Knowing Thinking Doing Collaborative Development of Expertise (CDE) On-the-Job Training and Debriefing Strategies The preceptor and trainee work together to master these key components: Does s/he know the basics about what to look for and what steps to follow in conducting a survey? Is s/he noticing subtle cues, considering the appropriate things, evaluating how events have unfolded, and anticipating what else s/he should investigate? Has s/he mastered when and how to make assessments & decisions, and what standard sequences of action are appropriate at different times to help with the critical assessments and decisions? Knowing Thinking Doing General CDE Strategies for Preceptors 1. ASK OPEN ENDED QUESTIONS ABOUT ASSESSMENTS AND DECISIONS e.g., What should you consider when you hear/see/smell __? Why did you make that assessment? What is the most important thing you are considering right now? 2. TELL e.g., When investigating__, you should gather information about____. When you are on the tour, you should look for ____. 3. PASS ON EXPERTISE ABOUT ASSESSMENTS AND DECISIONS e.g., When I was in a similar situation I considered ____. What I am thinking about now is ____ . 4. GIVE FEEDBACK e.g., When you made that assessment, it was accurate. When investigating __, you could also look into ___. 5. STRUCTURE LEARNING TASKS e.g., First, I want you to concentrate on learning how to assess __ When __ is happening, I want you to be looking at ___.

General CDE Strategies for Trainees 1. STATE WHEN YOU NEED HELP WITH THE ASSESSMENTS AND DECISIONS e.g., I understood__, but not __. Could you explain? I feel like I’m starting to lose track of the big picture. Can You help me? 2. REQUEST FEEDBACK e.g., What else should I have considered in making this decision? Should I have asked the nurse a different question? 3. CLARIFY EXPECTATIONS e.g., What are the goals for this training session? What decision making skills should I focus on during the record review? 4. ASK FOR RESOURCES TO LEARN OFF-LINE e.g., I’m having some trouble with ___, what do you recommend that I do or read? Who else could I talk to about __? 5. ASK TRAINER QUESTIONS ABOUT HIS/HER THINKING e.g., When ___ was happening, what were you noticing? What would you have considered in ___ situation?