McMaster Mohawk Conestoga
BScN Preceptorship Workshops 2012-13
About Our BScN Preceportship Program Logo
Introductory Workshop
Learn about the fundamentals of BScN nursing
preceptorship, emphasizing the roles & expectations
Introductory Preceptorship
of preceptors, students, & tutors. Review essential
Workshop
components of the BScN curriculum renewal with a
focus on practice.
Advanced Workshops
Try out specific skills & techniques that will enhance
your clinical teaching effectiveness as a preceptor.
Learn about topics like questioning, clinical
Clinical Teaching Strategies
simulation, role playing, & the relationship between
FULL DAY
supervision & student autonomy.
Preceptors can use a coaching role to guide students
Coaching for Preceptors:
in discovering their strengths and achieving their
Coaching Students to Discover
professional goals. Learn about the possibilities for
their Potential
integrating coaching within the preceptor/preceptee
FULL DAY
relationship.
Effective collaboration & teamwork have been
linked to positive patient outcomes. Help increase
Collaboration & Teamwork
your student’s practical knowledge & skills for use in
intra & inter-professional collaboration, including
the patient & family. Effective communication
techniques for teamwork are included.
Focus on diversity in clinical learning encounters
between BSN students & preceptors. Learn about
responsiveness-to-diversity & the creation of
inclusive & rich learning environments. Discuss
Diversity and Learning
diversity issues, like abilities (physical,
developmental, emotional, cognitive), age cohorts &
inter-generational relationships, gender, religion,
language & ethic background.
Review important principles & tips about giving
Effective Feedback & Evaluation
effective feedback both on an ongoing basis & in
summary situations. Add practical teaching &
evaluation strategies/techniques to your repertoire.
Conflict is an everyday occurrence in health care
Managing & Harnessing Conflict
environments. Help students to recognize, manage
in Health Care
& harness conflict. Help students to learn to use
FULL DAY
creative & supportive strategies for successful
conflict management.
Understand the principles of student-centred
learning in our BScN curriculum, including selfStudent-Centred Learning
directed learning & problem-based learning. Use of
learning plans in professional practice courses is
featured. Critique several learning plans.
Focus on the key role that you play in teaching &
role modelling professional behaviours. Learn about
Teaching Professional Behaviours
ways to assess, model, teach positive professional
behaviours that are so critical in today’s health care
arena.
For further information about the schedule of our upcoming
Preceptor Workshops,
Contact Betty McCarthy, Secretary to the Preceptorship Program at:
bmccarth@mcmaster.ca or via 905 525-9140 x 22405.
©2012, McMaster University. All rights reserved. No part of this publication may be reproduced or
transmitted in any form or by any means without prior written permission from McMaster University.
The three interrelated components of the circle above
represent the collaboration within the preceptorship triad.
Together, the nursing student, preceptor, and faculty tutor
form a unique and cohesive partnership.
The triad’s principal goal is to assist the learner in making
the transition from that of a nursing student to a
professional nurse.
The component shapes and configuration illustrate the
dynamic nature of the partnership. At once, the three
members are both teachers and learners.
In this reciprocal relationship, the growth of each member
and contribution to the professional expectation of life-long
learning are facilitated.
Making and sustaining this pivotal commitment influences
the next generation of professional nurses; and it enriches
each triad member at a personal and professional level.
Shaping the profession, one nurse at a timeTM.
Printed by Allegra Print & Imaging, Hamilton, ON
www.allegrahamilton.ca
Table of Contents
Le er to our Preceptors ................................................................. 2
About the Preceptorship Handbook
.................................................................................................................................... 3
About the McMaster Mohawk Conestoga BScN Program
Mission and Philosophy .............................................................................................. 3
Model of Nursing ........................................................................................................ 4
Model of BScN Nursing Educa on .............................................................................. 6
What is Self-Directed Learning (SDL)? ........................................................................ 6
What is Person-Based Learning within a Problem-Based Learning Approach? .......... 7
Overview of the Kaleidoscope (Renewed) Curriculum ............................................... 7
Key Kaleidoscope Curriculum Themes and Concepts ................................................. 8
Goals of the BScN Program......................................................................................... 9
Overview of Our Three-site BScN Program .............................................................. 10
BScN Program Clinical Reasoning and Judgment Model .......................................... 11
Overview of the Courses in the Kaleidoscope Curriculum ....................................... 13
Professional Prac ce Courses ................................................................................... 17
About Preceptorship
Our BScN Program’s Preceptorship Framework ...................................................... 21
Experien al Learning ................................................................................................ 23
Roles & Responsibili es ........................................................................................... 24
About Preceptor Func ons & Role Modelling
Role Modelling by Preceptors................................................................................... 31
Orien ng................................................................................................................... 32
Assessing
About Assessment in Professional Prac ce Courses (including evalua on) ..... 33
Learning Plans .................................................................................................. 35
Facilita ng ................................................................................................................ 38
Major Teaching Strategies:Ques oning & Feedback ........................................ 40
Guiding ..................................................................................................................... 45
Supervision & Coaching ................................................................................... 45
Suppor ng ................................................................................................................ 47
Types of Support............................................................................................... 47
Understanding Difficul es in Learning.............................................................. 48
Managing a Learning and/or Performance Challenge ...................................... 49
Administra ve Considera ons ...................................................... 51
References ..................................................................................... 53
Suggested Resources ........................................................................................54
Appendices ...........................................................................................................62
A: Glossary of Terms ................................................................................................. 62
B: Principles of Adult Learning ................................................................................. 65
C: Examples of Care Scenarios Across the Program Levels ....................................... 66
D: Professionalism Documents Related to Profession Prac ce Courses .................. 70
E: Nine Tips for Giving Feedback .............................................................................. 73
F: Preceptor Version Level IV Professional Prac ce Evalua on Tool ........................ 75
H: Evalua on of Clinical Preceptor Performance ...................................................... 78
G. Suppor ng the Student in Difficulty..................................................................... 79
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Dear Preceptors,
We are very apprecia ve of your educa onal contribu ons. Thank you for all that
you do to support and nurture senior nursing students!
The McMaster Mohawk Conestoga BScN Program has changed. A er engaging in
a lengthy process of curriculum renewal, we have emerged with what we call the
Kaleidoscope Curriculum. This renewed curriculum emphasizes the person first,
and then the diagnoses or problems. The holis c and person-centred features bring
person-based learning (PBL) to our tradi onal educa onal model of problem-based
learning; it is Person-Based Learning within a Problem-Based Learning approach
(PBL PBL).
With every turn, a kaleidoscope provides a different image or picture, and so it is
with our Kaleidoscope Curriculum. Students learn to apply mul ple ways of knowing to their pa ent-centred nursing care. As with the unique images produced by a
kaleidoscope, using mul ple ways of knowing reveals different ways of seeing the
pa ent, family and health care. This reflects an emphasis on clearly ar culated concepts that students encounter in greater depth as they progress through their course
of studies.
All of the BScN Program’s senior students that you will be precep ng have been immersed in the Kaleidoscope Curriculum. Level IV students comple ng the Program in
2013 were the first to graduate from our renewed curriculum and have experienced
a shi to a Person-Based Learning within a Problem-Based Learning approach.
In addi on, we have integrated more clinical simula on experiences across all four
BScN levels and we expect that you will see students with greater competence and
confidence in the prac ce se ngs. You will begin to see students more ready to contribute to the health and well-being of those that they encounter. Also, in the final
professional prac ce course of the program, students’ required direct care hours
increase, providing them with more nursing experience and integra on of learning
before gradua on.
Finally, have you registered to take advantage of LibAccess? With the use of an Internet connec on LibAccess provides full electronic access to McMaster University’s
vast collec on of online journals, books, and other documents. It is truly amazing
and it’s free! LibAccess is available for your use over a year (September –
August ). See Suggested Resources for applica on informa on.
Together we are shaping the profession, one nurse at a me.
Respec ully,
Olive Wahoush,
Assistant Dean, Undergraduate Nursing Educa on
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About the Preceptorship Handbook
The primary purpose of the Handbook is to provide preceptors with a resource to
facilitate effec ve preceptorship experiences. Because all preceptors may not have
had the opportunity to a end the BScN Program Introductory Preceptorship Workshop, and one or more of the advanced workshops prior to precep ng students, the
Handbook has been designed to address the fundamentals of preceptorship.
Please see the Preceptorship Ready Reference Guide for Preceptors and the professional prac ce course material inserted in this Handbook. In most cases, electronic
course and preceptorship material has been uploaded to the health agency’s intranet.
Students and faculty tutors have access to the Handbook and their versions of the
Preceptorship Ready Reference Guides via an electronic learning environment available through McMaster University.
Finally, Appendix A: Glossary of Terms provides defini on for words and phrases
related to the curriculum renewal.
To learn about the symbolism of our Preceptorship Program
logo, see the inside of the back cover.
About the McMaster Mohawk Conestoga
BScN Program
Mission
We strengthen the contribu on of nursing to the improvement of health for all, locally
to interna onally, through the discovery, communica on, and knowledge applica on.
Philosophy
We believe that nursing is a scien fic and humanis c ac vity of professional caring.
The goal of nursing is the promo on and restora on of health. The following concepts
are central to our philosophy: PERSON/CLIENT, HEALTH, HEALTH PROMOTION, HEALING, CONTEXT, PROFESSIONAL CARING, LEARNING, and KNOWING.
We believe that LEARNING is a process of inquiry and collabora on in which the
student, preceptor, and tutor work toward a common goal/outcome. The process is student-centred and occurs through dialogue within a context of respec ul
rela onship(s).
Effec ve collabora on implies mutual respect and trust, shared accountability and responsibility, and the recogni on and u liza on of the strengths of
each partner within the collabora ve rela onship.
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About the McMaster Mohawk Conestoga BScN Program
We believe that learning is a process of inquiry and collabora on in which the
student, preceptor and tutor work toward a common goal/outcome. The process
is student-centred and occurs through dialogue within a context of respec ul
rela onship(s). We believe:
 Learning requires each of the par cipants to engage in cri cal reflec on
and self-assessment leading to personal and professional growth.
•
Knowledge and KNOWING are the outcomes of learning. Knowing
involves knowledge of self and others, understanding of the meaning of
situa ons from objec ve and subjec ve perspec ves, and the significance of these situa ons to self and others.
•
Knowledge is the form of knowing that can be communicated with others. Knowing and knowledge enable judgments to be made regarding
responsible and ethical ac ons.
Model of Nursing
This diagram of the McMaster Model of Nursing (Fig. 1) illustrates what occurs
during a health-related episode when a nurse and person (individual, family,
group, community, popula on) come together in a nurse-person rela onship.
Either the nurse or the person may ini ate this rela onship.
Figure 1: Model of Nursing
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About the McMaster Mohawk Conestoga BScN Program
Each nurse-person interac on occurs in a present context (involving both iinternal
and external factors, such as , lifestyle choices, environment), but is influenced by
past context for both the nurse and the person, as a result of their lived experiences. The present context may be highly dynamic and may therefore be constantly
changing as the nurse-person rela onship develops.
Within the rela onship, the nurse and the person engage in DIALOGUE, which
is a mutual exchange of messages. These messages may be verbal, non-verbal,
emo onal, spiritual or physical. The purpose of dialogue is to explore the meanings that the current health-related situa on has for both person and nurse. The
person and nurse enter into an authen c rela onship and use communica on,
self-awareness, knowledge, skills, and life experiences to understand the meaning
of the client situa on. The nurse must understand this meaning from the person’s
point of view and validate this interpreta on with the person. This is MUTUALITY.
If, through dialogue, the nurse and person are unable to reach mutuality, the
nurse then engages in cri cal self-reflec on. Resources, knowledge and other
strategies for reassessing her/his own professional and personal understanding of
the nurse-client rela onship. The person situa on and the meaning that situa on
holds for the person. Once the nurse and person have established a mutual understanding of the person’s context, capaci es, needs and goals, the partnership is
directed toward suppor ng the person to meet these needs and goals.
Nursing interven ons are ac ons of professional caring that enable the person to
achieve or maintain their fullest health poten al. Nursing interven on results in
an altera on in the person’s internal and external personal context. Professional
caring may include working with other members of the health care team. In these
instances, interven ons may be directed outside of the health care context to
other sectors relevant to the person’s health-related situa on (e.g., educa on,
social services, poli cal).
Once the person context is altered, the nurse and the person re-engage in dialogue to explore the meaning of the person’s current health-related situa on and
to plan for further interven on(s). This may include a mutual decision to terminate the nurse-person rela onship.
If you want one year of prosperity, grow grain.
If you want ten years of prosperity, plant trees.
If you want one hundred years of prosperity, educate people.
- Based on a Chinese proverb
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About the McMaster Mohawk Conestoga BScN Program
Model of BScN Nursing Educa on
Our BScN Program curriculum is based on adult learning theory and principles
(see Appendix B: Principles of Adult Learning). Self-directed and person-based
learning are central within a problem-based educa onal approach (see Figure
2: Model of BScN Nursing Educa on).
This cyclical model depicts the transforma on that occurs when one or more
learners come together with a facilitator (peer, faculty tutor, preceptor, or other
person) and engage in dialogue. Through mutuality, teaching-learning intervenons lead to altered context. Learners construct their meaning and understanding of situa ons and come to know nursing.
Figure 2: Model of BScN Nursing Educa on
What is Self-Directed Learning (SDL)?
Through self-directed learning, students are encouraged to iden fy their learning needs and goals; suggest strategies to meet those learning needs; and
assume an interest in assessing their progress towards the achievement of the
established goals. Self-directed learning is closely related to the principles of
adult learning (Appendix B: Principles of Adult Learning).
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About the McMaster Mohawk Conestoga BScN Program
What is Person-Based Learning (PBL) within a ProblemBased Learning (PBL) Approach?
Problem-Based Learning (PBL) is the pedagogical approach and hallmark of
teaching and learning in McMaster University’s Health Sciences programs.
Problem-based learning facilitates a cogni ve learning approach; involves the
student in ac ve, par cipatory inquiry; and implies that there is a problem
to be solved. Building from this approach, the McMaster School of Nursing’s
Kaleidoscope Curriculum shi s the focus from the problem to the person;
hence, Person-Based Learning within a Problem-Based Learning process or
PBL PBL. This shi , both in language and process, reflects the inclusion of the
whole person as the springboard for learning. Students are ini ated into the
cycle of learning through “care scenarios,” that include narra ves about the
person (individual, family, community, system). See Appendix C: Examples of
Care Scenarios.
The person is put into the centre of the problem-based learning process with
a narra ve that brings the person’s story to life. Each narra ve is shared in a
media form, such as, a short video, which engages the students in the person’s experience and the poten al experience of the nurse. It is the person’s
story that leads to ac ve learning, as opposed to learning about the problem
and topics from a discipline-specific perspec ve. Relevant health and illness
data, as well as system’s level informa on are part of the learning process.
Through group discussion, and applica on of the clinical reasoning and judgment processes to concepts introduced in the care scenarios, students learn
about the hallmarks of professional nursing.
PBL PBL explicitly integrates the five ways of knowing (Chinn and Kramer,
2008) in nursing throughout each care scenario which include:
• empiric (scien fic),
• ethical,
• personal,
• aesthe c (the percep on of depth of meaning that is used crea vely to
develop nursing ac ons), and
• emancipatory (recogni on of unfair and unjust social situa ons that
s mulate posi ve changes in people’s lives) .
Overview of the Kaleidoscope (Renewed) Curriculum
Advances in cogni ve psychology suggests that mul ple exposures to concepts
in different context help students to learn concepts. Learning concepts, rather
than just content, can later be readily applied to future situa ons. Nursing
courses in the Kaleidoscope Curriculum are organized and sequenced around
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About the McMaster Mohawk Conestoga BScN Program
key nursing concepts. Concepts are presented through the nursing and science courses,
and across lifespan and clinical prac ce se ngs. Concepts are revisited over the years
with increasing depth of explora on and complexity.
Integrated into the nursing courses (PBL PBL, professional prac ce courses) are evidence-informed decision-making modules and learning ac vi es. Beginning in Level 1,
students learn essen al informa on about how to use the best available scien fic evidence to inform their prac ce. Students learn how to use literature databases and the
hierarchy of evidence. They learn about research methods and designs, how to design
a research ques on, and how to cri cally appraise research in increasing complexity as
students move through the Program.
Key Kaleidoscope Curriculum Themes and Concepts
Themes
The themes that guide our Kaleidoscope Curriculum include:
•
•
•
Personhood and Caring: Focusses on the humanis c aspect of nursing beginning with a focus on the nurse and client as a person, and the
professional therapeu c rela onship between nurse and client.
Context, Health and Healing: Focusses on the internal and external influences on health and the nurse’s ability to provide safe and competent
care as part of the health care team within a health care system and
broader community.
Learning and Knowing: Focusses on cri cal inquiry, discovery and appropriate use of technology within nursing to facilitate lifelong learning
and reflec ve prac ce.
Concepts
Advocacy
Change
Communica on
Cri cal Inquiry
Diversity
Interprofessional Teamwork
Leadership
Nursing as a Profession
Professional Nursing Care
Research
Technology
Frequently recurring concepts are grouped together under the curriculum themes.
Concepts may link to other themes/concepts, as well. See the summary of concepts
that follows.
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About the McMaster Mohawk Conestoga BScN Program
Personhood & Caring
Context, Health & Healing
Learning & Knowing
Concepts
Concepts
Concepts
Communica on
Change
Cri cal inquiry
Nursing as a profession
Interprofessional teamwork Technology
Leadership
Professional nursing care
Advocacy
Diversity
Research
Goals of the BScN Program
The BScN Program goals are informed by the concepts and themes in
our Kaleidoscope Curriculum. Graduates of McMaster University’s BScN
Program will be prepared to provide competent professional prac ce in
a variety of health care contexts, and with diverse clients across the lifespan who have stable and unstable outcomes and mul -factorial influences (internal and external) on their health status. Graduates will:
1. Provide competent care with a holis c awareness of the impact of the
internal and external context on health and healing.
2. Integrate an understanding of the client’s unique perspec ve on his/
her health and how this perspec ve influences par cipa on in one’s
health care.
3. Iden fy the need for appropriate change in health care. Create a
climate for adop ng change. Contribute to effec ng and evalua ng
change.
4. Build rela onships in a team environment and be ac vely engaged in
team decision-making around client care.
5. Contribute to the body of nursing knowledge through demonstra ng
an inquiring approach to prac ce.
6. Provide technologically appropriate care in a variety of contexts.
7. Contribute to the future of the nursing profession through a commitment to lifelong learning and professional growth. Integrate cri cal
inquiry into professional prac ce.
8. Assume leadership roles in partnership with clients and health care
team.
9. Assume advocacy roles in partnership with clients and the health
care team. Challenge inequi es that have an impact on the health of
clients.
10. Prac se within the professional standards, guidelines, legisla on and
values of the nursing profession.
11. Establish therapeu c partnerships with clients to enhance health
and healing. Communicate effec vely in a variety of media.
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About the McMaster Mohawk Conestoga BScN Program
Overview of Our Three-site BScN Program
Figure 3: 2012-13 BScN Students Receiving Degrees Conferred
by McMaster University
Notes:
1.
Preceptorship is used as the educa onal approach in professional prac ce
courses at the senior level with the Basic, Basic-accelerated, Post-Diploma,
and RPN to BScN Streams, as well as with cer ficate programs.
2.
The Basic Stream prepares undergraduate nursing students for prac ce as
Registered Nurses. Students in this four year stream typically enter directly
from high school. The Program includes professional prac ce courses, nursing
theore cal courses, sciences, pharmacology, research, sta s cs, service
learning and elec ves. This stream is delivered using the same content and
educa onal strategies across the three ins tu onal sites.
3.
In a three year Program the RPN to BScN Stream prepares students
who are Registered Prac cal Nurses.
4.
Over a 20 month period the Basic-accelerated Stream prepares students with
a previous university degree (or part of a degree) with a science background.
5.
Post-Diploma Stream students enter the BScN Program in Level III and take
Level IV professional prac ce courses.
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About the McMaster Mohawk Conestoga BScN Program
BScN Program Clinical Reasoning and Judgment Model
Tanner (2006) describes clinical reasoning as “the processes by which nurses and
other clinicians make their judgments, and includes both the delibera ve process of
genera ng alterna ves, weighing them against the evidence, and choosing the most
appropriate…”(p. 204-205). Clinical judgment is “an interpreta on or conclusion about
a pa ent’s needs, concerns, or health problems, and/or the decision to take ac on (or
not), use or modify standard approaches, or improvise new ones as deemed appropriate by the pa ent’s response” (Tanner, 2006, p. 204).
The nursing process is the decades old framework for approaching a pa ent situa on,
using the problem-solving method: assessment, nursing diagnosis, planning, implementa on and evalua on. Current nursing research indicates that our clinical thinking
processes are best described as clinical reasoning and judgment. In fact, clinical reasoning and judgment build on the nursing process and provide a broader base for using our mul ple ways of knowing and own personhood to provide person-based care
to our pa ents. With these ideas in mind, we have moved to using Tanner’s model of
clinical reasoning and judgment. This shi means that in our BScN Kaleidoscope Curriculum we have endorsed Tanner’s clinical reasoning model, formally known as the
Clinical Judgment Model (see figure below). Our Program no longer uses the nursing
process or North American Nursing Diagnosis Associa on’s (NANDA) model.
Tanner developed a research-based model of clinical judgment that details nurses’
thinking when they are engaged in clinical decision-making. Tanner’s (2006) model
uses four phases that are part of an ongoing thinking process. These phases are no cing, interpre ng, responding and reflec ng. In our Kaleidoscope Curriculum, Level I
students begin to learn how to use Tanner’s model which is fully integrated throughout each Level of the Program.
Figure 4: Clinical Judgment Model (Tanner, 2006)
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About the McMaster Mohawk Conestoga BScN Program
Below are the four major aspects of the clinical reasoning and judgment model and
its processes.
No cing is more than assessing. It refers to the nurse’s expecta ons of the situa on
(whether or not they are made explicit). No cing involves what the nurse already
knows from experience, personal and professional, and what expecta ons she/he
has for the pa ent based on this understanding. These expecta ons stem from the
nurse’s knowledge of the par cular pa ent and his/her pa erns of responses; their
clinical or prac cal knowledge of similar pa ents drawn from experience; and their
textbook knowledge. It also includes aspects of the context, such as the nurse’s values, the culture of the unit, etc.
Interpre ng occurs when a reasoning pa ern is triggered based on the nurse's “nocing” and ini al grasp of the situa on. Addi onal assessments may be performed
to help iden fy and rule out hypotheses un l the nurse forms an interpreta on and
suggests an appropriate response. Pa ern recogni on is important at this point.
Responding occurs following the point at which an interpreta on is formed. A er
that point, further decision-making about a course of ac on is undertaken (which
may include a decision that no ac on is needed). This is called responding (ac ng).
Reflec on includes two types of reflec on. Reflec on-in-ac on refers to the nurse’s
ability to “read” the pa ent and adjust the interven ons based on that assessment.
Several itera ons of this process may be necessary. Reflec on-on-ac on refers to
cri cal reflec on by the nurse about the process of care and the outcomes. This type
of reflec on completes the cycle when, a er reflec on, the nurse gains knowledge
from the insights gleaned, thereby enhancing clinical learning which can be applied to
a similar or iden cal future experience.
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About the McMaster Mohawk Conestoga BScN Program
Overview of the Courses in the Kaleidoscope Curriculum
Table 1 provides informa on about the major educa onal foci and courses delivered across each level of the BScN Program.
Table 1: Overview of BScN Courses, Level I-IV
Level I
PBL PBL
Professional
Prac ce
Group process,
working in
groups, group
roles and mo vaon
Health nursing
as a profession
Introduc on to
reflec on
Informa on literacy
Clinical reasoning & judgment
Pa erns of
knowing in
nursing
Clinical ques ons
Transi on and
change theory
McMaster Model
of Nursing
Therapeu c
communica on
Introduc on to
health assessment
Infec on
preven on &
control
Comple on of
7 care scenarios
over 2 terms
Scholarly wri ng
EIDM
Sciences
(Evidenceinformed
Decision-Making)
Foreground and
background
Finding best available evidences
CRAAP: (Currency, Relevancy,
Authority, Accuracy,
Purpose)
Introduc on to
database searching, hierarchy of
evidences PICO PS
Vital signs
Pain assess
ment
Musculosketal
posi on &
transfer
Professional
caring
Health Teaching
Assignment
Field trip to community centre
for health older
adults
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Human
anatomy &
physiology
Human biochemistry
Service
Learning
32 hours community service/
volunteer in
community
agency; wri en
reflec ons, small
group discussion,
por olio
About the McMaster Mohawk Conestoga BScN Program
Table 1: Overview of BScN Courses, Level I-IV (cont’d)
Level II
PBL PBL
Professional
prac ce
Clinical reasoning
applied to care
scenarios
Clinical reasoning
Group theory
Change theory
Nursing theory
Leadership
Diversity
Therapeu c
communica on
Infec on
preven on and
control
Surgical asepsis
& wound care
EIDM
Sciences
Other
Nursing
Courses
Pathophysiology:
- Stress & adapta on
Service Learning
(Evidenceinformed
Decision-Making)
Review of EIDM,
6S pyramid of
evidences
Research design:
Quan ta ve and
qualita ve
Model for
Evidence-informed
Clinical Decisions
- Diabetes
Type 2
- Cardiovascular
disease
- COPD, asthma
Review PIC/PS
Nursing as a
profession &
professional
organiza ons
Inter-professional
teamwork
Advocacy
Comple on of
11 care scenarios
over 2 terms
Medica on
Administra on
Intravenous
therapy
Oxygen therapy
32 hours of service/volunteer
in a community
agency over 2
terms; wri en
reflec ons, small
group discussion,
final por olio
Type of ques on
and selec ng study
design
Cri cal appraisal
of quan ta ve and
qualita ve studies
Tube care and
enteral feeding
- Childhood
obesity
- Depression
inflamma on &
immunity
- Fluid & electrolytes
- Delirium
Urinary catheters
Pharmacology
Microbiology
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Social Determinants of Health
About the McMaster Mohawk Conestoga BScN Program
Table 1: Overview of BScN Courses, Level I-IV (cont’d)
Level III
PBL PBL
Professional
prac ce
EIDM
(Evidence-informed
Decision-Making)
2 simula ons
( 1 each term)
Cri cal appraisal of
RCT’s
Group facilita on
Parenteral
medica on
Cri cal appraisal of
qualita ve studies
Concept integraon
Interprofessional prac ce
Clinical reasoning
Pathophysiology
integra on
Accurate and
refined pa ent
assessment,
systema c approach
Learning &
working in large
groups
Enac ng professional caring
Diversity of professional roles
Ways of knowing
Comple on of
10 care scenarios
over 2 terms
Family violence,
duty to report
Cri cal appraisal of
prac ce guidelines
Sciences
Pathophysiology
- Altera on in
reproduc ve funcon
- Altera on in
mental health;
schizophrenia &
psychosis
- Inflamma on
- Immune Response
Recognize
changes &
devia ons in
pa erns of
responses
Nutri on
Biochemistry
Iden fy & priori ze pa ent
issues using the
clinical reasoning model
Able to respond
with appropriate intervenons, guided
by principles
of therapeu c
rela onships,
best evidence,
safe prac ce,
professional
standards and
legisla on
- 15 -
Community
Nursing
6 hours per week
over one term
Community
health nursing
prac ce with
individuals,
families, groups,
communi es
and popula ons
in variety of setngs
About the McMaster Mohawk Conestoga BScN Program
Table 1: Overview of BScN Courses, Level I-IV (cont’d)
Level IV
PBL PBL
Professional prac ce
Nursing &
Research
Process
Remaining
Elec ves
Leading as influencing
Complete, systema c assessment, uses to guide clinical
reasoning and decisions making
Becoming & belonging
in nursing
Care of pa ents with increasing
complexity
Enables students to
learn about the research process from
the lens of a beginning researcher
All elec ves
must be
completed
by the end of
Term 1
Transi on
Collabora on with interprofessional tem and nursing
colleagues
Leadership
Integra on
Complexity
Implements well planned nursing ac ons
Inter-professional collabora on
Reflec on
Joining a community
of prac ce
Considers influence of beliefs
and values on clinical reasoning
Exposed to a variety
of experienced
nursing researchers from academia,
clinical prac ce,
and from our community
Virtual and actual
execu on of components of nursing
research projects
Facilita on
EIDM (Evidenceinformed DecisionMaking)
Comple on of 9 care
scenarios in Term l
Comple on of 6 care
scenarios in Term 2
Integra on of
concepts and use of
research in clinical
reasoning process
Capstone Project (end
of Term 2) provides
students with an opportunity to iden fy a
prac ce issue, design
an ac vity to address
it, and disseminate
their work
- 16 -
About the McMaster Mohawk Conestoga BScN Program
Professional Prac ce Courses
Person-centred caring is central to our curriculum and our teaching-learning. Person-centred caring is accomplished by listening to the person’s
story, being nursing presence, and crea ng a caring professional rela onship. The BScN Program emphasizes the process of learning to build lifelong learning skills required of a professional nurse. The acquisi on of skills
for caring prac ce in the BScN Program is context-specific. Focus is placed
on clinical reasoning and judgment, ways of knowing, problem-solving,
evidenced-informed decision-making and being and becoming a professional.
Table 2: Descrip on of Professional Prac ce Course Experiences
Levels I - IV
Level
Descrip on
I
In a simulated learning se ng, students learn with a tutor 4 hours/
week focussing on founda onal nursing skills (e.g. hand washing,
therapeu c communica on, vital signs, physical assessments).
II
In small groups, students are supervised by a faculty tutor prac ce in
health agency placements for 8 hours/week. All students complete
1 medical and 1 surgical placement a er 3 weeks of simula on in
prepara on for the placement, including: infec on preven on and
control, medica on administra on,OR surgical asepsis (depending on
the placement), intravenous therapy, oxygen therapy, tube care (NG
tube, enteral feeding tube, catheter) & urinary catheteriza on.
III
In small groups, as in Levels I and II, students are supervised by a
faculty tutor in the prac ce placement(s) for 12 hours/week. Placements include: acute and varied se ngs (e.g. paediatrics, mental
health, maternal/child). In groups of 2-3, students experience community prac ce under the supervision of community placement
professionals and faculty tutors.
IV
Using a preceptored educa onal approach, students are individually placed in a variety of professional prac ce se ngs where they
are engaged in the nursing role for 24 hours/week for 12 weeks in
first term and in the second Term, 24 hours per week in the first
six weeks, and 35 hours per week in the last 6 weeks. Students are
supervised directly by the preceptor and indirectly supervised by the
tutor.
- 17 -
About the McMaster Mohawk Conestoga BScN Program
Table 3: Details about Professional Prac ce Courses Across Levels
Level
Hours
Prac ce Se ng Foci
Prac ce
I
4 hours/week
Lab, university/ Health nursing
college, comas a profession
munity se ng Intro to reflecon
Clinical reasoning and judgment
Pa erns of
knowing in
nursing
Therapeu c
communicaon
Health assessment:
Hygiene
Infec on
preven on and
control
Mobility
Cardiovascular
Respiratory
Abdominal
Intro to neurological
Musculoskeletal
Vital signs
Pain assessment
II
8 hours/week
Acute care hos- Altera ons in
pital; medical
health
and surgical
Clinical Reasoning and
judgment
Therapeu c
Communicaon Nursing as
a profession
Infec on
preven on and
control
Surgical asepsis
and wound
care
Medica on
adsministra on
Intravenous
Therapy
Oxygen
therapy
Tube care and
enteral feeding
Urinary catheters
- 18 -
About the McMaster Mohawk Conestoga BScN Program
Table 3: Details about Professional Prac ce Courses Across
Levels (cont’d)
Level
Hours
Prac ce Se ng
Foci
Prac ce
III
12 hours/
week
Varied, acute
medical/surgical
including subspeciali es, such
as, neuro, peds,
ortho, oncology,
community, long
term care, palliave care
Interprofessional
prac ce
2 simula on, 1 each
term
Increasing paent complexity
Parenteral medica on
Clinical reasoning and judgment
Accurate and refined
pa ent assessment,
systema c approach
Recognize changes and
devia ons in pa erns
of responses
Priori ze pa ent issues
using the clinical reasoning model
Able to respond with
appropriate interven ons, guided by
principles of therapetuc
rela onships, best evidence, safe prac ce
Professional standards
and legisla on
IV
Term 1
Term 2
12 weeks Many and varied, Integra on
288 hours including local,
provincial, interna- Transi on into
onal
professional
community of
prac ce
First 6
weeks
Increasing pa144 hours
ent complexity
Last 6
weeks
Leadership
210 hours
Health care
system
Interprofessional
collabora on
- 19 -
Complete systema c
assessment, using assessment to guide
clinical reasoning and
decision-making of
pa ents with increasing
complexity
Implements well
planned nursing ac ons
Reflec on
Considers influence of
beliefs and values on
clinical reasoning
24 hours/week (288hrs.)
Individual, family, community, popula on
Dependent on learning needs & context
Context-specific
Client focus
Pa ent Load
Professional Skill Development
- 20 -
Several major components & individualized
learning plan (finalized by midterm with
comple on by wk. 11)
At midterm & final evalua on, student, preceptor & tutor complete the role-specific Tool
& meet during professional prac ce me to
discuss the evalua on
Refinement
Approx. 8 hours/week
Several major components & individualized learning plan (finalized by midterm
with comple on by wk. 11)
At midterm & final evalua on, student,
preceptor & tutor complete the rolespecific tool & meet during professional
prac ce me to discuss the evalua on
Use of Clinical Reasoning
Model
Other Courses
Academic Assignments in
the Professional Prac ce
Course
Professional Prac ce Performance Evalua on Tool
PBL PBL (6 hours/week) during the first six
weeks of the term
Refinement
Yes
Research U liza on
Yes
Context-specific
Dependent on learning needs & context
Individual, family, community, popula on
1st 6 weeks: 24 hours/week (144 hrs.) Final 6
weeks: 35 hours/week (210 hrs.)
12 weeks
12 weeks
Length of Course
Hours/Term/Week
Term 2
Learning and refining with integra on in the
final 6 weeks of the course
Term 1
Learning and refining
Focus
Features of the
Experience
Table 4: Features of Level IV Professional Prac ce Courses
About the McMaster Mohawk Conestoga BScN Program
About Preceptorship
Our BScN Program’s Preceptorship Framework
Figure 5: Preceptorship Framework
Preceptorship is viewed within the context of professional nursing and its major
domains of prac ce, educa on, research, administra on, and policy.
Preceptorship is a process that fosters reciprocal learning among the teachinglearning triad (student, preceptor, and faculty tutor) and experien al learning is
central to this collabora on (Tran, 2008). Experien al learning (see Figure 6) assists
learners in making the transi on from the senior student role to that of a professional nurse.
A number of concepts contribute to successful comple on of this educa onal
approach to professional prac ce. Effec ve communica on is founda onal to the
development and maintenance of the preceptorship triad, and it also is vital to the
delivery of safe nursing care and sa sfac on with teamwork. Competence
- 21 -
About Preceptorship
and caring are fundamental expecta ons of the professional prac ce experiences, as is ethical prac ce (conscience) and comportment, which refers to
professional behaviours to which students are socialized (for example, appropriate workplace grooming and a re, interac on with pa ents, families, and interprofessional team members). All members of the triad make a commitment to
the experience. Students commit to their educa onal development, striving to
achieve entry-to-prac ce competencies; preceptors commit to ac ng as role
models and clinical teachers; and faculty tutors commit to providing educa onal
support and guidance to the preceptors and students during the preceptorship
experience.
Collabora on occurs both formally and informally. Clinical agencies formally
agree to collaborate in students’ professional prac ce learning and each triad
informally agrees to form a partnership that meets the goals of the professional
prac ce courses. As learners, each member of the triad assists one another in
developing confidence in their respec ve educa onal roles. Finally, all three
members make a contribu on to the health and health care of ci zens, as well
as to the future of nursing.
The BScN Program has produced Guidelines for Professional Behaviours in the BScN Program (see the Appendix D: Professionalism in
Professional Nursing Prac ce) which correspond to the College of
Nurses of Ontario (CNO) 2008 Entry-to-Prac ce Competencies for
Registered Nurses (CNO, 2009). These competencies fall under the
headings: Professional Responsibility & Accountability, Knowledgebased Prac ce, Ethical Prac ce, and Service to the Public.
Following the Guidelines, please find the McMaster Mohawk Conestoga BScN Program Professional Appearance Policy.
- 22 -
About Preceptorship
Experien al Learning
Figure 6:
An Experien al Learning Cycle for Nursing
Educa on in Professional Prac ce Courses
This cycle illustrates steps or phases through which students and preceptors
progress in professional prac ce learning encounters.
Step 1
Having a prac cal experience - Depending on the situa on, the
experience may range from an observa on through to autonomous
prac ce.
Step 2
Sharing the experience - Preceptors and others assist students to
relate previous knowledge and experiences to new informa on and
ideas.
Step 3
Reflec ng on the experience - Preceptors and others a end to students’ observa ons, ques ons, and/or inferences that may lead to
new insights (reflec on-on-ac on)
Step 4
Discussing important aspects of prac ce based on the reflec on Learning needs are iden fied. Preceptors and others pose ques ons
and ideas that may involve revising old approaches or adop ng new
ones.
Step 5
Assessing the learning and planning for future experience(s) Learning is assessed by students, preceptors and others. Preparaons are made to apply the new learning to future clinical situa ons
that are similar or related to the ini al prac cal experience (Step 1).
- 23 -
About Preceptorship
Roles & Responsibili es
The following roles and responsibili es, par cularly those of the preceptors, are
based on social learning theories and work by Johnston (2004).
Who is the clinical preceptor?
The preceptor is a skilled and mo vated professional nurse who chooses to act
as a clinical teacher, role model, and colleague to a senior nursing student engaged in experien al clinical learning.
In a cross-sec onal survey examining important criteria for selec ng preceptors
as ranked by nurses, students, and faculty, preliminary analysis of the 10 most
important criteria revealed two clear roles at play, prac cing as a nurse, and
being a teacher (Mohide et al., 2012). Selec on criteria related to the nursing
role included clinical competence, confidence in one’s prac ce, good interpersonal skills, and being passionate about nursing. The teaching role included the
following criteria: enthusiasm about teaching, iden fica on of students’ learning needs and facilita on of learning, giving posi ve and construc ve feedback,
and promo ng autonomy. Providing guidance for problem-solving and clinical
judgment straddle both roles (e.g., being effec ve at problem-solving and clinical
judgment, and then providing guidance in learning these processes).
While a preceptor func ons as a clinical teacher and engages the student in
teaching-learning encounters, one of the most powerful educa onal strategies
employed by the preceptor is role modelling. Preceptors also play a key role in
socializing students to the profession.
You will note that in the preceptor diagram on the next page that the preceptor role func ons (e.g., facilita ng) are framed by professional prac ce (clinical)
teaching and role modelling. The frame around the role func ons indicates that
no ma er which of the preceptor roles are being enacted, a preceptor is always
role modelling. Preceptors are, at once, both clinical teachers and role models.
See page 27 for informa on about the co-preceptor role. Co-preceptorship can be
an excellent way to ra onalize resources for the teaching role and it’s a great way
for experienced preceptors to mentor new nurse preceptors.
- 24 -
About Preceptorship
What are the roles of the clinical preceptor?
Please note: Typically, Level IV students in professional prac ce
courses are preceptored by direct care Registered Nurses; however,
in some situa ons, such as, interna onal professional prac ce placements may be precepted by a health/social services professional.
The la er situa ons are set up on a case-by-case basis.
Preceptors:
Orient students:
• considering such topics as, the se ng, the nursing and interprofessional
team, experiences typically available on the unit, skills set required, etc.
• considering students’ previous experiences and professional prac ce
course performance; ask to review previous professional course evaluaons with the student
• clarifying preceptorship triad roles (preceptor, student, tutor) at the beginning of the course
Assess students’:
• learning needs ini ally and on an ongoing basis
• performance via ongoing specific and mely feedback throughout the
course
• progress in learning how to learn with input into the learning plan development (relevance, feasibility, suggested resources)
• performance at midterm and the end of the course via comple on of the
preceptor-specific version of the evalua on tool and recommenda on of
sa sfactory/unsa sfactory performance level
- 25 -
About Preceptorship
Facilitate learning, assis ng students to set and achieve realis c learning goals,
and to move towards more independent prac ce by:
• role modelling high quality nursing prac ce and competencies associated
with being professional nurses
• maintaining ongoing availability to discuss any learning issues and progress
• planning and selec ng a variety of experiences to meet learning needs
• applying appropriate teaching strategies
• discussing the CNO 2008 Entry-to-Prac ce Competencies for Registered
Nurses (CNO, 2009) in rela on to the roles performed in the prac ce se ng
• reviewing strategies that aid in the transi on from the role of a student to
that of a Registered Nurse.
Guide clinical reasoning and judgment, and reflec on through:
• supervision and coaching
• debriefing and reflec on within the context of experien al learning situa
ons (see the Experien al Learning Cycle).
Support students using the following types of support:
• emo onal
• appraisal
• informa onal
• instrumental
See the next sec on About Preceptor Func ons & Role Modelling for
more detail.
- 26 -
About Preceptorship
Implemen ng the Co-Preceptor Role: An
Alterna ve to Assigning One Preceptor to a Student
While we strive to assign one preceptor to one student, factors, such as, agency
staff scheduling and the s pula on that nights not be worked before nursing concepts courses, can present challenges to this model.
U lizing two co-preceptors is an approach that preserves preceptorship as a clinical
teaching method, where factors pose challenges to having one consistent preceptor. With co-preceptors, the two share the clinical teaching responsibili es, teaching consistency is maintained, and successful learning outcomes are facilitated.
This arrangement also enables an experienced preceptor to mentor a new nurse
preceptor!
PLEASE NOTE: The student may occasionally be partnered with other nurses, but
overall consistency in assignment needs to be maintained with the co-preceptors.
Other nurses are expected to provide feedback on the student’s performance.
For the co-preceptor approach to work well (see Preceptor Roles & Responsibilies), the two preceptors must communicate regularly with each other to ensure
that the student i) progresses with the course aims/ends-in-view, ii) receives mely
support to address learning challenges, and iii) is given a wri en mid-term and
final evalua on, incorpora ng feedback from both, and others working with the
student.
Some condi ons apply to the triad when employing co-preceptors:
•
•
•
•
•
One of the preceptors must be designated as the primary preceptor, who is
ul mately responsible for the clinical learning (including the learning plan),
mee ng with the student/faculty tutor (ini ally, and at mid-term and final
evalua ons), ongoing student feedback, and comple on of wri en evaluaons. The secondary preceptor is expected to contribute to the clinical learning, ongoing student feedback, and formal evalua on.
Prior to mee ng the student, the co-preceptors should have a preparatory
discussion to nego ate the roles of the respec ve co-preceptors (primary or
secondary) in advance of the student orienta on. If possible, both preceptors
should be at the ini al student/faculty tutor mee ng.
To promote consistency over the term, the student is expected to nego ate
the learning plan with the co-preceptors and maintain ongoing communicaon with them. The co-preceptors are expected to discuss the student’s progress in a aining the course aims and the learning goals. If mee ng to address
learning challenges, both preceptors should a end, wherever possible.
Co-preceptors are encouraged to consult with the faculty tutor about copreceptorship issues related to the student; the co-preceptors also may wish
to consult the clinical educator about the use of this approach.
The faculty tutor is expected to forward the names and contact informa on
for both preceptors to the BScN Program Office in a mely fashion.
- 27 -
About Preceptorship
Who is the BScN student?
In rela on to preceptored Level IV professional prac ce courses, the BScN
nursing student is a learner in a clinical prac ce se ng who uses the course
resources and a self-directed learning plan to fulfill learning needs.
What are the roles of students?
Students:
Review current level of knowledge, experience, and skills as a founda on for further
growth and development in the current course/placement
Assess learning needs, examine strengths, and areas for improvement by reviewing
previous professional prac ce course evalua ons, and other relevant documents and
develop tenta ve learning plans that are then nego ated with the preceptors and
finalized with the faculty tutors.
Prepare for the professional prac ce experiences by using relevant learning resources. Students are expected to review and prac ce skills, especially psychomotor skills,
in simulated or controlled learning environments. Depending on the BScN Program
site, the environment may be referred to as The Learning Resource Centre or The
Centre for Simula on-Based Learning.
Enact nursing roles under direct and indirect supervision in the context of the course
ends-in-view and learning plan; students follow the preceptors’ work schedule.
Self-assess their:
• learning needs ini ally and on an ongoing basis
• professional prac ce performance and seek ongoing, specific, and mely feedback throughout the course, in situa ons where it might not be given
• progress in learning how to learn by developing, execu ng, and assessing their
learning plans with input from preceptors and guidance from faculty tutors
• performance at midterm and the end of the course via comple on of the
student-specific evalua on tool and es ma on of a grade.
- 28 -
About Preceptorship
Who is the faculty tutor?
The faculty tutor has one of a number of possible of academic appointments
with McMaster University, Mohawk College, or Conestoga College. The faculty
tutor guides the learner and provides consulta on to the preceptor in educaonal areas that may be unfamiliar. The faculty member play a cri cal role in
orien ng the preceptor and the student to their roles in the partnership.
What are the roles of faculty tutors?
Tutors:
Orient preceptors and students:
•
a ending an ini al mee ng with preceptors and students within the first few
weeks, and providing an ini al orienta on to preceptorship as a teachinglearning approach and the par culars of the course; orienta on and educaon con nues throughout the term, as needed.
Assess students’:
•
learning needs ini ally and on an ongoing basis
•
performance via ongoing specific and mely feedback throughout the course,
with emphasis on the applica on of previous and current learning (e.g.,
pathophysiology, evidence-informed decision-making, personal and professional prac ce experiences)
•
progress in learning how to learn, using various teaching-learning strategies
and learning resources (e.g., learning plan)
•
progress (passing/failing at midterm; pass/fail at the end of the course) via
comple on of the faculty-specific evalua on tool and grade assignment
Link to the BScN Program/University by:
•
communica ng the academic and excepted professional prac ce standards to
students, preceptors, and clinical agencies
•
communica ng the preceptor name(s) and contact informa on to the Program office in a mely fashion
- 29 -
About Preceptorship
•
collabora ng with students, preceptors, agency administrators, and the
BScN Nursing Program in the provision of crea ve, high quality professional
prac ce experiences.
Support students and preceptors by:
• establishing and maintaining regular communica on
• mee ng at the specified mes (within the preceptors’ work hours) to
clarify issues and engage in formal student assessment
•
facilita ng students’ development of their learning plans, with an emphasis
on scien fic and theory-based prac ce
• acknowledging and recognize the efforts of preceptors and students.
Act as consultants & resources by:
• providing ongoing general and individualized preceptorship orienta on/
educa on
• consul ng with students and preceptors, where there are teaching-learning challenges
• ac ng, as appropriate, to assist in resolving conflicts that might arise
For further informa on, see Suggested Resources Websites. Refer to the
CNO Prac ce Guidelines: Suppor ng learners (2005) and the Canadian
Nurses Associa on (CNA) Achieving excellence in professional prac ce: A
guide to preceptorship and mentoring (2004).
- 30 -
About Preceptor Func ons & Role Modelling
Role Modelling by Preceptors
Role modelling is well recognized as a powerful teaching method, especially in
the context of experien al learning. In undergraduate nursing educa on, role
modelling is essen al to both professional prac ce learning and socializa on
into the profession. Role modelling involves observa on and imita on. Ideally,
a role model should be viewed as a person who sets a posi ve example.
Preceptors are influen al role models for nursing students not only in knowledge and competence development, but also in rela on to professional behaviours and socializing students to the nursing profession. Preceptors’ role modelling conveys powerful and long-las ng impressions to students. As an example
of using role modelling strategically, when preceptors make their pa erns of
thought explicit this assists learners in understanding the preceptors’ clinical
reasoning and judgment (Cavalieri, 2012).
What strategies can preceptors use to facilitate their role modelling?
• When preceptors talk to students about what preceptors are thinking, clinical reasoning and judgment can be modelled.
• Explicitly state what is being role modelled in situa ons where the role
modelling might not be recognized as such by students.
• Facilitate access to and experiences with a variety of role models (other
nurses, members of the healthcare team).
• Be authen c – when you are talking with students about your prac ce,
discuss both posi ve and nega ve consequences of events or ac ons. This
shows your use of self and your ability to reflect-on-ac on.
• Provide mely opportuni es for students to prac ce newly acquired learning. Prac ce and feedback reinforce modelling by preceptors.
While this Handbook provides the preceptorship fundamentals,
formal con nuing educa on opportuni es contribute to increased preceptor knowledge, skills and confidence.
- 31 -
About Preceptor Func ons & Role Modelling
Preceptor Func on: Orien ng
When students are being ini ated to clinical se ngs for their professional
prac ce courses, being welcomed to a suppor ve workplace environment
that is conducive to learning and being introduced to team members help
students develop a sense of belonging within nursing and within the health
care team. These condi ons promote students’ learning and also may help
iden fying new recruits to the nursing staff!
During their orienta on to the se ngs, students will be inquiring about the
components of communi es of prac ce (see below):
-Domain: What are the shared nursing competencies, guidelines, and policies
that need to be acquired in order to provide quality care in this se ng? (e.g.,
post-opera ve care for pa ents with cardiac disorders, health history-taking
in a sexual health clinic)
-Community: What rela onships nurture effec ve teamwork and health care?
(e.g., interprofessional team members and community resources)
-Prac ce: What are the typical health care issues for which knowledge,
resources, and a skill set are required? (family mee ngs for newly admi ed
residents to long term care; steps and processes in planning health
promo on projects)
- 32 -
About Preceptor Func ons & Role Modelling
Preceptor Func on: Assessing
About Assessment in Professional Prac ce Courses
About Educa onal Assessments, Including Evalua on
Over the past 10 years, interpreta on of assessment as an educa onal process has
changed. The once rather generic term has now more specific meanings and uses
within educa on. Because assessment is a key aspect of professional prac ces from
both the teacher and the student.
Diagnos c assessment relates to current knowledge and learning, whereby
gaps and learning needs are iden fied.
• This type of assessment is useful during the orienta on phase of the studentpreceptor rela onship, when iden fying learning needs and priori es, and
planning for experien al learning are high priori es.
• Students can conduct diagnos c self-assessments as they review previous
learning, iden fy what new learning will be required, and prepare to enter a
new prac ce se ng at the beginning of professional prac ce course.
Forma ve (ongoing) assessment of performance is followed by specific, mely,
feedback.
• This is helpful in improving performance, especially where there are opportuni es for repeated prac ce of related or similar situa ons within a short
meframe (e.g., applica on of the clinical reasoning model to pa ents with
similar health problems during a course).
• See Appendix E: Nine Tips for Giving Feedback. In the BScN Program, the
midterm evalua on is treated as a forma ve assessment.
Integra ve assessment concerns not so much the material being learned, but
the ongoing goal of discovering effec ve personal approaches to learning.
• For example, well developed learning plans help students learn how to be
life-long learners, keeping pace with current knowledge and prac ce.
• For more informa on about integra ve assessment, see Learning Plans.
Summa ve assessment (evalua on) of learning usually occurs at the end of a
course or some other offering with educa onal aims, such as, specific career
development.
•This evalua ve form of assessment provides a mechanism to iden fy students
who have achieved the course ends-in-view.
•A final passing grade signals acceptable performance and permission to
proceed to the next course or in the case of a career, a higher level of career
development.
Please note: Each member of the triad has a role-specific evalua on tool. For
informa on about the evalua on form and its use, see Appendix F: Preceptor
Version of the Professional Prac ce Evalua on Tool
- 33 -
About Preceptor Func ons & Role Modelling
Table 5: Summary of Performance Assessments
and Assessors within the Triad
Components
Professional Pracce Evalua on
Tool
Midterm (Forma ve) AssessFinal Assessment
ment
(Summa ve Evalua on)
Student completes written self-assessment using
student version of the Tool.
Student assigns a grade
ex mate.
Same process
Preceptor completes wri en
Same process
assessment using the preceptor version of the Tool,
making recommenda onsand assesses the student
as sa sfactory or unsa sfactory.
Same process
Tutor completes wri en
tutor version of the Tool.
A er considering input
A er considering
from preceptor and student preceptor and student
feedback, the tutor assigns
feedback, the tutor aseither: Progressing Towards signs either Pass or Fail
Mee ng Course Ends-in-view
or Failing
Course Assignments and Learning Plan
Tutor incorporates comments about progress into
tutor version of the Professional Prac ce Evalua on
Tool
Tutor incorporates final
comments into the
tutor version of the
Professional Prac ce
Evalua on Tool
Ask the student about favoured learning style(s) and effec ve
learning strategies. As a preceptor, compare these styles and
strategies with your own. Consider both when planning learning
opportuni es to op mize the learning. Remember to consider the
importance of the intergenera onal context of learning, too.
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About Preceptor Func ons & Role Modelling
Learning Plans
Learning plans are used throughout the BScN Kaleidoscope Curriculum to
engage learners in iden fying their own learning needs, and the strategies to
address and evaluate them. We believe that learning plans are dynamic and that
keeping them meaningful to student learning requires ongoing re-evalua on of
goals and ac ons.
Students’ personal knowing will direct the learning goals, which will vary according to the area in which they are prac sing. Learning plans begin with students’
reflec ons of who they are, what they already know, and how this shapes the
way that they evolve as professional nurses.
Learning plans reflect an understanding of self-directed learning. The goals are
framed by the course ends-in-view (aims) and the applicability to the prac ce
se ng. Preceptors and tutors play an important role in guiding students in
planning, refining, and comple ng the learning plan, according to the students’
needs. When the goals are complete, the evidence that the goals have been met
is documented on the Professional Prac ce Evalua on Tool. All areas of professional prac ce are well suited to goals that promote Ac ng like a nurse. Through
ongoing dialogue and feedback with preceptors and tutors, students’ learning
plan supports and facilitates a sense of Belonging to the nursing profession.
Learning plans iden fy in detail a) what the students intend to learn (learning
goal and ques ons); b) how this will be accomplished (resources and ac vi es);
c) what evidence will demonstrate that the students have accomplished the
objec ves; and d) how and by whom the evidence will be evaluated.
The template (below) for the learning plan guides the development of each
goal. Typically, Level IV students develop several learning plan goals.
Learning
Goal
On what
do I want
to focus
my learning?
Learning
Ques on
What specific
ques ons
do I have
related to my
goal?
Resources
What resources can
I use to help
me learn?
Ac vies
What
ac vies will I
complete
to help
me
learn?
- 35 -
Evidence
How will
I demonstrate
what
I have
learned?
Due Dates
Should be
completed
by Week 11
Evalua on
Criteria
How will
my learning be
evaluated?
By whom?
Against
what
criteria or
standard?
About Preceptor Func ons & Role Modelling
Within each preceptorship triad:
The student’s responsibili es are to:
• Reflect on personal knowing, ac ng and self-efficacy (belief in one’s
ability to act), and ask learning ques ons relevant to their prac ce
environment and course ends-in-view.
• Prepare a dra learning plan within the first few weeks of course, or
as nego ated with tutor and in consulta on with preceptor.
• Nego ate and revise learning plan with the tutor, including input
from the preceptor.
• Implement the learning plan and demonstrate evidence of learning
and mee ng learning goals by target dates outlined in the due date.
The tutor’s responsibili es are to:
• Facilitate the student’s Becoming a professional nurse by engaging
in an ongoing dialogue about the learning goals, resources, ac vies that support Knowing and Ac ng, and the proposed evidence,
including the criteria for evalua on sourced through the literature.
• Recommend changes that will strengthen the plan; increase congruence with the professional prac ce se ng and course ends-in-view;
enhance learning opportuni es; and/or facilitate mely comple on
of the learning plan.
• Provide ongoing feedback, guidance and support, encouraging mulple ways of knowing, evidence-informed decision-making (EIDM),
and development of clinical reasoning and clinical judgment. The
learning plan provides valuable evidence of student learning, which
is then documented on the Professional Prac ce Evalua on Form.
The preceptor promotes the student’s sense of self and the ability to act as
a professional nurse by:
• Helping to iden fy what is relevant and realis c within the professional prac ce se ng.
•
Ensuring that the goals can be accomplished within course meline.
• Ac ng as an assessor of evidence, where appropriate.
(Chen et al., 2012)
See Table 6: An Example of an Early Dra of a Learning Plan Goal on the
next page.
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About Preceptor Func ons & Role Modelling
Table 6: An Example of an Early Dra of a Learning Plan Goal
Learning
Goal
On what
do I want
to focus my
learning?
Learning
Ques on
What
specific
ques ons
do I have
related to
my goal?
Resources
What resources can
I use to help
me learn?
Ac vi es
What
ac vi es will
I complete
to help me
learn?
Evidence
How will
I demonstrate
what
I have
learned?
Due Dates
Should be
completed
by Week 11
Evalua on
Criteria
How will
my learning be
evaluated?
By whom?
Against
what
criteria or
standard?
To increase
clinical reasoning and
judgment
about effec ve pain
management
in postopera ve
pediatric
pa ents
What
theories
and models
support
effec ve
pediatric
pain management?
Peer
reviewed,
high-quality
journal arcles
A end inservice on
pain management
Design an
educa on
session
for new
graduate
RN or
present a
poster to
unit staff
Outline by
Week 7
Evaluaon form
designed
by student
wri en
feedback
from
preceptor/
staff
What do
I need to
know to
manage
pain effecvely?
Are there
cultural/
developmental
differences
in pain
percep on/
response
that migh
influence
pain management?
Pain Team
Preceptor
experience
Best prac ce
guidelines
Meet with
members of
pain team
Professional
caring for
post-opera ve peds
pa ents in
pain
Reflect on
personal and
professional
experiences
caring for
post-opera ve peds
pa ents in
pain
Have
preceptor
assess my
knowledge
of pediatric pain
management
Specific
date to be
nego ated
with staff,
preceptor,
and tutor
Verbal
feedback
by preceptor and
staff
Week 7
Personal
journal
shared
with tutor
Discussing the CNO 2008 Entry-to-Prac ce Competencies
(CNO, 2009) in the context of clinical experiences will help
students make the student-to-professional transi on. Use
real life examples to discuss specific competenices.
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About Preceptor Func ons & Role Modelling
Preceptor Func on: Facilita ng
Level IV Professional Prac ce Foci:
Complexity, Integra on, Transi ons
Preceptors can facilitate learning by providing access to varied resources and
opportuni es, par cularly involving agency and community professionals who
can act as learning resources that might mot be available to students when they
are outside the health care se ng. Depending on the professional prac ce experience, and other factors, students may need assistance to iden fy and plan
appropriate learning opportuni es.
For example, a student with a placement on a cardiac surgery unit may benefit
from an examina on of the cardiac health-illness con nuum. This might be
achieved by accessing: healthy living resources within the community, observing care in out-pa ent services, and following a pa ent/family’s progress
through diagnos c procedures, hospitaliza on, and discharge to resump on of
community living.
Building on students’ previous knowledge and experience assists in construc ng
new learning ac vi es.
Figure 7: Transi on from Student to Professional Nurse
and Beyond
(Adapted from: Benner, 1984)
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About Preceptor Func ons & Role Modelling
As can be seen in Figure 3: 2012-13 BScN Students Receiving Degrees Conferred by McMaster University, this BScN Program offers a number of streams
targeted to different types of BScN learners. While it might be assumed that
all Level IV students beginning professional prac ce courses are neophytes or
novices with respect to most nursing roles and ac vi es (see Figure 6 Transion from Student to Professional Nurse and Beyond), in fact, many of our
students have rich backgrounds which allows them to bring knowledge, skills,
and valuable experience to their Level IV placements. For example, Registered
Prac cal Nurses and diploma-educated RNs (approximately 10 are in the BScN
Program at this me) have nursing skills and in-depth knowledge of varied specialty areas and types of health care se ngs, and our Accelerated Basic Stream
students come into the Program with a par al or completed undergraduate
degree from numerous programs with strong science components.
In addi on, many students who work part- me are employed in fields related
to nursing, for example, as personal support personnel to individuals with
complex health and social challenges. Finally, among the Level IV students is a
cadre of nursing students who have completed their first Level IV professional
prac ce course in developing countries all over the world. In order to set appropriate learning expecta ons in specific areas within the health care se ng,
during the orienta on phase talk with the students about their personal experiences, work, and educa onal backgrounds. With respect to some aspects of
professional prac ce, preceptors may find that students’ knowledge, skill, and/
or performance levels are at an entry-to prac ce level or beyond (see Figure 7).
One Level IV focus is on the prepara on of students for the successful transion to professional prac ce a er gradua on. Newly graduated nurses o en
report how tough their student-to-professional transi ons were during the first
year following gradua on. In the Level IV professional prac ce courses, emphasis is placed on aspects, such as, an analysis of the community of prac ce (see
Orien ng, page 32) in which the students are placed and the roles of the Registered Nurses in these varied health care agencies. Student have an opportunity
to discuss and reflect on these issues within the preceptorship triad, as well
as in other nursing courses. This form of ‘rehearsal’ is a valuable resource in
lessening the shock of the student-to-professional transi on, and in heightening the responsiveness to change and resilience of new graduates.
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About Preceptor Func ons & Role Modelling
Major Teaching Strategies: Ques oning and Feedback
Effec ve Ques oning Techniques
•
•
•
Give students plenty of me to process ques ons by waiting up to 10 seconds before expec ng a response
Make sugges ons or offer hints to guide students in forming their responses, if assistance is needed
If students respond incorrectly, build confidence by asking follow-up ques ons that explore their thinking and
decision-making processes, which may be facilitated by
using an ordered approach to the complexity of the quesons (See Table 7).
Ques oning by preceptors and others is perhaps the most frequently employed
teaching-learning strategy in senior professional prac ce courses. Ques ons can be
used to peak interest, assess learning needs, s mulate and challenge thinking, and
evaluate learning. Ques oning also is an excellent way to encourage discussion that
may lead to greater depth of thinking and learning.
While ques oning is a significant teaching strategy, the level of complexity of the
ques oning is of equal importance. In senior professional prac ce courses, because
students are preparing to make the transi on to professional nursing, preceptors
should be focussing most of their ques ons on higher order levels of complexity.
In Table 7, the levels of ques on complexity are listed from the most elemental to
more complex ques ons. In the first row of the table, the most elementary level of
ques on complexity would involve “recall” of material (content learned through
memoriza on). Moving through the table, the levels of ques oning become more
complex, for example, comprehending, reasoning, solving, integra ng, and finally
reflec ng.
An illustra on of how preceptors can use increasingly complex ques ons with students in professional prac ce situa ons is presented. The table is organized so that
the BScN Program’s cri cal reasoning and judgment model (Clinical Judgment Model)
is related to the levels of ques on complexity. Using the ordered levels of ques on
complexity in this situa on (pa ent with Type 1 diabetes experience hypoglycemia)
helps students develop be er clinical judgment, because preceptors are posing
increasingly more complex ques ons as the situa on about a pa ent with Type 1
diabetes unfolds and the hypoglycemia is managed.
The development of cri cal reasoning and judgment are crucial for senior BScN
students, and using the levels of ques on complexity is a direct way that preceptors
can facilitate this.
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About Preceptor Func ons & Role Modelling
Table 7: Asking Ques ons to Assess Learning Needs &
Assess Performance
Clinical Judgment
Model (CJM)
Tanner (2006)
STUDENT KNOWING
REQUIRED BEFORE
INITIATING THE CJM
Level of Ques on Complexity
Situa on: A pa ent with Type 1
diabetes is experiencing hypoglycemia (low blood glucose).
KNOWLEDGE (RECALL) REMEMBERING previous learned work.
Regardless of the complexity, these
ques ons require the student to
recall previously learned material
(rote learning). Examples: define,
list, outline, recognize.
What do you know about insulin
(types, onset, peak, dura on,
administra on, storage, cost)?
KNOWLEDGE (COMPREHENDING)
UNDERSTANDING meaning. Quesons require the student to restate
material to show an understanding
of essen al meaning. Examples:
explain, infer, dis nguish, relate.
What are the func ons of insulin
in an individual not producing
endogenous insulin?
NOTICING
OBSERVING Ques ons require the
“a perceptual grasp of student to iden fy health issues
the situa on”. p. 208 within the context of the healthrelated care.
What autonomic & neuro-glycopenic signs & symptoms are you
likely to no ce in the pa ent
experiencing hypoglycemia?
INTERPRETING
“developing a sufficient understanding
of the situa on to
respond”. p. 208
EXPLORATION of REASONING Quesons requires the student to break
an idea into component parts for
analysis. Examples: compare, contrast, deconstruct, differen ate.
How does exogeneous insulin
differ from the self-regula on of
endogeneous insulin producon/regula on in a person
without Type 1 diabetes?
What thinking & assessment(s)
would be required before progressing to a treatment plan?
RESPONDING
“deciding on a course
of ac on, which may
include no immediate
ac on”. p. 208
SOLVING Ques ons require the
student to solve problems in new
situa ons with minimal iden ficaon of the principles, concepts, or
rules. Examples: modifies, changes,
predicts.
What ac on(s) would you take?
What would be the ra onale for
administering ¾ cup of orange
juice to a conscious & alert
pa ent with Type 1 diabetes
experiencing hypoglycemia?
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About Preceptor Func ons & Role Modelling
Table 7: Asking Ques ons to Assess Learning Needs & Assess Performance (cont’d)
Clinical Judgment
Model (CJM)
Tanner (2006)
Levels of Ques on Complexity
Situa on: A pa ent with Type 1
diabetes is experiencing hypoglycemia (low blood glucose).
REFLECTING-IN-ACTION
the “ability to “read”
the pa ent, how the
pa ent is responding to
the interven ons & adjus ng the interven ons
based on the assessment”. p.209
ASSESSING PROGRESS & OUTCOMES Ques ons require the
student to use objec ve criteria
to draw a conclusion about an
outcome of a plan. Examples:
discriminate, jus fy, defend.
What outcomes would you assess?
How & when would you evaluate
the effect of your treatment of the
pa ent’s hypoglycemia a er administering ¾ cup of orange juice?
REFLECTION-IN-ACTION
the “ability to adjust
or modify/change the
interven ons based on
the assessment” . p.209
INTEGRATING Ques ons require
the student to combine parts
together or synthesize with
emphasis on new meaning,
planning & revising. Examples:
modifies, combines, generates.
Suppose that you came back
twenty minutes a er giving the ¾
cup of orange juice & you find that
the pa ent is restless, shaking,
diaphore c, & vague. How would
you modify your plan?
REFLECTION-ONACTION
the ability to self-reflect
on the clinical reasoning & judgment applied
to the situa on; to
iden fy new learning &
determine how it can be
incorporated into future
experiences. p.209
REFLECTING Ques ons may be
self-generated or suggested by
others. Reflec on requires the
student to ask ques ons that
iden fy, probe & explore as a
means of gleaning new learning & planning to incorporate
changes in future prac ce
experiences.
What, if anything, might you have
done to prevent or resolve the
pa ent’s low blood glucose level?
What have you learned from this
experience? How will the new
learning change your prac ce in
future experiences?
Acknowledgement: Diana Sherifali, RN, PhD kindly provided the diabetes-related content for this situa on.
- 42 -
About Preceptor Func
ons & Role Modelling
Feedback
Students may not be able to reflect accurately on aspects about their own performance, feedback from preceptors to adjust and refine their behaviours and performance. Student success is informed by:
•
hearing about the details of the performance in a mely fashion, and
•
sharing meaning and understanding.
Feedback should be provided in ways that enhance the students’ feelings of
accomplishment by recognizing the posi ve aspects, as well as areas for improvement.
Feedback also should be used to inform learning needs in
future courses (o en called feed forward).
Below are listed nine ps for giving feedback (see Appendix E: Nine Tips for Giving
Feedback for short explana ons about each of the ps).
Focus your feedback on...
•
•
•
•
•
•
•
•
•
Behaviour rather than the person
Observa ons rather than inferences
Descrip on rather than judgment
Descrip ons of behaviour which are “more or less” rather than “either-or”
Behaviour related to a specific situa on in ther “here” and “now”
Appropriate ming and loca on
Sharing ideas, informa on and alterna ves
The value of the feedback that it can have for the recipient
The amount of feedback that the receiver can use
Feedback can be delivered in terms of:
Clinical reasoning and judgment - The Clinical Judgment Model ( see Figure 4) provides
an excellent pla orm for staging feedback. Labelling the phases to which the feedback
relates: no cing, interpre ng, ac ng and reflec ng. Referring to the phase(s) of clinical
reasoning as they relate to a par cular pa ents’ care reinforces the applicability of the
cycle to iden cal, similar, or different situa ons.
Evidence - is provided based on observa on of student performance using comparisons
to learning goals.
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About Preceptor Func ons & Role Modelling
Interpreta on - giving feedback as “for for thought” takes into account the complexity and context of a given situa on. Through reflec on-on-ac on students
interpret their ac on and derive new learning.
Measurement - when learning psychomotor skills (where safety is o en of cri cal importance), feedback should be given in objec ve terms to provide specificity, thereby assuring the correct ac ons, and acceptable sequencing of them, are
achieved.
See Appendix G: Evalua on of Clinical Preceptor Performance.
The preceptor behaviours listed on the evalua on form may assist
preceptors in determining their learning needs and self-evalua ng
their progress. It is a good idea to go over the criteria with the student periodically throughout the course to receive feedback from
the students. This is a reciporical growth opportunity.
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About Preceptor Func ons & Role Modelling
Preceptor Func on: Guiding
Supervision
At the beginning of the course, when preceptors and students are ge ng to
know each other, and as they work together, observa on is an essen al part
of a diagnos c assessment (see About Assessment). Reviewing preceptors’
ul mate responsibility for the provision of safe and effec ve pa ent care provides a sound ra onale for the need to observe ini al student performance.
Shadowing the preceptor may be an ini al step, followed by working together.
Providing specific and mely feedback, par cularly at the beginning of the
term, helps students gauge their developing level of performance. As student
performance increases, in most cases, so should the degree of autonomy.
Coaching Role with Students
Coaching students involves encouraging curiosity and emphasizes strengths
while crea ng new opportunity for ac on. Coaching is used to enhance the
development of skills and knowledge through suppor ng iden fied strengths
and providing meaningful, mely feedback.
Preceptors can u lize coaching strategies to develop students’ clinical reasoning skills as well as professional behaviours in the preceptor-student rela onship. In the coaching role, preceptors and students mutually learn from one
another within a conversa on guided by preceptors.
Ques ons are a founda onal part of the coaching conversa on and can assist
students in iden fying their strengths, barriers, and important learning goals.
In a coaching conversa on, ques ons o en begin as an explora on of founda onal informa on and move to specific ques ons that encourage students
to see a situa on and themselves with new eyes.
Example of exploratory ques ons:
Tell me about a situa on in your professional prac ce experience that would
give me an idea of where you are in your nursing prac ce.
Tell me about your experiences nursing (fill in specific placement area) paents?
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About Preceptor Func ons & Role Modelling
Iden fying Strengths and challenges:
What strengths do you have that you would like to develop?
What challenges have you encountered in professional prac ce? Tell me more about
these challenges.
What strategies did you use to work through this challenge?
How did this situa on affect you? What would you do differently? What strengths can
you develop or draw on to assist you next me you have this experience?
Iden fying goals:
Right now, what is your most important learning need?
What goals do you have for your experience in this area? Which of these goals is the
most important?
What barriers do you an cipate in mee ng this goal(s)?
Supports/Ac ons:
What supports do you have that can assist you in being successful in mee ng your
goal?
Describe an ac on that you can do in the next 3-4 days that will move you towards
mee ng your goal.
Debriefing & Reflec on
All of the following sugges ons are reflected in the Experien al Learning
Cycle (Figure 6).
Debriefing can be employed to s mulate reflec on on experiences, in addi on to promo ng clinical reasoning. Through
debriefing, students and preceptors:
• share ideas and observa ons about an occurrence
• ques on familiar prac ces, their validity, and theore cal founda ons
• affirm strengths and recognize areas for development
• reflect upon experiences and interpret new situaons to develop new ideas.
• plan for future experiences
- 46 -
About Preceptor Func ons & Role Modelling
Debriefing can occur through:
Discussion and Ques oning
•
Students are assisted to explore their experiences, describe their knowledge, reasoning or
thinking processes, and assign/interpret meaning from them and plan for future experiences
(Figure 6).
Feedback
•
Students process specific, mely, & construcve feedback about their performance and
are assisted to consider others’ perspec ves,
especially those of preceptors.
Reflec on
•
Students are assisted to reflect on an experience, comparing their present prac ce with
previous ones, the prac ce of experts, or ideal
situa ons. Students derive new meanings
and plan experiences incorpora ng their new
learning.
If you have knowledge, let others light their candles at it.
-Margaret Fuller
Preceptor Func on: Suppor ng
Suppor ve behaviours can be employed to encourage, mo vate, promote risk-taking, enhance confidence, and reinforce role performance. Preceptors can model
suppor ve behaviours through their daily interac ons with individuals, families,
colleagues, and students. Suppor ve clinical placements that demonstrate engagement and acceptance of students help students nego ate complex learning
situa ons.
Types of Support
Emo onal Support
•
•
Ac ng as colleagues and allies. Taking an ac ve interest by engaging
students as members of the team.
Listening and providing advice in rela on to personal or professional concerns can enhance students’ self-esteem and help them to deal with the
reali es of professional prac ce and the stresses of learning in real- me.
- 47 -
About Preceptor Func ons & Role Modelling
Appraisal Support
•
•
Crea ng suppor ve and posi ve environments for learning
Providing affirma on and feedback that is specific, immediate, and concrete informs students about their progress (forma ve assessment) and
speeds performance development.
Informa onal Support
•
Orien ng students to the se ng, in addi on to providing advice, informa on, and assistance with problem-solving and clinical reasoning in
uncertain or ambiguous situa ons.
Instrumental support
•
Providing access to addi onal resources (e.g., e-learning modules ) and
personnel at case conferences, in-services, and mee ngs.
Understanding Difficul es in Learning
Difficul es experiences in learning may be related to any of the following areas. Difficul es may require further explora on with the
faculty tutor.
Cogni ve
•
Difficulty with wri en/oral communica on or spa al-perceptual ability, knowledge and/or intergra on of material
that is below what would be expected (at a minimum, a
sa sfactory level).
Situa onal
•
Personal adjustments, such as, rela onship difficul es, illness or death in the family.
Organiza onal
•
Inability to organize skills or manage me well; ineffec ve
study habits.
Interpersonal
•
Difficulty rela ng to others; they may lack appropriate communica on and team building skills in the clinical se ng.
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About Preceptor Func ons & Role Modelling
If students develop difficulty in mee ng the course
ends-in-view:
•
•
•
•
Approach with concerns and concrete obsera ons in a non-threatening
way (See Appendix E: Nine Tips for Giving Feedback)
Review the course ends-in-view and learning plan
Explore extenua ng circumstances that may impact on the ability to meet
the course objec ves
Seek addi onal assistance in the form of feedback, advice, and guidance
from the faculty tutor. See Appendix H: Suppor ng the Student in Difficulty in a Professional Prac ce Course, A Guide for Students, Preceptors
and Tutors.
Managing a Learning and/or Performance Challenge
Step 1 - Explore and define the specific problem(s).
Step 2 - Iden fy the desired state and be as specific as possible.
Step 3 - Design interven ons to achieve the desired state.
Step 1 - Define the Problem
•
•
Try to determine what type(s) of diffficul es the student is facing:
cogni ve, situa onal, organiza onal, interpersonal, etc.
Meet with the student to engage in mutual feedback and to share
observa ons. What factors might be contribu ng to the problem?
In what ways and to what extent does the current performance
fall short of course ends-in-view? What is the student’s percep on
of the issue(s)?
Step 2 - Iden fy the Desired State
•
•
•
Generate ideas and strategies collabora vely that will assist the
student to achieve the course ends-in-view and personal goals.
Revise the learning plan as necessary to make goals achievable
within the se ng and allo ed course mefrrame.
Provide support and affirma on that the desired state can be
achieved.
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About Preceptor Func ons & Role Modelling
Step 3 - Design the Interven on
•
Nego ate - Consider the student’s perspec ve and interest in
achieving the goals developed to achieve the desired state. Goals
that are not directly related to the course ends-in-view or learning plan may not be viewed as priori es by the student; therefore,
flexibility is important to enable collabora ve goal se ng.
•
Be realis c - Discuss the student’s goals and past experiences to
assure goals are achievable and realis c in the prac ce se ng.
•
Focus on performance - Focus on what can be assessed, such
as, listening to a student using therapeu c communica on skills,
reviewing the student’s clinical reasoning and judgment as applied
to specific situa ons, or changing a complex dressing.
•
Make goals challenging - Goals that are perceived as simple
may not provide the mo va onal drive to achieve them. Goals
should be a ainable but also a challenge.
•
Rehearsal - In situa ons that are new or possibly threatening,
the preceptor can assist the student to rehearse the steps of an
ac vity (physical, cogni ve or verbal), while imagining the situaon and possible responses. Role playing can be effec ve, especially for issues that involve the use of communica on skills.
•
Provide feedback - Discussion and concrete feedback close to
the me of performance facilitate integra on and refinement of
the learning.
It is important to iden fy any difficul es in clinical perfor-
mance and/or the evalua on process by mid-term (preferably before mid-term).
If difficul es exist, the student should seek appropriate
help early in the term from the preceptor and faculty tutor.
The course planner should become involved, if difficul es
cannot be resolved by the faculty tutor and preceptor, or if
further informa on and advice is required.
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Administra ve Considera ons
Below please find the contact informa on for professional prac ce course planners across the three-sites. Please do not hesitate to contact the responsible
person if you have concerns or ques ons. Please contact the course planner if
the faculty tutor does not a end any of the three mandated triad mee ngs.
Table 8: Course Planner Contact Informa on
Level
Course(s)
Faculty Course Planner
Phone/Email
Level IV
N4J07/N4K07
Ruth Chen
905 525 9140 X 24096
chenrp@mcmaster.ca
Level IV
N4S06/N4T06
Michele DrummondYoung
905 525-9140 X 22300
drummond@mcmaster.ca
N4J07/N4K07
Luba Raso
905 540-4247 X 26818
luba.raso@mohawkcollege.ca
N4J07/N4K07
Susanne Bush
519 748-5220 X 3914
sbush@conestogac.on.ca
McMaster
Mohawk
Level IV
Conestoga
Level IV
Open communica on among all par es in the preceptorship triad is required to
facilitate learning). A breakdown in communica on can result in frustra on, and
conflict, thereby interfering with the learning process.
Conflict within supervisory rela onships may
be related to differences in:
•
•
•
communica on styles
expecta ons
knowledge and skill
•
•
•
learning style
world-view
situa onal issues
To prevent situa ons from escala ng to conflict:
•
•
•
•
•
be sensi ve to the poten al for conflict situa ons; communicate clearly
with one another
schedule regular check-ins with each other to clarify expecta ons and
goals; review plans
act immediately when there is an indica on of conflict
assume a proac ve role in the process
seek assistance from the faculty tutor, when guidance or support are
needed by the preceptor and/or the student
- 51 -
About Preceptor Func ons & Role Modelling
Absences/Student Injuries
i)
In the case of a preceptor’s absence due to vaca on me or illness,
the student should be paired with a subs tute nurse, hopefully,
someone who is able to provide consistent precep ng during the
preceptor’s absence. When a preceptor’s absence is foreseen, another approach to handling this situa on is to assign a co-preceptor
to the student at the beginning of the course. For more informa on
see page 27, Implemen ng the Co-Preceptor Role: An Alterna ve to
Assigning One Preceptor to a Student.
ii)
Students are expected to a end all professional prac ce hours.
Student absence(s) must be reported to the preceptor, professional
prac ce se ng, and the tutor in a mely fashion. Time off due to illness does not necessarily require that the me be “made up”, unless
the preceptor or tutor feels that the absence(s) jeopardizes the course
ends-in-view or necessary professional prac ce experience. In such
situa ons, triad discussion (perhaps involving the course planner) is
required to plan strategies to compensate for the missed me.
Please note: The only night shi s that cannot be a ended are those
that fall on the night before academic nursing classes.
iii) If a student is injured in a professional prac ce se ng, provide first
aide and seek treatment, as necessary (e.g., employee health, ER,
physician). EVEN IF AN INJURY IS CONSIDERED MINOR, the incident
must:
• be reported to the course planner. See Table 8: Course Planner
Contact Informa on
• be recorded, including a clinical agency incident report, WSIB
form, and BScN Program report. The course planner will provide
the necessary BScN Program form.
(From the N4J07 Course Manual, 2012)
Addi onal informa on about the BScN Program, relevant
policies and procedures are available on the internet at:
McMaster: www. s.mcmaster.ca/nursing
Mohawk: h p://www.mohawkcollege.ca/calendar/nursingBScN.html
Conestoga: h p://www.conestogac.on.ca/full me/program.jsp?School
ID=3&ProgramCode=1043&p=o
- 52 -
References
Canadian Nurses Associa on (CNA). (2004). Achieving excellence in professional prac ce:
A guide to preceptorship and mentoring. O awa: Canadian Nurses Associa on. Retrieved from h p://www.cna-nurses.ca/CNA/documents/pdf/publica ons/Achieving_Excellence_2004_e.pdf
Cavalieri, V. (2012). Preceptors’ role modelling of senior BScN students explored through
reflec ons of faculty tutors. Project being completed to par ally fulfill the requirements for an MSc, McMaster University.
Chen, R., Lunyk-Child, O., Hanna, E., Jewiss, T., Lawlor, Y., & Palma, A. (2012). Learning
Plan Guide. Hamilton, ON: McMaster University, School of Nursing.
Chinn, P.L., & Kramer, M.K. (2008). Integrated theory and knowledge development in nursing. St. Louis: Mosby Elsevier.
College of Nurses of Ontario (CNO). (2009). Na onal Competencies. Adopted for Ontario
Registered Nursed Entry-to-Prac ce Competencies. Retrieved from h p://www.cno.
org/docs/reg/41037_EntryToPraci c_final.pdf
College of Nurses of Ontario (CNO). (2006). Prac ce Standard. Decisions about procedures and authority. h p://www.cno.org/Global/docs/prac/41071_Decisions.pdf
College of Nurses of Ontario (CNO). (2009). CNO prac ce guideline: Suppor ng learners.
Retrieved from h p://www.cno.org/Global/docs/prac/44034_SupportLearners.pdf
Johnston, C. (2004). Delinea ng triad roles and func ons in an undergraduate preceptorship program. Project completed to par ally fulfill the requirements for an MSc.,
McMaster University.
Mohide, E.A., Jennings, B., Akhtar-Danesh, N., Seidlitz, W., Norman, D., Gerardi, O., Cavalieri, V., & McKey, C. (2012). Selec ng nurse preceptors: What quali es & characteris cs should be considered? Sigma Theta Tau 23rd Interna onal Nursing Research
Congress, Paper presented at Brisbane, Australia.
N4J07 Professional Prac ce Course Manual. (2012). Hamilton, ON: McMaster Mohawk
Conestoga BScN Program.
Tanner, C.A. (2006). Thinking like a nurse: A research-based model of clinical judgment in
nursing. Journal of Nursing Educa on, 45(6), 204-211.
Tran, A.H. (2008). Promo ng preceptors’ use of reflec on with senior undergraduate
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McMaster University.
- 53 -
Suggested Resources
Selected Journal Ar cles
Back, A.L., Arnold, R.M., Tulsky, J.A., Baile, W.F., & Edwards, K. (2010). “Could I
add something?”: Teaching communica on by intervening in real me during a clinical encounter. Academic Medicine, 85(6), 1048-1051.
Barne , R. (2009). Knowing and becoming in the higher educa on curriculum.
Studies in Higher Educa on, 34(4), 429-440.
Baxter, P. (2007). The CCARE model of clinical supervision: Bridging the theoryprac ce gap. Nurse Educa on in Prac ce, 7, 103-111.
Benner, P. (1984). From novice to expert: Excellence and power in clinical nursing prac ce. California: Addison-Wesley Publishing Co.
Boychuk Duchscher, J.E.B. (2009). Transi on shock: The ini al stage of role
adapta on for new graduated Registered Nurses. Journal of Advanced
Nursing, 65(5), 1103-1113.
Boychuk Duchscher, J. (2008). A process of becoming: The stages of new nursing
graduate professional role transi on. Journal of Con nuing Educa on in
Nursing. 39(10), 441-450.
Bo , G., Mohide, E.A., & Lawlor, Y. (2011). A clinical teaching technique for
nurse preceptors: The five minute preceptor. Journal of Professional Nursing, 27(1), 35-42.
Carlson, E., Pilhammar, E., & Wann-Hansson, C. (2010). Time to precept: Suppor ve and limi ng condi ons for precep ng nurses. Journal of Advanced
Nursing, 66(2), 432-441.
Cruess, S.R., Cruess, R.L., & Steinert, Y. (2008). Role modelling - making the
most of a powerful teaching strategy. BMJ, 336, 718-721.
Delany, C., & Watkin D. (2009). A study of cri cal reflec on in health professional educa on: ‘learning where others are coming from’. Advances in Health
Science Educa on, 14, 411-429.
- 54 -
Suggested Resources, cont’d
DeWolf, J.A., Laschinger, S., & Perkin, C. (2010). Preceptors’ perspec ves on recruitment, support, and reten on of preceptors. Journal of Nursing Educa on,
49(4), 360-367.
Donaldson, J.H., & Carter, D. (2005). The value of role modelling: Percep ons
of undergraduate and diploma nursing (adult) students. Nurse Educa on in
Prac ce, 5, 353-359.
Duffy, A. (2009). Guiding students through reflec ve prac ce - The preceptors’
experiences. A qualita ve descrip ve study. Nurse Educa on in Prac ce, 9,
166-175.
Earle, V., Myrick, F., & Yonge, O. (2011). Preceptorship in the intergenera onal context: An integra ve review of the literature. Nurse Educa on Today, 31, 82-87.
Earle-Foley, V., Myrick, F., Luhanga, F., & Yonge, On. (2012). Preceptorship: Using an
ethical lens to reflect on the unsafe student. Journal of Professional Nursing,
28(1), 27.33
Elisabeth, C., Wann-Hansson, C., & Ewa, P. (2009). Teaching during clinical prac ce:
Strategies and techniques used by preceptorsin nursing educa on. Nurse
Educa on Today, 29, 522-526.
Ferrara, L.R., (2012). Strategies for success as a clinical preceptor. Nurse Prac
ner, 37(5), 49-53
o-
Field, D.E. (2004). Moving from novice to expert - the value of learning in clinical
prac ce: a literature review. Nurse Educa on Today, 24, 560-565.
Forneris, S.G., & 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), 17151724.
Gillespie, M. (in press). Using the Situated Professional Prac ce Decision-Making
Framework to guide analysis of nurses’ decision-making. Nurse Educa on in
Prac ce.
Gillespie, M., & Paterson, B.L. (2009). Helping novice nurses make effec ve professional prac cedecisions: The Situated Professional Prac ce Decision-Making
Framework. Nursing Educa on Perspec ves, 30 (3), 164-170.
- 55 -
Suggested Resources, cont’d
Haggerty, C., Holloway, K., & Wilson, D. (2012). Entry to nursing prac ce preceptor educa on and support: Could we do it be er? Nursing Praxis in New
Zealand, 28(1), 30-39.
Hallin, K., & Danielson, E. (2010). Preceptoring nursing students: Registered
Nurses’ percep ons of nursing students’ prepara on and study approaches
in clinical educa on. Nurse Educa on Today, 30, 296-302.
Hardin, P. K. & Richardson, S. J. (2012). Teaching the concept curricula: Theory
and method. Journal of Nursing Educa on. 51(3), 155-159.
Harwood, C.H., Reimer-Kirkham, S., Sawatzky, R., Terblanche, L., & Van Hofwegen,
L. (2009). Innova on in community clinical placements: A Canadian survey.
Interna onal Journal of Nursing Educa on Scholarship, 6(1), 1-19.
Hasley, P.B., & Arnold, R.M. (2009). Summa ve evalua on on the hospital wards.
What do faculty say to learners? Advances in Health Science Educa on,
14,431-439.
Haugan, G., Sorensen, A., & Hanssen, I. (2012). The importance of dialogue in
student nurses’ clinical educa on. Nurse Educa on Today, 32(4), 438-442.
Hickey, M.T. (2010). Baccalaureate nursing graduates’ percep ons of their clinical
instruc onal experiences and prepara on for prac ce. Journal of Professional Nursing, 26(1), 35-41.
Hoke, M.M., & Robbins, L.K. (2005). The impact of ac ve learning on nursing students’ clinical success. Journal of Holis c Nursing, 23, 348-355.
Hrobsky, P.E., & Kersbergen, A.L. (2002). Preceptors’ percep ons of clincal performance failure. Journal of Nursing Educa on, 41, 550-553.
Johnston, C.,, & Mohide, E.A. (2009). Addressing diversity in clinical educa on:
Support for preceptors. Nurse Educa on in Prac ce, 9(5), 340-347.
Kaufman, D. (2003). Applying educa onal theory in prac ce. BMJ, 326, 213-216.
Kim, K.H. (2007). Clinical competence among senior nursing students a er their
preceptorship experiences. Journal of Professional Nursing, 23(6), 369-375.
Knowles, M.S., Holton , E.F., & Swanson, R.A. (2005). The adult learner: The
defini ve classic in adult educa on and human resource development. (6th
ed.). London: Elsevier Inc.
- 56 -
Suggested Resources, cont’d
Lasater, K. (2011). Clinical judgment: The last fron er for evalua on. Nurse Educa on in Prac ce, 11,86-92.
Luhanga, F., Myrick, F., & Yonge, O. (2010). The preceptorship experience: An
examina on of ethical and accountability issues. Journal of Professional
Nursing, 26(5), 264-271.
Luhanga, F.L., Billay, D., Grundy, Q., Myrick, F., & Yonge, O. (2010). The one-toone rela onship: Is it really key to an effec ve preceptorship experience?
A review of the literature. Interna onal Journal of Nursing Educa on Scholarship,7(1),1-15.
Luhanga, F., Yonge, O., & Myrick, F. (2008). Precep ng an unsafe student: The
role of the faculty. Nurse Educa on Today, 28, 227-231.
Mamchur, C., & Myrick, F. (2003). Preceptorship and interpersonal conflict: A
mul disciplinary study. Journal of Advanced Nursing, 43, 188-196.
Modic, M.B., & Schoessler, M. (2010). Preceptorship: The pa ent experience.
March/April. Journal of Nurses in Staff Development, 88-89.
Modic, M.B., & Harris, R. (2007). Masterful precep ng: Using the BECOME
method to enhance clinical teaching. Journal of Nurses in Staff Development, 23(1), 1-9.
Mohide, E. A., & Ma hew-Maich, N. (2007). Engaging nursing preceptorstudent dyads in an evidence-based approach to professional prac ce.
Evidence-Based Nursing, 10, 36-40.
Myrick, F. (2002). Preceptor behaviors integral to the promo on of student
cri cal thinking. Journal for Nurses in Staff Development, 18, 127-133.
Myrick, F., & Yonge, D. (2005). Nursing Preceptorship. Connec ng Prac ce &
Educa on. Philadephia: Lippinco Williams & Wilkins.
Myrick, F., & Yonge, O. (2002). Preceptor behaviors integral to the promo on of
student cri cal thinking. Journal for Nurses in Staff Development,18, 127133.
Myrick, F., & Yonge, O. (2002). Preceptor ques oning and student cri cal thinking. Journal of Professional Nursing,18, 176-181.
Myrick, F., & Yonge, O. (2001). Crea ng a climate for cri cal thinking in the preceptorship experience. Nurse Educa on Today, 21, 461-467.
- 57 -
Suggested Resources, cont’d
Myrick, F., Yonge, O., & Billay, D. (2010). Preceptorship and prac cal wisdom: A process of engaging in authen c nursing prac ce. Nurse Educa on in Prac ce,10(2),
82-87.
Nielsen, A., Stragnell, S., & Jester, P. (2007). Guide for reflec on using the professional
prac ce judgment model. Journal of Nursing Educa on, 46 (11).
Paton, B., Thompson-Isherwood, R., & Thirsk, L. (2009). Preceptors ma er: An evolving framework. Journal of Nursing Educa on, 48(4), 213-216.
Paton, B., & Binding, L. (2009). Keeping the centre of nursing alive: A framework for
preceptor discernment and accountability. The Journal of Con nuing Educa on
in Nursing, 40(3), 115-120.
Perry, B., (2009). Role modeling excellence in clinical nursing prac ce. Nurse Educaon in Prac ce, 9, 36-44.
Rush, K.L., McCracken, B., & Talley, C. (2009). Nursing students’ self-percep ons as
insiders in the prac ce culture. Nurse Educa on in Prac ce, 9, 314-321.
Sand-Jecklin, K. (2009). Assessing nursing student percep ons of the clinical learning
environment: Refinement and tes ng of the SECEE inventory. Journal of Nursing
Measurement, 17(3), 232-246.
Sedgwick, M., Yonge, O., & Myrick, F. (2009). Rural-hospital-based preceptorship.
Journal of Nurses in Staff Development, 25(5), E1-E7.
Simmons, B. (2010). Professional prac ce reasoning: Concept analysis. Journal of
Advanced Nursing, 66 (5) 1151-1158.
Yonge, O. & Myrick, F. (2004). Preceptorship and the preparatory process for undergraduate nursing students and their preceptors. Journal for Nurses in Staff
Development, 20, 294-297.
Yonge, O., Krahn, H., Trojan,L., Reid, D. & Haase, M. (2002). Suppor ng preceptors.
Journal for Nurses in Staff Development, 18, 73-77.
Yonge, O., Ferguson, L., Myrick, F., & Haase, M. (2003). Faculty prepara on for the
preceptorship experience: The forgo en link. Nurse Educator, 28, 210-211.
Other
Undergraduate Nursing Educa on McMaster University (2012). 2012-2013 Program
Handbook. Hamilton: McMaster University.
- 58 -
Suggested Resources, cont’d
Websites*
College of Nurses (CNO)
CNO Na onal Competencies (June 2009)
h p://www.cno.org/Global/docs/reg/41037_EntryToPraci c_final.pdf
These Na onal Competencies are in the context of entry-level Registered
Nurse prac ce. They have been adopted by CNO as Ontario Registered
Nurses Entry-to-Prac ce Competencies.
CNO Prac ce Guideline: Suppor ng Learners
h p://www.cno.org/Global/docs/prac/44034_SupportLearners.pdf
CNO Standards and Guidelines
h p://www.cno.org/learn-about-standards-guidelines/standards-andguidelines/
Cri cal Thinking
The Cri cal Thinking Community h p://www.cri calthinking.org
Preceptorship
Canadian Nurses Associa on (CNA). (2004). Achieving excellence in professional prac ce: A guide to preceptorship and mentoring. O awa: Canadian Nurses Associa on.
h p://www2.cna-aiic.ca/CNA/documents/pdf/publica ons/Achieving_
Excellence_2004_e.pdf
CNO Prac ce Guideline: Suppor ng Learners
h p://www.cno.org/Global/docs/prac/44034_SupportLearners.pdf
Office of Interprofessional Health Educa on & Research On-line Preceptor/
Preceptee Educa on h p://www.ipe.uwo.ca/preceptor/index.html
Preceptor Resources for Public Health Units (Ontario), Student Placement,
Educa on and Preceptorship (SPEP) Network Student Placement, Educaon and Preceptorship (SPEP) Network
h p://www.publichealthontario.ca/en/ServicesAndTools/ResearchAndEduca onSupport/Pages/Preceptor-resources-for-public-health-units.aspx
Other
Community Health Nurses of Canada
h p://www.chnc.ca/
Health Canada
h p://www.hc-sc.gc.ca/index-eng.php
- 59 -
Suggested Resources, cont’d
Preceptorship (cont’d)
Nursing Code of Ethics
h p://www.cna-nurses.ca/cna/prac ce/ethics/code/default_e.aspx
Public Health Agency of Canada
h p://www.phac-aspc.gc.ca/index-eng.php
Registered Nurses Associa on of Ontario, Knowledge Depot, What is a healthy
workplace?
h p://www.rnaoknowledgedepot.ca/strengthening_nursing/phwe_what_
is_a_hwe.asp
Last accessed and retrieved July 2013
- 60 -
Suggested Resources, cont’d
LibAccess
A en on all McMaster Mohawk Conestoga BScN Program nurses
ac ng as preceptors in the upcoming year, and clinical educators responsible for units/programs where senior BScN students have placements:
In recogni on of your valuable clinical educa on roles, you are eligible to register
for a LibAccess account, available through the McMaster University Health Sciences
Library (see h p://library.mcmaster.ca/libaccess).
LibAccess en tles account holders to access the vast McMaster University electronic
resources (on-line journals and books) during the academic year (September to August), free of charge. LibAccess makes it easier to get the latest wide-ranging publicaons and informa on relevant to nursing.
Access can be gained using a commercial internet provider, or when on-site, at the
Faculty of Health Sciences Library. A large selec on of high quality pre-cri qued
research sources are of par cular interest to preceptors and educators. These include
the Cochrane Library, and Clinical Evidence.
For more informa on, or an applica on, please contact Sharon Bap st, McMaster
University, BScN Program Office, Room 2J36, or at (905) 525-9140, ext. 22310, or via
sbap st@mcmaster.ca
Workshops
Introductory and Advanced Preceptorship Workshops are offered through the BScN
Preceptorship Program. Call Be y McCarthy at (905) 525-9140 ext. 22405 or email
bmccarth@mcmaster.ca for upcoming topics, dates, mes, & loca ons.
We are pleased to offer a Cer ficate of Advanced Preceptorship Educa on to all
those who par cipate in the Introductory Workshop and any three advanced workshops.
Workshops and other educa onal opportuni es also may be offered within healthcare agencies:
•
•
•
Contact the Manager, Clinical Educator or staff development personnel
Iden fy other preceptors at the healthcare agency to develop a preceptor
interest group, so experiences and accumulated exper se can be shared
Watch for regional workshops offered through RNAO and other professional
organiza ons.
- 61 -
Appendix A: Glossary of Terms
Community
of Prac ce
In the case of health care, a community of prac ce is a group of individuals in a work se ng that has i) a common or shared set of professional
prac ces for ge ng the work done as defined by the organiza on, ii) as
individuals, iden es that relate to their par cular work, and in par cular,
what the group or individuals are known for within the organiza on, and
iii) a shared work mission or objec ves are defined by the organiza on.
Context
Influences the client’s health and personal meaning. This context is internal
(biophysical, emo onal, psychological, rela onal and spiritual) and external
(physical, cultural, social, poli cal, economic and ecological).
Cri cal
Reflec on
Involves probing, iden fying, ques oning, and exploring underlying assump ons, values, beliefs & meaning related to experiences. Cri cal reflecon frequently results in ac on through changed or reaffirmed assumpons, values, beliefs, & a tudes.
Dialogue
The mutual exchange of messages that may be verbal, non-verbal, emoonal, spiritual or physical.
Evidenceinformed
DecisionMaking (EIDM)
Involves learning how to access/appraise and use new knowledge to inform
clinical prac ce or knowledge u liza on.
Knowing
An outcome of learning, knowing involves knowledge of self and others and understanding of the meaning of situa ons from objec ve and
subjec ve perspec ves, and the significance of these situa ons to self and
others. Knowledge is the form of knowing that can be communicated with
others. Knowing and knowledge enable judgments to be made ethically
and responsibly.
Learning Plan
Students iden fy their learning needs. Learning plans spell out, in detail,
(a) what the students intend to learn (objec ves); (b) how this will be
accomplished (resources and strategies) within a given period of me; (c)
what the evidences will demonstrate that the students have accomplished
the objec ves; and (d) how and by whom the evidences will be evaluated.
Mutuality
Established when the nurse understands the meaning of the person’s situaon, from the person’s point of view, and validates this interpreta on with
the person.
Narra ve
Thinking
Narra ve thinking that involves trying to understand the par cular case;
viewed as human beings’ primary way of making sense of experience,
through interpreta on of human concerns, intents, and mo ves (Tanner,
2006, p. 207).
- 62 -
Appendix A: Glossary of Terms (cont’d)
Personhood
Is the state or condi on of being human (person) and especially having
those quali es, capabili es or a ributes that confer dis nct individuality.
Historically, memory, character, self concept, personal iden ty, lived experience and internal mo va on would be aspects of personhood influencing
both the nurse and the person, and shapes the therapeu c rela onship.
The caring encounter is established and defined by the humanis c quali es
of both the nurse and the person.
Person Based
Learning in
Problem Based
Learning approach
(PBL/PBL)
The person is at the centre of the learning and the person’s story (care
scenario or narra ve) is what ini ates the learning. The learning process,
Problem-Based Learning (see defini on below) is the educa onal approach
used in all Levels of the Program.
Preceptorship
A process that fosters reciprocal experien al learning within the teachinglearning partnership: preceptor, student, and faculty tutor. In our BScN
Program, we use experien al learning and the learning plan as major foci
for three-way interac on and learning within the triad.
Problem-Based
A method of teaching and learning in which the learners are presented
with a situa on or “care scenario” as a star ng point for the iden fica on
of learning needs. The process is meant to mirror, as closely as possible,
the clinical reasoning process. The curriculum is organized around care
scenarios and desired outcomes, rather than topics or disciplines.
Learning
Professional
Caring
Suppor ng the person in the processes of iden fying, determining, and
ac ng upon experiences relevant to health and healing. Professional caring is dis nguished from the generic human capacity to care. Nursing as
a profession is guided by professional standards, adheres to professional
values, and uses learned behaviours, validated knowledge, theories, cri cal reflec on, and techniques or processes that characterize professional
caring. Professional caring has both scien fic and humanis c components.
Interprofessional and intersectoral collabora on are frequent features of
professional nursing care.
Self-Directed
Learning
An approach to learning whereby students are encouraged to iden fy their
own learning needs and goals, suggest strategies to meet their learning
needs, and assume an interest in evalua ng their progress towards the
achievement of the goals.
- 63 -
Appendix A: Glossary of Terms (cont’d)
Ways of Knowing (Chinn & Kramer, 2008)
Empiric knowing
Knowing acquired and expressed through theory, scien fic understanding, focus on use of sensory experience.
Ethical Knowing
Informs moral and ethical comportment, expressed in ethical codes,
standards.
Personal knowing
One’s learning and knowing through life experiences, values, beliefs,
history; becoming self-aware. Integrated in prac ce as therapeu c use
of self.
Aesthe c knowing
Relates to the percep on of deep meanings of a situa on, bringing into
one’s knowing inner crea ve resources; is expressed through ac ons,
narra ve, interac ons; can be formally expressed through art forms,
brings forward transforma on of art of prac ce.
Emancipatory
knowing
Process of knowing that makes social and structural change possible;
ability to consider fairness, recognize barriers to fairness and social
jus ce. It involves considering complexity of sociological and poli cal
context, intent is to change lives for the be er.
- 64 -
Appendix B: Principles of Adult Learning
Adults prefer learning situa ons that:
Show respect for the individual
•
•
Validate and affirm their knowledge, contribu ons, and growth.
Ask for feedback about your prac ce and ideas.
Promote posi ve self-esteem
•
•
Plan learning ac vi es that are related and build upon each other with
increasing complexity.
Help them to become more confident through guided professional
prac ce, construc ve mely feedback, recogni on, and reinforcement
of learning achieved.
Are prac cal and problem centered
•
•
•
Discuss and help students to plan for experien al learning.
Give examples and summarize to link theory to professional prac ce.
Suggest ways which might assist the learner in rela ng new knowledge
to experience and prac ce.
Capitalize on their experience
•
•
Create opportuni es that use their exis ng knowledge and experience.
Plan ac vi es that fit with their level of experience and competency.
Integrate new ideas with exis ng knowledge
•
•
•
Assist students to recall what they know from prior professional pracce experience and help them to relate past learning to the present
situa ons.
Explicitly share ideas and ask for input.
Ask what they would like to learn within the context of the professional course.
Encourage self-direc on and choice
•
•
•
Ask what they already know about a topic and what they would like to
learn within the context of the course ends-in-view and the learning
environment.
Build your teaching plans around their learning needs and goals.
Assist them in developing their individualized learning plans.
- 65 -
Appendix C: Examples of Care Scenarios Across
the Program Levels
Level I Care Scenarios
Scenario Title
Age/Focus
Summary
Key Learning
“I’m fine, don’t
worry about me”
Margaret Adams, 75-year-old
female
Focus: Individual,
family
Margaret has had
a fall, lives alone,
does not want to
give up independence
-Transi on in older
adulthood, effect on
health
-Normal growth and
development
-Safety in the home
-Communica on
“I want to quit...I
think”
John, 35-year-old
male
Focus: Individual
Father, husband,
trying to quit
smoking, has
tried to quit
before, wife and
children want
him to quit
Smoking cessa on
strategies, barriers, social influences, trends,
nursing role
“20 weeks already”
Valerie and Todd
First pregnancy
Focus: Individual,
family
Health first pregnancy, transi on
to paren ng,
healthy pregnancy, Aboriginal
health
(Mohawk culture)
Preconcep on health,
prenatal care, healthy
pregnancy, nursing
role, role transi on to
parents, family theory,
cultural care
Summary
Key Learning
Level II Care Scenarios
Scenario Title
Age/Focus
“Not me”
Mark, 55-year-old Newly diagnosed
male
with Type 2 diaFocus: Individual betes
Nursing role, interprofessional team, pa ent
educa on and diabetes, lifestyle change,
adapta on
Failing to Succeed Ka e, 18-year-old First-year univerfemale
sity student expeFocus: Individual riencing mental
health challenges, depression
Mental health assessment, role of nurse, ER,
suicide screening and
assessment, impact on
family
- 66 -
Appendix C: Examples of Care Scenarios Across
the Program Levels
Level II Care Scenarios (cont’d)
Scenario Title
Age/Focus
Summary
Key Learning
Dreaming of a
Perfect Body
Martha Winfrey, 17-year-old
female
Martha iden fies
herself as overweight, wants
to be healthier
weight
Obesity, cardiovascular
disease, atherosclerosis,
family history, dietary
aids, lifestyle change
“She’s going
home?”
Jessie Corman,
12-year-old
female
Focus: Individual
Nursing care and
advocacy for 12year-old in hospital for asthma
exacerba on
Caring for adolescent;
asthma assessment and
educa on; role of nurse
as advocate on health
care team; health educaon
Summary
Key Learning
Level III Care Scenarios
Scenario
Age/Focus
“I thought this
was going to be a
breeze”
Terry Fletcher, 68- Terry has surgical
year-old male
wound that has
Focus: Individual become infected;
ill, requires isolaon, hospitalizaon
Nursing care to support
persons experiencing
anxiety related to severe
illness; assessment;
infec on control
Trouble in the
Playground
Julia Hamer, 8year-old female
Focus: Individual,
family system
Julia has an anaphylaxis reac on
to nuts at school
Clinical reasoning related
to child with anaphylaxis,
nut allergy; nursing and
school policy; advocacy;
health educa on; suppor ng parents
Broken Silence
Meredith Sims,
34- year-old
female; husband
David
Focus: Individual,
family
Meredith is experiencing partner
violence, goes to
ER and receives
care from expert
RN; safety and
protec on
Cycle of abuse; care of
person experiencing
spousal abuse; advanced
communica on and
interviewing; legisla on
and nursing prac ce;
interprofessional collabora on
- 67 -
Appendix C: Examples of Care Scenarios Across
the Program
Notes
Level IV Care Scenarios
Scenario Title
Age/Focus
Summary
Key Learning
Cost of Silence
Angela, 22-yearold female
Focus: Individual,
system
Angela, new graduate nurse, experiences bullying from
nursing peers, has
impact on pa ent
care and outcome
Conflict management,
horizontal violence,
communica on,
legisla on, workplace
culture, reflec on
Nurse Heroes
Valerie, 23- yearold female
Valerie makes
medica on error while working
short-staffed, unit is
experiencing budget
limita ons
Ethical decisionmaking, resiliency
and innova on, moral
distress
Failure-to-No ce
Lauren, 22-yearold female
Focus: Individual,
system
Lauren, a new RN
grad, fails to no ce
subtle changes in
Rosa’s health status,
pa ent dies
Quality of care; caring
and safety; theore cal
frameworks; expert
clinical reasoning;
complexity; transi ons
Alley of Escape
Pam, 45-year-old
female
Focus: Individual,
RN, client, and
system
Pam is homeless,
lives in alley, taken
to ER with GI bleed,
leaves; visited by
street nurse
Nursing and care of
marginalized populaons; street nursing; barriers to care;
advocacy; health care
system
Steps to Leadership
Wendy, 22-yearold female
Focus: Individual,
system
Wendy makes a
delega on error affec ng pa ent safety
and care; debriefs
with manager; advocates for change at
professional prac ce
council mee ng
Student’s role as a
leader; leadership
and management;
nego a on and
delega on;Louzes and
PousnerLeadership
model
- 68 -
Appendix C: Examples of Care Scenarios Across
the Program
Scenario Title
Age/Focus
Summary
Key Learning
Strength of a
Mother
Claude e 34year- old female,
son Jean Luc 8year-old male
Focus: Individual,
family, system
Claude e and
son are from
Hai ; expressed
trauma of surviving earthquake;
trajectory from
Hai to primary
health clinic
Global policy and
health rela ons,
public policy,
nursing role,
advocacy, PTSD
- 69 -
Appendix D : Professionalism Documents Related to
Professional Prac ce Courses
Guidelines for Professional Behaviour in the BScN Program
All students in the BScN Program are expected to be aware of the 2008 Entry-to-Pracce Na onal Competencies (CNO, 2009).
The following competencies are associated with behaviour in a professional nursing
program.
Professional Responsibility and Accountability
• Is accountable and accepts responsibility for ac ons and decisions, including personal safety.
• Exercises professional judgment when using agency policies and
procedures, or when prac cing in the absence of agency policies and
procedures.
• Organizes own workload and develops me-management skills to meet
responsibili es.
• Demonstrates responsibility by comple ng assigned work and
and communicates honestly about work completed and not completed.
• Uses basic conflict resolu on strategies to transform situa ons
of conflict into healthier interpersonal interac ons.
• Adheres to the duty to report unsafe prac ce in the context of
professional self-regula on.
• Protects clients by recognizing and repor ng unsafe prac ces
when client or staff safety and well-being are poten ally or
actually compromised.
Knowledge-based Prac ce
• Knows how and where to find evidence to support the provision of safe,
competent, and ethical nursing care.
Ethical Prac ce
• Establishes and maintains appropriate boundaries with clients and other
health care team members, including the dis nc on between social
and professional rela onships.
Service to the Public
• Par cipates in and contributes to the development of nursing
prac ce and the health care team by:
a) Building partnerships with health care team members based on respect for the
unique and shared competencies of each team member;
- 70 -
Appendix D : Professionalism Documents Related to
Professional Prac ce Courses (cont’d)
b) Recognizing that their values, assump ons and posi onal power affect team interacons and uses this self-awareness to facilitate team interac ons;
c) Contribu ng nursing perspec ves on issues being addressed by other health care
team members;
d) Knowing and suppor ng the full scope of prac ce of various team members;
e) Using appropriate channels of communica on;
f) Providing and encouraging construc ve feedback among team members; and
g) Demonstra ng respect for diversity and viewing differences as an opportunity to
learn.
The above competencies correspond to CNO (2009) Entry-to-Prac ce Competencies
Nos. 2,9,10,12,13,14,31,88, and 105.
Excerpted from the Undergraduate Nursing Educa on McMaster University 2012-13
Program Handbook. Hamilton: McMaster University.
McMaster Mohawk Conestoga BScN Program
Professional Appearance Policy
As a McMaster nursing student, it is important to present yourself in a professional
manner, par cularly when in a professional prac ce se ng (community or hospital).
A professional appearance is important in establishing effec ve working rela onships
with pa ents and nursing colleagues. The following uniform policy has been created by
students and faculty to address the issue of professional appearance.
*Please note that each professional prac
ce se ng has its own uniform
policies that are also to be followed.*
In professional prac ce se ngs (includes hospital and lab) all students must:
• McMaster and Mohawk site students must wear a photo ID badge purchased
through the School of Nursing.
• Conestoga site students must wear a yellow School of Nursing name pin that is
to be purchased from Conestoga Bookstore
• Maintain hair neat, clean and secure long hair while working with pa ents.
• Have hair colour not extreme in colour due to bleaching, dyeing or colouring.
• Maintain beards or moustaches neatly trimmed.
• Keep jewellery to a minimum, one set of earrings and no facial piercings.
• Keep fingernails clean and neatly trimmed. No coloured nail polish. Ar ficial
nails are not to be worn.
• Remain fragrance free in all professional prac ce and lab se ngs
• Cover, if possible, any ta oos
- 71 -
Appendix D : Professionalism Documents Related to
Professional Prac ce Courses (cont’d)
• For students who entered the BScN program before 2011, students can select
•
•
•
•
•
scrubs of their choice, appropriate to the professional prac ce se ng. Pant suit
or dress scrubs are acceptable OR green scrubs are only allowed in special setngs and are provided by the agency.
For students in the Basic, RPN-BScN and Basic Accelerated BScN streams McMaster-Mohawk-Conestoga BScN uniform, mandatory blue uniforms with the BScN
Program crest are required.
The uniform is to be worn in the lab se ngs in all years of the program and in
professional prac ce se ngs in levels 2, 3 and 4 of the program.
Wear shoes that are white or predominantly white in colour, neat and clean.
Wear white coloured nylons or socks.
Change into uniform upon arrival to the professional prac ce se ng when
change rooms are available.
In community se ngs students must NOT:
• Wear bib overalls, leggings, hip hugger and similar casual style pants.
• Wear shorts except in specifically approved situa ons.
• Wear athle c fleece sweatshirts or sweatpants or yoga type pants
• Wear excessively ght, revealing or baggy clothing. Bare midriffs and cleavage
are unacceptable.
• Wear skirts and dresses that are shorter than knee length. Backless, spaghe
strap and sun dresses are unacceptable
• Wear clothing with large logos, slogans or sayings.
• Wear jeans, ‘jean-cut’ or ‘jean-style’ pants in any fabric except in specifically approved situa ons.
Adapted from: Salem Hospital Regional Health Services. (2004). E que e of the Job
Shadow Retrieved April 8, 2005, from h p://www.salemhospital.org/jobs/cxpETIQUETTE.htm
Approved by:
Undergraduate Nursing Educa on Commi ee (UNEC), June 1, 2012
BScN Opera ons, May 7, 2012
MUNSS Execu ve, May 4, 2012
- 72 -
Appendix E: Nine Tips for Giving Feedback
Feedback can provide valuable learning opportuni es, making us more aware
of what we do, how we do it, and the effects of our behaviours and ac ons. By
increasing our ability to change and modify our behaviours, we can become
more effec ve in our interac ons with others. The following is a brief outline of
some important considera ons when giving feedback.
Focus your feedback on…
•
Behaviour rather than the person
Focusing on behaviour implies that the behaviour is related to a specific
situa on and that the behaviour can be changed. It is less threatening to
hear comments about one’s behaviours than one’s personal traits.
•
Observa ons rather than inferences
Observa ons refer to the facts – the “what, when, where and how” of a
person’s behaviour. In contrast, the “why” of the behaviour can only be
inferred. Inferences come from interpreta ons that we form and conclusions that we draw. O en, inferences contaminate our observa ons, thus
clouding feedback.
•
Descrip on rather than judgment
A descrip on represents neutral (as far as possible) repor ng, whereas a
judgment arises from a personal frame of reference or values.
•
Descrip ons of behaviour which are “more or less” rather
than “either-or”
The “more or less” terminology implies a con nuum on which par cipa on
as being on a con nuum. In that way, par cipa on can be described in a
range varying from “low” to “high” par cipa on. Thus, the terminology is
as objec ve and meaningful as possible.
•
Behaviour related to a specific situa on in the “here and
now”
We increase our understanding of behaviour by rela ng the behaviour to
me and place. Feedback is generally meaningful if given as soon as appropriate a er the observa on or reac on occurs. By doing this, the feedback
is likely to be concrete and rela vely free of me-lapse distor ons.
- 73 -
Appendix E; cont’d

Appropriate ming and loca on
Because feedback can involve strong emo onal reac ons, be sensi ve
to the me and place. Excellent feedback presented in an inappropriate
me or place can do more harm than good. Feedback that is perceived as
humilia ng is never effec ve.
•
Sharing ideas, informa on and alterna ves
Rather than giving advice, share ideas and informa on and explore a variety of alterna ves. The recipient of the feedback is free to make personal
decisions about thoughts, ideas, events and future ac ons.
•
The value of the feedback that it can have for the recipient.
Remember, feedback is a gi . Help and feedback need to be given as an offer, not as an imposi on. Focus on the value it has for the person receiving
the feedback, not the person giving the feedback.
•
The amount of feedback that the receiver can use. When we
give more feedback than the person receiving it can effec vely manage, it
reduces the possibility that the feedback will be used. Focus on quality, not
quan ty.
Giving feedback requires understanding, skill,
courage, and above all, respect for others.
Adapted from: Lehner, G.F. (1975). Aids for giving and receiving
feedback. San Diego: CA: University Associates.
- 74 -
Appendix F : Preceptor Version: Level IV Professional Prac ce
Evalua on Tool
A Descrip on of the Level IV Professional Prac ce Evalua on
Tool and the Evalua on Process
As a part of ongoing feedback, a role-specific Level IV Professional Prac ce Evalua on Tool is
completed by the student and preceptor at mid-term (Week 6-7), therea er, the triad members
discuss the tutor evalua ons at a student-preceptor-faculty tutor mee ng. At the final evaluaon (summa ve), the Tool is completed during Week 11-12, and again, the preceptorship triad
meet to discuss the evalua ons.
There are three versions of the Tool that are each tailored to the preceptorship triad roles:
student, preceptor, and faculty tutor. In the purposes of the Handbook, the preceptor version is
discussed.
The Level IV Professional Prac ce Evalua on Tool reflects the Level IV themes and concepts that
are relevant to the professional prac ce courses. Under each of the themes, related key characteris cs are listed. For example, under the theme Personhood and Caring, one of the key characteris cs is Person-centred Care. For each key characteris c, a number of statements describe a
“picture” of a student’s expected level of performance. (See the example that follows).
A er making a comparison between the statements outlined for the key characteris c, the preceptor selects one of the evalua on scale descriptors (UNSATISFACTORY, NEEDS IMPROVEMENT,
SATISFACTORY, EXEMPLARY) that best represents the student’s performance to date. In the case
where there has been no opportunity for the student to demonstrate awareness, knowledge,
and/or skill or the preceptor has not experienced the key characteris c with the student, the key
characteris c would be checked off as “N/A”. Please note that if the selected scale descriptor is
UNSATISFACTORY or NEEDS IMPROVEMENT, comments and examples are to be made.
Following the key characteris cs, there is a sec on for comments for factors that may need to
be considered in making a final decision about progress, for example, unexpected occurrences
or absences. This is followed by a sec on for the summary of student strengths and weaknesses
(which students find very helpful).
At the end of the discussion, the preceptor provides a recommenda on of UNSATISFACTORY/
SATISFACTORY. The tutor and student each provide a self-assessment of the grading PROGRESSING TOWARDS ENDS-IN-VIEW or FAILING at midterm, and a PASS/FAIL at the final evalua on.
Taking both the SATSIFACTORY/UNSATISFACTORY preceptor recommenda on and the student’s
self-assessed grade into account, and considering the faculty tutor’s assessment, the tutor
makes the final decision about the grade at midterm, and assigns a PROGRESSING TOWARDS
MEETING THE COURSE ENDS-IN-VIEW or FAILING and at the final evalua on, a PASS/FAIL. In the
case of unsa sfactory ra ngs on key characteris cs or an overall FAILING/FAIL grade, the faculty
tutor will work with you and the student to nego ate remedia on and will document the plan
and progress.
Please note: Ini ally it may take more me to complete this Tool; however, a er using
it once or so, it will become easier to use. Faculty tutors in Levels I-III have found that
using this form is helpful in providing specific feedback to students and guiding their
future learning opportuni es.
- 75 -
Appendix F : Preceptor Version: Level IV Professional
Prac ce Evalua on Tool (cont’d)
U
Unsa sfactory
•
•
•
•
•
NI
Needs
Improvement
•
•
•
•
•
•
S
Sa sfactory
•
•
•
E
Exemplary
•
•
•
N/A Not Applicable
•
Deficient in awareness, knowledge, and/or skill [for key
characteris cs]
Displays poor mo va on for learning
Lacks accountability for ac ons
Places pa ents at risk
Needs significant further learning, supervision & student effort to achieve an acceptable standard
Shows some evidence of awareness, knowledge, and/or
skill [for key characteris cs]
Displays limited mo va on for learning
Some accountability for ac ons
May have had minor instances of irresponsibility
Performance is inconsistent
Is likely to improve to an acceptable standard with
some further learning, supervision & student effort
Consistently demonstrates awareness, knowledge, and/
or skill [for key characteris cs]
Accountable for ac ons
Performs consistenly at an acceptable standard
Consistently exceeds expecta ons of awareness, knowledge, and/or skill [for key characteris cs]
Consistently accountable for ac ons
Performs consistently above an acceptable standard, at
an advanced level
Has not had an opportunity to demonstrate awareness,
knowledge, and/or skill or the preceptor has not experienced this key characteris c with the student
- 76 -
Appendix F : Preceptor Version: Level IV Professional
Prac ce Evalua on Tool (cont’d)
An Example of a Key Characteris c and the Descriptors of the Evalua on Scale for
Use with the Key Characteris cs
Theme: Personhood and Caring
Key Characteris c:Person-centred Care
• Views the pa ent in a holis c manner, seeing the pa ent as a person with needs,
not a disorder or disease that needs to be treated
• Includes the pa ent (and family/friends, where appropriate) as members of the
health team
• Individualizes care plan based on clinical judgement, pa ent’s values, beliefs, and
preferences, including those of the family, where appropriate
• Demonstrates mely responsiveness to pa ent needs and care
•Check one (√ ): Unsa sfactory( ) * Needs Improvement ( )* Sa sfactory( X)
Exemplary ( )
NA ( )
*Comments and Examples:
- Did a good job in individualizing the plan of care for the pa ent with Type I
diabetes. Con nue to improve by doing this more consistently throughout the
remainder of the term.
- 77 -
Appendix G: Evalua on of Clinical Preceptor
Performance
Evalua on of preceptor performance provides valuable informa on for ongoing
professional development. When completed, this evalua on should be given
directly to the preceptor.
Preceptors are rated on the following scale for each expecta on listed. Students
have an opportunity to add comments to each item.
1
2
3
4
5
Poor
6
7
Excellent
For each student, the preceptor:
1.
Discussed course expecta ons for the term with the student
2.
Helped to plan realis cally to meet learning objec ves
3.
Objec vely assisted the student to iden fy strengths and limita ons
4.
Provided posi ve reinforcement
5.
Provided construc ve cri cism
6.
Sensi vely responded to the student’s learning needs
7.
Displayed empathy and concern for student
8.
Demonstrated enthusiasm toward teaching/learning tasks
9.
Accepted the approach to learning within the course expecta ons
10. Effec vely assisted the student to improve communica on skills
11. Objec vely evaluated student performance based on course criteria
12. Effec vely facilitated the student’s cri cal thinking
13. Effec vely facilitated the student’s problem-solving
14. Demonstrated appropriate applica on of knowledge
Students also provide an overall ra ng of the preceptor’s performance and list
both strengths and areas for improvement.
- 78 -
Suppor ng the Student in Difficulty in A Professional Prac ce Course,
A Guide for Students, Preceptors, and Tutors
Appendix H:
*Note: The preceptor and tutor receive a student’s signed learning
plan, as revised. Any difficul es not covered in the learning plan
must be outlined in a le er wri en by the tutor detailing the required
remedia on to the student. A copy of the le er is given to the
preceptor.
- 79 -
Notes
- 80 -
McMaster Mohawk Conestoga
BScN Preceptorship Workshops 2012-13
About Our BScN Preceportship Program Logo
Introductory Workshop
Learn about the fundamentals of BScN nursing
preceptorship, emphasizing the roles & expectations
Introductory Preceptorship
of preceptors, students, & tutors. Review essential
Workshop
components of the BScN curriculum renewal with a
focus on practice.
Advanced Workshops
Try out specific skills & techniques that will enhance
your clinical teaching effectiveness as a preceptor.
Learn about topics like questioning, clinical
Clinical Teaching Strategies
simulation, role playing, & the relationship between
FULL DAY
supervision & student autonomy.
Preceptors can use a coaching role to guide students
Coaching for Preceptors:
in discovering their strengths and achieving their
Coaching Students to Discover
professional goals. Learn about the possibilities for
their Potential
integrating coaching within the preceptor/preceptee
FULL DAY
relationship.
Effective collaboration & teamwork have been
linked to positive patient outcomes. Help increase
Collaboration & Teamwork
your student’s practical knowledge & skills for use in
intra & inter-professional collaboration, including
the patient & family. Effective communication
techniques for teamwork are included.
Focus on diversity in clinical learning encounters
between BSN students & preceptors. Learn about
responsiveness-to-diversity & the creation of
inclusive & rich learning environments. Discuss
Diversity and Learning
diversity issues, like abilities (physical,
developmental, emotional, cognitive), age cohorts &
inter-generational relationships, gender, religion,
language & ethic background.
Review important principles & tips about giving
Effective Feedback & Evaluation
effective feedback both on an ongoing basis & in
summary situations. Add practical teaching &
evaluation strategies/techniques to your repertoire.
Conflict is an everyday occurrence in health care
Managing & Harnessing Conflict
environments. Help students to recognize, manage
in Health Care
& harness conflict. Help students to learn to use
FULL DAY
creative & supportive strategies for successful
conflict management.
Understand the principles of student-centred
learning in our BScN curriculum, including selfStudent-Centred Learning
directed learning & problem-based learning. Use of
learning plans in professional practice courses is
featured. Critique several learning plans.
Focus on the key role that you play in teaching &
role modelling professional behaviours. Learn about
Teaching Professional Behaviours
ways to assess, model, teach positive professional
behaviours that are so critical in today’s health care
arena.
For further information about the schedule of our upcoming
Preceptor Workshops,
Contact Betty McCarthy, Secretary to the Preceptorship Program at:
bmccarth@mcmaster.ca or via 905 525-9140 x 22405.
©2012, McMaster University. All rights reserved. No part of this publication may be reproduced or
transmitted in any form or by any means without prior written permission from McMaster University.
The three interrelated components of the circle above
represent the collaboration within the preceptorship triad.
Together, the nursing student, preceptor, and faculty tutor
form a unique and cohesive partnership.
The triad’s principal goal is to assist the learner in making
the transition from that of a nursing student to a
professional nurse.
The component shapes and configuration illustrate the
dynamic nature of the partnership. At once, the three
members are both teachers and learners.
In this reciprocal relationship, the growth of each member
and contribution to the professional expectation of life-long
learning are facilitated.
Making and sustaining this pivotal commitment influences
the next generation of professional nurses; and it enriches
each triad member at a personal and professional level.
Shaping the profession, one nurse at a timeTM.
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