristics and behaviors differently than novice students. <br>This study conducted a qualitative content analysis to identify preceptor characteristics and behaviors that are valued by experiential experts and pharmacy students. It further examined whether there are differences in the value placed on these characteristics and behaviors between experiential experts and students and between the IPPE and APPE students. Preceptor evaluation instruments as developed by experiential experts from 44 schools of pharmacy and open-ended comments derived from preceptor evaluation instruments completed by IPPE and APPE students from Duquesne University Mylan School of Pharmacy over the 2009-2010 and 2010-2011 academic years were analyzed. <br>Results uncovered four distinct themes: preceptor as professional, instructor, support, and partner. These themes find their roots in transformational leadership theory, adult learning theory, social cognitive theory, and experiential learning models. Results also demonstrated that IPPE and APPE students closely resemble each other in the value they place on desirable preceptor characteristics and behaviors. There was weak correlation between the experiential expert and student voices. Results from this study can be foundational to future research and used to inform preceptor selection criteria, preceptor development programs, and the design of preceptor evaluation instruments. / School of Education / Instructional Leadership Excellence (ILEAD) / EdD / Dissertation

Discussions between clinical nurse leaders and nurse faculty regarding changes in healthcare that affect the new Bachelor of Science in Nursing (BSN) graduate resulted in the creation of the Senior Partnership Practicum. This article describes the process that took place to implement this clinical partnership model at Johnson City Medical Center (JCMC).

While academic nursing programs teach the concepts and theory of providing care, these programs cannot provide sufficient experiential learning to prepare the nurse for all that might be faced in diverse clinical practice settings. As a result, each nurse faces transition to practice hardships with the first nursing role and again each time the clinical setting changes. The Specialty Nurse Residency intervention offers support and instruction during the crucial transition period. Efficacy of the intervention is evaluated based on data analysis from pre and post-intervention survey responses. This quantitative, descriptive study solicits feedback from experienced staff to answer the question: Are the positive outcomes of the Specialty Nurse Residency program reproducible in specialty units other than the Burn ICU as evidenced by preceptor, manager and educator feedback before and after program implementation? The intervention engages new-to-specialty nurses within an evidence-based support system that validates competence and development of clinical reasoning skills. Preceptor development and support are key elements of intervention and program delivery, as these crucial staff members safeguard program and learner success. / Doctorate of Nursing Practice

Submitted by DHARA CARLESSO ZAMPIVA (dhara.zampiva@univates.br) on 2018-08-07T17:59:45Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) 2018ElisângelaMaraZanelatto.pdf: 2213756 bytes, checksum: b91fb0ee3a2e05cecc4a5d0a65adc466 (MD5) / Rejected by Ana Paula Lisboa Monteiro (monteiro@univates.br), reason: Inserir o Lattes do autor. on 2018-09-11T18:21:14Z (GMT) / Submitted by DHARA CARLESSO ZAMPIVA (dhara.zampiva@univates.br) on 2018-09-17T17:09:55Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) 2018ElisângelaMaraZanelatto.pdf: 2213756 bytes, checksum: b91fb0ee3a2e05cecc4a5d0a65adc466 (MD5) / Approved for entry into archive by Ana Paula Lisboa Monteiro (monteiro@univates.br) on 2018-10-02T18:46:01Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) 2018ElisângelaMaraZanelatto.pdf: 2213756 bytes, checksum: b91fb0ee3a2e05cecc4a5d0a65adc466 (MD5) / Made available in DSpace on 2018-10-02T18:46:01Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) 2018ElisângelaMaraZanelatto.pdf: 2213756 bytes, checksum: b91fb0ee3a2e05cecc4a5d0a65adc466 (MD5) Previous issue date: 2018-08-07 / Como se ensina a cuidar? Como se aprende a ensinar na formação em saúde? Impulsionado por tais inquietações, este trabalho, que apresenta os resultados da pesquisa realizada junto ao Programa de Mestrado em Ensino da Univates, buscou investigar os processos de ensino e de aprendizagem na Residência Multiprofissional em Saúde (RMS), sob o olhar dos preceptores. Tal modalidade de ensino, ofertada em nível de pós-graduação, tem como finalidade qualificar os profissionais de saúde no tempo e espaço do serviço. Como aporte teórico, a pesquisa contou com estudos de Foucault (2009, 2012, 2013) para a compreensão da constituição do sujeito do conhecimento, dos modos de subjetivação e da produção dos discursos; de Kastrup (1999, 2005, 2008), que apresenta a possibilidade de pensar a aprendizagem de modo inventivo, distanciando-se do modelo da representação, recognição; e de Merhy (2007, 2009), que entende o cuidado em saúde como um trabalho vivo que se faz em ato e assim permite a atualização dos modos de produzir cuidado. Este trabalho também buscou traçar uma conversa com a história do Mágico de Oz (BAUM, 2013), ao problematizar os processos de ensinar e de aprender, bem como a relação construída entre ensinante e aprendente pelos caminhos da Residência. Foram realizadas entrevistas semiestruturadas aliadas ao processo de foto-elicitação com sete preceptoras da RMS - Ênfase em Saúde da Família das áreas de Nutrição, Psicologia, Enfermagem e Fisioterapia, vinculadas à Universidade do Vale do Taquari e à Secretaria Municipal de Saúde de Lajeado. O tratamento dos dados foi orientado pela análise de discurso foucaultiana. Destaca-se a Residência como um programa de ensino em serviço, que vem sendo construído por meio da atuação das preceptoras e residentes, e se compõe no fazer cotidiano de saúde. Neste contexto, os processos de ensino e de aprendizagem acontecem em ato, mediados pelo diálogo, pelo trabalho em equipe e de modo interdisciplinar. As preceptoras anunciam que essa vivência possibilita suspender o tempo e permite a abertura a novas buscas, ao encontro com o outro, tecendo coletivas aprendizagens sobre o cuidado em saúde. A formação das Preceptoras também acontece no caminho trilhado pelo País das Residências, articulada pela constelação de fluxos e forças presentes neste cenário. Dessa forma, pode ser ampliada com a criação de espaços que permitam a troca das experiências vivenciadas bem como as dúvidas e possibilidades criativas que compõem o repertório docente de cada Preceptora. Acredita-se que investigar sobre a temática da RMS mostrou-se uma forma de conhecer os modos de ensinar e aprender no cuidado em saúde, que se apresentam indissociáveis e suscetíveis à atualização permanente. Por fim, adentrar o território da RMS permitiu reconhecer a potência dessa proposta de formação em saúde, voltada para a humanização, a integralidade do cuidado e o fortalecimento do Sistema Único de Saúde. / How can care be taught? How to learn how to teach in health training? Leveraged by such restlessness, this paper presents the results from research carried out at the Univates Teaching Masters Program and it sought to investigate the teaching and learning processes at the Multiprofessional Health Internship (Residência Multiprofissional em Saúde - RMS) from the viewpoint of the preceptors. That teaching modality is offered at the post-graduation level with the purpose of qualifying health professionals within the service time and space. For the theoretical foundation, the research relied on Foucalt studies (2009, 2012, 2013) to comprehend the constitution of the knowledge subject, the forms of subjectivation and production of discourse; those of Kastrup (1999, 2005, 2008), which presents the possibility of thinking about learning in an inventive fashion; and those of Merhy (2007, 2009, 2013), who understands health care as living work that is performed in acts and thus allows for updating the manners of producing care. This paper also sought to outline a conversation with the Wizard of Oz history (BAUM, 2013) by problematizing the teaching and learning processes, as well as the relation built between teacher and learner along the paths of the Internship. Semistructured interviews were applied in conjunction with the photo-eliciting process with seven RMS preceptors - Emphasis in Familiy Health in the areas of Nutrition, Psychology, Nursing, and Physiotherapy linked to the Vale to Taquari University and the Lajeado Municipal Health Office. Data handling was guided by Foucalt's discourse analysis. The Internship is highlighted as an in-service teaching program that is being constructed by means of the preceptors and interns activities and is comprised in the daily health deeds. Within this context, the teaching and learning processes take place in acts, mediated by dialog, team work and an interdisciplinary fashion. The preceptors state that such experience allows to suspend time and to open new pursuits, heading towards the other and weaving collective learning about health care. Preceptor training also takes place along the path followed by the Internship Country, articulated by the constellation of flows and forces that are present in such a scenario. This way, it may be broadened through the creation of spaces that would allow for exchanging the experiences lived as well as the doubts and creative possibilities that comprise each Preceptor's teaching repertoire It is believed that investigating the RMS issue has shown to be a way of learning about teaching and learning health care that appear as being inseparable and susceptible to permanent updating. Lastly, seeping into the RMS allowed for the acknowledgment of the power of this health training proposal aimed at health humanization and wholesomeness and the strengthening of the Single Health Care System (Sistema Único de Saúde - SUS).

Nurse turnover is a significant problem that has led to a nursing shortage in hospitals, particularly in rural hospitals. The nursing shortage will continue to grow if changes are not implemented to retain qualified nurses. Nurse turnover puts patients at risk for substandard care and increases healthcare-related costs, as organizations try to recoup costs to train and orient new nurses. Retention, turnover, and quality of care are important organizational drivers. One strategy that targets each of these drivers is to have newly hired nurses partake in a preceptorship, where a preceptor facilitates the assimilation and amalgamation of newly hired nurses into their role. Guided by the preceptor conceptual framework, the purpose of this project was to develop and plan a preceptor-training program, which targeted the field sites specific needs. Preceptor and preceptee roles were defined and training modules were created on topics such as communication, adult learning, diversity, time management, assessment, critical thinking, and problem solving. One master binder was created that contained the content required to teach each module of the preceptor-training program. The field site will use this information in conjunction with different delivery methods to implement and evaluate the program. The evaluation plan is to perform formative evaluation after each module is presented and summative evaluation at the conclusion of the allotted training days, using a Likert scale questionnaire. Establishing an instructive program for preceptor training may assist and support preceptors in their role; this program may also affect the preceptee's job satisfaction and ultimately, retention. Safe, efficient, quality care is the cornerstone of the social change implications in practice. Preceptors may feel better about the precepting process and patients may benefit from improved care.

The clinical experience prepares nursing students to become competent and professional practitioners. Therefore, it is important to identify the key characteristics of a positive and constructive clinical learning environment. This cross-sectional study assessed undergraduate nursing students. (n=61; response rate of 38%) perceptions of their clinical learning environment and their suggestions to enhance it. The participants were fourth year nursing students enrolled in the Faculty of Nursing at the University of Manitoba who were doing their senior practicum (NURS 4290). Participants were invited to complete anonymously the actual and preferred versions of the Clinical Learning Environment Inventory (CLEI) (Chan, 2001). It was found that there were significant differences between students. perceptions of the actual and the preferred CLEI they desired. Participants also responded to two open-ended questions related to obstacles or things that would enhance their learning experience. Nine categories were identified that added to an understanding of the quantitative findings. The study indicated that there is still work to be done to provide a healthy clinical learning environment for nursing students and this task belongs to nursing researchers, educators, and health care organization preceptors and leaders.

The clinical experience prepares nursing students to become competent and professional practitioners. Therefore, it is important to identify the key characteristics of a positive and constructive clinical learning environment. This cross-sectional study assessed undergraduate nursing students. (n=61; response rate of 38%) perceptions of their clinical learning environment and their suggestions to enhance it. The participants were fourth year nursing students enrolled in the Faculty of Nursing at the University of Manitoba who were doing their senior practicum (NURS 4290). Participants were invited to complete anonymously the actual and preferred versions of the Clinical Learning Environment Inventory (CLEI) (Chan, 2001). It was found that there were significant differences between students. perceptions of the actual and the preferred CLEI they desired. Participants also responded to two open-ended questions related to obstacles or things that would enhance their learning experience. Nine categories were identified that added to an understanding of the quantitative findings. The study indicated that there is still work to be done to provide a healthy clinical learning environment for nursing students and this task belongs to nursing researchers, educators, and health care organization preceptors and leaders.