Helping Preceptors Help Students Access Evidence for Practice Susan J. Zahner, DrPH, MPH, RN Assistant Professor Wisconsin Health Information Outreach Summit Supporting Evidence-Based Practice Green Bay, Wisconsin August 16, 2006

Funding Southwest Wisconsin Area Health Education Center

Preceptor Defined Preceptors are experienced practitioners who teach, supervise, and serve as role models for student nurses for a set period of time in a formal educational program (Usher et al., 1999)

Preceptor Model: Advantages: –Closer relationship allows for talking through decision-making and rationale for actions (Crawford, et al., 2000) –Closer observation allows effective evaluation of student performance (Yonge, et al., 1997) –Cost of clinical education (Nehls et al., 1997) Challenges: –Lack education in evaluation (Yonge, et al., 1997) –Lack education in teaching/constructive feedback (Atack, et al., 2000) –Less effective in stimulating critical thinking (Phillips & Duke, 2001) –Worthwhile benefits, rewards, and supports for the preceptor (Dibert &Goldenberg, 1995; Usher, et al., 1999) –Time and energy (Rittman & Osburn, 1995)

UW-Madison School of Nursing ~20 years experience Undergraduate Madison and Western Campus (Gundersen- Lutheran Hospital, La Crosse, Wisconsin) Senior level –Community Health Practicum (N419) –Nursing Care of Persons and Families with Complex Health Care Needs (N449)

Literature review Preceptor interviews Summer Teaching Institute Video ETeach Consultation #1 Writing Consultation #2 Editing Programming Pilot-testing Implementation Adaptation Course Development Process Revisions Plan Do Check Act

Course modules Module 1: Role of the preceptor Module 2: Course expectations Module 3: Policy/procedures for students in clinical course Module 4: Learning population-focused public health nursing Module 5: Learning styles and teaching strategies Module 6: Learning critical thinking Module 7: Learning cultural competence in community health nursing Module 8: When difficult situations arise Module 9: Feedback and evaluation

Pre-test (mean=5.69, SD=1.03, Range=4-7) Post-test (mean=8.38, SD=.65, Range=7-9) Post-semester (mean=7.54, SD=1.51, Range=5-9) Repeated measures ANOVA Multivariate F=55.603; df=2; error df=11; p<.000 Paired t-test Pre-test to post-test (t= , p<.0000) Pre-test to post-semester (t=-4.95, p=.0003) Post-test to post-semester (t=1.94, p=.08)

Strongly disagreeDisagreeAgreeStrongly Agree

Course Enhancements “Generic” version (available now) Acute care version (in pilot-testing) New modules –Helping Students Learn Interdisciplinary Practice  Helping Students Use Evidence in Community Health Nursing

Helping students use evidence in community health nursing practice Purpose: This module will provide an overview of evidence-based practice in community health nursing. In addition, the module will provide guidance on how a preceptor can assist a student nurse in formulating appropriate questions, searching for relevant evidence, appraising the quality of evidence, and developing plans for action based on evidence in community health nursing settings. Objectives: 1.Understand the basic concepts and processes for evidence-based community health nursing practice. 2.Describe sources of evidence to guide community health nursing practice at individual/family and community/systems intervention levels. 3.Identify strategies for assisting students in using an evidence-based approach to community health nursing practice.

Course Content & Methods Introduction to EBP Steps for EBP Locating evidence Quality of evidence PICO Integrating EBP into student activities Thinking activities Case scenarios Handouts Links to resources and references CE quiz

Improving Evidence Based Practice: Students and Preceptors Helps prepare preceptors for educator roles –Common language and concepts for education –Contemporary language, concepts, and skills for practice Access to information –Teaching/learning –Course specific –Anytime Increasing quality and consistency