Preceptorship Research Project Report: Chesterfield Royal Hospital NHS foundation trust

Nurse education in the UK has been solely university based since the mid-1990s but
despite careful preparation and assessment of student nurses it has been
considered necessary to provide a period of additional support for Newly Qualified
Nurses (NQNs) to help them settle into their new role and responsibilities.
Preceptorship is the process of supporting NQNs over this transition period from
student to registered nurse and it is recognised that this can be a stressful and
difficult time for NQNs. This project developed from work already undertaken by the
clinical placement learning team at Chesterfield Royal Hospital NHS Foundation
Trust and was led by the University of Derby in partnership with them and took a
case study approach to evaluating how preceptees and their preceptors are
supported in practice; what their expectations are and what factors in the clinical
area support or inhibit transition to qualified nurse.
A systematic review was conducted as part of this project (Whitehead et al 2012 and
2013). The evidence suggests that properly resourced and organised preceptorship
is a positive and essential experience for NQNs and their employers. Negative
experiences come from an absence of preceptorship; preceptorship being offered
but not fully delivered; and feelings of poor self-confidence despite having sufficient
competence. The implication of this is that organisations can improve their likelihood
of producing reliable and competent registered nurses (RNs) by the introduction of
properly resourced and organised preceptorship frameworks. Recommendations for
practice and for further research are made.
A modified version of Lincoln and Guba’s Naturalistic Inquiry (1985) was used. This
provided an authoritative and reliable ontological framework upon which to base the
project. A qualitative case study method was developed and consisted of a multistage approach to data collection including semi-structured interviews with key
personnel; documentary analysis of preceptorship material and focus groups with
key actors. Ten interviews and five focus groups were undertaken with a total of 40
focus group participants. The participants were purposively sampled from
representative groups within the Trust. NVivo was used to support analysis and
ethical approval was attained for the project.
Findings are grouped under the headings of: preceptor training; preceptor support;
experiences of preceptorship; what the nurse should be like at the end of a period of
preceptorship and the use of the tool. In addition further themes emerged from the
findings in relation to indicators for successful transition; formal recognition of
preceptor role; confidence and resilience; culture of support including peer support
and management structure to support preceptorship; selection and preparation of
preceptors and clinical skills. It is evident that there are a range of factors which are
seen to affect the success or otherwise of the preceptorship period and the transition
to confident RN.
The findings indicate that there are a range of factors which are reported to affect the
successful transition from student to NQN with the period of preceptorship in this
case. These are : the selection and preparation of preceptors; a need to formally
recognise the preceptor role; specific time to engage with preceptorship ; a
management structure to support preceptors and preceptorship; the individualisation
of preceptorship needs and ways to ensure successful preparation of students and
NQNs ; the acquisition of the right clinical skills for the job; the culture of support;
peer support for preceptees and preceptors; the confidence and resilience of
preceptees and technological support processes. Based on these factors
recommendations are made for this case in practice and for further research
generally.