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Preceptorship: The Process of Guiding Reflection in Clinical Teaching and Learning Open Access


Other title
Guiding Reflection
Type of item
Degree grantor
University of Alberta
Author or creator
Zeran, Vicki A.
Supervisor and department
Dr. Florence Myrick, Faculty of Nursing
Examining committee member and department
Dr. Olive Yonge, Faculty of Nursing
Dr. Randy Wimmer, Faculty of Education
Dr. Pauline Paul, Faculty of Nursing
Dr. Joanne Profetto-McGrath, Faculty of Nursing
Dr. Tanya Park, Faculty of Nursing
Dr. Marilyn Oermann, Duke University
Faculty of Nursing

Date accepted
Graduation date
2016-06:Fall 2016
Doctor of Philosophy
Degree level
Since the 1970s, preceptorship has become the leading approach to clinical teaching in nursing programs across Canada, with 70 percent to 85.9 percent of North American baccalaureate nursing programs employing preceptorship programs. Considering the present faculty shortages, the benefits of preceptorship for student learning and development, the student demand, and the flexibility of implementing a preceptorship program to meet the needs of small, rural and northern clinical settings, the dependence on preceptorship for clinical teaching of nursing students will most likely increase. Thus, it became prudent to examine how preceptorship provides an effective learning environment. Although a considerable amount of research has been conducted concerning preceptorship, to date, no studies have been conducted specifically to examine the process involved in creating an environment conducive to student learning in the preceptorship approach to clinical teaching. Thus, a grounded theory method was utilized to examine the social psychological process involved in creating an environment conducive to student learning in preceptorship. Participants comprised nursing students, preceptors, faculty advisors and staff nurses were drawn from a small town in northwestern Canada. Findings from this study revealed that a preceptored clinical learning environment is one which entails a process of guiding reflection which is informed by the following ambient conditions: a) the balancing act; b) making time; c) belonging; d) paying tribute and e) grappling with challenges. As a result of these findings, several implications for nursing education emerged. These include: 1) the process of guiding reflection is influenced by teaching/learning pedagogy and thus can be facilitated by a variety of educational theories such as those posited by Schön and Dewey. With that said, from a pedagogical perspective, it is important that preceptorship be informed by a variety of educational theories that support the process of guiding reflection in the clinical setting; 2) considering the findings of this study demonstrate that all members of the nursing team with whom students participate in preceptorship have an enormous impact on the process of guiding reflection, it is incumbent upon nurse educators to develop and provide preceptorship orientations and preparatory sessions that are inclusive of all members of the nursing unit; and 3) taking into account one of the challenges that impeded the process of guiding reflection in the preceptorship was bullying, the preparation of nursing students in preceptorship settings requires an understanding of horizontal violence and how students can effectively identify and confront bullying behaviours.
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