Looking beneath the surface of a preceptor-training programme through a realist evaluation

Area of Science:

• Nursing Education
• Healthcare Training Programs
• Clinical Competency Development

Background:

• South Africa's Department of Health emphasizes preceptors in clinical nursing education.
• A preceptor-training program was developed based on this model to enhance student competence.
• Initial theory posited trained preceptors would improve student support and competence.

Purpose of the Study:

• To investigate the reasons for the poor outcomes of a preceptor-training program.
• To understand the context, mechanisms, and outcomes of the training intervention.
• To refine the program theory for effective preceptorship in nursing.

Main Methods:

• A realist evaluation approach was employed.
• Reflective field notes from the intervention were analyzed.
• The study explored how, for whom, and under which circumstances the program could be effective.

Main Results:

• The preceptor-training program yielded poor outcomes with low preceptor participation and high student attrition.
• Analysis revealed that the training program alone was insufficient to motivate preceptors.
• Implementation context emerged as a significant factor influencing program effectiveness.

Conclusions:

• A preceptor-training program requires a systems approach, not just training, to ensure motivation and learning transfer.
• The effectiveness of such programs is heavily dependent on the implementation context.
• Refined program theory suggests a holistic strategy for successful preceptorship is needed.