This document provides guidance and information for field preceptors working with EMS students. It outlines the roles and responsibilities of preceptors and students, including providing feedback, evaluating students, and documenting encounters and skills practice using the FISDAP program. Preceptors are instructed to orient students to each shift, supervise skills and allow increased responsibility over time, and provide feedback both verbally and through formal evaluations completed via FISDAP at the end of each shift. The goal is for students to develop clinical competency under the guidance of knowledgeable preceptor mentors.

1. FIELD PRECEPTOR ORIENTATION
2014

2. Purpose…
This Field Preceptor program endeavors to provide
you with the essential tools and information to
successfully fulfill your influential role of EMS
preceptor.

3. Welcome!
 Thank you for being a preceptor for the VCU
Paramedic Program
 The Objectives of this orientation is to familiarize
you with:
• The Preceptor & Student Roles
• Adult Learning Theory Review
• Training Objectives
• How to provide feedback
• How to evaluate students

4. Paramedic Program Goals:
 To prepare competent entry-level health
care providers in the cognitive,
psychomotor, and affective learning
domains,” at the Paramedic, Emergency
Medical Technician-Intermediate, and
Emergency Medical Technician-Basic
levels.

5. You Are Now The Mentor
 You are now a preceptor and thus a mentor
 Your attitudes and actions has an impact on the kind
of EMT or paramedic the student will eventually
become.
 The mentoring the student receives is just as
important (maybe more so) as the training he/she
receives in the classroom

6. Remember That You Weren’t
Always Successful
 Many new paramedics look at successful health-
care providers & think they were always that way
 Most professionals have had great mentors
 We developed over time & through much trial &
error
 We received correction along the way

7. Why Do They Need A Preceptor?
 Students need help managing anxiety
 They need to develop a professional identity
 They need to understand that there are a variety of
strategies that are effective – there is not just one
way
 They need guidance to develop their own “style”

8. Preceptor Responsibilities
 Provide a model for the student to emulate
 Transmit knowledge and experience
 Help the student manage anxiety
 Supervise & guide skill acquisition and performance
 Provide positive & correctional feedback that will allow the
student to “grow”
 Completely & honestly fill out & sign the students evaluations

9. Preceptor Characteristics
 Possess good communication skills
 Establish a climate that is conducive to learning
 Share practical steps in patient care
 Provide positive & correctional feedback, when necessary
 Listen to the student
 Maintains proficiency in their clinical area

10. Paramedic Preceptor & Team
 The team must consist of three people.
 The student cannot be the driver.
 Preceptor must be a Paramedic
 Must be a released provider for a minimum of 1 year.
 Maintains proficiency and be in good standing with the
department.

11. Thinking back to your orientation?
What makes a bad preceptor?
What makes a good preceptor?

12. Preceptor Role
 Guides the student and provides help when needed
 Creates opportunities for students to provide care for
patients while preventing the student from doing harm to
the patient or themselves.
 Makes mental notes about the good & the bad aspects of
care & reviews with the student in a private setting.

13. Preceptor Role (Cont.)
 Preceptors should keep an open mind that
there is more than one way to reach a certain
goal
 Remember students are still in the learning
process
 They should not be expect students to
perform to the level of an experienced EMT
or Paramedic

14. Student Role
 Come to station or field site enthusiastic, prepared, and
appropriately dressed.
 Perform assessments and clinical skills under supervision
with increasing competency and responsibility.
 Paramedic students should actively seek out learning
opportunities and be available to the preceptors when
learning opportunities arise.
 Demonstrate professional behaviors including: motivation,
integrity and accurate self-assessment.

15. Requirements for Successful Completion
(Paramedic level)
 Patient Assessments
30- Pediatric
50- Adult
30- Geriatric
 Airway management – 50+
 Patient Complaints
8 – Pediatric Respiratory
10 – Change in Responsiveness
30 – Chest Pain
20 – Altered Mental Status
20 – Respiratory
20 – Abdominal Pain

16. Requirements for Successful Completion
(Paramedic level)
 Patient Impressions
40- Trauma
10 - Obstetric
20 – Psychiatric
 Skills Performed
25 – Medication Administration
50 – Successful IV Insertions
10 – Ventilations
3 – ET Intubations
 Additionally, each student will be required to complete
50 team leads, of those team leads 20 must be ALS
level transports.

17. Traits of Adult Learners
 Self-directed & Autonomous
 Resistant to change
 Practical, Results or Goal Oriented
 Applies Personal Experience
 Motivation
 Multi-level Responsibilities
 High Expectations

18. EMS Version of Dreyfus Model

Novice:

-- Has no experience at the present certification
level. This student must be directed in all
aspects of patient care, and may require step-by-
step directions. Protocols are considered
absolute, and the student may not be able to
combine protocols in complex patients.

19. EMS Version of Dreyfus Model

Advanced Beginner:

-- has gained an understanding of individual
skills, but may not know when to use them in
complex cases. This student functions well as a
team member, and understands that protocols
may not always fit every situation. However,
they will need directions, and will seek
permission for any “outside the box” issues.

20. EMS Version of Dreyfus Model

Competent:

-- Still relies on protocols, but is able to
understand the value and purpose of each. This
student can provide patient care, but still follows
algorithms and may use references during
patient care. This provider/student is able to
function as a team leader, and requires minimal
or no direction, possessing the ability to think
critically, and find answers when needed.
Begins to differentiate relevant from irrelevant
information.

21. EMS Version of Dreyfus Model

Proficient:

-- Experienced providers who have developed
pattern recognition, but still follow a systematic
process during assessment and treatment of
patients. Few students will ever achieve this
level during an initial education program.
Providers at this level make ideal preceptors,
because they are easy to follow, and can identify
the steps used to draw conclusions and make
decisions.

22. EMS Version of Dreyfus Model

Expert:
 -- is exceptional in patient care, and uses vast
experience to make decisions. This provider does
not rely on protocols and algorithms, and is able to
follow “gut instinct,” and is usually right. Complex
cases are not a problem, as creative problem-solving
is natural. This level of provider is often a difficult
preceptor for students, because they multi-task and
rely on experience, rather than a systematic
approach. The expert may have difficulty explaining
“why” and “how” conclusions were drawn.

23. Our Dreyfus Goal…
 It is important to understand that students
should not be expected to meet a proficient or
expert level of practice. They may need
resources that the experienced preceptors may not
find necessary, and they will need to follow a
systematic, step-by-step process when providing
patient care.

24. Start of Each Shift
 Review with the student how much field time they
have completed & what they currently studying.
 Find out the student’s perceptions of their own
strength & weakness
 Find out any issues of concern that student may
have and try discuss and focus on these areas
 Relay your expectations of the student

25.  Make sure the student understands what is
expected of him/her
 Tour the station if this is their first shift at this
location
 Review and involve them in the daily routine and
station responsibilities
 Review location of supplies, equipment, & involve
them in the process of checking the ambulance out.

26. During the Shift
 Under direct supervision assign students specific
tasks or skills. (e.g. IV, 12-lead, or ET)
 During downtime or on slower days supervise skill
simulations and chart them with the student in
FISDAP (They can help you with this…)
 With supervision allow the student to be team
leader for certain calls.
 Provide feedback

27. Providing Feedback
 Types of feedback:
 Correctional
 Positive reinforcement
We understand all the time constraints you are under as you go about
your shift, our hope is that you will find opportunities to provide feedback
and suggest opportunities for improvement throughout the shift.

28. Types of Feedback
 Correctional:
 Correctional feedback should be given in a positive
manner
 Identifies areas of performance that require improvement
or an area in which the student must change their behavior
 Example: Reminding a student of the importance of strict aseptic
technique when starting an IV.
 Example: You did a great job with that patient assessment and I think
together we can identify some things we could do better …

29. Types of Feedback
 Positive reinforcement:
 Encourages desired behavior
 Helps build self-confidence
 Example: “Your calm & confident behavior
really helped to relax the patient. You did a
very good job”

30. Qualities of Good Feedback
 Timely manner:
 Feedback should be provided as soon as possible
after performance.
 Private:
 Correctional feedback is always done in private
 Positive reinforcement can be done in private
or
In front of others, depending on the personality of
the person receiving the reinforcement.

31. Qualities of Good Feedback
 Direct:
 Always directed at the person for whom it was
intended
 Only discuss correctional feedback with those
individuals that are directly concerned
 Objective:
 Good feedback is conducted without any bias to race,
gender, ethnic origin, sexual preference, or creed

32. Qualities of Good Feedback
 Clear:
 Does the student understand what
you as the preceptor said or meant to say?
 Remember that feedback should not be
general goals for improvement, but
pinpointed actions that the student can take
to improve patient care
Vague feedback doesn’t give the student any idea of
how to realistically improve their performance

33. What To Look For As A Preceptor?
Look for students with the:
 Ability to communicate clearly with patients
 Ability to manage patient care efficiently
 Ability to complete a thorough patient assessment
 Ability to identify a patient’s chief complaint
 Ability to formulate and provide appropriate treatment
strategies at their level of training
 Ability to provide patient care in a safe and effective
manner.

34. Problem Resolution
 The lines of communication begin at the level of
the student & preceptor
 If an issue cannot be resolved you may contact:
Clinical Coordinator:
Basil Asay (804) 283-1483 or basay@vcu.edu
Paramedic Program Director:
Ken Williams (804) 828-3687or kwilliams6@vcu.edu

35. Completing the Shift
 Students should report to their preceptor anytime
they leave the station or before the shift is to end.
 Throughout the shift students will chart their
assessments, patient contacts, and skills
completed in a program called FISDAP.
 To complete their shift they will need their
preceptors assistance in the FISDAP program.

36. From this screen the student will be able to select from which assigned
shift he is working and begin completing assessments and entering
completed tasks.
 Students should report to their preceptor
anytime they go off the unit or before the shift
is to end.
 Throughout the shift students will chart their
assessment and tasks completed in a
program called FISDAP.

37. Notice that multiple types of shifts have been assigned. This page will also
indicate whether you their preceptor have signed off on this shift. Note the pencil
in the preceptor signoff column. The checkmark indicates that you, their preceptor,
has electronically signed off on the work completed.
 Students should report to their preceptor
anytime they go off the unit or before the shift
is to end.
 Throughout the shift students will chart their
assessment and tasks completed in a
program called FISDAP.

38.  Students should report to their preceptor
anytime they go off the unit or before the shift
is to end.
 Throughout the shift students will chart their
assessment and tasks completed in a
program called FISDAP.
This is the shift signoff screen. The student will open this screen for you to signoff
on at the end of the shift. However before you do you will need to have them first
allow you to complete an evaluation and look over what they did…

39. Before signing off you should have the student show you this shift summary
it will identify the number of patients they assessed or skills performed. Under
the intervention column it should show what skills/tasks they performed…
 Students should report to their preceptor
anytime they go off the unit or before the shift
is to end.
 Throughout the shift students will chart their
assessment and tasks completed in a
program called FISDAP.

40. This is the area of FISDAP where both you and the student can chart any
simulated skills practice done during the shift. This will really help the student
if we can do this frequently throughout the program.
 Students should report to their preceptor
anytime they go off the unit or before the shift
is to end.
 Throughout the shift students will chart their
assessment and tasks completed in a
program called FISDAP.

41. By clicking on the link with the patient identifier, you can view what has been
charted on the patient and view the completed narrative. Student should not
chart anything that would violate HIPPA or patient confidentiality.
 Students should report to their preceptor
anytime they go off the unit or before the shift
is to end.
 Throughout the shift students will chart their
assessment and tasks completed in a
program called FISDAP.

42. This section shows what evaluations have already been filled out for this
shift. Once you have completed the evaluation it should show up here. You
will also notice the student can do a self-evaluation as well.
 Students should report to their preceptor
anytime they go off the unit or before the shift
is to end.
 Throughout the shift students will chart their
assessment and tasks completed in a
program called FISDAP.

43. This is where you or the student will select the evaluation that needs to be
completed at the end of the shift. It’s labeled: “Preceptor evaluation of
student.” After selecting the correct evaluation form click the “GO” link…
 Students should report to their preceptor
anytime they go off the unit or before the shift
is to end.
 Throughout the shift students will chart their
assessment and tasks completed in a
program called FISDAP.

44. This screen should appear, either you or the student will have to change the
evaluator section to reflect you being their “Preceptor,” Student will assist…
There will be evaluation sections for psychomotor and affective domains…
 Students should report to their preceptor
anytime they go off the unit or before the shift
is to end.
 Throughout the shift students will chart their
assessment and tasks completed in a
program called FISDAP.
Note the Grading
Scale. “We don’t
expect exceptional
all the time…”

45. After you have scrolled down and answered all the questions there will be a
score provided, and a button to submit and close. The preceptor should be
the person filling this form out.
 Students should report to their preceptor
anytime they go off the unit or before the shift
is to end.
 Throughout the shift students will chart their
assessment and tasks completed in a
program called FISDAP.

46.  Students should report to their preceptor
anytime they go off the unit or before the shift
is to end.
 Throughout the shift students will chart their
assessment and tasks completed in a
program called FISDAP.
At this time you can have the student bring you back to this signoff screen
and you may add any comments you would like to this screen and electronically
sign your signature on the line.

47.  Students should report to their preceptor
anytime they go off the unit or before the shift
is to end.
 Throughout the shift students will chart their
assessment and tasks completed in a
program called FISDAP.
The last thing you do is check the box lock shift and click save. Before doing
so ask the student if they there is anything else they have forgotten, because
they will not be able to go back and make changes to a locked shift…
Step one Step two
Once you click “Save” the shift is complete…

48. Completing the Shift
 Students have been authorized to use handheld
devices and the screen may be slightly adapted
for mobile use.
 Students should still be able to walk you through
all the same information and you should still be
able to complete the “evaluation form”
 The responsibility of navigating the software is not
left to the preceptor alone, but the preceptor
should know what information they are signing off
on.

49. THANK YOU!
 It is dedicated preceptors like yourself
that allow us to educate and train
quality pre-hospital medical providers.
 Paramedic Program Clinical Coordinator:
Basay@vcu.edu Office: (804) 828-4917