Table 3 Outline of active blended learning preceptorship educational programme

Online learning resources

Six-month process involved the codesign team following a participatory approach based on the ASPIRE framework (Aims, Storyboarding, Population, Implementation, Release, and Evaluation) [30]. Each RLO unit was peer-reviewed by all codesign team members using the learning object review instrument (LORI) [31], reviewing the overall design, usability, motivation, learning goal alignment, and quality of the content before production began. The content for the RLOs was created, including videos, images, voiceovers, and infographic slides. An educational technologist (A.B.) populated all media on an online platform, Articulate 360 (https://articulate.com))

A series of six online reusable learning objectives (RLOs) was created incorporating a mixture of presenting information, touchpoints, video demonstrations, case study scenarios, interactive exercises, reflective exercises and on the spot feedback

Unit 1: Introduction to Interpersonal and Communication skills in Nursing Preceptorship

Unit 2: Psychological Safety: Creating a Safe Learning Environment

Unit 3: First Impressions & Orientation

Unit 4: Teaching in the Clinical Environment

Unit 5: Feedback

Unit 6: Conflict Resolution

All learning units will be opened up to learners (hosted on Articulate) to complete at their own pace over the three weeks prior to the half-day face to face teaching described below. Each unit takes approximately 40–60 min to complete. Learners can complete the units repeatedly if they wish to do so. An accompanying workbook will also be provided for learners to use with the RLOs to make notes and complete their reflective exercises

Role play simulations

The lead researcher and an academic with a specialist background in simulation-based education and patient safety led the design of the role-play simulations, which was iteratively peer-reviewed by the remaining co-designers. Applying the International Nursing Association for Clinical Simulation and Learning (INACSL) framework [32], the codesign team considered design criteria such as creating a simulation experience that can achieve measurable objectives, is participant-centred and incorporates a level of fidelity that creates a perception of realism to the simulated scenario. The INACSL framework also guided the inclusion of a structured pre-brief session and a structured debrief session following the role plays

Two role-play simulations were designed to provide a safe learning environment to apply the new knowledge and skills from the RLOs

Role-play scenario 1: focuses on the learners' ability to provide a psychologically safe learning environment for students

Role-play scenario 2 focuses on the learners' ability to provide effective feedback and conflict resolution skills

Learners will be provided with a pre-brief pack that will outline the role play goals and objectives. Learners will be divided into groups of three and alternate between the student, nurse, or patient positions. Each will run for 20 min, followed by 20 min debrief session each time. The learner playing the part of the patient will be provided with an observational feedback sheet to provide structured feedback during the debriefing session

Virtual reality simulation

The lead researcher and a member of the codesign team with a specialist background in storytelling and film production led the design of the VR simulation in collaboration with a VR production company [33]. It was also iteratively peer-reviewed by the remaining co-designers applying the INASCL framework [32]

Using critical touchpoints from the interviews and the three-act structure to storytelling (Introduction; rising action; falling action (conclusion)) to structure the storyline, a short 10 min VR storytelling was scripted, storyboarded and peer-reviewed. Using a state of the art 360 VR camera, the simulation was filmed in a simulated hospital ward environment using actors

A state-of-the-art VR simulation was designed to experience nursing preceptorship from a patient's perspective, permitting the learners to "walk in someone else's shoes". The VR simulation depicts a patient's interpersonal interactions with a nurse and student and what it feels like from their perspective, e.g., if a nurse doesn't make eye contact when speaking to the patient or a student who talks over a patient

Leaners will be provided with a pre-brief pack that will outline the VR simulation goals and objectives. Each learner will be provided with a VR headset to use with their smartphones. The VR simulation will run for 7 min. A structured 20 min debrief session will follow the VR experience