Nov 23, 2020, By: Danielle Fabischek, Shelley McAllister, Stacey Freemantle, Danielle Normand
- Preceptors provide a positive learning environment for newly hired nurses by assessing and identifying their needs, coordinating learning opportunities, providing feedback and reviewing progress.
- Nursing staff said they would benefit from training and resources to support them as preceptors, presenting an opportunity to integrate this in the work environment.
- The preceptor education program increased the capacity of staff members to support preceptees and enhanced the quality of work environments for nurses and students.
Introduction and background
St. Joseph’s Care Group (SJCG) is a multi-site health-care organization located in Thunder Bay, Ontario. It specializes in complex care and rehabilitation, seniors’ health, and addictions and mental health services. Each year, SJCG supports approximately 1,000 student placements and hires approximately 108 new health-care professionals, including approximately 38 registered nurses and 55 registered practical nurses (average captured from January 1, 2017, to December 31, 2019, data collection period).
Preceptors are clinical experts and play a pivotal role in supporting the transition of newly hired staff and students into practice settings by guiding and role modelling their knowledge, skills, and practice to increase confidence and enhance the practice of newly qualified professionals (Panzavecchia & Pearce, 2014). Preceptors are also imperative to providing a positive learning environment by assessing and identifying learning needs, coordinating learning opportunities, providing regular feedback, and reviewing progress on a daily basis.
SJCG’s recent nursing strategy highlighted nursing leadership as a priority based on staff engagement and survey results. In addition, the SJCG leadership team identified the need to support new learners (students and staff) to achieve their learning objectives and to enhance a healthy work environment within SJCG.
Despite the recognized importance of nursing leadership and learner support, within our organization preceptors were not formally identified and trained, and there was diminished interest expressed by clinical managers. Through stakeholder engagement, we identified that some staff felt hesitant to be a preceptor owing to lack of experience or knowledge, while others may have been held back because of poor past experience as a preceptor, or because they were part-time employees.
Specific to nursing, direct-care staff identified they would benefit from training and resources to support them to provide consistent messaging and guidance to their preceptees, presenting an opportunity to integrate best practice into our work environment.
SJCG’s program features learning resources, such as the preceptor toolkit, and a four-hour interactive classroom session.
The Registered Nurses’ Association of Ontario’s Best Practice Guideline: Practice Education in Nursing (2016) recommends that institutions provide preceptors with a structured, participatory professional development and education program (RNAO, 2016). This best practice led to the development of our organization’s preceptor education program. Preceptors have expressed the need for flexible, accessible education programs for ongoing support (Haggerty, Holloway, & Wilson, 2012).
SJCG has supported the development of a comprehensive preceptor program as a leadership development initiative for direct-care nursing staff to enhance leadership and clinical skills as preceptors. Initial planning began in May 2018, led by the nursing professional practice and best practice spotlight organization (BPSO) lead and the director of collaborative practice and chief nursing executive.
SJCG’s program features learning resources, such as the preceptor toolkit, and a four-hour interactive classroom session, facilitated by the organization’s nursing professional practice and BPSO lead. The toolkit is designed to provide new and existing preceptors with basic tools to support learners during preceptorship.
Planning and collaboration continued throughout the summer months. Key experts in clinical teaching and professional practice collaborated with our local academic partners to design a multi-faceted preceptor education experience for our staff, with the goal of creating positive teaching and learning environments for students entering our facilities for clinical placements and preceptorships.
Concepts and educational materials outlined in the toolkit are guided by adult education and learning principles and best practices. The four-hour, interactive classroom sessions are designed to focus on roles and qualities of excellent preceptors, providing a welcoming orientation; assessment of learning needs, objectives, and goals; strategies to provide feedback and evaluation; and support for learners experiencing difficulties. (See Appendix 1 for an image used in the program.)
The first preceptor education program was implemented in December 2018 for nursing staff. Stakeholder feedback identified that some staff (e.g., part-time employees and those with a poor preceptor experience in the past) were not asked or permitted to precept students or new staff. To address this gap, the program opportunity was provided to all nursing staff who expressed an interest and were able to attend.
This initiative was supported by management in advance through stakeholder engagement and communication. The program was promoted by the nursing professional practice and BPSO lead through the nursing quality practice council, clinical managers, and the corporate newsletter. All nursing staff interested in becoming a preceptor were encouraged to complete an expression of interest form and to register for a participatory classroom education session.
Expression of interest forms were shared back to managers to raise awareness of staff who were interested in participating in the classroom session and precepting students. Twenty-one staff members participated in the first cohort of the interactive classroom sessions and received paid education by their managers to attend.
The program received positive feedback after the first round of participants. Out of the 21 participants, 20 evaluation forms were returned. The forms focused on evaluation of the content, organization of the session, level of discussion, relevance of material, the facilitator, the learning environment, and the evaluation of the session as a whole.
Participants rated the session as a whole as excellent (65%), good (30%), and fair (5%); no one rated it as poor. Participants also provided qualitative feedback that they found great value in group discussions, where different perspectives and strategies for teaching were shared. Participants recommended more practice examples of how to approach and deal with learners experiencing difficulties, as well as integrating a representative from academic partners during the education session.
All feedback has been taken into consideration as the lessons learned and next steps for the program.
Supporting learners is a rewarding experience that comes with sharing professional knowledge, skills and expertise.
After launching the first two sessions of the program, we learned there are significant benefits to staff participating in preceptor education. Supporting learners is a rewarding experience that comes with sharing professional knowledge, skills and expertise.
We recognize that preceptors have different starting points, strengths, and skills related to the practice of teaching, and it is beneficial to bring them together to share their experiences as leaders and preceptors. The integration of an evidence-based preceptor education program has helped build the capacity of our staff, enable them to support preceptees, and enhance the quality of work environments, nursing practice, and the student experience.
We have adapted our online student evaluation form to include information about the preceptor experience, so that we can track student satisfaction on an ongoing basis.
SJCG’s preceptor education program has been integrated into our annual education plans to continually support the development of nursing leadership and evidence-based practice in daily nursing practice. To date, we have delivered five education sessions with future plans to continue to offer education twice a year, trained 39 preceptors, and are currently considering alternative ways to develop an engaging online virtual education program.
We have modified our new-hire process to include utilizing staff who have participated in the program to be the preceptor or “buddy” for the new hire, to improve continuity of practice. We have also added content to the program as required when the learner situation is somewhat varied (e.g., new staff hired through the new graduate guarantee program).
Although we have focused our preceptor program on nursing, unregulated health-care professionals (e.g., PSWs) have requested similar education. Our intent is to modify the material for their needs.
Looking to the future, we plan to analyze the staff satisfaction survey questions to determine whether we can correlate the student and staff satisfaction survey results with new-hire successes.
Appendix 1: Selected image from SJCG’s preceptor education program
Haggerty, C., Holloway, K., & Wilson, D. (2012). Entry to nursing practice preceptor education and support: Could we do it better? Nursing Praxis in New Zealand, 28(1), 30–39.
Panzavecchia, L., & Pearce, R. (2014). Are preceptors adequately prepared for their role in supporting newly qualified staff? Nurse Education Today, 34, 1119–1124.
Registered Nurses’ Association of Ontario. (2016). Best practice guideline: Practice education in nursing. Toronto: RNAO. Retrieved from https://rnao.ca/bpg/guidelines/practice-education-nursing
The authors of this article all work at St. Joseph’s Care Group in Thunder Bay, Ontario.
Danielle Fabischek, RN, BScN, is manager, clinical innovation and client safety.
Shelley McAllister, RN, BScN, is director, collaborative practice and chief nursing executive.
Stacey Freemantle, RN, BScN, is coordinator, leadership development.
Danielle Normand, RN, BScN, is nursing professional practice and best practice spotlight organization (BPSO) lead.