Nurse Education in Practice 33 (2018) 1–3
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Nurse Education in Practice
journal homepage: www.elsevier.com/locate/nepr
Clinical education
Exploring the intrinsic benefits of nursing preceptorship: A personal
perspective
Tara Lafrance
Registered Nurse, Cornwall Community Hospital, Clinical Nurse Educator, St. Lawrence College/Laurentain University, Canada
1. Introduction
Nursing preceptorship is a strategy widely used in undergraduate
and post graduate clinical nursing education to provide students and
novice nurses reality based knowledge alongside skill acquisition,
confidence, and professional socialization (Happell, 2009; Hyrkas and
Shoemaker, 2007). The literature shows that nursing preceptorship
provides an invaluable source of embedded knowledge, and is an es-
sential component of nursing education (Hyrkas and Shoemaker, 2007;
Smedley et al., 2010). Nursing preceptorship has a long standing history
in nursing education and is reportedly used in Canada (DeWolfe et al.,
2010; Dibert and Goldenberg, 1995; Hyrkas and Shoemaker, 2007), the
United States (Hyrkas and Shoemaker, 2007), Australia (Happell, 2009;
Kelly and McAllister, 2013; Smedley et al., 2010), New Zealand (Korzon
and Trimmer, 2015), and the United Kingdom (Tracey and McGowan,
2015). Nursing preceptorship gained popularity in the early 1980's and
has had a plethora of accounts written on the model and its application
in practice both in clinical and educational settings (Hyrkas and
Shoemaker, 2007). The majority of the literature however, focuses on
the academic framework and the perspectives of the model from the
preceptees' point of view. Perceptions of the preceptors are often
mentioned but focus on the challenges associated with the added re-
sponsibility (DeWolfe et al., 2010; Korzon and Trimmer, 2015). The
preceptor role is multi-faceted, complex and forever evolving, as the
scope and practice of nursing and nursing education evolve. Therefore,
the implications of preceptorship are still not well known (Hyrkas and
Shoemaker, 2007). In addition, the intrinsic elements that contribute to
a preceptor's commitment and desire to participate in such a learning
endeavour are mainly unexplored. Using appreciative inquiry as a
format to highlight positive connections, this article will explore the
intrinsic benefits of nursing preceptorship in an attempt to understand
the preceptors' affirmation to the role, and to motivate and inspire
seasoned nurses to participate in the development of the role in clinical
practice.
E-mail address: tlafrance@sl.on.ca.
https://doi.org/10.1016/j.nepr.2018.08.018
Received 4 May 2017; Received in revised form 21 January 2018; Accepted 26 August 2018
1471-5953/ © 2018 Elsevier Ltd. All rights reserved.
T
2. Background
2.1. History of preceptorship intrinsic value
The first author to identify the importance of internal rewards to
preceptorship was Ellis Turnbull in 1983 (Hyrkas and Shoemaker,
2007). The initial studies related these rewards with the renewed desire
for learning and education (Hyrkas and Shoemaker, 2007). These initial
findings were later enhanced in a 1995 Canadian study by Dibert and
Goldenberg. The 1995 study not only looked at the intrinsic factors of
preceptorship, but at the extrinsic rewards and benefits which included
premium pay, continuing education and appreciation days as incentives
(Dibert and Goldenberg, 1995). Later studies focused primarily on the
extrinsic factor of preceptorship as a means to compensate and over-
come the added challenges of precepting such as: limited time, added
responsibility, and failure to fail (DeWolfe et al., 2010; Korzon and
Trimmer, 2015). Rewards need to be individualized, worthwhile and
provide personal meaning and professional benefits (Benner, 1995). A
closer look at the intrinsic benefits and rewards to preceptors needs to
be viewed in today's environment in order to sustain the preceptor
model and foster the benefits of the preceptor-preceptee relationship in
clinical practice.
2.2. Current need for nursing preceptorship
With individuals living longer, nursing schools and health care
agencies are under pressure to deliver a greater number of trained
proficient nurses into clinical practice (DeWolfe et al., 2010; Kelly and
McAllister, 2013). International literature suggests that stress, burnout,
and difficult transitions associated with new graduates entering clinical
practice, are associated with decreased retention. Preceptorship is a
significant relationship that supports new graduate nurses into practice
and is key to sustaining the workforce (Korzon and Trimmer, 2015;
Tracey and McGowan, 2015). Various organizations internationally, are
responding to this supply and demand issue by providing new graduate
initiatives and preceptor programs for new hires that provide one-on-
one training for periods of upwards of six months (Health Force
Ontario, 2015; Tracey and McGowan, 2015). As well as assist seasoned
nurses in maintaining their professional responsibilities and
T. Lafrance
accountability to continued competency in compliance with current
nursing practice standards. That require nurses to remain updated and
share knowledge with colleagues to contribute to the future of the
profession (CNO, 2002; Korzon and Trimmer, 2015). With today's
precepting demands centering on the support and transition of new
graduate nurses in clinical practice the focus of this article will be on
the intrinsic benefits that preceptorship provides to the precepting
nurse, to further inspire seasoned nurses to participate in nursing pre-
ceptorship in their professional clinic practice.
3. Appreciative inquiry
3.1. Discovery
The first of four phases of appreciative inquiry is discovery.
Discovery looks at current preceptorship models in real clinical practice
and looks to focus on the “best of what is” in current practice
(Cooperrider and Srivastva, 1987). The most commonly used strategy of
discovery, is the use of stories. Stories are narratives that are shared to
highlight what makes the system work and showcase appreciation and
values that reinforce the preceptor's commitment to the transfer of
knowledge from oneself for the benefit of the preceptee and the pro-
fession of nursing (Cooperrider and Srivastva, 1987; Daft, 2015).
Personal reflection. As a relatively new nurse in my sixth year of
nursing, I was working in critical care in a temporary full time position.
While working in this capacity I was approached by management to
take on a new graduate for an extended orientation process for our unit.
I had some experience with clinical education in the undergraduate
program, but this was the first time I had been approached to assist in
the transfer and assimilation of knowledge and skill with a newly
graduated nurse. Over the course of the orientation process, the pre-
ceptee and myself developed a working friendship. We had similar
personal backgrounds that brought nursing as an appealing profession
for us both. I found her easy to relate to, therefore making commu-
nication simple and the transfer of knowledge was well received.
During the orientation process, she would question the processes of the
profession that had become second nature or accepted for the way
things are providing an opportunity to reflect and question as to whe-
ther this remains the best practice standards. I taught her that chlor-
hexidine is the new and better solution to sterilize central line ports
versus alcohol swabs and she taught me that in the process of Foley
catheterization, it is no longer necessary to test the bulb prior to in-
sertion that this is now thought to degrade the integrity of the product.
The preceptee continued to ask questions and probed into ideas that I
had not thought or considered since I myself was a student, reigniting
my passion for the profession. The preceptor-preceptee experience
proved to be pleasing and informative for both parties involved.
Identification of intrinsic themes. Assignment of the preceptor
role itself, is considered an acknowledgement by peers and manage-
ment of the preceptor's abilities as a clinical nurse, instructor, and of
their professional demeanor. Considering the preceptor described
above was a junior nurse the distinction of such an assignment re-
inforced her competencies and is perceived as rewarding (Hyrkas and
Shoemaker, 2007).
The pairing of like-minded individuals and the development of the
preceptor-preceptee relationship, lays the ground work for the devel-
opment of a professional connection amongst colleagues in future
practice. This leads to professional collaboration, teamwork in clinical
practice, and a shared sense of belonging and acceptance while building
the potential for friendship outside of the workplace (Happell, 2009;
Kelly and McAllister, 2013; Korzon and Trimmer, 2015; Tracey and
McGowan, 2015).
Reciprocal learning is highlighted in the personal reflection, re-
cognising the need for understanding the methods of one's current
practice, and ensuring the transfer of current and safe practices.
Preceptorship also provides the opportunity to seek academic
2
Nurse Education in Practice 33 (2018) 1–3
knowledge from a generation of nurses who have just completed studies
on the most recent and up to date standards available. Similarly, pre-
ceptorship allows for witnessing preceptee enthusiasm and passion for
the new knowledge and opportunities to perform skills for the first time
as a new practitioner. This regenerates the lens in which the preceptor
views their roles and ignites their passion for nursing (Happell, 2009;
Kelly and McAllister, 2013; Korzon and Trimmer, 2015; Tracey and
McGowan, 2015).
3.2. Dreaming
The second phase of appreciative inquiry is dreaming. The dream
stage is focused on ideas of “what might be” (Cooperrider and
Srivastva, 1987). Building on the narrative and positive themes in the
discovery stage, the dream stage looks to create a shared vision of
compelling images for the future of preceptorship in nursing education
(Cooperrider and Srivastva, 1987; Daft, 2015).
Personal reflection. Upon completion of my preceptee's orienta-
tion, she was offered a regular part time position in my unit. The pre-
ceptor-preceptee relationship expanded to colleagues in the work en-
vironment. We worked well together. Her work ethic was an extension
of my own. It is reassuring having team members that you can depend
on. Having worked with the preceptee closely for such an extended
period of time, I could be confident in the skills, and knowledge set that
she acquired to meet the safety and quality care needs of the patients
we serve in clinical practice. I feel that I played a vital role in the de-
velopment of those positive attributes of the preceptee. Not only do I
feel that through preparing my preceptee for clinical practice I con-
tributed to a better work environment for myself, and my patients, I
have also contributed to the future of health care by securing and
supporting new staff in transition into professional practice; thus in-
creasing the chances of retaining their post. Along with creating my
own legacy in my professional practice the skills I have passed on to my
preceptee will later be passed on to others when she contributes to her
professional responsibility of sharing knowledge with future genera-
tions of nurses.
Identification of intrinsic themes. Through preceptorship, a joint
respect is obtained through recognising characteristics that make for a
valuable team member and future colleague in the nursing workforce.
There is a feeling of satisfaction associated through the support and
observation of the development of the preceptee from watching them
grow; knowing that you helped play an integral role in the development
of their ability to stand for and work on their own. There is additional
value seen as being an active participant in the solution to securing
adequate numbers of well-prepared nurses to meet health care needs,
decreasing burn out in your work environment, by recruiting and re-
taining additional trained staff to support colleagues to ensure adequate
staffing and reasonable workloads (Happell, 2009; Korzon and
Trimmer, 2015; Tracey and McGowan, 2015).
Everyone wants to know that their life has purpose. Nursing itself is
a noble profession dedicating our time and effort to caring for others.
By passing our knowledge on from one generation of nurses to another,
we create a legacy that will sustain time. We will forever leave a
footprint on the future of health care (Happell, 2009; Korzon and
Trimmer, 2015; Tracey and McGowan, 2015).
3.3. Designing and destiny
The final two phases of appreciative inquiry are designing and
destiny. It is in these two phases where a vision of preceptorship is
developed into an action plan of “what should be” to create “what can
be”, to foster a sustainable preceptorship model that highlights intrinsic
rewards to entices seasoned nurses' involvement in the development
and transition of nursing knowledge from one generation to the next
(Cooperrider and Srivastva, 1987).
Personal reflection. Following the preceptorship process, the team
T. Lafrance
I worked with had a celebration. We brought in cake to commemorate
the completion of the preceptees orientation period and her official
transition to nursing practice. Everyone welcomed the preceptee as an
equal member of the team. The preceptee presented me with a heartfelt
gift and card thanking me for the time, effort and faith in her that I
provided over the orientation period. In addition, management pro-
vided me with a certificate acknowledging my service and commitment
to the development of nursing knowledge in practice.
Identification of intrinsic themes. The above reflection might
appear to be full of extrinsic rewards for the preceptor's time and energy
placed during the orientation process. However, each of the extrinsic
elements represent a higher intrinsic value. The celebration that in-
cluded cake and acceptance of the preceptee as one of their own pro-
vided the preceptor with recognition and affirmation by their peers that
management made a good choice in selecting them as preceptor, that
they were successful in their role and truly possesses the necessary skill
set for preceptorship (Hyrkas and Shoemaker, 2007).
The personalized thank you card from the preceptee and certificate
of acknowledgement from management represents appreciation and
acknowledgement of the additional efforts and emotion that the pre-
ceptor put into the growth and development of the preceptee and their
work environment. Receiving intrinsic rewards that represent ac-
knowledgement reinforce all other intrinsic rewards throughout the
preceptorship experience and as such should be highlighted in order to
contribute to the retention and recruitment process of such a model in
clinical practice (DeWolfe et al., 2010; Hyrkas and Shoemaker, 2007).
4. Discussion
4.1. Recommendations for future practice
Preceptorship plays an invaluable role and is associated with mul-
tiple benefits for the organization, the preceptee as well as the pre-
ceptor. It is evident that partnership and collaboration amongst stake-
holders is an essential component of the preceptor model.
Acknowledging that the production of knowledge, skill and socializa-
tion is a shared responsibility and can be fostered through the right
pairing and support of the preceptor in practice (Happell, 2009; Hyrkas
and Shoemaker, 2007). This article raises awareness of the intrinsic
value rewarded to the preceptor through the implementation of a pre-
ceptor model in practice. Additionally, research and attention should be
placed on the perceptions of the other stakeholders to complete a
comprehensive picture of the model in practice. Recruiting, selecting
and maintaining passionate preceptors to develop and promote the
socialization of novice nurses in clinical practice in order to maintain
preceptor programs and sustain nurses for future health care needs; can
be accomplished through sharing stories that highlight the intrinsic
rewards one obtains from the process (DeWolfe et al., 2010; Hyrkas and
Shoemaker, 2007). It would be recommended for organizations to
provide a platform for sharing positive experience with preceptorship
to strengthen and enrich such programs in their clinical practice en-
vironment.
Nurse Education in Practice 33 (2018) 1–3
5. Conclusion
Appreciative inquiry is a valuable tool that managers' can use to
entice preceptors to reflect and find the intrinsic rewards within their
experiences. It will give managers the answers to what works, how it
can be improved and find ways to collaboratively focus on positive
elements to design and sustain a preceptor program that fits their or-
ganization. Intrinsic rewards to the preceptor as viewed from the per-
sonal perspective identified are: acknowledgement of skill and ability,
preceptor-preceptee relationship/friendship, reciprocal learning, pas-
sion, satisfaction, helping, legacy, and affirmation. These rewards are
merely the result of one experience of one preceptor. Personal reflection
and sharing of positive experiences amongst colleagues is encouraged
to augment positive associations with preceptorship in clinical practice.
Conflicts of interest
None.
Funding source
None.
Ethical approval
Not applicable.
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