Supporting Learners: Regulatory and an Acute Care Practice Perspective Ashley Graat RN, BScN, M.Ed(c) Professional Practice Leader - Evidence Based Practice Murray Krock RN, BScN, MN Corporate Nursing Education Leader, Professional Practice 1
Presentation Pathway Overview of St. Michael s Hospital (SMH): Who we are Why we developed a preceptorship workshop Introduce & review key components of SMH nursing preceptorship workshop Demonstrate the application of the College of Nurses of Ontario s (CNO) Supporting Learners Guideline to preceptorship 2
St. Michael s Hospital: Who we are Academic health sciences centre affiliated with the University of Toronto, and a major tertiary and quaternary referral centre $500M+ operating budget 475 acute adult inpatient beds 5,368 staff 1,800 nurses 713 physicians 537 volunteers 71,951 emergency visits 29,549 surgical cases 466,631 ambulatory visits 26,406 inpatients 3, 357 students trained Source: Community Report 2012-2013 3
Supporting Learners Nurses have a professional obligation to support learners to develop and refine the competencies needed for safe, ethical and effective practice, and to support the development and socialization of colleagues who are learning. (Supporting Learners Practice Guideline, College of Nurses of Ontario) As preceptors, nurses support the transition and integration of new nurses and nursing students into the organization and practice setting. This workshop (preceptorship)will prepare nurses with the knowledge and skills to function effectively in a preceptor role. (St. Michael s Hospital, Preceptorship Workshop) 4
Preceptorship Workshop: Components Differentiate preceptorship and mentorship Benefits of preceptorship programs Qualities of an ideal preceptor Adult learning theory and principles VARK learning style preferences Promoting critical thinking Factors that affect the preceptorship experience Providing effective feedback Conflict resolution strategies Evaluating the preceptorship Roles & responsibilities of the preceptor, preceptee, educator/administrator 5
Preceptorship is A frequently employed teaching and learning method using nurses as clinical role models. It is a formal, one to one relationship of predetermined length between an experienced nurse (preceptor) and a novice nurse (preceptee) designed to assist the novice in successfully adjusting to a new role. The novice may be a student, a new graduate nurse, or an already practicing nurse moving into a new, domain or setting. Preceptorship is a partnership between the preceptor who is responsible for teaching, evaluating and providing feedback to the preceptee. Canadian Nurses Association, 2004 6
Exercise: Preceptorship versus Mentorship Definition: Purpose: Type of Relationship: Role Model Characteristics: Participant Characteristics: Assessment and Evaluation: Time Frame: Preceptorship Mentorship 7
Qualities of an Ideal Preceptor Demonstrates professionalism and competence Interested and committed to the preceptor role and life long learning Strong leadership and conflict-resolution skills Role model, teacher, coach and provides ongoing feedback Trusting, caring, patient and enthusiastic Demonstrates strong interpersonal and communication skills Strong knowledge, skills and judgment (CNO Professional Standards, hospital policies and procedures, unit specific competencies/routines etc.) 8
Preceptor & Preceptee Interview Getting to know your preceptee Purpose: To foster the preceptor/preceptee relationship & to tailor the preceptorship to maximize the preceptee s experience. 1. Describe the types of clinical experiences you have had. 2. What do you expect to gain from the preceptorship? 3. Describe the best way you learn. 4. What do you see as your major strengths? 9
Preceptor & Preceptee Interview Getting to know your preceptee..cont d 5. What do you see as your greatest challenges? 6. What are your future aspirations? 7. Is there anything else you would like your preceptor to know and understand about you/your professional needs? 8. How can your preceptor further assist you during the preceptorship experience? 9. What questions do you have for your preceptor? Adapted from: Swihart, D. (2007). Nurse Preceptor Program Builder: Tools for a Successful Precptor Program (2 nd ED). Danvers: HCPro 10
Adult Learning Theory & Principles: Malcolm Knowles Six Principles of Adult Learning 1. Adults are internally motivated and self-directed 2. Adults bring life experiences and knowledge to learning 3. Adults are goal oriented 4. Adults are relevancy oriented 5. Adults are practical 6. Adult learners like to be respected 11
VARK Learning Styles KINESTHETIC 12
One Minute Preceptor Step 1: Get a commitment Have your preceptee present their plan of care or intervention plan for the problem. Step 2: Probe for supporting evidence Establish the knowledge basis for decisions in step 1. Step 3: Teach general rules Provide correct information or provide location of resources. Step 4: Reinforce what was right Provide positive feedback to promote confidence and self-esteem. Step 5: Correct mistakes Provide specific information regarding necessary improvement. 13
Preceptees want and value feedback Builds confidence Can accelerate learning Feedback: is the sharing of specific information related to a learner s performance in order to help him/her continue or modify a behaviour. Without feedback, incorrect assumptions about performance may be made Without feedback, learners may discontinue positive behaviours Promote self reflection and independent study 14
Tips for Providing Effective Feedback Self-Assessment Balanced Well-Timed Based on Observation Descriptive and Specific Regularly Provided 15
Sources of Conflict Between Preceptor & Preceptee Role expectations CONFLICT: A clash or struggle when a real or perceived threat or difference exists in the desires, thoughts, attitudes, feelings or behaviours of two or more people. Different learning/working styles Inadequate skills/knowledge Personal/personality issues 16
Dealing with Conflicts 1. Provide positive feedback on performance. 2. Focus on the observed behaviour that could be improved. 3. Describe impact of behaviour. 4. Work together to identify solutions. 5. Develop an action plan. 6. Set a date for evaluation. 17
Lessons Learned 1. Preceptors want to support preceptees 2. Planning & development of education to support preceptorship development is critical to secure corporate support 3. Education is a recognized a strategy 4. Participants need an opportunity to share and discuss their experience 18
Preceptor Resources: College of Nurses of Ontario. (2009). Practice Guidelines: Supporting Learners. Toronto, ON. http://www.cno.org/global/docs/prac/44034_supportlearners.pdf College of Nurses of Ontario. (2011). Entry to Practice Competencies. Toronto, ON. http://www.cno.org/global/docs/reg/41042_entrypracrpn.pdf College of Nurses of Ontario, (2002). Professional Standards. Toronto, ON. http://www.cno.org/global/docs/prac/41006_profstds.pdf College of Nurses of Ontario. (2006). Practice Standard: Decisions About Procedures and Authority. Toronto, ON. http://www.cno.org/global/docs/prac/41071_decisions.pdf 19
Preceptor Resources: College of Nurses of Ontario. (2010). Developing SMART Learning Goals. Toronto, ON http://www.cno.org/global/docs/qa/developingsmartgoals.pdf College of Nurses of Ontario. (2006). Practice Standard: Decisions About Procedures and Authority. Toronto, ON. http://www.cno.org/global/docs/prac/41071_decisions.pdf Preceptor Education Program (PEP), The Faculty of Health Sciences at the University of Western Ontario, a project funded by The Ministry of Health and Long-Term Care. http://www.preceptor.ca/index.html VARK Learning Style Questionnaire. Retrieved from http://www.varklearn.com/english/index.asp 20
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