Exploring the issue of failure to fail in a nursing program.

A study using a qualitative descriptive design was undertaken to explore the issue of "failure to fail" in a nursing program. Individual in-depth interviews were conducted with nursing university faculty members, preceptors, and faculty advisors (n=13). Content analysis was used to analyze the data. Results indicate that: (a) failing a student is a difficult process; (b) both academic and emotional support are required for students and preceptors and faculty advisors; (c) there are consequences for programs, faculty, and students when a student has failed a placement; (d) at times, personal, professional, and structural reasons exist for failing to fail a student; and (e) the reputation of the professional program can be diminished as a result of failing to fail a student. Recommendations for improving assessment, evaluation, and intervention with a failing student include documentation, communication, and support. These findings have implications for improving the quality of clinical experiences.

Views on unsafe nursing students in clinical learning.

Clinical education is a cornerstone of undergraduate nursing education programs. Although protecting patient safety in clinical learning experiences is a standard of practice, no standard definition of the "unsafe" student exists. The purpose of this study was to describe the viewpoints of undergraduate student nurses and their clinical educators about unsafe clinical student practices. Using Q methodology, 57 students and 14 clinical educators sorted 39 unsafe student practice statements. These statements were generated from an integrated review of nursing and related literature and two undergraduate student focus groups. The use of centroid factor analysis with varimax rotation produced three dimensions of unsafe student practices. An unsafe student was characterized by his/her Compromised Professional Accountability, Incomplete Praxis, and Clinical Disengagement. A shared attribute among these three features was violated professional integrity. While students' affective, cognitive, and praxis competencies were priority elements in the conceptualization of unsafe student practice, this study also identified the salient role of educators as active participants in preparation of safe practitioners.

Preceptor preparation: an investment in the future generation of nurses.

Nurse preceptors fulfill a primary role in the success of preceptorship experiences during the education of student nurses in their final year of study. Evidence suggests that this success depends greatly on adequate preceptor role preparation and support. The purposes of this qualitative, descriptive study were to explore and describe preceptor role support and development within the context of a rural and northern mid-sized Canadian community. More specifically, in this study the following are described: preceptors' (a) perception of past role preparation and current role support; (b) use and evaluation of the existing print-based fourth-year Preceptor Resource Manual (PRM); (c) perception of role support facilitators and barriers; and (d) recommendations for improvements to preceptor role preparation and support. Data were collected through individual and group interviews. Through content analysis four major themes emerged: accessible resources, role complexity, partners in precepting, and role development.

The one-to-one relationship: is it really key to an effective preceptorship experience? A review of the literature.

Currently, considerable focus is directed at improving clinical experiences for nursing students, with emphasis placed on adequate support and supervision for the purpose of creating competent and safe beginning practitioners. Preceptors play a vital role in supporting, teaching, supervising and assessing students in clinical settings as they transition to the graduate nurse role. Intrinsic to this model is the assumption that the one-to-one relationship provides the most effective mechanism for learning. With the current Registered Nurses (RN) shortage, among other factors, the one-to-one relationship may not be feasible or as advantageous to the student. Thus, nurse educators need to carefully assess how this relationship is configured and maintained to assist them in fostering its evolution. In this review of the literature, the authors explore the assumption that a one-to-one relationship in the preceptorship experience fosters a rich and successful learning environment, and implications for nursing education, practice and research are outlined.