ArticleBMJ open2026
Clinical teaching behaviours of preceptors of undergraduate nursing students: results from a convergent mixed-methods study in Islamabad, Pakistan.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundClinical learning is central to undergraduate nursing education, with preceptors translating theoretical knowledge into practical competence. Preceptors' clinical teaching behaviours (CTBs) shape students' confidence, skill development and professional identity. While CTBs have been studied globally, evidence from Pakistan is limited, highlighting the need for research that offers a comprehensive, integrated perspective.
objectivesTo investigate preceptors' CTBs by evaluating students' perceptions, exploring preceptors' experiences, and integrating these insights to identify points of agreement and discrepancy for a thorough understanding of CTB.
designConvergent mixed-methods study, with quantitative and qualitative data collected concurrently, analysed independently, and integrated using the Pillar Integration Process.
settingA tertiary teaching hospital in Islamabad, Pakistan, providing clinical placements for undergraduate nursing students.
participantsAll undergraduate nursing students (n=50) engaged in clinical practicum and their preceptors (n=14) were included through census sampling. Students completed the CTB Inventory (CTBI) following student-preceptor interactions. Preceptors participated in semistructured face-to-face interviews.
resultsQuantitative data from 44 undergraduate nursing students, based on 88 student-preceptor encounter observations, showed generally positive ratings of preceptors' CTBs across all six CTBI domains (mean scores range: 3.48-3.97 on a 5-point scale). The highest-rated domain was guiding interprofessional communication (M=3.97, SD=0.89), with 85.2% of students agreeing that preceptors demonstrated professional role modelling. The lowest-rated domain was showing concern and support (M=3.48, SD=0.89), with only 31.8% of students agreeing that preceptors expressed concern about students' lives outside work. Qualitative interviews with 14 preceptors identified six categories reflecting clinical teaching practices, including commitment to teaching, learning environment creation, instructional strategies, communication facilitation, feedback and evaluation, and supportive behaviours. Integration of quantitative and qualitative findings yielded six overarching themes, demonstrating convergence in professional role modelling, structured teaching, scaffolded learning, feedback and communication practices. Divergence was observed in the area of personalised support, with qualitative findings explaining lower quantitative ratings through heavy workloads, competing clinical responsibilities and limited protected teaching time.
conclusionsPreceptors play a critical role in shaping undergraduate nursing students' clinical competence and professional identity. Enhancing preceptor training, institutional recognition and supportive policies can strengthen teaching effectiveness and optimise student learning outcomes.
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