Community Health Nursing

 Module 1: PRECEPTORSHIP

At the end of this module you will have achieved the following objectives:

  1. Define and describe a clinical nurse preceptor.
  2. Identify characteristics of an effective preceptor.
  3. Describe concepts of a preceptor program.
  4. Identify requirements needed to be a preceptor.
  5. Relate preceptor program responsibilities to student learning and success.

 1. Define and describe a clinical nurse preceptor

A clinical nurse preceptor is a highly competent registered nurse (RN) with a current State of Texas license, a specific area of expertise, and the ability and desire to guide student learning in the achievement of course objectives. Health care professionals (non-RNs) who serve as preceptors must have a bachelor’s or master’s degree. The preceptor demonstrates a philosophy of health care congruent with that of the nursing program. The preceptor participates in the evaluation of a student’s performance although the final responsibility for evaluation rests with the course professor.

The Board of Nursing (BON) for the State of Texas defines a preceptor as “a registered nurse or other licensed health professional who meets the minimum requirements in §215.10(j)(6) of this chapter (relating to Clinical Learning Experiences), not employed as a faculty member by the controlling agency/governing institution, and who directly supervises a student's clinical learning experience. A clinical preceptor facilitates student learning in a manner prescribed by a signed written agreement between the educational institution, preceptor, and affiliating agency (as applicable).”

§Link to BON definition of preceptor:
Click here (PDF)

p. 67 of the BON Rules & Regulations


 2. Identify characteristics of an effective preceptor

Effective preceptors:


  • Use time efficiently
  • Use sound clinical judgment
  • Are clinically proficient
  • Have effective teaching skills
  • Show interest in new experiences
  • Are self-directed
  • Have the ability to establish rapport with others
  • Cope well with change
  • Demonstrate a positive professional image
  • Have an interest in working with students
  • Maintain professional behaviors and attitudes, including but not limited to:
    -Encouraging participation in professional organizations
    -Using appropriate, professional language
    -Reporting to work consistently and faithfully. However, if an emergency should arise causing an absence, the preceptor calls and notifies the student.
    -Reporting to work on time. However, if an emergency should arise causing tardiness, the preceptor calls and notifies the student.

Effective Preceptors are Role Models, Socializers, and Educators.

  • Role Models
    -Inspire, investigate, support
    -Teach by example
    -Aide students in development of interpersonal skills
    -Foster use of problem-solving skills
    -Provide prompt, positive and negative feedback
    -Assist in coping with reality shock
    -Provide supervision with progression toward independent, safe practice

  • Socializers
    -Assist students to integrate into work settings on the unit
    -Include students in social activities of the unit

  • Educators
    -Assist in assessment of learning needs
    -Plan learning experiences for students
    -Implement learning plans
    -Evaluate learning performance

 3. Describe concepts of a preceptor program

According to the BON, clinical preceptorship is an organized system of clinical learning experiences which allows a nursing student, under the direction of a faculty member, to attain specific learning objectives under the supervision of a qualified clinical preceptor. It is a means by which a specified target group is provided comprehensive and progressive experiences for individual role development in application and utilization of learned knowledge and skills. A preceptorship provides a one-on-one relationship between experienced nurse and student in order to learn the roles and responsibilities of clinical nursing. This learning occurs as the student practices alongside the expert nurse.

According to the BON, when preceptors are the primary educators in the clinical setting, the preceptor may precept no more than two students at one time. However, it is the belief and philosophy of the School of at UTEP and EPCC that preceptors will have a primary assignment of one student at any given time. The only exception to this might occur near the end of the semester when students have become more independent in the clinical setting and the preceptor is asked to work with another student temporarily due to an unforeseen situation where the student’s primary preceptor is unavailable.

§Link to BON Ratio of Preceptors and Faculty to Student. Chapter 215, Rule §215.10, (h)2
Click here

p. 82 of BON Rules and Regulations 


Benefits of a preceptor program for the student, preceptor, and the host facility.

Benefits to the Student:

  • Increased confidence and competence in the practice setting
  • In-depth understanding of the nursing role through exposure to everyday practice, with its satisfactions and frustrations
  • Increased ability to problem solve
  • Feelings of satisfaction as a result of professional nurturance
  • Smoother transition to an area of nursing practice
    -Less traumatic for students
    -More effective for students

Benefits to Preceptor:

  • Opportunities for sharing knowledge
  • Opportunities to facilitate the growth of an enthusiastic learner
  • Increased status by being in the preceptor role
  • Recognition as an expert practitioner
  • Increased job satisfaction
  • Experience of increased learning
  • Increased possibility for advancement of practice

    Goldenberg, 1987/88)

Benefits to the Agency:

  • A learning environment builds morale and collegiality as staff focus on patient outcomes and help students learn
  • A learning environment fosters professionalism and encourages growth and development, creating highly competent staff who in turn provide expert nursing care.
  • A pool of qualified potential employee is created from students being preceptored

    (MCGREGOR, 1999)

Purposes of a Preceptorship are to facilitate:

  • Learning experiences of the student 
  • Application of theoretical knowledge into clinical practice 
  • Enhancement of clinical skills 
  • Transition of student into the profession of nursing


Phases of Preceptorship

Phase I: Establishing the relationship between preceptor and student, the most crucial phase.

  • Provides the foundation upon which the learning experience will develop 
  • Enhances trust through clarification of roles, discussion of mutual experiences, as well as reviewing student’s background, career goals, and learning objectives. 
  • Includes discussion of agency policies and procedures 
  • Student’s experience is planned. The preceptor’s availability at the beginning of the rotation is crucial in planning the student’s experience. In the first few weeks of the semester, the focus of the relationship is to clarify roles, discuss mutual experiences, review the student’s background, career goals and learning objectives, and to discuss agency policies. Orienting the student to the clinical setting, especially if this is the student’s first time in the facility, promotes entry into the system and communicates respect and acceptance. The preceptor and student negotiate and determine the frequency of scheduled conferences that best meet the needs of the student and the schedule of the preceptor. Weekly or bi-weekly conferences are recommended.

Phase II: The Working Phase

  • Focus on implementation of student’s educational plan
  • Review student’s experiences, discuss patients, explore feelings about experiences & identify learning objectives
  • Provide feedback on a regular basis which assists students to maximize strengths & address problems systematically
  • Preceptor functions as role model in application of theory, problem solving & decision making
  • Mutual sharing of observations & discussion of strategies to enhance student understanding
  • Apply principles of adult learning
  • Over time, preceptor becomes less directive & student becomes more independent
  • On-going evaluation. Daily feedback is recommended. Input of the preceptor is invaluable. The School of Nursing clinical faculty liaison is responsible for any assigned grade. Even if the student does not agree with the evaluation received, all parties involved will sign the evaluation form. The student has the opportunity to write a response.

 4. Identify requirements needed to be a preceptor

BON Requirements to be a preceptor


  • Competence in designated area of practice
  • Philosophy of health care congruent with that of the School of Nursing program
  • Current licensure as a registered nurse
  • If not a registered nurse, a current license in Texas as a health care professional with a bachelor’s degree (minimal) in that field.

School of Nursing requirements to be a preceptor (in addition to the BON above)


  • Competence as clinicians
  • Ability to apply nursing theory to nursing practice
  • Ability to communicate and relate effectively with patients, students, peers, and other members of the health care team.
  • Have self-confidence and realistic perceptions of own nursing performance
  • Show interest in and have the ability to facilitate learning of students and/or new staff
  • Demonstrate leadership ability by initiating efforts to improve patient services and care


Other Criteria for selection as a preceptor

Preceptors are carefully selected and must meet the requirements of being a preceptor as stated in the BON definition of a preceptor and the above listed requirements. The preceptor is not compensated with pay by the school of nursing. Preceptors must meet their organizational policy for being a preceptor. The preceptor agrees to adhere to preceptor requirements, responsibilities, and professional behaviors while supervising the student during the clinical experience. Success of the student is largely dependent on the preceptor’s ability to motivate the student as well as create and maintain an atmosphere that allows and encourages independent self-directed learning.

Schools of Nursing require preceptors agree with their mission, philosophies, and vision prior to accepting role of preceptor. Please refer to mission, philosophy, and vision statements located at Preceptor Program log-in.


 5. Relate preceptor program responsibilities to student learning and success

BON Rule 215.10 (j) states the criteria for use of clinical preceptors. Written agreements shall delineate the functions and responsibilities of the affiliate agency, clinical preceptor and nursing program. Preceptored experiences may occur after the student has received basic theory and clinical experiences necessary to safely provide care to clients (within course or curriculum).

 

§Link: BON 3.8.3.a. Education Guidelines for Precepted Clinical Learning Experiences:
http://www.bon.texas.gov (PDF)



School of Nursing/Faculty Responsibilities

  • Provide preceptor training course for nurse preceptors and students, to include:
    -School(s) of Nursing mission, philosophy, curriculum
    -Course and clinical objectives
    -Student expectations, skills performance, guidelines for student achievement of procedures
    -Methods of evaluation
  • Ensure preceptors meet requirements of program. That preceptors:
    Are licensed as a Registered Nurse in Texas
    Preferably have a Bachelor’s Degree in Nursing or a Bachelor’s Degree as a health care professional
    Have competence in designated areas of practice
    Have a philosophy congruent with the Schools of Nursing

Preceptor Responsibilities

  • Completes the preceptor orientation
  • Has clinical expertise in the clinical area assigned with student
  • Functions as a role model, socialize, and educator in the clinical setting
  • Participates in identification of learning needs of the nursing student
  • Guides, facilitates, supervises, and monitors the student in setting and achieving personal learning objectives and course objectives in collaboration with the faculty and curriculum
  • Facilitates learning activities for the student
  • Orientates the student to the clinical facility, personnel, policies/procedures
  • Supervises student’s performance of skills and other nursing activities to assure safe practice
  • Supervises student’s administration of medications to assure safe practice
  • Assurance that student has been educated to the agency’s policy and procedures for medication administration.
  • Assures that student performs the 6 rights of medication administration (Right: patient, medication, dose, time, route, IV compatibility) in addition to those medication rights specific to the agency.
  • Verifies that student has thorough knowledge of medications, side effects, nursing consideration, etc., prior to administration.
  • Assures student is taught proper procedure for use of medication administration equipment, ie: IV pumps & tubing.
  • Verifies accuracy of medication pre and post administration to patient.
  • Maintains verbal and/or written communication with the faculty member.
  • Contacts faculty if assistance is needed and/or any problem with student performance occurs.
  • Provides faculty and student with written student evaluations at designated times or as needed.
  • Provides feedback to student regarding clinical performance.
  • Discusses evaluation with the student and faculty
  • Determines, with student (and faculty as needed) goals to help student achieve objectives and/or improve performance where indicated.
  • Discusses with faculty/student arrangements for appropriate supervision of student should the preceptor be absent.
  • Provide feedback to the School(s) of Nursing regarding clinical experience for students and suggestions for future program development.


Student Responsibilities

  • Maintain open communication (in person, telephone, email, pager) with preceptor and clinical faculty
  • Comply with University, College, and School of Nursing policies/procedures
  • Meet responsibilities as presented in course syllabi and student handbook
  • Function within the framework of the assigned clinical agency
  • Maintain accountability for own learning through participation in planning, goal setting, and implementation of learning experiences
  • Prepare for each clinical experience as needed
  • Be accountable for own nursing actions while in the clinical setting
  • Arrange for preceptor supervision when performing procedures
  • Contact faculty if faculty assistance is necessary
  • Attend scheduled clinical conferences
  • Complete self-evaluation
  • Discuss self-evaluation with preceptor and clinical faculty
  • Determines with assistance from preceptor, and faculty as needed, goals to aide in achievement of objectives and/or to improve performance
  • Conduct self in accordance to professional values and as directed by preceptor
  • Abide by all HIPAA rules and regulations, maintaining the confidential nature of all information obtained during the clinical experience

Agency Responsibilities

  • Retain ultimate responsibility for care of clients
  • Maintains responsibility for preceptor salary, benefits, and liability
  • Arranges preceptor work schedule to accommodate required clinical hours of student
  • Interprets preceptor program and expectations to other agency personnel not directly involved with the preceptorship