Preceptor Education & Credentialing Susan A. Boyer, RN, M.Ed. Director, VT Nurse Intern Project

Objectives Describe impact of preceptors Explore preceptor development Identify potential collaboration

Role of Preceptors Orientation of new nurses Nurture and teach new graduates Provide support for nursing students Cross training staff from other units Provide performance feedback PROTECT SAFETY

Precepting skills Used in patient/family relations Teaching and mentoring colleagues Teaching role with clients/community Support the function of the unit Team work/collaboration Conflict resolution Communication Role model, etc

High Quality Preceptors Need: Educational preparation Ongoing Support Time to precept Evaluation and feedback Role definition (expansion?)

Educational prep Just in time, just enough? or Research and theory based educational preparation - ongoing development

Ongoing support Program structure Clearly defined and accessible resources Support group meetings Continuing education – role Planning for improvement – self and program

Time Time to precept Time to plan Meeting place Time to give feedback

Evaluation and feedback Planned into program Continuous performance appraisal Planning for improvement Professional development

Role definition Clearly defined role and responsibilities Communication between parties Manager understanding of role and expectations Improved connections with faculty Consider role expansion

What does a preceptor need to know? Cognitive? Psychomotor skills? Affective objectives? Other?

Development of Preceptors Two fold purpose: Existing RNs will improve skills in teaching, leadership, communication, and evaluation – thus increasing their effectiveness in working with novices Change the culture of the workplace!

Research and Theory based education Self study Workshop Clinical Application With support and resources Evaluation and feedback

Pre-assignment Self-learning module Articles Self-exploration Story telling Web assignment for learning style and personality inventories Practice with critical thinking and reflective practice

Articles assigned for pre-reading Nurses, are we still eating our young? Professional development through Preceptorship. Interpretive Analysis of Precepting an Unsafe Student. Critical Thinking Skills for at-the-bedside success. Improving Your Ability to Think Critically Alfaro-LeFevre, R. (2002) Nursing Spectrum - Career Fitness Online http://nsweb.nursingspectrum.com/ce/ce168.htm

Introduction to Precepting Role & Responsibilities Novice to Expert Learning styles and adult learning theory Delegation/Liability Team Building and Group Dynamics Preceptor Toolkit New Graduates and competency assessment Personality Styles Communication Conflict Management Fostering Critical Thinking in the Novice

Requested topics include: (these are requested in addition to basic workshop!) Change Theory Case Scenarios Conflict Resolution Communications Legal issues Pt. Teaching Dealing with the difficult preceptee Practice with documentation tools Specialty area orientation check lists Writing critical & positive evaluation comments More on Benner’s model in precepting

Clinical Application Develops skills and networking Feedback based Professional development Preceptor support groups Preceptor Expertise Evaluation

Statewide Credentialing Recognition and reward Pay differential ? Standardization of expectations Performance appraisal Professional development Demographic data collection Work with externs ?

Recognized by: Vermont State Nurses Association Vermont Organization of Nurse Leaders Vermont Inservice and Continuing Education VNA Health Systems of Vermont Long Term Care Community Coalition Vermont Assoc of Hospitals and Health Systems BlueCross BlueShield of Vermont Vermont Department of Health, Board of Medical Practice, Division of Health Care Administration, Program for Quality in Health Care, Inc., Area Health Education Centers

Recognition and reward Educational bonuses Preceptor Support Clinical Educator Networking/list serve ‘For credit’ course Certificate or credentialing Nat’l Certification Pay differential Clinical ladders Paid time for WS Lessened workload Colleague support Networking Tuition Luncheon &/or coupon for meal

Program strengths Collaboration between nurse leaders from education, practice settings, and regulation Advanced preceptor development Developing programs for statewide use, rather than facility specific Standardization

Advanced Preceptor Prep Educational preparation Ongoing Support Time to precept Evaluation and feedback Role definition (expansion?) Recognition and reward

Collaboration Builds strength Adds attendance Spreads the workload Standardization of approach

The Effective Preceptor Educational Monograph Series http://www.oucom.ohiou.edu/fd/monographs/monographs.htm Southern NH AHEC Preceptor development The Effective Preceptor – CME program

VT Nurse Intern Program web page at: http://www.vahhs.org/vnip.htm   "Teachers do not empower adult learners; they encourage the use of the power that learners were born with."   Vella, J.

References Addendum: Craven & Broyles. (1996) Professional Development Through Preceptorship. Journal for Nurses in Staff Development, Vol. 12, No. 6, pp. 294-299 (2001) Critical Thinking Skills for at-the-bedside success (editorial). Nursing Management, January 2001, pp 37 – 39 Freiburger, O. (2001). A Tribute to Clinical Preceptors. Journal for Nurses in Staff Development, Vol. 17, No. 6, 320-327 Godinez, G., Schweiger, J., Gruver, J., Ryan, P. (1999) Role Transition from Graduate to Staff Nurse: A Qualitative. Analysis Journal for Nurses in Staff Development, Vol. 15, No. 3, 97-110 LaDuke, S. (2001). The Role of Staff Development in Assuring Competence. Journal for Nurses in Staff Development, Vol. 17, No. 5, 221-135 Mee, C. (1999) Nurses, are we still eating our young? Nursing99, 29(11), 48-50. Ohrlin, K, Hallberg, I. (2000) Student nurses’ Lived Experience of Preceptorship. International Journal of Nursing Studies 37 (2000) 13-23

References Addendum: Rittman and Osburn. (1995) Interpretive Analysis of Precepting an Unsafe Student. Journal of Nursing Education, Vol. 34, No. 5, pp. 217-221 Stone, C., Rowles, C. (2002) What Rewards do Clinical Preceptors in Nursing Think are Important? Journal for Nurses in Staff Development, Vol. 18, No. 3, 162-166 Yonge, O., Krahn, H., Trojan, L., Reid, D., Haase, M. (2002) Supporting Preceptors. Journal for Nurses in Staff Development, Vol. 18, No. 2, 73-79 Yonge, O., Krahn, H., Trojan, L., Reid, D., Haase, M. (2002) Being a Preceptor is Stressful! Journal for Nurses in Staff Development, Vol. 18, No. 1, 22-27 lfaro-LeFevre, R. (2002) Improving Your Ability to Think Critically. , RN, MSN Nursing Spectrum - Career Fitness Online http://nsweb.nursingspectrum.com/ce/ce168.htm Benner, P., Wrubel, J. (1982) Skilled Clinical Knowledge: The Value of Perceptual Awareness The Journal of Nursing Administration, May 1982, Vol 12, No. 5, 11-14