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Abstract

Transitioning into the nurse practitioner (NP) role is stressful. The stress arises from both internal or personal and external or organizational and professional sources. The novice NP may have a sense of inadequacy and lack of confidence in the ability to provide optimal patient care. The organizational expectations to be clinically competent and able to meet the demands of a complex health care system can be overwhelming. Most NP programs excel in their ability to provide the didactic information and clinical exposure necessary for the beginning-level practitioner; however, additional guidance and support are essential for the novice NP to evolve into an expert clinical practitioner. To this end, mentorship is an effective transition strategy for novice NPs. An awareness of the many stressors facing the novice NP, the benefits of mentorship, and how an effective mentoring relationship can ease the transition establishes sound rationale for mentoring as a strategy for optimal transitioning into the NP role.

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... Se espera que los recién graduados sean funcionales en un nivel avanzado, pero se ha informado que existe una gran incertidumbre con respecto a su papel en una profesión cada vez más exigente 7,20-21,24 . En consecuencia, este deterioro del desarrollo del rol puede afectar la continuidad en el empleo y fomentar la decisión de dejar la profesión en el primer año de práctica profesional [25][26][27] . De hecho, se cree que el año de transición inicial es la base fundamental sobre la cual los nuevos profesionales de Enfermería Clínica construyen su práctica profesional 25,27 . ...
... En consecuencia, este deterioro del desarrollo del rol puede afectar la continuidad en el empleo y fomentar la decisión de dejar la profesión en el primer año de práctica profesional [25][26][27] . De hecho, se cree que el año de transición inicial es la base fundamental sobre la cual los nuevos profesionales de Enfermería Clínica construyen su práctica profesional 25,27 . El conocimiento de las etapas por las que atraviesan los EPAs recién recibidos durante su primer año de práctica profesional y los posibles factores de estrés a los que se enfrentan esbozan una idea de la magnitud del problema 7,25-26 . ...
... Orientación: la importancia de un período de orientación pormenorizado y el apoyo de otros profesionales, en especial de otros enfermeros del equipo y compañeros de trabajo de EPA, es particularmente importante en el proceso de transición 4,28 . Los programas formales de tutoría brindan la base para una práctica exitosa y se complementan con oportunidades adicionales para el crecimiento profesional 16,25 . Los EPAs novatos señalan una mayor satisfacción laboral cuando se les ofrece un programa de tutoría formal, por el cual se los prepara y capacita de manera exitosa, lo que permite transiciones oportunas y una mayor satisfacción con su rol 26,29 . ...
... New graduates are expected to function at an advanced level yet, it has been reported that there is significant uncertainty regarding their role in an increasingly demanding profession 7,[20][21]24 . Consequently, this impaired role development can affect employment continuity and the decision to leave the profession within the first year of practice [25][26][27] . Indeed, the initial transitional year is thought to be the critical foundation on which new NP professionals build their practice 25,27 . ...
... Consequently, this impaired role development can affect employment continuity and the decision to leave the profession within the first year of practice [25][26][27] . Indeed, the initial transitional year is thought to be the critical foundation on which new NP professionals build their practice 25,27 . An awareness of the stages that the typical novice NPs go through during the initial year of practice and the potential stressors they face may provide insight into the magnitude of the problem 7,25-26 . ...
... Orientation: the importance of a thorough orientation period and the support of other professionals, particularly staff nurses and NP coworkers, is especially influential in the transition process 4,28 . Formal orientation programs provide the foundation for successful practice and are augmented by additional opportunities for professional growth 16,25 . Novice NPs report a higher job satisfaction when they are offered a formal orientation program, successfully preparing and empowering them while allowing timely transitions and increased role satisfaction 26,29 . ...
... Espera-se que os recém-formados sejam funcionais em um nível avançado, mas foi relatado que há uma incerteza significativa em relação ao seu papel em uma profissão cada vez mais exigente 7,20-21,24 . Consequentemente, esse desenvolvimento de papel prejudicado pode afetar a continuidade do emprego, levando à decisão de deixar a profissão no primeiro ano de prática [25][26][27] . De fato, acredita-se que o ano de transição inicial seja a base crítica sobre a qual os novos profissionais da EPA constroem sua prática profissional 25,27 . ...
... Consequentemente, esse desenvolvimento de papel prejudicado pode afetar a continuidade do emprego, levando à decisão de deixar a profissão no primeiro ano de prática [25][26][27] . De fato, acredita-se que o ano de transição inicial seja a base crítica sobre a qual os novos profissionais da EPA constroem sua prática profissional 25,27 . Uma consciência dos estágios pelos quais os EPAs iniciantes típicos passam durante o primeiro ano de prática e os potenciais estressores que enfrentam pode fornecer informações sobre a magnitude do problema 7,25-26 . ...
... Orientação: a importância de um período de orientação minucioso e o apoio de outros profissionais, principalmente enfermeiros da equipe e colegas de trabalho do EPA, é particularmente influente no processo de transição 4,28 . Os programas formais de orientação fornecem a base para uma prática bem-sucedida e são aumentados por oportunidades adicionais de crescimento profissional 16,25 . Os EPAs novatos relatam uma maior satisfação no trabalho quando lhes é oferecido um programa de orientação formal, preparando-os e capacitando-os com sucesso, permitindo transições oportunas e maior satisfação com o papel 26,29 . ...
... This is not uncommon. Many previous studies have also found this (Andregard & Jangland, 2014;Barnes, 2014;Duffield et al., 2009;Hill & Sawatzky, 2011;Hoffart, Waddell, & Young, 2011;Valdez, 2008;MacLellan et al., 2015). Nicely and Fairman (2015) commented that NPs benefit from transition to practise support, needing to formalise their identities as NPs, and to affirm their confidence as they undertake the new roles. ...
... However, there is no evidence-based research or other discourses that examine the transitional processes specific to ENPs. One of the strategies said to have been of value in assisting the transition for ENPS, and NPs more generally, is that of mentoring, either formal or informally (Hill & Sawatzky, 2011;Raftery & Tori, 2015a). ...
... The benefits of mentoring in nursing have long been discussed (Hayes, 2001;Hoffart et al., 2011;Nelsey & Brownie, 2012). Mentoring for those undertaking the NP role is invaluable, offering an opportunity to learn from those whom have undertaken the role before them (Carryer, Boddy, & Budge, 2011;Hayes, 1998;Hill & Sawatzky, 2011;Raftery & Tori, 2015b;Valdez, 2008 Most of the ENPs found that the mentorship relationship with their more senior nursing colleagues was positive, offering amongst other things the role socialisation deemed crucial during the transitional phases of becoming an ENP (Hayes, 2001;Leggat et al., 2015;Tori & Morley, 2011). Also, appointed either formally or informally the participants reported that it was the addition of the medical mentor/s that helped to facilitate their transition. ...
... The four stages of the Limbo to Legitimacy model, Laying the Foundation, Launching, Meeting the Challenge, and Broadening the Perspective, progress the APRN from initial struggle to form a new identity to the establishment of legitimacy and acceptance of greater responsibility; though the stages are not necessarily uniform or linear (Brown & Olshansky, 1997). Internal and external threats that can alter or delay APRN transition require further study (Brown & Olshansky, 1997;Hill & Sawatzy, 2011). TTP programs to help APRNs advance through the stages of the Limbo to Legitimacy model have shown benefits, yet the ideal structure, content, and length of such programs as well as potential funding sources in LTC have yet to be identified. ...
... These agreements may institutionalize oversight and reinforce subservience that interferes with collaboration (Martin & Alexander, 2019). A more useful and effective transition model consists of mentorship with an experienced colleague, with modeled behaviors, networking, and stress relief (Hill & Sawatzy, 2011;Kleinpell & Hravnak, 2005;Poronsky, 2012;Twine, 2017). Thus Charlotte, even though she had the least nursing experience, let alone APRN experience, found a mentor and guide in her medical director, who quickly and without judgment answered her questions about patient care. ...
Article
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Advanced practice registered nurses are successful in improving quality outcomes and filling provider care gaps in long-term care. However, little is known about the nurse’s transition to practice in this setting. A 12-month ethnography was conducted via participant-observation with nine advanced practice registered nurses in five long-term care facilities to understand practice environment influence on the nurses’ transition and on the reciprocal influence of the nurse on the practice environment. Transition was fraught with uncertainty as documented by five themes: where’s my authority, institutional acceptance, personal role fulfillment, provider relationships, and individual versus organizational care. These findings suggest that transition in this setting is complex, characterized by insecurity whether the individual is new to advanced practice or experienced. Transition in long-term care could be strengthened by formal programs that include clinical practice, reconceived mentorship for advanced practice registered nurses, and education designed to improve comfort and expertise with indirect care.
... While research suggests that the transition to NP practice is challenging, positive aspects such as relationships within the team and the effectiveness of the role are also described. 8,9,[14][15][16] One Australian study surveyed NPs and identified challenges for NPs within employment settings but also found that NPs felt valued by their organizations and were generally able to practice without restriction. 11 Few studies have sought to understand the role of an NP in palliative care services in Australia. ...
... Some of the literature describes the process of implementing the NP role as 'a tortuous journey towards a partially unknown destination' and recognizes that the 'journey' is challenging. 15,16 The implementation of the role demands careful negotiation, strategic planning, role clarity, organizational support and the broader insights that the NP offers, to contribute to both short and long-term success of the role. [9][10][11] Education and discussion of the NP role was provided initially to the community team and inpatient ward, and then periodically to help establish the role. ...
Article
In Australia, despite the growing need for palliative care, there is a shortage of palliative care professionals. The literature suggests that nurse practitioners (NPs) are well positioned to innovate the current model of palliative medicine. This prospective study evaluates the implementation of a new NP role within an established multidisciplinary palliative care service. In this study, patients under the care of the NP had fewer admissions to an acute hospital compared to the rest of the service (17.0% vs. 27.2%), as well as no acute admissions for terminal care and a greater number of patients who achieved their preferred place of death (87.2% vs. 72.2%). A survey of the multidisciplinary team revealed that the majority of responders (93.3%) felt that the NP role had a positive impact on patient care and was holistic, safe, and met patients’ needs. Neutral or negative survey responses highlighted the need for further education or refinement of the role in areas such as prescribing and ability to refer patients directly to medical specialists. Overall, study results were positive and support the introduction of the NP role into a specialist palliative care service but more research is required to assess the effectiveness of the role.
... Stres yang dialami oleh perawat baru dapat disebabkan oleh banyak faktor. Perawat baru akan merasa ketakutan dalam tahun pertama bekerjanya (Hill & Sawatzky, 2011). Masa peralihan perawat baru menjadi perawat klinik mendapatkan banyak tantangan (Freeling & Parker, 2015). ...
... Mentoring merupakan interaksi yang dibina dengan baik antara mentor sebagai pembimbing dan mentee sebagai terbimbing yang memiliki tujuan untuk menyampaikan pengalaman dan pengetahuan mentor. Mentor memberikan panduan kepada mentee untuk memfasilitasi mentee dalam pertumbuhan dan perkembangan mentee dalam pekerjaannya (Hill & Sawatzky, 2011). Mentoring merupakan salah satu dukungan bagi perawat baru. ...
Article
Background: The new graduate nurses have been in a stressful situation about their workplace. The High level of work stress has been decreased the nurse’s motivation in the work, so it will have an impact on the decline the nursing services quality. The new graduate nurses with the work stress will be motivated to quit their jobs. Objective: This study aims to determine the factors associated with decreased job stress of new graduate nurses. Method: This study was a quantitative research. The data was analized with the associative analytic method and cross sectional approach. The population of this study was all new graduate nurses who have had experience for 1-6 months. The sample size is determined by total sampling technique of 30 nurses. The study was conducted at Semarang Medical Center. Work stress measurement using DASS 42 instrument. The analysis process of the data performed using Spearman rank test and multiple linear regression to measure the relation of factors related to work stress. Result: The new graduate nurses work stress has a normal until light category. The average value of new graduate nurses work stress was 27, with the minimum and maximum score 8-40. The factors that have been eligible for the multivariate analysis of new graduate nurses work stress reduction were age and the mentoring programs. The result of the multivariate test showed that nurse ages together with the mentoring program had significant effect to the decreased of new graduate nurses work stress (p-value = 0,007). Discussion: Has increased of ages have been improved adaptability and positive response to stressors. The mentoring was the process of coaching for the new graduate nurses. Mentoring can be used as a support system for new graduate nurses in facing the transition from student to being nurses. The combination of increased the ages and the mentoring programs have been reduced the new graduate nurses work stress.
... Η καθοδήγηση μπορεί να οριστεί ως μια έντονη σχέση μεταξύ ενός αρχάριου και ενός έμπειρου επαγγελματία που προωθεί το ρόλο της κοινωνικοποίησης και δημιουργεί ένα υποστηρικτικό περιβάλλον. 7 Σύμφωνα με το Ινστιτούτο Ιατρικής σε έκθεση του το 2010 σχετικά με το μέλλον της νοσηλευτικής, η μέθοδος της καθοδήγησης είναι ένας αποτελεσματικός τρόπος για την ενίσχυση του νοσηλευτικού εργατικού δυναμικού και τη βελτίωση της ποιότητας της περίθαλψης των ασθενών. 8,9 Σκοπός της παρούσας μελέτης ήταν η διερεύνηση του εκφοβισμού στο χώρο εργασίας των νοσηλευτών. ...
... Η καθοδήγηση βελτιώνει την νοσηλευτική επάρκεια, καθώς αυξάνεται η αυτοπεποίθηση των νοσηλευτών. 7 Οι νέοι νοσηλευτές προσαρμόζονται στους ρόλους τους πιο αποτελεσματικά και έτσι αναπτύσσουν νέες δεξιότητες και γνώσεις και γίνονται έτοιμοι να συνεργαστούν με τους συναδέρφους τους. 21 Ο νέος νοσηλευτής μαθαίνει να συνεργάζεται με τους ασθενείς, τα μέλη της οικογένειάς τους, και την ομάδα υγειονομικής περίθαλψης από την διδασκαλία και την καθοδήγηση που παρέχουν οι καθοδηγητες. ...
Article
Full-text available
Introduction: Bullying in the workplace of nurses is an issue with great interest. It is defined as repeated and persistent negative actions by one or more individuals in the workplace and more specifically an act of deliberate and continuous rather than individual events. The purpose of this study was to explore the bullying of nurses at their workplace. Methodology: The methodology used included a search review and research studies primarily in electronic ballast «PubMed». Results: According to the literature intimidation is a major cause for the abandonment of the profession by new nurses. Therefore, intimidation make most crucial the problem of shortage of nurses. The role of advisory nurses is an effective way to deal with bullying. Furthermore, it improves nursing efficiency and increases the confidence of young nurses, adapting them more effective in their roles. Conclusions: It becomes an imperative need to create a healthy working environment in which bullying has no place.
... Mentorship: An intense relationship between a novice and an expert practitioner that promotes role socialization, creates a supportive environment, fills the gap between didactic and real-world experience, and results in ultimate role success of the novice (Barker, 2006;Hayes, 2005;Hill & Sawatzky, 2011). ...
Conference Paper
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The study aimed at assessing the perceived factors affecting faculty and clinical-based mentorship among undergraduate nursing students in Kano. A descriptive cross-sectional study design was used. A stratified and proportionate sampling method was employed to recruit the sample from the clinical level students. The sample size was 165 with a proportion of 77, 67, and 21 for 300L, 400L, and 500 levels undergraduate students. A self-administered questionnaire (SAQ) developed by the researchers was used to collect data from the respondents. The data were analyzed using SPSS Version 20. This study highlighted alienated opinions factors affecting both faculty and clinical-based mentoring. Lack of time, mentoring structure, and workload were the perceived factors affecting faculty-based mentoring while lack of time, mentoring skills, the non-supportive attitude of the mentors, gender, workload, number of students in training, and lack of clear evaluation criteria were the factors affect clinical mentoring of students. The study provided new insights into the exclusive factors affecting both faculty and clinical-based mentoring among undergraduate nursing students. Therefore, lecturers and nurse clinicians involved in the training, supervision, and mentoring of students should be up-to-date with current trends in nursing and research to impact the academic and clinical knowledge required of the students.
... However, new NP graduates can have a sense of inadequacy or lack confidence in their abilities when support and resources are limited. 13,14 Transitional support can be particularly effective for improved role satisfaction and preparedness for new NPs in rural settings. 14,15 Ensuring a sufficient supply of NPs to serve as primary care providers in rural areas requires exposure and education. ...
Article
A multisite health system identified a need to improve recruitment and retention of rural nurse practitioners (NPs) through enhanced transitional support. In 2019, the health system collaborated with an accredited Midwestern doctor of nursing practice/family NP program to expand a transition-to-practice program into a 1-year residency program for new NPs. The residency was made possible through a 4-year Health Resources and Services Administration grant specifically for NPs hired in rural communities. This article describes the rural NP residency, including budget and human resource decisions, core curriculum, and program outcomes.
... More than one clinical supervisor may be necessary in order to cover absences especially where there are a group of trainees at the site. Literature explains that the supervision arrangement whether formal or informal influences the success of the mentorship [31]. ...
Article
Full-text available
Background Following evidence published in the Pharmacists in Emergency Departments (PIED 2016) study Health Education England funded novel advanced clinical practitioner training for pharmacists (ACP-p), to support service delivery.Objective To explore experiences and clinical activity of trainee ACP-p, and opinions and recommendations of both trainees and clinical supervisors.Setting Five Urgent/Emergency Care Departments in London UK.Method Longitudinal mixed-methods study in three phases of registered UK pharmacists appointed as trainee ACP-p. Phase 1 (May-July 2019) - early semi-structured interviews and focus group using an experiences, opinions and recommendations (EOR) framework, Phase 2 (January-December 2019) - prospective recording of trainee clinical activity, standardised using bespoke spreadsheet, Phase 3 (November-December 2019) - as Phase 1 but at conclusion of training.Main outcome measure Experiences, clinical activity, opinions and recommendations of study participants.Results Twelve (92 %) eligible trainee ACP-p and five supervisors were recruited. Identified themes were: trainee personality, educational components, length of programme, support/supervision, career transition, university and placement training alignment, recommendations. Success was dependent on effective support and supervision. Clinical supervisors should be allocated adequate supervision time. Trainees, their supervisors and emergency department staff should be given a clear brief. Study participants agreed that the programme could be successful. Trainee ACP-p reported that they could manage 82 % of 713 pre-selected clinical presentations. Additional training needs include: ECGs, X-rays and CT scans.Conclusions Pharmacists can successfully train as ACP-p in this setting over a two-year period. This career transition needs careful management and clear structures. Training ACP-p is a useful way of enhancing skills and supporting clinical services to large numbers of patients.
... More than one clinical supervisor may be necessary in order to cover absences especially where there are a group of trainees at the site. Literature explains that the supervision arrangement whether formal or informal in uences the success of the mentorship [32]. ...
Preprint
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Background Following evidence published in the Pharmacists in Emergency Departments (PIED 2016) study Health Education England funded novel advanced clinical practitioner training for pharmacists (ACP-p), to support service delivery. Objective To explore experiences and clinical activity of trainee ACP-p, and opinions and recommendations of both trainees and clinical supervisors. Setting and participants Five Urgent/Emergency Care Departments in London UK. Registered UK pharmacists appointed as trainee ACP-p. Method Longitudinal mixed-methods study in three phases. Phase 1 – early semi-structured interviews and focus group using an experiences, opinions and recommendations (EOR) framework, Phase 2 – recording of trainee clinical activity using bespoke spreadsheet, Phase 3 – as Phase 1 but at conclusion of training. Main outcome measure Experiences, clinical activity, opinions and recommendations of study participants. Results Twelve (92%) eligible trainee ACP-p and five supervisors were recruited. Identified themes include: trainee personality, educational components, length of programme, support/supervision, career transition, university and placement training alignment, recommendations. Success was dependent on effective support and supervision. Clinical supervisors should be allocated supervision time. Trainees, their supervisors and emergency department staff should be given a clear brief. Study participants agreed that the programme could be successful. Trainee ACP-p reported that they could manage 82% of 713 reported cases. Additional training needs include: ECGs, Xrays and CT scans. Conclusion Pharmacists can successfully train as ACP-p in this setting over a two-year period. This career transition needs careful management and clear structures. Training ACP-p is a useful way of enhancing skills and supporting clinical services to large numbers of patients.
... Mentorship is a critical aspect and is cited as a facilitator of NNPRT (Faraz, 2019;Sargent & Olmedo, 2013;Zapatka et al., 2014). It has been theorized that mentorship of novice NPs may lead to increased self-efficacy, improved job satisfaction, and retention (Barnes, 2015;Harrington, 2011;Hill & Sawatzky, 2011). Mentorship has been described as an environmental factor or form of extrinsic support (Barnes, 2015); however, the emergence of mentorship as a factor separate from measures of the NP's organizational fit demonstrates its importance to the larger concept of NNPRT. ...
Article
Full-text available
Background: Novice nurse practitioner role transition (NNPRT) can be described as stressful and turbulent, leading to decreased job satisfaction and increased intent to leave. No published instrument exists to measure NNPRT. Thus, researchers, educators, and administrators are limited in their ability to measure the concept and therefore understand the factors that lead to a successful, or unsuccessful, role transition experience. An instrument with evidence of validity and reliability is needed to conduct large-scale and systematic examinations of NNPRT. Purpose: The purpose of this study was to develop and examine the initial factor structure of a novel instrument that measures NNPRT. Methods: Initial item development was guided by concept analysis, literature review, and qualitative data. Face and content validity were established from expert review. Using pilot data from 89 novice nurse practitioners (NPs), an exploratory factor analysis (EFA) was conducted to examine the instrument's internal factor structure. Results: The NNPRT Scale includes 40 items that measure an individual's perception of their role transition experience. The EFA revealed a five-factor structure: organizational alignment, mentorship, sense of purpose, perceived competence and self-confidence, and compensation. Implications for practice: In an evolving health care system, provider well-being is at the center of workforce, educational, and organizational conversations. Understanding how to optimize the workforce and prepare NPs for health care delivery is increasingly important. The NNPRT Scale will allow for large-scale examinations of the factors that influence NP role transition, as well as assess interventions to prepare and support novice NPs' transitions.
... Transitioning from student to provider of care can cause feelings of stress, isolation, self-doubt, frustration, and uncertainty about clinical knowledge. [2][3][4][5][6][7][8] In surveying organizations with NP residency or fellowship programs, Kersten and El-Banna 9 found the following benefits: increased competence and skill, increased confidence, enhanced recruitment and retention of NPs, improved communication and collaboration, enhanced clinical judgment, improved socialization to the NP role, increased NP satisfaction, and improved patient safety. Morgan et al 1 interviewed 13 health care organizations regarding their experience of onboarding new NPs and PAs. ...
Article
The benefits of transition to practice programs are well supported in the literature. Despite this support, there are often numerous organizational barriers to the implementation of such a program. Key strategies to establish organizational support include securing leadership buy-in, having a clear advanced practice registered nurse/physician assistant leadership model, and creating a business case to financially support a transition to practice program. Essentia Health’s advanced practice registered nurse/physician assistant transition to practice pilot used engagement, turnover, and productivity data, which were presented to leadership to secure buy-in and ultimately expand the program to all departments within the health system.
... Community health organizations can address these challenges by implementing formal mentorship to new nurse practitioners (NPs) entering the workforce. Mentorship during the first year of practice can provide additional guidance and support to facilitate the transition from novice NP to experienced clinician (7). ...
Article
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The increasing need for psychiatry services in medically underserved communities has proven to be challenging for health care systems. Caring for this population is complex and can be overwhelming for the inexperienced provider. Proper utilization of psychiatric and mental health nurse practitioners in this setting can expedite meeting the mental health needs of the community. A postgraduate fellowship program that provides supervision and additional training specific to community psychiatry facilitates the transition from novice provider to experienced clinician while aiming to improve retention rates. In this Open Forum, the authors outline the structure of a federally qualified health center's Community Psychiatry Nurse Practitioner Fellowship.
... 23,24 International literature suggests that clinical supervision by a suitable mentor is crucial for novice NPs to develop the skills and competencies required to provide health services such as home visits autonomously and with high quality. 25 Switzerland is in the early stages of introducing NPs. There are working groups developing a regulatory framework but for now, the role, tasks, and responsibilities are not legally defined or recognized. ...
In Swiss primary care, general practitioner (GP) home visits have decreased due to impending GP shortages particularly in rural areas. Nurse practitioners (NP) are newly introduced in family practices and could potentially offer home visits to the increasing number of multimorbid elderly. We analysed consultation data from two pilot projects (Practice A and Practice B) with the goal to measure the frequency and patient characteristics of NP consultations both in the practice and on home visits, and to determine the NPs’ autonomy based on the required GP supervision. In Practice A, 17% of all NP consultations were home visits, in Practice B 51%. In both practices, the NPs saw older patients and reported higher autonomy on home visits compared to consultations in the practice. In Practice A, the NP encountered a higher share of multimorbid patients on home visits than in the practice, and the NP’s proportion of autonomously conducted consultations increased from 0% in the first month to 19% after 13 months of GP supervision. In Practice B, the NP was autonomous in about three-quarters of consultations after 2 years on the job. These first cases provide some evidence that NPs could reach a relatively high degree of autonomy and might pose a potential solution for the decreasing numbers of GP home visits to multimorbid elderly in Swiss primary care.
... The semistructured interview guide was developed to reflect the current literature on transition to practice in health care. 9,10,[15][16][17][18][19][20][21] The questions focused on the participants' experiences as they transitioned to their new positions as credentialed athletic trainers, and the development reflected the purpose of the study (see Appendix). ...
Article
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Context Transition to practice is a current topic in athletic training and needs to be explored from a longitudinal perspective. Many athletic training programs and employing organizations are supporting transition to practice, yet little is known about the most common methods. Moreover, transition to practice is an ongoing process that can persist up to a year while current literature draws from snapshots. Objective Longitudinally explore the educational and organizational socialization practices used to support transition to practice. Design Qualitative study. Setting Nine higher education institutions. Patients or Other Participants Fourteen athletic training students (7 male, 7 female, age = 26 ± 4 years) participated. Data Collection and Analysis Participants completed semistructured interviews over the phone 3 times over the course of a 15-month period (before graduation, 4–6 months, and 10–12 months during their first job). All transcribed interviews were analyzed using a general inductive approach. Member checks, multiple analyst triangulation, and peer review were used to ensure trustworthiness. Results Two main educational mechanisms were found to support transition to practice; they included (1) mentorship and (2) past experience. Three main organizational mechanisms were identified to support transition to practice: (1) mentorship, (2) orientation to the job, and (3) living the job. Conclusions A blend of educational and organizational mechanisms is necessary to help support newly credentialed athletic trainers as they transition into clinical practice. Mentorship is important throughout the process, before and after newly credentialed athletic trainers enter their professional role.
... The Institute of Medicine has called for formal postgraduate educational programs to help the transition in roles from APP students to practicing clinicians (Institute of Medicine [US] Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine, 2011). A previous study reported that fellowships increased the clinical skills and overall job satisfaction of NPs (Hill & Sawatzky, 2011). Development of the subspecialty fellowship program is a step forward in the future training of APPs. ...
Article
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Advanced practice providers (APPs), including nurse practitioners (NPs) and physician assistants (PAs), are part of a growing cancer care workforce. Current hematology-specific education provided by most graduate NP and PA school educations is limited. Mayo Clinic School of Health Sciences launched a hematology-specific fellowship in 2018 to provide APPs with the skills and knowledge required to deliver high-quality specialty care in hematology and blood and marrow transplant (BMT). The fellowship curriculum was developed based on a needs-based assessment study as well as the qualitative reported experiences of current hematology-specific APPs. The curriculum contains didactic in-class education, research opportunities, and mentored clinical rotations in both inpatient and outpatient practice in hematology and BMT. This 12-month fellowship, one of the only postgraduate training programs dedicated to benign and malignant hematology practice, provides structured training for highly qualified graduate APPs interested in developing a rewarding career in hematology.
... Consistent with Hart and Bowen' (2016) and Wilkes and Feldman (2017), this study showed that formal preceptorship was uncommon post-graduation leaving NPs to learn from others informally. Though, mentorship is essential to one's successful transition to practice (Barnes, 2015a;Faraz, 2016;Farrell et al., 2015;Hill and Sawatzky, 2011;Zapatka et al., 2014), patient care takes priority decreasing time available for mentoring NPs (Bazzell and Dains, 2017;Forsberg et al., 2015;Giddens et al., 2014;Keough et al., 2015;Poronsky, 2012;Roberts et al., 2017). Training preceptors and decreasing their' workload pre graduation, as well as creating formal preceptorships post-graduation, may provide a stronger foundation for NPs' role transition. ...
... 14 The process required the interviewer to engage the participants through a series of questions, while allowing the freedom for discourse that may be unplanned or unintentional to fully capture their experiences. We created our interview guide (Table) to reflect an integration of current literature in athletic training 9,10,15-17 and nursing [18][19][20][21][22][23] regarding the needs of newly credentialed practitioners and transition to practice. A peer completed a content review of the interview guide followed by a small pilot study (N ¼ 3) to confirm comprehensiveness, clarity, and to gain rigor with our procedures 24 prior to data collection. ...
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Context Newly credentialed athletic trainers are expected to be independent practitioners capable of making their own clinical decisions. Transition to practice can be stressful and present challenges for graduates who are not accustomed to practicing independently. Objective Explore the perceptions of professional master's students as they prepare to experience role transition from students to autonomous clinical practitioners. Design Qualitative study. Setting Nine higher education institutions. Patients or Other Participants Fourteen athletic training students (7 male, 7 female, age = 25.6 ± 3.7 years) participated. Main Outcome Measure(s) Participants completed a semistructured interview over the phone which focused on the perception of preparedness to enter clinical practice. All transcribed interviews were analyzed using a general inductive approach. Multiple-analyst triangulation and peer review were used to ensure trustworthiness. Results We found themes for facilitators and challenges to transition to autonomous clinical practice. Students felt prepared for independent practice due to (1) mentoring networks they had developed, (2) exposure to the breadth of clinical practice, and (3) autonomy allotted during clinical education. Potential challenges included (1) a pprehension with decision making and (2) a lack of confidence. Conclusions Our findings suggest graduates from professional master's programs, although ready for clinical practice, may require more time and exposure to autonomous practice to build confidence. Professional master's program administrators should work to provide clinical education experiences that expose students to a wide variety of clinical situations (patients, settings, preceptors) with appropriate professional role models while providing decision making autonomy within accreditation standards.
... The needs of NPs are also discussed by others (Brand, Cesario, Symes, & Montgomery, 2016;Doerksen, 2010;Jarrell, 2016), in terms of identifying specific areas such as clinical skills, leadership and research and highlights the novice to expert NP journey. Mentorship is cited as reducing anxieties in novice NPs as they transition, but no studies measured psychological well-being specifically (Hill & Sawatzky, 2011). However, the transition from novice to expert was seen as stressful and the authors endorsed the use of experienced NPs as mentors. ...
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Aim: To synthesise available data on current educational provision related to preparation for the advanced clinical practice role. Design: A mixed methods rapid review of the literature. Data sources: A search of Ovid Medline and Ovid EMBASE for English language papers published 2006-2018 resulted in 38 publications, which met the criteria for inclusion. Review methods: Using Tricco's seven-stage process, following identification of relevant papers and data extraction, a data-based convergent synthesis was used to convert quantitative papers into qualitative data prior to completing a narrative synthesis. Results: The four themes identified from data synthesis were consolidation; theory practice gap; competency and mentoring. A lack of preparedness for new advanced clinical practitioners completing an educational programme was noted with a need identified for a clinically focussed consolidation period to enable practitioners to develop their skills under supervision in the clinical environment. Conclusion: As the needs for different models of healthcare evolves with the expansion of advanced practice; appropriate education and clinical supervision are important aspects in the delivery of programmes that allow individuals to be competent and confident practitioners providing safe and effective healthcare. Impact: There is a paucity of papers on educational preparedness of advanced clinical practitioners. Our findings demonstrate a lack of preparedness and the need for a clinically focussed consolidation period with good role models and mentors following completion of a Master's programme. Employers and higher education institutions need to ensure a protected period of time is available for newly qualified advanced clinical practitioners to allow consolidation of clinical practice. This article is protected by copyright. All rights reserved.
... The obstacles to achieving interprofessional team collaboration in a surgical care environment in Sweden have been explored, with recommendations to optimize the role (Andregard & Jangland, 2015). Lack of confidence and a sense of inadequacy is common amongst trainees, which can be overwhelming (Hill & Sawatsky, 2011). The transition of socialization into the new working environments may be challenging with adaptation to new processes and methods of practice becoming stress inducing (Feng & Tsai, 2012). ...
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Advanced Clinical Practitioners (ACPs) are a rapidly growing workforce worldwide with the USA showing the highest absolute number and rate per population, followed by the Netherlands, Canada, Australia, Ireland and New Zealand (Maier et al 2016). Whilst many practitioners are nurses by background, the development of the role has encouraged the inclusion of other professions such as physiotherapists, pharmacists and paramedics. The progression of the ACP role involves the acquisition of new skills alongside post graduate academic education at Masters level and peer support (NHS Education for Scotland 2012, Aguilard et al 2017, Health Education England 2017). This article is protected by copyright. All rights reserved.
... However, half a century has not been long enough to fully resolve the NPs' challenge to nursing's boundaries. The problem of RN-to-NP "role transition" remains as salient today as it was in the 1970s (see Barnes 2015;Brown and Olshansky 1998;Cusson and Strange 2008;Heitz, Steiner, and Burman 2004;Hill and Sawatzky 2011). The longevity of this dilemma has structural roots. ...
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Boundary-work is constitutive of both jurisdiction and professional identities. For groups attempting domain expansion, changed boundaries present risks for group cohesion. In this article, I examine the boundary-work that nurse-practitioners-in-training perform to negotiate the contradictions of moving into the new terrain of diagnostic medicine. I found that students engaged in reparative boundary-work that re-inscribed the new terrain of the nurse practitioner into the “old work” of bedside nursing. These strategies not only resolved the contradictions of nurse practitioner identity, but they also provided strategies of action for negotiating new relationships with future physician colleagues. This analysis demonstrates that the defense of breached boundaries is activated not only by external threats but also by the internal threats of jurisdictional expansion.
... Mentor exact great influence on their trainees' career and ultimate success hence mentorship is a critical issue to address regarding raise the next generation of neurosurgeons. Mentoring is a symbiotic relationship aimed at promoting career satisfaction and fulfilment in practice for both the mentor and mentee in a supportive environment created by the mentor to facilitate growth and smooth transition [3]. For example, heuristics are rules of thumb that experts learn through trial and error. ...
... There is empiric evidence for the importance of mentorship during the NP transition to practice (Harrington, 2011;Hayes, 1998Hayes, , 2001Hill & Sawatzky, 2011), but limited information regarding successful mentoring programs and successful mentoring of NP students (Poronsky, 2012). Mentorship by a colleague (Sullivan-Bentz et al., 2010), and a formal orientation program (Bahouth & Esposito-Herr, 2009;Barnes, 2015;Cleary, Matheson, & Happell, 2009;Cusson & Strange, 2008, Flinter, 2012 have been associated with improved NP role transition, but more information is needed on the ideal structure and content of successful mentoring and mentorship programs (Poronsky, 2012). ...
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Purpose: Little is known about the workforce transition and turnover intention of novice nurse practitioners (NPs) in primary care (PC). This research aimed to describe the individual characteristics, role acquisition and job satisfaction of novice NPs, and identify factors associated with their successful transition and turnover intention in the first year of PC practice. Data sources: A descriptive, cross-sectional study was conducted via online survey administered to a national sample of 177 NPs who graduated from an accredited NP program and were practicing in a PC setting for 3-12 months. Conclusions: This study demonstrated that greater professional autonomy in the workplace is a critical factor in turnover intention in novice NPs in the PC setting. Implications for practice: Further research is needed regarding the novice NP workforce transition to provide adequate professional autonomy and support during this critical period.
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The transition to professional practice is a challenging time for the novice NP. Mentorship is an effective strategy to ease this transition and increase success in the role. This article provides recommendations for best practice in mentoring the transitioning novice NP.
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Background: A volume of literature reflects that mentorship is key in producing quality nurse practitioners. Mentoring leads to increased confidence, role clarity, and other benefits improving practice. However, there is little to no research focusing specifically on the impact of mentoring in psychiatric nurse mental health nurse practitioners (PMHNPs). Purpose: To explore process of acquiring mentorship and mentoring experiences of newly graduated PMHNPs, all of whom obtained their respective degrees partially or completely online. The study also seeks to describe perceptions of mentoring in PMHNP leaders. Methods: Nine new graduate PMHNPs and 10 PMHNP leaders were recruited from membership rosters of professional organizations in the Southwestern United States. Informants participated in semi-structured interviews with questions sourced from an interview guide. Interviews were conducted via videoconference or telephone from informants' homes. Data were coded via an in vivo approach and analyzed by thematic methods. Results: New graduates reported that mentoring was dependent on four themes: connectivity, educational stewardship, practice confidence, and luck. Mentor access via work, institutions, or schools was inconsistent. Leaders were concerned about limited educational and professional investment in mentorship because this process is an important component of professional development. Conclusion: Mentorship for new graduates is based on a variety of factors, some of which are out of their control. Lack of mentoring may affect practice, which affects patient care. Dialogue between educators, professionals, and organizations may improve mentoring stewardship. Implications: Enhanced communication between educational institutions and professional organizations to create a more fluid process from graduate to mentorship is needed.
Chapter
Mentorship is critical to the development and professional growth of graduate medical education (GME) trainees. It is a bidirectional relationship between a mentor and a mentee. Mentorship has consistently been shown to be beneficial for both the mentor and mentee, with the mentee gaining valuable skills in education, personal growth, and professional support, and the mentor attaining higher career satisfaction and potentially greater productivity. Yet, there is a lack of research and in-depth analysis of effective mentorship and its role in postgraduate medical education. This chapter outlines different approaches toward mentorship and provides the reader with basic concepts relevant to the effective and competent practice of mentorship. The authors discuss the challenges that physician mentors and mentees face, the organizational models of mentorship, the approaches and techniques for mentorship, and the deleterious effects of mentorship malpractice. Our general discussion touches on best practices for both the mentor and mentee to allow for self-improvement and lifelong learning. The variety of applicable models makes it difficult to measure effectiveness of mentorship in GME, but there is an ongoing need for expanded research on the benefits of mentorship, as greater amount of supporting evidence will likely incentivize organizations to create mentorship-friendly policies and support corresponding institutional changes.
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Aim: To explore trainee and qualified advanced practitioner learning experiences, how training has prepared learners for clinical practice and role transition. Evaluation of a multidisciplinary learning approach was sought, identifying its impact on developing collaborative learning and working partnerships. Design and methods: A small-scale, mixed-methods cross-sectional study was used to gather descriptive data. Convenience sampling was used with two groups: trainees and qualified advanced (paediatric) nurse practitioners/advanced clinical practitioners (ANPs/ACPs). All participants had completed or were undertaking master's level training. An anonymous, voluntary online survey was used to gather quantitative and qualitative data reflecting participant learning experiences. Evaluation research methodologies and their application were examined through exploration of three advanced practice frameworks and a well-established framework for evaluation of training. Findings: Overall, responses indicate positive learning experiences, and that current and previous ANP/ACP training in the UK does adequately prepare trainees for practice. However, further improvements in curriculum content are suggested. Consistent with the literature, collaborative multidisciplinary teaching, learning and mentorship were identified as key elements in the learning process and role transition.
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Advanced nursing/clinical practice has emerged worldwide in response to the demands of changing complex healthcare needs and ageing populations, and the need to improve services and outcomes, decrease waiting times and reduce overall healthcare cost. A reduction in medical practitioners' working hours has meant other healthcare disciplines have to develop medical skills. Evidence suggests there are global differences in the advanced nursing/clinical practice role definition, expectations and scope of practice. Education and training for role development varies around the world. Part 1 of this review, which explores international approaches to advanced practice, examines literature findings that look at learner experiences of training and preparation and highlights a gap in educational research in this field. A small-scale cross-sectional mixed methods study that was subsequently undertaken will be discussed in part 2.
Article
Background Mentors play significant roles in developing their mentees’ careers. To study how effectively mentors contribute to their mentees’ career development, a valid and reliable measure is needed considering cultural background. Purpose The twofold aim of this study was to evaluate the psychometric properties of the Ragins and McFarlin Mentor Role Instrument – Saudi version (RMMRI-S) and assess the effectiveness and satisfaction of staff nurses’ mentoring roles as perceived by nursing interns. Methods This descriptive study used translation, validation, exploratory factor analysis, and reliability tests. The pretesting data were collected in November 2017 and the main study data were collected between January 2018 and December 2018. A convenience sample of 342 Saudi nursing interns enrolled in the internship programme of three teaching hospitals in Riyadh, Saudi Arabia was recruited to participate in the study. The study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Results The RMMRI-S yielded a scale-level index and an item-level index of 1. The factor analysis yielded two components that collectively explained 71.39% of the variances. While the inter-item correlation coefficients of the RMMRI-S and career development subscale were a = 0.97, it was a = 0.88 for the psychosocial subscale. All demographic variables were significantly correlated with the mentoring roles. Likewise, career development and psychosocial roles were significantly correlated with mentoring effectiveness and satisfaction. Conclusion The study confirmed the robustness of the psychometric properties of the RMMRI-S and showed sound validity and strong reliability for measuring staff nurses’ mentoring role effectiveness and satisfaction according to nursing interns during their internship training. This scale can be utilised across the Arab Gulf region and internationally for Arabic-speaking nursing interns and students.
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Los significados que las enfermeras egresadas entre 2009 y 2014 de la Universidad de La Laguna atribuyen al desempeño de su puesto profesional tras su incorporación laboral en distintas instituciones sanitarias en la isla de Tenerife (España), se relacionan con un proceso de interacción con el contexto laboral donde la nueva enfermera siente y actúa dentro de ese contexto socializador. La incorporación laboral se ve influenciada además por las vivencias de la enfermera experimentada como estudiante a las que se suman las vivencias de la responsabilidad, de asimilar el nuevo rol profesional, de las faltas de preparación y de estabilidad profesional unidas a la complejidad del servicio en el que poder integrarse y sentirse o no apoyadas y el temor al error, caracterizan la vivencia a la incorporación laboral.
Article
Background: Mentoring is a process in which a more skilled or experienced person builds a supportive relationship with a less experienced person to promote the latter's professional development. The National Association of Neonatal Nurse Practitioners (NANNP) supports the establishment of formalized mentoring programs for neonatal nurse practitioners (NNPs) and published a mentoring toolkit in 2017. Completing suggested activities outlined in the toolkit promotes the incorporation of evidence-based practice into the NNP professional role. Purpose: This quality improvement project's purpose was to measure utilization and meaningfulness of NANNP mentoring toolkit activities. Methods: A convenience sample of 21 nurse practitioners was paired in 2 mentoring cohorts. Dyads were encouraged to meet monthly to complete NANNP mentoring toolkit activities in the context of a formalized mentoring program. Monthly data were collected to evaluate use and meaningfulness of the toolkit activities. Quantitative data included frequency and length of mentoring meetings, activities completed, and ratings of meaningfulness on a Likert-type scale. Results: Six of the 9 (67%) NANNP mentoring activities completed by the 2 cohorts were rated as "meaningful" or "very meaningful" by participants. Implications for practice and research: Activities from the NANNP mentoring toolkit provide structure to mentoring relationship development. Recognizing the challenge to recruit and retain NNPs, organizations are encouraged to explore creative solutions to develop and support formalized mentoring programs. Further research is warranted to validate use of NANNP toolkit activities in the establishment and evaluation of a formalized mentoring program in various neonatal intensive care unit settings.
Article
Little research exists on mentoring programs for nurse practitioner (NP) students. This pilot project aimed to develop, implement, and evaluate a distance program with NP alumni mentoring NP students across the United States. Mentor-mentee pairs (113) were hand-matched and surveyed at six months to collect program data. Most mentees wanted more job-hunting and resume-writing tips; mentors were interested in receiving strategies for mentoring and calendar reminders of important school events. Alumni were interested in helping prepare future NPs by serving as mentors but needed training. Distance mentorship programs may require additional structured guidelines and resources to facilitate success.
Article
Academic–clinical partnerships demonstrated sustained learning experiences for nurse practitioner students to apply concepts of social determinants of health and cultural competency learned in classrooms. The purpose of this project was to evaluate concept mastery and clinical application of social determinants of health and cultural fluency in NP students, while assessing the impact of ACPs as clinical settings on student performance in this area. Students were evaluated by clinical preceptors at mid-semester and final semester time points in academic–clinical partnerships or non-academic–clinical partnerships clinical settings on concept mastery of social determinants of health and cultural fluency. Students in both settings had better final evaluation scores for social determinants of health and cultural fluency. Yet, students in non-academic–clinical partnership settings performed better than academic–clinical partnerships on cultural fluency scores at midterm and final evaluations. Findings suggest the expansion of advanced practice educational curriculum to include evaluation measures for cultural fluency and social determinants of health. Diverse clinical assignments provide immersion experiences that incorporate the application of expanded content into clinical situations.
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Introduction: Recruitment and retention of healthcare providers to rural workplaces is often challenging due to many factors, such as complex work environments requiring a broad skill set, minimal staffing, and limited community support and resources. Mentorship has been proposed as a strategy to encourage recruitment and retention of staff in rural workplaces. This article describes a rural-specific pilot mentorship program that was implemented and evaluated in terms of supporting rural mentorships, easing workplace transition, strengthening community connections, and encouraging recruitment and retention in rural communities. Methods: Thirty volunteer registered nurse mentors and mentees were recruited from within a western Canadian province. These individuals worked in communities with populations of less than 10 000. Mentors and mentees were matched by program coordinators based on self-identified relationship priorities and similar responses to questions including preferred frequency and method of contact. Online orientation to the program was provided and the formal mentorship lasted 4 months. Follow-up program evaluation was conducted via informal electronic feedback and comprehensive interviews that were analyzed using thematic analysis. Results: Three themes were identified by participants that serve as key considerations when implementing a rural mentorship program: connection, communication, and support. Connection describes the variety of relationships participants formed throughout the mentorship program, including connections to their mentor/mentee, themselves, their profession, colleagues, and the larger rural community. Communication includes the logistics of corresponding between mentee-mentor dyads during the program, participant communication with the coordinators of the program, and future communication about and promotion of rural mentorship programs. Support was described as interpersonal and professional assistance provided to the mentee from the mentor as well as to the mentor from the mentorship program and management. Data from the study suggest that rural-specific mentorships are effective in terms of supporting mentorships, easing workplace transition, strengthening community connections, and encouraging recruitment and retention of registered nurses in rural health care. Pervasive throughout the themes derived from the thematic analysis of interview data was the pivotal role of four key groups (mentors, mentees, the healthcare organization, and the rural community) in developing, facilitating, and sustaining mentorships in rural areas. Conclusion: Participants in this study believed that mentorship was beneficial to support healthcare providers working in rural environments. However, greater strides need to be made in terms of creating and supporting such relationships. The responsibility for mentorship resides with not only the mentor and mentee but also health organizations and rural communities. Members from all groups need to be committed and contribute to mentorship for rural mentorship programs to be successful and sustainable. Rural residents are often underserved due to insufficient numbers of healthcare professionals working in rural areas along with a limited number of services offered. The greater the numbers of healthcare professionals that can be recruited and retained within rural communities, the greater the likelihood the community residents will have timely and appropriate access to quality health services. These services can result in positive patient outcomes and greater community health.
Article
Background: Evidence-based practice (EBP) is a core requirement for nurses, contributing toward better clinical outcomes. Mentorship could prepare early adopters of EBP to create an EBP culture. Method: Nine nurses in an acute hospital in Singapore participated in a mentorship program throughout 2015. Mentees conducted ward-based EBP education sessions for nursing colleagues. The Evidence-Based Practice Questionnaire (EBPQ) was used to measure the program's effect on mentees' and their ward colleagues' knowledge, attitude, and practice of EBP. Both groups completed the EBPQ before and 3 months after completion of the program. Wilcoxon rank-sum tests were performed to compare changes in EBPQ scores. Results: Both mentees and ward colleagues reported improved posttest median scores for all EBPQ subscales and the overall score. However, mentees reported a larger magnitude of improvement. Conclusion: A hospital-based research and EBP mentorship program increases nurses' knowledge, attitude, and practice of EBP, creating an EBP culture change. [J Contin Educ Nurs. 2020;51(1):46-52.].
Chapter
Mentoring programs play a valuable role in higher education. Formal mentoring processes and relationships increase the overall perceived quality of an educational program and the professional success of new hotel management graduates. To evaluate an established mentoring program in higher education, a single case study of the Blue Mountains International Hotel Management School at Torrens University Australia (BMIHMS @TUA) was developed and that is presented and discussed in this chapter. The evaluation of the mentoring program found that mentoring relationships enable mentees to build knowledge and skills, develop networking opportunities, build confidence, and gain self-reflection abilities. The chapter offers insights and recommendations for higher education institutions to consider when setting up mentoring programs. The knowledge gained through this research will assist higher education institutions to better prepare students for a transition to work through mentoring whilst enhancing the quality of educational courses.
Article
Purpose: The purpose of this article is to describe an immersion model implemented in a doctor of nursing practice program with the goal of engaging students and optimizing learning. Description of the project: The immersion model was designed to support learners in an online doctor of nursing practice program to promote self-direction and active involvement in diagnosing, planning, implementing, and evaluating their own learning. The Community of Inquiry framework, based on learning and teaching theory, was used in developing this immersion model. Outcome: Students expressed positive opinions about immersion. Students valued simulation and skills practice, peer interaction, engagement with faculty, and the leadership colloquium. Faculty reported value in having group advising meetings and in collaborating across specialty tracks for skills laboratory experiences. Conclusion: The immersion model has enhanced student engagement and helped optimize learning outcomes. Students and faculty found the use of the immersion model to be beneficial for practicing skills, use of simulated learning experiences, and student advising.
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Navigating the unique challenges associated with the role transition from experienced nurse to novice nurse practitioner requires engagement from all levels within the health system. This article describes a new onboarding process supporting the nurse transitioning into advanced practice. Beginning with recruitment and continuing throughout the first year of practice, the process is designed to facilitate ease of assimilation into this new role.
Article
Purpose: Subspecialty training programs rarely are available for advanced practice providers (APPs). New curricula are needed to prepare APPs with the skills and knowledge required to deliver high-quality care in hematology and blood and marrow transplantation (BMT). Methods: A Web-based needs assessment survey was distributed to APPs currently working in hematology and BMT at three Mayo Clinic sites (Rochester, MN; Scottsdale, AZ; and Jacksonville, FL). The survey assessed participants' perceptions of readiness to practice in hematology after completion of their APP education and identified APP learning needs. Results: Of 68 APPs, 49 (72%; 34 nurse practitioners, 15 physician assistants) completed the survey. Twenty-eight APPs (57%) were new graduates, and 17 (35%) had no prior experience in hematology/BMT. All APPs held a master's degree or higher (doctorate, 31%). Thirty-nine (80%) reported that less than 5% of their APP school curriculum was hematology focused. More than 90% felt unprepared to practice in hematology or BMT after their APP education and believed that hematology-specific training could improve their competency as providers and positively affect job satisfaction. APPs reported that they would like more formal training in the following areas of clinical focus: malignant and benign hematologic disorders, hematopathology, palliative care, transfusion medicine, infectious disease, and hematology-related pharmacology. They also preferred the following learning strategies: active learning from patient care, case-based teaching, and experience during hospital rounds. Conclusion: This needs-based assessment project confirmed the necessity to develop a hematology-specific fellowship for APPs and helped to optimize the curriculum.
Article
Background Utilizing skills identified in previous research on successful role transition, this study evaluated the relationship between a strategically designed practicum course and the readiness for role transition to family nurse practitioner (FNP) in graduate nursing students. Methods A mixed methods approach evaluated pre‐ and post‐participation survey data for the FNP role preparedness in graduate nursing students in a strategically designed practicum course. The survey addressed 22 skills associated with readiness for role transition and had three open‐ended questions to collect narrative student perceptions. Results Mann‐Whitney U tests revealed readiness for the FNP role increased from pre to post‐participation in the course for 19 out of 22 skills with significant increases (P < 0.05) for one skill and marginally significant increases (P < 0.10) for three skills. Qualitative findings yielded an overall sense of readiness in students for novice FNP roles. Conclusion A well‐designed practicum course that reviews prior knowledge gained through the program and reinforces critical thinking, assessment, and decision‐making skills facilitates role transition from registered nurse to novice FNP.
Article
Background and purpose: Nurse practitioner (NP) faculties are challenged to offer programs that balance didactic knowledge with the clinical experiences required to prepare graduates for the complexities of health care. Students have the stress of extrapolating the information they obtain during these programs and applying it to postgraduation certification examinations. Innovative educational tools are necessary to ease the uncertainty that NP students experience to graduate and pass certification examinations. Tools include academic-clinical partnerships (ACPs) to enhance clinical opportunities and resources to integrate diagnostic readiness tests (DRTs) into curricula. Methods: This was a quasi-experimental one group, pretest/posttest design using a convenience sample of NP students randomly assigned to clinical in ACP or non-ACP clinical placements. They completed the DRTs twice during their final program semesters. Conclusions: The overall DRT group scores for the NP students significantly improved over time. The Wilcoxon signed ranks test showed that the posttest scores were significantly higher than the pretest scores. The Mann-Whitney U test revealed no differences between the ACP and non-ACP students. Students performed the best on assessment, diagnosis, management, and pharmacology domains. This demonstrates support for the integration of DRTs into NP programs. Implications for practice: Integrating DRTs into NP programs can facilitate transition to the NP role.
Article
Practice nurses are strategically placed to provide high-quality care to their patients; however, a shortage in the nursing population and increasing demands on general practice have left nurses in need of new development schemes to meet these workforce challenges Background A training scheme was devised to address a deficit in recruiting practice nurses. It was a competency-based programme tailored to the role and population needs. Aims This study aimed to evaluate the effectiveness of the training scheme, assess whether or not objectives were met, and identify areas in need of improvement. Methods An online survey was created and sent to nurses. Satisfaction questionnaires were given to patients seen by the nurses towards the end of their training scheme. Findings Responses were received from 6 nurses and 16 patients. Nurses rated the scheme highly and reported confidence in handling the role, but had notable variation in perception of competency in different programme domains. Patients consistently rated the nurses as ‘outstanding’ and were ‘very likely’ to recommend them. There was a correlation between patients' and nurses' perception of competency. Conclusion A successful pilot of the training scheme which will ideally pave the way for further research.
Article
Background and purpose: Role transition is a natural process that occurs when the registered nurse pursues additional education to become a nurse practitioner (NP). Role transition generates feelings of anxiety and insecurity, leading to a longer and more tumultuous adjustment. This study investigated whether an evidence-based role transition webinar would support NP role transition during this critical period. Methods: This study was a nonrandomized, pretest-posttest, and single-group study using a convenience sample to address the research question: "Does completion of a role transition webinar enhance the perception of new NPs of their ability to perform well in their role?" Conclusions: The educational webinar was shown to have a positive influence on some aspects of the participant's reported perceptions of NP role transition. Having practical and assessable educational interventions to optimize NP role transition and determining factors that contribute to the success of these interventions would be prudent. Implications for practice: This is the first quantitative study to investigate the positive association between an online educational intervention and NP role transition. A timelier and less tumultuous transition would allow NPs to perform more effectively in their new role.
Article
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Introducción: El inicio de la profesión enfermera se vive de una forma dura. Además las instituciones sanitarias contratan a las enfermeras sin tener en cuenta su formación o experiencia. Es necesario que exista un entorno donde pueda trabajar de forma segura la nueva enfermera. Objetivo: comprender, desde el punto de vista de las enfermeras, las mejoras que se pueden hacer para facilitar la incorporación laboral. Material y método: Se trata de un estudio cualitativo fenomenológico hermenéutico mediante análisis de discurso. La herramienta de recogida de datos es la entrevista semiestructurada. Se toma como población de estudio a las enfermeras egresadas de la Universidad de La Laguna entre 2009 y 2014, con una muestra de n=13 participantes, habiendo comenzado a trabajar en instituciones sanitarias de Tenerife. Resultados: las categorías establecidas son “tutorización”; “período de adaptación”; “trabajar en unidades ya conocidas”; “problemas para implantar el período de adaptación” y “especialidad”. Discusión y conclusiones: Es necesario encontrar fórmulas para mejorar la incorporación de las nuevas enfermeras a los puestos de trabajo como la tutorización o los períodos de adaptación.
Article
Role transitions in nursing may lead to stress and anxiety or the novice, which can be decreased with appropriate mentoring by preceptors. However, preceptors commonly describe having a lack of mentoring skills. This project focused on nurse practitioner preceptors and their gap in mentoring communication skills when handling difficult communications with novice nurse practitioners. The use of a simulation as a means for learning communication skills was evaluated for its effect on increasing preceptor skill level in mentoring.
Article
The transition from novice nurse to expert nurse has been widely studied, most notably by Patricia Benner; less is known about the transition from expert nurse to new nurse practitioner (NP). Novice NPs come from highly diverse backgrounds, with variable levels of experience in health care. Transition shock is common and can be decreased with proper preceptorship and mentors, establishing a good knowledge base, forming successful workplace relationships, joining a novice NP group, and seeking frequent evaluations. This report reviews the literature and discusses our experience leading a novice NP group at a large, academic, urban hospital.
Article
Preparedness for clinical practice is a critical issue for new nurse practitioners (NPs). We assessed new NPs' perceptions of their preparation for and transition into clinical practice. A national sample of 698 licensed NPs who graduated between 2006 and 2011 and were practicing as NPs in the United States completed a survey related to clinical preparation and practice transition. The majority reported feeling generally or somewhat prepared for practice after their NP education. They also expressed interest in receiving assistance as they transition into practice through residencies and mentoring. Specific findings regarding preparedness and transition into practice are described, and recommendations are offered.
Article
Aim: We explored the impact of job content and stress on anxiety, depressive symptoms and self-perceived health status among nurse practitioners (NPs). Background: Taiwan's NP roles vary between hospitals as a result of the diverse demands and complex tasks that cause job-related stress, potentially affecting the health of the NP. Methods: This study utilised a cross-sectional descriptive design with 161 NPs from regional hospitals participating. Data collection involved demographics, the Taiwan Nurse Stress Checklist, the Job Content Questionnaire, the Beck Anxiety Inventory, the Beck Depression Inventory, a General Health Status Checklist and salivary cortisol tests. Results: NPs reported moderate job stress, similar job control to nurses, mild anxiety and depression, and below-average self-perceived health. Being a licensed NP, personal response, competence, and incompleteness of the personal arrangements subscales of job stress, and anxiety predicted self-perceived health after adjusting for other covariates. Conclusions: Job stress and anxiety affect NP health. Implications for nursing management: NPs are a valuable resource, and the healthcare system demand is growing. Reasonable NP staffing, working hours, proper promotion systems, the causes of job stress, job content clarification and practical work shift scheduling need to be considered. The occupational safety and physical and psychological health of NPs are strongly associated with the quality of patient care.
Article
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The qualities of an effective mentor from the student nurse’s perspective: findings from a longitudinal qualitative study Parker and Carlisle (Journal of Advanced Nursing24, 771–778) argue that there is a scarcity of empirical research focusing on issues such as supernumerary status and mentorship in Project 2000 courses from the students’ perspective. This paper presents the findings of a longitudinal cohort study using Grounded Theory to discover the effect(s) of mentorship on student nurses following the introduction of the 1992 programme of education leading to a Diploma of Higher Education in Nursing and registration with the United Kingdom Central Council (UKCC). The cohort consisted of 10 students from a large Scottish College of Nursing & Midwifery who were interviewed on five occasions during the three years of their course. Students also kept a diary to record their thoughts and experiences regarding mentorship during their practice placements. In addition, a further seven students volunteered to participate by diary only. Data were analysed with the aid of NUD.IST and subjected to the constant comparative method of analysis. Findings indicate that Diploma students quickly lose their idealistic view of their mentor and over time develop an insight into the qualities they perceive are required of an effective mentor. Students quickly become aware of the importance of choosing good role models and learning their own mentor’s likes and dislikes as they realize this impinges on the outcome of their assessment. As students move into their Branch programme, a gradual distancing from their mentor is evident. This coincides with a development in their confidence, skills and a holistic perspective of care.
Article
In the current chaotic healthcare environment, growth and development of nursing staff is essential to maintain quality outcomes. The purpose of this article is to highlight the concept of mentoring, explain the benefits of mentoring in fostering the development of novice nurses, and present a primer for how advanced practice nurses could implement a mentoring relationship. A three-step mentoring process of reflecting, reframing, and resolving is described with examples of implementation of these steps.
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Mentorship in nursing: a literature review¶ The recent increase in published work relating to the supervision of nurses and in particular mentorship suggests that nurses value the opportunities that such schemes present for developing practice. Much of the literature surrounding mentorship concerns the supervision of students in practice settings but more recently, especially following the changes to post-registration education, attention has shifted to the supervision of qualified nurses. Although the principles of supervision for students and qualified nurses are the same, differences do occur in supervisory practices. This review examines the literature associated with the supervision of student nurses and focuses on the nature and practice of mentorship in practice settings. The literature reveals that confusion exists regarding both the concept of mentorship and the role of the mentor. Many authors propose models or frameworks for mentoring activities. These tend to outline the stages of the mentoring process and the relationship between mentor and mentee. No one model is seen as more appropriate than another and choice usually depends upon the mentor’s familiarity with a particular framework. It is also evident that there is inconsistency in the length and level of preparatory courses for mentors. As yet there is in the United Kingdom no national minimum requirement or common preparation route and in practice mentors are prepared by way of the appropriate National Board Teaching and Assessing module and/or short local 2-day course.
Article
PROBLEM. Hospitals are facing nurse retention challenges in the new millennium. Nurses are abandoning the bedside because of job dissatisfaction. Mentorship programs should be developed to enhance nursing satisfaction and thus improve retention and ultimately patient outcomes. FINDINGS. Mentorship training in hospitals and the support of formal mentorship programs for new nurses are ways in which hospitals can meet this challenge. CONCLUSIONS. This paper offers an overview of recent research on the value mentoring has for participants and healthcare organizations. The components of successful mentorship programs are discussed, and guidelines for implementation are recommended.
Article
The purpose of this study was to examine the experiences of mentees and mentors in a structured mentorship program. A qualitative study using focus group methodology in a nonrandom purposive sample was used. The study was conducted at a level 1 university-affiliated hospital within a 9-bed cardiothoracic intensive care unit. Mentors were identified as Clinical Nurse III's within the institution's clinical ladder. Mentees were identified as Clinical Nurse I's who had no previous critical care nursing experience. To meet inclusion criteria, mentors and mentees had to be paired for at least 10 months before the study. All mentors participated in the study (n = 6) and all but 1 mentee participated (n = 5). Results of this study revealed the following shared perceptions from the mentees and mentors: (1) availability, (2) sense of community, and (3) support and knowledge. This study suggests that mentees and mentors undergo similar experiences and perceptions in a mentorship program despite different roles. Mentorship programs create a unique environment that facilitates the educational opportunities for both the novice and expert clinician.
Article
This study examines the role transition that occurs during RN-to-family nurse practitioner (FNP) education, described in an earlier qualitative study that identified a role transition framework of influential positive forces and obstacles. The purposes of the study were to validate the educational phase of the original framework and explore other role transition issues. The study used a descriptive correlational design by asking all FNPs in two rural western states to participate by answering a questionnaire. Findings evidenced a stronger level of agreement with the positive forces than with the obstacles. In addition, two significant relationships were found between the positive forces and obstacles and personal life circumstances. These included personal support systems, which were significant for those who had to travel to class, and personal sacrifices, which were significant for those who had children at home. Further research will focus on testing across nurse practitioner specialties nationally.
Article
The initial transitional year of professional practice is thought to provide the critical foundation on which new professionals build their expertise. The purpose of this study was to describe the experiences of new nurse practitioner graduates during their first year of primary care practice. Thirty-five persons were interviewed alone or in focus groups at approximately 1, 6, and 12 months after graduation. Grounded theory methodology guided the data collection and analysis. A theoretical model was constructed that represents the transition to the primary care nurse practitioner role. This model consists of a process called From Limbo to Legitimacy, which encompasses four major categories: Laying the Foundation, Launching, Meeting the Challenge, and Broadening the Perspective. Each category contains a set of subcategories that detail the multiple aspects of the experience. This model highlights both the distress and the accomplishments of the initial year of advanced practice.
Article
Nurse practitioners (NPs), frequently called upon by graduate schools of nursing to be preceptors for NP students, are asked to play an active role in the socialization of these students as capable primary care providers. Much is expected of the preceptor in the typical short-term clinical preceptorship with little guidance available to her or him. A mentoring model of clinical education, while representing a longer-term commitment for preceptors than usual precepting arrangements, may ultimately be a more effective model for student learning and more satisfying for the preceptor than currently practiced models. Eastern philosophical principles, very much in harmony with valued nursing approaches to relationships, can provide a framework for examining mentoring as a strategy for promotion of self-efficacy for advanced practice that can be of benefit to both the NP preceptor and the NP neophyte.
The transition from student to primary care practitioner is exciting and challenging and offers seemingly limitless opportunities. This article presents results of a model generated from a longitudinal study of 35 newly graduated primary care nurse practitioners during their first year of practice. Stages of development include laying the foundation (recuperating from school, negotiating the bureaucracy, looking for a Job, and worrying); launching (feeling real, getting through the day, battling time, and confronting anxiety); meeting the challenge (increasing competence, gaining confidence, and acknowledging system problems); and broadening the perspective (developing system savvy, affirming oneself, and upping the ante). Anticipatory guidance is offered for new graduates and their mentors and colleagues. Mentors can provide crucial information about appropriate expectations and create key structures to facilitate new practitioners' needs for consultation and advice.
Article
The relationship between nurse practitioner students and their clinical teachers (preceptors) may have an impact on students' confidence in their ability to take on the advanced practice role of the nurse practitioner. This descriptive, correlational study investigated the relationship between nurse practitioner students' perceptions of mentoring by their clinical preceptors and student self-efficacy. Bandura's Self-Efficacy Theory and Biddle's Role Theory provided the framework for the research. Study results may have an impact on graduate nursing program philosophy, clinical placement management strategies, and preceptor selection.
Increasing competition, health care complexity, threats to quality, and rapidly changing environments confront nurse practitioners (NPs) as they enter the new millennium. If NPs are to strengthen their positions as health care providers and continue to make a lasting contribution, they must exhibit proficiency in creating and managing change. Lessons gleaned from those who pioneered the NP role can provide the wisdom needed to address contemporary role challenges. The purpose of this study was to identify the strategies employed by NP pioneers who contributed to role survival and growth. This article provides a discussion of the change strategies utilized by NP pioneers and highlights their relevance to current practice issues.
Article
The nurse who graduates from a nurse practitioner program leaves a comfort zone of nursing practice to enter a new position where feelings of insecurity and stress are common. Because the role of the nurse practitioner (NP) continues to evolve and is influenced by many environmental issues, the preparation of the NP by the academic institution needs to be assessed on a frequent basis. The purpose of this research was to obtain a better understanding of the transitional phase to the first position as NP after graduation. The perceptions of preparation, gains, losses, barriers, facilitators, and strategies for adjustment were explored. A qualitative approach using focus groups was developed in which 21 recent NP graduates from a large university participated in one of four focus groups. Peer debriefing and participant verification were techniques used to ensure credibility and trustworthiness of the data and subsequent analysis. The themes identified were: loss of personal control of time and privacy; changes and losses in relationships; feelings of isolation and uncertainty in establishing the NP role; and a special bonding with clients. Although the participants perceived they were adequately prepared for their role, they also described feelings of guilt and uncertainty from not knowing information they believed they should know. They concluded that they functioned differently than the physician as well as other nurses and found it necessary to distance themselves from the role of other health care providers. This study has implications for colleagues, academic institutions, and the individual nurse practitioner.
Article
Mentoring, a process thought to be crucial for the novice nurse practitioner during the time of transition to advanced practice, has implications for role socialization and, ultimately, for patient care outcomes. In-depth interviews of mentored or non-mentored nurse practitioner students, drawn from an earlier phase of the present study (Hayes, 1998) and identified as outliers, provided a basis for exploring the meaning of factors that may facilitate or hinder mentoring in the NP preceptor/student relationship. Study findings confirmed and illuminated earlier results (Hayes, 1998) predictive of mentoring, such as time in the practicum, preceptor experience, and choice of preceptor rather than acceptance of faculty assignment. However, NP preceptor/student age differences, student nursing experience, and the tone of the clinical setting can either facilitate or hinder the development of mentoring. Although gender and discipline of the preceptor may be important to many students, a humanistic precepting style may be equally or more important. Understanding factors that facilitate or hinder mentoring will help faculty to better plan clinical experiences, assist preceptors in their potential roles as mentors, and maximize learning opportunities for mentor-seeking students who must navigate successfully in today's cost-conscious, quality outcome-oriented health care environment.
Article
In the current chaotic healthcare environment, growth and development of nursing staff is essential to maintain quality outcomes. The purpose of this article is to highlight the concept of mentoring, explain the benefits of mentoring in fostering the development of novice nurses, and present a primer for how advanced practice nurses could implement a mentoring relationship. A three-step mentoring process of reflecting, reframing, and resolving is described with examples of implementation of these steps.
Article
To address the process of mentoring the advanced practice nurse (APN) and provide suggestions for the formulation, implementation, and termination of the relationship. Research studies from nursing as well as other disciplines and personal experience as a mentor and protégé. Mentoring is a dynamic and complex relationship that can support growth, increase synergy, and develop ways to succeed as an APN. Before entering into the relationship, care should be taken to assure compatibility between the mentor and the protégé. Major pitfalls include poor communication patterns and inadequate identification of objectives. Keys for repair or termination of the relationship include personal introspection, honest and nonblaming communication, and development of alternative support networks. Successful mentoring relationships improve professional growth, competency, and productivity. They also form the basis for ongoing preparation of a new generation of APNs.
Article
Staff retention presents a common challenge for hospitals nationwide. Mentorship programs have been explored as one method of creating environments that promote staff retention. Successful achievement of nurse competencies identified in the Synergy Model for Patient Care can best be achieved in an environment that encourages and facilitates mentoring. Mentoring relationships in critical care provide the ongoing interactions, coaching, teaching, and role modeling to facilitate nurses' progression along this continuum. Mentoring relationships offer support and professional development for nurses at all levels within an organization as well as an optimistic outlook for the nursing profession.
Article
This paper reports data from an evaluation study to determine whether new graduate nurses: (1) were satisfactorily matched with mentors; (2) received guidance and support; (3) attained socialization into the nursing profession; (4) benefited from having a role model for acquisition of professional behaviours; (5) maintained contact with mentors; and (6) were satisfied with the mentorship. The literature indicates that mentorship facilitates transition of new graduate nurses into the workplace and social culture of the organization. In addition, mentoring increases staff retention by decreasing stress and promoting positive self-esteem and confidence. Data were generated from participant responses to survey items about mentoring from 1999 to 2005. Item responses were summarized with descriptive statistics, and then logistic regression was performed to see whether demographic variables predicted successful programme outcomes. In addition, content analysis was performed on respondents' comments on survey items. For participants who met with their mentors on a regular basis (54%), the mentor provided guidance and support for more than 90% and facilitated stress reduction for the majority. On the other hand, comments raised several concerns that apparently contributed to lack of connection between mentor and mentee. These included possible lack of commitment and time, and scheduling constraints of mentor and mentee. Inadequacy of both mentor and mentee in their roles was also apparent, especially in relation to socialization/career advice. Diversity of new graduates, including educational level, age and choice of nursing unit, were shown to add or decrease stress and influence the mentoring relationship. A successful relationship between mentor and resident-mentee requires adequate time for the connection to grow through face-to-face meetings on a regular basis. Obstacles to meeting regularly and adequate role training of both mentors and mentees must be addressed in mentorship programmes for new graduate nurses.
Article
The aim of this study was to elicit student nurses' perceptions of the impact of mentorship on clinical learning. A qualitative descriptive research design was used in the study. A purposive sample of 29 student nurses in their third year of a Diploma Programme (Project 2000) participated in the study. The study was undertaken at a British university. Data were collected by focus group interviews. The interviews were taped and transcribed verbatim by the researcher. Data were analyzed using content analysis. The findings of the study indicated that mentors played a major role in enhancing students' learning through support, acting as role models, performing socialization roles, and acting as assessors. While mentors played a major role in enhancing learning for students, there was a general agreement between students that there would need to be more emphasis on the acquisition of analytic skills and problem solving for students in order to prepare them for the demands of clinical nursing practice in the future. While this is a small study, its findings reiterate the importance of a clinical learning environment, which is conducive to learning.
Article
Nurse practitioners in Victoria, Australia must be prepared to Masters level before seeking nurse practitioner (NP) endorsement. The challenge from a university curriculum development perspective was to develop a programme that prepares the NP theoretically and clinically for their advanced practice role. The aim of this discussion paper is to outline how the internship model was developed and report the students' opinions on the model. The NP students complete the internship with a suitably qualified mentor which requires them to work together to develop and maintain a clinical learning plan, keep a log of the weekly meetings that shows how the objectives have been achieved. The internship includes advanced clinical assessment, prescribing, diagnostic and treatment skills and knowledge related to the nurse's specialty. The clinical assessment tool incorporates the National Competency Standards for the Nurse Practitioner and allows students and mentors to identify the level of practice and set clinical objectives. Students were asked to give feedback on the clinical internship and overall their comments were favourable, reporting benefits of a clinical mentor in their work and the clinical case presentations. The clinical internship allows the acquisition of knowledge and clinical skills in the clinical specialty with an expert clinical mentor in this innovative programme.
Article
This paper explores the role of the mentor in contemporary nursing practice in the UK. It presents findings from a recent study which investigated the impact of a locality-based nursing education initiative on students, practice mentors and academic staff and draws on another study, conducted in the same setting and two Australian sites, to examine the perceptions of nursing students and mentors. Within nursing, mentorship is integral to students' clinical placement experiences and has attracted increasing interest among researchers. Despite a plethora of studies focussing on mentoring and its nature and application within the practice setting, limited attention has been paid to the extent to which guidelines provided by regulatory bodies for nursing inform and influence the practice of mentoring in contemporary health-care settings. The study used a two-phased design with data on mentorship being focussed on the second phase. Data were collected using an online survey questionnaire of pre-qualifying students and a postal questionnaire for practice mentors. The findings highlight the importance of mentorship for prequalifying students and emphasise the need to provide mentors with adequate preparation and support. They confirm previous research, but also highlight improvements in bridging the gap between rhetoric and reality for mentorship. Results are further strengthened when compared with those of the second study. Findings provide new evidence of a narrowing of the gap between the theory and practice of mentoring and for the continuing implementation of national standards to clarify the roles and responsibilities of the mentor. They also suggest the benefits of developing such standards in countries with similar systems of support for nursing students. Mentorship is pivotal to students' clinical experiences and is instrumental in preparing them for their role as confident and competent practitioners.
2008–2009 enrollment and graduations in baccalaureate and graduate programs in nursing
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  • C Tracy
  • G D Bednash
Fang, D., Tracy, C., & Bednash, G. D. (2009). 2008–2009 enrollment and graduations in baccalaureate and graduate programs in nursing. Washington, DC: American Association of Colleges of Nursing.