The leadership characteristics of the preceptor in selected clinical practice settings in Botswana

Curationis 29(3): 24-40 A non-experimental, explorative, descriptive, quantitative study was undertaken. The purpose was to explore and describe the views of preceptors and preceptees regarding the fulfilment of the role of the preceptor in selected clinical nursing practice settings in the Botswana context. The study included 72 preceptors and 200 nursing students/preceptees who voluntary agreed voluntarily to participate in the study. A questionnaire was used to collect data, which was analyzed by using descriptive and inferential statistics. The findings of this study indicated that the preceptor lacked leadership characteristics in the accompaniment of the preceptee. These constraints included the lack of desirable characteristics such as intellectual, emotional, physical and other traits that are common to all good leaders. Recommendations were stated for improvements in selecting preceptors with certain leadership skills for the clinical practice settings. The limitations of this study were highlighted.


Introduction and rationale
The term preceptorship has been used in the context of nursing for a relatively short period, time, having first appeared as a classification in the International Nursing Index of 1975, and has a general co n n o tatio n o f tu to r or in stru c to r (S ham ian & Inhaber, 1985:79).G oldenberg (1987/88:11) states that 24

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preceptorship is a unique experience in which the preceptee/student is guided by a preceptor in developing higher-level practice skills that contribute to quality p atien t care.On the o th er hand leadership involves changes that lead to the attainment of goals by leaders and followers.'Leadership is a com plex process by which a person influences others to accomplish a mission, task or objective and directs the organization in a way that makes it more cohesive and coherent' (Bennis, 2002:1).Preceptors in nursing education should act as leaders in the present health care environment and have a challenging role to play in educating and guiding followers towards the outcomes of standards set by the educational system of their country.A p re cep to r th e re fo re needs specific leadership traits to guide preceptees in their clinical educational setting that m otivates them tow ards achieving a shared purpose of quality health care delivery.
A study about the significance o f a professional nurse leader that acts as a preceptor could offer future guidance to those activ ely in v o lv ed in nursing education (Ohrling & Hallberg, 2000:13).Furthermore, this knowledge could help to make clinical teaching more efficient and effective.
The nursing profession has through the years, adapted and modified the meaning of "preceptor" to describe a unit-based professional nurse who carries out oneto-one teaching of new employees or nursing students.The description of p recep to rs o f S ham ian and Inhaler (1985:79) notes that the one-to-one situation in preceptorship provides an effective mechanism for learning.It is evident from literature that the student/ preceptee can learn effectively under the guidance of a competent senior person or leader who interacts with the student in a one-to-one situation (B ashford, 2002:14).
A study of nurses' lived experiences as preceptors revealed their conviction that preceptorship instilled confidence in students and empowered them in clinical practice learning situations (Ohrling & Hallberg, 2001:530).A preceptor should possess leadership traits to influence p recep tees to o b tain the necessary co m p ete n cies to act as co m p ete n t practitioners.However, Been (2001:132-134) found that the effectiveness of clinical accompaniment in the learning process diminished by the growth in the num ber o f stu d en ts re q u irin g such accompaniment in a changing hospital environment.The latter is one of the reasons why the N ursing Education sy stem in B o tsw an a em ployed preceptorship as a clinical teaching approach.
Statement of the problem Myrick (2002:154) states that although preceptorship is increasingly being used in practice settings, little is known about the leadership traits that preceptors d em o n strate to teach p re cep tee s effectively.The same situation prevails in Botswana and needed to be examined w ith a view to selec t a p p ro p riate preceptors to prom ote and facilitate clinical learning for students.Preceptors ex p ressed co n cern s ab o u t v ario u s problems and issues during a Systematic Programme Review Sem inar held in Gaborone in October 1999.The issues raised during this presentation were related to the characteristics o f the preceptor being a leader in the clinical situation.The basis of good leadership should be an honourable ch aracter (Bennis, 2002:2).
Two important issues raised by the said p re cep to rs in re la tio n to the characteristics o f the preceptor were that: • preceptors were inadequately prepared for their role to lead and guide preceptees in the clinical setting; and • the lack of motivation among the preceptors.

Purpose of the study
The overall purpose of this study was to ex p lo re and d escrib e the view s of preceptors and preceptees regarding how the role of the preceptor as a leader is fulfilled in clinical nursing practice settings.
One of the main objectives of this study was to explore and describe: • which leadership character istics the preceptors possess to carry out their role in the clinical practice setting.This article will focus on the said objective re g ard in g the c h a ra c te ris tic s o f a preceptor.
The findings were used to describe recommendations for improvements in the future selection and role of preceptors in c lin ical p ra ctice settin g s in the Botswana context.

Conceptual framework
To lead means to influence, to guide in term s of direction, course, action or opinion (chap.1, L eadership).The 25 Curationis August 2006 characteristics of the preceptor as a leader could be viewed against the background of the trait theory.This earlier leadership theory tried to explain leadership in terms o f a single elem ent o f a p articu lar situation.The assumption was made that leaders are bom leaders.This implies that some people are naturally better leaders than others and that for exam ple, a preceptor in the educational setting is needed to influence preceptees in this setting.This approach entails identifying peo p le w ho have the ap p ro p riate leadership characteristics for a specific situation (Tappen, 2001:22).Traits are a p e rso n 's d istin g u ish in g p erso n al characteristics, such as intelligence, values, self-confidence and appearance.
The trait theory identifies intellectual, emotional, physical and other traits that are com m on to all good lead ers.
In te llig e n c e and a b ility tra its are identified as judgement, decisiveness, know ledge and fluency o f speech.Im p o rtan t p e rso n a lity tra its are ad a p tab ility , o rig in ality , alertn ess, creativity, cooperativeness, personal in teg rity , eth ical co n d u c t, selfconfidence, em otional b alance and control, and independence.The Social characteristics/abilities needed for an effective leader are outlined as the ability to en list c o o p e ratio n , p o p u larity , prestige, sociability, social participation and tact/d ip lo m acy .P h ysica l characteristics are related to activity and energy in a specific situation.Workrelated characteristics are achievement, d riv e /d e sire to ex cel, d riv e for responsibility, responsibility in pursuit of goals and task orientation (Daft, 1999:66;Swansburg, 1996:424).
The traits of a preceptor correspond to the traits of a leader and some of these traits will be outlined in the findings.

Definitions of other concepts Preceptor
Preceptor is defined as "a teacher or instructor" (Concise Oxford Dictionary, 1999:1075).Different authors define preceptorship as reality-based clinical strategies involving the preceptee/novice nurse and an experienced, clinically competent nurse' (Atkins & Williams 1995:1006-1015;Reilly & Oerm ann (1999:196).These authors also emphasize the importance of the preceptor having the right characteristics and qualities, which include but are not lim ited to clinical com petences, interest in the preceptorship role and socialization of the p recep tee to the ro les o f a professional nurse.
F or this study the term p re c e p to r included an expert registered nurse who assists stu d en ts to achieve predetermined learning objectives in a clinical milieu through role modelling and the subsequent practice of appropriate nursing behaviours.In this study, the term registered nurse referred to a nurse who holds a diploma in general nursing, is reg istered w ith the N ursing and Midwifery Council of Botswana, and works in a hospital or clinic setting in Botswana.

Characteristic
The term characteristic is defined in the Concise Oxford Dictionary (1999:237) as 'typical of a particular person, place or thing'.The term refers to the attributes, features or traits that the preceptor needs to possess and how these personal attributes influence the preceptorship re la tio n sh ip and the stu d en t accompaniment process.
Certain characteristics of a preceptor are d esira b le to su stain an e ffec tiv e p re cep to r-p rec ep tee re la tio n sh ip .B ashford (2 0 0 2 :15) id e n tifie s characteristics of a good preceptor as acting as a role model and the ability to demonstrate leadership skills.For the purposes of this article, the focus will be on leadership characteristics.

Preceptee
A preceptee is a student who is engaged in studying something or a person who takes a particular interest in a subject (Concise Oxford Dictionary, 1999:1424).In this study a preceptee was a final-year nursing student (third year) training for a Basic Diploma in General Nursing or an Enrolled Nurse Upgrade student being supervised by a preceptor during a clinical attachment or internship.

Clinical practice
Clinical practice setting in this study refers to a health facility (either a hospital or clin ic) w here the p re cep to r and preceptee interact during preceptorship relationships.

Research design
The approach to this study was a nonexperimental, exploratory, descriptive and quantitative survey.The main purpose of this non-experimental research was to determine and reflect the views of preceptors and preceptees regarding the preceptor's role in some clinical practice settings in Botswana.The quantitative, descriptive and exploratory approach was em ployed in this study for the following reasons: • Descriptive and inferential statistics are used to examine the significance of the opinions of the preceptor-preceptee research groups (Bums & Grove, 2003:195)

Method
The quantitative perception survey used was a useful way of investigating the leadership characteristics necessary in preceptorship by means of the direct questioning of a sample of respondents (Polit, Beck & Hungler, 2001:472;Bums & Grove, 2003:481).The survey was undertaken over four years.

Data collection approach and m ethod
The study employed a structured data collection approach by distributing two sim ilar questionnaires to the sample groups of preceptors and preceptees, with a view to collecting systematic and u n b iased d ata on the view s o f the re sp o n d en ts.A q u e s tio n n a ire was chosen as the data-collecting tool for this d escriptive study to g ather a broad sp ectru m o f in fo rm a tio n from respondents on the role of the preceptor in preceptee accompaniment.The items in the questionnaire were formulated as statements that were answered on a 4 point scale.
The re se a rc h e r id e n tifie d research assistants (nurse educators from some health training institutions) to assist in th e d istrib u tio n o f the re searc h in stru m en ts to b oth the re le v an t resp o n d en t groups (p recep to rs and preceptees).Before handing out the questionnaires, the researcher briefed the research assistants on the instrument so that they could explain the questions to the participants, if the need arose, thus ensuring that the questionnaires were completed correctly.The main themes that were outline in the questionnaire addressed the ch aracteristics o f the preceptor as a leader (work-related,, and the role of the preceptor in planning, im p le m e n tatio n and e v a lu a tin g o f learning opportunities for the preceptee. Two hundred preceptees completed and returned their questionnaires (response rate of 90.1 %).A total of 80 questionnaires were distributed to preceptors who met the inclusion criteria for the study.S ev en ty -tw o q u e s tio n n a ire s w ere completed and collected by either the researcher or research assistants (90% response rate).

Data analysis
A quantitative data analysis was done with the assistance of a statistician who used the Statistical Package for Social Sciences (SPSS).Both descriptive and in ferential statistical m ethods were employed.The statistical tests performed in clu d ed the c h i-sq u a re (-r2) o f association and frequencies for both preceptors and preceptees on the items on the questionnaire.

Reliability and validity of the research process
Reliability R e lia b ility is the co n siste n c y and d ep e n d ab ility d em o n strate d by a research instrument when it is used to measure a variable or attribute that it was designed to measure (Brink, 2000:213-214;Struebert & Carpenter, 1995:317).
The reliability of the factor analysis was tested in the original instrument (Jooste, 1991) by means of scale counts, and the Cronbach Alpha measured the reliability of the factors obtained.The Cronbach A lpha in dicated a reaso n ab ly high reliability of the scale counts for the different factors.

Validity
To ensure validity and reliability, the researcher took care to be objective throughout the study.Objectivity should be an integral part of research to ensure that the researcher's personal biases and p re fe re n c e s do not in flu en c e the in terp re tatio n o f the fin d in g s.The questionnaires used for this project were structured and standardized from one respondent to the other, making it less prone to different interpretations and changes in em phasis.The research assistants were orientated beforehand about the purpose and contents of the instrument, and how to administer it.

Internal validity
In this study, the researcher ensured internal validity by complying with ethical re searc h stan d ard s d u rin g data collection, ensuring that the data was recorded fully, maintaining principles of neutrality, and ensuring the competence of both the researcher and the research assistants (nurse educators) in data collection techniques by thoroughly orientating the research assistants (nurse educators) for the data-collection process (Rossow, 2000:178-179).

Face and content validity of the instrument
In this particular study, the content and face validity of the questionnaires were determined by means of the input from five nursing education experts who scru tin iz e d the q u e stio n n a ire s to ascertain the appropriateness o f the questions and wether those questions corresponded with the objectives of the 27 Curationis August 2006 study (P olit et al. 2001:309).Both questionnaires were given to five nurse educators to comment on the clarity and re le v an ce o f c o n te n t/ite m s on p re cep to rsh ip from the B o tsw an a perspective.The overall comment was that the instruments comprehensively covered all the aspects that needed to be explored about preceptorship in the clinical practice settings.

Construct validity of the instrument
The instrument for this research project was tested by means of a factor analysis in a study done by Jooste (1991) for construct validity.Factor analysis is a method of identifying clusters of related items on a scale.The major purpose of the factor analysis done by Jooste (1991) was to reduce a large set of variables to a smaller, more manageable set (Polit et al. 2001:311,364).Six factors emerged in the study by Jooste (1991) through oblique rotation.The factors corresponded to the items as they were originally grouped in the four sections of the questionnaire.This proved to be a validly constructed instrument.

External validity
The external validity of this study was determined by supporting the findings from the preceptors and the preceptees with reviewed literature and with findings from similar related studies from other settin g s (B rink, 2 0 0 0:12 4 ).The co n v e n ie n ce o f sam p lin g has implications for the external validity.However, for this study, relatively large sam ples of preceptors (100.0% ) and preceptees (50.0%) participated in the study to overcome this obstacle.

Ethical considerations
In ensuring the safety of the participants and preventing the violation of human rights, permission to carry out this study was sought from the Ministry of Health (Research Unit) through the Office of the State President, District Matrons from selected clinical practice settings (health facilities) and the Principals of all eight Health Training Institutions.Informed co n se n t was o b tain ed from each respondent after a full and thorough explanation of the aim of the study and the potential benefits of participating in the study w ere ex p lain e d .The respondents were assured verbally and in writing that for the sake of anonymity and confidentiality their names would not appear anywhere in the research findings.Anonymity was of particular importance to the preceptees who might have felt threatened by the presence of senior m em bers o f the pro fessio n , particularly lecturers if interviews were to be co n d u cted .The re s e a rc h e r's absence ensured that the su b je c ts' responses could not be influenced by the research er.T h eir co n sid e ra tio n s/ responses were based on descriptions provided in the questionnaires (Brink, 2000:153;Polit et al. 2001:269;Bums & Grove, 2003:272).The anonymity also enabled the participants' preceptors to express their views on the process of preceptorship without fear of causing co n flic t am ong th em selv es.The respondents were also informed that participation was voluntary, and that they could withdraw at any time during the process if they felt uncomfortable about it.

Data analysis and presentation
The number of responses differs from item to item.Two hundred preceptees and seventy-tw o preceptors returned the questionnaires, but they did not all respond to all the items.

Characteristics of a preceptor
The characteristics of the preceptor as a leader will be discussed in rela tion to work-related characteris tics, intelligence, personality, so cial and physical traits.

Work-related characteristics Preceptor's interest in supervising students
The findings indicated that 10 preceptors (38.5%) stated they lacked interest in supervising and teaching students (Figure 3).Over sixty per cent of the preceptees (63 or 68.5%) agreed that the precep tors lacked interest in teaching and su pervising preceptees.
A ccording to Jooste and T roskie (1995:12) preceptors should be se lected according to their interest in preceptorship.Therefore this means that if preceptors lack interest in the role, efforts to prepare them for the role will be futile and simply a waste of resources.Preceptors' lack of inter est in teaching and su p erv isin g preceptees could lead to preceptees not being able to accomplish their clinical assignments due to the lack of guidance and role modelling by the preceptors.In response to the open q u estio n , one precep tee stated : 'Some preceptors lacked knowledge and skill about preceptorship thus why they seem not to have interest in the students, may be that they feel chal lenged when students ask them ques tions'.
From a leadership perspective, a lack of interest in preceptorship could lead to a lack in influencing preceptees to obtain their goals.Influence could be thought of as the ability to affect the perceptions, attitudes or behaviours of others.If a preceptor can make a preceptee recog- The preceptees therefore advocate the proper orientation of preceptors to help them perform their roles.

Willingness to demonstrate procedures
The Preceptors and preceptees differed in their responses to the preceptors' willingness to demonstrate procedure to the preceptees during the clinical prac tice attachment.In Figure 4, a total of 62 preceptors (86.1 %) agreed that they were willing to demonstrate procedures to the students while only 140 preceptees (71.4%) were in agreement with this view.The major role of the preceptor is that of the clinical teaching and demonstration of clinical skills as a very im portant m ethod of clinical teaching.People remember what they practise and observe for much longer than w hat they hear.W right (2002:138-139) emphasize that preceptors are expected to have experience and advanced clinical skills, and be willing to demonstrate clinical skills and teach in an effective manner.
From a leadership perspective, the lack of abilities (knowledge, skills, values and attitudes) or the lack of overall capacity in terms of resources, of which staff, time, willingness/motivation and commitment are the most significant, is leading to poor qu ality a c tiv itie s, in clu d in g preceptorship (Muller, 2003:262).
The willingness to take action to resolve a problem is related to a person's perceived degree of in fluence in the situation, clinical ex pertise, concern and education (Jooste & B ezu id e n h o u t, 2003:250).Mutur1 espect and the willingness to help each other should be evident in the preceptor-preceptee relationship.
Preceptor's interest in teaching Bashford (2002:14) states that an interest to teach is one of the de sired in te rp e rso n a l c h a ra c teristics of a preceptor.
The findings reflect that a large num ber o f 64 o f p re c e p to rs (91.4%) agreed that they showed interest in supervising and teach ing students (Figure 5).A lower.per centage (68.7%) of the preceptees agreed with this statement.Ohrling and Hallberg (2001:531) argue that nurses who opt voluntarily to be preceptors perform the role much better than those who are selected by their managers.The lack of in terest in the teaching role indicated by approximately one third (31.3%) of the preceptees could be a result of preceptors being appointed to the role, when they did not opt for it themselves.
You know people are committed when they take action and have the will to carry something they have started to the very end.Leaders de vote their life to doing what they need to do, every day.What does a leader need to be committed?The an swer includes facets of self-motivation, inner norms and values, job satisfaction, the necessary ch a lle n g e s in the workplace, success stories, knowledge and expertise, freedom to make choices, good working conditions, incentives and people sk ills (Van D yk, Van d er Westhuizen & Jooste, 2003:31).It is never too late to become a leader and an effec tive preceptor, and one should have the courage to change and do things differ ently (Jooste, 2003:22).

Providing guidance when preceptees experience problems
In Figure 6, the majority of the preceptors 67 or (94.4%) and, to a lesser extent, 163 (82.4%) preceptees agreed that the precep- tors guided the preceptees when they experienced problems.
The differences in opinion indicate that preceptees are not fully satis fied with the guidance they receive from preceptors.Byrd, Hood and Youtsey (1997:344) state that guid ing students in clinical practice is one of the benefits of preceptorship as it gives the students the oppor tunity to practices clinical skills with a clinical nurse who has the exper tise required for day-to-day practice.This implies that the role of the pre ceptor is to provide guidance to the preceptee in complex situations to attain the clinical learning objectives and master certain clinical competen-_ cies.
From a leadership perspective, the commitment to guide followers when needed centres on meeting role ex pectations defined for the organiza tion, the profession and the job.It involves a realistic vision based on the strengths and lim itations in bringing others together in carrying out their respective role responsibil ity.In order to achieve this wide range of commitment, it is imperative to know and care for those with whom you come into contact, with out losing sight of the mission and the needs of the changing times.
A ctiv e co m m itm en t to guide preceptees demands that preceptors as leaders use their intelligence, heart and will in integrating the values of L the job, the profession and the or ganization (Jooste & Bezuidenhout, 2003:253).

Intelligence traits Preceptor's ability to clarify topics to preceptees
The item on the clarification of topics was included in the q u estionnaire in an endeavour to determ ine w hether the preceptor was able to clarify topics for the preceptees in relation to learning ac tiv itie s th at tak e place during preceptorship.The details of the findings are outlined in Figure 7.
Figure 7 indicates that the majority of preceptors (59 or 83.1% ) perceived themselves as able to clarify topics to the level of the students' understanding.In contrast 134 (68.7% ) preceptees agreed with their preceptors' views on this statement.A general conclusion from these re su lts w ould be th at the preceptors felt that they had provided a sound preparation base to equip the preceptees with the needed nursing skills.The findings of this study should be a challenge for the preceptors in that they should pay more attention and take more time to clarify topics and concepts to the level of the preceptee's understanding.
It is important for preceptors to be able to clarify ambiguities for the preceptees in their accom panim ent in order to eliminate anxiety and fear, which are obstacles to effective learning (Ashton & R ich ard so n , 1992:144;T aylor, 2000:173).
The preceptor as a leader should spend a significant amount of time talking with follow ers/preceptees, responding to questions, and listening to their concerns.They should do this in person -they 31

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should not delegate this task to other colleagues or followers.By personally championing the cause of good com munication, they lessen the follow er's fears changes that are being im ple mented and set a precedent for other m a n a g e rs to fo llo w (R o b b in s , 1996:390-1).

Preceptor's knowledge of basic nursing skills
It is important for the preceptors to have adequate knowledge and skills in nursing so that they can transfer their knowledge to the preceptees in their accompaniment.
A significant difference between the responses o f the preceptors and the preceptees was observed in this item as 70 preceptors (97.2%) agreed they had knowledge of basic nursing skills and only 149 of preceptees (75.3%) agreed with the preceptors, views.Preceptees

Preceptor's ability to stimulate professional interest in the preceptee
Preceptors as role models and resource persons are expected to stimulate the p re cep tee s' in tere st in the nursing profession.The preceptees should have a desire to emulate their role models in order to be com petent professional nurses upon completion of their clinical practice.
Figure 10 reflects a significant difference between the responses of the preceptors and the p re cep tee s.A to tal o f 63 preceptors (90.0 %) agreed that they stimulated the preceptees' interest in the profession.On the contrary, 130 of the preceptees (65.7%) were in agreement with the preceptors in this regard.Ac cording to Gillespie (2002:572), the pre ceptor's ability, clinical skills and confi dence should be a strong influence on students' development of an identity as a professional nurse.The preceptor should be instrumental in setting the pace to influence professional behaviour in their preceptees.
From a leadership perspective, the pre ceptor should empower the preceptees to accept ownership in the process of development.Empowered preceptees will join in creating their own destiny, and their work becomes exciting, stimulating, enjoyable and meaningful (Scamati & Scamati, 2002:115).
Preceptor's self-confidence Jooste and Troskie (1995:15) indicate that preceptors should have self-confidence, but be aware of their own weaknesses at the same time.
A very significant difference between the view s o f the p re c e p to rs and the preceptees on the confidence of the pre ceptors in their preceptorship role was noted as indicated by the findings in Fig ure 11.All the preceptors who responded to the item, namely71 (100%), agreed that they had confidence in their work, while only 133 preceptees (67.5 %) shared simi lar views with the preceptors with regard to this statement.nurse influenced their ability to meet students' learning needs.Preceptors can create a distance between them selves and the preceptees if they lack self-confidence in their role.

Social traits The preceptor respects students in the workplace
The findings in Figure 12 reveal a sig nificant difference in the views of the preceptors and the preceptees regard ing the respect preceptees receive from their preceptors.
One hundred per cent of the precep tors (71) who responded to the item indicated that they respected their preceptees.Only 154 preceptees (78.6%) responded that they agreed with this statement.In an open-ended ques tion, one o f the preceptees said: 'Some preceptees often experienced criticisms from some of their precep tors and that the preceptors are b i ased against us because of our tribal origin so we are considered as not intelligent'.Such comments are a cause for concern, which could in te rfe re w ith th e a tta in m e n t o f preceptorship objectives.
It is very im portant for the precep tor and the preceptee to respect one another to facilitate a good relation ship and enhance learning opportu nities.

Preceptor's acknowledgement of students' frustrations
A preceptor has a responsibility to id en tify and acknow led g e a preceptee's frustration in the clinical setting, which is often a new and un familiar environment, different from the familiar classroom setting.
A relatively high num ber o f p re ceptors (52 or 73.2% ) agreed that they acknow ledge and understand stu d en ts' feelings of fru stratio n .Only 112 of the preceptees (57.1%) in d ic a te d a g re e m e n t w ith th e statem ent (F igure 13).B ashford (2002:17) em phasizes that it is im portant for preceptors to acknow l e d g e th e f r u s tr a t io n th a t preceptees m ay experience in the clinical setting.From a leadership perspective, the pre ceptor should act as an advocate by listening to the proposals and frustra tions of preceptees with the aim of con veying them to a higher authority.If these proposals are acceptable, they ought to be implemented.Power sharing should thus take place through advocacy of the leader, by implementing the suggestions of preceptees and addressing their frus trations (Jooste, 2003c:222).

Use of good communication during preceptorship
Good com m unication is one o f the m any a s s e ts re q u ire d fo r the preceptorship role (Coates & Gormely, 1997:95).S im ilarly, M am chur and Myrick (2003:188) affirm the potentially deleterious effects of poor com m uni cation and interpersonal problem s be tween preceptors and preceptees.

Communication skills
In Figure 14, it is observed that 67 pre ceptors (97.1%) who responded to this item agreed that they use good and appropriate com m unication skills.A notion supported by only 146 preceptees (74.1 %).Based on this evidence, there is a need to employ corrective measures to improve the com m unication process, hence facilitating the clinical teachinglearning process.Byrd, Hood & Youtsey (1997:345)  Communication should be open, clear, p recise and ap p ro p riate to avoid m isconceptions and suspicion.Most importantly, com m unication requires feed back to en sure th at co rrec t information has been disseminated to the relevant party (Mariner-Tomey, 1996:102).Inappropriate communication strains the preceptor-preceptee relationship and h in d ers the goal a ttain m en t in preceptorship.

Allowing free exchange of ideas between the preceptor and preceptee
In response to this item a significant difference was observed between the responses o f the preceptors and the preceptees on allowing the exchange of ideas betw een p re cep to rs and preceptees.While a large number of preceptors (66 or 93.0%) agreed that they allowed a free exchange of ideas with the preceptees, only 147 preceptees (77.4%) concurred with this view.Reilly and O erm ann (1999:182) state that the relationships between the preceptor and the preceptee should be significant in promoting discussions, and preceptees should be comfortable with the precep tor so they can express their views and feelings and take risks in responding to questions.The significant differences of opinions in Figure 15 indicate that the preceptors should pay more attention to allowing students to exchange ideas with them more freely.

The preceptor listens to the students' problems in the workplace
In this item, the level o f agreem ent betw een the p re cep to rs and the preceptees in their responses was sig nificantly different.In Figure 16, a total of 69 preceptors (95.8%) indicated that they listened to the preceptees' problems in the workplace versus 156 preceptees (78.4%) who agreed with this viewpoint.
Ohrling and Hallberg (2000:27-29) state that in a good example of preceptoring, the preceptor should provide student nurses with space for learning.Creating space for learning in this context includes listening to the students' questions, see ing and supporting individual students in questions, and welcoming their opin ions in order to help students to fit smoothly into the unit.communicators.Communication is en hanced even futher when the leader lis tens carefully and is sensitive to others.Successful leaders are able to persuade others and enlist their support (Jooste, 2003b:200-201).Communication is an exchange, not just a giving action, as all parties must participate to complete the information exchange (Bennis, 2002:2).

Interpersonal relationships between preceptors and preceptees
One hundred per cent of the preceptors who responded to the item in Figure 17 agreed that they demonstrated good in terpersonal relatio n ships w ith their preceptees.On the contrary, only 151 preceptees (76.3%) were in agreement with the views of the preceptors.If the relationship between the precep tor and preceptee is strained for w hat ever reason, it could have a negative im pact on the entire preceptorship process culm inating in failure to ac com plish the learning objectives.De Young (1990:3) states that an effec tive teacher should be skilful in inter personal relationships.This skill could be dem onstrated by taking a personal interest in the students, being sensi tive to students' feelings and problems, conveying respect for students, alle viating students' anxieties, being ac cessible for conferences, fairness in all dealings w ith others, perm itting students to express differing views, creating an atm osphere in which stu dents feel free to ask questions, and conveying a sense o f w arm th.The preceptorship relationship needs to be revitalized so as to influence and s u s ta in th e p re c e p to rs h ip p r o gramme in nursing education.
From a leadership perspective, several principles to foster effective interper sonal relationships should be fol lowed, such as collaboration between different parties to discuss issues of importance, and giving feedback on important matters to foster a trusting relationship (Minnaar, 2003:333).Grealish and Carroll (1998:5) contend that when working with preceptors, students value the independence pro vided to them, working with other nurses, opportunities to practise and the sense of being part of a unit team.

Promotion of team spirit
According the statistical data in Figure 18 a significant difference was ob served in the perceptions of the two respondent groups in relatio n to team spirit.W hile 71 preceptors (98.6%) agreed that they prom oted team spirit in the units, only 147 preceptees (74.6%) were in agree ment with their preceptors.Since preceptors are role m odels, they should be able and are expected to unite the nurses and preceptees as a team and be role models in execut ing professional behaviour and the spirit of belonging.
Grealish and Carroll (1998:5) found that when preceptees worked with pre ceptors they valued the sense of be ing part of a unit team.This statement confirms the importance of the exist ence of team spirit facilitated by the preceptor.
From a leadership perspective, the con cepts of teams and teamwork are in creasingly becoming important keys to productivity and employee satis faction, and it is virtually impossible to avoid being a member of a team to day (Roos & Pilane, 2003:157).

Physical traits
Preceptor's professional behaviour Oliver and Aggleton (2002:33) argue that when preceptors exhibit profes sional behaviour, it offers a framework within which preceptees may ground the principles of their practice in the context of a dialogue with a more ex perienced professional.
The findings on this item depict clearly that the preceptors and preceptees do not agree that all preceptors exhibit pro fessional behaviour in the workplace.While 68 preceptors (98.6%) agreed that they exhibited professional behaviour, only 151 preceptees (76.6%) were in agreement with the preceptors regarding this statement (Figure 19).Preceptors should alw ays be available for the preceptees and act professionally to so cialize them to the professional role of a nurse (Westra & Graziano, 1992:212;Nehls et al., 1997:220-226;Byrd et al., 1997:345;Reilly & Oermann, 1999:196).Similarly, Oliver and Aggleton (2002:34) state there is a relationship between the preceptorship model, the culture of the profession and the extent to which the profession is regulated externally.
From a leadership perspective, a 'pro fessional' person suggests that she/ he is a good person, that she/he has a sense of right and wrong, that she/he strives to realize and maintain a high moral standing -to be com m itted to principles specifically appropriate to h er/h is p ro fessio n and its d ig n ity (Wambari, 1999:80).

Conclusions, implications, recommendations and limitations of the study
The objective of the study was to explore and d escrib e w hich lead e rsh ip characteristics the preceptors possessed to carry out their preceptorship role in the clinical practice setting.

Conclusions
The characteristics of the preceptors have a direct bearing on the outcome of 36

Curationis August 2006
the preceptorship relationship and attain ment of the preceptees' clinical objectives as indicated in research literature.Pre ceptors must possess characteristics that enable them to be sensitive to the learn ing needs of their preceptees at all times.This reduces tension, fear and stress that could be associated with the unfamiliar environment and fear of failure as well as possible ridicule for not being able to meet the set expectations.The precep tor's ability or inability to possess desir able characteristics could act as a moti vator or barrier to, the effective execu tion of the preceptor role.
The following are the characteristics/ traits that are desired from preceptors and on which more focus should be placed to fulfil their role in preceptorship:

Work-related characteristics
The preceptee respondent group indi cated that they needed the preceptors to be responsible and

Personality characteristics
The findings indicate that the preceptors should pay more specific attention to acting as role models for their preceptees, instilling rofessional interest among their followers, and promoting self-confidence in p re cep tee s to e n te r the n ursing practice as independent practitioners.
• Preceptors should improve their own self-development.By consulting relevant journals and literature, self-enrichment could be established.This would contribute to improving behaviour towards the preceptees.The preceptors should know their strengths and weaknesses as leaders and should develop their strengths.Time should be made for a regular programme of relaxation, so that pressure can be managed in the workplace.
• Understanding one's own personality is not easy.Some aspects of our personality are obvious to others but not to us.
Inner leadership provides tools to help us understand our own personality.These tools are body, emotions, thoughts and constituents of personality.
Pre ceptors should practise inner leadership in their working life, which means allowing space for transformation, realizing one's self-leading potential, and gaining the clarity to respond to the real needs of each situation with awareness (England, 2002:21-27).

Social characteristics
Preceptors should pay more attention to their interpersonal relationships with preceptees in their learning environment.Therefore, preceptors should respect stu d en ts in the w ork situ a tio n , acknowledge their frustrations, display effective communication skills and listen to their problems in the workplace.The latter could promote a positive team spirit during preceptorship.providing problem-solving ideas, keeping appointments with preceptees, and then opening dialogue with them and, where necessary, assisting them with their problems.Twoway communication between followers and their preceptors creates a platform for an exchange of opinions and openness to criticism.The preceptor should not hesitate to communicate the frustrations of preceptees to top-level management and to inform them of the result of such communication.

Physical characteristics
The findings indicate a the preceptee expects professional behaviour from a preceptor.As a leader, the preceptor should act as a role model for followers, within the ethical, professional and legal frameworks of the profession.

•
The preceptor should display effective body language that demonstrates a willingness to act as a preceptor.& Troskie, 1995:11 -15;Atkins & Williams, 1995:1006-1015;Bain, 1996:1(M-107;Reilly & Oermann, 1999:196;Usher, Nolan, Reser, Owens & Tollefson, 1999;Sawin, Kissinger, Rowan & Davis, 2001).The findings indicate that some preceptors in this study lacked these im portant characteristics and this could interfere with their ability to carry out the role of preceptee accompaniment effectively.The findings illuminate an overwhelming demand for selecting preceptors and the preparation of the preceptors with ideal c h a ra c te ris tic s to su stain the preceptorship relationship.Based on the findings of the study, it could therefore be concluded that there is a need fo r the p re c e p to rs to d ev elo p d esira b le characteristics to enable them to fulfil their role efficiently.

•
It should be ensured that prospective preceptors are selected based on the important ■ leadership characteristics of an effective preceptor.

Limitations of the study
Very little lite ratu re was found on preceptorship in Botswana despite the fact that it is the clinical teaching approach adopted by most of the health training institution in the country.The non-probability sampling used in this study does not permit generalization of the research fin d in g s to the entire population of the preceptees.
The population of preceptors was very limited compared with the population of preceptees.The study also took four years to complete due to the fact that it was co nducted th ro u g h d istan ce education.

Conclusion
This non-experim ental, exploratory descriptive quantitative study sought to describe the role of the preceptor in selected clinical practice settings.The findings of this study indicated that there were numerous constraints that interfered with the preceptors' ability to carry out their role of preceptee accompaniment in the clinical setting effectively.These co n stra in ts in clu d e not being in po ssessio n o f the d esira b le characteristics of a preceptor.These findings provided an understanding of the situ atio n s faced by both the preceptors and the preceptees during the preceptorship process and how it affects the clinical teaching process and the attainment of learning objectives.The information serves as a basis for the im provem ent o f the p re cep to rsh ip function in the majority of the clinical practice settings.It could be concluded that preceptors and preceptees differed significantly in their views on various aspects of preceptorship.

Figure
Figure 3: Preceptor's interest in supervising students Figure 4 W illingness to demonstrate procedures to students Figure 6 Giving students guidance when they experience problems

Figure
Figure 8: Knowledge on basic nursing skills

Figure 9
Figure9reflects that a total of 64 of the preceptors (98.5%) agreed that they acted as role models in the nurs ing units or wards versus 155 of the preceptees (78.3%) who agreed with this statement.W right(2002:139)   states that the role of the preceptor should demonstrate model behaviours and technical skills expected o f a nurse in a unit, and aid in socialising the novice nurse into the work situa tion.

S
Figure 10 Stimulating students' interest in the profession Figurel3 Acknowledge and understand students' frustratioi cite factors enhancing the experience of preceptorship as a clearly structured p rogram m e to be open and clear communication and ongoing feedback.
From a leadership perspective, leaders who engage in frank, open, two-way communication and whose non-verbal communication reinforces their verbal communication are seen as informative 34 Curationis August 2006

Figurel6
Figurel6 Listening to the students' problems in the work situation

Table 1 : Clinical experiences of preceptors
0%) fell in the age bracket of 30 to 34 years.It was also interesting to note that there was only one preceptor respondent in the 50 to 54 years age group.Figure 1 highlights the age distribution of the preceptee respondents.The ages From a leadership perspective, experience is closely intertwined with a power base.Leaders use power as a means of facili-28 Curationis August 2006