Sjuksköterskan som handledare. Innehåll i och förutsättningar för sjuksköterskors handledande funktion i verksamhetsförlagd utbildning - en etnografisk studie

Sammanfattning: Nurse education has undergone major changes during the last three decades, internationally as well as nationally. It is assumed that new and different nursing competencies will be needed in a rapidly changing society. This implies that undergraduate nursing education will have to address issues like life long learning and problem solving skills, and provide students with cognitive and interpersonal tools to support this process. Clinical education, where clinical nurses precept students in a one-to–one relation preparing them for their coming profession, seems to be a significant part for this process to occur. To a much lesser extent, nurses also participate as preceptors for students from divergent professions at clinical training wards during interprofessional education. For all the above reasons, nurses need to be prepared to precept students entering clinical practice with different knowledge and skills. Preceptorship also entails for nurses to create a learning climate where students are given opportunities to merge theoretical and practical knowledge as a mean to develop professional competence. In addition, precepting usually takes place in the stressful and demanding area of a clinical setting. Therefore, nurses’ precepting function and the conditions influencing precepting will be vital to ensure a high academic standard throughout the entire undergraduate nurse education programme. The overall aim was to describe content of and conditions for nurses´ precepting function during clinical practice within the undergraduate nurse education programme. The thesis presents findings from an ethnographic study guided by symbolic interactionism. Data collection was conducted through participant observation, focus group interviews and individual interviews. Findings showed that precepting was a continuous process during which preceptors used several teaching techniques, cognitive as well as perceptual. Preceptors mostly mediated a content of medical and technical character. However, preceptors also stressed the caring aspect of nursing and described how they supported students in understanding possibilities and limitations of their coming profession. Supportive organizational routines, cooperation with colleagues and a well functioning collaboration between clinical and educational settings was also shown to enable preceptorship. Time or rather lack of time was the main limiting condition for precepting nurses as precepting was parallel to ordinary clinical duties. During interprofessional clinical education precepting was steered towards collaboration and independent work for the student teams. As precepting was the primary responsibility for nurses at the clinical training ward lack of allocated time was not discussed as a hindrance. This thesis has illuminated the complexity of the precepting function for nurses. To precept students during their clinical training, calls for pedagogical competence and sufficient time allocated for precepting. This implies that continuous collaboration between all stakeholders involved in clinical practice is needed to ensure a nursing education that fulfils the demands of an academic programme.

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