Introduction to Grounded Theory Designs

According to Creswell (2009), grounded theory is a qualitative strategy in which the researcher can extract a general theory from the processes, actions, and interactions of participants in a study that is grounded in the participant’s point of view. What differentiates grounded theory from other types of qualitative research is its focus on building theory. The goal of the grounded theory approach is to generate a comprehensive explanation of phenomena that are grounded in reality. A procedure referred to as constant comparative is used to develop and refine theoretically relevant categories (Merriam, 2009). In other words, grounded theory suggests that theory emerges inductively from data.

According to Merriam (2009), “the constant comparative method of data analysis is inductive and comparative and so has been widely used throughout qualitative research without building a grounded theory” ( p. 175). Constant comparative method is a process in which any newly collected data is compared with previous data that was collected in one or more earlier studies. Categories that are elicited from the data are constantly compared with data obtained earlier and, once the data has been categorized, then it is examined for properties that characterize each category. This is an ongoing procedure because theories are formed, enhanced, confirmed, or even discounted as a result of any new data that emerges. Merriam distinguished between two types of grounded theory which are substantive and formal theory. Substantive theory is specific to everyday world situations and hence useful for addressing questions about processes that change over time (Merriam, 2009, p. 31). Substantive theory can serve as a springboard for formal grounded theory. Formal grounded theory involves developing a more abstract level of theory.

 Research Problem Statement

During clinical, the quintessence of where nurses learn about nursing (Madhavanpraphakaran, Shukri, & Balachandran, 2014; Paton, 2010), nurses function as preceptors for undergraduate nursing students. The nurse preceptor is a key player in bridging classroom to the real world of human patients and clinical settings. The preceptor is a nurse who teaches and supports the student nurse and is seen as pivotal to student learning within the clinical environment. Preceptorship programs are widely used in undergraduate and postgraduate nursing programs (Henderson, Winch, Holzhauser, & De Vries, 2006; Raines, 2012; Richards & Bowles, 2012) as an available, alternative clinical teaching strategy to the traditional approach. The preceptorship experience affords faculty and staff nurses the opportunity to collaborate in enhancing the clinical education of nursing students and the continuing development of the nursing profession (Raines, 2012; Yonge, Myrick, & Ferguson, 2011).

The practice gap exists and literature supports that preceptors play a pivotal role to student learning within the clinical environment that leads to nursing graduates who are better prepared to become sound, autonomous practitioners when they enter the workplace and hence retained in the nursing profession after graduation. The problem for clinical nurse educators is a knowledge gap. That is a gap in knowing exactly how the preceptor/preceptee relationship and precepting guidance leads to successful clinical training and completion, and thus retention to graduation.

As such, if successful precepting processes could be illuminated and explained via substantive theory, clinical educators would have the knowledge needed to better support preceptors, to better prepare and train new preceptors, and to better reward preceptors which will strengthen the retention efforts. Therefore, the researchable problem is the need to develop a substantive theory that explains how successful preceptor relationships are formed and maintained and how learners are successfully precepted through program completion.

Purpose of the Research and Significance

The purpose of the proposed grounded theory study is to develop a substantive theory that explains how successful preceptor relationships are formed and maintained and how baccalaureate nurses are successfully precepted through a four-year nursing program in order to strengthen the precepting program. The focus of the study is to gather information on how successful preceptor relationships are formed with nursing students by conducting semi-structured interviews with preceptors. Findings that emerge from the ground study will be useful in developing a substantive theory for addressing the central research question of, how are baccalaureate nurses precepted.

Central Research Question

How successful preceptor relationships are formed and maintained and how student nurses are successfully precepted through baccalaureate program completion in order to strengthen the precepting program?

Research Sub-questions

  • How are strong preceptor/preceptee relationships formed and maintained?
  • How do preceptors guide learners through successful clinical training?
  • How do preceptors guide learners through clinical training successfully completing their baccalaureate programs?

Description of Sampling Criteria, Participants, and Data-Collection Procedures

The grounded theory approach of Merriam will be used to illuminate how successful preceptor relationships are formed and maintained and how student nurses are successfully precepted through baccalaureate program completion in order to strengthen the precepting program. The grounded theory approach will provide the opportunity for an in-depth look through the use of various information sources. A combination of data collection methods will be employed in order to yield richer data. Thus, semi-structured interviews with individual preceptors will be conducted lasting 20 to 50 minutes each. The interviews will give the researcher the opportunity to ask a range of in-depth open-ended questions, allow the participants to describe their experiences, express their opinions, concerns, and feelings. Additionally, observation will also be used to gather rich data.

Purposive sampling will be used for this study. The main goal of purposive sampling is to focus on particular characteristics of a population that are of interest in order to enable the researcher to answer the research questions. The sample for this grounded theory study will be thirty nurse preceptors. According to (Mason, 2010), a sample size of thirty-one (31) in relation to saturation is congruent with the principles of qualitative research. Preceptors who are assigned to work with baccalaureate nursing students in their junior and senior year will be selected from the operating room unit and the medical-surgical unit. The preceptors will be both males and females. There will be a mixture of Caucasians, African-Americans, and Hispanic nurse preceptors. The participants will range in age from 26 to 62 years old. Preceptors will be prepared at the BSN level or above. Preceptors with previous knowledge and experience who have developed relationships with student nurses while training them in the clinical setting constitute the main inclusion criteria.

The purpose of the study is to develop a substantive theory which explains how successful preceptor relationships are formed and maintained and how student nurses are successfully precepted through baccalaureate program completion in order to strengthen the precepting program. The following questions guided the study:

  1. How are strong preceptor/preceptee relationships formed and maintained?
  2. How do preceptors guide student nurses through successful clinical training?
  3. How do preceptors guide student nurses through clinical training successfully completing their baccalaureate programs?

Grounded theory was chosen as the most appropriate method to explore how successful preceptor relationships are formed and maintained and how student nurses are successfully precepted through baccalaureate program completion in order to strengthen the precepting program.

Defense of Research Design

The use of a ground study enables the researcher to fully explain how successful preceptor relationships are formed and maintained and how student nurses are successfully precepted through baccalaureate program completion in order to strengthen the precepting program. The ground theory approach is best utilized when a holistic and in-depth investigation is needed. Findings that emerge from the ground study can be useful in developing a substantive theory for addressing the central research question of how are baccalaureate nurses precepted.

Grounded theory research differs from other qualitative designs in a few ways. Grounded theory strives to build a substantive theory, one that is grounded in the data collected specifically to everyday world situations and hence useful for addressing questions about processes that change over time (Merriam, 2009). Substantive theory can also serve as a springboard for formal grounded theory. Formal grounded theory involves developing a more abstract level of theory  (Polit & Beck, 2004). Case study design, on the other hand, investigates a current phenomenon within its real-life context when the boundaries between phenomenon and context are not clearly evident. In addition, a case study explores a bounded system or case over a period of time using in-depth and comprehensive data collection. Ethnography focuses on a sociocultural interpretation. The basic qualitative design focus is on understanding how people make sense of their experiences. Grounded theory is the best fit for the research intention which is to explore how successful preceptor relationships are formed and maintained and how student nurses are successfully precepted through baccalaureate program completion in order to strengthen the precepting program.

References

Creswell, J. W. (2009). Research design: Qualitative, quantitative, and mixed method approaches (3rd ed.). Los Angeles, CA: Sage.

Henderson, A., Winch, S., Holzhauser, K., & De Vries, S. (2006). The motivation of health professionals to explore research evidence in their practice: An intervention study. Journal of Clinical Nursing, 15(12), 1559-1564. doi:10.1111/j.1365-2702.2006.01637.x

Madhavanpraphakaran, G. K., Shukri, R. K., & Balachandran, S. (2014). Preceptors’ perceptions of clinical nursing education. The Journal of Continuing Education in Nursing, 45(1), 28-34. doi:10.3928/00220124-20131223-04

Mason, M. (2010). Sample size and saturation in PhD studies using qualitative interviews. Forum: Qualitative Social Research, 11(3), 1.  Retrieved from http://www.qualitative-research.net/index.php/fqs/article/view/1428/3027

Merriam, S. (2009). Qualitative research: A guide to design and implementation (2nd ed.). San Francisco, CA: Jossey-Bass.

Paton, B. I. (2010). The professional practice knowledge of nurse preceptors. Journal of Nursing Education, 49(3), 143-149. doi:10.3928/01484834-20091118-02

Polit, D. F., & Beck, C. T. (2004). Nursing research: Principles and methods (7th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

Raines, D. A. (2012). Nurse preceptors’ views of precepting undergraduate nursing students. Nursing Education Perspectives, 33(2), 76-79.

Richards, J., & Bowles, C. (2012). The meaning of being a primary nurse preceptor for newly graduated nurses. Journal for Nurses in Staff Development, 28(5), 208-213; quiz 214-205. doi:10.1097/NND.0b013e318269fde8

Yonge, O., Myrick, F., & Ferguson, L. (2011). The process of developing a framework to guide rural nurse preceptors in the evaluation of student performance. Nurse Education in Practice, 11(2), 76-80. doi:10.1016/j.nepr.2011.01.001