“ Leadership is like art, sometimes it can’t be explained but it can be demonstrated!” George Bernard Shaw Preceptors have a great opportunity and responsibility to teach, train and develop their student into a truly effective leader.

10 Reasons to be a clinical preceptor 1.1.sharing skills 2.2.challenging students' knowledge 3.3.preparing tomorrow's caregivers 4.4.sharing experience 5. being challenged by a student's knowledge 6.6.being an educator 7.7.continuing a tradition 8.8.improving the quality of education 9.9.showing students what it's really like 10.helping students grow

What is our Program Goal? Prepare students to be competent entry-level EMT- Paramedic Practitioners Prepare students to be competent entry-level EMT- Paramedic Practitioners

What is the definition of Competent? Properly or well qualified Properly or well qualified Capable Capable Adequate for the purpose Adequate for the purpose Sufficient Sufficient Legally qualified or fit Legally qualified or fit

Three Learning Domains Cognitive Domain Cognitive Domain Psychomotor Domain Psychomotor Domain Affective Domain Affective Domain Student must be measured in each domain to achieve entry-level competency Student must be measured in each domain to achieve entry-level competency

Cognitive Domain Student demonstrates the knowledge and reasoning required to perform tasks or skill independently and proficiently Student demonstrates the knowledge and reasoning required to perform tasks or skill independently and proficiently

Psychomotor Domain Student can thoroughly describe all elements of applicable procedures and accomplish psychomotor skills independently and proficiently Student can thoroughly describe all elements of applicable procedures and accomplish psychomotor skills independently and proficiently

Affective Domain Often referred to as the behavioral domain Often referred to as the behavioral domain The student’s behavior demonstrated integrity, empathy, self-motivation, self- confidence, team work, diplomacy, respect, patient advocacy, careful delivery of inservice, appropriate time management, appropriate appearance, and personal hygiene The student’s behavior demonstrated integrity, empathy, self-motivation, self- confidence, team work, diplomacy, respect, patient advocacy, careful delivery of inservice, appropriate time management, appropriate appearance, and personal hygiene Reports to work on-time and in full uniform Reports to work on-time and in full uniform

Course Schedule 1st Day of Class is: 1st Day of Class is: Four Semesters Four Semesters

Clinical Schedule Pre-Operative / Same- Day Surgery Pre-Operative / Same- Day Surgery Emergency & Trauma Emergency & Trauma Anesthesia Anesthesia ICU ICU Psychiatric Unit Psychiatric Unit Labor & Delivery Labor & Delivery Pediatrics Pediatrics

Field Internship Schedule Field Internship I: Field Internship I: Field Internship II: Field Internship II: Field Internship III: Field Internship III: Field Internship IV: Field Internship IV:

Terminal Objectives in the Clinical and Field Internship Program Medications: 15 live patients Medications: 15 live patients Intubations: 5 live patients Intubations: 5 live patients Venous Access: 25 live patients Venous Access: 25 live patients Ventilations: 20 live patients Ventilations: 20 live patients Pediatrics: 30 live patient assessments Pediatrics: 30 live patient assessments Adults: 50 live patient assessments Adults: 50 live patient assessments Geriatrics: 30 live patient assessments Geriatrics: 30 live patient assessments Trauma: 40 live patient assessments Trauma: 40 live patient assessments

Terminal Objectives Continued Psychiatric: 20 live patient assessments Psychiatric: 20 live patient assessments Chest Pain: 30 live patient assessments Chest Pain: 30 live patient assessments Adult Respiratory Complaints: 20 live patient assessments Adult Respiratory Complaints: 20 live patient assessments Pediatric Respiratory Complaints: 8 live patient assessments Pediatric Respiratory Complaints: 8 live patient assessments Syncope: 10 live patient assessments Syncope: 10 live patient assessments Abdominal Complaints: 20 live patient assessments Abdominal Complaints: 20 live patient assessments Altered Mental Status: 20 live patient assessments Altered Mental Status: 20 live patient assessments

Terminal Objectives Continued Team Leader Skills: Team Leader Skills: –The student must demonstrate an ability to serve as a team leader in a variety and a total of 50 prehospital emergency situations Field Internship II & III: Field Internship II & III: – 20 team leads (5 ALS - 15 BLS) Field Internship IV: Field Internship IV: – 30 team leads (20 ALS - 10 BLS)

Clinical & Field Internship Student Evaluations Student responsibilities: Student responsibilities: Complete top portion and list learning objectives Complete top portion and list learning objectives Fill in gender, age, and diagnosis, and field impression for each patient contact or observation on back page Fill in gender, age, and diagnosis, and field impression for each patient contact or observation on back page

Student Evaluations Continued Preceptor responsibilities: Fill in time arrived, time departed, objectives completed (yes or no), and total hours in clinical/field area Preceptor responsibilities: Fill in time arrived, time departed, objectives completed (yes or no), and total hours in clinical/field area Rate student’s cognitive, psychomotor, behavioral and team leader performance on a scale of 1-5 Rate student’s cognitive, psychomotor, behavioral and team leader performance on a scale of 1-5 Rate student’s performance in each skill category on a scale of 1-5 Rate student’s performance in each skill category on a scale of 1-5 Make comments regarding strengths, weaknesses, and plan for improvement Make comments regarding strengths, weaknesses, and plan for improvement

Student Evaluations Continued Sign and return form to: Sign and return form to: Vicki Berreth Po Box 778 Jamestown ND 58402

FISDAP The student will complete a patient report for each patient contact The student will complete a patient report for each patient contact The student will take that report and log onto and enter patient data The student will take that report and log onto and enter patient data FISDAP is a data collection program that displays a real time report of the student’s clinical and field internship experiences FISDAP is a data collection program that displays a real time report of the student’s clinical and field internship experiences We use it to monitor the student’s progress in meeting the outlined terminal competencies We use it to monitor the student’s progress in meeting the outlined terminal competencies

Other Key Points  The student will complete a mock trip ticket after each successful team lead  The student may collect data during the patient contact for the purpose of completing a case study  FISDAP must display completion in all terminal competency categories prior to graduation

Introduction to Mentoring Characteristics of Good Mentors Characteristics of Good Preceptors The “How” and “Why”

Mentoring for the future Mentorship: What & Why Mentorship: What & Why What is a Mentor? What is a Mentor? Why do we need or want Mentors? Why do we need or want Mentors?

Mentorship: What is a Mentor? M Motivational E Esteem builder N Needs assessor T Talks less, listens more O Outcome focused R Refining abilities

The catch words for mentoring are: Instruct & Guide

Mentoring is about giving people broader outlooks, more things to consider. It is for career planning, succession planning, and retention People want to be around people who are exceptional!

The Role of a Mentor Be willing to share personal and professional experience Be willing to share personal and professional experience Be willing to direct the new employee to available resources Be willing to direct the new employee to available resources Be willing to commit time and effort assisting the employee Be willing to commit time and effort assisting the employee Be willing to coach them through difficult situations Be willing to coach them through difficult situations Understand the needs of the “new” EMT Understand the needs of the “new” EMT

Ten Tips for Mentors Know you work Know you work Know your organization Know your organization Get to know your associate Get to know your associate Learn to teach Learn to teach Learn to learn Learn to learn Be patient Be patient Be tactful Be tactful Take risks Take risks Celebrate success Celebrate success Encourage your associate to be a mentor Encourage your associate to be a mentor

Mentor Defined A wise and trusted counselor and teacher. One who offers knowledge, insight, perspective or wisdom that is especially useful to the other person.

So what is a preceptor? A preceptor is someone who is involved and supportive in the teaching approach for allowing others to realize their potential. You are the coach!

So how do you become a good coach? It is as much about passion as it is about reason- a good preceptor must motivate It is as much about passion as it is about reason- a good preceptor must motivate It is about substance and treating students as consumers of knowledge It is about substance and treating students as consumers of knowledge It is about listening, questioning, being responsive, and remembering that each student and each class is different It is about listening, questioning, being responsive, and remembering that each student and each class is different It is about being flexible and fluid, experimenting and having the confidence to react and respond to changing circumstance It is about being flexible and fluid, experimenting and having the confidence to react and respond to changing circumstance

Paramedic Preceptor Roles 1. Must be able to sit back and let the student care for the patient. (DO NO HARM) 2. Make mental notes about the good and bad aspects of care and reviews with the student as soon as possible after the run.

Paramedic Preceptors Roles Preceptors should keep an open mind that there is more that one way to reach a certain goal. When a paramedic student has a different style consider it. 1. Is it safe? 2. Does it meet the standard of care? 3. Does it provide the same outcome as my method? 4. Would medical direction approve? 5. Does it cause no harm? That may help you determine if the students alternative method is wrong or just different.

3 Phases of “Field Internship” Phase 1: Students are just beginning. The primary focus during the phase is for the student to become comfortable in the field environment and practice the newly learned skills.

Field Internship Phase 2: The student will begin gaining experience in the ALS team. They should be allowed to start taking the role as “team leader” on ALS non-critical calls and BLS calls.

Field Internship Phase 2 (cont) Under direct supervision of the paramedic preceptor the student is encouraged to take a more global view of the scene paying attention to details such as: Delegation of assignments Delegation of assignments Transportation needs Transportation needs Re-assessment of the patient and providing care accordingly. Re-assessment of the patient and providing care accordingly.

Field Internship Phase 3 The student should be able to be the “Team Leader” and take charge of Most ALS call including Cardiac Arrests and other involved calls. Remember, Students will progress to phases at different rates.

Field Internship Phase 4 Phase 4 The student should act as an entry level paramedic.

Starting out Greetings are important. The first ride! Making a good impression. Why you ask? The first ride! Making a good impression. Why you ask? We need to start off with a positive note. Building a honest and productive relationship. I did not say friendship. I said relationship. We need to start off with a positive note. Building a honest and productive relationship. I did not say friendship. I said relationship.

Start of Each Shift Review with the student the phase level reached. Review with the student the phase level reached. Get the students perception of their strengths and weaknesses Get the students perception of their strengths and weaknesses Ask if they have a focus or goal for the day. Get their goal sheet for the day. Ask if they have a focus or goal for the day. Get their goal sheet for the day. Tell the student what your expectations are from them. Tell the student what your expectations are from them.

Protocols and Equipment Ensure from day one that the student understands what is expected from him/her. Ensure from day one that the student understands what is expected from him/her. Review daily routines/duties and invite participation in the completion of the duties. Review daily routines/duties and invite participation in the completion of the duties. Do not expect the student to do what the preceptor won’t do. Daily duties are still the preceptors responsibility. Do not expect the student to do what the preceptor won’t do. Daily duties are still the preceptors responsibility.

Problem Resolution The lines of communication the level of student and preceptor.( not the bar or coffee shop with others) If an issue can not be resolved, the paramedic student and the preceptor need to contact the Course Coordinator.

Providing Feedback Positive / Reinforcement Encourage desired behavior Encourage desired behavior Helps build self-confidence Helps build self-confidence Example: “Your calm and confident behavior really helped relax the patient. You did a very good job!”

Qualities of Feedback Timely manor Feedback is provided as soon as possible after a performance. Feedback is provided as soon as possible after a performance.Private Correctional feedback is always done in private. Correctional feedback is always done in private. Positive feedback can be in private or in front of others, depending on the personality of the person receiving the reinforcement. Positive feedback can be in private or in front of others, depending on the personality of the person receiving the reinforcement.

Qualities of Feedback Direct Always directed at the person to whom it was intended. Always directed at the person to whom it was intended. Never discuss correctional feedback with any other than those concerned. Never discuss correctional feedback with any other than those concerned.Objective Please ensure that your feedback is conducted without bias to race, ethnic origin, gender or sexual preference. Please ensure that your feedback is conducted without bias to race, ethnic origin, gender or sexual preference.

Qualities of Feedback Be Clear Does the student understand what the preceptor said or meant to say? Does the student understand what the preceptor said or meant to say? Feedback should not be general goals for improvement, but pinpoint actions that the student can take to improve patient care. i.e. assessment skills

Qualities of Feedback Feedback can be unpleasant, but must not be avoided. Feedback can be unpleasant, but must not be avoided. Needs to be timely and specific Needs to be timely and specific Vague feedback doesn’t give the student any ideas of how to realistically improve their performance. Vague feedback doesn’t give the student any ideas of how to realistically improve their performance.

Providing Correctional Feedback Ask the student what they think went well first. Then what went wrong with the call. Ask the student what they think went well first. Then what went wrong with the call. Add your list of positive reinforcement for things that the student did correctly. Add your list of positive reinforcement for things that the student did correctly. Identify the weak areas of the call and provide correctional feedback. Identify the weak areas of the call and provide correctional feedback.

Preceptor Scenario #1 At the start of a shift the male paramedic student is unshaven, poor personal hygiene, and a wrinkled uniform. What do you do??

Preceptor Scenario #2 When trying to provide correctional feedback to a student for rocking on the teeth during an intubation attempt the student denies it and says “ I know what I am doing, it was a hard intubation, you would have had problems to.” What would your response be?

Preceptor Scenario #3 Your unit responds to a call for a 30 y/o male with chest pain. While the student is interviewing the patient, the patient states that he is HIV positive and has AIDS. The student backs up and asks you to finish the call. What do you do? What do you do?

So What do those sheets mean? Assessing the Cognitive Domain: (knowledge) Knowledge Knowledge Comprehension Comprehension Application Application Analysis Analysis Synthesis Synthesis Evaluation Evaluation

Assessing the Affective Domain (Attitude) Receiving Receiving Responding Responding Valuing Valuing Organizing Organizing Characterizing Characterizing So What do those sheets mean?

Assessing the Psychomotor Domain (Skill) Imitation Imitation Manipulation Manipulation Precision Precision Articulation Articulation Naturalization Naturalization So What do those sheets mean?

I hear; I forget. I see; I remember. I do; I understand

Thank You For All That you Do!

THANK YOU! Mitch Babcock, RN, NREMT-P Clinical Coordinator, Critical Care Coordinator Mitch Babcock, RN, NREMT-P Clinical Coordinator, Critical Care Coordinator