Graduate Preceptor Handbook: Preceptor Responsibilities

Roles

The preceptor's primary role is teaching. Preceptors assist the student to integrate and apply knowledge from their foundational courses incorporating the information in the assessment and management plan. Preceptors stimulate clinical decision making through questioning the student regarding their observations and reasoning. This process assists the student to reflect and describe their assessment and recommend differential diagnoses, diagnostic testing, and treatment plans. Additionally, preceptors assist the student in accurate and complete documentation of pertinent information. The preceptor has the opportunity to model interpersonal relationship skills with colleagues, patients, and families. Preceptors model behaviors to navigate the organizational system such as experiences with managed care and interagency referrals. Furthermore, the preceptor models the role of a health care provider and an interprofessional team member.

Communication with Faculty

While preceptors are encouraged to contact the faculty person at any time, preceptors should contact faculty as soon as possible for situations involving a student's unsafe practice, unethical conduct, or any changes in the preceptor's availability to precept. Any agency concerns should also be related to the faculty member. Additionally, preceptors will have the opportunity to discuss student progress with the faculty member when site visits are made.

Communication with Student

Preceptors are encouraged to provide regular feedback to the student including brief discussions of the student's daily performance, as well as midterm and final evaluations. Preceptors are encouraged to relate concerns to the student at the time of occurrence for the student to address any concerns as soon as possible.

Evaluation of Student

While the faculty member assumes ultimate responsibility for the formal written evaluation, the preceptor's input will provide supportive evidence for the ratings. The "Competency Based Evaluation" tool provides a framework that assists with collecting objective and subjective data about student performance. The preceptor's primary role is teaching. In the teaching process, the preceptor will observe the student in practice and fit those observations into the evaluation framework. Preceptors are able to collect data that provides evidence of student competence. Additionally, preceptors have an opportunity to support professional practice standards. Observations of the student's performance should be compared with practice standards, validated with faculty and shared with the student. The student's response to day-to-day feedback also serves as part of the preceptor's evaluation data.

Documentation of Credentials

A preceptor profile or curriculum vitae (CV) for each preceptor is required to be on file. Documentation of preceptor license and credentials to practice is important to ensure the quality of providers who mentor students. These documents must be available to the visiting accrediting bodies during program evaluation and renewal.

Guidelines for Preceptors

Beginning Student

• Spend the first day observing the preceptor.
• The second day of clinical, take on increasing aspects of the provider-patient encounter.
• Direction from the preceptor is needed, at times much direction; over time the preceptor learns to trust the students’ knowledge base and competency; less prompting is required as the student’s skill level increases.
• The Preceptor begins to delegate and allow the student to take on more independent responsibilities.

Intermediate Student

• The student is more proficient in analyzing data, more knowledgeable and comfortable with the diagnostic process and management planning.
• The student is more proficient with the use of time and resources.
• The student may require less prompting from the preceptor, but still may need help to remain focused.
• The student is ready to explore other provider role functions, such as teaching and quality assurance activities.
• The student will still require support and assistance for more complex patient cases.

Advanced Student

• The student is expected to perform all role function for an increasingly complex case load in a more thorough, efficient, organized, skillful and independent fashion.

Orientation Strategies

• Identify ground rules (i.e. patient selection, reviewing protocols specific to the setting).
• Review charts to outline documentation requirements used in the setting.
• Explain the role of the preceptor (i.e. how you will introduce the student to patients; how you will check the student’s findings on physical examination).
• Share your expectations of the student with the student.
• Get to know the student (i.e. what the student’s past professional and student experiences are; the student’s perceptions of their learning needs).

Strategies to Assist Students to Learn in the Clinical Setting

• Create an environment to decrease anxiety and enhance learning (i.e. give positive feedback; reassure the student that you are ultimately responsible for the patient’s care; reinforce their sense of competency by reminding them of their nursing experience to date).
• Role model (i.e. demonstrate components of the physical exam; joint counseling and educating the patient).
• Use charting/documenting as a teaching tool.
• Use pre and post conference as appropriate.
• Assign readings for specialty areas or interesting cases’.
• Use detailed, guided questioning with the student (it helps the student to focus and to give rationale for the actions taken).

Indicators of student readiness for increased responsibility

• There is a mutual increase in comfort, almost intuitive, a mutual decision.
• Trust is built between you and the student; it helps the student not get in over their head and to be responsible for their actions and decisions.
• The student proves they will not miss anything important
• There is no longer a need to review every detail with the preceptor.
• The student gives accurate clinical presentation of significant positives and negatives.
• The data presented by the student proves they have covered all the bases with the patient; they have not only met the patient’s needs, but has not found anything wrong with the normal patient.
• The students demonstrate the ability to incorporate past experiences with new skills and apply them to new scenarios.
• The student recognizes their limits of knowledge; admits to weaknesses.
• The student asks appropriate questions.
• The student becomes a self-starter; can cope with an unstructured setting or a change in schedule.