Leadership Lessons for the Future of Nursing: Student-Preceptor Dyads in Ambulatory Care

Purpose: Our four-year program evaluation of a primary care/public health immersion experience from 55 students and 14 preceptors aims to inform best practices in student-preceptor, urban ambulatory care immersion experiences and increase the practice scope and numbers of BSN graduates who are prepared to work in medically underserved primary care and public health

Background: Our nations’ underserved urban communities face rising costs, aging populations, and declining life expectancies. In response, ambulatory care leaders seek to empower future ambulatory care nurses to meet these rising needs. Two timely reports reinforce this vision, the Future of Nursing 2020-20301 and the National Academies’ “Implementing High Quality Primary Care”2, and both make clear that ambulatory care RNs are vital to improving healthcare outcomes. Relatedly, Morton3 and colleagues argue that gaps exist in undergraduate education, specifically ambulatory care essential content, including social determinants of health (SDOH), health disparities/health equity, cultural competency, community leadership, and the enhanced skills needed for community-based settings. In response to these calls for increasing academic ambulatory care readiness, nursing leaders at our urban federally qualified healthcare center (FQHC), alongside a local health department and another area FQHC, have expanded our long-standing academic partnerships to include BSN student immersive preceptorships at our respective sites.

Methods: Our evaluation design is assessing the effect of the clinical immersion on undergraduate nursing students in our three ambulatory care settings. Our 55 students and 14 preceptor participants completed validated instrument surveys using Qualtrics® before and after the students’150-hour clinical immersion. Qualitative data is collected from preceptor and student focus groups, Typhon© clinical tracking logs, and weekly reflective journals.

Results: Preliminary results will be discussed and compared to national shared measures data. The experiences of preceptors, their clinic leadership, and students provide quantitative data using two validated instruments, the SEPSS-364, measuring self-efficacy in self-management support, and C-LEST5, which measures undergraduate clinical learning environments. Qualitative data from each student-preceptor dyad is interpreted via clinical logs, journals, and preceptor focus groups.

Conclusions: Our data informs ambulatory care and academic leadership on how an ambulatory care setting’s academic-clinical partnership can enhance preceptor competencies and improve undergraduate students’ preparation for work in medically underserved, public health, and primary care settings. Our data add concrete guidance and value, as we seek to enable an optimum future of nursing in ambulatory care.

1) National Academies of Sciences, Engineering, & Medicine. 2021. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. doi.org/10.17226/25982.
2)    National Academies of Sciences, Engineering, and Medicine. 2021. Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care. doi.org/10.17226/25983.
3)    Morton, J. L., et al. (2019). New education models for preparing pre-licensure students for community-based practice. Journal of Professional Nursing 35(6):491–498. 4Duprez, V., et al., (2016). The development and psychometric validation of the self-efficacy and performance in self-management support (SEPSS) instrument. Journal of Advanced Nursing, 72(6), 1381-1395. doi:10.1111/jan.12918. 5 Saarikoski, M & Strandell-Laine, C. (2018). The CLES-Scale: An Evaluation Tool for Healthcare Education. 10.1007/978-3-319-63649-8.