It takes a village: rural nursing preceptorships as cultural mediation

In-depth interviews with five nursing students and five rural preceptors in the southern interior region of British Columbia were used to develop an ethnographically informed, multi-dimensional account of the nature and educational value of rural hospital-based preceptorships. Rather than a straightforward teacher-student or mentor-novice relationship, the reciprocity between preceptor and student was situated within a process of cultural mediation in which relationships with the healthcare team, community members, and place itself all played important roles. Specific issues or dimensions highlighted in this study included: the role of the rural preceptor as cultural mediator; the significance of the healthcare team in rural preceptorships; the unique importance of rural relational continuity for student learning and healthcare practices; the challenges of living the professional ethic of confidentiality in a rural context; and the interplay between independence and dependence in rural nursing practice, given the distribution of resources within and beyond the rural context. The preceptorship experience provided students with diverse learning opportunities, including learning to expect and prepare for the unexpected, that facilitated the development of technical skills and clinical decision-making skills. Recommendations are outlined for the redesign of rural practice-education in order to maximize educational opportunities and benefits and to develop a scholarship of place-based engagement in nursing education.