An Assessment Tool to Measure the Supportive Roles of Preceptors

Purpose:

According to Botma, Van Rensburg, Coetzee and Heyns's (2013) adapted version of Donovan and Darcy’s (2011)  systemic transfer of learning model, the preceptor plays a significant role in facilitating optimal performance of a student in clinical practice by considering students’ characteristics, educational approach, transfer climate and the physical work environment. For the purpose of this presentation a preceptor is defined as a “compassionate nurse expert who develops a one-to-one time limited relationship with a novice in a clinical setting, provides support, facilitates thinking processes, and assesses competence in order to promote meta-cognition and care that is based on the best available evidence” (Botma 2014). The definition by Botma depicts a daunting task as it highlights personal and professional characteristics of compassion and expertise, and delineates the role of a preceptor as a facilitator, assessor, knowledge translator and supporter. Support is categorized in the literature as system, tangible, cognitive and emotional (Williamson, Callaghan, Whittlesea, & Heath, 2011; Botma, Hurter, & Kotze, 2013).

System support is mostly associated with the liaison and monitoring role of the preceptor while tangible support addresses orientation and showing novices the “what, where and how”. Cognitive support is mainly about guiding students through the process of transferring their learning by facilitating critical thinking, clinical reasoning, clinical judgment and meta-cognition. Emotional support by the preceptors is being available, accessible and to debrief students after significant learning experiences.

Although numerous measurement instruments aim to measure the standard of precepting, none of them measures all the supportive roles (Fluit, Bolhuis, Grol, Laan, & Wensing, 2010). Therefore the aim of the study was to develop a valid and reliable instrument that measures the four types of support rendered by preceptors to undergraduate nursing students.

Methods:

A quantitative methodological study was conducted which started off with a critical analysis of 42 existing instruments. All the items were extracted and categorized according to the types of support. Items were reduced by clustering similar questions and rephrasing it as an item. Five experts on preceptorship and student support reviewed the draft instrument in order to promote face and content validity. The instrument was amended according to their recommendations and piloted. No meaningful changes were made to the piloted instrument. The instrument consisted of 73 items.

The validity of the instrument was determined by means of an exploratory factor analysis that was done on 303 questionnaires. Internal consistency or reliability was determined by means of the Cronbach Alpha coefficient.

Results:

The Cronbach alpha coefficient for the questionnaire is 0.98, which indicates a very good internal consistency. According to the Eigenvalues three factors, namely system, cognitive and emotional support was identified. Items loaded onto a factor when the value was >0.5. The final questionnaire consists of  17 items that loaded onto the first factor namely cognitive support, 18 items loaded onto emotional support and 17 items loaded onto the third factor namely system support.

Conclusion:

Through an exploratory factor analysis the constructs were reduced from six to three and the items were reduced from 73 to 52. The internal consistency is very high with a Cronbach alpha value of 0.98. Factor loadings were cut-off at 0.5 which is higher than the acceptable value of 0.3.

 Although this questionnaire has to be validated through confirmatory factor analyses, the newly developed instrument is promising to measure the expectations students and nursing education institutions have of preceptors.