Transcript Document

Core Curriculum for
Clinical Coaching
Intro - VNIP Model
Vermont Nurses In Partnership
Susan A. Boyer, RN, M.Ed.
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Collaborative approach
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Origins: Nurse leadership group
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Goal: Implement nurse internship
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Inclusive of various practice settings, specialty
services, academia, & regulation
Supports “transition to practice”
Applicable in multiple HC settings
Environment of nurture & support
Process: Based in Preceptor Program
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Requires preceptor development/support
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Transition to practice
3 levels of internship needed
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New graduate transition
New to specialty
Undergraduate
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Program Outcomes:
 Statewide
use of competency tool
 Same expectations for all staff
 Performance outcomes vs grocery list of
“tasks & procedures”
 Concept vs. case-based
 Fosters critical thinking development
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Program Outcomes:
 Prioritizes
evaluation, assessment,
management, human caring relationships
& critical thinking
 Concepts and framework fits across
continuum of care
 Applicable for allied healthcare team
 Statewide standardization of preceptor
development and support
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Intern, student &
Orientee Development
Preceptor
Instruction
/Support
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Clearly
Defined
Roles
Protocols &
Data
Collection
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Protocols &
Data
Collection
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Clearly Defined
Expectations
Preceptor
Support
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Evidence-based
Evaluation (data collection)
Support Systems for Intern
Policies – orient, preceptor, competency
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Performance Expectations
Competency assessment
Coaching Plans
Instructional strategies
Basic instruction
Tools/Resources to support roles
Ongoing skill development
Teaching Critical Thinking/Work org
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Why Preceptorship?
Builds one on one relationship
Improves satisfaction, retention, and
orientation process
 Provides bridge between theory and reality
 Develops capability
 Collects evidence of competence
 Protects safety for . . . .
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Why mentorship?
Ongoing development of clinical capability
 Support through 2nd & 3rd phase of initial
transition to practice
 Development of nursing judgment
 Development towards proficient practice
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Transition within the profession
 Deciding how and where you fit within the
nursing profession
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VNIP Preceptor development
Preceptor Development & Support
 Multi-disciplinary approach
 Need to:
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Revise/update the preceptor model
Develop high level preceptor workshops
Consider recognition and reward
Prioritize protector role
Delineate evaluator/validator role
Establish protocols
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reserved. No copying without permission. [email protected]
Determining content?
 How
do we determine “what to
teach” in regards to development
of preceptors and clinical coaches?
What's the goal?
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Establish our goal
 Preceptors
will collect evidence
of clinical capability of the
novice care provider.
 Must effectively develop
capability, where it is missing
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Developing Nursing Judgment
Develop & utilize cognitive foundation to:
Analyze – Evaluate - Synthesize
Psychomotor
Affective
 Follow directions
 Attitude/feelings
 Develop technical skills
 Internalize values
 Naturalization
 Adopt behavior
 Integrate related skills
 Organize personal
 Become automatic
 Develop value system
 Articulation & Precision
 Value - to understand & act upon
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Goal: To effectively develop & collect
evidence of capability
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Preceptors will require:
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Effective Communication
Supportive Interpersonal Skills
Core teaching/learning principles
 Foster critical thinking skills
Team process:
 Relationship-based care
 Relationship-based development
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To develop capability
Preceptor roles & responsibilities
 Teaching and learning theory
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Collaborative team approach
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Learning styles, Novice to expert, Simple to complex,
Principles of adult learning
Story-telling, Use of case scenarios, and/or practice with
difficult situations
Relationship-based process, Interpersonal issues, conflict
management, Socialization
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To validate capability
Define “competent practice”
 Delegation, accountability, liability
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Performance management
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Communication & feedback
Assessment & evaluation of capability
Data collection
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Nurse practice act, job descriptions, P & P
Validating performance, collecting evidence, complete
documentation tools
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VNIP: Collaborative Outreach
Core Concepts
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Theory and evidence-based
Clearly defined expectations
Competency-based – COPA model
Concept focus rather than task, procedure, case-based
Preceptor development and support
 Critical thinking development
 Data collection/evaluation
 Clinical coaching – plan for teaching
© 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved.
No copying without permission. [email protected]
VNIP: Collaborative Outreach
Electronic manuals with site license,
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Roles, JD, and protocols
How to teach, how to foster critical thinking
development
Tools for competency assessment
Tools for clinical coaching
PowerPoint Presentations, activities, notes, etc.
for preceptor development
Same for intern development
© 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved.
No copying without permission. [email protected]
VNIP: Collaborative Outreach
Consulting services & collaborative
workgroup
 Explanation of VNIP framework, core concepts,
and key processes
 Instruction specific to use & roles of various
resource materials
 Cyber-communications network
 Expert contributors adding to resource pool
 Web-based updates as they occur
 Linkages for shared workshop
delivery/participation
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© 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved.
No copying without permission. [email protected]
VNIP: Collaborative Outreach
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Key processes
 Preceptor development and support
 Critical thinking & critical thinking development
 Data collection/evaluation of process change
&/or effectiveness
 Clinical coaching with instruction specific to
various learning styles
 Clinical Coaching plan development & use
 Competency based evaluation – COPA model
 Concept focused rather than case-based
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No copying without permission. [email protected]
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Protector
- Safeguards patient
& preceptee
Preceptor
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Educator
Facilitator
- Teacher,
Coach,
Evaluator
- Role model,
Socializer &
Team leader
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No copying without permission. [email protected]
VNIP Annotated Bibliography 2009
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Nurses reported missing an alarming amount of care and when nurses
cannot provide the care they feel is necessary, it leads to turnover and
nurses leaving the field of nursing. (Kalisch et al, 2009)
The foundation of the preceptor’s role is the “Protector”, but formative
and summative data collection have shown the vital importance of the
“Evaluator” role as well. (Boyer, 2008)
Preceptorship programs facilitate development of confidence,
competence, self-sufficiency and accountability (Bell and Deans,
2000; Boyer, 2008; Hilligweg, 1993)
Preceptors need core instruction, ongoing support, recognition, and
access to reference resources (Boyer, 2008; Reid, et al., 2002)
Early identification and intervention of unsafe practice are critical and
consist of red flags regarding knowledge, attitudes, skills, and
professionalism. (Luhanga et al, 2008)
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© 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved.
No copying without permission. [email protected]
VNIP Annotated Bibliography 2009
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Ten years of research shows that new graduates meet basic entry level
expectations only 35% of the time. (del Bueno, 2005)
Research reveals the ‘transition to practice’ as a continuum that
requires twelve months. During that year, specific stages of
development result in evolving nursing judgment. (Boychuk, 2008)
Students need more opportunity to acquire broad general
competencies that facilitate transition to practice. These include critical
thinking and clinical judgment skills, teamwork, cost awareness, and
accountability. The millennial nurse views the first year as a process
and needs/wants support for this process . (Olson, 2009)
Graduates are not prepared for the realities of today's practice. Gaps
in capability include problem solving and clinical decision making .
When they enter the workforce, it is essential that those in the field
implement strategies to promote their success. (Hickey, 2009)
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S. Boyer, RN, MEd, FAHCEP, Executive Director , VNIP
© 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved.
No copying without permission. [email protected]
VT Nurses In Partnership
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Go to www.vnip.org
Check the links and learning page for connections to
additional resources and other web sites
Utilize the VNIP outcomes to validate or modify your
own systems for intern or preceptor development
Print our 2009 Bibliography list & peruse the supporting
literature and concepts that we apply for development
and delivery of the evolving VNIP framework
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© 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved.
No copying without permission. [email protected]