Objectives. The Problem and Practice Setting 6/2/2015. Interventions that Impact Nurse Preceptors Professional Development: A Systematic Review

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1 Interventions that Impact Nurse Preceptors Professional Development: A Systematic Review Maryann Windey PhD, MS, MSN, RN-BC Carol Lawrence PhD, MS, BSN, RNC-OB, CBC Kimberly Guthrie PhD MS, MSN, RN Debra Weeks DNP, MSN, RN-BC Objectives Describe steps to conducting a high level systematic review Discuss evidence-based interventions to develop preceptors Demonstrate the benefits of partnering with academic institutions while conducting systematic reviews The Problem and Practice Setting 1

2 LMHS EBP and Research Model Teaming and Collaboration Background and Significance Current nursing workforce trends 2

3 Gap in the Literature Predominate themes and gaps in literature Purpose Formalized high level systematic review of the state of the literature Review, assess, analyze, and synthesize the best available evidence Provide support for the NPDS Where to Start? Literature review versus Systematic review 3

4 Determine a Protocol Our Protocol Interventions that impact nurse preceptors professional development: A systematic review Review Question: What interventions impact nurse preceptors professional development? crd.york.ac.uk/prospero/display_record.asp?id=crd Tools 4

5 Search Criteria Quantitative Mixed method (focus on quantitative results) Studies regarding preceptor development in nursing Setting of acute care hospital or in-patient rehabilitation Published between January March 2014 Report at least one intervention Reported at least one outcome Databases PubMed CINAHL (EBSCOHost) Dissertations & Theses (ProQuest) ERIC Scopus Cochrane Libraries of Systematic Reviews Clinical Trials (OVID) Search Terms 5

6 Methods Who How What Two reviewers Title Abstract Conducted independent review Full Text Random reviewer assignments Reached consensus Discrepancies addressed by third reviewer PRISMA Flow Chart 4501 records (4407 data bases + 94 other) 2667 after duplicates removed 2667 titles/abstracts screened 462 full text articles screened 14 articles considered 12 articles selected Quality Assessment Tools: MERSQI Design Sampling Type of Data Validity of evaluation instrument Data Analysis Outcomes 6

7 Quality Assessment Tools: BEME Strength of Evidence Outcomes Data Extraction Results MERSQI BEME Outcomes Mean (SD = 2.21) Participation Median 11 (7-15) Attitudes/perceptions 25.0% Knowledge and skills 41.7% Behavioral Change 16.7% Organizational practice 8.3% Patient Benefits 8.3% BEME Strength Mean 3.08 (SD =.67) Median 3 (2-4) 0% 7

8 Results: Study Designs 10 articles quasi-experimental 2 experimental 7 longitudinal 5 cross sectional 11 prospective 1 retrospective/prospective 6 used a theoretical framework Results: Interventions 10/12 workshops CD-ROM Printed manual Results: Content 83% giving and receiving feedback 75% effective communication 58% facilitating adult learning 58% review of roles and responsibilities 50% developing and evaluating clinical judgment 8

9 Results: Dependent Variables Participation 0% Attitudes/perceptions 25.0% Knowledge and skills 41.7% Behavioral Change 16.7% Organizational practice 8.3% Patient Benefits 8.3% Results: Methodological Concerns Inappropriate design Post-test only High attrition rates Small sample sizes Lack of fidelity Unreported validity and reliability of instruments Risk of a Type I error Limitations 9

10 Implications for Future Research Rigorous study designs Control for the effect of time Comparison/control groups High-level outcome measures Valid and reliable instrumentation Adequate sample sizes Value of using a quality assessment tool (BEMI/MERSQI) Discussion and Implications for NPD Most common interventions, are there more creative strategies? Discussion and Implications for NPD What interventions do you provide for preceptor development? What creative interventions are you using? Any success with technology-driven interventions? Any generational-specific interventions? For self-directed activities, do you monitor compliance and time to complete? Are the interventions administered reliably/consistently? 10

11 Discussion and Implications for NPD What outcomes are you currently measuring? Patient Benefits What outcomes do you want to measure? Measurement challenges? Kirpatrick level of learning? Return on investment? Using valid and reliable tools? Organization Practice Behavioral Change Knowledge and Skills Attitudes or Perceptions Participation Conclusion What do you aspire to do at your organization? How will you add to the body of knowledge? Questions? 11

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