Preceptorship is intended to provide a learning opportunity for students that will occur over an extended period of time. A great deal of growth will occur during these twelve weeks. As the experience progresses, students will continue to develop increased independence and deepen their learning. (Kim et al., 2014)
Source: Edgar Dale (1969)
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By the completion of the twelve week preceptorship experience, you should be able to manage an average assignment in the area of practice. Focus on the following areas to develop competence and independence throughout the experience.
The following information has been developed by Em M. Pijl, BScN, MEd, PhD, RN © 2005 – University of Lethbridge. Adapted and used with permission of author by Debra Amirault, Dr. Lisa Keeping-Burke, Karen Tamlyn and Dr. Monique Mallet-Boucher, University of New Brunswick, 2017.
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Organization
Strong organizational skills will help you cope with the many unexpected situations and competing responsibilities inherent in daily practice. Ask your preceptor to help you to develop an organized approach to client care assignments and to formulate a daily routine and plan. Observe other nurses' methods of organization as potential alternative strategies, in addition to preferences and practices of your preceptor.
Prioritization
Managing responsibility and care for multiple clients is one of the most challenging things for students. In previous clinical practice, you have been assigned clients or populations by your instructors, and you are not accustomed to the new level of responsibility associated with a full workload. As such, students tend to address issues in the order in which they arise, rather than prioritizing them. Talking with your preceptor about how they/you can decide what to do first and why, is veryimportant in learning how to set priorities. Ask for the rationale for clinical decisions when managing your assignment, including potential implications to alternative courses of action.
Working as a Team
You cannot do everything alone. Working as part of a team and seeking assistance when needed, is something the preceptor should discuss and role model. Ask questions about how to work with other health care team members and the expectations around this collaboration.
Understanding the roles and contributions of other health care team members, working together, and sharing workload is a skill essential to managing the demands of most assignments. In clinical courses completed during the nursing program, you have not had consistent opportunities to develop this skill. Preceptors can assist students to work together with the entire health care team in order to coordinate and assign care and take a role in ensuring a safe and professional practice environment (NANB, 2015).
Confidence Building
You will become more confident over time as skills are successfully performed and appropriate clinical decisions are made. Ask for feedback so that you can understand what was done well and how to adapt for next time. Knowing these things give you confidence in future decision making. Celebrate your successes and recognize that you will need guidance here and constructive feedback is a must for you to accomplish your goals!
Guided Independence
Knowing when the preceptor needs to intervene is one of the most challenging aspects of the role. It is important for you to have the opportunity to provide care when you have the skill and the knowledge to be able to do so safely. Your preceptor should coach you through decision making processes by stimulating critical thinking and encouraging the development of independent problem solving skills.
A preceptor must intervene if safety concerns arise.
It is inevitable that during a twelve week learning experience, there will be some challenging times. You may find that you are struggling in more than one area. This section will include suggestions for those expected bumps in the road, as well as guidance if the preceptor has concerns about client safety or the student's ability to meet course outcomes.
Keep the lines of communication open with your preceptor. Because everyone reacts to and processes stressful situations differently, communication can be challenging at times. Open communication is the single most important thing in mitigating potential problems and resolving issues.
Communicating about your progress and areas for improvement will help you to develop insight into your own practice and will foster learning.
In the case of an incident or "near miss", it is important to debrief with your preceptor following the situation, so you can clearly understand the factors that lead to the situation and the potential consequences that were avoided.
The faculty liaison is available to support you and your preceptor at any point during the preceptorship experience. Their role is to be a resource and to provide guidance. The faculty liaison is familiar with both your learning goals as well as the course outcomes and can help to guide the learning experience.
The faculty liaison will be in contact with you and your preceptor on a regular basis - at minimum once per set of shifts. However, the preceptor is encouraged to contact the faculty liaison at any time with questions or concerns.
Assessment of student learning is an active process, involving ongoing dialogue between the student, preceptor and faculty liaison. It reinforces strengths and identifies challenges as students strive to improve and develop their nursing care and move toward independent practice. (Gaberson et al., 2015)
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The assessment tool utilized in preceptorship is a document you are familiar with using for clinical assessment; the Collaborative Assessment of Student Abilities (CASA). The CASA is not intended to replace ongoing verbal feedback, which is an integral part to learning within the preceptorship experience. It is a formal and summative assessment document which considers nursing care that has been provided, and your ability to meet course outcomes.
The CASA will be completed at two assessment points during the course; a midway assessment at approximately 5 weeks and a final assessment at 12 weeks. The CASA includes your self-assessment of your learning and progress as well as offers opportunity for preceptor feedback on progress toward the course outcomes.
The preceptor, student and faculty liaison should collaborate to determine the three assessment points. At each assessment point, this process will be followed:
The student must receive "Outcome Met" for all outcomes on the final CASA in order to receive credit for the course. As preceptorship is a university course, responsibility for determining whether a student will receive credit or no credit for this course rests with the faculty liaison.
Assessment meetings differ from the ongoing daily feedback discussions. These are formal discussions held at designated assessment points during the experience. Dates and times for these meetings will be scheduled collaboratively between the faculty liaison, yourself and your preceptor. After you have had an opportunity to review the CASA that has been completed by your preceptor, you will ensure that the faculty liaison receives a copy either in person or electronically. These assessment meetings will provide an opportunity for in- depth discussion of your developing practice and your progress toward achieving the learning outcomes. Additionally, the learning outcomes that require further development should be discussed and strategies for improvement identified.