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Nursing students' perception of

desirable leadership qualities in
nurse preceptors: A descriptive
survey

ARTICLE in CONTEMPORARY NURSE: A JOURNAL FOR THE AUSTRALIAN NURSING

PROFESSION · MARCH 2008
Impact Factor: 0.65 · DOI: 10.5555/conu.2008.27.2.194 · Source: PubMed

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University of Notre Dame Australia
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Copyright © eContent Management Pty Ltd. Contemporary Nurse (2008) 27: 194–206.

Nursing students’ perceptions of

desirable leadership qualities in nurse
preceptors: A descriptive survey
ABSTRACT There is a paucity of literature examining the context of leadership within the
clinical preceptor/undergraduate nursing student relationship and the relevance
of this to the clinical learning environment.This study used a mixed methodo-
logical survey approach to explore the leadership qualities in nurse preceptors
that are considered desirable and contribute to positive practicum experiences
from the perspective of 23 undergraduate nurses. Findings showed students both
Key Words want and need leadership from their preceptors in order to develop psychomotor
nursing; nursing skill competency and to experience orientation to the real world of nursing care.
education; clinical Gaining insight into the leadership qualities that students perceive as desirable

CN
leadership;
preceptorship; to enhance the practical experience is vital since that practical experience is
nursing students; viewed as the ‘making or breaking’ of many students and influences retention in
clinical practice undergraduate education and within the profession post registration.
Received 12 April 2007 Accepted 26 June 2007

LEANNE MONTEROSSO
Associate Professor
Cancer Nursing
Western Australia Centre
for Cancer and Palliative
MELANIE ZILEMBO Care Research
PhD Candidate Division of Health
Edith Cowan Sciences
University Curtin University
Perth WA, Australia Perth WA, Australia

INTRODUCTION (Australian Institute of Health and Welfare

T he current global shortage of registered

nurses (RNs) across all specialties has
implications not only for patient care, but for
2004; Australian Nursing Federation 2005;
Dunn 2003). This is occurring in a climate
where RNs are already challenged by a high
the provision of education for the nurses of the level of demand on their services (National
future. These shortages are a world wide con- Review of Nursing Education 2002).
cern with noticeable reductions in the nursing In Australia the shortage of qualified nurses
workforce in the United States of America affects both rural and urban centres (AIHW
(USA), the United Kingdom (UK) and Australia 2005; Dunn 2003; Firtko, Stewart & Knox

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Nursing students’ perceptions of desirable leadership qualities in nurse preceptors CN

2005) and this issue is high on the political agen- have been shown to ‘make or break’ the practi-
da. Nurses are the fastest ageing group within cal placement (Cahill 1996). Nurse preceptors
the health profession workforce and the average can fulfil their role effectively by supporting
age of employed nurses increased from 39.3 students in their professional development and
years in 1995 to 42.2 years in 2001 (Australian being responsive to students’ needs (Dunn &
Institute of Health and Welfare 2004). In 1999/ Hansford 1997). However, barriers such as in-
2000 the national average attrition rate from creased workloads and patient acuity due largely
pre-registration programs was 7% (National to the nursing shortage (ANF 2005) lessen the
Nursing and Nursing Education Taskforce amount of support that can potentially be pro-
2005). To address this shortage in Australia, it vided and negatively impacts on students’ learn-
was estimated that between 10,182 and 12,270 ing experiences (Geraghty 2005). Cahill (1996)
new graduate nurses were required to enter contends there is little evidence to show that
the workforce in 2006 (AIHW 2005).The Aus- preceptorship is effective as few studies have
tralian Health Workforce Advisory Committee focussed on the needs and values of the students
projected only 6,131 new graduates would in this educational arrangement. Impressions of
enter the healthcare system, representing a the nursing profession are formed early by
shortfall of 4,051 nurses (AIHW). undergraduate nurses and these attitudes tend
Nursing education in Australia now compris- to be long lasting (Lockwood-Rayermann 2003;
es professional degree preparation in the higher Myrick & Yonge 2002). This, together with the
education sector (Daly, Speedy & Jackson 2000; current climate of industrial unrest and a global
Sellers & Deans 1999). Practical experience is nursing shortage underscored the need to
based predominantly on a model of education explore the manner in which supervision and
where students are partnered with RNs during guidance is provided to students.
clinical practice for supervision and guidance
(Nurses Board of Western Australia 2004).This LEADERSHIP DEFINED
represents a dichotomy because many nurses Leadership is distinguished by the interconnect-
are neither trained nor willing to accept the edness between people, their relationships and
role. This creates a ‘pot luck’ system of educa- influence (De Pree 1990). It encompasses con-
tion creating disparate clinical experiences for cepts of influence, driving accomplishment,
students and has been attributed as a causative vision and embraces the values and attitudes
factor for the theory–practice gap (White & of self and organisation. In short, leadership
Ewan 1991). involves a process, which involves one person
In summary, previous research confirms that influencing others to accomplish objectives
early practical experiences and relationships (Clark 1997). Morrison, Jones and Fuller (1997)
with clinical supervisors can shape a student’s define leadership simply as the ability to in-
perceptions of the profession (Lofmark & Wik- fluence a group toward achievement of goals.
blad 2001). Practical experience for undergrad- Vandeveer (2006) extends this definition to
uate nursing students can provide a ‘real world’ propose that leadership is a catalyst that trans-
nursing experience that will potentially reduce forms potential into action and thus reality.
the ‘reality shock’ of the clinical setting as well Mahoney (2001) argues that all nurses need
as expose the student to both positive and nega- leadership skills and that leadership is inherent
tive behaviours exhibited by clinical staff (Aus- in the role of the nurse.
tralian Universities Teaching Committee 2002; Transformational leadership (Burns 1978;
Lockwood-Rayermann 2003).The relationships Thyer 2003; Tichy & Devanna 1990) is viewed
experienced by the students with clinical staff as a leadership style that transforms those led

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CN Melanie Zilembo and Leanne Monterosso

through inspiration to ‘higher levels of motiva- often does not hold an official position of lead-
tion and morality’. Bass (1985) asserts that ership, do not always hold positions as senior
transformational leaders effect change in their nurses, and are genuine carers that are able to
followers by increasing their awareness of the critically think and prioritise their actions (Stan-
values of the tasks they perform and by focusing ley 2005).
on organisational goals rather than individual Another emerging leadership theory is that
interests which activates higher order needs. of authentic leadership, which asserts that, peo-
Transformational leadership within nursing has ple generally wish to be inspired. People want
been explored widely in the literature. Lett to enrol in enterprises that engage their spirits
(2002) explored the concept of leadership in as well as their minds (Bergeron 2002) and
nursing and concluded that effective leadership this embodies the uniqueness of the concept
results in improved patient care. Sofarelli and of authenticity and authentic leadership. The
Brown (1998) undertook a large scale review of authentic leadership model makes use of what-
literature relating to leadership in the nursing ever strategies may be apparent as long as they
profession and concluded that transformational are congruent with values and beliefs that ‘lead
leadership empowers nurses, which is a pivotal to positive action’ (Bergeron 2002). Duignan
process in effecting organisational change. and Bhindi (1997) argue that in order to
Transactional leadership is based on the become an authentic leader, the individual must
assumption that people are motivated by reward undertake serious self-examination and be
and punishment. The transactional leader sets acutely aware of their own values, attitudes and
clear expectations of what is required of the beliefs.
subordinate and the rewards offered for follow- This descriptive, two-phase, mixed method
ing orders (Changing Minds 2006). Research study used a survey to sample 23 pre-registra-
has shown that nurses are motivated to perform tion nursing students about their opinions of
by both intrinsic and extrinsic rewards (Usher leadership in the clinical practice context.
et al. 1999).Yet punishment, which is cited as a
motivation to achieve, is not considered a moti- CONCEPTUAL FRAMEWORK
vating factor in any identified literature dis- The conceptual framework underpinning this
cussing leadership in the nursing profession. study was adapted from a fusion of the synergy
Performance is an expected service in a trans- model of preceptorship proposed by Alspach
actional relationship.This may be simply in terms (2006) and the synergy model for patient care
of the performance of a job in exchange for a described by Kerfoot (2002). An adapted model
salary. The concept of demand and supply in is proposed which considers patient care, lead-
industry impacts greatly on the notion of reward ership and nursing preceptorship as interrelated
and punishment (Changing Minds 2006). elements that contribute to the learner’s clinical
Congruent leadership is an emerging theory experience.The central concept of the adapted
that sits well with clinical leadership in the model assumes that nursing students (pre-
nursing profession. Stanley (2005: 132) defines ceptees) experience clinical practice positively
congruent leadership as ‘where the activities, when the nurse preceptor demonstrates the
actions and deeds of the leader are matched by desirable characteristics required of a nurse pre-
and driven by their values and beliefs’. Like the ceptor, including leadership (see Figure 1).
transformational leader, the congruent leader
inspires the led through embodying a quality of ETHICAL CONSIDERATIONS
vision and being an effective communicator. This study was approved for implementation by
Stanley (2005) found that the congruent leader the Edith Cowan University Human Ethics Sub

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FIGURE 1: PROPOSED SYNERGY MODEL OF PRECEPTORSHIP FOR LEARNING AND CARE

Committee in June 2006. Ethical approval was six semesters of study (COGNOS 2006). Par-
granted on the provision that students were ticipants in both phases were selected from
given adequate information and assured that this population. Purposive sampling of students
declining to participate would not impact upon was undertaken using the following inclusion
their course progress. No ethical issues arose criteria:
during this study. • Enrolled in the Bachelor of Nursing (pre-
registration) course either a on a fulltime or
METHODS part-time basis;
This study comprised two phases. In Phase 1 an • Enrolled in the fourth semester of the
instrument titled ‘Qualities of Leadership Sur- course;
vey’ was developed, and then pilot tested for • Enrolled in the Nursing Practice Four unit;
clarity, apparent internal consistency and con- • Had completed a minimum of 200 hours of
tent validity. In Phase 2, the instrument was clinical practice.
administered to a group of nursing students rep-
resentative of the same group used for phase 1. Students enrolled in the second year of the pre-
registration course were excluded if they were
Setting not enrolled in the Nursing Practice Four unit,
Both phases of the study were undertaken with- and/or semester four of the pre-registration
in the largest undergraduate nursing school in course.
Western Australia where 1200 students were
enrolled in a pre-registration Bachelor of Nurs- Instrument
ing. This is a three year full-time course with Since no previously developed instrument was

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CN Melanie Zilembo and Leanne Monterosso

available, a questionnaire titled ‘Qualities of data was drawn in keeping with Aamodt’s
Leadership Survey’ was specifically developed (1982) recommendation. Students fitting the
for this study.The questionnaire comprised ten inclusion criteria were approached prior to a
items of which four were related to demograph- lecture and given information regarding the
ic information, two focused on opinions of the study. Seven students agreed to participate.
importance of clinical leadership, and one item Consent was implied if the anonymous ques-
asked respondents to describe negative and pos- tionnaire was returned.
itive aspects of their preceptored experiences.
Item seven replicated a question that was used Procedure
in an instrument developed by Stanley (2004) A copy of the instrument, an information letter
which explored 39 prescribed characteristics and a copy of the validity testing questionnaire
RNs associated with leadership. These charac- was given to each of the seven students along
teristics were drawn evenly from literature with an addressed envelope for return of the
relating to both transformational and transac- completed questionnaire. Five questionnaires
tional leadership. Preliminary face validity and were returned (71% response rate).
content validity testing of Stanley’s instrument
showed a strong link between clinical nurse Results
leadership and transformational leadership with Responses indicated the items within the instru-
100% of respondents (n=13) agreeing the char- ment were clear, non-ambiguous and relevant
acteristics of support, integrity and coping well (100% agreement rate).There were no recom-
with change were important. In adapting this mendations for change or review, thus no fur-
item for the current study, fourteen of the orig- ther analysis was required and phase two was
inal instrument characteristics were retained. undertaken.
Fourteen additional characteristics were drawn
from literature relating to authentic and con- Phase two
gruent leadership. Thus, the instrument com-
Sample
prised items according to the following four
models of leadership: transformational, transac- Students meeting the same inclusion criteria
tional, authentic and congruent. for Phase One were approached. Consent was
implied if the student returned the completed
Phase one questionnaire.
The ‘Qualities of Leadership Survey’ instrument
was tested for clarity, apparent internal consis- Procedure
tency and content validity in August 2006 using This Phase was undertaken between August
a questionnaire devised by the researcher to and September 2006. An envelope containing
assess the following criteria: an information letter, a questionnaire and ad-
1. Were the instructions clear? dressed envelope was distributed to students in
2. Were any of the questions ambiguous? attendance at a pre-designated lecture. Students
3. Were any topic areas omitted? were asked to return the completed question-
naires in the addressed envelope the following
A group of seven undergraduate pre-registra- week to the reception area of the nursing build-
tion Bachelor of Nursing students in the fourth ing where a fixed, locked box was located. One
semester of study were selected to participate hundred and eight questionnaires were distrib-
in the validity testing. Respondents were select- uted and 23 were returned within the two week
ed from the context within which the original timeframe. Owing to a poor attendance at

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Nursing students’ perceptions of desirable leadership qualities in nurse preceptors CN

the initial lecture and a poor response rate, the resentative of demographic profiles of both the
researcher attended the same lecture two weeks study university (COGNOS, 2006) and overall
later and repeated the above procedure. No fur- figures for Australian undergraduate nurses.Thir-
ther questionnaires were returned. teen percent (n=3) of respondents were aged
less than 20 years, 17% (n=4) aged between
Data analysis 20–24 years, 52% (n=12) aged between 30–39
Numeric and categorical data from the com- years, and 17% (n=4) were 40 years of age or
pleted questionnaires was entered into a SPSS more. The majority of respondents were aged
version 12 database and analysed using simple between 30–39 years (52%; n=12) which was
descriptive statistics. Qualitative data from each higher than that of the study university and Aus-
open-ended item of the instrument was tran- tralian wide average. According to The Australian
scribed verbatim by the researcher. Responses Institute of Health and Welfare (AIHW 2003)
from four open-ended questions were analysed data, many students entering undergraduate
using thematic analysis using three levels of nursing programs are mature aged. In 1998, stu-
analysis (level one coding for key words, level dents aged 30–39 years accounted for 17.4% of
two coding for sub-themes and level three cod- student intakes (see Figure 2).
ing for main themes). Forty seven percent (n=11) of respondents
reported their highest level of education was
RESULTS completion of Year 12. This was followed by
17% (n=4) respondents having attained a TAFE
Sample characteristics
(Technical and Further Education) certificate
Twenty-one students were female (91.3%) and level of vocational education. These four res-
two were male (8.7%).These figures were rep- pondents were enrolled nurses.

FIGURE 2: AGE DISTRIBUTIONS OF PARTICIPANTS

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CN Melanie Zilembo and Leanne Monterosso

Qualities of leadership Leadership and preceptors

A total of 96% (n=22) respondents agreed that All respondents (n=23, 100%) provided a defi-
leadership was an important role of the clinical nition of clinical leadership in their own words.
preceptor.The highest rated desirable character- The following themes emerged from the data:
istics in the item relating to leadership in nurse competence and knowledge; the importance of
preceptors were clinical competence and pur- teaching skills; and socialisation to the culture
posefulness, both of which were rated by 100% of nursing.
(n=23) of respondents. Characteristics of sup- Thirty nine percent of respondents (n=9)
port, motivation, approachability, consistency, identified the importance of clinical compe-
organisation and effective communication were tence and knowledge with leadership in precep-
all rated as desirable in relation to leadership tors. One respondent stated that a clinical
in preceptored education by 96% (n=22) of leader was ‘someone to learn clinical skills from
participants. Characteristics rated as the least years of experience’ while another included the
desirable leadership qualities were negotiation role of the preceptor as a teacher in his/her
(56%), analytical (52%) and reward and punish- response by stating the definition of a clinical
ment (30%). (See Table 1.) leader as ‘someone who has the skills and
knowledge to teach those who are learning’.

TABLE 1: QUALITIES OF LEADERSHIP ( N=23 )

Characteristic Yes Don’t know Don’t care No

Purposeful 23 0 0 0
Clinically competent 23 0 0 0
Supportive 22 0 0 1
Motivator 22 0 0 1
Approachable 22 0 0 1
Consistent 22 1 0 0
Organised 22 1 0 0
Effective communicator 22 1 0 0
Inspires confidence 21 1 0 1
Critical thinker 21 2 0 0
Sets goals and targets 21 1 0 1
Passionate 20 0 0 3
Guided by principles 19 4 0 0
Compassionate 19 2 0 2
Inspirational 18 2 0 2
Autonomous 18 5 0 0
Self-disciplined 18 4 1 0
Congruent 16 5 0 0
Relationships valuable 16 1 0 1
Visible 16 3 2 1
Resource allocation 15 6 0 1
Authentic 15 7 0 0
Empowered 15 8 0 0
Negotiator 13 9 0 1
Analytical 12 10 0 0
Reward/punishment 7 5 0 10

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Nursing students’ perceptions of desirable leadership qualities in nurse preceptors CN

One respondent stated that ‘having a good need for nurse preceptors to adapt to individual
knowledge base and understanding of the stu- situations and each learner as having unique
dent nurse’s role and their scope of practice’ learning needs.
enhances a leader’s role. Lett (2002) explored the concept of leader-
Clinical leadership was seen as a means ship in nursing and concluded that effective
of developing professionally as a student and leadership results in improved patient care.
into the culture of the nursing profession. One Sofarelli & Brown (1998) undertook a large
respondent stated: scale review of literature relating to leadership
Clinical leadership is the ability to, or res- in the nursing profession and concluded that
ponsibility of imparting knowledge in en- transformational leadership empowers nurses,
hance[ing] skill level while at the same time which is a pivotal process in effecting organisa-
promoting personal growth of the student. tional change.Trofino (1995: 48) examined the
concept of transformational leadership from a
Socialisation within the nursing environment global economics perspective and asserts that
was reported in terms of ‘fitting in’ with the ‘The transformational leaders will be persua-
ward routines and staff. Forty-three percent of sive, creative and intuitive, so as to enhance
respondents (n=10) indicated that they felt the these skills in others and to nurture nursing
clinical leader was able to actualise a clinical leaders for the future’.
environment conducive to these conditions for Transformational leadership is described as
the student nurse. One respondent stated: dynamic and capable of empowering change
[the clinical leader] leads a team or individual among individuals. Interestingly, transforma-
so that they can develop their understanding, tional characteristics were favoured among the
confidence and ability [and] also be able to study respondents as desirable which led into
support them emotionally and mentally by deeper themes relating to educational needs and
providing knowledge and resources that may outcomes.
be necessary and appropriate. The major themes included interpersonal
communication, integration of theory and prac-
This point was also described by other respon- tice, continuity of preceptor and psychomotor
dents in terms of the clinical leader possessing proficiency and were highlighted by participants
‘an actively supporting attitude’, ‘expertise and as conducive and obtrusive factors existing with-
guidance’ and ‘the ability to help in any way to in the preceptored model of clinical education.
assist a student to complete a practical rotation’.
The respondents within the study defined the Interpersonal communication
meaning of leadership broadly, though all The respondents within this study highlighted
responses related explicitly to clinical leadership the importance of a mutually positive working
qualities that relate specifically to preceptored relationship with their preceptors in order to
education. gain the most from the clinical placement.
Qualities of communication skills, supportive-
DISCUSSION ness and approachability were rated by 96%
The key findings from this study indicate unani- (n=22) of respondents as desirable. Nurse
mous agreement that leadership is an important preceptors who embodied and communicated
role of the nurse preceptor yet is a complex these interpersonal skills were viewed as effec-
issue for students to negotiate in practice. Data tive preceptors and clinical leaders.These find-
showed respondents favoured a transformational ings concur with those from interdisciplinary
approach to leadership style but identified the research that has shown a positive interpersonal

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CN Melanie Zilembo and Leanne Monterosso

relationship between teachers and students ceptor. Early positive socialisation experiences
results in an increased quality of learning have been shown to improve retention rates of
(Hekelman et al. 1995; Hilliard 2000;Vaughn & new nurses (Myrick & Yonge 2002), which are
Baker 2004). The development of a positive issues of premium concern in an era of worsen-
working relationship between a nurse preceptor ing nursing shortages at all levels of the pro-
and student involves developing a mutual fession. Therefore the lack of a conceptual
rapport (Geraghty 2005; Stevenson, Randle & framework to guide preceptorship may be a
Grayling 2006) and communicating effectively contributing factor to the difficulties expressed
and with mutual respect (Clay et al. 1999). by the respondents in building relationships
within the complex interactions of the nursing
Continuity preceptor environment.
Developing a positive interpersonal relationship
is a timely process and unless a student is ex- Assimilating theory and practice
posed to the same preceptor for a period of Findings demonstrated that students view the
time, an effective working relationship is unlike- practicum experience as the opportunity to
ly to be established. Continuity of preceptors contextualise theoretical learning within the
was highlighted by fourteen respondents (61%) practical setting. One respondent reported that
as important for effective preceptorship experi- she was ‘able to consider a real patient case
ences. This was further emphasised by eight to give knowledge of relevant pathophysiology
respondents (35%) who reported the difficulty and pharmacology meaning within the context
associated with ‘being passed from nurse to of that particular patient’s condition’. Four
nurse’ and the subsequent inconsistencies that respondents (17%) identified the link between
arose with each nurse teaching and practising theory and practice as embedded within the
various tasks differently. The lack of continuity practical experience. Previous work by Brans-
appeared to cause confusion for students who ford, Brown and Cocking (1999) showed that
reported that working with a new preceptor learning which can be assimilated in various
was like ‘starting over’. Geraghty (2005) exam- contexts enables the student to develop a more
ined the effectiveness of preceptorship within a flexible representation of that knowledge and
Western Australian perinatal hospital and high- thus an improved ability to draw upon that
lighted the difficulty preceptees have in building knowledge critically.This is arguably an essential
a rapport with a preceptor when allocated to skill for the Registered Nurse.
work together on only one occasion. Anecdotal-
ly, this is a common scenario in the majority of Confidence and psychomotor
teaching hospitals within Western Australia. proficiency
One of the contributing factors to this situation Findings highlighted that students also view
is that many nurses in Australia work part-time. the practicum experience as an opportunity to
In 2003, 50% of RNs in Australia worked less practice and refine clinical skills. Six respon-
than 35 hours per week (AIHW 2004). dents (26%) identified that practicing a skill
Respondents rated ‘supportive’ (96%) and gave them confidence in their ability to perform
‘inspires confidence’ (91%) as highly desirable that skill. Existing barriers within the nursing
qualities in their nurse preceptors. These find- clinical environment, such as the often frantic
ings were reinforced by responses to the open pace and skill-mix of the available staff, impact-
ended questions citing a positive practical ex- ed upon the respondents’ ability to receive the
perience results from feeling confident and appropriate guidance and instruction from pre-
supported in clinical practice by the nurse pre- ceptors.This was highlighted by 48% of respon-

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Nursing students’ perceptions of desirable leadership qualities in nurse preceptors CN

dents (n=11) as an obtrusive factor to a positive individuals are thrust into that position unwill-
learning experience within the clinical environ- ingly. If attitudes and values can be shaped over
ment. Previous research by Polofroni et al. the period of undergraduate education, then
(1995) highlighted that although preceptored that behaviour becomes the norm and the natu-
placements imply supervised and guided prac- ral behaviour that is modelled to the next
tice, students work without direct supervision generation.
for up to 75% of the time. This offers limited Appropriate leadership training embedded
scope for development and constructive feed- within the undergraduate nursing program at all
back on psychomotor skill development.When levels may be constructive.The model of leader-
students feel secure with their preceptor and ship training adopted must be context specific
supported in their practice, they are more likely for the nursing profession and be inclusive of
to ask questions and seek out learning opportu- strategies that are practical for students in early
nities (2004) which is also supported by find- nurse education to adopt and assimilate into
ings from this study that suggest students are their developing skill set.
more likely to seek out a learning opportunity The theory–practice gap represents a chal-
when paired with a preceptor who conveys lenge for new graduates and employers. One fac-
interest and friendliness toward their student. tor that has been shown to address the theory
This enhances not only their experience but practice gap is continuity of preceptor during
their competence and confidence. undergraduate clinical placements. While the
Findings from this study have reinforced current workforce demographic is not conducive
previous research that demonstrated nurse pre- to continuity, strategies to address the inconsis-
ceptors exert significant influence over the tency experienced by students exposed to mul-
practical experience of undergraduate nursing tiple nurse preceptors’ warrants attention.
students in clinical placements (Cahill 1996; In addition to the preparation of students for
Dunn & Hansford 1997; Lofmark & Wikblad preceptorship, nurse preceptors themselves
2001). This study’s findings also reveal that need ongoing support and preparation for the
students unanimously agree that leadership is role as a collaborative effort between healthcare
important in their nurse preceptors, and that organisations and tertiary education providers.
the qualities of the effective nurse preceptor The high turnover of staff in many areas of nurs-
and the clinical leader are synonymous. These ing both in clinical and education settings is a
findings suggest that a good nurse preceptor is a stark reality.Thus education related to the role
clinical leader by definition of the role and its and practical attributes of preceptors should
associated responsibilities. reflect this. The researcher recommends pre-
In summary, findings showed that although ceptor training should be a mandatory compe-
effective clinical leaders were seen to be clini- tency for all nurses, particularly since it is cited
cally competent and have a broad body of by many nursing regulatory and professional
knowledge, they also demonstrated effective organisations as a responsibility of the Regis-
interpersonal skills. These skills, such as effec- tered Nurse (Australian Nursing and Midwifery
tive communication, compassion and supportive Council 2005; NBWA 2004).
attitudes, are aspects of leadership that can be
fostered from early on during undergraduate LIMITATIONS
training. Equipping nursing students with the The study was limited by a small sample size
requisite foundation skills to think and behave as which impacts upon the generalisability of
leaders from the outset, may head off the prob- the results. However, trends and themes that
lems of apathy and resentment that exist when emerged from the study offer directions for

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CN Melanie Zilembo and Leanne Monterosso

future research within this previously under role. Findings may also impact on undergradu-
researched area. ate nursing curricula.
Although the purposive sample for the study Creating change and setting a course for a
was drawn from one tertiary institution, demo- new direction in nursing education will require
graphic data showed that the sample was gener- the collaborative effort of all the stakeholders to
ally representative of the local and Australia the profession. Believing in the capacity for
wide undergraduate nurse profile. change must become the underlying motivation
The instrument used for the study was newly to improve educational outcomes for pre-regis-
developed and requires further development tration students.This can begin to be actualised
and more rigorous testing to assess clarity, ap- through the construction of a critical mass of
parent internal consistency, validity and rel- individuals willing to embrace and act as leaders
iability. Findings indicate it may have been of the profession.
advantageous to include an item asking respon-
dents to provide a definition of the term ‘pre- References
ceptor’. Through the conduct of the study it Aamodt AA (1983) Problems in doing nursing
became apparent there was considerable incon- research: Developing a criteria for evaluating
sistency in the application and definition of qualitative research. Western Journal of Nursing
Research 5(4): 398–402.
the term preceptor and its synonyms such Alspach G (2006) Extending the synergy model to
as ‘buddy-nurse’, ‘facilitator’, ‘practice-partner’ preceptorship: A preliminary proposal. Critical
and even inappropriate synonyms such as ‘men- Care Nurse 26(2): 10–13.
tor’. Eliciting student meanings assigned to the Australian Health Workforce Advisory Committee
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N O W AVA I L A B L E F R O M e C O N T E N T
The Leading Way of Changing Meaning by Sandra Sytsma
(ISBN 978-1-921214-26-4; ii+242 pages; 2007; Post Pressed; Institution: $97.50; Individual: $65.00)
In studying leading as a way of changing meaning, this research documents a
journey of inner exploration amongst five self-nominated leaders in education.
In contrast to change limited by outer dimensional structure, changing meaning
in an inner dimension was seen as the necessary complement in creating real
difference in educators and in educating.
Over a period of almost a year, the leaders participated in an online project,
travelling together through email dialogue focused around leading, changing
and meaning. In this, they experiment with a changing way of researching,
developing a personalised space of changing in which they could truth-test
their thoughts and feelings about the multiple facts of leading and meaning.
Such a space – interstitial to their outer working and inner personal lives,
but deeply connective of both – was found useful in supporting coherent
change processes in the participant leaders.

Awakening Struggle: Towards Buddhist Critical Social Theory by Robert Hattam

(ISBN 978-1-876682-57-4; xx + 337 pages; 2004; Post Pressed; Institution: $104.25; Individual: $69.50)
‘Awakening-Struggle demonstrates conceptual creativity through grappling
with the foremost and advanced problems of contemporary critical theory.
This work is a prodigious, scholarly account of critical theory that goes
beyond the usual immanent reading and leads us to the ‘affinity’ between
critical theory and Buddhism as a way of working towards a self-society
dialectic that is a key to the critical theory tradition. Against critical theory’s
tendency towards social scientific objectivism that reinforces privilege in
society, Hattam proposes Buddhist ‘technologies of self’ as resources for
social activism and social revitalization.’
— Professor Philip Wexle (Hebrew University, Jerusalem)

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206 CN Volume 27, Issue 2, February 2008