Understanding the Preparation and Support Needed for Undergraduate Clinical Faculty: A Delphi Study

Sunday, 28 July 2019: 3:40 PM

Sara E. McPherson, PhD, RN
UIC College of Nursing, University of Illinois Chicago, Springfield, IL, USA

Purpose: Even as nursing programs attempt to meet public demands for more registered nurses in the workforce, they are challenged with finding qualified clinical faculty to teach them. Many programs have had to turn away otherwise qualified applicants due to lack of faculty (American Association Colleges of Nursing [AACN], 2017; National League for Nursing [NLN], 2014). One response to the shortage of nursing faculty has been to increase the number of part-time clinical faculty. Many clinical faculty members hired for part-time positions hold degrees outside of nursing education (Koharchik, 2017; Meyer, 2017). Additionally, new faculty are frequently expected to immediately begin teaching one or more clinical groups. While those new full-time and part-time faculty enter their role as expert clinicians, many lack knowledge or formal instruction in managing and evaluating students in the clinical setting.

A review of the literature revealed a small amount of information available on the issue of clinical faculty preparation for the role. What is known is that there has been a lack of guidance and support for clinical faculty (Dunker & Manning, 2018; Santisteban & Egues, 2014; Schaar, Titzer, & Beckham, 2015). Clinical faculty have admitted to passing underperforming clinical students for a variety of reasons. Faculty are often unclear about the evaluation criteria and grading processes (Hewitt & Lewallen, 2010; Luhanga, Yonge, & Myrick, 2008). Clinical faculty have reported they receive little or no helpful orientation prior to beginning their role as clinical faculty (Gies, 2013; Koharchik, 2017; Koharchik & Jakub, 2014). Nursing programs that offer orientation were described as beneficial, but the information received was general (Roberts, Chrisman, & Flowers, 2013). Passing underperforming students is a patient safety.

Methods: A Delphi study (McPherson, Reese, & Wendler, 2018) was conducted to explore the preparation and support needs of undergraduate clinical faculty. Two rounds were used: Round 1 included the use of a nine question open-ended questionnaire based on the literature review, to obtain the opinions of a panel of 15 experts on what preparation and support was needed for new clinical faculty success. Experts were recruited for the study using purposive sampling techniques. During Round 1, data collection and data analysis occurred simultaneously. Experts were asked to provide an email address if they were willing to review the Round 1 results to confirm accuracy. A total of n = 11 affirmed Round 1 results.

Round 1 data, analyzed using content analysis and frequency counts, provided the content for development of an instrument used for Round 2. The first part of the survey asked participants, (n = 77 clinical nursing faculty) to rate their level of agreement with the variables using a Likert scale. Of the participants, 74 reported educational background and 75 reported part-time or full-time employment. Round 2 data were analyzed with an independent t-test.

Results: Results indicated that faculty with a nursing education background were more likely to use a colleague as a resource person, t(74) = 2.35, p = .022. They also indicated that they had received more relevant content in their original training t(74) = 4.09, p = .000, that they had received more verbal instruction t(74) = 2.11, p = .038, and that they had received a brief overview of the clinical faculty role t(42) = 2.38, p =.022, than nurses with other educational backgrounds. Participants rank-ordered topics, that were identified by the experts in Round 1, and identified expectations on their role as clinical nursing faculty highest (36.4%). Significant differences were also found between part-time and full-time faculty. Part-time faculty reported that they received less support, t(75) = -2.96, p = .004, were less likely to have a mentor, t(75) = -4.28, p = .000, received no formal training, t(75) = 2.09, p = .04, and had less content presented in their educational preparation, t(51) = -2.32, p = .024, as compared to full-time faculty. Results of the study indicated that faculty who had received a degree in nursing education and those serving as full-time faculty had a better understanding of their role and expectations as clinical nursing faculty compared to those who did not.

Conclusion: This study indicated that clinical faculty, especially part-time clinical faculty, are not receiving the orientation and support they need to be successful as clinical faculty in nursing programs. Since clinical education is the core of education for practice disciplines such as nursing, it is imperative that schools of nursing allot resources, time, and training to clinical faculty development in order to ensure that students develop into safe and competent caregivers. Further research is needed to determine what is the best way to provide this support and the best ways to stimulate immediate and lasting improvement in the quality of clinical nursing education.

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