Essential Competencies of Preceptors: A Focus on Working with APRN Students

Module 1: Preceptor Roles and Responsibilities

Role of the Preceptor

The role of the preceptor is unique, challenging, and rewarding. While selected based upon clinical competence, the APRN may require formal development to function effectively as a preceptor. The preceptor's primary responsibility to the graduate student in the clinical setting is to provide meaningful and relevant learning experiences. While also coordinating requirements of the academic setting, the clinical agency, and individual learning needs of the students.

When serving as a preceptor for a graduate nursing student, the APRN has multiple roles and responsibilities. The preceptor is responsible for guiding the student's learning experiences, demonstrating new skills and procedures, creating a positive learning environment, and providing timely and constructive feedback. These outcomes are accomplished through the preceptor's implementation of specific roles including teacher/coach, role model, and socializer (Alspach, 2000; Ulrich, 2012).

Teacher/Coach

Teaching is what most students associate with the role of the preceptor and pertains to learning new knowledge and skills. Coaching differs from teaching, as it focuses on supporting the student in the application of that new knowledge. For example, the graduate student has been instructed on preparing for their first independent physical assessment of a patient, and has observed the preceptor complete several assessments within the clinical setting. As the coach, the preceptor supports the student in preparing for the examination and delivering the history and physical report. The teaching role includes preparing for the experience, assessing learning needs, planning learning experiences, implementing teaching strategies, and providing feedback about the learner's performance. More content about specific clinical teaching strategies is presented in Module 3.

As teacher, the preceptor is responsible for the overall learning experience for students. The preceptor is the person the student will rely upon most directly. Responsibilities related to the teaching role include:

• Assessing the student's learning needs
• Developing a plan of learning experiences (in collaboration with course objectives)
• Demonstrating new skills and procedures
• Observing as the graduate student practices new skills
• Providing feedback
• Introducing new learning experiences
• Supporting the development/improvement of organizational skills
• Evaluating performance

The teaching role demands a great deal of time for the preceptor. However, with a well-developed plan, and clear communication between the graduate student and preceptor, these preceptor experiences are integral to the student's transition to the role of APRN.

Role Model

The graduate APRN student may look to their preceptor as a role model for positive behaviors to emulate, during and even after the formal preceptorship has ended.

Primary responsibilities of the teaching role center on instruction, skills development, and role modeling of professional behaviors. Specific competencies associated with role modeling include:

• Defining professional expectations related to clinical roles
• Defining expectations related to attendance and punctuality
• Demonstrating patient care utilizing agency policies and procedures
• Collaborating with other healthcare providers
• Efficient and effective utilization of resources
• Researching best practices to guide patient care
• Implementing evidence based practice
• Serving as a patient advocate

APRN students also observe the preceptor as they organize care and delegate to other members of the healthcare team. As a preceptor, being explicit on how care is organized for the patients is an important strategy in providing effective organization. Similarly, role modeling effective delegation is important to the student learning this skill. It is important to allow the student to delegate to licensed personnel as they increase their patient load.

As role model, the preceptor is closely observed by the graduate student. For this reason, it is important that the preceptor be an effective role model. It is equally important for the preceptor to address "near misses" and to demonstrate best practices to prevent potential errors.

Socializer

APRN students can experience increased anxiety at the start of precepted clinical experiences. Up until this point in their education, clinical learning experiences for the student included peer and direct faculty support while in the clinical practice setting. Unfamiliar environments may lead to concerns about expectations related to direct patient care, as well as about acceptance by staff. Preceptor awareness of the student's anxiety and ability to take actions to make the student feel welcome in the setting can be accomplished through introducing the student to staff and familiarizing them with the setting.

Specific competencies associated with socialization roles include:

• Introducing the student to staff and other healthcare providers
• Providing a tour of the clinical setting
• Explaining policies
• Describing typical daily schedules and processes
• Describing role of the APRN in this setting
• Identifying the location of equipment and procedure manuals

Attention to these details can greatly decrease student's anxiety. Allowing APRN students to express their concerns and fears may help the preceptor plan specific learning activities to address these issues. It is important for the preceptor to discuss communication expectations, including those related to clinical absences and how to communicate this information to the clinical center. APRN students should be provided with the appropriate telephone numbers for the unit, as well as, designated contact person information.

Because the nursing student may be concerned about making a mistake, the preceptor may need to encourage the student to participate in, and seek out, specific clinical learning opportunities. From the beginning, the preceptor and graduate student need to clarify how new learning experiences will be managed. For instance, in many situations, the preceptor will need to demonstrate new skills prior to the student being allowed to complete the activity. In preparation for this, it is the student's responsibility to review the procedure, as well as to ask questions of the preceptor. One particular responsibility that the student usually has limited experience with is direct communication with physician and other healthcare providers, as well as participating in patient rounds. To decrease the student's anxiety, the preceptor can make sure the healthcare team understands the role of the ARPN student. To increase participation in patient care rounds, the preceptor can work directly with the student to explain the APRN's role, encourage the student to observe rounds on other patients, and to prepare to participate in rounds as confidence with this responsibility increases.