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1.
Acad Med ; 95(2): 301-309, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31425181

RESUMEN

PURPOSE: Difficulty in recruiting and retaining community preceptors for medical student education has been described in the literature. Yet little, if any, information is known about community outpatient preceptors who have stopped or decreased teaching time with students. This study aimed to examine these preceptors' perspectives about this phenomenon. METHOD: Using a phenomenology framework, this multi-institutional qualitative study used semistructured interviews with community pediatric preceptors who had stopped or reduced teaching time with medical students. Interviews were conducted between October 2017 and January 2018 and transcribed verbatim. Interviews explored factors for engaging in teaching, or decreasing or ceasing teaching, that would enable future teaching. An initial code book was developed and refined as data were analyzed to generate themes. RESULTS: Twenty-seven community pediatricians affiliated with 10 institutions participated. Thirty-seven codes resulted in 4 organizing themes: evolution of health care, personal barriers, educational system, and ideal situations to recruit and retain preceptors, each with subthemes. CONCLUSIONS: From the viewpoints of physicians who had decreased or stopped teaching students, this study more deeply explores previously described reasons contributing to the decline of community preceptors, adds newly described barriers, and offers strategies to help counter this phenomenon based on preceptors' perceptions. These findings appear to be manifestations of deeper issues including the professional identify of clinical educators. Understanding the barriers and strategies and how they relate to preceptors themselves should better inform education leaders to more effectively halt the decline of community precepting and enhance the clinical precepting environment for medical students.


Asunto(s)
Medicina Comunitaria/educación , Pediatras , Preceptoría/organización & administración , Femenino , Humanos , Entrevistas como Asunto , Masculino , Investigación Cualitativa , Estudiantes de Medicina , Enseñanza/estadística & datos numéricos
2.
Thorac Surg Clin ; 30(1): 111-120, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31761279

RESUMEN

Nonintubated thoracic surgery arose as supplemental evolution of minimally invasive surgery and is gaining popularity. A proper nonintubated thoracic surgery unit is mandatory and should involve surgeons, anesthesiologists, intensive care physicians, physiotherapists, psychologists, and scrub and ward nurses. Surgical training should involve experienced and young surgeons. It deserves a step-by-step approach and consolidated experience on video-assisted thoracic surgery. Due to difficulty in reproducing lung and diaphragm movements, training with simulation systems may be of scant value; instead, preceptorships and invited proctorships are useful. Preoperatively, patients must be fully informed. Effective intraoperative communication with patients and among the surgical team is pivotal.


Asunto(s)
Grupo de Atención al Paciente , Preceptoría , Cirugía Torácica Asistida por Video , Humanos , Grupo de Atención al Paciente/organización & administración , Grupo de Atención al Paciente/normas , Preceptoría/métodos , Preceptoría/organización & administración , Cirugía Torácica Asistida por Video/educación , Cirugía Torácica Asistida por Video/métodos
3.
Nurse Educ ; 45(1): 39-42, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-30801418

RESUMEN

BACKGROUND: RN precepted clinical immersion experiences have become a mainstay of prelicensure nursing education, as they increase autonomy and confidence as students prepare to graduate and enter the workforce. PROBLEM: Nursing students are often assigned a hospital unit that neither enables them to work with their preferred patient population nor appreciates the patient care continuum. APPROACH: A clinical immersion experience was developed using an innovative model focused on specific patient populations across the care continuum. OUTCOMES: Five clinically immersive experiences were developed. More than 50 students transitioned through varied areas across the care continuum, based on their chosen focus. CONCLUSION: Senior-level nursing students were able to care for patients along the care continuum in both acute and community settings through a new model.


Asunto(s)
Bachillerato en Enfermería/organización & administración , Atención de Enfermería/organización & administración , Preceptoría/organización & administración , Estudiantes de Enfermería/psicología , Selección de Profesión , Difusión de Innovaciones , Humanos , Modelos Educacionales , Investigación en Educación de Enfermería , Investigación en Evaluación de Enfermería
5.
J Nurs Adm ; 49(10): 463-465, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31517754

RESUMEN

This article describes an innovative academic-practice partnership designed to promote new nurse competency and meet employer needs for graduates with in-demand knowledge and competencies in specialty patient populations. Three practice partners identified areas of need and with the school of nursing developed specialty nursing elective courses with precepted clinical experiences.


Asunto(s)
Curriculum , Bachillerato en Enfermería/organización & administración , Relaciones Interinstitucionales , Colaboración Intersectorial , Personal de Enfermería en Hospital/educación , Preceptoría/organización & administración , Adulto , Femenino , Humanos , Masculino , Estados Unidos , Adulto Joven
6.
Clin Nurse Spec ; 33(5): 228-236, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31404001

RESUMEN

PURPOSE: Develop an evidence-based clinical nurse specialist (CNS) preceptor protocol to enhance preceptor's skills and effectiveness and strengthen the preceptor-preceptee relationship and outcomes. DESCRIPTION: An effective CNS preceptor is a key variable to quality, timely, and fiscally responsible CNS transition and retention. Most preceptors receive no formal education or skill development. Literature searched from the previous 10 years explored CNS preceptor, preceptee, and preceptorship process. OUTCOMES: Protocol key components are development of the mutual collaborative relationship, shared meaning, understanding, goal setting, timelines, and evaluations. The planning phase of the protocol includes face-to-face meeting to identify overarching goals and establish a trusting collaborative relationship. The mutual iterative learning and growing phase includes identification of learning needs, goals, and strategies such as debriefing, reflective journaling, and mutual ongoing evaluation. The concluding phase includes formal evaluation. The outcome phase includes safe autonomous CNS practice, along with mutual growth and satisfaction. CONCLUSIONS: The literature informed the CNS preceptor protocol development. The protocol may be evaluated within a preceptor-preceptee relationship across multiple settings. Higher levels of CNS research are vital to identify evidence-based CNS preceptorship strategies. As CNSs are integrated into advanced practice roles, a structured preceptor protocol and education program is critical to provide quality outcomes.


Asunto(s)
Educación en Enfermería/métodos , Enfermeras Clínicas/educación , Preceptoría/organización & administración , Práctica Clínica Basada en la Evidencia , Humanos
7.
J Nurs Adm ; 49(9): 430-435, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31436741

RESUMEN

OBJECTIVE: The purpose of this integrative literature review is to examine the effects that nurse residency programs (NRPs) have on the retention of new graduates. BACKGROUND: The Institute of Medicine recommends implementing NRPs and evaluating their effectiveness. Nursing leaders need to understand if an investment in a residency program is beneficial to their organization. METHODS: A database search was performed for research from 2010 to 2016 reporting outcomes of new graduate NRPs relating to retention. RESULTS: In the articles reviewed, the 1-year retention was higher than the national average for new graduate nurses ranging from 74% to 100%. Higher rates were associated with national programs such as the University Hospital Consortium/American Association of Colleges of Nursing or Versant compared with organization-based programs. CONCLUSIONS: NRPs can increase 1-year retention of new graduate nurses. More controlled and comparative studies are needed to evaluate program differences. Nurse leaders need evidence to ascertain which programs are the most effective in supporting retention and return on investment.


Asunto(s)
Competencia Clínica , Educación de Postgrado en Enfermería/organización & administración , Admisión y Programación de Personal/organización & administración , Reorganización del Personal/estadística & datos numéricos , Preceptoría/organización & administración , Estudiantes de Enfermería/psicología , Estudiantes de Enfermería/estadística & datos numéricos , Adulto , Femenino , Humanos , Masculino , Factores de Tiempo , Estados Unidos , Adulto Joven
8.
Nurs Manag (Harrow) ; 26(4): 29-35, 2019 Jul 29.
Artículo en Inglés | MEDLINE | ID: mdl-31468827

RESUMEN

BACKGROUND: Being able to speak up is a prerequisite for establishing safe communication in healthcare settings. The nursing preceptorship programme represents an opportunity for newly qualified nurses to develop and practise assertive communication skills. AIM: To examine newly qualified nurses' views on how nursing preceptorship programmes contribute to shaping their assertive communication skills. METHOD: 42 newly qualified nurses from four acute hospital trusts in east England completed open-ended questions included in a cross-sectional survey. Participants' qualitative comments were analysed using thematic analysis. FINDINGS: Three themes related to speaking up during the nursing preceptorship programme emerged: enthusiastic versus sceptical, the role of a supportive working culture, and logistical challenges. CONCLUSION: Nursing preceptorship programmes can develop newly qualified nurses life-enhancing assertive communication skills if they provide inspiring preceptors who act as role models, create a supportive working culture and support nursing preceptors to deliver effective preceptorship. It is imperative that nursing preceptorship programmes are adapted to enable newly qualified nurses to learn and practise assertive communication skills.


Asunto(s)
Asertividad , Comunicación , Personal de Enfermería en Hospital/psicología , Preceptoría/organización & administración , Inglaterra , Humanos , Investigación en Educación de Enfermería , Investigación en Evaluación de Enfermería , Investigación Cualitativa
9.
Nurs Outlook ; 67(6): 765-775, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31378414

RESUMEN

BACKGROUND: The abundant knowledge on nursing students' competencies in clinical safety, and the multiple approaches adopted make it difficult to obtain an overview of the current status of this question. PURPOSE: To review the literature on undergraduate nursing students' safety competencies during their clinical placements. METHOD: A scoping review was carried out. Searches were executed in PubMed, CINAHL, WOS, MEDES, and websites of relevant organizations. The framework proposed by the Joanna Briggs Institute was adopted. FINDINGS: A total of 43 studies were selected for the final sample. The review identified four major topics: the presence of adverse events in clinical placements, the acquisition of competencies in clinical safety, student experiences regarding clinical safety, and pedagogical approaches for clinical safety. DISCUSSION: Nursing students encounter adverse events and clinical safety incidents throughout their clinical training. Faculties should assign the highest priority to this question, due to its importance in the creation of a culture of safety.


Asunto(s)
Competencia Clínica , Bachillerato en Enfermería/organización & administración , Seguridad del Paciente , Preceptoría/organización & administración , Administración de la Seguridad/organización & administración , Estudiantes de Enfermería/estadística & datos numéricos , Adulto , Femenino , Humanos , Masculino , Adulto Joven
11.
Am J Health Syst Pharm ; 76(8): 543-550, 2019 Apr 08.
Artículo en Inglés | MEDLINE | ID: mdl-31361860

RESUMEN

PURPOSE: Leveraging pharmacy technicians to take on advanced roles can enable pharmacists to practice at the highest level of their license. Technicians trained through traditional venues may not have the necessary knowledge and skills to adequately take on these roles. To meet this need, a technician residency program was developed and implemented in a health-system pharmacy. SUMMARY: The technician residency program was designed to develop competency in the medication use process as assessed through achievement of 30 objectives based on successful completion of rotations, projects, and didactic examination. The program duration was 50 weeks with rotations which included compounding, technician-check-technician cart fill and floor stock replenishment, investigational drug services, regulatory compliance, and other functions. The resident also completed several projects to improve data analytics, communication, and leadership skills. By the end of the program, the residency program director and preceptors determined that the resident achieved 83% (25/30) of objectives and had developed competency in the medication use process superior to technicians with several years of experience. The resident was ultimately hired in a specialty technician position and was found to perform effectively in that role. CONCLUSION: The program allowed the technician resident to gain a comprehensive understanding of health-system pharmacy practice and continue to develop skills and abilities that would typically take several years of work experience to be achieved.


Asunto(s)
Residencias en Farmacia/organización & administración , Servicio de Farmacia en Hospital/organización & administración , Técnicos de Farmacia/educación , Preceptoría/organización & administración , Centros de Atención Terciaria/organización & administración , Comunicación , Implementación de Plan de Salud , Humanos , Liderazgo , Farmacéuticos/organización & administración , Técnicos de Farmacia/psicología , Rol Profesional , Evaluación de Programas y Proyectos de Salud
12.
Am J Nurs ; 119(5): 61-65, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-31033558

RESUMEN

: This article is one in a series on the roles of adjunct clinical faculty and preceptors, who teach nursing students and new graduates to apply knowledge in clinical settings. One of the first steps to becoming a preceptor is learning about the resources and support available within one's organization. This article offers tips to help preceptors prepare for and navigate the precepting experience.


Asunto(s)
Bachillerato en Enfermería/organización & administración , Preceptoría/organización & administración , Estudiantes de Enfermería , Competencia Clínica , Educación en Enfermería , Docentes de Enfermería/organización & administración , Humanos
13.
J Nurs Educ ; 58(3): 144-151, 2019 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-30835801

RESUMEN

BACKGROUND: An authentic learning environment fosters socialization of nursing students to a particular community context and unique culture of the individuals who reside in that culture. The final preceptorship provides an extended clinical practice experience allowing for this immersion, while providing consolidation of learning as preparation to enter practice. METHOD: PhotoVoice was used as an innovative data collection method to engage participants throughout the research process. Participants self-selected photographic images that represented the unique rural preceptorship experience through their eyes. RESULTS: Rurality was described by participants as more than a geographic location, but as a sense of place, or a way of being and doing, that represented rural life. Rurality was depicted more specifically by participants in terms of community spirit and cultural contexts. CONCLUSION: Rural practice placements have the potential to enrich undergraduate nursing education and to expose undergraduate nursing students to the role of the rural nurse. More research is needed about rural health to understand the cultural and contextual factors that uniquely affect the health status of rural Canadians. [J Nurs Educ. 2019;58(3):144-151.].


Asunto(s)
Preceptoría/organización & administración , Ubicación de la Práctica Profesional , Salud Rural , Autoeficacia , Estudiantes de Enfermería/psicología , Adulto , Canadá , Selección de Profesión , Bachillerato en Enfermería/métodos , Femenino , Humanos , Masculino , Investigación en Educación de Enfermería , Socialización
14.
J Nurs Educ ; 58(3): 160-164, 2019 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-30835803

RESUMEN

BACKGROUND: In nurse practitioner (NP) programs, NP faculty are responsible for evaluating student progress via clinical site visits. The purpose of this pilot study revolved around investigating the following aims: virtual clinical site visit feasibility, faculty perspectives related to implementing virtual and face-to-face clinical site visits, and exploration of student learning and related experiences with both virtual and face-to-face site visits. METHOD: This mixed-methods pilot study included cross-sectional assessment of faculty and preceptor perspectives, as well as an open-ended qualitative descriptive survey for students. RESULTS: Three themes of student experience were found: We Discussed Strengths and Weaknesses, I Had a Better Experience, and I Had Trouble. Faculty years in practice was significantly associated with preference of face-to-face visits and preference of observing preceptor teaching methods. CONCLUSION: Student learning needs for clinical site visits are multifactorial. Virtual site visits are feasible, cost effective, and time efficient for faculty and nursing administration needs. [J Nurs Educ. 2014;53(3):160-164.].


Asunto(s)
Educación de Postgrado en Enfermería/organización & administración , Enfermeras Practicantes/educación , Preceptoría/organización & administración , Interfaz Usuario-Computador , Comunicación por Videocoferencia/organización & administración , Estudios Transversales , Humanos , Investigación en Educación de Enfermería , Proyectos Piloto , Estudiantes de Enfermería
16.
Nurs Outlook ; 67(4): 433-440, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30819506

RESUMEN

BACKGROUND: The Doctor of Nursing Practice (DNP) facilitator/mentor is a collaborative member of the project team, yet little has been reported about this role. This qualitative study explored the experiences of DNP project facilitators. METHODS: Focus groups were conducted using a purposeful sample of project facilitators. Focus group questions were developed using Gitlin, Lyons, and Kolodner's five-stage model of collaboration. Data were transcribed and content analyzed using Kruger and Casey methods. RESULTS: Three focus groups included 21 facilitators who were affiliated with an academic health system. Six themes emerged: (a) exploring student interest, (b) establishing a collaborative fit, (c) connecting with key stakeholders, (d) overcoming barriers, (e) role clarity, and (f) interaction. CONCLUSION: DNP project facilitators have an important role not only in students' formation, but also in contributing to the academic-practice partnership. The importance of the facilitator role as the student progresses through their DNP project cannot be overstated.


Asunto(s)
Enfermería de Práctica Avanzada/organización & administración , Educación de Postgrado en Enfermería/organización & administración , Colaboración Intersectorial , Mentores/psicología , Preceptoría/organización & administración , Preceptoría/estadística & datos numéricos , Estudiantes de Enfermería/psicología , Centros Médicos Académicos/estadística & datos numéricos , Adulto , Enfermería de Práctica Avanzada/estadística & datos numéricos , Curriculum , Educación de Postgrado en Enfermería/estadística & datos numéricos , Femenino , Grupos Focales , Humanos , Masculino , Mentores/estadística & datos numéricos , Persona de Mediana Edad , Rol Profesional/psicología , Estudiantes de Enfermería/estadística & datos numéricos , Estados Unidos , Adulto Joven
17.
Fam Med ; 51(2): 159-165, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30736041

RESUMEN

In late 2015, the Society of Teachers of Family Medicine (STFM) was charged with Family Medicine for America's Health's (FMAHealth) Workforce Education and Development Core Team's task of identifying, developing, and disseminating resources for community preceptors. The charge from FMAHealth came at a time when STFM was discussing strategies to address the critical shortage of clinical training sites for medical students. STFM hosted a summit to identify the most significant reasons for the shortage of community preceptors and shape the priorities, leadership, and investments needed to ensure the ongoing education of the primary care workforce. Summit participants were asked to propose solutions to achieve the following aims: (1) decrease the percentage of primary care clerkship directors who report difficulty finding clinical preceptor sites, and (2) increase the percentage of students completing clerkships at high-functioning sites. The outcome of the summit was an action plan with five tactics that are being implemented now: Tactic 1: Work with the Centers for Medicare and Medicaid Services (CMS) to revise student documentation guidelines. Tactic 2: Integrate interprofessional/interdisciplinary education into ambulatory primary care settings through integrated clinical clerkships. Tactic 3: Develop a standardized onboarding process for students and preceptors and integrate students into the work of ambulatory primary care settings in useful and authentic ways. Tactic 4: Develop educational collaboratives across departments, specialties, professions, and institutions to improve administrative efficiencies for preceptors. Tactic 5: Promote productivity incentive plans that include teaching and develop a culture of teaching in clinical settings.


Asunto(s)
Prácticas Clínicas , Medicina Familiar y Comunitaria/organización & administración , Preceptoría/organización & administración , Medicina Familiar y Comunitaria/educación , Humanos , Estudiantes de Medicina
18.
Br J Nurs ; 28(3): 168-173, 2019 Feb 14.
Artículo en Inglés | MEDLINE | ID: mdl-30746973

RESUMEN

There is a shortfall of over 10% of the NHS workforce in the UK and the Nursing and Midwifery Council has reported that an estimated 18% of nurses leave the profession altogether within 3 years of qualification. Canada and the USA also face retention issues. The transition period from student to registered nurse is considered an important period during which the newly qualified nurse (NQN) gains experience. This article aims to analyse how the transition from student to registered nurse can be more effectively facilitated, thereby enhancing the delivery of patient care. It examines how NQNs perceive the transition period and discusses how effective transition supports the optimal management of patient care.


Asunto(s)
Modelos Organizacionales , Enfermeras y Enfermeros/psicología , Atención al Paciente/normas , Preceptoría/organización & administración , Estudiantes de Enfermería/psicología , Actitud del Personal de Salud , Humanos , Investigación en Evaluación de Enfermería , Reorganización del Personal/estadística & datos numéricos , Medicina Estatal/organización & administración , Reino Unido
19.
Am J Nurs ; 119(3): 62-67, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30801318

RESUMEN

While developing a standardized approach to orient new staff in the U.S. Army Institute of Surgical Research Burn Center at Fort Sam Houston in Texas, nurse leaders identified the need to also standardize preceptor selection and instruction. A multidisciplinary research team conducted a two-year pilot project based on the evidence-based Vermont Nurses in Partnership Clinical Transition Framework, which provides a structured method for preceptor selection, development, and evaluation. Minimum preceptor qualifications; preceptor validation processes; and modifiable, unit-specific coaching tools were established. The authors previously published a description of the preceptor program implementation process and their findings. In this article, they discuss lessons learned during the project, highlighting the challenges and obstacles encountered when implementing this preceptorship program.


Asunto(s)
Educación en Enfermería/organización & administración , Preceptoría/organización & administración , Curriculum , Humanos , Proyectos Piloto , Criterios de Admisión Escolar
20.
Eval Program Plann ; 73: 195-203, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30685736

RESUMEN

South Africa's department of health devoted themselves to the clinical nursing education and training model, which indorses preceptors as essential stakeholders to promote competence in students. A preceptor-training programme was developed that build on this model and implemented through an intervention. The initial programme theory hypothesised that trained preceptors would promote support and develop competence in students in comparison to untrained preceptors. Results showed a poor outcome because few preceptors participated and a high student attrition rates. The authors then posed the question "Why did the preceptorship training programme not work?" This article offers insight into the context, mechanism, and outcome of the preceptor-training programme through a realist evaluation. Reflective field notes, gathered during the intervention, were used and gave insight regarding how, for whom, and under which circumstances the programme could work and offered a refined programme theory for preceptorship. The main conclusion drawn showed that a preceptor-training programme alone is not the sole determining factor to ensure preceptors' motivation to transfer their learning; a systems approach, ensuring the effectiveness of the programme, should be followed. Reflection on findings indicated the implementation context as a major determining factor of the training programme.


Asunto(s)
Mentores/educación , Preceptoría/organización & administración , Desarrollo de Personal/organización & administración , Actitud del Personal de Salud , Competencia Clínica , Humanos , Aprendizaje , Investigación en Educación de Enfermería/organización & administración , Preceptoría/normas , Evaluación de Programas y Proyectos de Salud , Investigación Cualitativa , Sudáfrica , Desarrollo de Personal/normas
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