Preceptorships

PreceptorshipsErin Kibbey, BS, RN, CCRN1Learning ObjectivesDefine a preceptorship

Describe the benefits of preceptorships

Recognize the characteristics of preceptorships with positive outcomes

Distinguish between the current preceptorship program at Munson/A2 to current research

Evaluate a plan for improvement2DefinitionOrganized instructional programs that facilitate the integration of newly employed nursing staff into their role responsibilities in the work setting (Alspach, 2000)

Not mentoring

GOAL: Training nurses while still maintaining competence and ensuring highest quality of care3Preceptor CharacteristicsRole modelFacilitatorSocializerCommunicatorTeacherEvaluatorProvider of feedback

What is the least comfortable aspect of the preceptor role?

(Moore, 2008)Wear many hats

Answer: Evaluating employee performance

Above all else honest and open communication will establish a positive learning environment4BenefitsContribute to ability to adapt to changeRetentionRecruitmentFosters better prepared nurses and increased confidenceIncreased efficiency and time management skillsImproved problem-solvingAdvantages to preceptor (Bratt, 2009; Moore, 2008; Ullrich & Haffer, 2009; Wright Shpritz & OMara, 2006)

2 shortages have prompted an increased use of precepted experiences: nursing faculty, professional nurses

Turnover is costly and affects quality of care - health care organizations have been challenged to design effective programs that offer support for new nurses to ease their transition

Nurses leaving profession within 2 years of graduation 30-61% 1st year, nurse with less than a year of experience can cost an organization almost $50,000. Does not factor in negative influence on staff morale and patient satisfaction.

One study shows change of 50% retention rate before implementation of nurse resident program to rates of 79% to 97%.

Preceptor advantagesIncreased job satisfaction, new dimension to work - stimulationMotivation to maintain skillsLearn from studentsContributes to professional growth

5What Makes a Good Preceptorship?Preceptor preparation in the form of a workshop or class identified as most important prerequisiteProcess of selecting individualsTime for preparation, resources, practiceCreating a climate conducive to learningAdult centeredConsistencyFeedback that is timely, provided in an encouraging manner, and related to identified goalsOngoing recognition & support

(Baltimore, 2004; Moore, 2008; Morris et al., 2007; Myrick & Yonge, 2001; Wright Shpritz & OMara, 2006 )Selection process for preceptors Clinical nursing characteristics, professional characteristics, personalityMost important personality characteristic - *Willingness and desire to be a preceptor*

Adequate preparation for helping preceptors identify strategies for balancing multiple demands.

Factors that contribute to climate: preceptor (ability to value, work with, and support) and staff acceptance of orientees as part of team, how preceptor gets along with staff

Adult centered: Variety of learning methods, Self-direction when possible, Constant opportunity for assessment and evaluation

6Example Model for Critical Care

(Morris et al., 2007)Builds on learners experiences, provides a variety of learning methods, uses task-oriented problem-solving approaches to learning, and uses self-directed learning 7Preceptor workshop Varying preceptor eligibility requirementsInconsistent preparation to the precepting roleOutdated/lack of resources for preceptors to guide orientationSkills checklistsLack of instruction on how to promote higher order cognitive skills during bedside teachingECCO - Online learningMunsons Strategic Plan for Nursing Services 2013-2016

How Does Munson/A2 Measure Up?

Ask how many have gone to this out of those that have precepted?

Goal 4: Nurses grow professionally as preceptors, mentors, and leaders within the organization.Tactics: Standardize preceptor eligibility, education, support, and incentives, including structures for organizational and unit oversight, scheduling, and evaluation. Develop preceptor committees, both unit-based and hospital-wide. Incorporate simulation learning opportunities as able. 8Plan for ImprovementCombined self-study and team based approachSoftware/training modules and bookshttp://www.aacn.org/WD/Elearning/Content/preceptor/preceptor.contentPrecepting in Nursing: Developing an Effective Workforce by Ullrich & HafferMore resourceshttp://a2ccnursingeducation.weebly.com/critical-care-topics.htmlDevelopment of a case study guide for preceptorsEducator bloghttp://cardiothoracicnursingeducation.blogspot.com/Simulation training for both orientees and preceptorsAACNs Preceptor Challenge Module 3.5 CNEs Interactive simulation based. Precepting different learning styles and levels of proficiency. Practice constructive feedback, complete an evaluation and learning plan.

Maximum benefit from orientation if preceptor is able to refer them to appropriate learning resources

Case study guidea collection of case studies, with increasing levels of complexity, developed for use by the preceptors.

Simulation could provide opportunity to learn better feedback techniques in addition to assessment techniques that can stimulate higher order thinking. Article about CATs

9Outcome MeasuresRevise preceptor program by end of 2013Decreased new graduate RN turnover Safety culture survey increases in this organization does a good job in training new staff"Increase in employee engagement question this organization provides opportunity to improve professional knowledge and skillIncrease in the number of hours where the simulation lab is used

(Munson Medical Center, 2013)Exit evaluation/survey of orientation experience specific to A2.10ReviewOne minute paper

What was the most important thing you learned in this teaching session?

Purpose: To assess comprehension of major concepts covered during session11Conclusion

You cannot hope to build a better world without improving the individuals. To that end each of us must work for his own improvement, and at the same time share a general responsibility for all humanity, our particular duty being to aid those to whom we think we can be most useful. - Marie Curie12ReferencesAlspach, J. G. (2000). The educational process in nursing staff development. Annapolis, MD: American Association of Critical Care Nurses. Baltimore, J. J. (2004). The hospital clinical preceptor: Essential preparation for success. Journal of Continuing Education in Nursing, 35(3), 133-140.Bratt, M. (2009). Retaining the next generation of nurses: the Wisconsin Nurse Residency Program provides a continuum of support.Journal of Continuing Education in Nursing,40(9), 416-425. doi:10.3928/00220124-20090824-05Fulmer, T. (2006). Foreword. In J. P. Flynn & M. C. Stack (Eds.), The role of the preceptor: A guide for nurse educators, clinicians, and managers (2nd ed.). (pp. xi-xii). NY: Springer Publishing Company, Inc.Munson Medical Center. (2013). Strategic plan for nursing services: 2013-2016. Retrieved from Munson Medical Centers intranet.Moore, M. L. (2008). Preceptorships: Hidden benefits to the organization. Journal for Nurses in Staff Development, 24, E9-E15.Morris, L. L., Pfeifer, P. B., Catalano, R., Fortney, R., Hilton, E. L., McLaughlin, J., . . . Goldstein, L. (2007). Designing a comprehensive model for critical care orientation. Critical Care Nurse, 27(6), 37-60.Myrick, F., & Yonge, O. (2001). Creating a climate for critical thinking in the preceptorship experience.Nurse Education Today, 21(6), 461-467.13References ContinuesUllrich, S. and Haffer, A. (2009). Precepting in nursing: Developing an effective workforce. Sudbury, MA: Jones and Bartlett Publishers.Wright Shpritz, D. and OMara A. M. (2006). A model preceptor program for student nurses . In J. P. Flynn & M. C. Stack (Eds.), The role of the preceptor: A guide for nurse educators, clinicians, and managers (2nd ed.). (pp. 28-53). NY: Springer Publishing Company, Inc

14