Date of Graduation

1-2023

Document Type

Dissertation

Degree Name

Doctor of Education (Ed.D.)

College/School

School of Education

Department

Leadership Studies

Program

Organization & Leadership EdD

First Advisor

Walter Gmelch

Second Advisor

Susan Prion

Third Advisor

Seenae Chong

Fourth Advisor

Patricia O'Sullivan

Abstract

Employer-based nurse practitioner residency programs have been implemented to address the significant shortage of primary care providers in the community clinic settings. However, there continues to be a shortage of clinicians who serve as preceptors to nurse practitioner residents and students. Preceptors, also referred to as clinician educators, are essential in the training of learners and their socialization into the profession. Just as there is a shortage of clinicians of diverse backgrounds to reflect the population served in the community, there is also a significant shortage of preceptors of color to train learners from diverse backgrounds. The purpose of this descriptive qualitative reflexive thematic analysis study is to examine the needs and lived experience of community-based clinicians who precept NP residents in four Federally Qualified Health Centers (FQHCs). The study explored the preceptors’ identity formation and role expansion process, as well as how communities of practice may have shaped their experience. Additionally, the intersectionality of race and gender in these processes were explored. Twelve participants each completed a one-hour semi-structured interview via Zoom. Key findings from the study revealed that the culture and leadership within each FQHC sets the stage for clinician educator identity formation and engagement. Clinician educators held multiple identities and the strength of the identities determined the support of their role expansion and engagement within the communities of practice. Four themes emerged from their role expansion experience: 1) benefits of role expansion, 2) expectations and preparation, 3) tension in balancing all their roles, and 4) compensation for the added role. Facilitating factors in expanding existing community of practice for clinicians to communities of practice for clinician educators were identified. The intersectionality of race and gender discussions were limited, and recommendations for practice and future research are presented. Results from this study set the stage for further exploration of how best to support clinicians in their expansion to clinician educators as well as benefit preceptors across all levels of learners. Confident and skillful clinician educators can prepare and retain the next generation of clinicians to care for the most vulnerable and underserved populations.

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