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4/24/15
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Preceptor Power and Influence: Transforming Student Learning
Carolyn Montoya PhD, CPNP Associate Professor and Chair Practice Team
Robyn Mintz LMT Senior Program Manager
“I feel that we as providers possess a great deal of knowledge and exper<se which lends us as invaluable resources for teaching those who will likely follow us in our fields. There will always be a need for con<nuous learning and I hope that other providers will consider sharing their exper<se with students.”
Diana Sanchez-‐Gallegos, FNP, PNP Presbyterian Medical Group
Benefits of Precep.ng
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Personal fulfillment ! Desire to “give back” ! Posi<ve experiences as a student
Invested in training the next genera<on of healthcare professionals ! CommiFed to building a healthier state
Mutually beneficial learning opportunity Professional rewards
! Credit for recer<fica<on by the ANCC ! Adjunct Faculty appointments or other <tles ! Opportuni<es to earn CEU’s
Peer support/professional partnership with faculty Perks offered by the ins<tu<on
Benefits of Precep.ng
Benefits of Precep.ng
What mo<vates YOU?
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“Preceptors are the vital link between the concepts and evidence-‐based approaches to care and the reali<es of actual prac<ce.” (Barker, et al., 2008)
Preceptor Roles and Responsibili.es
What level of student will you be precepEng? (Davis, et al., 1993)
Advanced beginner ! Rule oriented ! Need help in seang priori<es ! Examples: first year students -‐ Women’s Health, Adult Health I, Pediatrics I
Transi<on ! Moving towards competence ! S<ll need help seang priori<es ! Examples: second year students – Adult Health II, Pediatrics II
Competent-‐Proficient ! Increase in clinical judgement, skills and experience ! Deliberate planning ! Analysis of a plan ! Increasing organiza<on, speed, flexibility, and confidence ! Examples: Advanced Fieldwork – last clinical experience before gradua<ng
Preceptor Roles and Responsibili.es
Preceptor
! Orient student ! Discuss mutual expecta<ons
! Mentor & coach
! Teaching style ! Match pa<ents to student’s learning situa<on
! Direct observa<on ! Provide feedback & final evalua<on (Barker & Pi1man, 2010)
Preceptor Faculty Partnership
Faculty
! Provide didac<c content ! Match students with sites/preceptor
! Establish student goals/objec<ves ! Support preceptor ! Support student ! Conduct site visit ! Assign final grade
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The Mentored NP Student ! Vested interest ! Loving to teach ! Giving opportunity through trust and feedback
! Openness ! Friendship ! Life jacket ! Pa<ence and kindness, values beginner ! Job advice ! Modeling of confident, competent, empathe<c pa<ent care
What Makes a “Good” Preceptor (Hayes, 1999) The Non-‐Mentored NP Student ! Not mee<ng learning needs ! Not leang go ! Barriers to communica<on ! Disappointment in the rela<onship ! Feeling unsafe ! Impa<ence ! Compe<<veness ! Not liking the way the preceptor relates to pa<ents
Plan Ahead
! Understand expecta<ons
! Affilia<on Agreement and “Onboarding” requirements
! Make contact with the student
! Responsibility to management
Steps to Success: Preparing to Precept
Orienta<on ! Introduce to staff and management ! Conduct facility tour ! Review standard policies and procedures, dress code, self-‐protec<ve equipment, and per<nent pa<ent issues
! Provide EMR training ! Discuss fire and emergency safety prac<ces
The First Day ! Review roles and responsibili<es, goals, objec<ves, communica<on, and management style
! Discuss feedback mechanisms and performance assessment ! Confirm schedule ! Allow student observa<on ! Schedule <me for reflec<on and Q&A
Steps to Success: Preparing to Precept
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UNM College of Nursing Preceptor Tools and Resources
! Preceptor orienta<on handouts ! Evalua<on forms
! One-‐Minute Preceptor skills pocket card
! Nurse-‐Midwifery Preceptor Workshop h1p://www.youtube.com/watch?v=wTfL8h99ZJM
! Nurse-‐Midwifery Preceptor Pearls pocket card
! Library privileges ! Preceptor webpage (Launching Fall 2015) ! NewsleFer (Launching Fall 2015)
Steps to Success: Tools and Resources
Typhon Group’s NPST™ Student Tracking System
! Pa<ent encounter logs and reports ! Evalua<on and survey component for assessments
! Management of student rota<on scheduling
! Student porpolios ! Student and preceptor biographic databases ! Clinical site database
Steps to Success: Tools and Resources
Typhon Group’s NPST™ Student Tracking System
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Typhon Group’s NPST™ Student Tracking System
Observa<on vs. student seeing pa<ents
“Wave-‐Scheduling” (Barker & PiFman, 2010)
! 2-‐3 pa<ents scheduled at the same <me followed by a 10-‐15 minute break to allow for “catch-‐up”
Alternate experiences ! Char<ng ! Assignment
Teaching Strategies
Developed by medicine to model clinical teaching (Neher, & Stevens, 2003) ! Get a commitment ! Probe for suppor<ng evidence ! Teach general rules ! Reinforce what was done right ! Correct mistakes
Usual Prac<ce without the One-‐Minute Preceptor ! hFps://www.youtube.com/watch?v=937G0m5SUsI
One-‐Minute Preceptor ! hFps://www.youtube.com/watch?v=ndLbo7sDnKo
“One-‐Minute Preceptor”
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Power and anxiety – a potent cocktail for affec<ng cri<cal thinking! (Forneris, & Peden-‐McAlpine, 2009).
Students expected to con<nually self-‐evaluate.
Feedback should be: ! Given in private ! Timely ! Specific ! Posi<ve ! Construc<ve (incorpora<on of areas for improvement) ! Par<cipatory on the part of the student
Evalua.on of Students
What to expect
! Student coordinates site visit appointment ! Faculty
• Observes student with pa<ents • Reviews student char<ng • Discusses student progress with preceptor
! Opportunity for mutual feedback
Faculty Site Visit
Observa<on vs. student seeing pa<ents
Medicare Rules
! Physical presence of the provider necessary for all billable services. ! Preceptor must document the visit – cannot “ini<al” student char<ng.
Challenges of Char<ng
! Electronic char<ng Commission on Collegiate Nursing Educa<on (CCNE) Accredita<on Requirement
! Student and site visitor evalua<on of preceptor and clinical site.
Special Considera.ons of Precep.ng
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UNM College of Nursing Student Tes<monial
“There are <dbits of informa<on that we cannot find on an iPhone, skills we cannot learn by watching YouTube, and a sou touch to medicine that is not easily understood by reading books. Thankfully, we have preceptors who take the <me to teach us these finer points so that we can grow into sound prac<<oners.” Erin Weber, Family Nurse PracEEoner ConcentraEon
Transforming Student Learning
UNM College of Nursing Student Tes<monial
“I will always be grateful to my preceptors for sharing their knowledge, experience and their pa<ents with me. The strength of this program is dependent on willing preceptors and their focus on our learning.” Erin Stopani, Nurse-‐Midwifery and Family Nurse PracEEoner ConcentraEons
Transforming Student Learning
! This fund was established in 2015 by Dr. Diane Viens, CFNP and Dr. Carolyn Montoya, CPNP.
! Provides support for Nurse Prac<<oner students’ educa<on inclucing clinical travel in rural and under-‐served areas.
! Dr. Viens was the first permanent director of the Family Nurse Prac<<oner (FNP) program. Dr. Montoya con<nues to coordinate the Advanced Prac<ce Programs at UNM.
! Drs. Viens and Montoya were instrumental in the successful passage of the bill which led to NPs in New Mexico having full prescrip<ve authority and independent prac<ce in 1993.
! Contact Dimple Bhakta (505) 272-‐4455 or [email protected] for more informa<on
Viens/Montoya Nurse Practitioner Fund – UNM, College of Nursing
Dr. Diane Viens
Dr. Carolyn Montoya
Transforming Student Learning
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References American Associa<on of Nurse Prac<<oners™ (2015). 2013-‐2014 Na<onal Nurse Prac<<oner Prac<ce Site Census.
Retrieved from hFp://www.aanp.org/images/documents/research/2013-‐14na<onalnpcensusreport.pdf
Barker, E. R., & PiFman, O. (2010). Becoming a super preceptor: A prac<cal guide to preceptorship in today’s clinical climate. Journal of the American Academy of Nurse PracEEoners, 22(3), 144-‐149.
Davis, M. S., Sawin, K.J., & Dunn, M. (1993). Teaching strategies used by expert nurse prac<<oner preceptors: A
qualita<ve study. Journal of the American Academy of Nurse PracEEoners, 5(1), 27-‐33. Forneris, Susan Gross, & Peden-‐McAlpine, C. (2009). Crea<ng context for cri<cal thinking in prac<ce: the role of the
preceptor. Journal of Advanced Nursing, 65(8), 1715-‐1724. Neher, J. O., Gordon, K. C., Meyer, B., & Stevens, N. (1992). A five-‐step “microskills” model of clinical teaching. The
Journal of the American Board Family PracEce, 5(4), 419-‐424. Neher, J.O., & Stevens, N. G. (2003). The one-‐minute preceptor: Shaping the teaching conversa<on.
Family Medicine, 35(6), 391-‐393.