Introduction
Nursing school prepare graduates to undertake care duties successfully and competently. The college focuses on scientific inquiry, evidence-based care, problem-based pedagogy, and patient engagement to fulfill educational objectives. Nonetheless, there is a gap in the ability of novice nurses to work just after graduation. Recent graduates lack some competent core nursing skills required for their roles. In addition, there is a mismatch between preceptors ‘expectations and nurse managers’ and new nurse abilities. This project determines the effects of education module on preceptors and novice nurses working in acute care.
DNP Project Synopsis
The Lack of adequate preparation for new graduates to undertake their duties results in adverse outcomes. For instance, high depression and stress levels, high turnover rates, risks to patient safety, and increased cost to the employer have been attributed to poor transitioning from a student to an employee (Mattney et al., 2016). Ineffectively prepared nurses are not likely to excel and retain in their positions. Consequently, an increase in job turnover rate is experienced because they work under duress and stress, additionally; their ability to function optimally is curtailed.
Preceptor and nurse residency programs are utilized by hospitals to facilitate on-the-job remediation for new nurses. These courses are very expensive but are worth undertaking because they decrease turnover rates and adverse events by improving job satisfaction. The preceptor theory approach commonly utilized to deliver the skills is usually tailored to the needs of novice careers. Although this model has been shown to correct deficiencies and minimize stress, it is currently unknown whether this educational intervention increases preceptor satisfaction in regards to critical thinking. In addition, whether cognitive competence for new employees is improved after the course is unknown. This DNP project aims at assessing the impacts of the education program on the preceptor and new nurses based on performance.
In this project, novice nurses will be required to undertake a 12 months residency training program before working at hospital. The program also offers standardized, structured, and formal classes for expert nurses serving as preceptors. The nurse leaders have already identified the areas requiring educational interventions. Data will be collected from newly hired graduate nurses in the program and the senior ones acting as trainers through questionaries, which will be analysed later. The variables of the study to be measures will include the knowledge increase in novice nurses, the satisfaction rate of the participants, preceptors’ competence, and satisfaction based on self-assessment.
Project Problem
Newly graduated nurses have difficulties coping with the work environments, there has been an unexplained rise in novice nurses’ turnover rates within the first six months of employment (Kurniawan et al., 2019). This occurrence has provoked a need for educational intervention. Although the benefits and outcomes of the preceptors program to a novice have been elucidated, less is known regarding satisfaction, morale, and support available for preceptors. Thus, there is a need to augment the preceptor education program and assess the benefits based on satisfaction and competence gained for both the trainer and trainee.
The PICO question is: For nurse preceptors working in acute care, what is the effect of an education module on teaching critical thinking skill to newly graduated nurse on preceptor satisfaction pre-and -post the learning module? The objectives of this study include increasing preceptor satisfaction and competence, improving novice nurses knowledge, and increasing novice nurse critical thinking and analytical skills.
Purpose
In this project, the principle researcher needs to ascertain whether preceptor programs make new nurses more comfortable in their work places. In addition, whether the training is necessary and the impacts it has on independent functioning, critical thinking, and confidence among the trainees has to be established. Information regarding self-perception of preceptors in the program will be documented.
Theoretical Framework
The theoretical framework provides a procedure of connecting ideas to be utilized in developing knowledge supporting a nursing practice (Mattney et al., 2016). Wisdom is a critical aspect in care practice that is cultivated through life experiences, understanding, and judgment. Its application is guided by theoretical models that bring consistency by putting structures into relationships in nursing constructs (Mattney et al., 2016). Patricia Benner’s theory and Dreyfus model will be used for this study.
Patricia Benner’s model describes the stages of professional growth, it focuses on ways of learning how to care for rather than becoming a nurse. She proposes that one can be a skilled nurse without learning the theory part. Learning is achieved through experiences and education (Murray et al., 2019). Benner utilized the Dreyfus Model of Skill Acquisition model to develop her theory, which was formed after a realization that experts in different occupations learned through experimentation.
According to the Dreyfus model, a learner’s progression during professional development is portrayed as a theoretical field of skills acquisition from novice status to an expert. Novice workers follow directions strictly without thinking critically because in most cases they focus on task completion without considering the objectives (Kurniawan et al., 2019). An interest in results is cultivated gradually as students pass through different stages from advanced beginner, competent performer, and proficiency consecutively.
The expert stage is characterized by intuitive activities performed unconsciously from experimental learning. Both Benner’s theory and Dreyfus model concepts are based on the learning of nurses (Murray et al., 2019). They both suggest that efficient skills progression in nursing depends on exposure to practical learning as well as education. The theories are applicable in this project because novice nurses as expected to gain expertise cumulatively over time in the preceptorship program.
Components of Benner’s Theory
Benner’s theories classify nurses’ experience into four categories, which are a novice, advanced beginners, competent, and expert level. A novice refers to a new nurse just after graduation or one delving into an area requiring different expertise. They are not able to foresee possible outcomes and aspects of clinical conditions due to lack of exposure, thus, they should be supervised and engaged in hands-on training. Advanced beginners are those with education and insufficient experience to base their clinical decisions. In most cases, freshly graduated nurses who have participated in internship programs fall under this category.
Competent refers to those nurses who have begun to gain some experience, they can recognize developing patterns or deteriorating events in a patient. In this phase organizational skills and the capacity to recognize non-fitting events are cultivated. Proficient ones are alert to developing patterns and they can adjust therapies based on the patient’s situation. In this stage, intuition is utilized according to experiences, and decisions are guided by the desired outcomes and previous results (Kurniawan et al., 2019). Expert is the highest cadre of development, where one can analyze situations according to their experiences before making plans and commencing the care process. In addition, they may also act on their intuition to decide on actions that can give a desirable outcome.
Application of Theory to the DNP Project
The continuum of phases in Benner’s theory can be used by preceptors to determine the kind of training required by a particular nurse. This model evidenced that skilled nurses gain more competencies and understanding of patients’ situations through experience and education advancement. This idea was used as a model successfully by Thomas and Kellgren, (2017) in the interactive care development using simulation study. It can be applied to students’ nurses and facilitators who desire growth to an expert level.
The model applies to novice nurses enrolled in the preceptorship program; this group has theoretical knowledge of how to approach situations in the hospital (Thomas & Kellman, 2017). This education program is expected to augment their critical thinking capacity and their ability to anticipate events associated with decisions made. For instance, if a patient becomes dizzy, a novice will ask for help and follow instructions from a senior nurse. However, an advanced beginner will act swiftly by drawing blood intravenously because it is part of a process, while a competent one will think about what might be needed for further action. A proficient care provider will assess the patients’ protocol order in case of delays from a physician. Nonetheless, an expert would evaluate the symptom, determine differential diagnosis, and ask the doctor for appropriate directions in regards to the observations.
Teaching and Learning Theories
Preceptorship is vital for novice nurses because it ensures that quality care services are delivered in the hospitals. In this DNP project, teaching and learning theories will be applied to increase preceptor satisfaction and competence. Cognitivism and constructivism theory is based on the critical thinking and information processing ability of the learners. The constructivism approach focuses on the effects of individual experiences on learning activities. In this case, learners with different perspectives perceive new knowledge differently. Thus, preceptor education will be a self-discovery process where novice nurses will apply knowledge and skills accessible to them. On the other hand, cognitivism methodology suggests that reflections and connection to prior information improve knowledge acquisition. In relation, to the DNP project, novice nurses are expected to build further skills and from the theories learned in nursing school.
Social constructivism theory highlights the importance of both the student and preceptor in a program. The principle suggests that since learning occurs as a result of language utilization and social interaction, it is a collaborative process facilitated by shared experience (Mitchell et al., 2018). The concept of this theory is based on teachers guiding the students to support development through activities and duties that bridge the knowledge gap between experts and novices. In this project, the application of this theory in the training will help new graduate nurses to obtain several unfamiliar skills and knowledge. The information and expertise obtained will aid in reducing medical errors and stress levels, which will result in low turnover rates and increased job satisfaction.
Conclusion
Learning takes place as a response to stimuli, education intervention acts like reward system. A positive change in the students’ performance will be a reflection of positive reinforcement. Since the practical part will be demonstrated by the preceptor, knowledge gained will be attributed to the teacher’s effort to increase satisfaction levels. The application of Benner’s and Dreyfus model in the project is expected to produce positive results such as job satisfaction in all the project participants. Thus, from the results the employers may need to organize training sessions for novice nurses.
References
Kurniawan, M. H., Hariyati, R. T. S., & Afifah, E. (2019). The relationship between caring preceptor, self-efficacy, job satisfaction, and new nurse performance. Enfermeria Clinica, 29, 464-470. Web.
Mattney, S., Avant, K., & Staggers, N. (2016). Toward an understanding of wisdom in nursing. Online Journal of Issues in Nursing, 21(1). Web.
Mitchell, A., Lucas, C., Cisar, P., Wilson, K., & Bowe, J. (2018). Mentoring novice nurses in healthcare organizations. Journal of Medical Science and Health Research, 2(1) 91-96. Web.
Murray, M., Sundin, D., & Cope, V. (2019). Benner’s model and Duchscher’s theory: Providing the framework for understanding new graduate nurses’ transition to practice. Nurse education in practice, 34, 199-203. Web.
Thomas, C. & Kellgren, M. (2017). Benner’s novice to expert model: An application for simulation facilitators. Nursing Science Quarterly, 30(3) 227-234. Web.