Qualitative Annotated Bibliography
For this assignment you will continue to review current research from Souths Online Library and provide a critical evaluation on that research through an annotated bibliography. An annotated bibliography is a brief summary and analysis of the journal article reviewed. For more information on annotated bibliographies please visit Purdues OWL: Purdue Online Writing Lab
A total of two annotated bibliographies are to be submitted (not to exceed one page each). The articles must come from nursing scholarly literature and may not be older than 5 years since publication. Please note that the articles must be research based and reflect a qualitative methodology (review our reading assignments). Web pages, magazines, textbooks, and other books are not acceptable.
Each annotation must address the following critical elements:
Explanation of the main purpose and scope of the cited work
Brief description of the research conducted
Value and significance of the work (e.g., studys findings, scope of the research project) as a contribution to the subject under consideration
Possible shortcomings or bias in the work
Conclusions or observations reached by the author
Summary as to why this research lends evidence to support the potential problem identified specific to your role specialization TEACHER COMMENT
Hi Kenya,
Your project was submitted at a 34% turnitin (TII) match. This means that about one third of your paper is lifted or at least not properly cited. Once I have excluded your references that does not appreciably reduce your TII match to an allowable level. Therefore, I am assessing your work at a grade of zero and extending an offer of 48 hours for you to revise and resubmit your annotated bibliographies. Please submit by Thursday 9/3/20 by 9pm
Running Head: QUALITATIVE ANNOTATED BIBLIOGRAPHY 1
QUALITATIVE ANNOTATED BIBLIOGRAPHY 4
Qualitative Annotated Bibliography
Students Name: Kenya Leyva
Professors Name: Yvonne Johnson
Course: Nursing Research Method CP02
Date: 08-26-2020
Pleshkan, V. Y. (2018). Nurse Practitioners’ Experiences with Role Transition: Supporting the Learning Curve Through Preceptorship.
Retrieved from: https://scholarworks.waldenu.edu/dissertations/5586/
The nurse practitioner (NP) responsibility change is poorly supported and difficult prior to and following graduation. Despite the fact that preceptorship is important in giving a hand in a nurse practitioner’s responsibility change, students’ information and NP’s trainee experience with their responsibility change and how the use of preceptorships advocate it are scarce. The main purpose of this study was to find out more knowledge and explain the meaning of NPs responsibility change experiences as they undertake preceptorship prior to and following graduation. The cognitive apprenticeship model and the Schlossberg transition theory were applied to guide the research of the concept of preceptorship and responsibility change. Three skypes, one face-to-face and twelve phone interviews, were carried out with NPs currently in practice in the NP responsibility in states that needed collaborative practice agreement. Write interviews were coded through Van Manens research strategies. The findings showed that the NPs difficult change to practice was connected to their preceptorship support in both NPs working and schooling setting. The data collected showed poorly supported preceptorship when in NP projects. The Unavailability of preceptorship following the graduation was accompanied by employers expecting inexperienced NPs to operate as experts with regular minimum guidance. The research’s limitation was that the accuracy of the data collected depended on the participants’ recall power. The study was also limited to NPs who had been employed in an NP role for not less than three months and not longer than five years. Having knowledge of how NPs change to practice and how their responsibility change is supported using preceptorship can be applied to inform NP teachers and organizations that employ NPs of the transitions required to strengthen NPs responsibility change. The research findings may influence a positive social change by instructing stakeholders to enhance the NP responsibility change since it may assist in improving NPs’ retention, autonomy, and job satisfaction.
Kaihlanen, A. M., Elovainio, M., Haavisto, E., Salminen, L., & Sinervo, T. (2020). The associations between the final clinical practicum elements and the transition experience of early career nurses: A cross-sectional studynurse Education in Practice, 42, 102680.
Retrieved from: https://www.sciencedirect.com/science/article/pii/S1471595319305323
The final clinical practicum prior to graduation makes the nursing student ready for the change from a student to a nurse, although the important features of the final clinical practicum that improves successful change are not known. The main purpose of this research was to find the association of five features of the final clinical practicum using four indicators of the change experienced by novice nurses. The research also examined if psychosocial work behaviors adjusted these associations. The research participants were 712 Finnish nurses who had received their graduation within the prior two years before data collection. Data was collected through a questionnaire survey, and the five features included the systematicness of the practicum, the quality of supervision, being part of the professional team, teachers involvement, and preparing for the requirements of a nurse work. The research findings showed that all the features excluding the quality of supervision had a relation in showing the changes of experience. Job requirements changed a number of these associations, and the findings of this study bring out the possibility of well-implemented final clinical practicums to encourage smoother change for novice nurses. The research had several limitations, such as the low response rate introducing complications in determining whether the study’s findings were representative.
Additionally, the cross-sectional evaluation hindered significant interpretation of any recognized association. The research outcome showed that final clinical practicum experiences impact nurses in the first year of work. Particularly the systematic planning and application of the final clinical practicum and chances of being an active member of community workers should be taken into account to encourage smoother change from student to nurse. The possible advantages of a good clinical practicum experience may be noted in nurses who do have high job requirements in their first working conditions. This research introduced a new understanding of the connection between the pre-graduate preparation and the change experience of the early nursing career. Contents lists available at ScienceDirect
Nurse Education in Practice
journal homepage: www.elsevier.com/locate/nepr
Doctorate Studies
Nurse practitioners experiences with role transition: Supporting the
learning curve through preceptorship
Viktoriya Pleshkana,, Leslie Husseyb
a Loewenberg College of Nursing, University of Memphis, 4055 North Park Loop, Community Health Building, Memphis, TN, 38152, USA
b School of Nursing, College of Health Professions, Walden University, 100 Washington Ave S. Suite 900, Minneapolis, MN, 55401, USA
1. Introduction
Registered nurse (RN) to nurse practitioner (NP) role transition is
characterized by significant changes in nurses’ role, including increased
levels of autonomy and new responsibilities of being a prescriber. The
problem begins with the gap between NPs’ education and the level of
skills required at the start of NP practice. To close the gap between
education and practice, preceptorships have been used to support NPs’
clinical learning, both before and after graduation. However, pre-
ceptorships used prior to graduation have not had major changes since
the 1960s and preceptorships used after NPs graduate are scarce
(AACN, 2015; Giddens et al., 2014; LeFlore and Thomas, 2016). Pre-
ceptorships are essential for NPs clinical skill acquisition.
1.1. Background
NPs are RNs with advanced nursing education and clinical training
who are licensed to diagnose and prescribe in the United States
(Coombs, 2015). In recent years, the demand for NPs grew due to the
shortage of primary care (PC) services (Giddens et al., 2014). The
number of practicing NPs has increased by more than 100,000 since
2009 with the current total number of practicing NPs exceeding
234,000 (American Association of Nurse Practitioners [AANP], 2017a).
To accommodate this increased need, the number of NP programs also
proliferated to approximately 350 (AANP, 2017b). Because NPs obtain
their skills through experiential learning, clinical education is the
foundation of NP programs. However, the clinical training model has
not had major changes in 45 years (AACN, 2015; Giddens et al., 2014;
LeFlore and Thomas, 2016).
The RN to NP role transition has been identified as difficult and
stressful (Brown and Olshansky, 1997; Flinter and Hart, 2016; Steiner
et al., 2008). Though many other medical professions offer residencies
to their new graduates, most NPs start practicing independently right
after graduation (Hevesy et al., 2016). The ill-supported clinical edu-
cation during school is followed by the lack of transition support after
graduation (AACN, 2015; Brown and Olshansky, 1997; Donley et al.,
2014; Flinter and Hart, 2016; Logan et al., 2015; Roberts et al., 2017;
Steiner et al., 2008; Webb et al., 2015). Employers expect newly
graduated NPs to care for a wide range of complex patients. Novice NPs
expressed concerns about the lack of training to perform procedures,
such as suturing, fracture care, X-ray readings, etc. (Jones et al., 2015).
Lack of clinical skills may have an impact on NPs transition to practice.
Preceptorship is fundamental to NPs’ experiential learning, both
before and after graduation and vital for NPs’ successful transition to
practice (Brown and Olshansky, 1997; Jones et al., 2015; Leggat et al.,
2015; Wiseman, 2013); however, the literature on preceptorship and
transition is scarce (Jarrell, 2016; Poronsky, 2012). Before graduation,
NP students struggle with their preparedness for clinical experiences
and with the availability of their preceptors and clinical sites. Many
preceptors have expressed concern about students’ preparation level
and questioned their preparation for practice (Roberts et al., 2017). The
challenges of obtaining clinical sites and preceptors have been well
documented (Drayton-Brooks et al., 2017). Further, preceptors are
struggling to accommodate NP students learning needs without having
their workload adjusted (Giddens et al., 2014; Keough et al., 2015;
Poronsky, 2012). Though preceptorship is at the core of NP clinical
education, it is in great need of restructuring and support.
Although many other medical professionals are being supported
through well-structured clinical education and residency programs,
formal NP preceptorship is uncommon after graduation (Wilkes and
Feldman, 2017). With the lack of formal preceptorship to support no-
vice NPs’ role transition after graduation, the major source of pre-
ceptorship for NPs comes through a formal collaborative relationship
with their assigned physicians (Jones et al., 2015). However, the MDs’
abilities to train may be limited. Medical and nursing paradigms differ
significantly and yet, MDs are expected to guide NPs in their role
transition. Physicians’ knowledge of NPs’ role and scope of practice is
important for these professionals’ effective collaboration. However,
MDs have little familiarity with NPs’ role, education, and training
(Schadewaldt et al., 2013; Van der Biezen et al., 2017), which is the
most common barrier to a successful NP and MD collaboration
(Schadewaldt et al., 2013). Lack of formal preceptorships after the
graduation contributes to NPs difficult transition to practice.
It is important to explore the current state of preceptorship support.
https://doi.org/10.1016/j.nepr.2019.102655
Received 17 October 2018; Received in revised form 27 October 2019; Accepted 6 November 2019
Corresponding author.
E-mail addresses: [emailprotected] (V. Pleshkan), [emailprotected] (L. Hussey).
Nurse Education in Practice 42 (2020) 102655
1471-5953/ 2019 Elsevier Ltd. All rights reserved.
T
http://www.sciencedirect.com/science/journal/14715953
https://www.elsevier.com/locate/nepr
https://doi.org/10.1016/j.nepr.2019.102655
https://doi.org/10.1016/j.nepr.2019.102655
mailto:[emailprotected]
mailto:[emailprotected]
https://doi.org/10.1016/j.nepr.2019.102655
http://crossmark.crossref.org/dialog/?doi=10.1016/j.nepr.2019.102655&domain=pdf
Several studies were conducted about NPs’ role transition after gra-
duation (Brown and Olshansky, 1997; Chappell, 2014; Flinter and Hart,
2016). Scholars confirmed that NPs’ role transition and preceptorship
need support. However, how this transition process is currently sup-
ported through preceptorship remains largely unknown. The problem is
that NPs role transition is difficult and poorly supported through an
outdated preceptorship model. Learning about the current state of
preceptorship model may add insight into how it can be improved.
2. Theoretical foundation
The theoretical lens of this study consisted of the combination of
two theories, Schlossberg’s transition theory, and Collins, Brown, and
Holum’s Cognitive Apprenticeship Model (CAM). The concept of tran-
sition was guided by transition theory, and the concept of preceptorship
was guided by CAM.
3. Aim
The purpose of this study was to explore the NPs experiences with
their role transition while in a preceptorship. Understanding how NPs
transition to practice and how a preceptorship supports their transition
may inform educators and employers on how to strengthen the transi-
tion.
4. Method
4.1. Study design and approach
The nature of this study was qualitative. The approach to this
qualitative inquiry was Van Manen’s (1990) hermeneutic phenomen-
ology. When used together, the descriptive and interpretive approaches
allow a deeper understanding of the participants’ experiences (Matua &
Van Der Wal, 2015). Using phenomenology allowed for a description of
participants’ experiences, while applying hermeneutics allowed ex-
tracting the essence of participants’ lived experiences in a specific
context (Van Manen, 1990). Hermeneutic phenomenology design as-
sisted with obtaining and explaining descriptive data in a study specific
context.
4.2. Sample
After receiving an Institutional Review Board Approval from the
Walden University (Approval Number 01-16-18-0522648), a con-
venience sample of 16 currently practicing NPs who had been employed
as a NP for at least three months but no longer than five years and who
had a current collaborative agreement with an MD, was recruited
through the Greater Memphis Area Advanced Practice Nurses
Association, social media sites, and snowballing.
4.3. Data collection
Sixteen participants were interviewed by the author using a seven
question interview protocol. One face-to-face, three Skype, and 12
phone semi-structured interviews were conducted. The interview
questions were based on an extensive review of literature and the
transition and CAM theories described above. Each interview ranged
from 37 to 95 min. Audio recordings were manually transcribed and
transferred into the MAXQDA program.
4.4. Data analysis
All data were transcribed manually by the authors using the
MAXQDA qualitative data analysis software. Data analysis was con-
sistent with the chosen hermeneutic phenomenological design guided
by Van Manen’s approach. Sixteen transcribed interviews were coded
using Van Manen’s analysis strategies. During the initial stages of open
coding, transcripts were read several times. Field notes created during
the transcription process were analyzed. Over 200 codes were derived
and each was assigned a memo (code’s short description). Next, data
were analyzed according to the two participants’ role transition stages
(pre and post-graduation), clinical settings where their experience took
place, participants’ relationships with their preceptors, and their reac-
tions to their role transition experiences. Seven major themes were
identified. MAXQDA analysis program assisted in proper data display
and its easy retrieval.
4.5. Trustworthiness
To ensure data trustworthiness, data credibility, transferability,
dependability, and confirmability were established. Clear, detailed de-
scriptions, prolonged engagement with participants and data, rich data,
and triangulation were ensured. Prolong engagement with participants
was achieved by conducting interviews. Longer interviews allowed es-
tablishing of trust between researcher and participant leading to a more
comfortable discussion of the phenomenon by the participant.
Triangulation in data collection was established through multiple data
collection methods. Namely, to collect data, field notes and partici-
pants descriptions were used.
4.6. Ethical considerations
All study participants were provided with the written information
regarding the study purpose and research process. All participants re-
ceived information about the study prior to and during the interviews.
All participants were informed of the voluntary nature of their parti-
cipation and ability to cancel at any time. All participants consented via
e-mail and received an Amazon certificate of $10 dollars after the in-
terview.
5. Results
In exploring participants experiences with their transition to prac-
tice and preceptorship before and after the graduation, the following
seven themes emerged from the data, (a) transition preparation and
learning; (b) preceptorship during role transition and learning; (c)
learning to care for complex patients; (d) learning in clinical environ-
ment; (e) transitioning to a greater autonomy and new responsibilities;
(f) embracing the role and identity confusion, and (g) transition reac-
tions (Table 1).
5.1. Theme I: Transition preparation and learning
In this theme, participants’ preparation for clinical experiences pre
and post-graduation was explored during their role transition. Prior to
graduation except for the occasional meet and greet clinical or-
ientation, there was no other preparatory work before the participants’
start of their clinical rotations. Participants were not aware of their
preceptors’ expectations or work style until the start of their clinical
rotations, P5: I don’t feel like I understood what was going to be
Table 1
Themes.
Theme Number Theme Name
Theme I Transition preparation and learning
Theme II Preceptorship during role transition and learning
Theme III Learning to care for complex patients
Theme IV Learning in clinical environment
Theme V Transitioning to a greater autonomy and new responsibilities
Theme VI Embracing the role and identity confusion
Theme VII Transition reactions
V. Pleshkan and L. Hussey Nurse Education in Practice 42 (2020) 102655
2
expected of me in clinical. Immediately after graduation, many par-
ticipants reported feeling unprepared to practice independently, P2:
You kind of just get thrown and figure it out. Many reported lack of
orientation for their clinical experiences while in school. Similarly,
post-graduation, many reported lack of adequate onboarding process.
5.2. Theme II: Preceptorship during role transition and learning
The second theme contained the data related to the instructional
strategies used to precept NPs pre and post-graduation. Before gra-
duation, the most effective instructional strategy reported was see one,
do one, in which the preceptor demonstrated the skill and then ob-
served the student perform the skill, after which, the student performed
more independently. However, such hands-on experiences were rare:
P16: the only procedure I really got to do in clinicals doing a pelvic
exam. Preceptors’ teaching styles were reported to be inconsistent
among various preceptors and clinical settings. Preceptors’ workload
and lack of day to day feedback frequently prevented them from pro-
viding participants with adequate instruction, P12: 40 patients a
day, so I don’t know if they had time to sit down and explain a lot of
stuff to me. Case discussions and debriefings were frequently omitted
from students’ learning experiences due to the time constrains.
After graduation, participants learned their NP role through self-
teaching and asking questions, P1: most of the things that I have
learned and that I do it is because I looked it up and I researched it
myself. Though all participants had collaborative agreements with
their MDs expecting them to mentor, many reported minimal to no help
from their collaborators: P14: post-graduation I had collaborators
on paper and I did not have anyone to really break down my day to
I wish I may be had some support Being left alone to learn and
master their new skills generated feelings of stress and fear.
Both before and after graduation, participants reported their pre-
ceptors’ lack of time to teach them, which affected participants’ ability
to learn their clinical skills. Overall, dependence on their preceptors for
clinical decision making prior to the graduation was changed to a lack
of formal preceptorship after graduation. Because most did not have
access to a formal preceptor and many participants collaborators were
unavailable to mentor, self-teaching was employed extensively by all
participants post-graduation.
5.3. Theme III: Learning to care for complex patients
Theme III included participants’ experiences with learning how to
care for complex clients before and after graduation. Participants’ ex-
periences with learning complex patient care while in the program were
random, P16: it was like completely random because you were just
lucky to get what you could get. When advancing to clinical practice
after graduation, participants reported rude awakening as they did
not feel prepared to care for complex patients independently right after
graduation. Participants reported the lack of support from their em-
ployers administration as they did not yet feel equipped to care for
complex clients and were in need of such support, P16: So complex
patients is what I really struggled on when I first became an NP
trying to like cram all that in, assess the patient, talk to them, figure out
everything to order and change in like 15 min, it was very, very over-
whelming at first. Participants particularly struggled with poly-
pharmacy, comorbidities, noncompliant clients, complex diagnoses,
underserved, and less known patients. Without having adequate
structured support, participants struggled with managing their time as
well as took some of their work home. Learning to care for complex
clients was preceptor and cite dependent while in NP program, which
translated into an overwhelmingly steep transition post-graduation.
5.4. Theme IV: Learning and clinical environment
Participants’ experiences with clinical sites and preceptors prior to
graduation and collaboration support post-graduation were explored.
Before graduation, most NPs reported the greatest challenge was
finding and securing clinical sites and preceptors, which often led to
mismatch between the preceptors, sites, and student’s learning needs,
P8: . it was so hard you pretty much take anyone you could get and
there was no way of telling if they were going be good teacher. A
mismatch between the clinical sites and students’ learning needs led to
limited training opportunities available to NP students.
While locating the sites was one of the most stressful components of
many participants’ experiences, frequent preceptor change with a lim-
ited number of clinical hours spent with each preceptor led to shorter
clinical rotations. In this study, short clinical rotations along with
mismatch and lack of selectiveness when securing sites and preceptors
led to a decrease in students’ autonomy during their clinical rotations.
After graduation, participants’ relationship with providers they were
learning from was reported as important to their successful transition to
practice. Those participants who were learning alone reported more
challenging transition experiences. Lack of selectiveness in sites and
preceptors prior the graduation translated into the participants’ need for
their employers support, which was often not available.
5.5. Theme V: Transitioning to a greater autonomy and new responsibilities
Participants experiences with advancing to a greater level of au-
tonomy and new role responsibilities were explored. Increased de-
pendency on preceptors along with decreased hands-on clinical ex-
periences led to reduced autonomy during school clinical experiences,
P14: . I never had a situation that I had to do it on my own in any of
my rotations. When in NP program, participants reported little in-
dependent decision making, prescribing, or practicing differential di-
agnoses.
After graduation, a sudden increase in autonomy, accompanied by
the lack of support, led to participants feeling unprepared, P14:
very challenging lots of frustration, lots of thinking I chose the wrong
profession . Participants reported having particular difficulties with
autonomously prescribing multiple medications, coding, diagnosing,
and laboratory testing interpretation. Many reported day dreaming of
returning to their safer RN role; however, too much was already in-
vested in NP degree. While participants were overwhelmed with their
new responsibilities, they also appreciated the new autonomy level and
began to embrace it when becoming more comfortable with new re-
sponsibilities.
5.6. Theme VI: Embracing the role and identity confusion
Participants’ experiences with identifying with their new role of an
advanced practice nurse were explored. While some participants re-
ported that practicing in an RN role was helpful in learning how to be
an NP, others reported it being confusing, P16: I would go from I am
the one making the decisions and ordering stuff during the week on
patients too, now on the weekend I can’t do any of that, I am just like
following orders, so it was really weird to live in both of those worlds at
the same time. After graduation, when in an NP role, participants re-
ported that it was hard not to perform in both roles, RN and NP since
their new role functions were not clearly defined. Such unclear role
boundaries led to confusion about the scope of an NP role.
5.7. Theme VII: Transition reactions
Participants’ reactions to their experience with the transition before
and after graduation were explored. While feeling stressed out about
finding preceptors and sites when in the program was commonly re-
ported, participants did not express concerns about their new role re-
sponsibilities, P11: I was not stressed out or anxious at all when I was
an NP student, because the responsibility was not on me and now the
responsibility is on me. After graduation, most of reported emotional
V. Pleshkan and L. Hussey Nurse Education in Practice 42 (2020) 102655
3
reactions to NP transition experience were negative. Participants felt
fearful of making a mistake that could negatively affect their patients’
health, P14: can you imagine killing somebody unintentionally, acci-
dently because you did not get the right support; that left me very
stressed out, very unfulfilled in my role as an NP, I thought I was going
to be coming in making a world of difference I feel alone It was
important to explore participants feelings as part of their role transition
experience because human feelings and reactions constitute an im-
portant part of any experience.
6. Discussion
Findings suggested that NPs’ difficult transition to practice was re-
lated to the lack of their preceptorship support in NP school and in NP
work settings. The data showed ill-supported preceptorships when in
NP programs. Lack of preceptorships after graduation was accompanied
by employers expecting novice NPs to function at an expert level, fre-
quently with minimal guidance. Understanding how NPs transition to
practice and how their role transition is supported through preceptor-
ships can be used to inform NP educators and organizations that hire
NPs of the changes needed to strengthen NPs role transition.
The study findings provided insights into how NPs’ role transition is
supported through preceptorship during the two transition stages, pre
and post-graduation. An abrupt increase in autonomy from pre-gra-
duation to post-graduation transition stage accompanied by the lack of
support was this study’s central finding. The awareness of new re-
sponsibilities did not take place until the post-graduation transition
stage, which was the result of overreliance on preceptors for clinical
decision making while in the program. Similarly, Cusson, and Strange
(2008) found that the time of performing independently coincides with
the time of becoming aware of new responsibilities. The abrupt increase
in autonomy coincided with identity confusion.
Struggling to identify with their new role as an advanced nurse,
trying to merge the roles of nursing and medicine, participants reported
their role boundaries were blurred. This finding was consistent with
Jangland et al. (2016) who reported that being positioned in between
the two roles caused identity confusion. Similarly with Brown and
Olshansky (1997), feelings of being an imposter were reported in this
study. NPs enjoyed their new autonomy after settling into their role,
confirming that increased autonomy level facilitates NP role transition
(Faraz, 2017, 2019; Horner, 2017). However, the abrupt change from
overreliance on preceptors while in the program to a poorly supported
role transition post-graduation caused NPs to feel fearful and alone,
which was consistent with previous studies on NP role transition
(Barnes, 2015b; Brown and Oshlansky, 1997; Hart and Macnee, 2007;
Heitz et al., 2004). This variation between the pre and post-graduation
autonomy level combined with blurred role boundaries may be a culprit
of NPs difficult role transition.
When exploring NPs’ experiences with preparation for their clinical
rotations, consistent with Babcock et al. (2014), Flott and Linden
(2016), and Roberts et al. (2017), this study’s findings confirmed that
having an EMR access, becoming familiar with clinical site’s workflow,
as well as preceptors’ and students’ expectations were critical. Frequent
preceptor changes and shorter clinical rotations led to preceptors’ lack
of comfort with their NP students, which caused an increase in ob-
servation-only clinical hours. Similarly to Hallas et al. (2012) results,
participants’ clinical hours did not translate into attaining all necessary
competencies prior the graduation. Though hands on clinical experi-
ences were always desired by participants, they experienced many
observation-only clinical hours while adjusting to their new preceptors
and learning the workflow of their clinical sites. To assist NP students
with preparation for their clinical rotations, it may be beneficial to
assign some observation-only clinical hours prior starting clinical ro-
tations. It may also be of benefit to minimize preceptor and site changes
to increase students’ clinical hours with each preceptor to allow
learning of more complex skills. Lack of NP students’ preparation for
their clinical rotations was followed by rushed and variable pre-
ceptorship process.
When exploring preceptorship during NPs’ role learning, incon-
sistent preceptors’ teaching styles, lack of feedback, and preceptors’
heavy workload were identified. Bazzell and Dains (2017) reported the
lack of guidelines to train preceptors and Marfell et al. (2017) under-
lined the importance of feedback in mentoring. Preceptors’ heavy
workload assignments combined with the lack of training on how to
precept impacted NP students learning of their clinical skills. While
preceptorship processes varied significantly, securing preceptors was
also a challenge.
Challenges with finding and securing clinical sites were identified
and consistent with AACN, 2015, Drayton-Brooks et al. (2017), and
Erikson et al. (2014) findings. Poorly supported preceptorship com-
bined with difficulties in finding clinical sites and preceptors impeded
NPs’ clinical skills acquisition when in the program. Consistent with
Hart and Bowen (2016) and Wilkes and Feldman (2017), this study
showed that formal preceptorship was uncommon pos
