montoya mintz - preceptors · 4/24/15 3...

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Preceptor Power and Influence: Transforming Student Learning

Carolyn Montoya PhD, CPNP Associate Professor and Chair Practice Team

Robyn Mintz LMT Senior Program Manager

“I feel that we as providers possess a great deal of knowledge and exper<se which lends us as invaluable resources for teaching those who will likely follow us in our fields. There will always be a need for con<nuous learning and I hope that other providers will consider sharing their exper<se with students.”

Diana Sanchez-‐Gallegos, FNP, PNP Presbyterian Medical Group

Benefits of Precep.ng

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Personal fulfillment !  Desire to “give back” !  Posi<ve experiences as a student

Invested in training the next genera<on of healthcare professionals !  CommiFed to building a healthier state

Mutually beneficial learning opportunity Professional rewards

!  Credit for recer<fica<on by the ANCC !  Adjunct Faculty appointments or other <tles !  Opportuni<es to earn CEU’s

Peer support/professional partnership with faculty Perks offered by the ins<tu<on



What mo<vates YOU?

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“Preceptors are the vital link between the concepts and evidence-‐based approaches to care and the reali<es of actual prac<ce.” (Barker, et al., 2008)

Preceptor Roles and Responsibili.es

What level of student will you be precepEng? (Davis, et al., 1993)

Advanced beginner !  Rule oriented !  Need help in seang priori<es !  Examples: first year students -‐ Women’s Health, Adult Health I, Pediatrics I

Transi<on !  Moving towards competence !  S<ll need help seang priori<es !  Examples: second year students – Adult Health II, Pediatrics II

Competent-‐Proficient !  Increase in clinical judgement, skills and experience !  Deliberate planning !  Analysis of a plan !  Increasing organiza<on, speed, flexibility, and confidence !  Examples: Advanced Fieldwork – last clinical experience before gradua<ng

Preceptor Roles and Responsibili.es

Preceptor

! Orient student ! Discuss mutual expecta<ons

! Mentor & coach

!  Teaching style ! Match pa<ents to student’s learning situa<on

! Direct observa<on !  Provide feedback & final evalua<on (Barker & Pi1man, 2010)

Preceptor Faculty Partnership

Faculty

!  Provide didac<c content ! Match students with sites/preceptor

!  Establish student goals/objec<ves !  Support preceptor !  Support student ! Conduct site visit ! Assign final grade

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The Mentored NP Student ! Vested interest !  Loving to teach ! Giving opportunity through trust and feedback

! Openness !  Friendship !  Life jacket !  Pa<ence and kindness, values beginner !  Job advice ! Modeling of confident, competent, empathe<c pa<ent care

What Makes a “Good” Preceptor (Hayes, 1999) The Non-‐Mentored NP Student ! Not mee<ng learning needs ! Not leang go ! Barriers to communica<on ! Disappointment in the rela<onship !  Feeling unsafe !  Impa<ence ! Compe<<veness ! Not liking the way the preceptor relates to pa<ents

Plan Ahead

! Understand expecta<ons

! Affilia<on Agreement and “Onboarding” requirements

! Make contact with the student

! Responsibility to management

Steps to Success: Preparing to Precept

Orienta<on !  Introduce to staff and management !  Conduct facility tour !  Review standard policies and procedures, dress code, self-‐protec<ve equipment, and per<nent pa<ent issues

!  Provide EMR training !  Discuss fire and emergency safety prac<ces

The First Day !  Review roles and responsibili<es, goals, objec<ves, communica<on, and management style

!  Discuss feedback mechanisms and performance assessment !  Confirm schedule !  Allow student observa<on !  Schedule <me for reflec<on and Q&A

Steps to Success: Preparing to Precept

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UNM College of Nursing Preceptor Tools and Resources

!  Preceptor orienta<on handouts !  Evalua<on forms

! One-‐Minute Preceptor skills pocket card

! Nurse-‐Midwifery Preceptor Workshop h1p://www.youtube.com/watch?v=wTfL8h99ZJM

! Nurse-‐Midwifery Preceptor Pearls pocket card

!  Library privileges !  Preceptor webpage (Launching Fall 2015) ! NewsleFer (Launching Fall 2015)

Steps to Success: Tools and Resources

Typhon Group’s NPST™ Student Tracking System

!  Pa<ent encounter logs and reports !  Evalua<on and survey component for assessments

! Management of student rota<on scheduling

!  Student porpolios !  Student and preceptor biographic databases ! Clinical site database

Steps to Success: Tools and Resources


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Observa<on vs. student seeing pa<ents

“Wave-‐Scheduling” (Barker & PiFman, 2010)

!  2-‐3 pa<ents scheduled at the same <me followed by a 10-‐15 minute break to allow for “catch-‐up”

Alternate experiences ! Char<ng ! Assignment

Teaching Strategies

Developed by medicine to model clinical teaching (Neher, & Stevens, 2003) ! Get a commitment !  Probe for suppor<ng evidence !  Teach general rules ! Reinforce what was done right ! Correct mistakes

Usual Prac<ce without the One-‐Minute Preceptor ! hFps://www.youtube.com/watch?v=937G0m5SUsI

One-‐Minute Preceptor ! hFps://www.youtube.com/watch?v=ndLbo7sDnKo

“One-‐Minute Preceptor”

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Power and anxiety – a potent cocktail for affec<ng cri<cal thinking! (Forneris, & Peden-‐McAlpine, 2009).

Students expected to con<nually self-‐evaluate.

Feedback should be: ! Given in private !  Timely !  Specific !  Posi<ve ! Construc<ve (incorpora<on of areas for improvement) !  Par<cipatory on the part of the student

Evalua.on of Students

What to expect

!  Student coordinates site visit appointment !  Faculty

•  Observes student with pa<ents •  Reviews student char<ng •  Discusses student progress with preceptor

! Opportunity for mutual feedback

Faculty Site Visit

Observa<on vs. student seeing pa<ents

Medicare Rules

!  Physical presence of the provider necessary for all billable services. !  Preceptor must document the visit – cannot “ini<al” student char<ng.

Challenges of Char<ng

!  Electronic char<ng Commission on Collegiate Nursing Educa<on (CCNE) Accredita<on Requirement

!  Student and site visitor evalua<on of preceptor and clinical site.

Special Considera.ons of Precep.ng

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UNM College of Nursing Student Tes<monial

“There are <dbits of informa<on that we cannot find on an iPhone, skills we cannot learn by watching YouTube, and a sou touch to medicine that is not easily understood by reading books. Thankfully, we have preceptors who take the <me to teach us these finer points so that we can grow into sound prac<<oners.” Erin Weber, Family Nurse PracEEoner ConcentraEon

Transforming Student Learning

UNM College of Nursing Student Tes<monial

“I will always be grateful to my preceptors for sharing their knowledge, experience and their pa<ents with me. The strength of this program is dependent on willing preceptors and their focus on our learning.” Erin Stopani, Nurse-‐Midwifery and Family Nurse PracEEoner ConcentraEons


!  This fund was established in 2015 by Dr. Diane Viens, CFNP and Dr. Carolyn Montoya, CPNP.

!  Provides support for Nurse Prac<<oner students’ educa<on inclucing clinical travel in rural and under-‐served areas.

!  Dr. Viens was the first permanent director of the Family Nurse Prac<<oner (FNP) program. Dr. Montoya con<nues to coordinate the Advanced Prac<ce Programs at UNM.

!  Drs. Viens and Montoya were instrumental in the successful passage of the bill which led to NPs in New Mexico having full prescrip<ve authority and independent prac<ce in 1993.

!  Contact Dimple Bhakta (505) 272-‐4455 or [email protected] for more informa<on

Viens/Montoya Nurse Practitioner Fund – UNM, College of Nursing

Dr. Diane Viens

Dr. Carolyn Montoya


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References American Associa<on of Nurse Prac<<oners™ (2015). 2013-‐2014 Na<onal Nurse Prac<<oner Prac<ce Site Census.

Retrieved from hFp://www.aanp.org/images/documents/research/2013-‐14na<onalnpcensusreport.pdf

Barker, E. R., & PiFman, O. (2010). Becoming a super preceptor: A prac<cal guide to preceptorship in today’s clinical climate. Journal of the American Academy of Nurse PracEEoners, 22(3), 144-‐149.

Davis, M. S., Sawin, K.J., & Dunn, M. (1993). Teaching strategies used by expert nurse prac<<oner preceptors: A

qualita<ve study. Journal of the American Academy of Nurse PracEEoners, 5(1), 27-‐33. Forneris, Susan Gross, & Peden-‐McAlpine, C. (2009). Crea<ng context for cri<cal thinking in prac<ce: the role of the

preceptor. Journal of Advanced Nursing, 65(8), 1715-‐1724. Neher, J. O., Gordon, K. C., Meyer, B., & Stevens, N. (1992). A five-‐step “microskills” model of clinical teaching. The

Journal of the American Board Family PracEce, 5(4), 419-‐424. Neher, J.O., & Stevens, N. G. (2003). The one-‐minute preceptor: Shaping the teaching conversa<on.

Family Medicine, 35(6), 391-‐393.

montoya mintz - preceptors · 4/24/15 3...

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