Enhancing Nurse Preceptor proficiency and Nursing Students Quality of Learning on a
Dedicated Education Unit
NAME HERE
University
Running head: Enhancing Nurse Preceptor proficiency and Nursing Students Quality of Learning
on a Dedicated Education Unit
Overview
Nursing practice and education has always been synonymous to actual based practice, skills
development and well versed theory based practices, protocols and teachings, the nursing
practice as a whole accommodates the idea that a holistic approach of the nursing process should
be taught and demonstrated in the class and in the clinical areas in real time practice and skill
showcase to fully assess the application of theory and practical approach in nursing techniques,
roles and management. As we entered a new era of practice in this time where the world is swept
with a pandemic, as that the teachings of nursing practices have been severely
compartmentalize, Would the clinical instructors be able to maintain quality teaching through
online interactions? Would the clinical instructors adequately assess correctness and
completeness of tasks as that would certify that student nurses have a full grasp of the nursing
process without clinical personal interaction? What can be done to ensure quality of teaching
without compromising health protocols on both student and clinical instructors? The objective of
this paper is to relay a core analysis that would co-relate the Transition theory of Afaf I. Meleis
to the effectiveness of dedicated education unit in nursing schools and institutions, to provide
adequate holistic nursing teaching and comprehension. The new approach of our local education
systems in nursing practice are based on schemes that takes advantage of online class and
materials, modules and online based interactions. The Clinical instructors can maintain the
theory based course outline with the use of online class and practice based course outline, with
the use of a dedicated education unit that observes proper health and infection protocols to retain
an interpersonal teaching method and return demonstrations that would ensure a skill based
practice that can be developed by the students
Running head: Enhancing Nurse Preceptor proficiency and Nursing Students Quality of Learning
on a Dedicated Education Unit
Table of Contents
Overview..........................................................................................................................................2
Defintion..........................................................................................................................................3
Introduction......................................................................................................................................3
Method ............................................................................................................................................4
Heading 2.....................................................................................................................................4
Heading 3.................................................................................................................................4
Heading 4...........................................................................................................................4
Heading 5.......................................................................................................................4
Reference list...................................................................................................................................7
Appendix A......................................................................................................................................8
Appendix B....................................................................................................................................10
Running head: Enhancing Nurse Preceptor proficiency and Nursing Students Quality of Learning
on a Dedicated Education Unit
Definitions
Nurse Preceptor: Refers to Clinical Instructors and educators that is adept in teaching and
imparting the core teachings of nursing process, nursing practices and nursing techniques.
Nursing Students: Undergraduates taking up a course in Bachelors of Science and Arts in
Nursing
Dedicated Education Unit: A Dedicated Education Unit is one floor or unit of a health facility
or school based institution devoted entirely to nursing students from a nursing program and
staffed by a consistent group of Nurses and Nurse Preceptor and who provides professional
development as educators.
Transition Theory: A middle range theory by Afaf I. Meleis with Major concepts of the
middle-range theory of transition include: (1) types and patterns of transitions; (2) properties of
transition experiences; (3) transition conditions (facilitators and inhibitors); (4) patterns of
response (or process indicators and outcome indicators); and (5) nursing therapeutics.
Running head: Enhancing Nurse Preceptor proficiency and Nursing Students Quality of Learning
on a Dedicated Education Unit
Introduction
A competent health workforce is central to achieving universal health coverage (WHO,
2006). Quality education is the foundation for developing competent health workers who are
equipped with the knowledge, attitudes and skills necessary to deliver quality care. There is
evidence, however, that health workers, including nurses, may not be adequately prepared to
meet the needs of society, especially in developing countries. It is therefore imperative that
educational institutions are provided with support and guidance to develop competence-based
curricula for their education programs, It is inherently in the interest of the Nurse preceptors and
the Nursing school to ensure that the delivery of instruction to the Nursing Students are not
compromised by the ever changing teaching strategies and teaching methods to .
This paper aims to gain insight into the relationship between Nurse Preceptors
Proficiency and Nurse Student learning quality on a dedicated education unit, Nurse Preceptors
should maintain current knowledge and skills in theory and practice, based on the best evidence
available, moreover Nurse Preceptors must be able to adapt with current educational and
teaching trends that adheres to the safety of students and Nurse Preceptors alike. The use of
online teaching materials and the use of Smartphones and Laptops that affects the quality of
students’ retention in the household will be discussed and analyse.
Running head: Enhancing Nurse Preceptor proficiency and Nursing Students Quality of Learning
on a Dedicated Education Unit
Nursing Preceptor Proficiency
Middle range theory (Transition Theory by Afaf Ibrahim Meleis)
Here, the major concepts and definitions from the most current Transitions Theory—the middle-
range theory of transition suggested by Meleis, Sawyer, Im, and colleagues (2000)—are
presented. Some concepts are defined in greater detail based on the transition framework
by Schumacher and Meleis (1994).
Major concepts of the middle-range theory of transition include: (1) types and patterns of
transitions; (2) properties of transition experiences; (3) transition conditions (facilitators and
inhibitors); (4) patterns of response (or process indicators and outcome indicators); and (5)
nursing therapeutics.
Types and patterns of transitions
Types of transitions include developmental, health and illness,
situational, and organizational. Developmental transition includes birth, adolescence,
menopause, aging (or senescence), and death. Health and illness transitions include recovery
process, hospital discharge, and diagnosis of chronic illness (Meleis & Trangenstein, 1994).
Organizational transitions refer to changing environmental conditions that affect the lives of
clients, as well as workers within them (Schumacher & Meleis, 1994).
Running head: Enhancing Nurse Preceptor proficiency and Nursing Students Quality of Learning
on a Dedicated Education Unit
Patterns of transitions include multiplicity and complexity (Meleis, Sawyer, Im, et al., 2000).
Many people experience multiple transitions simultaneously rather than experiencing a single
transition, which cannot be easily distinguished from the contexts of their daily lives. Indeed,
Meleis, Sawyer, Im, and colleagues (2000) noted that each of the studies that were the basis for
the theoretical development involved people who simultaneously experienced a minimum of two
types of transitions, which could not be disconnected or mutually exclusive. Thus, they
suggested considering if the transitions happen sequentially or simultaneously, the degree of
overlap among the transitions, and the essence of the associations between the separate events
that initiate transitions for a person.
Properties of transition experiences
Properties of the transition experience include five subconcepts: (1) awareness; (2) engagement;
(3) change and difference; (4) time span; and (5) critical points and events. Meleis, Sawyer, Im,
and colleagues (2000) asserted that these properties of transition experience are not
fundamentally disconnected, but are interrelated as a complex process.
Awareness is defined as “perception, knowledge, and recognition of a transition experience,”
and level of awareness is frequently reflected in “the degree of congruency between what is
known about processes and responses and what constitutes an expected set of responses and
perceptions of individuals undergoing similar transitions”(Meleis, Sawyer, Im, et al., 2000).
While asserting that a person in transition may be somewhat aware of the changes that they are
experiencing, Chick and Meleis (1986) posited that a person’s unawareness of change could
Running head: Enhancing Nurse Preceptor proficiency and Nursing Students Quality of Learning
on a Dedicated Education Unit
mean that the person may not have began his or her transition yet; Meleis, Sawyer, Im, and
associates (2000) later proposed that this lack of awareness does not necessarily mean that the
transition has not begun.
Engagement is another property of transition suggested by Meleis, Sawyer, Im, and colleagues
(2000). Engagement refers to “the degree to which a person demonstrates involvement in the
process inherent in the transition.” The level of awareness is considered to influence the level of
engagement; there is no engagement without awareness. Meleis and colleagues (2000) suggested
that the level of engagement of a person who has this awareness of changes is different from that
of a person who does not have this awareness.
Changes and differences are a property of transitions (Meleis, Sawyer, Im, et al., 2000).
Changes that a person experiences in her or his identities, roles, relationships, abilities, and
behaviors are supposed to bring a sense of movement or direction to internal as well as external
processes (Schumacher & Meleis, 1994). Meleis and associates (2000) asserted that all
transitions associate changes, although not all changes are associated with transitions. They then
suggested that to comprehend a transition completely, it is essential to disclose and explain the
meanings and influences of the changes and the scopes of the changes (e.g., “nature, temporality,
perceived importance or severity, personal, familial, and societal norms and expectations”).
Differences are also suggested as a property of transitions. Meleis and associates (2000) believed
that challenging differences could be demonstrated by unsatisfied or atypical expectations,
feeling dissimilar, being realized as dissimilar, or viewing the world and others in dissimilar
ways, and they suggested that nurses would need to recognize “a client’s level of comfort and
mastery in dealing with changes and differences.”
Running head: Enhancing Nurse Preceptor proficiency and Nursing Students Quality of Learning
on a Dedicated Education Unit
Time span is also a property of transitions—all transitions may be characterized as flowing
and moving over time (Meleis, Sawyer, Im, et al., 2000). Based on the assertion by Bridges
(1980, 1991), in the middle-range theory of transition, transition is defined as “a span of time
with an identifiable starting point, extending from the first signs of anticipation, perception, or
demonstration of change; moving through a period of instability, confusion, and distress; to an
eventual “ending” with a new beginning or period of stability.” However, Meleis, Sawyer, Im,
and colleagues (2000) also noted that it would be problematic or infeasible, and possibly even
prejudicial, to frame the time span of some transition experiences.
Critical points and events are the final property of transitions suggested by Meleis,
Sawyer, Im, and associates (2000). Critical points and events are defined as “markers such as
birth, death, the cessation of menstruation, or the diagnosis of an illness.” Meleis and colleagues
(2000) also acknowledge that specific marker events might not be evident for some transitions,
although transitions usually have critical points and events. Critical points and events are usually
linked to intensifying awareness of changes or dissimilarities or to a more exertive engagement
in the transition process. Also, Transitions Theory conceptualizes that final critical points are
differentiated by a sense of counterpoise in new schedules, competence, lifestyles, and self-care
behaviors, and that the duration of uncertainty is characterized by variations, consecutive
changes, and interruptions in existence.
Transition conditions
Running head: Enhancing Nurse Preceptor proficiency and Nursing Students Quality of Learning
on a Dedicated Education Unit
10
Transition conditions are “those circumstances that influence the way a person moves through a
transition, and that facilitate or hinder progress toward achieving a healthy transition”
(Schumacher & Meleis, 1994). Transition conditions include personal, community, or societal
factors that may expedite or bar the processes and outcomes of healthy transitions.
Personal conditions include meanings, cultural beliefs and attitudes, socioeconomic status,
preparation, and knowledge. Meleis, Sawyer, Im, and colleagues (2000) considered that the
meanings attached to some events accelerating a transition and to the transition process itself
would expedite or bar healthy transitions. Cultural beliefs and attitudes such as stigma associated
with a transition experience (e.g., Chinese stigmatization of cancer) would influence the
transition experience. Socioeconomic status could influence people’s transition experiences.
Anticipatory preparation or lack of preparation could facilitate or inhibit people’s transition
experiences. Community conditions (e.g., community resources) or societal conditions (e.g.,
marginalization of immigrants in the host country) could be facilitators or inhibitors for
transitions. Compared with personal transition conditions, the subconcepts of community
conditions and societal conditions tend to be underdeveloped.
Patterns of response or process and outcome indicators
Indicators of healthy transitions in the framework by Schumacher and Meleis (1994) were
replaced by patterns of response in the middle-range theory of transitions. Patterns of response
are conceptualized as process indicatorsand outcome indicators. These process
indicatorsand outcome indicators characterize healthy responses. Process indicators that direct
Running head: Enhancing Nurse Preceptor proficiency and Nursing Students Quality of Learning
on a Dedicated Education Unit
11
clients into health or toward vulnerability and risk make nurses conduct early assessment and
intervention to expedite healthy outcomes. Also, outcome indicators may be used to check if a
transition is a healthy one or not, but Meleis, Sawyer, Im, and associates (2000) warned that
outcome indicators could be associated with irrelevant events in people’s lives if they are
appraised early in a transition process. The process indicators suggested by Meleis and
colleagues (2000) include “feeling connected, interacting, being situated, and developing
confidence and coping.” “The need to feel and stay connected” is a process indicator of a healthy
transition; if immigrants add new contacts to their old contacts with their family members and
friends, they are usually in a healthy transition. Through interactions, the meaning attached to the
transition and the behaviors caused by the transition can be disclosed, analyzed, and understood,
which usually results in a healthy transition. Location and being situated in terms of time, space,
and relationships are usually important in most transitions; these indicate whether the person is
turned in the direction of a healthy transition. The extent of increased confidence that people in
transition are experiencing is another important process indicator of a healthy transition. The
outcome indicators suggested by Meleis, Sawyer, Im, and colleagues (2000) include mastery and
fluid integrative identities. “A healthy completion of a transition” can be decided by the extent of
mastery of the skills and behaviors that people in transition show to manage their new situations
or environments. Identity reformulation can also represent a healthy completion of a transition.
Nursing therapeutics
Running head: Enhancing Nurse Preceptor proficiency and Nursing Students Quality of Learning
on a Dedicated Education Unit
12
Schumacher and Meleis (1994) conceptualized nursing therapeutics as “three measures that are
widely applicable to therapeutic intervention during transitions.” First, they proposed assessment
of readiness as a nursing therapeutic. Assessment of readiness needs to be interdisciplinary
efforts and based on a full understanding of the client; it requires assessment of each of the
transition conditions in order to generate a personal sketch of client readiness, and to allow
clinicians and researchers to determine diverse patterns of the transition experience. Second, the
preparation for transition is suggested as a nursing therapeutic. The preparation of transition
includes education as the main modality for generating the best condition to be ready for a
transition. Third, role supplementation was proposed as a nursing therapeutic. Role
supplementation was suggested by Meleis (1975) and used by several researchers (Brackley,
1992; Dracup, Meleis, Clark, Clyburn, Shields, & Staley, 1985; Gaffney, 1992; Meleis
& Swendsen, 1978). Yet, in the middle-range theory of transitions, there is no further
development of the concept of nursing therapeutics.
Running head: Enhancing Nurse Preceptor proficiency and Nursing Students Quality of Learning
on a Dedicated Education Unit
13
Method
Using the transition framework, a middle-range theory by Afaf Ibrahim Meleis for transition
was developed by the researchers who had used transition as a conceptual framework. They
analyzed their findings related to transition experiences and responses, identifying similarities
and differences in the use of transition; findings were compared, contrasted, and integrated
through extensive reading, reviewing, and dialoguing, and in group meetings. The collective
work was published in 2000 (Meleis, Sawyer, Im, et al., 2000) and has been widely used in
nursing studies.
Figure 1
Running head: Enhancing Nurse Preceptor proficiency and Nursing Students Quality of Learning
on a Dedicated Education Unit
14
Analysis
