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DEPARTMENTS: Preceptorship

Tools to Enhance Learner Engagement for Preceptors

Young, Michele MSN, RN, NPD-BC

Editor(s): Bodine, Jennifer L. DNP, RN-BC, CEN

Author Information
Journal for Nurses in Professional Development: May/June 2020 - Volume 36 - Issue 3 - p 177-179
doi: 10.1097/NND.0000000000000633
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You’ve heard of the golden rule, “Treat others how you want to be treated.” I have a nursing professional development (NPD) golden rule, “Educate others as you would want to be educated!” No one wants to sit in a room for 8 hours, learning from lecture slides. NPD practitioners must figure out a way to engage learners and educate using methods that make the mundane marvelous! The NPD practitioner should always ask, “If I was the nurse sitting in this particular education, how would I want to be educated?” Creating engaging tools is where NPD practitioners reveal the art of their specialty. We can take an educational topic that may seem boring to most learners and present it using exciting, stimulating, and inclusive activities that will not only educate the learner but also allow them to have fun in the process.

Sometimes NPD practitioners are so focused on teaching that we forget to educate. There is a difference! You can teach a skill with knowledge and repetition. The learner may become proficient, but they may have no regard for why they are completing the skill or what happens when they make a mistake. Educating includes understanding the rationales and consequences involved in a skill. New nurses need to understand the possible complications and signs or subtle nuances a patient may exhibit when complications arise.

NPD practitioners have the responsibility to educate preceptors about the difference between teaching and educating and ensure they are confident in their ability to precept new nurses. Empowering preceptors to produce highly skilled new nurses who think critically requires the use of engaging tools to capture the essence and importance of the preceptor role.

A perfect opportunity to impart these techniques is creating learning strategies for a preceptor workshop. This process begins with deciding which tools or methods to use from the variety of options available. Ask yourself the NPD golden rule, “How would I want to be educated?” Answer the question from a seasoned nurse’s perspective who just worked three night shifts in a row. Are your activities going to be engaging enough to keep the preceptors awake? Will you present valuable information they have not heard before? How will you be able to help them realize that a lack of quality precepting skills might be the reason orientees quit?

Keeping the preceptors awake in class is the first challenge. Minimizing the use of slides is helpful in this endeavor. Replace the slides with different types of activities. A successful formula for educational planning is ensuring it is “effective, efficient, engaging, valuable, and outcome driven” (EEEVO). Tools and education must be effective for participants to learn the presented topics. The activities and classes must be efficient because the staff are busy and have competing priorities. It is essential to avoid wasting their time. The learning must be engaging. Just because it is required education does not mean it has to be boring! NPD practitioners should find a way to make learning fun, inclusive, and exciting. Education must also be valuable. Is there value in the words you are using? Is there value in the information you are providing? If not, then do not use the information. Do not provide information just for the sake of providing information. If information is included in education, it needs to be there because the participants need to know it. Commonly, people say “more information never hurt anyone.” However, there is plenty of research to the contrary. Brain-based learning suggests when the brain is overwhelmed, it shuts down and does not know what to focus on (Winter, 2019). What outcome do you want to achieve? Make sure you are focused on the outcome when creating education. Outcomes help to keep education focused on a specific goal. Are the delivery styles, tools, and words focused on achieving the desired outcome?

Another aspect to focus on when creating educational tools is the evidence-based literature. Do not recreate the wheel. Investigate if the needed tools or strategies already exist and then customize them. It is like finding an online recipe for a meal and then tweaking it to meet your needs. Benner (1984) is always a good go-to base recipe for creating education. Benner describes the Dreyfus model as a progression from novice to expert. This model can easily be applied to both new preceptors and preceptees. The Dreyfus model of skill acquisition proposes learning occurs through experiences and performance and is relational to the circumstances learners are placed in (Murray, Sundin, & Cope, 2019). Successful preceptors keep in mind that the orientee must progress through the levels of skill acquisition and seek out relevant learning experiences for their orientees.

Keeping the NPD golden rule and EEEVO formula in mind is how a county hospital redesigned their preceptor workshop. The team set out by reflecting on activities they found valuable in previous preceptor workshops and set the goal of enhancing learner engagement in the new workshop. The current preceptor program was evaluated to determine what content met the objectives, which material was extraneous, and which content could be changed into interactive activities.

The first revision of the workshop changed the standard introductions into a learning experience. Before introductions, a slide is presented regarding all of the roles of a preceptor. The slide ends emphasizing the importance of the socializer role. The socializer role, one of the most important roles of a preceptor, is used to introduce the preceptee to their peers. At this time, the preceptors are partnered and have 3 minutes to learn about their “preceptees” and then introduce them to the group. This exercise is an effective role-play to practice a skill they can replicate within their units. It is efficient because the activity only lasts a few minutes. During the activity, preceptors are required to find out one “fun fact” about their preceptee. This activity provides engagement because fun facts are interesting and add humor to the class. It is a valuable activity because it is a good ice breaker to get preceptors comfortable speaking in front of the rest of the group and it meets the outcome of role orientation.

Another aspect of the redesign was education related to generational differences. The previous program had many slides describing the differences, specific teaching strategies, and expectations of each generation. When presented as a lecture, the topic quickly became mundane. Therefore, an activity was created to increase engagement and replace the lecture. Preceptors are grouped in pairs to create a teaching strategy specific to the generation of the imaginary preceptee they are given on a laminated card. The preceptors also receive a generational chart that includes suggested preferred learning styles by generation. Preceptors are instructed to create a teaching strategy for the provided skill based on the preceptee’s preferred learning styles from the generational chart. They then present their teaching strategies to the group. During the group discussion, the NPD practitioner emphasizes generational differences are only a starting point to help preceptors determine what may be needed, and preceptors should discuss individual learning styles with their preceptee because generational differences can be a stereotype and may not always apply. This activity meets the EEEVO formula. It is effective because each group focuses on a different generation, so they learn all of the generational learning preferences when each strategy is presented. It is efficient because the generational presentation previously took 1 hour to complete, and the current activity is only 30 minutes. Engagement is demonstrated by the participants’ lively conversations. The activity is valuable and outcome driven because the learners hear about the importance of each generation's preferred learning style and apply it when appropriate while precepting.

The technique of activity-based learning is continued throughout the workshop. An activity discussing the characteristics of good preceptors involves the learners sharing two characteristics they do not possess and ideas on how they can obtain those characteristics. During an adult learning principles activity, preceptors read through a list of the principles, circle two of the styles they agree with, and share their reasoning with the group. For learning styles, learners take a survey to determine their preferred learning styles. In groups, the preceptors create sample weekly goals using the Specific, Measurable, Achievable, Relevant, and Time bound goal format. A picture that appears to change from different perspectives is used to demonstrate differing perceptions. This activity leads to a robust discussion on the importance of respecting different viewpoints. In addition, the group role-plays providing constructive feedback to orientees using the Behavior, Effect, Expectation and Result feedback method.

A favorite activity is the Lego game. Learners work in pairs with one person as the preceptee and one as the preceptor. The preceptor is given a picture of the Legos put together into a nonfigurative design, and the preceptee is given the Legos. The team is challenged to recreate the nonfigurative design with the stipulation that the preceptor must refrain from looking at the preceptee’s progress, and the preceptee may not see the picture. The preceptee can ask questions and the preceptor can be descriptive, but they are not allowed to look at the progress being made. Each group has 15 minutes to complete the design. After 15 minutes but before the group can see their completed design, the preceptors are asked if they feel that they described the task with as much detail as possible. Then, the preceptees are asked if all their questions were answered. Only after each member responds are they permitted to look at the picture to see how they did. Not once, in the hundreds of learners who have participated in this activity, have the designs been replicated perfectly. It is a great exercise to demonstrate barriers to communication and the importance of giving and receiving feedback. The exercise also helps the preceptors realize that, sometimes no matter how well they think they are communicating with the orientees, they just do not get it, and the preceptor must try another tactic. When time allows, the activity is repeated, the pair switches roles and is only given 10 minutes. The second exercise lends itself to increased teamwork, better communication, and better time management.

Another objective of the class is to address the newly redesigned unit-based orientation checklists the preceptors will complete on their units with new preceptees. Previous checklists contained large quantities of duplicated information, provided no competency verification methods, and required preceptors to sign over 200 line items. The new checklists include a scavenger hunt for required regulatory items and policy review to be completed during initial hospital orientation. The scavenger hunt removed the burden from preceptors to complete these items on the units. The rest of the checklists are divided into knowledge acquisition sections and competency validation sections. The topics were also condensed to reduce the number of line items needing the preceptor’s initials. The preceptors only need to place checkmarks and initial in the appropriate areas. After discussing Benner’s (1984) novice to expert model and Donna Wright’s (2015) competency verification methods, the learners are asked to correctly simulate completing the unit-based checklist using different examples of preceptee experiences.

The outcomes of the redesigned preceptor class have been incredibly positive. Of the 58 preceptors who have taken the redesigned class, 100% self-reported enjoying the hands-on activities during class. They also reported a 100% increase in confidence and preparation to precept on their units. The redesigned unit-based checklists have been completed at a rate of 100% for accuracy of completion and are completed an average of 42 days earlier than the prior checklists. An anecdotal measurement of our outcomes is the comments from the nightshift nurse who not only stayed awake for class but also stated she “may have been doing a few things wrong with her new hires.” This statement was a huge compliment to the class because when she first arrived in class, she said she’d “been precepting for years and did not need this class.”

Some challenges encountered with these tools to enhance learner engagement included class preparation time. Depending on the size of the class, obtaining the supplies for the activities can be quite time-consuming. There are times when the classes do not readily engage in the activities, so additional techniques were implemented to encourage class participation. The initial implementation of the new checklists was burdensome as we need to ensure all past and present preceptors know how to complete the checklist. However, the feedback was that the new checklists were more intuitive to complete than the prior checklists.

NPD practitioners are charged with the responsibility to adapt to the needs of their learners. We must create education that engages and inspires preceptors to educate and acclimate new hires to the ever-changing work of health care. The role of the preceptor is integral to the success of our future generations of nursing. We must find innovative ways to prepare preceptors with the tools and skills they need to be successful when precepting. They are already burdened with high patient-to-staff ratios, increased turnover, and constant change. We must ensure we are preparing our preceptors to teach new nurses to critically think and be competent and compassionate care givers.

References

Benner P. E. (1984). From novice to expert: Excellence and power in clinical nursing practice. Menlo Park, CA: Addison-Wesley.
Murray M., Sundin D., & Cope V. (2019). Benner's model and Duchscher's theory: Providing the framework for understanding new graduate nurses' transition to practice. Nurse Education in Practice, 34, 199–203. doi.
Winter R. M. (2019). The benefit of utilizing brain-based learning. Journal of Instructional Research, 8(1), 82–91.
Wright D. K. (2015). Competency assessment field guide: A real world guide for implementation and application. Springer.
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