An exploration of nurse preceptors’ perspectives of a pre-registration nursing clinical preceptorship programme in an acute hospital context in Egypt: A constructivist grounded theory approach

Abstract

Background: The proposed reforms of Egyptian nursing education are based on competencies to achieve well-educated nurse graduates. There is a shortage of clinical faculty and increasing demands for nurse preceptors to act as clinical instructors. There is no national framework to prepare nurse preceptors or clinical instructors, nor a clear framework for implementation of an evidence-based competency-based pre-licensure internship. Research is needed to explore factors influencing the preparation of preceptors and preceptorship programme priorities in the nursing context in Egypt. Aim: To explore preceptors’ perspective of their previous preceptorship experiences and the factors that influence their professional role and development while introducing competency-based internship in an acute critical care hospital in Egypt. Purpose: To develop a contextual preceptorship model to help prepare professional nurse preceptors as clinical leaders within their organizations. Methodology: A qualitative inquiry approach was used with two phases of spiral Constructivist Grounded Theory to develop the proposed theoretical themes. The first study phase engaged semi-structured interviews and comparative analysis of data to construct initial codes. The second phase shared theoretical sampling with participant focus groups. Further data verified initial codes and analysis continued until theoretical themes emerged. Results: The concepts of self-awareness and self-esteem become first steps in an over-arching theme of developing preceptors as lifelong learners. These concepts emerged from the core themes of, ‘Education misalignment issues’, ‘Preceptor selection criteria’ and ‘Developing preceptors as lifelong learners. Discussion: The study analyzed findings with comparison to relevant research literature. A contextualized developmental model of competency-based preceptorship programme is proposed as based on four key phases ‘Discovery’, ‘Selection’, ‘Socialization’ and ‘Development’. Conclusion: A critical component of the conceptual model is improving self-esteem through promoting self-awareness. The proposed program can help academic and hospital leaders to sustain the competency-based internship, orientation and preceptorship to improve the quality of nursing care.