This proposal explores the experiences preceptors go through when training nursing students within a clinical setting. It will demonstrate the critical role of preceptors in helping nursing students gain experience in healthcare facility settings and achieve personal and professional growth. Today, preceptorship has been integrated into nursing education programs. The lack of sufficient preceptorship programs makes nursing students report various cases, such as bullying and professional sabotage and undermines the goals of preceptorship programs. Facing such challenges can influence students’ academic performance and self-confidence, hampering their professional growth. While Saudi Arabia has relied on foreign professionals to serve their healthcare sectors, the sector stakeholders have revealed how preceptorship programs can bridge the workforce gap by reducing the nurse shortage in the country. The research benefits the healthcare sector because it will identify the challenges nurse practitioners go through when training nursing students to become reliable nurse practitioners. The study will help determine the literature gap and recommend strategies to streamline the healthcare sector in Saudi Arabia. The literature review will be critical in exploring what past authors revealed regarding the topic. Their insights will help establish the literature gap around the preceptor’s experiences. The qualitative method will be the central methodology of the study, utilizing a qualitative descriptive design. Data collection will be completed through semi-structured interviews because time is limited. The research will be conducted at King Fahad Hospital, Saudi Arabia. The data will be analyzed through thematic analysis to make a viable conclusion for the study.

Introduction MAKE IT AS (700 words)

Nursing students need to develop critical thinking and other abilities to plan, carry out, and evaluate their everyday nursing care. Acquiring skills essential to becoming self-sufficient professionals and delivering high-quality, safe, evidence-based care is crucial for their educational and professional journey. Saudi Arabia has been in the limelight because it lacks enough certified nurses. Foreign nationals comprise a sizable share of the nation’s nursing employment. Alharbi and Alhosis (2019) estimate that around thirty percent of Saudi nationals are nurses overall. Social causes, the educational system, and individual pressures are only a few reasons for this shortfall. The transformation of students’ knowledge into practice via education, particularly in clinical experience, has been highlighted as a critical aspect (Rosli et al., 2021). To support clinical decision-making and advance nursing professional growth, clinical experience in various settings is required.

According to Omer & Moola (2019), preceptors have essential responsibilities in students’ lives, such as providing one-on-one coaching at random and ensuring students’ actions reflect professional ethics. They serve as student nurses’ mentors, instructors, and coworkers (Mhango et al., 2021). In helping and inspiring students to become self-reflective, independent learners, preceptorships require the preceptor’s commitment, time, and attention (Carlson & Idvall, 2014). Recent reviews revealed that most preceptors noted that the training was labor-intensive and highly stressful. Nonetheless, it is one of the most creative approaches for integrating new nurses into the system while upholding healthcare’s professionalism and nursing culture (Omer & Moola, 2019). Preceptorship is a process that marks the shift from student to professional, according to Omer and Moola (2019). According to studies conducted in Saudi Arabia, positive preceptorship training improves the number of nursing professionals and narrows the theory-practice gap. Saudi Arabian nursing schools have included preceptorships in clinical practice during the past thirty years to improve education and training.

In nursing preceptorship, some nurses offer guidance and may have had a bad experience with the students whom they guide. A good example is Jimenez (2015), where a student nurse tells the story of her beautiful memories of her guide preceptor, who passed away long after learning nursing guidance. From the experience of Jimenez (2015), it was evident that the guidance has been practical and remarkable in increasing the readiness of the guide preceptor in training nursing students. Jimenez (2015) states that the preceptor was firm in making decisions and did not allow for “nonsense.” However, she cared for and defended the nursing students each time they failed to meet other healthcare expectations but later offered guidance that helped them stand up to standards. She realized the students were far from becoming as perfect as her experienced reason counterparts and stood for them when not fast enough. On the other hand, she gave directions and advised on situations until when the students were nearly professionals.

Maybe some other bitter experiences of nursing preceptors, on the contrary, end up as hindrances in some nurses’ careers. For instance, according to Nurse.com (2011), one of the examples in the story was a scenario where the student feels bullied and sabotaged professionally by their guide preceptor. In the story, the student and the guide preceptor seemed to compete for who was doing better than the other, with the guide preceptor making sure that every time she got a chance, the student had to be belittled. In the story, the nurse supposed that the student tried to show her that she was competent, but the student tried hard to catch up fast as she expected much learning from the guide preceptor. The case was a competition rather than teamwork to the extent that the student requested another preceptor. Therefore, the management humiliated her to the extent that she was forced to resign, which destroyed her career. It failed in a significant area many employers require before being offered employment. Not only that, but this made her liable for future workplace instability, as she already had a track record that always put her on probation. These are just some of the stories found online about nursing preceptors. At the same time, the same is making nursing preceptorship popular as many countries are adapting it from areas where they have seen it work.

Over the years, myriad studies have been done on the experiences of nurse preceptors and preceptors in diverse settings. Öhrling and Hallberg (2001) report that preceptorship sought to heighten student learning and empowerment during clinical studies. Raines (2012) explored the nurse preceptors’ perspectives on precepting undergraduate nursing students. The study identified two factors that might foster or impede nurse preceptors’ will to precept prelicensure nursing students in clinical settings: engagement within the educational process and recognition of the student’s efforts and qualities (Raines, 2012). Girotto et al. (2019) further researched the views about the role of preceptors among educators and professionals.

The study reveals that preceptorship is described as one of the chief educational activities of a clinical environment applied with different types of active learning techniques in implanting knowledge in the learners. In 2021, Ong et al. conducted a qualitative study using a descriptive approach that identified the significance of nurse preceptors as vital parts of creating the future batch of nurses and studying to develop the training done for nurse preceptors that is significantly important (Ong et al., 2021). Nurse preceptors should be given more heed and favor for their professional growth, which would incorporate courses that would improve their knowledge regarding educational and research advancements, along with teaching seminars to develop effective relationships with their preceptors.

Problem Statement

Even though massive hurdles and differences observed in the quality of preceptorship experiences are still manifested within clinical settings, particularly in Saudi Arabia, an increasing awareness of nurse preceptors’ importance in guiding nursing students with their professional growth is witnessed. Preceptorship is being added to the nursing education programs. However, several crucial implications need to be sorted out for the preceptorship program to be successful and have its intended effect. Additionally, the help and guidance that nursing students receive differ because there is an apparent lack of standardization in training and support for the nurse preceptors, as Raines (2012) states. A lack of consistent training and continued professional development of preceptors provides a variety of teaching approaches, student feedback systems, and overall educational experience.

The ways through which bad preceptorship experiences that nursing students report, such as professional sabotage, bullying, and lack of support, thereby undermine the purpose for which the preceptorship programs are designed to achieve. Such encounters also undermine the self-confidence and academic performance of the students, in addition to hampering the students’ professional growth and general well-being. They may even discourage them for this purpose in the future. Further, the shortage of registered nurses in Saudi Arabia because of reliance on foreign nurses adds more reason to spur efforts recollected towards preceptorship programs to build an adroit sustainable nursing workforce that can make up Saudi Arabian nationals (Ong et al., 2021). The country will continue to grapple with the need for qualified healthcare personnel and the provision of patient care unless largely ineffective preceptorship programs that answer the specific cultural and professional demands of the nursing students are instituted. In enhancing nurse preceptor recruitment, training, and supportive systems, creating conducive learning environments, and improving excellence in nursing education and practice within Saudi Arabia, there is a need for concrete research to explore keen interventions that are not limited to this possibility.

Significance of the Study

While studies on nursing preceptorships and their related subjects are expanding worldwide in literature, they are still relatively less focused than the locally-driven research or evidence-based practices conducted in Saudi Arabia. Although a few studies have touched on preceptorship and nursing education from the Saudi context, the desire for in-depth evaluations and analysis of issues maintained within the country’s unique social, cultural, and medical environment remains visible (Mhango et al., 2021). So, the literature that is being published may not fully encompass all of the complex needs and realities of nursing and preceptorship in Saudi Arabia. It emphasizes appropriate research in a contextually proper manner to address the unique opportunities and challenges getting implemented into the nation’s healthcare system. This paper, therefore, adds to the existing literature gap by providing a comprehensive analysis and recommendations based on the Saudi context for future research and policy initiatives regarding nursing education and practice in the Kingdom of Saudi Arabia.

The significance of this problem is the urgent need for qualified and competent nurses even before considering nursing practice experience. The preceptors are critical stakeholders in ensuring that responsible nurses start to practice possessing the necessary qualifications and competence demanded in the nursing profession. Using preceptors provides some evidence-based background on a student’s qualifications (Mhango et al., 2021). It makes it possible for the students to relate to most of the experiences they are about to meet professionally. Having a problem in the nursing preceptorship means a problem in the evidence-based principles required at the beginning of practice. Nevertheless, the most notable factor affecting the clinical learning experience is the relationship between preceptors, often experienced nursing staff, and nursing interns. Nursing students have always recorded poor interpersonal skills with clinical staff and preceptors, leading to many nursing students abandoning the program.

Operational Definition

Preceptor: A preceptor is described as an experienced registered nurse who assumes varying roles, including mentor, tutor, and guide to student nurses throughout clinical rotation. The preceptors are relevant in the nursing education world. Preceptors exhibit a lot of clinical knowledge, skill, and experience in their areas of specialization.

Nursing Preceptorship: Preceptorships are an organized teaching strategy in nursing education programs. The primary objectives of a nurse preceptorship are to foster professional development, help nursing students gain and develop critical thinking and clinical judgment, and facilitate bridging the theoretical and actual practice (Mhango et al. (2021).

A Nursing Student: Someone who undergoes a nursing course such as a Bachelor of Science in Nursing (BSN), our variable in this study. Nursing students take clinical practicums and theoretical courses to inculcate the routines, knowledge, and skills needed to be qualified as a professional nurse (Mhango et al., 2021). Nursing students apply academic concepts, develop clinical reasoning abilities, and refine their nursing skills in different healthcare environments during experiential clinical experiences with the support and guidance of preceptors along the educational path.

Clinical Experience: Clinical experiences are the learning experiences that nursing students engage in within hospitals under the direction of clinical teachers and preceptors. It involves interprofessional collaboration, administration of medicines, health screening, direct care of patients, and curative activities. With practical training, new nursing students can apply their theoretical knowledge, develop and refine excellent clinical reasoning skills, enhance their interpersonal and communication skills, and indulge professionally in actual clinical conditions (Mhango et al., 2021). It ensures that it bridges the gap between professional practice and classroom instruction and equips students to enter the nursing field, making it an essential element of nursing education.

Theoretical Framework

A volume of theoretical frameworks supporting nursing education, preceptorship dynamics, and professional growth enriches the research on nursing preceptorship in Saudi Arabia. According to Albert Bandura, the Social Learning Theory provides a fundamental basis for people to learn new behaviors, skills, and information through modeling, imitating, and observing others (Rotter, 2021). Following this point, nursing students accumulate their knowledge based on the experience of the preceptors, their actions, and tips during the nursing preceptorship. By seeing the clinical practices of preceptors, they absorb professional ideals, ethical norms, and clinical competencies that shape their professional identity, critical thinking, and clinical reasoning. To make it concrete, the Adult Learning Theory, also known as Andragogy, developed by Malcolm Knowles, emphasizes the significance of active learning, self-directed learning, and relevance to the experiences of adult learners. It becomes considered beneficial to nursing students since they are adult learners, and they benefit when they engage in their learning by applying theory to practical clinical situations. A preceptorship program based on these pedagogical concepts would motivate nursing students to be reflective of self and autonomous with a lifelong learning commitment. In doing so, they take initiative in their studies and acquire independent nursing practice skills.

In professional organizations, nursing students attach themselves to experienced preceptors with whom they address real issues while actively participating in meaningful activities and interactions. Effective nursing practice requires that the student is equipped with situational awareness, clinical judgment, and networks that facilitate professionalism. These are acquired during active patient care involvement and multidisciplinary teamwork engagement. This study aims to explore nursing preceptorships’ complex dynamics amidst the unique socio-cultural context of Saudi Arabia’s healthcare system and do so by fusing various theoretical orientations, acknowledging arising challenges and opportunities for development, and proposing informed practice-based approaches.

Aim and objectives of the study

This study aims to explore preceptor experiences during clinical training for undergraduate students. The study objective is to explore the experience, challenges, and barriers preceptors face while assisting nursing students in completing their clinical rotations.

Research Question

Nursing preceptorship is of broad consequence to the students who are positively or negatively impacted concerning their professional development. Some nursing students tend to exit from those programs after having experienced negative preceptorship that traumatizes them. This conclusion arises from some underqualified preceptors and uncooperative students, making it challenging to coordinate through the process. With these elements, this research analysis will focus on the preceptors’ experiences while training the students. Thus, the main research question is: What experiences do preceptors pass through while teaching nursing students in clinical settings, and how could the outcome be more favorable?

Literature Review: MAKE IT AS(1000- 2000 words)

This section should include a short justification for the proposed research study. The

literature review must show evidence of wide reading and analysis, synthesis, and

evaluation of research findings. It should contain the following:

Provide evidence of a systematic approach to searching the literature (i.e., Medline,

Web of Science, Psychinfo, etc.)

Use various search techniques (i.e., manual, computer, library, local documents,

Government papers, other Reports, etc.) and using research literature from different

disciplines (i.e., Psychology, Sociology, Physiology)

Provide evidence of a range of international, national, and regional empirical studies
You must critically evaluate these studies, indicating their strengths and weaknesses

employed within such studies

This section’s literature study aimed to respond to the research question. The review’s primary goal is to pinpoint pupils’ positive and negative aspects that inspire or demotivate preceptors to instruct others in the future. The answers reveal the preceptors’ capacity to overcome adversity, achieve their objectives, and deal with the challenges of providing instruction. Getting the resources utilized in this part was similarly a simple procedure. Priority was given to peer-reviewed publications since they are trustworthy and can provide insightful information. Respectable libraries and other internet resources were also utilized to ensure various opinions and representation of areas.

Google and Google Scholar were the primary search engines used for the information search, which included the terms “nurse preceptor,” “preceptor experience,” “preceptorship,” and “clinical experience.” On the other hand, reliable publishers and libraries that are reliable sources of nursing information were mentioned, including Pubmed, JBI EBP, and Clinical Key. Only publications published between 2014 and 2023 (the period considered in other evaluated literature) were included in the search parameters. 495 English-language publications from various sources, including full-text, research papers, and qualitative designs, comprised the whole sample that was retrieved using the PubMed database. Five hundred-three articles from different English sources, including full-text, research papers, and qualitative designs, comprised the entire sample from Google Scholar. The inclusion criteria were strict, and studies using search phrases unrelated to nursing or healthcare were only rejected due to the small number of accessible papers. After it was reduced to 23 articles by this approach, essential literature lists were evaluated and determined.

Nurse Preceptors

The primary emphasis of our analysis of the retrieved papers was on the sections that addressed the study issue and our goals. As a result, the content of the conclusion, the study methodology, and the variables employed were fundamental factors in determining which publications to keep or add for additional assessment. The report’s primary points are summed up in the results and findings, which also provide much of the information on the concerns of the original research participants. Across the globe, literature has commended preceptors for putting great effort into creating meaningful and positive learning experiences for students (Broadbent et al., 2014).

Also, among the papers in this review, the most pertinent was Mhango et al. (2021). Mhango et al. (2021) state that most research has praised nursing preceptors for volunteering to assist in transitioning students into professionals. It is already a sacrifice to accept the request. A thorough procedure for selecting and training nursing preceptors should be in place to lessen the likelihood of negative interactions with students. Mhango et al. (2021) state that nursing preceptors must possess critical attributes. One of the best traits a preceptor should possess is the ability to educate. Hardie et al. (2022) argued that the ability to become a competent educator could result from having a minimum qualification of BSN or even a Master’s degree. Most universities and nursing schools now require a Master’s degree or even a doctorate for teaching positions.

Nurse Preceptors Experience

The core of nursing education is clinical education, as nursing is a skills-based profession. Thus, a prerequisite for becoming a successful preceptor is having a great deal of clinical experience. Experienced nurses are more likely to confidently assist students than less experienced ones, according to Mhango et al. (2021). Some students even have educational backgrounds that are comparable, or almost identical, to those of preceptors, according to Jönsson et al. (2021). As a result, a nurse cannot become a preceptor for the sole purpose of instruction. Nevertheless, experience is not necessarily a benefit. Younger professionals might occasionally be more self-assured and effective than more seasoned ones. As a result, Mhango et al. (2021) recommended that 4-6 years of experience be considered, as these years have the most impact on a professional healthcare provider’s career. However, it was shown that preceptors with more than nine years of experience were less confident in their preceptor training and exhibited some laxity (Mhango et al., 2021).

In addition to the experiences that came with readiness, there was an issue with the preceptors’ function. According to Kleijer et al. (2023), most preceptors believed that their responsibilities superseded their responsibilities as nurses. As a result, they felt powerless when forced to fill the responsibilities of educators and eventually wished that the nursing faculty had provided them with more assistance. Due to increasing work pressure from the nursing faculty’s lack of support, nursing preceptor productivity was lower than it might have been with some help. According to Jönsson et al. (2021), nursing faculty members do not always visit the students in the ward; occasionally, they fail to make an effort to see them, allowing the nursing students to do all of the job. A typical day for a nurse preceptor also involves more activities, which presents another experience or set of problems. Kleijer et al. (2023) state that to educate and guide, one must be prepared for various novel tasks that the nurse is unfamiliar with. As a result, it is not easy to mix the responsibilities of a preceptor with the other minor duties that nurses perform regularly. Preceptors assist with both student instruction and patient care. It impacts how long the preceptor needs to spend with a student. Moreover, preceptors who put much effort into completing everything may become too tired, lowering their productivity. Kleijer et al. (2023) claim these incidents are more noticeable when many patients and students are in the ward. Preceptors can get into conflicts with their coworkers about being overly involved while the colleagues are not doing anything.

The guiding preceptor will eventually have to delegate some tasks to the nursing students. When postgraduate nurses are assigned clinical tasks, preceptors play a dangerous role since they are held accountable if something goes wrong, according to Kleijer et al. (2023). When delegating responsibilities, trust is the only thing that matters. In the absence of it, a preceptor finds it difficult to place their faith in their pupils, unlike colleagues, when it comes to commitments. A preceptor is responsible for many tasks that provide diverse forms of experience. One illustration would be the ability to coach nursing students, irrespective of the student’s capacity to preserve cordial relationships with their preceptors. Therefore, when students act as their preceptors to their seniors, it may be challenging for a preceptor to assist them if the students are what Levitt-Trujillo (2019) called “know-it-alls.” Rather than fostering mentorship, supervising pupils of this type may engender resentment in the preceptor. Such incidents may impact how a nurse handles kids who fall behind these individuals. It may even make it more challenging to provide a supportive atmosphere when the students are acting disrespectfully or with a sense of superiority.

According to Foster et al. (2022), nursing students who feel overly competent should be handled by ensuring they complete most of the duties without being presented initially and correcting their mistakes. It is in line with psychological reasoning. This system functions well when the students and the preceptor make no significant errors and supervise their work at all times. Foster et al. (2022) suggest that pupils who learn from professors who are tolerant of errors may become more competent than those who are rigid. It facilitates the recall of mistake origins and increases caution to prevent the coach from growing less forgiving. However, this makes things more confusing for nursing preceptors, who are held accountable for any mishap. Also, it gives the students who do most things right some esteem that ends up even more complex to beat.

Impact of Preceptor’s Experience in Training Nursing Students in the Clinical Setting

As a result, having strong leadership qualities is crucial for supervising nursing students. Kane et al. (2019) found that most preceptors who were respected by their students and were free to consult whenever necessary found it more straightforward to train even the most challenging pupils. Because they were courteous and easy to follow, these nurses had an easier time with their patients and coworkers. Because they gain confidence that the preceptor is knowledgeable beyond what they can question, students are also more likely to learn more from these preceptors while facilitating. It is also challenging to discover pupils who despise these nurses since, despite their apparent superiority, they exude an air of superiority, regardless of their educational background.

Nursing preceptors are also likely to encounter insecurities and want to assist those who have acquired knowledge. It takes intellect, which may not always be evident, to have future graduates under one’s care. Several nurses have expressed that this experience was problematic, mainly when dealing with students who think they have mastered their professions. Judkins (2020) asserts that emotional intelligence is crucial for precepting. Judkins (2020) explained the ongoing dissatisfaction that specific former preceptors felt from feeling unappreciated, abandoned by their colleagues, experiencing periods of falling retention, and occasionally finding the nursing cultures poisonous. These experiences are significant causes of mental breakdown, which could also lead to emotional breakdown for people with lower emotional intelligence.

Judkins (2020) proposed that the integrity of the training programs provided to preceptors may be one of the potential explanations. Many programs might not have enough knowledge to support preceptors in overcoming most obstacles during the training process, such as developing leadership abilities. Thus, updating the programs often to reflect current trends would be one start toward resolving this issue and preventing preceptors from being overburdened with student demands for explanations. According to this viewpoint, hospitals and other healthcare institutions provide students with this kind of instruction to guarantee that new preceptors can access competent preceptor role development (PRD) programs. Nevertheless, despite all the bad experiences, preceptors were able to impart invaluable expertise to their mentees. When things go right, a nurse might be proud of being a preceptor since they can impart best practices and brilliant ideas they have learned from their work as nurses, claims Briese (2022). To promote responsible practice, it is typically simpler for nurses who are happy in their jobs to mentor other nurses to feel the same way about their careers. Furthermore, while clinical instruction is the ideal practice mode, these occurrences greatly enhance its quality (Briese, 2022).

Also, preceptors act as assessors Throughout their guidance of students’ nursing careers. As a result, they get to assist several pupils in lowering their imperfections. Nursing preceptors can spot some shortcomings in the nursing sector among their students and address them before they have a significant influence, claim Mhango et al. (2021). As there is a considerable chance to save lives, a preceptor is a highly regarded person who can assist students develop into more vital professionals. A clinical collaboration approach exists in Saudi Arabia, where the College of Nursing and the teaching hospital work together. Al Harbi et al. (2021) state that these two organizations cooperate to uphold the educational process. The nursing college employs preceptors to instruct students to achieve clinical goals in several domains. The college usually employs these preceptors as experienced RN staff nurses and clinical Teaching Assistants. The college course coordinator creates an atmosphere favorable to meeting clinical learning objectives in various clinical units through suitable exposure. The preceptors selected often possess exceptional clinical nursing judgment and are well-trained and proficient in preceptorship (Al Harbi et al., 2021). They also give patients immediate medical attention.

According to different research by Omer and Moola (2019), preceptors must help student nurses transition from student nurses to professional nurses. They assist in acclimating the students to the clinical setting. Nursing preceptors ‘ essential tasks and responsibilities are setting learning objectives for trainees, teaching students hospital procedures, promoting evidence-based practice and critical thinking in healthcare delivery, and offering feedback on the learning process. The preceptors can better determine whether the learning objectives have been reached when student nurses are actively involved. Through self-evaluation and reflection on the assigned work, nursing students gain professional skills and knowledge in clinical settings through their interactions with the preceptor. Preceptors have enjoyed sharing their expertise and abilities by explaining clinical processes and procedures, as nursing is an ongoing learning process. They believe that through teaching, you are also learning (Omer & Moola, 2019). Through preceptorship, they get an opportunity to improve their clinical expertise and procedural skills.

Preceptors do, however, encounter difficulties in their clinical practice and training. One of their difficulties is not being adequately prepared for the preceptorship position. For their preceptorship duty, the majority of preceptors require further formal training. A clinical educator must know the most recent advancements in science, clinical practice, and research. A deficiency of current knowledge and abilities in the teaching field may result from lacking formal training and preparation during the preceptorship. Alghamdi et al. (2019) list lack of support, communication problems with nursing college instructors, and accountability for student triumphs and failures as other challenges.

Additionally, there are occasionally communication gaps between preceptors and student nurses. Furthermore, several students bemoan the harshness of their preceptors and the lack of opportunities for them to serve as role models for them. Preceptorship role confusion is another more difficult thing that nursing preceptors have to deal with, mainly when a student nurse is a preceptor under the supervision of many trainers. Students perceive an unhealthy connection between the preceptor and preceptee due to the transition from theory to practice, facing several discrepancies (Omer & Moola, 2019). Learning how to adapt theory to practice with a preceptor’s assistance might be difficult since the preceptor must find methods to illustrate various tactics and make sense in the real world.

The Preceptorship Program in Saudi Arabia (mention the programs applied in Saudi Arabia and in which institutions)

The preceptorship program is very critical to nursing education in Saudi Arabia. It acts as the bridge between what is learned in theory and imparted in practice. In the face of the severe nursing shortage, preceptorship programs are vital for increasing the competency of nursing students in their clinical work (Nielsen et al., 2017). While there has been rich literature and research on the experiences of nursing preceptors in guiding nursing students in practical placements, a visible gap is the lack of formal training programs in shaping the preceptorship process, especially in Saudi Arabia. While earlier studies on preceptorship had taken varying aspects about preceptorships, such as the role and responsibility of preceptors, challenges in a preceptorship, and impact on student learning outcomes, very few literature have been developed concentrating on the effectiveness and delivery of the preceptorship training program in Saudi Arabia (Mhango et al., 2021). One of the important gaps in the research relates to assessing the quality and effectiveness of the training programs regarding preceptorship in Saudi Arabia. Though there is agreement on the importance of preceptorship toward the linkage between theoretical preparation and practical knowledge learned in nursing education, the effectiveness of preceptor programs in providing preceptors with proper training to meet the expectations and desired outcomes of a preceptor role is underresearched, as per Omer and Moola (2019). Knowledge of the strengths and weaknesses of preceptorship training programs will aid in developing more comprehensive and specifically targeted training initiatives to raise the quality of preceptorship experiences for both the preceptor and students.

Mhango et al. (2021) claimed that few studies have been involved with the effects of preceptorship programs on the experiences of preceptors and nursing students in Saudi Arabian settings. The study of perceptions, challenges, and outcomes related to preceptorship by people in the roles of preceptors and students to help find the effectiveness of current models and areas for improvement in preceptorship.

Research Gap (Compare and contrast the relevance of your study to previous studies identifying gaps in the research literature)

Despite the plethora of research on the experiences of nursing preceptors regarding instructing nursing students in practical settings, several gaps still exist and need to be filled. A literature review reveals several areas where formal training is required to improve understanding and issue resolution surrounding the preceptorship process.

Formal Training and Preceptor Preparation

Inadequate formal training and preparation of nursing preceptors for their jobs is a significant lacuna in the research. While preceptors play substantial roles in supporting and mentoring nursing students, most of them are not given any formal training and support that is necessary in the execution of these kinds of duties. Prior research emphasized the importance of all-inclusive preceptorship programs that would equip preceptors with tools, resources, and knowledge to guide student learning successfully. However, knowledge-based evidence is still scant on how best to guide the creation of training programs specifically to suit the training needs of preceptors (Mhango et al., 2021). Still, more investigations are needed for effective ways of improving preceptor training and preparation, including, among other things, but not limited to, incorporating adult learning types of theories, clinical teaching approaches, and mentorship practices, among others.

Collaboration and Communication

The research also stipulates that there are barriers to communication among nursing students, teachers, and preceptors. Effective communication and teamwork have been stated to be among those considered vital to ensuring a favorable learning environment and the promotion of good preceptorship experiences. Mhango et al. (2021) argued that poor communication channels, vague expectations, and perceived ambiguity of roles are some of the issues that should be researched to hinder successful collaboration from the parties involved in the preceptorship process. On the same note, researchers should also embark on studies revealing the impact of good communication on student satisfaction, clinical learning experiences, and preceptorship outcomes.

Role Overload and Clarity in Preceptorship Responsibilities

The literature also identifies role overload as a problem that nursing preceptors face, along with a lack of clarity. These individuals already participate in many other tasks, including patient care, teaching, mentoring, and assessment. It could ultimately result in stress, burnout, and decreased job satisfaction. Moreover, the inconsistencies and difficulty transitioning from theory to practice for nursing students may largely contribute to the dysfunctional functional link between preceptors and preceptors. More research is needed to understand preceptorship tasks and responsibilities further, to reduce role overload, and to promote a healthy balance between clinical and teaching obligations.

Methodology: (1000 -2000 words)

The study used qualitative methods to understand some of the complex and subjective aspects of the preceptorship process, such as the relationship between the preceptor and preceptee, the learning context, and the outcomes of these interactions. Further, the nature of preceptorship experiences and the description will be given by the Saudi Arabian healthcare system participants using phenomenology as the study’s qualitative approach are also targeted. The phenomenon is thoroughly explored using this approach, and the positive recommendations that can be adopted to promote preceptorship programs and nursing education within the locality were put forward.

Study Design

The study adopted the qualitative descriptive design, and data collection entailed semi-structured interviews. The nature of the design is ideal for little or no initial knowledge of the question at hand (Kyngas, 2020). Semi-structured interviews are particularly suited to collecting data directly from human sources who have gone through the phenomenon under investigation, mainly when the time and resources are limited (Bradshaw et al., 2017). According to Kumar et al. (2023), one prefers research interviews because of the joy of holding the same, with the probability of getting optimistic respondents who enjoy sharing their experiences. Therefore, they are a great way to learn many things from interviewees who are more experienced in the research topic. This research applied interviews since the desired qualitative information demanded open-ended questions. Hence, more critical points were recorded for the responses than the number of particular answers.

Study Setting

The study will be done at King Fahad Hospital, Saudi Arabia. King Fahd Hospital was chosen because it is a health facility and because of its power in the region’s sphere of influence regarding nursing education and training.

Sample and Population

You must provide details of your choice of sampling technique, sample size,

and details about the participants (i.e., age, gender, religion, medical conditions,

employment, etc.). Inclusion and exclusion criteria must be stated along with the rationale

for these decisions.

Interviewees will be ten nurse preceptors actively engaged in guiding nursing students in the clinical setting. Inclusion Criteria are Nurse Preceptor: Participants must be practicing nurse preceptors at any clinical institution. Working at King Fahad Hospital: The participants must be currently employed at the King Fahad Hospital, which binds the study to its setting. Minimum 2 Years Preceptor Experience: The members must have a minimum of 2 years of preceptor experience for studying nursing students to give them the scope to experience tremendous insights concerning the dynamics of preceptorship. Educational Background: Participants may have a diploma or degree in nursing or higher, representing the different academic qualifications among nurse preceptors. Exclusion Criteria are Nurse Preceptors not from King Fahad Hospital: This is to ensure consistency of the study setting. Hence, those not employed at King Fahad Hospital will be excluded. Less than 2 Years of Experience as Preceptor: Those with less than two years of experience as a nurse preceptor will be excluded to avoid the effect of familiarity with the role. Non-Nurse Preceptors: Any participants who were not precepting nursing students at the time of the study or did not carry any nursing qualifications will be eliminated from the study to sustain the focus determined for the scope of the nurse preceptor’s experiences.

Data Collection Tool and Procedure

Qualitative research will derive primary data from semi-structured interviews on the preceptors’ experiences training the nursing students in the clinical area. Semi-structured interviews are compelling for exploratory studies given that they tend to explore the participant’s experience with a sense of focus on the study’s objectives. An interview guide will be developed based on the research questions and the study’s objectives (Nielsen et al., 2017). Questions featured in the interview guide will comprise issues questioning the respondents’ perceptions, experiences, challenges, and suggestions about preceptorship in nursing education in broad detail. Only a few preceptors will be piloted at each stage to ensure clarity and relevance.

Procedure for Data Collection

Step in Recruitment of Sample

Permission will be sought by the selected clinical institution, King Fahad Hospital, seeking to conduct a study and collect intended subjects by forwarding the application and the information of the study, including the data collection method necessary by the instrument prepared by the investigator (Nielsen et al., 2017). Cooperation of the institution will be sought in identifying prospective participants who have experience acting as preceptors in preparing nurse graduates.

Selection of Participants

Information-rich cases will be identified using a purposive selection of the study participants to understand the phenomenon of interest. Variables for selection include the number of years as a preceptor, level of involvement in nursing education, and the settings.

Informed Consent

Before data collection, written informed consent will be sought from all the participants after briefing them with the purpose of the research to ensure that they understand the research process, their rights as participants, and the voluntary nature associated with participating.

Conducting Interviews

The shortlisted participants will be scheduled for individual interviews at a mutually convenient time for the participant and the interviewer. The type of interview, that is, actual or through telecommunication platforms, will be determined by the convenience of the participants as well as viability. All the interviews will be recorded in audio following permission from the concerned participants.

Analysis

It will give rise to verbatim transcripts from the audio-recorded interviews, which will be used to recognize patterns and themes besides categories about experiences the preceptors have during the training of nursing students (Nielsen et al., 2017). Analyses will constitute coding, identifying common themes and interpretations of findings about the research objectives.

Confidentiality

Information on the participants shall be treated with the highest level of confidentiality. The data to be collected shall remain anonymous in any form to identify the participants participating in the research. Consent-seeking guidelines, privacy, and confidentiality on ethical issues will be followed throughout the study (Nielsen et al., 2017). Therefore, this study wishes to use semi-structured interviews as the data collection method to furnish richness and depth to this understanding of preceptorship.

Instrument

The instrument for this research includes instrument interviews. Azad et al. (2021) used these methods for research because of cost-effectiveness, ease, and confidentiality. Interviews offer a lot of free space and private time for the participants during the process, whereby they can talk about their experiences without revealing or exposing their identity to other uninvited parties. It is vital at this degree of isolation, especially when looking into sensitive topics such as the preceptors’ experiences in training the nursing students. This study tries to explore preceptors’ experiences while training undergraduate nursing students within clinical settings. The research also investigates the challenges and barriers preceptors face while training nursing students (Vuckovic et al., 2019). Based on the study objectives, research questions, and aims, a semi-structured interview guide can be established with themes such as demographic information, experiences, challenges and barriers, Improving the outcome, and resources and support.

Introduction

Appreciate the respondent for their valuable time and presence
Guarantee privacy and confidentiality to each participant before starting the interview
Explore the aim of the semi-structured interview by restating the topic
Ensure the respondent is conversant with the research, allowing them to cover a wider scope when responding.

Demographic Insights and Information

While focusing on the participant’s role (preceptor), start with questions related to education levels and years of experience as a preceptor.
Seek information about the setting they have worked for, including their current employment. The respondents should be specific on whether they work in hospitals, long-term care facilities, community centers, or as mobile receptors.
In addition to years of experience, ask how many students the respondents have trained during their working tenure.
Apart from the preceptor role, have your current employer assigned you any other role, working or not working with nursing students?
Beyond training and mentoring nursing students, ask the preceptors whether they are engaged in other career development activities.

Work Experience (as questions such as)

What inspired you to become a preceptor?
How would you describe your experiences when interacting with nursing students during training?
Have you experienced memorable or challenging moments during the mentorship program?
How do students perceive the training? Do they enjoy learning new things within a real-time clinical setting?
How do you perceive your role as a preceptor?

Barriers and Challenges facing Preceptors

What critical challenges do you encounter when mentoring nursing students and helping them navigate their shifts?
Is there a specific barrier or challenge that makes you not deliver effectively when training nursing students within clinical settings (Varghese et al., 2023)?
How effective are you in work/life balance?
How do you manage tricky or challenging events, especially during training sessions?
In your view, do you think these challenges are familiar to other preceptors working with different populations?

Resources and support

Ask the preceptors whether they have any support mechanisms within their clinical facility.
Does the facility offer necessary training programs, conferences, and other viable resources to enhance your competencies as a preceptor (Jassim et al., 2022)?
What changes would you recommend to your organization’s management to make to the current training programs and available resources?

Enhancing the Outcomes

In your view, what elements fuel positive outcomes from student-preceptor training relationships?
What changes could be made within and outside the facility to enhance the overall experience for nursing students and preceptors?
What changes do they suggest when interacting with students to enhance nursing training and development within clinical settings?

Conclusion

Offer the respondents a platform to offer their views, comments, additional insight, or thoughts regarding nursing training or the interview.
I appreciate them again for their time and participation.

Issues Regarding the Reliability and Validity

A literature review was done to guide the construction of the interview questions to elicit information about the preceptorship experiences, including the past experiences of the nursing preceptors in teaching students in clinical settings. It ensured that the questions to be constructed capture significant dimensions of preceptorship experiences. A further expert panel review enriched the questions to meet the relevance and clarity of the questions in their contribution towards the study’s objectives. Feedback from the pilot phase was used to refine the methodology, increase the validity, and align with the study objectives (Azad et al., 2021). Besides, rigid training for the interviewers went a long way in reinforcing the skills of making rapport, active listening, and clarity in communication (hence, enhanced uniformity in the process of interviews). It was to ensure reliability as the standard procedures, including centralized data capture and transcription of recorded interviews, presented very limited chances of biasing in the data collection process. There was a parallel process monitor to ensure that interview protocols were followed; hence, the data collected would be uniform.

Data analysis

Thematic analysis is one of the most widely used methods in which patterns or themes discovered within data in qualitative research are sought, examined, and summarized. It will be used to explore data collected from telephone interviews. The thematic analysis involves several crucial stages: familiarization with the data, generating initial codes, revising the codes for themes, reviewing themes, defining and naming themes, and finally, producing the report (Braun & Clarke, 2006). The phone interviews will then be transcribed, and the transcripts will be reviewed a few times during the familiarization period to gain in-depth familiarity with the information. It would then be followed by establishing preliminary programs to identify themes, concepts, or notions emanating from the data. These codes will then be grouped under possible themes, which will be examined and refined in line with the study’s objectives.

The final themes that emerge from the data in a coherent and relevant manner are those that have been specified as being reviewed for their richness of support before being chosen as themes that best align with the research objectives. The participant quotations that highlight established themes will be used within the final report so that the selected themes for illustrative purposes are exemplified through direct participant quotes and utilized throughout the report. Also, thematic analysis permits a thorough and methodical approach to examining qualitative data, which guarantees that the conclusions are based on the viewpoints and experiences of the participants (Braun & Clarke, 2006). This methodological approach will thus provide a deeper clarification as to the challenges and facilitating factors and outcomes of preceptorship within nursing education and practice, therefore presenting an opportunity in which the experiences of nursing preceptors with their task of instructing nursing students in the clinical learning environment can be explored fully to its most excellent possibilities.

Ethical Considerations

The ethical considerations will be at different levels:

The intentions of performing the research will be clean and unbiased to the best of our knowledge and abilities.
Conducting the research will pass through the required process described by the institution.
The participants of the interviews who help improve the quality of this report will give the respect they deserve and prior training done to them. It means the information shared through the record is professional and does not bring down other people’s careers or personalities.
Written consent will be obtained before data collection, and requests will be sent to the participants for approval before planning or scheduling any stakeholder contribution.

Therefore, the names of the interviewees will be left unknown, and the names of specific people whose stories will be told during the interviews will not be recorded. The personal contact details will also be recorded on different devices to ensure they are apparent from the final work. The prior training of the interviewees will help level the amount of unverifiable information provided unless based on experience. Any information from something other than experience will be stated as thoughts or ideas. Since there is no integrity, all non-verifiable information should have had an address, especially one contradicting the literature collected. Despite its absence in the literature, information that is only considered developed specific topics and logical solutions to problems noted in the literature or the previously done interviews. All participants, however, will receive written information and a verbal explanation regarding the research and how the researcher will ensure their confidentiality, together with their participation being voluntary and their capability of withdrawing from the study without any adverse effects on their job. The participants will not receive any financial or other benefits from participating.

Pilot Test

Pilot testing of the research tools and methods was carried out to test the feasibility, workability, and appropriateness of the technique before actual implementation. The pilot test aimed to discover possible problems, uncertainties, or weaknesses in the interview procedure to improve it before the central data-gathering stage. For the pilot test, nurse preceptors who were not part of the leading research setting were chosen from a different Saudi Arabian healthcare facility. The pilot test had five nurse preceptors in all. The choice of these subjects emanated from their willingness and availability to comment on the tools and methods used in the study.

The researcher used the semi-structured interview methodology developed for the project in the pilot test and interviews with the nurse preceptors. The research group members conducted the interview following the guidelines set out in the study protocol. Concerning contributing to the interview, the participants were also asked to contribute their ideas on the overall interview process and to rate the questions for their inclusiveness, relevance, and clarity. After the interviews, the research team held a debriefing session regarding the input from participants, which helped identify areas that could be improved. After thoroughly analyzing the pilot test participants’ input, the interview process was modified to address any difficulties or concerns. Specifically, changes were introduced to increase clarity in several questions, to reword questions that did not yield clarity, and to bring the interview up to the general standard of good flow. Further, changes were introduced to ensure the interview process was culturally sensitive and fit within the Saudi Arabian healthcare environment.

Quality of Evidence

Qualitative studies have generalizability, reliability, and validity limits compared to empirical investigations. In qualitative research, data are subjectively interpreted, which opens the door to bias or interpretation on the researcher’s part. Furthermore, the sample groups used in qualitative investigations are smaller, which may reduce the representativeness of the results. In contrast, Briese’s cross-sectional survey study from 2022 depended on self-reported data, which can add bias and reduce the validity of the results despite having a moderate degree of evidence. Adopting self-reported data and the absence of a control group also impacted Hong and Yoon’s cross-sectional study in 2021. Therefore, the paper’s dependence on self-reported data could reduce the quality of its supporting data.

The publications’ absence of experimental design or randomization also indicates a potential flaw in their supporting data. For example, cross-sectional studies, like the one conducted by Carlson and Idvall in 2014, offer a momentary view of a specific occurrence and do not address variations over time or demonstrate causality. Similarly, scoping reviews, like the one conducted by Hardie et al. (2022), are constrained by the standard of the papers they assess and do not offer a comprehensive critical evaluation of the studies included.

The Practicality of the Research in Practice

This research was based on the nursing experiences of preceptors and nursing students, making it highly recommendable for people interested in or pursuing nursing careers. There are many ways that this research could be used. First, any student should understand the expectations and limits that their lecturers and supervisors expect of them. For nursing students, the information in this research could appear deeper and more meaningful than for other students. However, it is still recommended that anyone wishing to pursue a course related to handling people, such as human resources, study it. However, in nursing practice, there are many opportunities that a person could face during their career, and these opportunities bring challenges along. When dealing with people, it will be easy to overcome many challenges when equipped with the information contained in this research.

Secondly, preceptors are key beneficiaries of this information compiled from extensive research. The research was based on the preceptors’ experiences training students in a clinical setting. Therefore, most preceptors have experienced most of the things that were discussed. This makes it convenient research since there are many complaints of preceptors giving up on students and students getting demoralized or even dropping their dream careers due to a bad experience with the students. For example, in one of the cases discussed in this report, a student got frustrated by a preceptor to the extent of requesting a swap with a different preceptor. The case ended badly when the student was denied the chance, and the preceptor took it as hatred. The preceptor and the student could have made very different decisions if they had understood the concepts discussed in this report.

Finally, as much as being a preceptor requires experience and training, there is always room for more information. The information contained in this research is purely about handling people and does not lead preceptors to incur extra costs. Instead, it helps preceptors and students have more professional relationships, making it more productive and leading to fewer errors in practice. Therefore, this research was fundamental since most people find the preceptorship period very different from their expectations and training. The leadership skills and psychological hints given in this report are powerful tools for practice.

Planning the research project

Anticipated outcome of the study. Discuss your proposed study’s expected outcomes (linked to the initial research question or aims and objectives). Give a short explanation of how the findings can be disseminated.

Conclusion

This study finally provides valuable insight into preceptors’ experiences while teaching nursing students in the clinical environment. Some challenges determined from the results endured by preceptors comprise high workload role ambiguity and poor training related to preceptorship positions. Preceptors remain critical in fostering the professional development of nursing students and making a significant contribution to the nursing workforce despite these challenges. It is clear that in the future, more resources and help will be needed to solve issues brought up by the study. Formal training initiatives, structured preceptorship programs, and the ever-changing and never-ending continuing professional development opportunities may maximize the preceptorship experience for all involved parties and empower the preceptors. In addition, nursing education programs and healthcare organizations may foster an environment of support in which the underlying issues are temporarily addressed by focused solutions designed to encourage the growth of preceptors and nursing students. In essence, funding for the preceptorship program is vital in developing a competent and versatile nursing workforce that can provide excellent health care to the patient in a real-life clinical environment.

Future Research

This research was one-sided since it considered the experiences of nursing preceptors alone. However, there is a need to have students or student representatives in a single sitting to review the major cause of the problems experienced in preceptorship. It was observed that the preceptors complained that some students are hard to teach and could sometimes reveal rudeness traits. In the process, the preceptors needed to have students trained before getting the permit to attend the preceptorship. Therefore, hearing the students’ side and what they expect from preceptorship could be more fruitful.

Also, there is a need to research whether preceptorship should be made a subsidiary course mandatory for all preceptors before being allocated such duties. Therefore, the strengths of a preceptor observed in this research could be made a skill where the preceptors can handle even the most stubborn students. Therefore, this research could go well with a different research question of whether preceptors should study a full course for preceptorship and be given enough power to report or send students to retake basic education levels before graduating nurses. This change could make such nurses so powerful over students that their authoritative nature could be expected by the students, making it easy for them to listen and do as they are told instead of having reports of competition-like preceptorships.

Finally, from the research findings, some students were so demoralized by preceptors that they gave up their careers. Therefore, another study gap is whether nursing preceptors could do more harm than good in the coming generation’s attitude toward nursing. In this research gap, many students surrendered their careers because of bad relations with preceptors and could transfer their hatred for nursing to their mentees. This research could help understand the benefits of nursing to patients and nursing culture versus the effects on the number of students who enroll in nursing should preceptorship be made mandatory. The reason for this research question is the growing need for nurses, as discussed above, which could require all obstacles to attaining the desired number to be eliminated and the integrity preserved simultaneously.

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EXPERIENCES OF PRECEPTORS IN TRAINING NURSING STUDENTS IN THE CLINICAL SETTING: A QUALITATIVE REVIEW

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Abstract (200 – 250 words)