Transcript Document
Supporting Transition for
New Graduate Nurses: a
Statewide Nurse Internship Model
Vermont Nurses In Partnership
Susan A. Boyer, RN, M.Ed.
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© 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved.
No copying without permission. [email protected]
Collaborative approach
Origins: Nurse leadership group
Goal: To Implement a statewide nurse internship
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 (Clinical Coaching)
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Requires preceptor development/support
© 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved.
No copying without permission. [email protected]
Transition to practice
3 levels of internship were needed
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2.
3.
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New graduate transition
New to specialty
Undergraduate
© 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved.
No copying without permission. [email protected]
Program Outcomes:
Statewide use of single competency tool
Same expectations for all staff
Performance outcomes vs grocery list of
“tasks & procedures”
Concept-based vs. case or task-based
Foster critical thinking development
Prioritizing evaluation, caring relationships,
leadership, management & critical thinking
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© 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved.
No copying without permission. [email protected]
Program Outcomes:
Concepts
and framework fit across
continuum of care
Applicable for full allied healthcare team
Statewide standardization of preceptor
development and support
Evidence-based preceptor development
Focus on Preceptor’s role of ‘Protector’
for the patient and new graduate
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© 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved.
No copying without permission. [email protected]
Intern, student &
Orientee Development
Preceptor
Instruction
/Support
.
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Clearly
Defined
Roles
Protocols &
Data
Collection
© 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved.
No copying without permission. [email protected]
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
© 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved.
No copying without permission. [email protected]
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© 2003 - 2008 Vermont Nurses In
Partnership, Inc. All rights reserved.
N
U
R
S
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Professional
Role
Nursing
Judgment
S
T
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D
E
N
T
Critical
Thinking
Proficient
/Expert
Practice
Clinical
Preceptor
Clinical
Mentorship
Professional
Mentorship
As Adapted from: “Transition Stages Model“ diagram © Boychuk Duchscher 2007 - used with permission.
© 2009 Vermont Nurses In Partnership, Inc. All rights reserved. No copying without permission
Why Preceptorship?
Builds one on one relationship
Improves satisfaction, retention, and
orientation process
Provides bridge between theory and reality
Develops capability
Protects and ensures safety for patient,
new care provider and organization
Collects evidence of competence
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© 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved.
No copying without permission. [email protected]
Why mentorship?
Ongoing development of clinical capability
Support through 2nd & 3rd phases of
Boychuk’s “Transition Stages”
Development of nursing judgment
Development towards proficient practice
Transition within the profession
Deciding how and where you fit within the
nursing profession
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No copying without permission. [email protected]
Nursing Judgment
Analyze – Evaluate - Synthesize
Psychomotor
Affective
Develop Precision Act upon Attitudes
Articulation
Develop value system
Become automatic Organize own values
Integrate related skills
Naturalization
Technical skills
Adopt behavior
Internalize values
© 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved.
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No copying without permission. [email protected]
Preceptor development
Preceptor Development & Support
Multi-disciplinary approach
Need to:
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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© 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights
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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© 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved.
No copying without permission. [email protected]
Goal: To effectively develop & collect
evidence of capability
Preceptors will require:
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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© 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved.
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To develop capability
Preceptor roles & responsibilities
Teaching and learning theory
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
© 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved.
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To validate capability
Define “competent practice”
Delegation, accountability, liability
Performance management
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
© 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved.
No copying without permission. [email protected]
Core Concepts
Theory and evidence-based
Clearly defined expectations
Competency-based – COPA model
Concept focus rather than task, procedure, case-based
Preceptor development and support
Protector and Evaluator roles
Critical thinking development
Data collection/evaluation = Evidence based
Clinical coaching plans – “roadmap” for teaching &
evidence collection that is based in the clinical setting
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No copying without permission. [email protected]
VNIP: Collaborative Outreach
Electronic manuals with site license,
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Roles, JD, survey tools 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
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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© 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved.
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
© 2003 - 2008 Vermont Nurses In Partnership, Inc. All rights reserved.
No copying without permission. [email protected]