Putting knowledge to work in clinical practice: understanding experiences of preceptorship as outcomes of interconnected domains of learning.

Abstract

AIM: To explore how preceptor support can assist newly qualified nurses (NQNs) to put knowledge to work across interconnected forms of knowledge when delegating to health care assistants (HCAs). BACKGROUND: Current literature on preceptorship in nursing has failed to explore how competence is underpinned by knowledge frameworks in clinical practice. DESIGN: An ethnographic case study in three hospital sites in England (2011-2014). METHODS: Data collection included participant observation, interviews with 33 newly qualified nurses, 10 HCAs and 12 ward managers. Data were analysed using thematic analysis. A tool to assist NQNs to delegate and supervise NQNs during the preceptorship period was developed and piloted with thirteen NQNs in the same sites. A process evaluation was undertaken. FINDINGS: Focusing on a key task for NQNS, delegation to HCAs, we argue that preceptorship can support NQNs as they put knowledge to work in the transition from qualifying student to NQN. In supportive ward cultures, limited access to formal preceptorship can be bolstered by team support. NQNs in less supportive ward cultures may have both a greater need for preceptorship and have fewer compensatory mechanisms available to them when formal preceptorship is not available. We argue that organisational learning contexts and individual learning styles (interconnected domains of learning) are key to understanding effective preceptorship. CONCLUSIONS: We suggest that putting knowledge to work early in their careers with preceptorship support may assist NQNs to develop confidence and competence in delegation and supervision of health care assistants. This article is protected by copyright. All rights reserved.