Introduction

Knowledge, attitudes and skills are foundational to developing competence in any professional individual. As a preceptor, you have a unique opportunity to share your knowledge, attitudes and skills with a fellow nurse who has no or limited experience in your clinical area. As the preceptor, you are the expert and have the opportunity to facilitate someone learning about your professional practice setting. Does this seem overwhelming? Read on and explore more about what it means to be a preceptor.

Basically, being a preceptor refers to establishing a one to one professional relationship between a clinically skilled individual and a novice (Ferguson, 1996). By being a role model, socializer, and educator (Alspach, 2000) the preceptor assists the student to acquire professional skills in a time-limited relationship. Since nursing is a practice-based profession, the student is able to increase competence and confidence in clinical skills, decision-making, and application of knowledge in a specific clinical setting.

The preceptor serves as a role model for the student. A role model allows the student to see and experience what you, the expert, does on a daily basis while encouraging the student to ask questions. The preceptor challenges, guides, and directs. Fundamental to this process is the preceptor’s willingness to share one’s professional values, beliefs, and skills while incorporating legal, ethical, and professional practice standards. Your student is a professional nurse, he/she is new or unfamiliar with your practice area. This is your opportunity to teach them and show your knowledge.

What are the tools that a preceptor needs? Of primary importance is a willingness to share your knowledge and skills – to let someone see and experience nursing through your eyes, hands, and mind. You will practice nursing as someone (i.e. your student) is watching, participating and learning. While the idea of someone watching can make you nervous, remember that you are the expert and the student is learning. So relax, teach the learner what you know.

As a guide in this clinical practice setting, you allow the student to “do” direct patient activities under your supervision. You and the student decide on the specific clinical experiences selected to meet learning objectives. This may involve caring for patients at different acuity levels, patients requiring specific monitoring interventions, or teaching of individuals within the agency. Remember, the student is under your guidance or supervision, so work closely together while providing interesting or challenging opportunities to learn. These opportunities may include observation in related areas such as pharmacy, cardiac catheterization laboratory, community agency, or intradisciplinary meeting. Attendance at a continuing education program or professional organization meeting related to the clinical setting may also be counted as clinical experience. Students may be placed in charge of a journal club where relevant professional articles can be discussed in an informal setting.

While serving as a role model, it is helpful to remember what it was like when you first started in this practice setting. By stopping to remember, empathy will probably be used to support the learner. This will also help you to recognize the individuality of the learner. What do they want to learn? What skills and knowledge can you give to the student so that his/her professional skills are improved? This allows for flexibility within the learning setting so that educational goals can be achieved.

Lastly, the preceptor needs to recall that the student is an adult learner and is motivated by professional and personal attributes. While the learner may be experiencing some anxiety and uncertainty, he/she is there to learn. By facilitating the adult learner, the energy of the student is released.

Knowles (1990) identified the characteristics of an adult learner. These are briefly summarized in the following statements.

• Adults prefer to know why they need to learn something before undertaking to learn it.
• Adults will invest considerable energy to something that they want to learn and perceived value in learning.
• Adult learners wish to be treated with respect and that they are capable of self-direction.
• Adults bring with them a volume of past experiences, including experiences with learning. These past experiences can e positive or serve as a barrier.
• Adults want to learn materials that have practical application. They want to learn in real-life situations.

With these characteristics it becomes useful to review some helpful teaching methods for adult learners. Many of these methods you already know from personal experience as a learner and from teaching patients and families. There is no one way or method to teach clinical skills, rather it is a process of choosing from a repertoire of methods depending on the learner and practice setting. Information about possible teaching methods follows. It is important that the instructional methods involve active participation in learning.

Experiential Learning. Since nursing is a practice discipline, experience is the most common method of learning. It provides for direct experience in a practice setting, including patient care, but also interaction with other disciplines. While the RN learner may never professionally work in this clinical practice setting, thinking processes are developed as the individual confronts unfamiliar situations. When considering the clinical assignments for the learner, you, the preceptor should consider, the student’s learning goals, and clinical preparation as well as your ability to provide adequate supervision. Always look for “windows of opportunity” to meet the student’s priority learning needs as well as infrequent events that broaden the student’s experience. Activities to supplement experiential learning include having the student read journals specific to the clinical setting, develop worksheets (i.e. rhythm strips), and return demonstration of a procedure. It is possible to involve other staff members in these instructional activities.

Another method of experiential learning involves written assignments. As a preceptor you are not required to grade this work, but you may be asked to provide an appropriate clinical experience that serves as the basis of the written work. For example, a nursing care plan may be required on a patient in a specific circumstance.

Often with experiential learning, a diary or learning log is kept by the student. Generally this involves the student recording thoughts about one’s clinical experience. In addition, the student may be required to respond to questions identified by the course faculty. If a learning log is part of the course, it will be spent or evaluated by course faculty.

Problem solving. Problem solving is a teaching method that allows the learner to analyze a clinical situation in depth. Often problem solving is initiated by having the student clearly explain the specific problem, consider multiple interventions while applying clinical knowledge, and then make a decision recognizing one’s own beliefs and values. It is often helpful to have the student distinguish between facts, assumptions, and inferences. Gaps in the needed information should be identified.

Conference. A conference is a discussion often involving multiple persons. Once again, problem solving is encouraged as well as the development of communication and group process skills. Problem solving, time management, and knowledge application are all possible areas for conference topics. Often, conferences can be discussion that occurs in a relaxed atmosphere.

Observation. Observation allows a student to experience an area on a short-term basis. At times, the experience can be a participatory observation where the learner contributes by performing some limited activities. Observation allows the student to view a new professional role or see a procedure performed. It is important to have the student express one’s thought before the experience, and then, after the experience to identify any changes in perception.

Tools to help make all of these suggested teaching methods work include:

• asking questions
• answering questions
• facilitating discussion
• explaining everything
• demonstrating new or unfamiliar procedures
• providing feedback

Once again, this may seem overwhelming, but many of these tasks you already do with patient and family teaching.

One very specific area that as a preceptor you will participate in, is the evaluation of the student. While this may evoke personal memories, the provision of timely feedback to the student can be very beneficial. Remember the student often feels uncertain and honest feedback is welcomed and often a motivating force for improvement.

Feedback should be:

• specific rather than general
• factual rather than opinionated
• descriptive rather than judgmental (Alspach, 2000)

In addition, feedback should be provided in a timely and appropriate manner. Recall that the message sent isn’t always the one received so clarity and completeness is important. The purpose of feedback is always to improve and not to destroy. Negative feedback constructively given can improve the knowledge, attitude, and skills of the student.

Remember, as a clinical preceptor you:

• are responsible for the actions of the student
• always develop a clear and specific plan of what aspects of nursing care you are responsible for and what the student is responsible for
• continuously communicate with the learner
• share responsibility
• evaluate the student’s performance with both positive and constructive feedback

Toward the end of the clinical experience, the student will have the opportunity to evaluate the experience and complete a preceptor evaluation form. These are submitted to course faculty who will share the results with you. A copy of the preceptor evaluation form is found within this packet.

While being a preceptor may involve some discomfort and work, it also has benefits. Benefits center on the professional satisfaction of teaching a novice about the area of nursing that you enjoy. With the new perspective the student will experience professional development due to your effects. Take pride and satisfaction in knowing this. While Chamberlain provides no financial pay to the preceptor, the College acknowledges your participation in providing educational opportunities to the student.