Factors Influencing Nursing Preceptors' Role in Saudi Arabia: A Mixed Methods Study

The global shortage of nurses is a significant issue of concern. There is a need to increase the number of registered nurses to cover this shortage and maintain the quality of care and safety required to deal with unexpected crises. Clinical education equips nursing students to integrate theory into real-world practice. Registered nurses, who act as preceptors, play a vital role through formal assessment and feedback in teaching novice nurses how to provide safe, high-quality patient care. The increase in nursing students enrolled in nursing colleges places more responsibility on preceptors as they train a new generation of nurses alongside their daily roles in the hospital. There is limited research on preceptorship in Saudi Arabia, especially in relation to its multicultural workforce. Because of staff shortages in Saudi Arabia, nurses are often recruited from other countries; thus, expatriate nurses play a significant role in the education of Saudi nursing students. The value of preceptorship in terms of preparing nurses in the clinical practice environment should not be underestimated. Preceptorship provides important opportunities for novice nurses to be prepared for the nursing profession by developing their confidence and competence. Despite its importance, there is a lack of detail and insight into the way Saudi and expatriate preceptors undertake the critical role of preceptorship. his aim of this study was to investigate factors influencing preceptors’ experiences in performing their role of training intern nurses in the Saudi Arabian context. An explanatory sequential mixed methods design was conducted, consisting of three phases. In Phase 1, a quantitative study of 285 preceptors identified their backgrounds and perceptions, and investigated the factors influencing their role. The findings indicated that most preceptors were not formally prepared for their role. Organisational factors negatively affected preceptors regardless of their nationality, and cultural factors significantly hindered the expatriate preceptor role. In Phase 2, a qualitative study was conducted to obtain an in-depth understanding of preceptors’ lived experiences through semi-structured interviews with eight participants. The interviews were analysed using Interpretive Phenomenological Analysis framework. Three superordinate categories with nine subordinate themes described the participants’ journeys from uncertainty to satisfaction as well as the challenges and obstacles they experienced. After the data from the two phases were separately collected, analysed and reported, the findings were integrated in Phase 3 to understand the complete picture and achieve the aim of employing a mixed methods approach. Joint display and contiguous integration methods were employed to bring the data together, and the results of the integration revealed two main categories of factors influencing preceptors in Saudi Arabia. The first was organisational factors, which covered several issues related to a lack of clarity in the preceptors’ responsibilities, inadequate preparation, excessive workload, lack of appreciation and lack of communication. The second, individual factors, included concerns related to precepting across cultures, interns who are uninterested in learning and preceptors maintaining their own motivation. The key results from this project provide evidence that will inform nursing education leaders specifically in Saudi Arabia to consider these factors and incorporate them to develop well-structured guidelines and policy imperatives that will ensure the sustainability of the preceptor role. The study offers insights for an international readership that may inform the development of cultural training content in curricula, to prepare preceptors to competently teach new nurses from a variety of nationalities, ethnicities and backgrounds. Investment in preparing preceptors could help ensure that the new generation of nurses cultivates the knowledge, skills and confidence needed to retain them in the profession. This may further ease the staff shortages that threaten the provision of safe and quality care to patients.Thesis (Ph.D.) -- University of Adelaide, Adelaide Nursing School, 202