1. Vermont Nurses In Partnership Susan A. Boyer, RN, M.Ed., FAHCEP
Supporting Transition for New Graduate Nurses: via a Statewide Nurse Internship Model
Vermont Nurses In Partnership Susan A. Boyer, RN, M.Ed., FAHCEP
© Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission.

2. Collaborative approach
Origins: Nurse leadership group
Inclusive of various practice settings, specialty services, academia, & regulation
Goal: To Implement a statewide nurse internship
Supports “transition to practice”
Applicable in multiple HC settings
Environment of nurture & support
Process: Based in Preceptor Program (Clinical Coaching)
Requires preceptor development/support
VNIP started as a nurse internship project in It has evolved into a collaborative non profit business structure that provides staff development consulting within and outside Vermont.
© Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission.

3. Transition to practice
3 levels of internship were needed
New graduate transition
New to specialty
Undergraduate
© Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission.

4. Program Outcomes: Statewide use of single competency tool
Same expectations for all staff
Performance outcomes vs grocery list of “tasks & procedures”
Concept-based vs. case or task-based
Foster critical thinking development
Prioritizing evaluation, caring relationships, leadership, management & critical thinking
© Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission.

5. Program Outcomes: Concepts and framework fit across continuum of care
Applicable for full allied healthcare team
Statewide standardization of preceptor development and support
Evidence-based preceptor development
Focus on Preceptor’s role of ‘Protector’ for the patient and new graduate
© Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission.

6. What we have learned from:
10 years of program implementation
Across the continuum of care
Across the state
With ongoing data collection and analysis
With formative and summative research application
An evolving project, product and process
© Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission.

11. Why Preceptorship? Builds one on one relationship
Improves satisfaction, retention, and orientation process
Provides bridge between theory and reality
Develops capability
Protects and ensures safety for patient, new care provider and organization
Collects evidence of competence
© Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission.

12. Why mentorship? Ongoing development of clinical capability
Support through 2nd & 3rd phases of Boychuk’s “Transition Stages”
Development of nursing judgment
Development towards proficient practice
Transition within the profession
Deciding how and where you fit within the nursing profession
© Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission.

13. Determining content? What's the goal?
How do we determine “what to teach” in regards to development of preceptors and clinical coaches?
© Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission.

14. Establish our goal
Preceptors will collect evidence of clinical capability of the novice care provider.
Must effectively develop capability, where it is missing
© Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission.

15. Clinical capability with emphasis on Nursing Judgment
VT Nurses In Partnership, Inc Susan A Boyer, RN, MEd, FAHCEP, Executive Director
2/24/2019
Clinical capability with emphasis on Nursing Judgment
Analyze – Evaluate - Synthesize
Affective
Act upon Attitudes
Develop value system
Organize own values
Adopt behavior
Internalize values
Psychomotor
Develop Precision
Articulation
Become automatic
Integrate related skills
Naturalization
Technical skills
Does your current ‘transition support system’ develop the novice’s ability to perform above the basic level or “receiving phase”?
© Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission.
© Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission.

16. Goal: To effectively develop & collect evidence of capability
Preceptors will require:
Effective Communication
Supportive Interpersonal Skills
Core teaching/learning principles
Foster critical thinking skills
Team process:
Relationship-based care
Relationship-based development
© Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission.

17. To develop capability Preceptor roles & responsibilities
Teaching and learning theory
Learning styles, Novice to expert, Simple to complex, Principles of adult learning
Story-telling, Use of case scenarios, and/or practice with difficult situations
Collaborative team approach
Relationship-based process, Interpersonal issues, conflict management, Socialization
© Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission.

18. To validate capability
Define “competent practice”
Delegation, accountability, liability
Nurse practice act, job descriptions, P & P
Performance management
Communication & feedback
Assessment & evaluation of capability
Data collection
Validating performance, collecting evidence, complete documentation tools
© Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission.

19. Preceptor development
Preceptor Development & Support
Multi-disciplinary approach
Need to:
Revise/update the preceptor model
Develop high level preceptor workshops
Consider recognition and reward
Prioritize protector role
Delineate evaluator/validator role
Establish protocols
© Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission.

20. Core Concepts Theory and evidence-based Clearly defined expectations
Competency-based – COPA model
Concept focus rather than task, procedure, case-based
Preceptor development and support
Protector and Evaluator roles
Critical thinking development
Data collection/evaluation = Evidence based
Clinical coaching plans – “roadmap” for teaching & evidence collection that is based in the clinical setting
© Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission.

21. VNIP: Collaborative Outreach
Electronic manuals with site license,
Roles, JD, survey tools and protocols
How to teach, how to foster critical thinking development
Tools for competency assessment
Tools for clinical coaching
PowerPoint Presentations, activities, notes, etc. for preceptor development
Same for intern development
© Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission.

22. VNIP: Collaborative Outreach
Consulting services & collaborative workgroup
Explanation of VNIP framework, core concepts, and key processes
Instruction specific to use & roles of various resource materials
Cyber-communications network
Expert contributors adding to resource pool
Web-based updates as they occur
Linkages for shared workshop delivery/participation
© Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission.

23. VNIP: Collaborative Outreach
Key processes
Preceptor development and support
Critical thinking & critical thinking development
Data collection/evaluation of process change &/or effectiveness
Clinical coaching with instruction specific to various learning styles
Clinical Coaching plan development & use
Competency based evaluation – COPA model
Concept focused rather than case-based
© Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission.

24. 24

25. Preceptor Protector Facilitator Educator
- Safeguards patient & preceptee
Facilitator
- Role model, Socializer & Team leader
Educator
- Teacher, Coach, Evaluator
Preceptor
© Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission.