Module 2

Module 2 — Overview and Objectives

In this module, you will be presented with the responsibilities of the preceptor, as well as those of the faculty and student. Because you’ll be working as a team, it’s important that the expectations are clear for all team members. We want you to be confident that we support your role in our team. Ideally, preceptorship is mutually beneficial to all – so, it’s our goal that all team members have an excellent experience.

When you’ve finished this module, you will be able to:

1. Identify the expectations and responsibilities of the clinical preceptor, faculty, and student for the  EMSON Doctor of Nursing Practice Program.
2. Describe ways to best prepare for precepting Nursing Practise students at your clinical site.
3. Examine EMSON DNP Program evaluation forms and process of providing feedback and evaluation.

Module Two Learning Activities:

1.  EMSON Clinical Practice Responsibilities and qualifications for becoming a preceptor.
2.  Read Preparing for Clinical Experience and watch video: Preparing to Precept: Precepting in a Busy Clinic.
3. Read Building the Student-Preceptor Relationship.
4.  Read Clinical Feedback and Evaluation. Watch videos: One-Minute Preceptor: Working with the Overly Confident Student and Dealing with the Challenging Student: The Overly Sensitive Student.
5.  Review Tools for EMSON Student Evaluations and Tools for EMSON Preceptor and Site Evaluations.

EMSON Clinical Practice Responsibilities

It is our goal that the preceptorship experience will be mutually beneficial to students, preceptors, and clinical faculty alike. Numerous surveys have identified preparation and good communication as key to a positive preceptorship. To be well-prepared, it’s important that each participant – preceptor, student, and faculty – are clear about expectations of their specific role and, collaboration among the three is critical to the successful establishment and completion of the clinical experience (Pitts et al., 2019). To make sure you have a good understanding about the expectations of each role, please review the following responsibilities. If you need any clarification about your role, please do not hesitate to contact us! 

EMSON Clinical Practice Expectations

Participant Responsibilities 

In order to ensure quality in the learning experiences of students in the professional program of studies, clinical assignments are designed to facilitate development of advanced nursing roles. The experiences are expected to provide students an opportunity to:

• Translate theory into practice in the delivery of advanced nursing care in a specific care setting and/or for a specific population
• Develop effective diagnostic reasoning, clinical judgment, and evidence-based practice through interactions with professionals who have demonstrated success in practice
• Increase competence and confidence in advanced nursing roles under the guidance of faculty and preceptors
• Benefit from the relationship between nursing education and nursing practice

Faculty Responsibilities

1. Assume responsibility for understanding course requirements and outcomes
2. Ensure overall coordination of the experience
3. Provide student with orientation to course expectations/requirements
4. Establish and maintain patterns of communication with clinical nurse and student
5. Facilitate problem-solving and provide on-going guidance to preceptor and student
6. Meet (virtually or face-to-face) with the student according to an arranged schedule to review progress in meeting course outcomes and goals for personal and professional growth
7. Assume responsibility for the evaluation of student clinical performance incorporating data supplied by preceptor and student
8. Assume responsibility for the overall evaluation of the experience collaborating with the agency, preceptor, and student

Preceptor Responsibilities*

1. Provide EMSON with a current curriculum vitae which reflects the affiliation with the clinical site where clinical experiences will occur. These sites must have a valid clinical affiliation agreement with EMSON before clinical experiences can begin.
2. Assume responsibility for understanding course requirements and outcomes.
3. Act as a role model as practitioner, teacher, and/or manager.
4. Provide the student with ongoing constructive feedback that relates performance standards to student performance.
5. Provide suggestions that will assist and improve student performance to achieve course and clinical objectives.
6. Assist students to gain competence and confidence in assuming responsibilities and functions comparable to the beginning graduate nursing role.
7. Communicate ongoing student progress to the student and faculty and contribute to the student’s summative evaluation.
8. Provide on-site supervision of student.
9. Disclose any potential conflict of interest.

*Note: A copy of the preceptor agreement, preceptor vitae, credentials and site agreement must be on file in School of Nursing before the clinical experience can commence at the site.

Student Responsibilities

1. Assume responsibility for securing preceptors and sites for clinical experiences and ensure valid preceptor and site agreements are attained. For each clinical experience, students should obtain a signed Preceptor Agreement and a current curriculum vita from each preceptor which reflects the preceptor’s affiliation with the clinical site.
2. Please Note: For the DNP students, preceptor and site requests for summer and fall semester are due March 15; requests for spring semester are due Oct. 15.
3. Assume responsibility for understanding course requirements and outcomes.
4. In collaboration with clinical preceptor, develop goals for personal and professional growth, communicating these to faculty.
5. Obtain faculty approval prior to beginning clinical experience.
6. Disclose any potential conflicts of interest with either site or preceptor.
7. Assume responsibility for fulfilling goals and directed learning activities.
8. Maintain lines of communication with clinical preceptor and faculty to promote achievement of directed learning activities.
9. Complete facility-required orientation and confidentiality/HIPAA compliance requirements prior to clinical experience.
10. Adhere to the Professional Appearance policy as found in the “Professional Appearance/Dress Code Guidelines” paragraph of the EMSON Graduate Student Clinical Handbook (PDF) and abide by any specific facility requirements in relation to appropriate dress and appearance during all clinical experiences.
11. Maintain punctual clinical schedule according to a predetermined agreement; notify preceptor and faculty at least 24 hours prior to planned experience when schedule cannot be met.
12. Assume responsibility for arranging and maintaining the schedule of conferences with faculty.
13. Maintain clinical log within 7 days of experience, and review this with faculty on a scheduled basis.
14. Complete a self-evaluation at the end of each course.
15. Complete an evaluation of achievement of directed learning activities, preceptor, clinical site, and the clinical experience as a whole.
16. Perform in accordance with evidence-based guidelines

Preparing for the Clinical Experience

Planning Ahead

Precepting an NP student can add complexity to an already busy clinical day. You wear many ‘hats’ as a preceptor, that include being both the clinician and the educator.  A challenge that many preceptors vocalize as a barrier to being a preceptor is not having enough time in the day to accomplish everything that they want to accomplish (Logan et al., 2015). Here are some tips that may help you plan for your precepting experience.

Tips for Effective Precepting

1. Identify some clear learning outcomes (goals or expectations) that will come from:
   1. The graduate nursing program that “sends” the learner
   2.  The strengths of your current practice and community
   3.  The student’s profile and previous clinical experience
   4. Prior to learner’s arrival:
      1. Notify office staff and colleagues
      2. Inform patients/clients
      3. Identify patient/client’s learner can work with over time
      4. Be specific when sending learner to patient/client. This saves teaching time
2. Obtain a profile of the graduate student before he/she joins your practice
   1. Invest time in initial conference with the student
   2. Provide overview of expectations
   3. Identify student’s interests and prior experience
3. Explain Feedback/Evaluation Process
   1. Have scheduled progress sessions at midpoint and end of preceptorship
4. A short orientation for the graduate student is helpful. Topics to consider:
   1. Attendance
   2. Appearance
   3. Office policies and procedures
   4. Allocated office space if available
   5. Responsibilities on rounds
   6. Patient/client characteristics
   7. Laboratory guidelines if possible
   8. Library and references
   9. Introduce learner to staff and colleagues
5. Review patient schedule in advance with learner; highlight patients/clients most beneficial for learners
6. Review and solicit student questions daily on scheduled basis

Please view this video and reflect on ways you can prepare for the NP student: 

Precepting in a Busy Clinic (12:32) (video)

Building the Student Preceptor Relationship

One of the most important aspects of clinical learning is the relationship between preceptor and student. Facilitating engagement and building a rapport with the student may increase enthusiasm and build trust, therefor contributing to a positive learning environment (Pearson et al, 2019). One way to do this is have a short “interview” session (NONPF, 2015).  Here are some examples of questions to possibly ask of your student prior to the clinical experience:

Interview Questions

• What is your preferred learning style? How do you learn the best?
• What are your preferences around feedback?
• What is your current level of skill and experience? What are your strengths and weaknesses?
• How do you handle mistakes?
• How would you describe your ability to work with other disciplines?
• What do you expect from me as your preceptor?.
• What are your objectives and personal goals for this course?
• Who is your main contact person at the school and how do I contact them?
• Why do you want to be a nurse practitioner? What are your future goals?

Clinical Feedback and Evaluation

Faculty rely on preceptor input to make decisions regarding student performance and progression (NONPF, 2015). Fulfilling the role of student evaluator can be a difficult and stressful task for preceptors, and it is important to review evaluation tools and understand the evaluation expectations before the clinical experience begins. Evaluations should be based on clinical outcomes, objectives, or competencies. Formative evaluation allows you to identify progress and develop learning strategies to meet required learning outcomes. Summative evaluation occurs at the end of the clinical experience and provides an overall competency level (NONPF, 2015). Throughout the clinical, the preceptor should see the student progress to a higher degree of autonomy and increased confidence in decision making.

Providing continuous feedback to the student is essential for the evaluation process to be effective. It allows the student to reflect on performance, identify learning needs, and develop a plan to meet them (Oermann & Gaberson, 2014).  Providing daily feedback is seen as a part of developing trusting relationships between the student and preceptor (Pearson & Hensley, 2019) According to Oermann & Gaberson (2014), there are 5 principles to providing feedback:

Principles to Providing Feedback

1. Feedback should be precise and specific, avoid generalizations such as “great job” or “that wasn’t your best assessment.”
2. For procedures, use of technology, and psychomotor skills, provide both verbal and visual feedback.
3. Be prompt, as time passes neither the preceptor or student may remember exact information and will not be as effective. Take anecdotal notes to help recall important information.
4. Adjust amount of feedback based upon needs of student progress, one approach does not fit all students.
5. Be diagnostic- develop a plan to guide future learning.

Other things to keep in mind when evaluating a student include:

• Develop a supportive learning environment
• Discuss observations with students to obtain the student’s perception of their behavior, be willing to modify judgment and ratings when new data are presented
• Avoid the “Halo Effect” — judgment based upon a general impression of the student, either positive or negative
• Avoid personal bias and favoring
• Set aside adequate time and privacy — “praise in public, critique in private”
• No surprises — provide ongoing feedback and summarize in evaluations
• When using a rating scale, be careful not to rate all students as high, low, or in the middle — make sure to individualize each evaluation
• Rating scale is a pattern of the performance over a period of time, collect sufficient information
• Practice confidentiality between student and faculty

In addition to the school having expectations of the student, it is important that you have your own expectations and that you clearly verbalize these to the student.  Faculty will contact you throughout the semester regarding student progression and questions. Please feel free to contact faculty if concerns arise. A good rule of thumb is if you are thinking about contacting faculty about a concern, do it. 

Please view the video links for evaluation and feedback tips in difficult scenarios.

• One-Minute Preceptor: Working with the Overly Confident Student (7:21) (video)
• Dealing with the Challenging Student: The Overly Sensitive Student (9:18) (video)

Tools for Evaluation of Student

We have provided the clinical evaluation tools that you will complete for the DNP student.  These evaluation tools are also available in the EMSON Graduate Student Clinical Handbook (PDF) beginning on Page 20, and from your student and/or faculty. Confirm the process of completion of these evaluation tools with clinical faculty. Please review the Clinical Evaluation that coincides with your clinical course (the second evaluation is specific to the DNP Project). You will also be contacted throughout the semester for conferences with faculty and/or student to discuss progress.  If you have questions regarding the evaluation process, please contact the clinical faculty early on in the clinical rotation to clarify.

Tools for Evaluation of Preceptor and Site

In addition to the importance of evaluation of NP students, maintaining a successful clinical experience requires evaluation of the preceptor and site by students and faculty. It is essential for faculty to review evaluations to determine performance and appropriateness of the clinical site for the student’s need (NONPF, 2015).  Please review the evaluations of preceptor and site to be familiar with full evaluation process. 

Please review evaluation forms in the EMSON Graduate Student Clinical Handbook (PDF) beginning on Page 20.