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NURS 624: Course Congress Presentation
- 1. Setting up and Supporting Collaborative Mentoring/Precepting Opportunities Among Students (Image Credit: Association Forum, 2019)
- 2. Meet Our Team Amy Giddens Deanna Waslewsky Samiira Mohamed Crystal Truman
- 3. Welcome to Our Course Congress ❏ Many healthcare organizations have implemented a mentorship or preceptorship program to improve the learning of new employees, students, or graduates. These relationships foster the development of professional knowledge for the workforce, allowing new staff, nursing students, and new nurses to function in a safe and competent working environment. ❏ This presentation will emphasize the significance of establishing and promoting collaborative mentoring/precepting opportunities for learners. We hope you have fun and gain new insights as we delve deeper into this topic. (Image Credit: Nursing CE, 2021)
- 4. Learning Objectives Upon completion of this presentation, the class will be able to: ● Explore the differences and similarities between mentorship and preceptorship opportunities ● Describe collaborative approaches to support mentoring and precepting opportunities among final placement nursing students ● Understand the application of theory to practice ● Identify the role and responsibilities of each (mentor/mentee; preceptor/preceptee; educational institution; healthcare organization) stakeholder in providing a supportive transition to practice.
- 5. Preceptorship ● A nurse or nursing student (the preceptee) is paired with a practicing nurse (the preceptor) for a period of time who is responsible for provide support and education to the preceptee as they complete a clinical rotation in a healthcare setting. ● The goal of a preceptorship is for the preceptee to develop the knowledge and skills needed to become competent and responsible for their nursing practice. (Loughran & Koharchik, 2019) (Image Credit: Swezey, 2019)
- 6. Mentorship ● The precepting role is distinct from the role of mentor. A mentoring relationship is a voluntary, long- term, one-to-one relationship without an established end time. The mentor provides support, teaching, and counsel but does not evaluate or assess the mentee. (Lazarus, 2016) (Image Credit: De Vasconcelos, 2015)
- 7. Applying Theory to Practice (Image Credit: Start School Now, 2016)
- 8. Purpose/Benefits of Preceptors ● An essential link between the academic program and clinical practice ● Enhance critical thinking, assisting in the development of clinical and problem- solving skills ● Foster independence, competence, and confidence ● Increase job satisfaction ● Enhance clinical skills through reflection and evaluation practice ● Provide a functional relationship last from days to months ● May include an assessment component (Lazarus, 2016)
- 9. Purpose/Benefits of Mentors ● Serve as role models; close personal friendship ● Provides advice for personal and professional development ● Supports education ● Personalize commitment to professional development and career ● Offers hands-on evidence-based knowledgeable work experiences ● Offer a supporter tool for retaining nurses at different stages of their career ● Not involved in formal evaluation ● Self-directed/collaborative determination of learning goals ● Leadership opportunity for mentor ● The relationship typically lasts for years (Dirks, 2021; Kardonsky et al., 2018; Miller et al., 2020)
- 10. Who is Involved? ● Educational Institution ● Healthcare Facilities ● Preceptee/Mentee ● Preceptor/Mentor (Image Credit: Nurse key, 2020)
- 12. Educational Institution Roles & Responsibilities Support from the Institute Assist / Support the Learner Communicate Guidelines Evaluate (Lazarus, 2016; Loughran & Koharchik, 2019; Matua et al., 2014; Phuma-Nggaiyaye, et al., 2017; Saskatchewan Polytechnic, n.d.)
- 14. Healthcare Organization’s Roles & Responsibilities Collaborative Preceptorship/mentorship programs Designing preceptorship/ mentorship programs Ongoing SUPPORT!! (Dirks, 2021; Lazarus, 2016; Loughran & Koharchik, 2019; Phuma-Nggaiyaye, et al., 2017; Miller, et al., 2020)
- 16. Roles & Responsibilities Preceptee/Mentee Take Ownership Personalize Goals Communication strategies Professionalism Participation Celebrating Reflect / Reevaluate Feedback / Evaluate (Baldwin et al., 2020; Dirks, 2021; Harvey & Uren, 2019; Kardonsky, et al., 2018; Lazarus, 2016; Loughran & Koharchik, 2019; Matua et al., 2014)
- 18. What is a preceptor? ● A Knowledgeable and skilled practitioner ● Support nursing students or new grads ● Roles of the preceptor ● Qualifications ● Reasons to be a preceptor (Baldwin et al., 2020; Fordham, 2021; Kardonsky et al., 2018; Lazarus, 2016; Loughran & Koharchik, 2019) (Image Credit: American Association for Respiratory Care, 2022)
- 19. Collaborating to prepare for preceptorship ● Training ● Reflection ● Assessing for preferred teaching style (Lazarus, 2016; Loughran & Koharchik, 2019; Matua et al., 2014) (Image Credit: Wilkes University, 2021)
- 20. Collaborating before preceptorship Meet with student (Loughran & Koharchik, 2019) (Image Credit: Mitchell, 2019)
- 21. Collaboration during preceptorship ● Assess learning needs ● Provide support ● Be approachable ● Relationship ● Client safety ● Ask for help when needed (Loughran & Koharchik, 2019) (Image Credit: Mitchell, 2021)
- 22. Supportive Collaborative Teaching Strategies
- 23. Collaborative teaching strategies (Lazarus, 2016; Loughran & Koharchik, 2019)
- 24. Collaborative educational approach: Five-minute preceptor technique (Pascoe et al, 2015, as cited in Lazarus, 2016) (Image Credit: Morgan & Jones, n.d.)
- 25. Collaborative educational approaches: SNAPPS (Lazarus, 2016) (Image Credit: O’Neal, n.d.)
- 26. Collaborative educational approach: Other approaches ● Manipulated-structure approach ● Sink of swim technique (Loughran & Koharchik, 2019) (Image Credit: Moore, 2019)
- 27. Supportive Feedback & Evaluation
- 28. Collaborative feedback and evaluation ● Discuss progress and goals ● Formative and summative ● Private, professional, empathetic, non-judgemental, timely, truthful, performance-based ● Positive and constructive, “feedback sandwich” ● Approaches ○ Directive approach ○ Elaborative approach ● If preceptee is struggling ○ Inform preceptee ○ Seek support from nurse manager, CNE, faculty ● Hone feedback skills (Lazarus, 2016; Loughran & Koharchik, 2019)
- 29. Barriers & Alternatives to Preceptorship/Mentorship
- 30. Challenges Organizational ● Time and financial constraints on organizations ● Lack of organisational mentors/preceptors with desired skills ● Lack of clear guidance and rules governing mentoring and precepting Individual ● Interpersonal conflict or boundaries issues ● Lack of time of unit staff to support the 1:1 learning of preceptees (Baldwin et al., 2020; Dirks, 2021; Harvey & Uren, 2019; Stefaniak & Dmoch-Gajzlerska, 2020)
- 31. Alternatives Group Preceptorships E-Mentoring (Image Credit: Grand Canyon University, 2021). (Image Credit: Cronin, 2020).
- 32. Conclusion Mentorship and preceptorship programs contribute to learning and professional development. Preceptorship is time-limited and often includes an element of evaluation. It is commonly used for new graduate nurses transitioning into the workforce. Mentorship is a more longitudinal relationship where experienced staff seeks guidance from senior staff members to foster professional development. Both are examples of collaboration and share benefits, including fostering professional growth and independence, competence, and confidence of those involved- which ultimately contribute to safer patient care and advancement of the profession.
- 33. Great Resources (are a click away!) Student Orientation Checklist Mentoring/Precepting Goals Competencies for Mentors Competencies for Mentees Mentoring Best Practices
- 34. Learning Activities #1. Journal Entry- Reflect on your preceptorship. What was the most valuable thing that your preceptor did for you? What did they do that was most effective? Did they do anything that hindered learning or decreased the effectiveness of the situation? #2. Humor- Watch this short video by Nurse Blake (2021) on Types of Nurse Preceptors. Please choose ONE of the preceptor types portrayed in this video and offer constructive feedback on their approach to precepting/mentoring nursing students. #3. Art- Create and share a Venn diagram showing the similarities and differences between mentoring and precepting. #4. Photovoice- Share a visual representation of precepting/mentoring describing which elements of collaboration your selected image represents. #5. Theory to Practice- Adult Learning Theory is one theoretical framework that can be used in the practice of mentorship/preceptorship. Share another learning theory as it applies to these processes.
- 35. Resources American Association for Respiratory Care. (2022). Why take the time to be a clinical preceptor? [Figure]. https://www.aarc.org/careers/career-advice/professional-development/why- take-the-time-to-be-a-clinical-preceptor/ Association Forum. (2019). The mentoring mix: Optimizing your personal and organizational mentorship efforts [Image]. https://forummagazine.org/how-to-align-your-podcast-with-your- associations-body-of-knowledge/ Baldwin, S., Coyne, T., Hynes, C., & Kelly, P. (2020). Reflections on setting up a nursing preceptorship programme. British Journal of Nursing, 29(11), 627-631. https://doi.org/10.12968/bjon.2020.29.11.627 CAMRT. (2018). Effective preceptorship: A Guide to Best practice. [E-Book]. Retrieved from https://saskpreceptors.ca/documents/preceptor-manuals/PreceptorGuidelines.pdf Canadian Nurses Association. (2004). Achieving excellence in professional practice. A guide to preceptorship and mentoring. https://saskpreceptors.ca/documents/CNA%20Preceptor%20guide.pdf Centre for Health Leadership & Practice. (November 2003). Mentoring Guide: A guide for mentors. https://www.rackham.umich.edu/downloads/more-mentoring-guide-for-mentors.pdf Chong, J. Y., Ching, A. H., Renganathan, Y., Lim, W. Q., Toh, Y. P., Mason, S., & Krishna, L. K. R. (2020). Enhancing mentoring experiences through e-mentoring: A systematic scoping review of e-mentoring programs between 2000 and 2017. Advances in Health Sciences Education, 25(1), 195–226. https://doi.org/10.1007/s10459-019-09883-8
- 36. References Cronin, N. (2020). [Untitled image of people on a video call]. Guider. https://uploads- ssl.webflow.com/5ffc84beb8e04879b07ba551/60255bb3549c4da454fcdea2_people-on-a-video-call-4226261.jpeg De Vasconcelos, G. (2015). My Best Advice For Entrepreneurs: Find A Mentor. This Is Why And How. [Image]. Retrieved from https://www.forbes.com/sites/goncalodevasconcelos/2017/11/02/my-best-advice-for-entrepreneurs-find-a-mentor-this-is-why-and-how/?sh=545b81dd1d46 Dirks, J. L. (2021). Alternative approaches to mentoring. American Association of Critical-Care Nurses, 41(1), 9-16. https://doi.org/10.4037.ccn2021789 Fordham, W. (2021). Does nurse preceptor role frequency make a difference in preceptor job satisfaction? Journal for Nurses in Professional Development, 37(4), 192-199. Retrieved from file:///C:/Users/Q/Downloads/Does_Nurse_Preceptor_Role_Frequency_Make_a.2.pdf Grand Canyon University. (2021). Tips on how to be successful in nursing school. [Photograph]. https://www.gcu.edu/blog/nursing-health-care/tips-how-be- successful-nursing-school Harvey, S. & Uren, C. D. (2019). Collaborative learning: Application of the mentorship model for adult nursing students in the acute placement setting. Nurse Education Today, 74(1), 38-40. https://doi.org/10.1016/j.nedt.2018.11.022 Kardonsky, K., Oliver, L., Shimkin, G., Lew, A., & Fitch, J. (2018). The mentoring relationship: A guide for mentors and mentees. University of Washington Department of Family Medicine. https://depts.washington.edu/fammed/wp-content/uploads/2016/05/UP-Mentoring-Guide-FINAL.pdf
- 37. References Lazarus, J. (2016). Precepting 101: Teaching strategies and tips for success for preceptors. Journal of Midwifery & Women’s Health, 61(1), 11–21. https://doi.org/10.1111/jmwh.12520 Leigh, K., Whitted, K., & Hamilton, B. (2015). Integration of andragogy into preceptorship. Journal of Adult Education, 44(1), 9-17. Retrieved from https://eric.ed.gov/?id=EJ1072924 Loughran, M. C. & Koharchik, L. (2019). Ensuring a successful preceptorship: Tips for nursing preceptors. The American Journal of Nursing, 119(5), 61-65. https://doi.org/10.1097/01.NAJ.0000557917.73516.00 Luhanga, F., Yonge, O., & Myrick, F. (2008). Strategies for precepting the unsafe student. Journal for Nurses in Professional Development, 24(5), 214–219. https://doi.org/10.1097/01.NND.0000320693.08888.30 Matua, G. A., Seshan, V., Savithri, R., & Fronda, D. C. (2014). Challenges and strategies for building and maintaining effective preceptor-preceptee relationships among nurses. Sultan Qaboos University Medical Journal, 14(4), e530. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4205066/ Miller, C., Wagenberg, C. & Loney, E. (2020). Creating and implementing a nurse mentoring program. The Journal of Nursing Administration, 50(6), 343-348. https://doi.org/10.1097/NNA.0000000000000895 Mitchell, G. (2019, August 8). Snack during night shift better than big meal, study finds [Figure]. Nursing Times. https://www.nursingtimes.net/news/research-and- innovation/snack-during-night-shift-better-than-big-meal-study-finds-08-08-2019/
- 38. References Mitchell, G. (2021, December 14). Preceptorship survey: Is support for newly registered nurses good enough? [Figure]. Nursing Times. https://www.nursingtimes.net/news/education/preceptorship-survey-is-support-for-newly-registered-nurses-good-enough-14-12-2021/ Moore, A. (2019, December 2). Sink or swim [Figure]. Association for Talent Development. https://www.td.org/magazines/td-magazine/sink-or-swim Morgan, H & Jones, E. (n.d.). The one minute preceptor [Figure]. SlidePlayer. https://slideplayer.com/slide/13226108/ Nurse Blake. (2021, October 21). Types of nurse preceptors. YouTube. https://www.youtube.com/watch?v=Xe9tT8xNYRY Nurse Key. (2020). Mentorship, Preceptorship, and Nurse Residency Programs. [Image]. Retrieved from https://nursekey.com/mentorship-preceptorship-and-nurse-residency-programs/ Nursing CE. (2021). Teamwork and Collaboration Nursing CE Course. [Image]. Retrieved from https://www.nursingce.com/ceu-courses/teamwork O’Neal, H. J. (n.d.). SNAPPS - Expressing clinical reasoning and uncertainties during case presentations [Figure]. SlidePlayer. https://slideplayer.com/slide/6668018/ Phuma-Nggaiyaye, E., Bvumbwe, T., & Chipeta, M. C. (2017). Using preceptors to improve nursing students’ clinical learning outcomes: A Malawian students’ perspective. International Journal of Nursing Sciences, 4(1), 164-168. http://dx.doi.org/10.1016/j.ijnss.2017.03.001 Saskatchewan Polytechnic. (n.d.). Mentorship Competencies. Retrieved February 10, 2022 from https://saskpolytech.ca/about/school-of-nursing/mentorship/mentorship- competencies.aspx#2
- 39. References Start School Now. (2016). The Basics of Adult Learning Theory. [Image]. Retrieved from https://www.startschoolnow.org/the-basics-of-adult-learning-theory/ Stefaniak, M. & Dmoch-Gajzlerska, E. (2020). Mentoring in the clinical training of midwifery students - a focus study of the experiences and opinions of midwifery student at the Medical University of Warsaw participating in a mentoring program. BMC Medical Education, 20(1), 1-9. https://doi.org/10.1186/s12909-020-02324-w Swezey, N. (2019). 7 Ways to be an Amazing Preceptor to a New Grad Nurse. [Image]. Retrieved from https://dailynurse.com/7-ways-to-be-an-amazing-preceptor- to-a-new-grad-nurse/ Wilkes University. (2021, June 17). Preceptors Needed: 10 benefits of being a preceptor [Figure]. https://onlinenursingdegrees.wilkes.edu/blog/preceptors-needed- 10-benefits-being-preceptor
Editor's Notes
- The theoretical framework chosen to support the aspect of mentorship/preceptorship is the Adult Learning Theory. Understanding the adult learner and the learning process will assist the preceptor in determining how to best motivate and sustain learning in the learning community. Andragogy, an adult learning theory by Malcolm Knowles, is based on five assumptions: self-concept, adult learner experience, readiness to learn, orientation to learning, and motivation to learn (Leigh et al., 2015). Faculty in RN-BSN programs share the common goal of developing knowledgeable and skilled graduates who are pleased with their education while ensuring that course outcomes are met or exceeded (Leigh et al., 2015). Research has shown that adult learners benefit from being active participants in their learning process. Therefore, preceptors/mentors should offer adult learners the chance to become actively involved in their educational experiences and encourage self-directed learning (Leigh et al., 2015). Mentees are typically engaged in their learning process and must be empowered to seek out mentors to reach their learning objectives (Leigh et al., 2015).
- (Lazarus, 2016).
- A mentor is an advisor for personal and professional development with the intellectual ability, integrity, and nurturing energy of another (Kardonsky et al., 2018). The role of the mentor is to suggest development opportunities, share clinical expertise, provide feedback, foster socialization, navigate workplace policies, exchange resources, create a safe environment, encourage reflection, and model professionalism (Dirks, 2021). Becoming a mentor is a guided opportunity for leadership self-efficacy and potential development into management roles (Dirks, 2021). Mentorship programs improve patient outcomes, support quality care through clinical expertise cultural safety, and increase engagement in succession planning (Dirks, 2021). A mentoring culture identifies competent professionals, develops leaders, and retains inspiring talented professionals benefiting the organization (Miller, Wagenberg, & Loney, 2020).
- Preceptorship/mentorship programs function as gatekeepers to recognizing and managing unsafe student practices ensuring patient safety (Luhanga, Yonge, & Myrick, 2008). The demands on the nursing educators and clinical staff are substantial when increased workloads and inadequate resources for student learning expectations (Phuma-Nggaiyaye, Bvumbwe, & Chipeta, 2017). Academic and healthcare facilities are expected to collaborate to facilitate the students learning needs (Phuma-Nggaiyaye, Bvumbwe, & Chipeta, 2017). Organizational support reduces barriers such as time constraints and scheduling conflicts by rigorously selecting and training preceptors and mentors (Dirks, 2021).
- Support from the education institution includes communicating with stakeholders regarding program objectives, teaching and learning tools, student performance progress, clinical requirements, and providing preceptors with specific resources as necessary (Lazarus, 2016; Loughran & Koharchik, 2019). Additionally, if available, give incentives to preceptors/mentors such as library access, adjunct faculty status, reduced fees for continuing education, verification of hours toward recertification, and access to services and events on campus (Lazarus, 2016). Educational faculty are responsible for preparing preceptees/mentees for their learning experience when they enter clinical practice (Matua et al., 2014). In addition, faculty conduct site visits to discuss concerns and be available to support students as needed (Lazarus, 2016; Loughran & Koharchik, 2019). Faculty are also responsible for awarding the preceptee with final grades or achievements upon completing their clinical experience (Saskatchewan Polytechnic, n.d.). The educational institution develops, facilitates, and maintains didactic education that fosters a positive learning experience (Saskatchewan Polytechnic, n.d.). Academic and healthcare facilities must collaborate to facilitate meeting students' learning needs and objectives by establishing communication guidelines (Phuma-Nggaiyaye, et al., 2017). Responsibilities include providing a clear explanation of the preceptorship/mentorship roles, obligations, and objectives, such as length of the learning experience and the types of clinical experiences required for the student (Lazarus, 2016). Communication guidelines must detail how student evaluations are to be conducted (Lazarus, 2016). Faculty can prepare for unfamiliar or complex situations that enable learners to develop professional competencies (Matua et al., 2014). Prior to clinical placements, faculty should advise students on the potential consequences of failed preceptorship programs or inappropriate student behaviors and be available to provide strategies for improvements, as needed, throughout preceptorships if a student is struggling (Lazarus, 2016). Providing feedback and conducting evaluations is an essential role and responsibility of the educational institution to determine performance outcomes aligned with objectives from student perspectives and involved stakeholders (Lazarus, 2016; Matua et al., 2014). Feedback and evaluations should include recommendations, focusing on what was done, potential consequences, and possible improvements (Lazarus, 2016).
- The roles and responsibilities of the healthcare organization are to use mentorship/preceptorship programs as a tool. An organizational tool to retain student nurses and serve as a potential solution when the demands on the nursing educators and clinical staff are significant and when increased workloads and inadequate resources for student learning (Dirks, 2021; Phuma-Nggaiyaye, et al., 2017). Organizations are responsible for sustaining the workforce, inspiring growth, enhancing leadership, expanding networks for organizational developments, promoting employee engagement; many of these goals are attainable with effective preceptorship/mentorship programs (Miller, et al., 2020). In addition, implementing collaborative programs supports improved patient outcomes, supports quality care through clinical expertise, and increases engagement in succession planning (Dirks, 2021). In designing and planning preceptorship/mentorship programs, responsibilities include defining the objectives, identifying resources, recruiting and training mentors, and ensuring collaboration with stakeholders (Dirks, 2021). Organizational workforce structures can approach staff to determine their interest and eligibility in becoming a preceptor/mentor (Loughran & Koharchik, 2019). Organizations provide the necessary training for nurses to ensure preparation for the role, focusing on building and maintaining effective teaching and learning in collaborative relationships, reducing the acclimatization period, and limiting potential patient errors (Loughran & Koharchik, 2019; Matua et al., 2014). Strategies include connecting like-minded individuals who are a good fit as mentors/preceptors, preferably having aligned communication styles, professional skills, and expectations of the clinical learning experience with their mentee/preceptee (Dirks, 2021; Miller, et al., 2020). Healthcare organizations should implement resources to determine preferred teaching and learning strategies and foster a safe learning environment about cultural safety, clinical judgment, and prioritization (Lazarus, 2016; Loughran & Koharchik, 2019). Healthcare organizations are responsible for developing a mentorship/preceptorship orientation checklist that includes orienting the student to the organizational policies that will impact them, standards or guidelines governing student behavior, dress code, documentation, and access to medical records (Lazarus, 2016). Academic and healthcare facilities are expected to collaborate to facilitate successful programs collaboration (Phuma-Nggaiyaye, et al., 2017). Organizations that provide ongoing support demonstrate that they value their preceptorship/mentorship programs and their impact on professional development (Loughran & Koharchik, 2019). This impact includes the production of independent, confident, competent nurses that can provide high-quality client care in a complex healthcare setting and retention of inspiring, talented professionals (Loughran & Koharchik, 2019). Ongoing support includes encouraging others to become mentors is a strategic opportunity for leadership, self-efficacy, and potential development into management roles (Dirks, 2021).
- There are various roles and responsibilities of the preceptee/mentee in collaboration with clinical learning programs. The preceptee/mentee is to take ownership to proactively integrate personal learning objectives, prepare, and understand the preceptorship/mentorship program (Lazarus, 2016). In addition, sharing clinical learning needs to help the mentor/preceptor understand where to focus teaching and learning and discuss strategies to measure progress tailoring to the individual learning goals (Baldwin et al., 2020). Preceptees/mentees are to establish communication guidelines and communication methods with the preceptor/mentor that supports open communication and commitment (Kardonsky, et al., 2018). Communication is essential in facilitating effective positive learning relationship that allows the preceptee/mentee to be open about their feelings and experiences (Matua et al., 2014). In addition, Preceptees/mentees have professional responsibilities such as attire and maintaining professional behaviors, including attendance, being prepared, and being on time for clinical shifts (Lazarus, 2016). Preceptees/mentees are to develop critical thinking, decision-making, and clinical skills through demonstrating progression and self-directed learning in clinical knowledge and skills (Harvey & Uren, 2019). Remember to celebrate successful learning opportunities and reach goals and objectives that improve confidence, reduce fears, and enhance collaboration (Lazarus, 2016). Preceptee/mentee are to take the time to reflect often and reevaluate learning to make revisions based on lessons learned, setbacks, overcoming barriers that ensure success (Dirks, 2021). Preceptees/mentees must participate in feedback and evaluations to improve clinical learning experiences and ensure outcomes align with stakeholders (Dirks, 2021; Loughran & Koharchik, 2019).
- Preferably, a preceptor is a knowledgeable and skilled senior practitioner (Baldwin et al., 2020). The preceptor role is most commonly associated with supporting nursing students near the end of their nursing program and newly licensed registered nurses employed in their first RN position (Fordham, 2021). It is perceived as an essential component of the successful transition to professional practice from a nursing student to a competent and confident novice nurse (Fordham, 2021). The preceptor functions as an educator, role model, evaluator, and protector for newly hired nurses to help them acclimatize to the healthcare organization’s environment and align their nursing practice with the organization’s mission, values, and goals (Fordham, 2021). Becoming a preceptor may require particular qualifications such as clinical competence, well-developed interpersonal skills, interest in teaching, empathy towards learners, strong problem-solving skills, a baccalaureate or more advanced degree, a passion for nursing, acute clinical judgment, cultural competence, or the ability to provide constructive feedback (Loughran & Koharchik, 2019). There are many reasons for choosing to become a preceptor, including personal satisfaction, a sense of accomplishment, personal duty, a commitment to the profession, a love for teaching, sharing and demonstrating knowledge, giving back to the profession and nursing community, and learning updated evidence-based clinical information from the student (Kardonsky et al., 2018; Lazarus, 2016; Loughran & Koharchik, 2019).
- The thought of being a preceptor can be stressful and intimidating to those new to the role; it is well documented in the literature that preceptors require and desire training and ongoing support throughout the preceptorship process (Lazarus, 2016). Training should be provided to ensure preparation for the role, especially with building and maintaining an effective collaborative relationship with preceptees (Matua et al., 2014). Preceptors can utilize resources and supports put in place by the organization and the educational institution to help them prepare for the preceptorship experience (Loughran & Koharchik, 2019). They can also reflect on their own experiences to emulate strategies that worked well (Loughran & Koharchik, 2019). Preceptors can use assessment tools offered by the organization, the educational institution, or available online to determine their preferred teaching and learning methods (Loughran & Koharchik, 2019). Similar to a student's journey, the new preceptor's journey will likely include the uncertainty associated with being a novice in a new arena (Lazarus, 2016). Preceptors learn and gain skills while growing into the clinical preceptor role (Lazarus, 2016).
- If possible, the preceptor should meet the preceptee before starting the preceptorship (Loughran & Koharchik, 2019). This provides both parties with an opportunity to meet and get to know each other better (Loughran & Koharchik, 2019). The preceptor can learn more about the preceptee’s experiences, self-identified strengths and weaknesses, preferred learning styles, learning interests, goals, and how the preceptor can best support the preceptee (Loughran & Koharchik, 2019). The preceptor can also share their work experiences and professional achievements. Together the preceptor and preceptee should establish goals, responsibilities, and clear expectations of the preceptorship relationship (Loughran & Koharchik, 2019). It is also an opportunity to welcome the preceptee to the unit and provide information about the unit routines, client population, and dress code to help ensure a smooth transition (Loughran & Koharchik, 2019).
- Near the beginning and periodically throughout the preceptorship, the preceptor can assess the preceptee’s knowledge, skills, performance, and experience to evaluate learning needs (Loughran & Koharchik, 2019). The preceptor can also provide support, answer questions, clarify policies and procedures, and facilitate the preceptee becoming more autonomous in their nursing practice throughout the preceptorship (Loughran & Koharchik, 2019). The preceptor can use various strategies to be approachable, develop trust, and create a positive, comfortable learning environment to facilitate critical thinking and increase the preceptee’s competencies (Loughran & Koharchik, 2019). The preceptor may need to find a balance between a professional and personal relationship with the preceptee (Loughran & Koharchik, 2019). The preceptor must monitor the preceptee to ensure client safety (Loughran & Koharchik, 2019). Individual differences exist in how long it takes for individuals to learn (Loughran & Koharchik, 2019). The preceptor needs to be patient and use different teaching strategies if the preceptee struggles to understand a concept (Loughran & Koharchik, 2019). Furthermore, preceptees need to demonstrate competence in skills before being considered learned (Loughran & Koharchik, 2019). Preceptors can support the learning of the preceptee by role modelling knowledge, skills, professionalism, respect, and effective communication when interacting with members of the interprofessional care team and with clients (Loughran & Koharchik, 2019). Preceptors can acquire other sources of workplace support provided by the nurse manager, the PCC, the CNE, and nurse colleagues for assistance throughout the preceptorship (Loughran & Koharchik, 2019).
- The preceptor can collaborate with the preceptee to determine the teaching strategies that best meet their learning needs. Preceptors can also use various learning strategies to enhance retention (Loughran & Koharchik, 2019). Modelling is a great strategy to demonstrate clinical skills and reasoning (Lazarus, 2016; Loughran & Koharchik, 2019). Case presentations can be used to reflect the preceptee’s ability to obtain complete histories, identify and report pertinent physical findings, generate relevant differential diagnoses, and develop appropriate management and follow-up plans (Lazarus, 2016). Case presentations are also helpful in identifying gaps in student learning (Lazarus, 2016). Direct questioning such as asking the preceptee “What do you think?” can nurture the development of critical thinking skills and allows the preceptor to assess the preceptee’s knowledge and ability to problem solve (Loughran & Koharchik, 2019). When using direct questioning, it is best to avoid “grilling” the preceptee and putting them on the spot in front of clients or other staff, which can be stressful for the preceptee and make it more challenging for them to concentrate (Loughran & Koharchik, 2019). During think-aloud sessions, the preceptee answers questions posed by the preceptor and the rationale for responses (Loughran & Koharchik, 2019). These sessions can help develop critical thinking and clinical reasoning skills. They can also be helpful to understand how the student is processing information and making decisions (Lazarus, 2016; Loughran & Koharchik, 2019). Providing the preceptee with readings can help develop conceptual frameworks for the preceptee that can be applied in practice (Loughran & Koharchik, 2019). The preceptor can then request the preceptee provide a brief synopsis of the reading the next day (Loughran & Koharchik, 2019). Coaching is the preceptor providing verbal support while the preceptee performs procedures in practice (Loughran & Koharchik, 2019). It can help the preceptee build and master clinical skills (Lazarus, 2016; Loughran & Koharchik, 2019).
- Educational approaches can help structure and guide interactions between the preceptor and the preceptee to enhance learning. The Five-Minute Preceptor Technique is a teacher-led approach in which the student is an active participant and does the bulk of the work in the interaction (Pascoe et al, 2015, as cited in Lazarus, 2016). The focus is on formulating the differential diagnosis and management planning. It is intended to help preceptors increase the frequency and quality of teaching in complex clinical settings. The preceptee presents the background of the case, including any relevant information. The preceptee may want the preceptor to provide the assessment and plan. The preceptor must avoid adding their thoughts at this point. The preceptor then asks the preceptee for a commitment. The preceptor may ask the preceptee to expand the differential diagnosis to include other etiologies of the presenting clinical problem. The key is to get the preceptee to commit to their thought process and differential diagnosis, even if incorrect. Again, avoid answering for the student. The next step is to probe for supporting evidence. The goal is to encourage students to display their knowledge base and thought processes. The next step is to provide management guidelines. This is where general management guidelines about the clinical situation are taught by the preceptor. Teach a maximum of three points in this stage. The fourth step is to reinforce what was done correctly. Comment on the strengths of students' thought processes. Reinforce what the student did well, which can be applied in similar situations. Finally, the preceptor corrects mistakes. The preceptor may start by asking the student to assess their performance. Constructive feedback should be based on student behaviour and provide specifics for improvement.
- The next approach is SNAPPS, which stands for Summarize, Narrow the Differential, Analyze, Probe, Plan, and Select (Lazarus, 2016). SNAPPS is a 6-step, learner-centered model to facilitate discussions between the preceptor and the preceptee. The focus of this technique is on case presentation and diagnosis. As opposed to the Five-Minute Preceptor, both the preceptor and the preceptee need to learn this technique. The preceptee is responsible for leading the teaching encounter; therefore, this technique might be best for advanced and/or highly motivated preceptees. The first step is to Summarize, during which the preceptee begins with a summary of the clinical case. The second step is to Narrow the differential, which encourages the preceptee to fully consider a range of differential diagnoses and then narrow it to three possible diagnoses. The next step is to Analyze the differential. The preceptee should identify critical factors related to the clinical issue in the diagnostic process. The fourth step is to Probe the preceptor. This is the place to point out missing concepts and for the preceptee to ask questions of the preceptor to gain information that may be difficult to look up. The preceptor can guide the learner to the correct answer by helping to identify and apply past acquired knowledge. The next step is plan management, which allows the preceptee to present their plan before adding anything. Finally, the preceptee selects a case-related issue for self-directed learning. The preceptor and preceptee can spend five to 10 minutes discussing the learner's findings at the subsequent clinical encounter.
- Other educational approaches include the manipulated-structure method and the sink or swim technique. The manipulated-structure approach matches the preceptee with a patient assignment based on their skills and previous experience (Loughran & Koharchik, 2019). During the sink or swim technique, the preceptor provides little or no support (Loughran & Koharchik, 2019). This approach is more appropriate later in the preceptorship when the preceptee has developed their knowledge, skills, and confidence and encourages independence (Loughran & Koharchik, 2019). Of course, the preceptor remains available to the preceptee if needed in both strategies (Loughran & Koharchik, 2019).
- Providing feedback and evaluation is an opportunity to discuss the preceptee’s progress and goals throughout the preceptorship (Loughran & Koharchik, 2019). Feedback can be both formative and summative (Loughran & Koharchik, 2019). Preceptors may want to consider how they can provide feedback privately, professionally, empathetically, and non-judgmentally (Loughran & Koharchik, 2019). It is also important to provide feedback in a timely manner such as at the end of every clinical shift (Loughran & Koharchik, 2019). Feedback should be truthful and based on performance rather than personality (Loughran & Koharchik, 2019). It is important to create a safe environment for making mistakes since mistakes are a key element in the clinical learning process (Lazarus, 2016). There is no place for shaming or humiliation in communication with a preceptee (Lazarus, 2016). Utilizing a positive, flexible approach that includes humor and respectful communication can help a preceptor create an optimal environment for learning (Lazarus, 2016). Preceptors can provide both positive as well as constructive feedback (Loughran & Koharchik, 2019). A “feedback sandwich” can be used to provide positive feedback followed by constructive feedback that is then followed by more positive feedback (Loughran & Koharchik, 2019). Two approaches to feedback can be used. In the directive approach, the preceptor voices observations on the preceptee’s performance but does not permit the preceptee’s involvement in the process (Loughran & Koharchik, 2019). The elaborative feedback, on the other hand, encourages the preceptee to self-reflect and self-assess their performance (Loughran & Koharchik, 2019). This approach can be more effective and builds trust (Loughran & Koharchik, 2019). Identify and try to resolve concerns early so preceptees have an opportunity to improve and include the preceptee in brainstorming strategies for improvement (Loughran & Koharchik, 2019). The preceptee should be informed if there are any concerns throughout the preceptorship so they are not surprised by a poor evaluation at the end the preceptorship (Loughran & Koharchik, 2019). Inform and request support from the nurse manager, the CNE, and/or faculty ASAP if the preceptee is struggling (Loughran & Koharchik, 2019). For example, the preceptor may find that the preceptee is coming to the unit unprepared, unable to prioritise care, or demonstrates knowledge gaps, inadequate skills, communication issues, problems integrating theory with practice, or personal concerns (Loughran & Koharchik, 2019). Include a description of the concern, any interventions applied so far, and any changes when reporting a concern (Loughran & Koharchik, 2019). Preceptors can attend educational programs offered by the educational institution, the organization, or that they find themselves to hone their feedback skills (Loughran & Koharchik, 2019).
- The literature identified several barriers to setting up and supporting collaborative mentoring and precepting opportunities. Organizational Challenges may include time and financial constraints, lack of organizational mentors/preceptors with desired skills, and lack of clear guidance and rules governing mentoring and precepting (Dirks, 2021; Stefaniak & Dmoch-Gajzlerska, 2020). Individual challenges may include interpersonal conflict or boundaries issues and unit staff lacking time to support the 1:1 learning of preceptees (Baldwin et al., 2020; Dirks, 2021; Harvey & Uren, 2019).
- Group precepting may be used when there are limited clinical placements available. In some cases, 1st, 2nd, and 3rd-year students are placed together and allocated clients to care for collaboratively, under the supervision of a single preceptor. This preceptorship model has been shown to encourage peer learning and positively influences the development of critical thinking skills, decision making, leadership, and clinical skills (Harvey & Uren, 2019). E-mentoring is proposed as a means of supplementing this dominant form of mentoring in healthcare by providing accessible, timely, and longitudinal support for mentees unencumbered by time and geographical restrictions (Chong, et al., 2020). In addition, E-mentoring reduces costs provides additional and timely support and the opportunity for privacy and honest discussions on sensitive issues (Chong, et al., 2020).
- We would like to take this opportunity to share with you a few great resources that our group came across while curating literature for this presentation: The Student Orientation Checklist was found in Lazarus (2016) Precepting 101: Teaching Strategies and Tips for Success for Preceptors, an article which discusses precepting and mentoring approaches and feedback strategies. Mentoring/Precepting Goals and Mentoring Best Practices were found in Mentoring Guide, by Centre for Health Leadership & Practice, published in 2003. This resource details the stages in building and developing mentoring relationships and contains an annotated bibliography with numerous more resources related to mentoring. Competencies for Mentors and Competencies for Mentees are from Saskatchewan Polytechnic’s School of Nursing Website. You are encouraged to explore this website and find out more about the history of mentoring in the nursing profession, mentorship styles and models. Mentor and mentee competencies can also be helpful to enhance recognition for the importance of the mentoring role in nursing, promote professional development for individual nurses by enhancing leadership, clarify the skill set each mentor has to offer when participating in a mentoring relationship and enhance role satisfaction for all involved, enhance quality of work environments and quality of care, help maintain standards within a formal mentorship program (Saskatchewan Polytechnic, n.d.) Engaging in mentorship can be used as a method of fulfilling Continuing Education (CE) and Professional Development (PD) commitments, competencies of the nursing profession (Canadian Nurses Association, 2004; Saskatchewan Polytechnic, n.d.). The Canadian Nurses Association (CNA) published its Achieving Excellence in Professional Practice: A Guide to Preceptorship and Mentoring in October 2004. In this document the CNA provides details about preceptorship, mentoring, coaching, and other collaborative working and learning relationships in nursing. This resource is a must read for all things mentoring and precepting in healthcare (Canadian Nurses Association, 2004).