Managing Up: Navigating Preceptorships Skillfully
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This is a preview of UCSF OCPD's Managing Up for Nurses workshop to help Nurse Practitioner navigate preceptorships skillfully. Designed in collaboration with the Office of Career & Professional Development and the School of Nursing.
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Managing Up: Navigating Preceptorships Skillfully
- 1. Managing Up Strategically Navigating your Preceptorships (Preview Slide Deck) Naledi Saul, Director. Office of Career & Professional Development. naledi.saul@ucsf.edu. career.ucsf.edu
- 2. 1. Describe a typical development over a 10 week period 2. Take change of your career: assess your readiness, develop learning goals, and prep to talk to your preceptor 3. Describe common obstacles in preceptorships and strategies to address them skillfully • Supervising Issues: what can (and can’t) you expect from your preceptor? • Syncing Issues: What to do when your preceptor’s teaching, communication or conflict management style is different than yours • Managing power differentials at work as a trainee, and how to respond when you see/experience inappropriate or bullying behaviors at work. By the end of this interactive workshop, you’ll be able to….
- 3. 3 Pre-week Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7 Week 8 Week 9 Week 10 • First exchanges with your preceptor • Possible some expectations articulated during this time Orientation Week: • Thank your preceptor for the opportunity • Talk about your responsibilities, their expectation and how you will be evaluated. • You should know expectations by the end of this week • This week you’re taking on some clinical responsibilities. • You’re getting “in the moment” feedback from your preceptor • This week you’re taking on even more clinical responsibilities. • Aim for some type of overall performance check-in during this time • This week is about “in the moment feedback” from your preceptor • & perhaps a midpoint evaluation convo. • Aim for some type of overall performance check-in during this time. • The focus on conversations are progress: “i.e.: We talked about improvement in this and that area; is your assessment that I am making progress in these areas?” • This week, It’s all gelling! Close Out Week: • Thank your preceptor for their time and effort. • Preceptor completes evaluation. Use as jump off for next clinical. • Ask about what you should focus working on. • Assess yourself: how do you think you did? Observation Independence Expected milestones over a ‘typical-ish’ ten week schedule Taking a patient history Conducting a patient physical Developing a plan Identifying differential diagnoses Working independently with complicated cases & clients Correct & concise reporting UCSF Office of Career & Professional Development. Do not reprint without permission. naledi.saul@ucsf.edu ‘Independence’ includes
- 4. • A learning goal is much more than simply saying that you want to learn about and/or improve on something; rather, it more specifically describes what you want to achieve. Source: UAB Department of Ob/Gyn, Residency Program Formal Mentoring Program. https://www.uab.edu/medicine/obgynresidency/images/PDFs/Handbooks/Writing_SMART_Goals.pdf Assess your clinical readiness Determine learning goals Decide the optimal way to complete conversing about the items on your tell/know list You’re prepped! Take Charge of Your Career: Getting Ready for your Preceptorship UCSF Office of Career & Professional Development. Do not reprint without permission. naledi.saul@ucsf.edu
- 5. Assess Yourself: Disagree Agree I know the 5 most common chronic conditions I will see 1 2 3 4 5 6 7 8 9 10 I can manage the most common chronic conditions I will see 1 2 3 4 5 6 7 8 9 10 I am able to assess the parameters of a new complaint 1 2 3 4 5 6 7 8 9 10 I am able to take a patient history 1 2 3 4 5 6 7 8 9 10 I am able to complete a physical exam 1 2 3 4 5 6 7 8 9 10 I am able to report my findings 1 2 3 4 5 6 7 8 9 10 I am concerned about my ability to move towards independence: formulating a plan, diagnostics and follow-up 1 2 3 4 5 6 7 8 9 10 I understand the characteristics of the population served by the site 1 2 3 4 5 6 7 8 9 10 I feel able to provide culturally responsive care 1 2 3 4 5 6 7 8 9 10 I feel competent utilizing electronic health documents to document visits 1 2 3 4 5 6 7 8 9 10 I think I will be able to quickly learn the technology and how to order the diagnostics I will use 1 2 3 4 5 6 7 8 9 10 (If you speak a language other than English) I have the medical vocabulary and fluency to use my language in a clinical capacity 1 2 3 4 5 6 7 8 9 10 I understand the structure of a typical day 1 2 3 4 5 6 7 8 9 10 I believe I will do well at this site 1 2 3 4 5 6 7 8 9 10 Think, Pair, Share! Assess Your Clinical Readiness For your Next Preceptorship UCSF Office of Career & Professional Development. Do not reprint without permission. naledi.saul@ucsf.edu
- 6. • A learning goal is much more than simply saying that you want to learn about and/or improve on something; rather, it more specifically describes what you want to achieve. Source: UAB Department of Ob/Gyn, Residency Program Formal Mentoring Program. https://www.uab.edu/medicine/obgynresidency/images/PDFs/Handbooks/Writing_SMART_Goals.pdf Assess your clinical readiness Determine learning goals Decide the optimal way to complete conversing about the items on your tell/know list You’re prepped! Take Charge of Your Career: Getting Ready for your Preceptorship UCSF Office of Career & Professional Development. Do not reprint without permission. naledi.saul@ucsf.edu
- 7. Learning Goals are SMART Your Turn: Deciding on Your Learning Goals Source: UAB Department of Ob/Gyn, Residency Program Formal Mentoring Program. https://www.uab.edu/medicine/obgynresidency/images/PDFs/Handbooks/Writing_SMART_Goals.pdf Specific A specific goal is detailed, focused and clearly stated. Provide anticipatory guidance to a pregnant women in all three trimesters Measurable A measurable goal is quantifiable, meaning you can see the results. Include precise amounts, dates, and so on in your goals so you can measure your degree of success. See 3 patients in one session by week ten Attainable An attainable goal can be achieved based on your skill, resources and area of practice. Formulate/review plan for acute or chronic diseases with minimal help from preceptor Relevant A relevant goal applies to your current role and is clearly linked to your key role responsibilities. Perform physical assessments by the end of my first quarter Time Limited A time-limited goal has specific timelines and a deadline. This will help motivate you toward your goal and to evaluate your progress Formulate at least one differential and one working diagnosis appropriate for the patients that I see by the end of the quarter UCSF Office of Career & Professional Development. Do not reprint without permission. naledi.saul@ucsf.edu
- 8. To be able to: • Perform physical assessments by the end of my first quarter • Provide anticipatory guidance to a pregnant women in all three trimesters • Perform and document a complete physical history by the end of February • Formulate at least one differential and one working diagnosis appropriate for the patients that I see by the end of the quarter • Obtain a complete history in 30 minutes • Formulate/review plan for acute or chronic diseases with minimal help from preceptor • Perform focused assessment pertaining to the symptoms the patient is presenting • Discuss disease management and educate patient and family members • Perform a sports physical • See 3 patients in one session by week ten Source: allnurses.com NP Forum. Written bt nitasarn, Jan 2013; Elizabeth Shabrell Start with an action verb: • Complete • Create • Demonstrate • Design • Develop • Describe • Discuss • Evaluate • Explain • Identify • Obtain • Perform • Plan • Provide • See Your Turn: Decide on Your Learning Goals UCSF Office of Career & Professional Development. Do not reprint without permission. naledi.saul@ucsf.edu
- 9. UCSF Office of Career & Professional Development. Do not reprint without permission. Naledi,saul@ucsf.edu Scenarios: How to Leap Over Common Obstacles in Preceptorships
- 10. Great, expectations! It’s been a week, and your preceptor hasn’t laid out the expectations yet. Groundhog’s Day: It’s week 3, and you’re doing the same thing you were in week 1: Observing. That Syncing Feeling: Still in week 3, and you’ve have come to the conclusion that your learning style and your (instructor) preceptor’s teaching style are out of sync: Supervising, Syncing, & Bullying Behaviors Wish 1: Wish you’d said something earlier. It’s week 5, and your preceptor just told you aren’t succeeding in your rotation. What now? Wish 2: Aaaww…I really wish you hadn’t said that. Week 7, and some one on the clinical team says something you think might be clinically incorrect or professionally inappropriate (about a patient or you) to you, or around you. Scenarios: How to Leap Over Common Obstacles in Preceptorships UCSF Office of Career & Professional Development. Do not reprint without permission. naledi.saul@ucsf.edu
- 11. Supervising Syncing Bullying Assess your Situation: When something is wrong, ask: “Is it a supervising, syncing or bullying issue?” UCSF Office of Career & Professional Development. Do not reprint without permission. naledi.saul@ucsf.edu
- 12. Visual Visual/Observational Aural Reading/Writing Kinesthetic Let me watch you do it. Talk me through it first. Is there a manual? Great, I’ll get back to you. Step aside and let me try to figure it out. Comments welcome! HOW YOU LEARN 1. Your preceptor wants to teach you how to read an x-ray or interpret an EKG. 2. What is your least preferred style to learn this? 3. Think of a scenario where you experienced or witnessed a syncing issue. 4. How do you think an out- of- sync learning/teaching style could affect your learning experience? 5. How you do think this would affect your perception or each other? Set expectations/Take baseline assessment Delegate/teach/train effectively Give kudos and corrective feedback continuously Articulate & enforce consequences Recognize & reward progress and achievement Manage conflict Provide support 1 2 3 4 5 6 7 7 Supervisory Responsibilities vs. Are you in Sync? Differences in Action & Why it Matters UCSF Office of Career & Professional Development. Do not reprint without permission. naledi.saul@ucsf.edu YOUR PRECEPTOR’S TEACHING STYLE
- 13. Managing Up Strategically Navigating your Preceptorships (Preview Slide Deck) Naledi Saul, Director. Office of Career & Professional Development. naledi.saul@ucsf.edu. career.ucsf.edu
Editor's Notes
- Hi there. My name is naledi saul, and I’m the director of the office aof carer andprofessional development. This session exists because all of you have worked way too hard and come way too far to get anything get in the way of you becoming an NP. Now that you’re beginning to step into clinical preceptorships, we thought it would be helpful is to talk through and think through some of the less visible, but equally challenging factors and issues that have previously been barriers for students just like yourselves succeeding in their training setting. We’ve turned these issues into 5 scenarios, which are sourced from suggestions from faculty, what the OCPD staff have heard in 1:1 appointments (partiuclarly when students come for mock interviews and we ask “so tell me about a time you had a difficult situation at work and how you handled it” or “Wo tell me about a time you disagreed with a colleague”_ , and examples that we’ve read in the literature, or on NP forums. . In this highly intereactive session, I’ll describe the issue and situation ,we’ll identify some complicating factors that are stressors and make it difficult at first glance to determine how to react appropriately, and you’ll pair up to take the time to consider how you would like respond, and how you might help a fellow student respond, if faced with that situation.
- Are you on track?
- In pursuit of meaning use of learning goals in residency: A Qualitative study of pediatric residents. Lockspeiser, T, Et Al. Factors Associated with Successful Self-Directed Learning Using Individualized Learning Plans During Pediatric Residency Su-Ting T. Li, MD, MPH, , Daniel J. Tancredi, PhD, John Patrick T. Co, MD, MPH, Daniel C. West, MD 1) their ability to identify their strengths; 2) their ability to identify their areas for improvement; 3) their ability to write specific goals to improve their performance; 4) their ability to develop an effective plan to accomplish their learning goal;
- Where you don’t feel ready, can you explain why?
- In pursuit of meaning use of learning goals in residency: A Qualitative study of pediatric residents. Lockspeiser, T, Et Al. Factors Associated with Successful Self-Directed Learning Using Individualized Learning Plans During Pediatric Residency Su-Ting T. Li, MD, MPH, , Daniel J. Tancredi, PhD, John Patrick T. Co, MD, MPH, Daniel C. West, MD 1) their ability to identify their strengths; 2) their ability to identify their areas for improvement; 3) their ability to write specific goals to improve their performance; 4) their ability to develop an effective plan to accomplish their learning goal;
- Not: I want to improve my ability to take a patient history
- The five scenarios that we’ve identified are: So we’re going to talk about these situations. In talking through this situation, you’ll do some self assessment, developing learning goals, learning styles, work styles, the definitition of bullying, and pinpoint what I call a red flag moment – the moment when you should read out for support. You all wouldn’t have made it this far if you weren’t already skillsful and savvy. What you’ll hopefully get is some confirmation that you’re handling difficult situations like these well wich is one of the reasons, while I went back and forth on this, I langded on the side that I’d like the faculty to be part of the conversation. You’ll also get, some frameworks and different lens which to look ah how to view, and respond and when you’re faced with these scenarios, which quite frankly, for a numbe rof reasons, aren’t always so cut and dry. Finally, I’ll say that we re piloting this session, and are still figuring it out for your fellow students. And so any feedback, on length, topic, format, scenario, faculty involvement, whether or not you think this session oguht to exist at all or is not the best use of your valuable time, is greatly appreciated and will be seriously considered. ….okay? Let’s get started.
- The five scenarios that we’ve identified are: So we’re going to talk about these situations. In talking through this situation, you’ll do some self assessment, developing learning goals, learning styles, work styles, the definitition of bullying, and pinpoint what I call a red flag moment – the moment when you should read out for support. You all wouldn’t have made it this far if you weren’t already skillsful and savvy. What you’ll hopefully get is some confirmation that you’re handling difficult situations like these well wich is one of the reasons, while I went back and forth on this, I langded on the side that I’d like the faculty to be part of the conversation. You’ll also get, some frameworks and different lens which to look ah how to view, and respond and when you’re faced with these scenarios, which quite frankly, for a numbe rof reasons, aren’t always so cut and dry. Finally, I’ll say that we re piloting this session, and are still figuring it out for your fellow students. And so any feedback, on length, topic, format, scenario, faculty involvement, whether or not you think this session oguht to exist at all or is not the best use of your valuable time, is greatly appreciated and will be seriously considered. ….okay? Let’s get started.
- Learning styles just got debunked. But does scientific research really support the existence of different learning styles, or the hypothesis that people learn better when taught in a way that matches their own unique style? Unfortunately, the answer is no, according to a major new report published this month in Psychological Science in the Public Interest, a journal of the Association for Psychological Science. The report, authored by a team of eminent researchers in the psychology of learning—Hal Pashler (University of San Diego), Mark McDaniel (Washington University in St. Louis), Doug Rohrer (University of South Florida), and Robert Bjork (University of California, Los Angeles)—reviews the existing literature on learning styles and finds that although numerous studies have purported to show the existence of different kinds of learners (such as “auditory learners” and “visual learners”), those studies have not used the type of randomized research designs that would make their findings credible. But preferences live one. If you’re about to learn a new techniwuq, or a new computer software, or how to change a tire. You may be one of the people who has a strong pference.
- Hi there. My name is naledi saul, and I’m the director of the office aof carer andprofessional development. This session exists because all of you have worked way too hard and come way too far to get anything get in the way of you becoming an NP. Now that you’re beginning to step into clinical preceptorships, we thought it would be helpful is to talk through and think through some of the less visible, but equally challenging factors and issues that have previously been barriers for students just like yourselves succeeding in their training setting. We’ve turned these issues into 5 scenarios, which are sourced from suggestions from faculty, what the OCPD staff have heard in 1:1 appointments (partiuclarly when students come for mock interviews and we ask “so tell me about a time you had a difficult situation at work and how you handled it” or “Wo tell me about a time you disagreed with a colleague”_ , and examples that we’ve read in the literature, or on NP forums. . In this highly intereactive session, I’ll describe the issue and situation ,we’ll identify some complicating factors that are stressors and make it difficult at first glance to determine how to react appropriately, and you’ll pair up to take the time to consider how you would like respond, and how you might help a fellow student respond, if faced with that situation.