1. Susan A. Boyer Director, VT Nurses In Partnership www.vnip.orgwww.vnip.org vt-nurses@earthlink.netvt-nurses@earthlink.net

2.  Distinguish positive aspects of how you impact both technical and critical thinking skill development. www.vnip.org susan.boyer@hitchcock.org2

3. Any fool can make things bigger, more complex, and more violent. It takes a touch of genius – and a lot of courage – to move in the opposite direction.  Albert Einstein www.vnip.org susan.boyer@hitchcock.org3

4.  Nurses “eat their own”  “Nursing literature reports that the inability to handle the intense working environment, advanced medical technology, and high patient acuity results in new grad turnover rates of 35% to 60% within the first year of employment.”  (Beecraft, Kunzman, & Krozek, 2001)  VNIP turnover rate – less than 10% for new graduates completing the internship www.vnip.org susan.boyer@hitchcock.org4

5.  History & background,  Unique features of VNIP  Target audience – team approach www.vnip.org susan.boyer@hitchcock.org5

6. 6 Preceptor development and support Clinical Coaching Plan - Development of Critical Thinking Preceptors Interns Clearly defined expectations

7. ... bigger, more complex, and more violent. It takes a touch of genius – and a lot of courage – to move in the opposite direction.  Albert Einstein www.vnip.org susan.boyer@hitchcock.org7

8.  People think better when they understand, like, and trust one another.  Critical thinking is essential and requires collaborative thinking www.vnip.org susan.boyer@hitchcock.org8

9.  Defined as learning occurs, a change in behavior/ performance ◦ Growth – expansion, progress, advance, increase ◦ Training – education, advancement, promotion, expansion, enhancement  Requires: ◦ Knowledge base, interpersonal, technical and critical thinking skills  How is this development supported in your workplace www.vnip.org susan.boyer@hitchcock.org9

10.  Your workplace –  Your role - www.vnip.org susan.boyer@hitchcock.org10

11.  Teach  Experiential learning  Safe environment www.vnip.org susan.boyer@hitchcock.org11

12.  Who to protect  How to protect ◦ Define competence ◦ Determine what competent practice looks like ◦ Establish performance outcomes ◦ Observe practice  Develop and validate competence www.vnip.org susan.boyer@hitchcock.org12

13. Think, Pair, Share:  What does C.T. look like in your practice?  How do we support the development of Critical thinking skills? www.vnip.org susan.boyer@hitchcock.org13

14.  Questions ◦ Anticipate questions that might be asked ◦ Explore possible consequences ◦ Focus on outcome – what is the goal? ◦ Focus on the rationale – why? ◦ Explore alternatives – what else? what am I missing  Case presentations, telling your ‘stories’, sharing experiences ◦ Turn them into “what if” discussions ◦ Continue with the questions listed above susan.boyer@hitchcock.org © 2001 Vermont Organization of Nurse Leaders (VONL) 14

15.  Develop & use habits of inquiry ◦ Take enough time to explore situation ◦ Keep an open mind - Verify information  Discuss ◦ What did I miss? How could this be made better? Why are we doing it this way?  Thinking out loud ◦ Did you notice… How can I find out.... ◦ I could do x, y or z,…. but for this patient, I think this is best…. Why? susan.boyer@hitchcock.org © 2001 Vermont Organization of Nurse Leaders (VONL) 15

16.  Understanding differences www.vnip.org susan.boyer@hitchcock.org16

17.  Ethnic, Religious, Socio- economic  Roles  Educational background  Personality, Learning styles  Conflict management  Generational  Gender www.vnip.org susan.boyer@hitchcock.org17

18.  How is the role of the preceptor instructor, clinical coach impacted by generational, cultural, personality styles?  Are there other influences to add to this list?  What response or actions can bridge these issues? www.vnip.org susan.boyer@hitchcock.org18

19.  the dominant set of behaviors, values, beliefs, and patterns of thinking that we learn as we grow and develop in our social groups.  Culture determines how we think about and behave toward ourselves, others and the world. susan.boyer@hitchcock.org © 2001 Vermont Organization of Nurse Leaders (VONL) 19

20.  Be aware that differences exist  Be sensitive to differences and the effect they have  Try to understand the individual and the differences involved  Consider what accommodations are necessary to make the relationship successful susan.boyer@hitchcock.org © 2001 Vermont Organization of Nurse Leaders (VONL) 20

21.  groups of people develop a different and distinct set of core values for their entire lifetime that are formed by so- called "coming-of-age experiences" between the ages of 17 and 23 susan.boyer@hitchcock.org © 2001 Vermont Organization of Nurse Leaders (VONL) 21

22.  If you understand where a person is coming from, it will help you predict their behavior.  It will help to know how to communicate with them. Center for Generational Studies susan.boyer@hitchcock.org © 2001 Vermont Organization of Nurse Leaders (VONL) 22

23.  Working effectively with different personality styles www.vnip.org susan.boyer@hitchcock.org23

24.  E xtraversion vs. I ntroversion ◦ Direction or how you recharge your energy?  S ensing vs. I N tuitive ◦ Perception of world or how you collect data?  T hinking vs. F eeling ◦ Judgment or how you make decisions?  J udging vs. P erceiving ◦ How you deal with the outer world & make lifestyle choices

25.  Key teaching/learning issues or concepts www.vnip.org susan.boyer@hitchcock.org25

26.  Novice  Advanced Beginner  Competent  Proficient  Expert Which makes the best preceptor? susan.boyer@hitchcock.org © 2001 Vermont Organization of Nurse Leaders (VONL) 26

27.  Inventory of learning styes ◦ Reflective vs. Active ◦ Sequential vs. Global ◦ Sensing vs. Intuitive ◦ Visual vs. verbal  VARK ◦ Visual, Auditory, Read/write, Kinesthetic, www.vnip.org susan.boyer@hitchcock.org27

28.  is diverse and brings a wealth of experiences to the situation  prefers to have some degree of control over their learning  learning is an active process of construction of meaning  needs to connect the content to their own meaning structures  focuses on what they WANT to learn susan.boyer@hitchcock.org © 2001 Vermont Organization of Nurse Leaders (VONL) 28

29.  6 – 1 ratio ◦ 6 positives to offset 1 negative – shows the need for positive feedback  Want to learn - Need to know ◦ Don’t try to teach if they aren’t interested in learning. You will waste your time and thiers.  Pictures - See = remember  Revisit 6 – 9 times to remember www.vnip.org susan.boyer@hitchcock.org29

30.  Interactivity is key – doing!  Success builds success  Build simple to complex  High anxiety reduces retention  Learners remember the odd & unusual  Amount of learning that occurs is directly proportional to how much fun you are having www.vnip.org susan.boyer@hitchcock.org30

31.  Communication skills www.vnip.org susan.boyer@hitchcock.org31

32. Verbal – the words we use + Vocal – our tone and intensity “The music we play with our voices” + Visual – Everything the listener can see = the meaning received100% susan.boyer@hitchcock.org © 2001 Vermont Organization of Nurse Leaders (VONL) 32

33.  It is better to remain quiet and be thought a fool then to speak and remove all doubt  Mark Twain susan.boyer@hitchcock.org © 2001 Vermont Organization of Nurse Leaders (VONL) 33

34.  Conflict Management www.vnip.org susan.boyer@hitchcock.org34

35.  Treat the Other Person With Respect  Respect for another person is an attitude conveyed by specific behaviors.  Listen Until You Have “Experienced the Other Side”  They need to be understood and accepted.  When the other person feels heard, you have earned the right to speak your point of view and express your feelings.  State Your Views, Needs & Feelings  State your point of view briefly.  Use “I” statements

36.  For many of us, an act of willpower is needed to fight the gravitational pull into disrespect.  A conscious effort must be made to convey respect and instill a sense of worth to all concerned parties.

37.  Interpersonal skills ◦ Combining effective use of all the previously discussed ◦ Plus theory related to skills development www.vnip.org susan.boyer@hitchcock.org37

38.  Fill in your chart www.vnip.org susan.boyer@hitchcock.org38 Current PracticeWhat might be added

39.  Distinguish positive aspects of how you impact both technical and critical thinking skill development  Could you expand this list? www.vnip.org susan.boyer@hitchcock.org39

40.  Preceptor development ◦ Research and theory based ◦ Define & prepare for the role  Competency development ◦ Clinical Coaching plans  Competence validation ◦ COPA model – for allied healthcare team  Staff development process & protocols ◦ Time to teach, time to assess capability ◦ Protector Role, competence assessment www.vnip.org www.vnip.org susan.boyer@hitchcock.org40