The Art of Precepting:

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The Art of Precepting Passing the Torch
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PARTICIPANT GOALS

• Learn preceptor role responsibilities
• Understand how adults learn
• Explore effective communication, how to give
  feedback conflict resolution
• Discuss techniques for stimulating critical
  thinking
• Review components of the UTT CON preceptor
  handbook
• Complete preceptor post-test

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Primary Roles of the Preceptor

• Role Model--demonstrates how competent staff
  perform their job--most familiar, most
  comfortable
• Socializer--helps preceptee feel welcome
  integrated into the unit culture--less familiar,
  less comfortable
• Educator--helps preceptee assess orientation
  learning needs, plan learning experiences,
  implement the plan, evaluate performance--least
  familiar, least comfortable

Role Model
Socializer
Educator
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Role Model Definition, Criteria

• Role Model-- an individual who exemplifies
  through his or her behavior how a specific role
  is to be enacted (JG Alspach, 2000)
• Nurse role model exhibits these qualities--
• Caring
• Positive interactions
• Empathetic
• Respected by peers
• Good communicator
• Strong patient advocate
• Expert practitioner
• Willing resource person
• Shares knowledge with others
• Respects dignity in all people
• Critical thinker
• Honest, accountable

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Preceptor and Staff Nurse Roles-- Balancing Dual
Role Demands

• Compare--your usual job activities with teaching
  others how to perform their job
• Major Role with Preceptee--teaching rather than
  doing
• Conflict--can arise if you do for the preceptee
  rather than guiding to do for themselves
• Challenge--balancing dual role of caregiver and
  preceptor

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Socialization of the Preceptee

• Think back to your own orientation--how you felt,
  new circumstances
• Reality Shock--4 phases
• HONEYMOON
• SHOCK
• RECOVERY
• RESOLUTION

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Factors that Affect Learning, Working Styles

• Adult Learning Principles
• How Communication is
• Received
• Generational Values
• Learning Styles

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Adults as Learners

• Self-directed--want to be actively involved
• Relate new knowledge to life experiences/previous
  knowledge
• Goal-oriented
• Must have a reason for learning
• Practical--want learning to be useful
• Want to state their views, be recognized, be
  accepted, feel important, be respected

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How We Receive Communication
Words
Vision
60
30
Hearing
10
Content
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How Generational Values Impact Work Styles

• MATURES--lt1946-- duty work ethic, follow
  orders, productive, fixers
• BABY BOOMERS--1946-1964--teamwork, process
  oriented, desire recognition, uncomfortable with
  conflict
• GENERATION Xers--1965-1980--self-reliant,
  skeptical, casual about authority, tech savvy,
  resourceful
• MILLENIALS--1981-1991--tech savvy, less focused
  on problem solving more on choices, buy into
  team concept, look for mentors, accepting of
  other cultures, expect management to be
  competent, demand equity

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Learning Styles

• Left Brain vs. Right Brain
• LEFT RIGHT
• Analytical Global
• Uses automatic codes Wholes, not parts
• Arranges details in order Novelty
• Auditory rather than visual Intuitive
• Spatial Visual over auditory

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How to Give Effective Feedback
Goal To IMPROVE Performance

• IIdentify learning objectives
• MMake a feedback-friendly learning environment
• PPerformance--assess it
• RRespond to your learners self-assessment
• OObjectivity--always keep it
• VValidate good work, suggest alternatives in
  weak areas
• EEstablish a plan

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Effective Feedback

• Feedback should be
• Immediate
• Clear
• Positive
• Objective

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Causes of CONFLICT
Task Interdependence
Individual Differences
Scarce Resources
Poorly Designed Reward Systems
Communication Failures
Goal Incompatibility
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Conflict Resolution

• Take responsibility
• Agree to disagree
• Define the problem
• Allow venting
• Establish ground rules--honesty, everyone will
  be heard, all listen, support feelings with facts
• Ask open-ended questions
• Listen objectively
• Restate problem, set goals, establish action
  plans
• Follow-up

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Stimulating Critical Thinking

• Create a climate of curiosity/questioning
• Ask Open-ended vs. Close-ended questions, qualify
  answers--correct, partially correct, incorrect
• Prepare for the unexpected-- What if
• Think out loud--Verbalize your processes
• Compare assessment findings with report
• Reflect on activities/findings of the day
• Challenge assumptions
• Seek meanings, connections, group data
• Keep professional humility--readily admit
  erroneous conclusions, seek the truth always

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6 Steps for Success

• Plan aheadtell staff date preceptee is coming to
  unit, outline daily plans
• First dayask your learner to share their
  goals/needs, share your goals/expectations
• Introduce to staffintegrate, welcome, include in
  break times
• Give specifics about what you expect
• Get/Give feedback often during the day
• Reflect on activities, skills completed

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Sample First Clinical Day

• Identify students learning needsask for
  critical skills list, clinical objectives
• Let student observe what you do, maybe only one
  client for student care
• Seek opportunities for student to perform
  identified high-anxiety procedures firstreduces
  fear, stress
• Have a brief conference with the student to
  double-check assessment priorities, medications
  changes
• Ask the student to reflect on the days
  activities and discuss situations, ask questions

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Preceptor Leadership Qualities

• Practice good time management
• Coach your learner towards excellence in practice
• Follow NPA delegation guidelines
• Create opportunities for learning
• Encourage people to have fun, enjoy their work
• Move from preceptor to mentor--assist new staff,
  peers in learning

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CON Preceptor Handbook

• Preceptor Program
• Preceptor Orientation Information
• Preceptor Agreement, Benefits
• Clinical Guidelines
• Evaluation Tool
• Student Medication Administration Incident Report
  Form
• Student Objectives/Skills

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Safe Practice

• Medications
• --RN must be at bedside with IV
  pushadministration by student
• --RN alone can access narcotics, sign narcotics
  forms for student
• --RN must supervise student narcotic
  administration and co-sign MAR

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Safe Practice-- continued

• Needle sticks/Exposures
• Student will
• --report incident to preceptor immediately and
  then notify appropriate person in clinical agency
• --Complete agency incident report
• --Follow agency protocols regarding wound care,
  reporting and notify clinical faculty as soon as
  possible
• --Seek treatment from Campus Health Center or
  private provider within 2 hours of incident

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References
Freiburger, O. (2001). A tribute to clinical
preceptors. Journal for Nurses in Staff
Development, Vol. 17, No. 6, 320-327. Alfaro-LeFev
re, R. (2002). Improving your ability to think
critically. RN, MSN Nursing SpectrumCareer
Fitness Online. http//nsweb.nursingspectrum.com/c
e168.htm Ohrlin,K. Hallberg, I. (2000). Student
nurses lived experience of preceptorship.
International Journal of Nursing Studies, 37,
13-23.
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Post-Test

• 1. On the students first clinical day
  with you, the best way to verify their assessment
  skills is to
• A. Instruct the student to assess the client
  and relate the findings to you
• B. Ask the student to show you their documented
  findings
• C. Perform the client assessment with the
  student and compare findings
• D. Tell the student to complete the client
  assessment form
• 2. After the student completes a head-to-toe
  assessment, you allow them to document findings
  on the interdisciplinary notes. The correct
  procedure is to
• A. Sign your full name and title only when you
  are satisfied the assessment is accurate
• B. Sign your name and title after you correct
  any inaccuracies by writing disagree with
  student assessment and write the correct
  assessment information.
• C. Sign your full name and title on the blank
  notes form and allow the student to complete the
  assessment documentation.
• 3. A student has helped you admit a client with
  type1 diabetes and influenza-like symptoms. The
  ED lab results are glucose 460 mg/dL, K 5.1
  mEq/L. The student encourages the client to
  drink all the juice and milk on the new admit
  food tray. How would you begin to discuss this
  scenario with the student?
• A. Why did you tell a diabetic with a blood
  sugar of 460 to drink fruit juice?
• B. Lets review this clients situation. Tell
  me first what you have learned about diabetics
  when they are sick.
• (continued on next slide)

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Post Test--continued

• 4. At noon you find your students has not yet
  documented the two assessments you performed
  together earlier. When questioned, the student
  states, Ive been snowed under with these two
  busy patients. How would you respond?
• A. Tell me what you have been dealing with so
  we can make a plan for the rest of the shift.
• B. Why didnt you come to me sooner? I
  could have handled them while you documented your
  care.
• 5. A student suffers a needle stick from an
  insulin syringe they just used on a client. The
  order of your actions should be
• ___A. Have the student express blood from the
  stick and wash vigorously with soap and water for
  five minutes
• ___B. Advise the student to seek treatment
  intervention from the UTT Campus Health Center or
  their private healthcare provider within 2 hours
• ___C. Notify the students clinical faculty and
  the appropriate person in the clinical agency
• ___D. Help the student complete the appropriate
  institutional incident report and forms

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Test Answers

• 1-- C
• 2 -- A
• 3 -- B
• 4 -- A
• 5-- A 1, B 4, C 3, D 2

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Congratulations!

• You have successfully completed the
• University of Texas at Tyler
• College of Nursing
• Preceptor Self-Paced Tutorial!