title: Putting knowledge to work in clinical practice: Understanding experiences of preceptorship as outcomes of interconnected domains of learning.
abstract: OBJECTIVE
  To explore how preceptor support can assist newly qualified nurses to put knowledge to work across interconnected forms of knowledge when delegating to healthcare assistants.
  
  
  BACKGROUND
  Current literature on preceptorship in nursing has failed to explore how competence is underpinned by knowledge frameworks in clinical practice.
  
  
  METHODS
  An ethnographic case study in three hospital sites in England (2011-2014).
  
  
  METHODS
  Data collection included participant observation, interviews with 33 newly qualified nurses, 10 healthcare assistants and 12 ward managers. Data were analysed using thematic analysis. A tool to assist newly qualified nurses to delegate and supervise newly qualified nurses during the preceptorship period was developed and piloted with thirteen newly qualified nurses in the same sites. A process evaluation was undertaken.
  
  
  RESULTS
  Focusing on a key task for newly qualified nurses, delegation to healthcare assistants, we argue that preceptorship can support newly qualified nurses as they put knowledge to work in the transition from qualifying student to newly qualified nurses. In supportive ward cultures, limited access to formal preceptorship can be bolstered by team support. newly qualified nurses in less supportive ward cultures may have both a greater need for preceptorship and fewer compensatory mechanisms available to them when formal preceptorship is not available. We argue that organisational learning contexts and individual learning styles (interconnected domains of learning) are key to understanding effective preceptorship.
  
  
  CONCLUSIONS
  We suggest that putting knowledge to work early in their careers with preceptorship support may assist newly qualified nurses to develop confidence and competence in delegation and supervision of healthcare assistants.
  
  
  CONCLUSIONS
  Our findings suggest that newly qualified nurses need to be supported by effective preceptorship in their learning as they transition from undergraduate to post graduate. Preceptorship programmes at ward and organisational level need to recognise the intensity of the learning required during this transition phase.
authors.affiliation: Middlesex University, London, UK.
authors.forename: Helen Therese
authors.identifier: http://orcid.org/0000-0001-9391-0385
authors.initials: HT
authors.lastname: Allan
authors.affiliation: Centre for Research in Nursing and Midwifery Education, University of Surrey, Guildford, UK.
authors.forename: Carin
authors.initials: C
authors.lastname: Magnusson
authors.affiliation: Institute of Education, University of London, London, UK.
authors.forename: Karen
authors.initials: K
authors.lastname: Evans
authors.affiliation: Centre for Research in Nursing and Midwifery Education, University of Surrey, Guildford, UK.
authors.forename: Khim
authors.initials: K
authors.lastname: Horton
authors.affiliation: School of Health and Social Care, University of Surrey, Guildford, UK.
authors.forename: Kathy
authors.initials: K
authors.lastname: Curtis
authors.affiliation: University of Salford, Salford, Greater Manchester, UK.
authors.forename: Elaine
authors.initials: E
authors.lastname: Ball
authors.affiliation: University of Salford, Salford, Greater Manchester, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Johnson
mesh_terms: D000488:Allied Health Personnel; D002983:Clinical Competence; D000068598:Data Accuracy; D032022:Delegation, Professional; D004739:England; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009741:Nursing Staff, Hospital; D009745:Nursing, Supervisory; D011231:Preceptorship / Q000458:organization & administration*
keywords: nurse education; practice-based learning; preceptorship; qualitative study