Precepting: Holding Students and Programs Accountable
Lack of training for preceptors. Preceptors must learn how to fulfill this role on their own, without any training or support. This is a significant problem, not only for nascent preceptors but also for seasoned ones, who often precept students from different programs with a variety of requirements and expectations (and paperwork!). In an editorial, a new preceptor expressed concern about her ability to “get it right” and give her student what was needed to accomplish the goals for the rotation.5 Training and supportive testimonies are essential for successful precepting. A simple approach would be for program faculty to “mentor” new preceptors: Spend time orienting them to the expectations of the program and explaining how to evaluate students. Be proactive—establish weekly conference calls and share both strategies for successful precepting relationships and the “pitfalls to avoid.”
Student preparation. The other problem discussed by Logan, Kovacs, and Barry—and attested to by many of our readers—was the skill level and readiness of students on the first day of their clinical experience. While this responsibility lies with the student (rightfully so), I believe awareness of this problem, and understanding of how it affects practitioners’ willingness to precept, offers an opportunity for our education programs. Students may not know what they don’t know, or some may be too timid to speak up if they feel unprepared to step into a clinical arena (not to confuse that unease with “first-day jitters”). It is incumbent on the program faculty to ensure their students—who are representatives of that program and the faculty—are ready for clinical rotations. What do they need to do? Conduct an assessment of skills and readiness, which would assist all parties—the student, the preceptor, and the faculty—in gauging the progress of skill improvement and student competency and capability as a provider. It is also imperative that any remediation be provided by the program (prior to the student’s entrance into the clinical setting) and not the preceptor.
The bottom line is that precepting is a partnership between the skilled practitioner, the NP faculty, and the focused student.2 The responsibility for a mutually enjoyable and rewarding experience lies with all parties involved. As seasoned NPs, we must be active participants in preparing the next generation of our colleagues. That is our professional responsibility—our fulfillment of the “social contract.” We owe it to them, we owe it to our patients, and we owe it to ourselves—because someday, down the road, these clinicians will be taking care of us!
When a topic merits two editorials, there is clearly much to discuss. What steps do you suggest we undertake to mitigate this conundrum? Share your ideas by writing to me at NPEditor@frontlinemedcom.com.
References
1. Danielsen RD. The death of altruism, or, can I get a preceptor please? Clin Rev. 2016;26(4):10,13-14.
2. Barker ER, Pittman O. Becoming a super preceptor: a practical guide to preceptorship in today’s clinical climate. J Am Acad Nurse Pract. 2010;22(3):144-149.
3. Levy BT, Gjerde CL, Albrecht LA. The effects of precepting on and the support desired by community-based preceptors in Iowa. Acad Med. 1997;72(5):382-384.
4. Logan BL, Kovacs KA, Barry TL. Precepting nurse practitioner students: one medical center’s efforts to improve the precepting process. J Am Assoc Nurse Pract. 2015;27(12):676-682.
5. Aktan NM. Clinical preceptoring: what’s in it for me? J Nurse Pract. 2010;6(2):159-160.
