Transitioning: A Synergy Care Practicum for Senior Nursing Students

For over 30 years, preceptorships have been used to facilitate student learning in the clinical setting (Udlis, 2006). “In the past this has been done under the previous ‘apprentice’ model within hospital education” (Charleston & Happell, 2005, p.303). Providing one on one matching of nursing students to professional nurses opens up positive role modeling to them which has been shown to be an effective method of encouraging good work place practices and retention in the profession – this is examined.

In the US, senior nursing students follow their assigned preceptors work schedule and are assessed by both preceptor, and faculty at the student’s learning institution. Not all preceptorships provide positive environments for learning. New nurses’ socialization into the professional clinical setting can be jarring, leading to what has been coined as “reality shock” (Procter, et al, 2010 ).  Twenty-five percent of new graduate nurses leave their first jobs within a year of starting (NCSBN, 2013). Additionally, there is ademonstrated history of a lack of preceptor incentives.

Clinical placement during the final semester of nursing school initiates socialization into the role of Registered Nurse prior to graduation. What do students/preceptees value most in a preceptor/nurse?” A search of the literature clearly establishes that both groups prefer to work with nurses who show positive attributes of professionalism and caring. A model was sought to conceptualize this phenomena. 

The AACN Synergy model mirrors characteristics and competencies of the patient-nurse relationship that can be translated to the preceptor-preceptee relationship (Alspach, 2006; Monterosso & Zilembo, 2008). Alspach (2006) dilineates assumptions of the preceptee-preceptor relationship.

The proposed experience will utilize professional registered nurses who fit the students’ learning needs profile and meet specific leadership competency requirements. Students will utilize the synergy model to meet the Knowledge, Skills and Attitude (KSAs) objectives of the program, encapsulate, and record a wholesome patient, nurse-nurse and nurse-system experience over a specified period. The student profile will be built utilizing the Pre 6-D scale of nursing performance, the learning style inventory and student preference of clinical setting (other tools to be considered). Tools for building a preceptor profile will include a resume/CV and other instruments to be considered. Faculty responsibility will lie in providing a focused seminar in utilizing the synergy model to provide patient care and learn about the system of care. The course was developed as a graduate level nursing education capstone. However, the full program has not been implemented in an undergraduate school of nursing.

A database search of CINAHL, MEDLINE, PUBMED and OMNIFile was conducted. Key terms utilized were nursing, preceptorship, undergraduate, transition, framework, and synergy.