If You Don’t Give Us Any Instruction, How Are We Supposed To Grow? Perceptions Of New Graduate Nurses Regarding Effective Teaching Strategies During Senior Preceptorships Tara Wilkens BSN, RN Nurse Educator Student Thesis Chair: Dr. Julie Klein PhD RN CNE Thesis Committee: Dr. Glenda Reemts PhD RN Mary Beth Johnson MN MA RNC

Nursing Shortage Current nursing shortage in the United States Demand of 3.24 million nurses by 2022 Approximate one million job openings from 2012 to 2022 Strong need to fill the nursing demand Decrease attrition rates and increase retention rates Society requires registered nurses who are: Safe Competent/ qualified Confident Socialized into the new role Preparation in didactic and clinical learning (Dimitriadou, Pizirtzidou, & Lavaniti, 2013; Rosseter, 2014; United States of America Department of Labor, 2013)

Role Socialization Integration of an individual into a new setting Nursing culture constituents: Behaviors Attitudes Actions (Dimitriadou et al., 2013; Mariet, 2016)

Research Purpose The aim, or purpose, of this qualitative study was to obtain the perceptions of new graduates during their first year of employment as registered nurses regarding teaching approaches utilized by preceptors during their senior preceptorship experience that most effectively prepared them to enter nursing practice.

Research Question What are the perceptions of first year graduate nurses regarding the most effective teaching methods utilized by preceptors during their senior preceptorship experience that best prepared and socialized them for a career in nursing?

Organizing Framework Bandura’s Social Learning Theory Identify the need for: observational learning a role model To adequately shape behaviors, attitudes, and values (as cited in Armstrong, 2008; Bandura, 1971)

Literature Review Major Themes Nursing Shortage (Egenes, 2012; Snavely, 2016) Transition Shock (Duchscher, 2009) Nursing Role Socialization (Dimitriadou et al., 2013) Role Modeling and the Social Learning Theory (Armstrong, 2008; Bandura, 1971) Prevention of Attrition (Snavely, 2016) Nursing Student Preceptorships (Kelly & McAllister, 2016)

Methodology and Design Qualitative methodology Phenomenological design Semi-structured guided interviews Cross sectional convenience sample Total of eight participants Employed in a variety of acute care settings Graduated from two Midwestern baccalaureate nursing programs

Categories Pushed me to learn: “Put us on a leash but let us have a little bit of rein on the leash” 1 Role socialization was enhanced by room for growth, feedback, and reflection 2 When I am preceptor, I want to… 3

Final Assertion All interviewees expressed that the senior preceptorship was a vital part of role socialization for professional growth. The benefits of the exposure to the hands-on environment gave them the opportunity to transition from nursing student to graduate nurse. The interviewees discussed teaching strategies and character traits that they want to take forward as preceptors in their nursing careers.

Implications for Nursing Practice Guides preceptor selection on behalf of nurse managers Provides guidance for preceptor training programs Best teaching strategies to utilize during preceptorship to assist with role socialization Strategies to assist with effective preparation of nursing student To improve nurse retention and prevent attrition To fill projected nursing shortage

Recommendations for Further Study Study to identify effective strategy for preceptor role selection criterion Research preceptor education programs to determine if successful or if need for revision exists Reevaluate needs of nursing preceptorship students every five years to check for change in student needs

References Armstrong, N. (2008). Role modelling in the clinical workplace. British Journal of Midwifery, 16(9), 596-603. Bandura, A. (1971). Social learning theory (Doctoral dissertation, Stanford University, 1971) (pp. 1-46). New York, NY: General Learning Press. Charleston, R., & Happell, B. (2005). Coping with uncertainty within the preceptorship experience: The perceptions of nursing students. Journal of Psychiatric & Mental Health Nursing, 12(3), 303-309. doi:10.1111/j.1365- 2850.2005.00837.x Dimitriadou, A., Pizirtzidou, E., & Lavdaniti, M. (2013). The concept of socialization in nursing education. International Journal of Caring Sciences, 6(3), 314-318. Retrieved April 8, 2017, from http://701- ezproxy2.bismarck.lib.nd.us:2242/ehost/pdfviewer/pdfviewer?sid=d5c70 70b-1aaa-4bcf-b930- 58c3166bee30%40sessionmgr4009&vid=73&hid=4001

References Duchscher, J. E. (2009). Transition shock: The initial stage of role adaptation for newly graduated Registered Nurses. Journal of Advanced Nursing, 65(5), 1103-1113. doi:10.1111/j.1365-2648.2008.04898.x Egenes, K. J. (2012). The nursing shortage in the U.S.: A historical perspective. Chart, 110(4), 18-22. Retrieved April 8, 2017, from http://701- ezproxy2.bismarck.lib.nd.us:2242/ehost/pdfviewer/pdfviewer?sid=d5c70 70b-1aaa-4bcf-b930- 58c3166bee30%40sessionmgr4009&vid=20&hid=4001 Kelly, J., & McAllister, M. (2013). Lessons students and new graduates could teach: A phenomenological study that reveals insights on the essence of building a supportive learning culture through preceptorship. Contemporary Nurse: A Journal for the Australian Nursing Profession, 44(2), 170-177. doi:10.5172/conu.2013.44.2.170

References Mariet, J. (2016). Professional socialization models in nursing. International Journal of Nursing Education, 8(3), 143-148. doi:http://701- ezproxy2.bismarck.lib.nd.us:2114/10.5958/0974-9357.2016.00107.0 Rosseter, R. J. (2014, April 24). Nursing shortage fact sheet (Publication). Retrieved March 3, 2017, from American Association of College of Nursing website: http://www.aacn.nche.edu/media-relations/NrsgShortageFS.pdf Snavely, T. M. (2016). A brief economic analysis of the looming nursing shortage In the United States. Nursing Economic$, 34(2), 98-100. Retrieved March 1, 2017, from http://701- ezproxy2.bismarck.lib.nd.us:2243/ehost/pdfviewer/pdfviewer?sid=8fbd1ff1- 163f-43aa-955f-de7868ef8404%40sessionmgr102&vid=4&hid=125 United States of America, Department of Labor, Bureau of Labor Statistics. (2013, December 19). Economic News Release. Retrieved March 3, 2017, from https://www.bls.gov/news.release/ecopro.t08.htm