Highlighting the Benefits of the Clinical Education Resource Nurse for New Graduate Nurses.

Nurse residency programs provide a valuable transition to practice environment for graduate nurses. The Clinical Education Resource Nurse (CERN) role offers continued clinical assistance to graduate nurses who have completed orientation with a preceptor during the 1st year of practice including education and continued clinical oversight when needed. This column defines the role of CERN and provides a description of the clinical application and support provided.

Nurse Preceptor Burnout: Contributing Factors.

OBJECTIVE: The aim of this study was to assess nurse preceptor burnout and examine related factors. BACKGROUND: Nurse preceptors are essential to the provision of optimal hospital-based care. Preceptors guide and support nurses' transition from professional training to practice as well as movement within practice roles. METHODS: As a component of the DevelopYou database, nurse preceptors (N = 210) were surveyed electronically using the BHLex Preceptor Role Questionnaire. Data retrieved from this data set were analyzed. RESULTS: Twenty-eight percent (n = 60) of participants experienced burnout. Most (n = 203, 96.7%) enjoyed their role. Reasons for becoming a preceptor included a love for teaching, a desire to help others, and feelings of responsibility to the profession and the institution. Strategies to enable perceived value of the role focused on activities involving person-to-person interactions. CONCLUSIONS: On the basis of the results of this analysis, it is apparent that nurse preceptors want to feel valued and supported by administration and have opportunities to interact regularly with colleagues.

Clinical supervisors' experience of a first-time application of entrustable professional activities in clinical supervision of medical students: findings from a Swedish pilot study.

BACKGROUND: Recently, all medical universities in Sweden jointly developed a framework for Entrustable Professional Activities (EPAs) for work-based training and assessment. This framework is now being introduced nationally in the new 6-year undergraduate medical programme that directly lead to a licence to practise. When EPAs are introduced, it is of central importance to gain clinical supervisors' acceptance to apply the framework in their supervision of students. The aim of this study was therefore to investigate how clinical supervisors, not familiar with EPAs, experience clinical supervision using the framework for EPAs. METHODS: We used a purposive sampling to recruit clinical supervisors. They were given written information on EPAs with a selection of suitable EPAs and the Swedish observation rating scale for assessment of autonomy, and they were offered to attend a 30-minute introductory web course. The participants were informed that EPAs were to be tested, and the students were asked to participate. After the study period the clinical supervisors participated in semi-structured interviews. Inductive qualitative content analysis was used to analyse the transcribed interviews. RESULTS: Three general themes emerged in the qualitative analysis: Promoting Feedback, Trusting Assessments and Engaging Stakeholders. The participants described benefits from using EPAs, but pointed out a need for preparation and adaptation to facilitate implementation. The structure was perceived to provide structured support for feedback, student involvement, entrustment decisions, enabling supervisors to allow the students to do more things independently, although some expressed caution to rely on others' assessments. Another concern was whether assessments of EPAs would be perceived as a form of examination, steeling focus from formative feedback. To understand the concept of EPA, the short web-based course and written information was regarded as sufficient. However, concern was expressed whether EPA could be applied by all clinical supervisors. Involvement and adaption of the workplace was pointed out as important since more frequent observation and feedback, with documentation requirements, increase the time required for supervision. CONCLUSIONS: EPAs were accepted as beneficial, promoting structured feedback and assessments of the students' autonomy. Preparation of supervisors and students as well as involvement and adaptation of the workplace was pointed out as important.

Exploring the problems and coping strategies of pharmacy internship in large general hospitals in China: from the perspective of preceptors.

OBJECTIVE: The role of the Hospital Pharmacy Preceptor (HPP) is pivotal in upholding the excellence of experiential training and fostering the professional growth of pharmacy interns. However, there is a lack of studies that provide an overview of pharmacy internships from the perspective of HPP. This study explores the experience and expectations of HPPs regarding existing problems and possible coping strategies in intern teaching. METHODS: This is a qualitative study that was conducted through individual interviews and focus group discussions. HPPs were invited as participants from large-scale tertiary hospitals in representative provinces of mainland China. Interview and focus group discussion data were analyzed using thematic analysis to see emerging themes from the data. Nvivo 12 was utilized for data management and processing. RESULTS: Eight individual interviews and two focus group discussions were conducted, involving 14 HPPs as participants. Upon the examination of the interviews and focus group data, four themes were summarized regarding HPPs' perceptions: 1) current presenting problems; 2) possible coping strategies; 3) something HPPs should do; 4) something interns should do. CONCLUSION: This study found that from the HPPs' perspective, the hospital-based pharmacy internship still has some problems from policy to practice, which need to be addressed by the joint efforts of the state, schools, internship bases, pharmacy preceptors, and students.

Trajectory of change in perceived stress, coping strategies and clinical competence among undergraduate nursing students during clinical practicum: a longitudinal cohort study.

BACKGROUND: Clinical practicum is crucial for strengthening nursing students' clinical competence. However, nursing students often experience considerable stress during clinical practicum, and so they employ coping strategies to alleviate it. There is almost no empirical evidence on the change trajectory of perceived stress, coping strategies, and clinical competence among nursing students during a one-year clinical practicum. This study aimed to investigate the trajectory of change in perceived stress, coping strategies, and clinical competence among undergraduate nursing students during a one-year clinical practicum. METHODS: This study used a longitudinal cohort design. Undergraduate nursing students were recruited from a science and technology university in Taiwan to participate from February 2021 to January 2022. Perceived stress, coping strategies, and clinical competence among students in basic training practicum (T1), advanced training practicum (T2), and comprehensive clinical nursing practicum (T3) were surveyed by using the Perceived Stress Scale (PSS), Coping Behaviour Inventory (CBI), and Clinical Competence Scale (CCS). PSS, CBI, and CCS in T1, T2, and T3 were compared using a generalized estimating equation (GEE) to deal with correlated data. The level of statistical significance was set at α = 0.05. RESULTS: A total of 315 undergraduate nursing students completed the questionnaire. The study results show that the overall perceived stress of the students is the highest in T2 and the lowest in T3. The main source of stress of the students is 'taking care of patients' at T1 and 'lack of professional knowledge and skills' at T2 and T3. Students' perceived stress in 'taking care of patients' gradually decreases over time. The four coping strategies of CBI, which are 'stay optimistic', 'problem-solving', 'transference' and 'avoidance' in this order, remain the same ranking in three surveys.The main stress coping strategy used by students is 'stay optimistic', while the coping strategy 'avoidance' is used more frequently in T2 than in T1 and T3. Students' mean scores of the overall clinical competence and in the 'general nursing' and 'management' subscales in T3 are higher than those in T1 and T2. However, their mean scores in 'self-growth' and 'positivity' subscales are the highest in T1 and the lowest in T2. CONCLUSIONS: The results show that through experiential learning in clinical practicum at different stages time after time, students' overall perceived stress is the lowest and their overall clinical competence is the highest in T3. The main coping strategy used when students managed stress is 'stay optimistic'. According to the results, we suggest that clinical educators provide students with appropriate guidance strategies at different stages of stress and continue to follow up the clinical competence and retention rates of these nursing students in the workplace in the future.

Participant Evaluation of a Multi-disciplinary Oncology Preceptorship Training Program for Oncology Health Professionals from Kumasi, Ghana.

A critical shortage of skilled healthcare workers is a primary cause of disparate global cancer outcomes. We report participant evaluation of a multidisciplinary preceptorship program. In collaboration with the city of Kumasi, Ghana, Mayo Clinic and the City Cancer Challenge hosted a preceptorship program for comprehensive multidisciplinary breast and cervix cancer training. A total of 14 healthcare workers from Kumasi received two weeks of training at Mayo Clinic in November and December 2021. Each participant and preceptor were requested to complete an anonymous post-participation survey. Of the 14 trainee participants, 10 (71%) completed the survey. All respondents found the program "valuable and applicable to their clinical practice." Ninety percent reported they were able to "review effective and critical elements in the development and expansion of the multidisciplinary team" and able to "solve practical clinical cases as a team". General themes of satisfaction included: (1) organization and administration, (2) clinical observations and demonstrations, (3) guidelines development, and (4) recognizing the central importance of cultivating a team-based approach. Of the 40 preceptors, 16 (40%) completed the survey. All respondents reported they felt the training would meaningfully "influence patient care in Ghana", that participation "added value or joy to their clinical practice," and all wished to "participate in future preceptorship programs". After a focused two-week program, trainees reported high satisfaction, usefulness from observing specialized cancer care, and value in closely observing a multidisciplinary oncology team. Preceptors reported the experience added joy and perspective to their clinical practice and wished to participate in future programs.

How Should We Answer the Preceptor Invitation?

When asked to serve as a preceptor, it is not uncommon to wonder: What should I consider when trying to decide if this is the right time for me to be a preceptor? How can it benefit me and my future career? Should I do it? These are some of the questions we are going to answer.

"You and Me Do It for the Love of Teaching": Exploring the Expansion of Clinical Training Opportunities for Midwives.

PURPOSE: To better understand the barriers and facilitators to precepting midwifery students from across the healthcare ecosystem in New Jersey. BACKGROUND: Growing the midwifery workforce is a crucial step to alleviating disparately poor perinatal health outcomes and expanding access to care. Difficulty recruiting and retaining preceptors has been identified as a barrier to graduating more midwives. METHODS: In-depth qualitative interviews were conducted with 19 individuals involved in different stages of the clinical training process: midwives, physicians, and administrators. Transcripts were coded using the tenets of qualitative description and thematic analysis. Analysis was guided by the Promoting Action on Research Implementation in Health Services framework. RESULTS: The following themes were identified and organized within the domains identified by our conceptual framework. Evidence: (mis)understanding the benefits of midwifery care and impacts on patient care. Context: the time and energy it takes to precept and practice considerations. Facilitations: developing the next generation of healthcare providers and the quiet and ever-present role of money in healthcare. CONCLUSIONS: Findings from this study support the importance of approaching midwifery precepting as a multifaceted endeavor, one that necessitates the full support of individuals within many different roles in an organization. IMPLICATIONS FOR PRACTICE AND RESEARCH: Getting buy-in from various levels of the healthcare ecosystem requires a flexible approach but must include a targeted effort toward showing the value of midwifery care in terms of patient outcomes, satisfaction, and cost.

Using a Delphi Technique to Define Primary Care Behavioral Health Clinical Supervision Competencies.

There is an increasing need for Primary Care Behavioral Health (PCBH) workforce development (i.e., increase in well-trained PCBH providers) given the growth of behavioral health (BH) integration into primary care, specifically at a time when behavioral health needs are increasing because of the COVID-19 pandemic (Kanzler and Ogbeide in Psychol Trauma 12(S1):S177-S179, https://doi.org/10.1037/tra0000761 , 2020). Therefore, it is imperative to provide current and future behavioral health clinical supervisors in primary care settings specific competencies, given there are no current competencies specific to clinical supervision within the PCBH Model. Using a Delphi process, the authors identified and reached expert consensus on competencies for BH clinical supervisors in primary care. A purposive sample (in: Patton, Qualitative evaluation and research methods, Sage, Newbury Park, 1990) of fifteen experts (n = 15) in PCBH clinical training and education evaluated quantitative and qualitative domains and specific competencies associated with PCBH supervision gathered during an initial in-depth qualitative interview. This was followed by two subsequent rounds of quantitative Delphi surveys to reach consensus. The response rates from our panel of experts were 100% (15/15) for all stages (interviews, round one and round two surveys). Three domains (Primary Care Knowledge, Clinical Supervisor Development, and Clinical Supervision Skills) were rated as essential for providing clinical supervision with PCBH for pre-licensure level learners. The development of competencies will further support BH clinical supervisor needs, professional development, and provide a concrete way to evaluate progress towards teaching and training excellence. This will also have a great impact on the development of the future BH workforce within primary care.

Registered nurses' perceptions of nursing student preceptorship: Content analysis of open-ended survey questions.

Nursing preceptors play a crucial role in supporting and educating clinical students. Understanding the perceptions and needs of nurse preceptors is essential to enhance their role as preceptors and to improve their teaching practices. This study aimed to explore preceptorship in diverse settings and specific contexts. Content analysis was performed to analyze open-ended responses from a questionnaire based on nurses' perceptions of preceptorship with undergraduate nursing students. Data were collected from two university hospitals, with different healthcare provision levels. Of the 370 responses, 295 (96%) were those of women, and 34.5% were in the age group of 41-50 years. Three main themes were identified: (1) the role of preceptorship as a key component in learning, (2) challenges in student preceptorship, and (3) personal recognition and compensation for teaching work. This study highlights the positive experiences and provides valuable insights into the challenges and opportunities faced by nurse preceptors in their teaching roles, and emphasizes the need for institutional support and educational programs to enhance their teaching responsibilities. Improving communication and collaboration among stakeholders is crucial for improving learning outcomes and satisfaction.

Staff Perceptions on the Effectiveness of GRiP-S, a New Approach to Clinical Supervision Incorporating Safewards: An Interpretive Phenomenological Analysis.

This study explored the impact of an innovative approach to clinical supervision for mental health nurses which integrates Safewards, named Group Reflective integrated Practice with Safewards - GRiP-S. Qualitative data was collected through 10 individual semi-structured interviews with nursing staff who had participated within the clinical supervision approach. Interviews provided insights into the nursing staff's perception and experience of the clinical supervision approach. Through interpretive phenomenological analysis six themes emerged (i) illuminating embodied practice of Safewards, (ii) building confidence through empowering connections, (iii) creating a culture of positive change, (iv) identifying internal motivation for and external barriers to supervision engagement, (v) navigating a global pandemic, and (vi) the transformative role of reflection. Findings demonstrated that the GRiP-S approach assisted mental health nurses' adoption of Safewards interventions in practice, while supporting the development of a cohesive staff team. The impact of COVID-19 within the study setting was addressed and nurses identified how the Safewards model assisted in navigating challenges during this time. Findings further supported prior research on the role of the supervisor and supervisee relationship. This study supports the integration of Safewards within reflective clinical supervision for mental health nursing staff to assist in Safewards fidelity and nursing staff personal and professional development.

Competency-Based Virtual Clinical Practicum in Response to COVID-19 Pandemic: A Quality Improvement Project.

PURPOSE: The purpose of the quality improvement (QI) project was to provide a learner and faculty preceptor high quality virtual clinical practicum (VCP) for Wound, Ostomy, Continence (WOC) Nurse learners during the COVID-19 pandemic and disseminate findings. PARTICIPANTS AND SETTING: Project participants were registered nurses post-bachelor's degree or higher with a minimum of 1-year clinical experience who had completed and passed the didactic portion of a Wound Ostomy Continence Nursing Education Program (WOCNEP). Learners completing the WOCNEP's VCP and the faculty preceptors were the subjects for this QI report. The setting was a virtual platform allowing live time visibility and interactions between learners and faculty preceptors including the ability to share documents and procedural videos. An initial group of 62 learners were asked open-ended questions after completion of the VCP; the most frequently recurring themes were converted into 5-point Likert scale questions as the evaluation tool completed by an additional 234 learners. In total, 296 learners completing the VCP evaluated this novel 100% simulation virtual practicum. APPROACH: This QI project evaluated a 100% simulation-based practicum at a WOCENP based in the United States. A competency based VCP used the Competency Outcomes and Performance Assessment (COPA) model. Learners were taught competencies via a preparatory virtual lab and then had to prepare documents and videos or pictures with step-by-step instructions prior to attending a Live Competency Assessment Lab with faculty preceptors and a small group of peer learners. OUTCOMES: Appraisal of the VCP was based on course evaluations anonymously completed by each of the 296 learners. Faculty preceptors were queried regarding their VCP evaluation and certification exam pass rates were tallied. Findings indicate positive outcomes of the VCP competency-based practicum from student and faculty preceptor perspectives along with higher certification pass rates; specifically, wound care pass rates increased by 16%, ostomy care increased by 18% and continence care pass rates increased by 13%. IMPLICATIONS FOR PRACTICE: Our reported experiences strongly suggest a VCP offers an attractive option for fulfilling practicum requirements while reducing barriers of the in-person split option practicum.

Renewing the Nursing Culture: Sustaining the Professional Community of Practice Through the Role of the Preceptor.

Culture is the driving frame within which all human action takes form. This article explores the elements and characteristics of culture and applies them to the nursing professional community of practice. As it drills down to the work in the cultural context, it argues for the central role of the preceptor in evidencing the influence of culture. For onboarding nurses and the nursing community, the preceptor becomes the carrier of culture, demonstrating the impact of culture in a way that exhibits its influence and impact on nursing practice and patient care.

The role, the risk, and the reciprocity: creating positive early rural placements in medical education.

INTRODUCTION: The Northern Ontario School of Medicine University seeks to address rural physician shortages in Northern Ontario. One key strategy the school employs is the use of experiential learning placements embedded throughout its undergraduate curriculum. In second year, students embark on two 4-week placements in rural and remote communities. This study sought to explore the factors that contribute to a positive learning experience from the preceptor's perspective. METHODS: Semi-structured interviews were conducted with five community preceptors who have participated in these placements. Using the information from these interviews a survey was created and sent to another 15 preceptors. Data were analyzed using qualitative methods and frequencies. RESULTS: Three key themes were identified from both the interviews and survey data: the role of early rural and remote placements; the risks of these placements; and the need for a reciprocal relationship between institutions, preceptors, and students to create a positive learning environment. CONCLUSION: Preceptors value the opportunity to teach students, but the aims of these placements are not clear and preceptors and local hospitals need more workforce resources to make these experiences positive.

Faculty Development for Community Preceptors: a Narrative Review of the Literature.

Community teaching physicians (i.e., community preceptors) have assumed an important role in medical education. More than half of medical schools use community settings to train medical students. Whether community preceptors are well prepared for their teaching responsibilities is unknown. In addition, best practice for faculty development (FD) of this population of preceptors has not been defined. The authors conducted a narrative review of the literature to describe FD programs for community preceptors that may be helpful to medical schools for future planning. Many databases were searched from their establishment to May 2022. Studies that described FD programs for community preceptors were included. Data were organized according to program aim, duration, setting, participants, content, and outcomes. The Communities of Practice theoretical framework was used to present findings. From a total of 6308 articles, 326 were eligible for full review, 21 met inclusion criteria. Sixty-seven percent (14/21) conducted a needs assessment; 57% (12/21) were developed by the medical school; 81% (17/21) included only community preceptors. Number of participants ranged from six to 1728. Workshops were often (24%, 5/21) used and supplemented by role-play, online modules, or instructional videos. Few programs offered opportunities to practice with standardized learners. Content focused primarily on teaching skills. Five programs offered CME credits as an incentive for engagement. Participant surveys were most often used for program evaluation. Learner evaluations and focus groups were used less often. Participants reported satisfaction and improvement in teaching skills after attending the program. Faculty development for community preceptors is primarily delivered through workshops and online materials, although direct observations of teaching with feedback from FD faculty and learners may be more helpful for training. Future studies need to focus on the long-term impact of FD on community preceptors' teaching skills, identity formation as medical educators, and student learning.

One-minute preceptor and SNAPPS for clinical reasoning: a systematic review and meta-analysis.

Clinical reasoning teaching strategies could be important models to teach healthcare trainees. This study aims to assess the effectiveness of clinical reasoning teaching strategies (one-minute preceptor (OMP) and SNAPPS) for developing clinical reasoning skills, attitudes and satisfaction of medical/healthcare students and post-graduate trainees as compared to controls. A systematic review and meta-analysis of randomised controlled studies, with no restriction on language or publication date, were carried out by searching the PubMed, SCOPUS, ERIC, Web of Science, Embase and Cochrane Library databases. The risk of bias of the studies selected was determined using Cochrane's risk-of-bias tool (RoB 2) and the quality of evidence used the Grading of Recommendations Assessment, Development and Evaluation system. Of the 1066 articles retrieved, 12 were included in the systematic review and 10 in the meta-analysis. The results showed a growing body of literature on the use of strategies for teaching clinical reasoning that consisted predominantly of low-quality quasi-experimental studies. When only randomised controlled trials were included, analyses showed effectiveness among both healthcare students and post-graduate trainees for a series of outcomes, including total presentation length, duration of discussion, number of basic attributes, number of justified diagnoses in differential diagnoses and number of uncertainties expressed. Lastly, results for SNAPPS were better than for OMP relative to the control group. The strategies for teaching clinical reasoning improved the performance of healthcare students and professionals on this skill, promoting deeper discussion of clinical cases and a higher number of differential diagnoses. Further good-quality trials are needed to corroborate these findings. PROSPERO Registration: CRD42020175992.

Impact of a professional development session based on learner evaluations within a preceptor community of practice.

BACKGROUND: Physician preceptors play key roles in teaching medical professional trainees but receive little formal teacher training. One proposed way to improve teaching is by providing preceptors with learner feedback. The feedback from learner evaluations often has a limited impact with changes to teaching practice difficult to implement. This study explores the effect of using learner feedback to create a professional development session on teaching within a preceptor community of practice. METHODS: In this case study, 15 preceptors agreed to release their learner evaluations, and ten participated in the professional development session. Immediately and 2-3 months after the session, participants completed surveys on their intention to change and the changes made. The community of practice lead was interviewed to discuss the professional development session's impact. Qualitative approaches were used to analyze the data. RESULTS: From the learner evaluations, nine areas of improvement were identified and discussed. All attendees made changes to their teaching practices, which the community of practice lead confirmed. Fewer changes were identified at the community of practice group level. CONCLUSION: Using learner evaluations to structure a professional development session within a community of practice can help identify areas of improvement and create strategies to address these challenges.

Nurse preceptors' experiences of promoting and teaching fundamental care to undergraduate nursing students: A qualitative study.

AIMS: To explore nurse preceptors' experiences in promoting and teaching the delivery of fundamental care to nursing students during their clinical period at nursing homes. DESIGN: The study used a qualitative descriptive approach. METHODS: Nine in-depth, semistructured interviews were conducted with clinical nurses employed at five different nursing homes. Data collection lasted from September 2020 to April 2021. The interviews were recorded and transcribed verbatim. Inductive, qualitative content analysis was employed to analyse the data. RESULTS: Qualitative content analysis yielded one main category-'Fostering nursing students' knowledge and understanding of fundamental care'-supported by two subcategories: (i) 'Raising awareness of the importance of fundamental care' and 'Providing for learning through exchange and cooperation', which are interpreted as the ways nurse preceptors enable students to learn how to provide fundamental care during their clinical period at nursing homes. CONCLUSION: By taking the role of nurse preceptors, clinical nurses act as enablers for students' learning of the provision of fundamental care within nursing homes as the learning context. Nurse preceptors possess the pedagogical skills to initiate and conduct nursing students' learning processes. The study reveals that nurse preceptors stress the importance of providing fundamental care to patients; hence, teaching students to provide fundamental care was also found to be important. IMPACT: Within a nursing home context, nurses are responsible for providing fundamental care; therefore, they play an essential role in both providing and teaching about caregiving. The study shows that because of their preceptorship, nurse preceptors can enhance students' awareness of the importance of learning to provide fundamental care to patients. In addition, the study reveals that nurse preceptors work to enhance student's reflection and critical thinking by targeting the student's zone of proximal development, which represents a preliminary phase in students' learning.

Advanced Practice RN Student Practicum Placements: An Academic Health Center and College of Nursing Collaboration.

Academic health centers are faced with limited resources to navigate placement of advanced practice RN (APRN) students at the same time as APRN programs continue to increase. Clinical practicum sites are in higher demand due to clinical hour increases by accrediting organizations. This article describes a successful approach to the inefficient use of administration and preceptor resources for APRN student practicum placements via an innovative academic health system partnership.

'What is it we are trying to achieve here'? Community maternal and child health nurses and clinical supervision: A qualitative descriptive study.

AIMS: To explore clinical supervision practice by Victorian Maternal and Child Health nurses, identify the self-reported supervision needs of nurses and the facilitators and barriers to meeting those needs. BACKGROUND: Community-based Maternal and Child Health nurses have responsibilities for the safety and wellbeing of children and specific clinical support needs. Clinical supervision has the potential to support nurses' clinical practice and reflective skills; however, little is known internationally about child and family health nurses' supervision practices. DESIGN: Qualitative descriptive study. METHODS: Twenty-three semi-structured interviews were conducted between October and December 2021 with nurses, managers and supervisors across metropolitan, regional/rural areas of Victoria, Australia. Inductive thematic analysis was applied to the data. The Consolidated Criteria for Reporting Qualitative Research guided this study. RESULTS: Three main themes, with subthemes were generated; 'Understand what we do', 'It's the gathering of the nurses' and 'Bringing a case'. A lack of agreed purpose, aims and varied understandings of clinical supervision contributed to suboptimal clinical supervision. Although participants agreed about the importance of clinical supervision, the perceived benefits were inconsistently realized. CONCLUSIONS: This study points to a need for greater organizational awareness of the conditions and leadership needed to build reflective skills and culture in community-based child and family nursing. REPORTING METHOD: The Consolidated Criteria for Reporting Qualitative Research has guided this study. NO PATIENT OR PUBLIC CONTRIBUTION: There was no patient or public contribution in the conduct of this study. IMPACT: A stronger focus is needed to build reflective culture and skill in child and family nursing. Areas for improving child and family nurses' use of clinical supervision have been identified. This study can inform nurse education, policy and service leaders, to strengthen clinical supervision in child and family nursing contexts.