A Critique of the Undergraduate Nursing Preceptorship Model

The preceptorship model is a cornerstone of clinical undergraduate nursing education in Canadian nursing programs. Their extensive use means that nursing programs depend heavily on the availability and willingness of Registered Nurses to take on the preceptor role. However, both the health service and education industries are faced with challenges that seem to undermine the effectiveness of the preceptorship clinical model. Indeed, the unstable nature of the clinical setting as a learning environment in conjunction with faculty shortages and inadequate preparation for preceptors and supervising faculty calls us to question if the preceptorship model is able to meet student learning needs and program outcomes. In a critical analysis of preceptorship, we offer a deconstruction of the model to advance clinical nursing education discourse. 1. Introduction A review of the nursing education literature reveals that clinical nursing education is considered to be a vital component of nurses’ education. Indeed, Florence Nightingale, the founder of contemporary nursing practice, placed clinical education at the center of nurses’ professional development. According to Nightingale, nurses’ first year of training should occur in the hospital setting under the direct supervision of practicing nurses who can guide neophytes in the care of their patients [1]. While this type of clinical education model was the prototype of what would later be called preceptorship, the model remained largely dormant during hospital-based programs until it emerged once again in the 1960s in nurse practitioner programs [1]. In Canadian undergraduate nursing programs, preceptorship is typically described as a formal one-to-one relationship between a nursing student and registered nurse that extends over a pre-determined length of time [2]. Since the 1980s it has become a cornerstone of clinical nursing education. Given that the use of the preceptorship model is extensive, most Canadian programs are somewhat to very dependent on preceptors to guide their students [3]. Furthermore, because of its wide use, many nurse scholars believe that preceptorship provides the perfect medium to bridge theory and practice [1] and a way to facilitate the transition from student to graduate nurse role for the majority of nursing students [4]. However, from an education and health sector perspective there is still significant concern about the clinical learning and teaching components of undergraduate nurse education [5]. Indeed, ongoing restructuring within the Canadian health care system juxtaposed with