lopa preceptor program workshop -...

LOPA Preceptor Program

Workshop

Facilitator: Stacy R. Landry, CTBS, Education Manager

Louisiana Organ Procurement Agency 3545 N. I-10 Service Rd.

Metairie, LA 70002

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LOPA Preceptor Workshop Agenda

June 11, 2012

8:30 am to 9:00 am Sign-In

9:00 am to 9:30 am Session I: Welcome & Review of Objectives Stacy Landry, CTBS

9:30 am to 9:50 am Session II: Onboarding Stacy Landry, CTBS

9:50 am to 10:00 am Break

10:00 am to 10:40 am Session III: Learning Styles

Joanne Ault, LCSW Anne Dours


10:50 am to 11:50 am Session IV: Effective Feedback Chrissy Hagan, PHR

11:50 am to 1:00 pm Lunch

1:00 pm to 1:20 pm Session V: Overcoming Reality Shock Beth Harvey

1:20 pm to 1:50 pm Session VI: Competencies Ashley Garfield, CST Lynette Lamarque

1:50 pm to 2:00 pm Break

2:00 pm to 2:45 pm Session VII: Training Documentation Requirements Stacy Landry, CTBS

2:45 pm to 3:00 pm Break

3:00 pm to 3:50 pm Session VIII: Breakout Sessions by Role Department Manager

3:50 pm to 4:00 pm Closing Stacy Landry, CTBS

6:00 pm Team Dinner with CEO

June 12, 2012

9:00 am to 9:50 am Session IX: Critical Thinking Lynette Lamarque Ashley Garfield, CST


10:00 am to 10:50 am Session X: Professional Communication Kitt Smith


11:00 am to 12:00 pm Session XI: Time Management Stacy Landry, CTBS

12:00 pm to 1:00 pm Lunch

1:00 pm to 1:30 pm Session XII: Letting Go/Preceptor to Mentor Joanne Ault, LCSW Anne Dours

1:30 pm to 2:00pm Discussion/Evaluations Stacy Landry, CTBS



PURPOSE/GOAL(S): To provide basic effective preceptor training

OBJECTIVES: 1. Identify what qualities make an effective preceptor 2. Outline the process of onboarding 3. Use adult learning and teaching principles 4. Better manage your time 5. Identify concepts in critical thinking 6. Identify attributes of professional communication 7. Learn concepts related to evaluating and determining competencies 8. Describe strategies for effective feedback 9. Develop orientation outline 10. Identify what documentation is required of you and your preceptee

Organizational Development Committee (Education Committee):

• Stacy R. Landry, Education Manager • David Vincent, Recovery Professional Development Coordinator • Lynette Lamarque, Surgical Coordinator III • Beth Harvey, Placement Coordinator III • Anne Dours, Hospital Resource Coordinator III • Joanne Ault, Family Advocate • Kitt Smith, Quality Administrator • Ashley Garfield, Tissue Recovery Coordinator II • Sally Gentry, Family Services Coordinator • Kelli Hill, Clinical Support Coordinator II



LOPA Preceptor Program SOP

SUMMARY:

A preceptor program fosters competence of preceptors and enhances socialization of the new orientee. Additionally the preceptor program facilitates the professional development of staff that serves as preceptors.

RELATED MATERIALS: N/A

DEFINITION:

A preceptor is an experienced and competent staff member who voluntarily chooses to serve as a role model and resource for new employees. The preceptor, in conjunction with the manager/director, provides an organized orientation for new employees for the roles and responsibilities of their job function. In addition, new employees will be socialized to their new environment, fostering an atmosphere of trust and acceptance. The preceptor performs activities related to orientation, competency assessment, and competency verification. The preceptor identifies orientation and competency needs, and collaborates with their manager/director and Education Manager to develop a plan to meet these needs during time-limited preceptorships.

A preceptee (orientee) can be any of the following: newly hired employee, staff who transfer to a new role, staff who take on additional roles, or staff who require support and/or learning experiences that can be provided by a preceptor.

RESPONSIBILITIES FOR PRECEPTOR PROGRAM:

Program Development/Implementation/Maintenance:

The Organizational Development Committee (ODC) will collaborate to develop, implement, and review all preceptorships.

The committee members are the Education Manager, the Recovery Professional Development Coordinator, a representative from the Family Services and Quality departments, and a staff member from each department recommended by the department manager (exception: those departments that do not utilize preceptors)

The committee will meet every other month, or as determined by the Education Manager. The committee will be responsible for the following:

o Recommendations for preceptorship criteria o Establishment of the appropriate preceptor recognition plans o Development and implementation of the preceptor workshop content o Review of the preceptorship program’s effectiveness

The HR department and Education Manager will collaborate to administer reward and recognition to preceptors, as necessary.



RESPONSIBILITIES FOR PRECEPTORSHIP:

Orientee

Assists preceptor in identifying education and training needs Follows orientation plan Reviews policies and procedures, learning material, and other resources to facilitate learning Contributes to identifying learning experiences and seeks learning opportunities Validates professional judgments with preceptor prior to intervening with LOPA customers, as needed Acknowledges areas in need of improvement Completes all appropriate and required orientation paperwork Participates in evaluation meetings with preceptor, manager/director, and Education Manager Evaluates preceptor using designated evaluation form Evaluates orientation program using designated evaluation form Utilizes time appropriately to facilitate learning

Preceptor

Serves as a role model of LOPA’s mission/vision, core values, and guiding principles Serves as a resource for orientees Follows orientation lesson plan established for the orientee, and updates/revises as needed Employs adult learning strategies appropriate to the orientee Validates and documents competency by observing performance Plans, selects, and facilitates experiences to meet orientee’s identified needs Provides ongoing feedback to the orientee regarding performance; holds evaluation meetings with

orientee at least monthly (including manager when possible), and documents on the Orientee Evaluation Form

Promotes independent functioning consistent with level of experience Promotes critical thinking development of orientee Facilitates socialization into the division and organization Communicates orientee’s progress to manager, director, and Education Manager at least monthly Completes all documentation required for evaluation of orientee, including specific task evaluations,

Phase Reviews, Final Orientation Review, and Letter of Recommendation for Completion of Orientation Attends and completes the scheduled Preceptor Workshop Consults with Education Manager as needed Participates in meetings with other preceptors as determined by department manager

Manager/Director

Recommends potential preceptors to Education Manager Pairs preceptor with orientee, and notifies preceptor of orientee’s name and other necessary

information Arranges schedule so that preceptor and orientee work the same schedule as often as possible. Ensures a current orientation lesson plan is in place Participates in evaluation meetings with preceptor/orientee when available, with preceptor and

preceptor group at least monthly, and with orientee at least monthly Provides ongoing feedback to orientee regarding performance Ensures all required documentation for orientation is completed by preceptor



Evaluates effectiveness of preceptor and orientation program, and provides feedback to preceptor. Evaluates preceptor’s competency annually, and includes feedback as a preceptor in employee’s annual

performance appraisal Education Manager

Serves as a resource to orientee, preceptor, and department manager/director in developing the orientation plan, assessing learning needs, planning and implementing teaching-learning style, providing learning materials and evaluating orientee’s progress as needed

Serve as the point of contact for all preceptees who need to provide confidential feedback regarding their preceptors.

Plans, coordinates, and implements preceptor workshop in conjunction with ODC Solicits feedback from participants on effectiveness of preceptor workshop Meets with orientee during first two weeks of employment, and at least two more times during

orientation period Notifies HR of orientee’s successful completion of orientation and preceptor/manager’s completion of

all required documentation. Provides a variety of continuing education learning activities for the ongoing development of preceptors

PROCEDURE:

Criteria for preceptor selection are defined by department manager/director and may vary based on needs of each division. The following criteria apply to all divisions:

Must meet all performance appraisal standards annually Must meet competency for both their primary job role, and that of the preceptor role annually Must meet fulfillment of quality standards as evidenced by annual evaluations and review of occurrence

reports Demonstrates effective communication skills with interdisciplinary team members and customers, and

the ability to work collaboratively Consistently demonstrates strong organizational skills, ability to prioritize responsibilities, and equitable

delegation skills Must express interest, verbally or in writing, to their manager in becoming a preceptor Must be full-time employee Must remain current on all mandatory training requirements Role model for LOPA’s mission/vision, core values, and guiding principles

The manager/director will recommend preceptor candidates to the Education Manager, at which time they will be contacted with information regarding the Preceptor Workshop.

Each manager/director that utilizes preceptors will establish a policy implementing the preceptorship model specific to that division.



Self-assessment Form Instructions: Use the attributes in the table below to rate yourself in a manner that best represents the actual you. Do not project an image of who you want to be. Give each attribute a ranking, from 1 to 5, based on the following rating scale: Rating Scale: 1 = Never. Definitely not me. 2 = Rarely. 3 = Sometimes. 4 = Often. 5 = Always. This is who I am. Personal attributes Attitude attributes

1. Warm____

2. Humorous____

3. Mature____

4. Self-Confident____

5. Charismatic_____

6. Empathetic_____

7. Trustworthy____

8. Flexible_____

9. Accountable______

10. Experienced_____

1. Enthusiastic_____

2. Respectful_____

3. Supportive_____

4. Concerned_____

5. Patient______

6. Accepting_____

7. Nurturing_____

8. Effective in coping____

9. Professional______

10. Delegator______



Role of the preceptor What is the role of a preceptor? 1. Servant leader 2. Educator/Teacher 3. Coach 4. Encourager 5. Socializer

6. Record keeper 7. Evaluator 8. Advocate 9. Role model 10. Mentor

What makes a good preceptor?

Attributes of a preceptor

Knowledge Skills/Abilities Attitudes

Policies and procedures Patient care Mature Practice standards Communication Respectful Unit/area routines Use of equipment Realistic Documentation Use of resources Patient Available resources Interpersonal relationships Flexible Adult learning principles Work organization Dependable Methods of teaching and learning

Problem-solving Supportive, encouraging Decision-making Positive

Teamwork Priority-setting Has a sense of humor Time management Delegation Constructive You were selected to be a preceptor because you have many of these characteristics. Which ones do you possess? Perform a self-assessment by highlighting those which you have. Which ones will you then have to develop? On an index card, write your name, job title, and three ways in which you think you can develop those attributes.



New Hire Orientation Agenda Employee Name: Date of Hire: Job Role:

Topic Date/Time Location Presenter Initials

Agency Overview 4/9/2012 Admin Office Mission, Vision, Guiding Principles 1100 Stacy Landry Overview "Who is LOPA?" Stacy Landry LOPA 4/9/2012 Admin Office Learning Styles Inventory 1130 Stacy Landry Bambi & Justin's Story Stacy Landry CSC, Organ, & Tissue 4/9/2012 Admin Office Overview 1145 Stacy Landry Master Control Stacy Landry HIPAA Compliance (video) Stacy Landry

Lunch 1230 Human Resources 4/9/2012 Admin Office New Hire Paperwork 1345 Melanie Hymel Insurance Melanie Hymel EZ Labor, HRIS, Promantek, Time Corr. Melanie Hymel

EAP, Corp. Compliance Overview, Benefits, Emp Handbook

Melanie Hymel

Safety/Environmental Orientation Melanie Hymel BLR Videos Melanie Hymel Family Services, Community, Coroner/FH, FA/HRC

4/9/2012 Admin Office

Overview 1615 Kirsten Heintz

Tuesday, April 10th Finance 4/10/2012 Admin Office Reimbursement/Mileage 900 Michele Szegfu Quality 4/10/2012 Admin Office Overview 930 Michelle Cavett Occurrence Reports Michelle Cavett

Travel to Clinical Office (4441 I-10 Service Rd.) I.T. 4/10/2012 Clinical Office Setup 1030 Richie Madere Systems Orientation Richie Madere Clinical Office Tour Richie Madere



Onboarding Tips

Review basic policies and guidelines Question them about how things are going Schedule their activities weekly and have things for them to do Help them build their social network within LOPA Establish a productive relationship with them Share unwritten rules Give them more in-depth overview of dept. they will work closely with Arrange special meetings, breakfast, or lunch for them to meet co-workers Review relevant decision making processes with them-who they have to consult about

what Ensure they know where to find the resources they need Establish goals for them weekly Give feedback often, both positive and constructive Use various training mediums Give them your undivided attention Set up their work station prior to their first day Don’t cram too much information in one session Don’t assume “no news is good news” Don’t let them be left alone doing “busy work” Don’t let them have to seek out co-workers and introduce themselves



Orientation Outline for Your Department What are the components of an orientation?

LOPA General Orientation (See your copy of LOPA’s general orientation outline.) Departmental or job-specific orientation (Create a departmental orientation outline)

Sample orientation outline for new nurse

Week One - Obtain hospital identification badge - Orient to unit and other related departments - Introductions: preceptor, nurse manager, charge nurse, staff members - Discuss preceptorship program: goals and objectives - Unit layout, location of supplies (linen, patient care items) - Policies and procedures - Unit forms and documentation templates and processes - Unit equipment and operation - Unit care processes: care of two patients with preceptor - Weekly review of progress, with feedback

Week Two - Participate in care of two to three patients, with preceptor supervision - Practice basic and advanced life support procedures (if applicable) - Practice basic nursing skills - Assess and complete basic care competency verifications - Weekly review of progress, with feedback

Week Three - Participate in care of three to four patients, with preceptor supervision - Practice advanced nursing skills - Spend time with specialty nurses (e.g., diabetes educator, wound care specialist) - Complete some of the selected advanced care competency verifications - Weekly review and midpoint summary of progress, with feedback

Week Four - Participate in care of four to five patients, with preceptor supervision - Practice advanced nursing skills - Spend time with discharge planners, social workers - Complete advanced care competency verifications - Weekly review of progress, with feedback

Week Five - Participate in care of six to eight patients, with preceptor supervision - Practice advanced nursing skills - Spend time with pastoral care, organ donation coordinator, hospice staff - Complete remaining advanced care competency verifications - Weekly review of progress, with feedback

Week Six - Provide total nursing care for six to eight patients - Participate in formal performance appraisal/evaluation (if appropriate) - Release from formal orientation process and assess remaining preceptorship needs - Transition from preceptee role to mentee role - Weekly review and final summary of progress, with feedback



Create a list of the most important job-specific orientation topics to be included in your orientation outline. Which General Orientation points need to be reinforced at the department level? Use the following chart to organize your list. Role-specific Orientation Checklist Sample

Orientee name (print)

Title

Topics Method Date Preceptor’s Initials

Tour of department

Introductions

Department organization

Software systems:

Outlook

R3

Portal

Job description

Manuals

Payroll

Lunch/Breaks

Staffing

Schedule

Sick time

Fire plan

Dress code

Staff communication Comments:



Preceptor Relationship Guide The information gathered from this form and the Preceptor and Preceptee Interview is designed to better acquaint you with one another. Respect the privacy of your preceptor/preceptee and use this information only within the confines of the precepting relationship. Preceptor/Preceptee name

Current position Location

Phone

E-mail

Describe your primary job activity. What do you hope to gain from this precepting relationship? What are you bringing to this precepting relationship? What nonprofessional interests or hobbies do you have? In what professional organizations do you actively participate? Which days and time would you like to meet? How long would you like to meet for each precepting session? Would you prefer meetings to be scheduled in advance or arranged on an as-needed basis?



Would you prefer face-to-face meetings, telephone sessions, e-mail, other (explain), or all of these? How would you prefer disagreements to be handled? What is your personal communication style? Describe the type of feedback you would prefer (i.e., verbal, written, or both). Preceptees, describe what role you would most like your preceptor to play: advisor, teacher, guide, resource person, and so on. What questions do you have about your preceptor/preceptee? How should the progress of the relationship be measured? What ground rules will govern the precepting relationship (i.e., confidentiality, no-fault early termination for mismatches, etc.)? What most concerns you about the precepting relationship?



What can be done to minimize your concerns about the precepting relationship?

Complete and return a copy of this form to: Date received: _ Received by: _________________________



Assumptions About Learning How do the following assumptions about learning impact you as a preceptor? Be prepared to discuss. New preceptors should consider the following assumptions about learning to enhance the learning experience of their preceptee:

New employees or students of all ages have the potential to learn, with some learning faster than others.

The new employee or student is in a change process (including the preceptorship program)

and is likely to feel stress and confusion. Some anxiety often increases the motivation to learn, but too much anxiety may cause fatigue, inability to concentrate, resentment, and other barriers to learning. The preceptee will learn more when the conditions support an open exchange of opinions and problem-solving strategies.

In the clinical area, the preceptor facilitates learning by incorporating the student’s

experiences, observations of others, and personal ideas and feelings. Exposure to varied behavior models and aptitudes helps the preceptee to refine his or her own actions and beliefs that will aid the preceptee in meeting his or her own learning goals.

The depth of long-term learning for preceptees may depend on the extent to which they try

to analyze, clarify, or articulate their experiences to others in their work group. The depth of learning increases when new concepts and skills are useful in meeting current needs or problems. This allows preceptees to immediately apply learning theory to a practical situation.

The formal education program of the student or orientee provides only one step in his or her

progress toward acquiring new behaviors. The adoption of a new behavior depends on many factors. Some conditions predispose an individual to take a particular action, such as practice settings. The goal of the preceptor is to reinforce the correct behavior changes.

Learning improves when the learner is an active participant in the education process. The

preceptor, when selecting among several teaching methods, should choose the one that involves the preceptee the most. Using varied methods of teaching helps the learner maintain interest and may help to reinforce concepts without being repetitious.

Notes:



Learning Styles Learning style Implications and strategies for preceptors

Visual: Learning by seeing, observing, and picturing things and events. There is more equipment in humans for processing visual information than for any other sense. Most people are visual learners. Research demonstrates that mental imagery increases learning ~12% on immediate recall and ~26% on long-term retention regardless of age, ethnicity, gender, or preferred learning style (Meier 2000). Preceptees think and communicate in pictures and multiple dimensions.

Preceptees learn best when they can see real-world examples, diagrams, idea maps, icons, pictures, and images of all kinds while they are learning.

They use peripheral learning objects (e.g., bulletin boards, wall maps and diagrams, and unit dashboards).

They ask learners to observe a clinical situation, and then to think and talk about it, drawing out the processes, principles, or meanings it illustrated.

Appeal to these preceptees by - adding visual words to describe what things look like - drawing pictures to illustrate your points - bringing color teaching and orientation materials - writing things down for them - providing charts and diagrams - practicing doodling while they speak; learning to draw

Auditory: Learning by talking, hearing, and reading, especially out loud. All learners, particularly strong auditory ones, learn by sounds, dialog, reading out loud, telling someone out loud what they just experienced, heard, or learned, talking to themselves, remembering jingles and rhymes, listening to audio cassettes, and repeating sounds in their heads.

Have preceptees read out loud, one paragraph at a time, and paraphrasing it.

Have them tell stories with embedded information (e.g., case studies). Pair preceptees with staff members. Let preceptees describe what they learned and how they might apply it.

Have them practice a skill and describe in detail what is being done. Ask preceptees to talk nonstop while problem-solving.

Appeal to these preceptees by - making eye contact - slowing down your speech - keeping control of your body language - resisting the urge to draw or write - pausing - resisting the urge to interrupt

Kinesthetic (or somatic): Learning by actively moving and doing, engaging the body (somatic) in the learning process. These learners often cannot sit still, must move their bodies to keep their minds alive and active, and prefer hands-on learning activities. Sometimes these preceptees may be considered disruptive or hyperactive, inattentive and

Don’t just sit there, do something! Get the body involved in activities. Have preceptees practice techniques, perform

procedures, do an active learning exercise, or complete a project that requires physical activity.

If part of the orientation is classroom-based, allow these preceptees frequent breaks and permission to get up during classes and walk



disrespectful of the preceptor’s attempts to explain details or review lengthy policies and procedures. It is important for the preceptor to understand that for preceptees who prefer to access information kinesthetically, inhibiting them from using their bodies in learning also interferes with their ability to fully engage their minds.

about in the back of the room. Limit distractions to preceptees who might be

present and have different learning styles by managing the types of activities and learning environments chosen for the orientation and competency verifications.

Appeal to these preceptees by - allowing them to multitask

- asking them to talk - interrupting them to move faster - giving them something to take with them - keeping the lights on for a presentation (during orientation, for example)

- asking about and talking about emotions

Intellectual: Learning by critical thinking, problem-solving, and reflecting—what learners do in their minds internally as they exercise their intelligence to reflect on experience and to create connections, meanings, plans, and values out of it; the reflecting, creating, problem-solving part of a person. This process connects the body’s mental, physical, emotional, and intuitive experiences to build fresh meaning. To some degree, all preceptors and preceptees engage this learning style. It is the sense-maker of the mind, how people “think,” integrate experience, create new neural networks, and learn. This is how preceptees turn experience into knowledge, knowledge into understanding, and understanding into wisdom.

[begin bulleted list] These preceptees may need to receive the

information and have time to reflect on it, to mentally pull it apart and restructure it before they can accept this learning for application.

Give preceptees orientations and competency verification methods that involve the following:

- Solving problems - Formulating questions - Analyzing experiences - Applying new ideas to work - Doing strategic planning - Creating personal meaning - Generating creative ideas - Thinking through implications of ideas - Accessing and distilling information - Creating mental models



Teaching Strategies In the Three Learning Domains There are three learning domains: the cognitive domain, the psychomotor domain, and the affective domain. Each time you begin a teaching session, you must consider the domain in which you are teaching. The cognitive domain focuses on preceptees’ knowledge and intellectual skills. Teaching strategies include lectures, presentations, tests, case studies, and written materials. Test retention with objective and subjective test items (e.g., ask the preceptee to calculate a drug dose [objective] and choose an accurate pain description on a patient pain scale [subjective]). The cognitive domain addresses three instructional levels: fact, understanding, and application.

Fact: Preceptees are asked to recall information; learning objectives use verbs such as define, match, and list.

Understanding: Preceptees join two or more concepts; learning objectives use verbs such as describe, explain, and contrast.

Application: Preceptees merge two or more concepts and apply this knowledge to a new situation; learning objectives use verbs such as apply, demonstrate, and illustrate.

The psychomotor domain focuses on preceptees’ skills and physical abilities. Teaching strategies include performance skill-testing, mock events, quality improvement monitors, return demonstrations, and evidence of daily work. The psychomotor domain addresses three instructional levels: imitation, practice, and habit.

Imitation: Preceptees complete a return demonstration of skill, either under direct supervision of the preceptor or with evidence of daily work (e.g., passing a medication and accurately charting it as evidenced by the chart review and patient’s report); learning objectives use verbs such as follow directions, initiate, and carry out.

Practice: Preceptees have the opportunity to repeat the sequence of events in any procedure as often as needed to build proficiency without direct supervision; learning objectives use verbs/words such as repeat, perform, and go through the motion.

Habit: Preceptees perform the identified skill in twice the time it takes the preceptor to perform it; learning objectives use verbs/words such as perform rapidly, fit action to a new situation, and complete smoothly and efficiently.

The affective domain focuses on preceptees’ emotionally based behaviors. Teaching strategies include reflective exemplars, self-assessments, discussions, storytelling, and peer reviews. Learning objectives use verbs such as accept, challenge, defend, dispute, judge, praise, question, support, and share. The affective domain addresses three instructional levels: awareness, distinction, and integration.



Principles of Adult Learners

Select one or two of the following principles. Write down a specific example of how you could use a principle to develop your potential as a preceptor.

1. Adult learning is a self-activity—preceptees will learn more, will learn faster, and will retain what they’ve learned longer when they are actively engaged in learning experiences and have contributed their own objectives.

2. Adult learning is intentional—purposeful and aimed at meeting the preceptee’s learning needs. It is most effective when directed at useful and necessary objectives that have been negotiated between the preceptee and the preceptor for the orientation and competency verification periods.

3. Adult learning is an interactive process—hands-on, experiential clinical experiences (task-oriented, problem-solving) maximize the amount of learning achieved and retained for preceptees who access and process information in multiple ways and preferences (Gardner 1993, 1996; Russell 1999).

4. Adult learning is a unifying process—preceptees respond to teaching–learning situations as whole entities influenced by all of their dimensions of being, their social and physical environments, and their lived experiences. Preceptors incorporate individual differences and learning styles, as well as variable interests, opinions, and paces of instruction when planning orientations and competency verifications with preceptees.

5. Adult learning is influenced by the motivation of learners—a strong and sustained desire to learn allows preceptees to more readily acquire and retain information and skills. Preceptors can enhance motivation by allowing preceptees to participate in identifying and meeting their own learning needs whenever possible.

6. Adult learning is influenced by the readiness of the learner—preceptees have a high degree of readiness to learn whatever is required of them that is typically associated with a new job or role expectation. Preceptors increase this readiness by emphasizing how useful, meaningful, and worthwhile the learning is to the situation, clinical experience, and patient care outcomes.

7. Adult learning is influenced by the learning environment, which is both psychological and physical—preceptors need to provide a comfortable, relaxed, nonjudgmental atmosphere for preceptees: sufficient work space, adequate lighting and visibility, and minimal noise and distractions. Clinical learning experiences are highly stressful to preceptees (e.g., learning emergency procedures and treatments, dealing with death and dying).



8. Adult learning is most effective when it is organized and clearly communicated—preceptors facilitate learning best for preceptees in several ways:

a. Select appropriate organizing principles that are conducive to learning (easy to hard, known to unknown, first step to last step) for orientation, verification of competencies, and teaching new skills and abilities, particularly on specialty units (e.g., critical care, pediatrics, operating room) b. Use teaching aids (media, worksheets, flipcharts, models, overheads, bulletin boards, books) that complement how preceptees access and process information c. Communicate orientation schedules, objectives, clinical guidelines and procedures, and evaluations clearly and accurately.

9. Adult learning is facilitated by positive and immediate feedback—preceptors facilitate learning by giving timely feedback and criticism in a constructive and sensitive manner. It is important here for preceptors to be generous in giving recognition, approval, encouragement, and praise when it is appropriate. Celebrate moments of excellence with preceptees frequently.

10. Adult learning is built on past knowledge and lived experiences—preceptees vary in the speed and effectiveness with which they combine new learning with previous knowledge, skills, or abilities.

11. Adult learning is reproducible—preceptors can best reproduce retention and transfer of learning in preceptees by emphasizing principles and general concepts in clinical experiences, offering frequent practice and performance opportunities, and giving feedback throughout the preceptorship. When preceptors compare similarities and differences of new applications of previous learning or performance, they reinforce new knowledge and skills for preceptees who can then reproduce and apply what they have learned.

12. Adult learning continues lifelong—after the orientation and competency verification periods end, learning continues (ANA Code of Ethics 2001; Benner 1984) as preceptees become preceptors and continue their own journey to excellence.

Notes:



Managing your time: Managing yourself List at least three things you do that waste time and how you could recover that time. Discuss your answers. Review the three primary tasks affecting time management (organization, priority setting, and delegation) and how these are applied in preceptorships. Discuss what tactics you would use or suggest to help preceptees manage their time effectively. How would you manage your time when given the added responsibilities of working with preceptees?



Time Management Benefits of Time Management Rewards are immediate and the results are obvious and can be measured in terms of

more work done higher work quality quicker job advancement better self-control fewer missed deadlines better self-image

Characteristics of time:

Measurable Irreversible Irreplaceable Dynamic, not static Force/energy Infinite

Subjective Neutral (neither negative nor positive) Universal Resource Cultural Cyclic Valuable (time is indeed money)

Positive attitudes about time:

You can control your time through planning, thereby increasing your productivity and decreasing your stress.

We all are given 168 hours a week, no more and no less, and how we spend it affects our outcomes, goals, and satisfaction with our life.

Only you can determine what is the best use of your time right now. Time provides opportunity for growth and development. Irrespective of your opinions, thoughts, or situations, “time moves on.” By being careful and aware of 5- and 10-minute segments of your time, you can increase your

efficiency and induce yourself to use your time wisely. Time robbers/wasters Activities, things, people, habits, or attitudes that divert us from our primary objectives. They reduce our effectiveness and interfere with us or prevent us from completing our tasks, or from obtaining our goals. They include ineffective or lack of planning, ineffective or lack of priority-setting, over-commitment, practice-setting clutter, interruptions, emergencies or crises, failure to delegate, unnecessary telephone, paperwork, perfectionism, procrastination, conflict, ineffective problem-solving skills, daydreaming or escape activities, cramming, and scurrying (haste makes waste). Time savers/helpers Activities, things, people, attitudes, or habits that direct us to meet our primary objectives or goals. They increase our efficiency and effectiveness and enhance our completion of tasks. They include planning/controlling your time, making lists, setting priorities, completing agendas for meetings (do we really need to meet?), handling paper only once, not procrastinating. Do it now, and delegate, delegate, delegate.



Your personal action plan Three primary tasks for time management:

1. Organize

2. Prioritize

3. Delegate

Manage interruptions, emergencies, and crises with tact, diplomacy, and courtesy. Become better at solving problems and resolving conflict (use tried and true models). Be assertive; say “no.” Control the controllable and accept the uncontrollable. Keep interruptions short. Be ruthless with time, and be generous and kind to people. Occasionally become invisible and not so completely available. Avoid getting angry or hurt if possible; these waste time and energy. Maintain a sense of humor. Don’t forget to plan and make personal time for fun and recreational activities.

Notes:



Time Management Check-list

Boss-imposed tasks: Can I do this? When do they need it by? Am I the one to do this? How will it affect the work I’m doing? What alternatives exist?

System-imposed tasks: Is this within my responsibility? Do I have time? Is it worth doing? Can it be referred somewhere else?

Self-imposed tasks: Is this important to me? How will it impact my position? Can I control this? Does this fit my job description? Where are the winners and losers? Best-case and worst-case scenario? Can it be subdivided for delegation?

Customer-imposed tasks: What is the bottom-line impact? Can I do what the customer needs? Will I keep my customer? What is the prevailing perception What are the opportunities? How do I create winners?



SMART GOAL SETTING WORKSHEET

With Guidance Notes

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A Brief Guide to SMART goal setting A SMART goal is a goal that is specific, measurable, attainable, relevant and time based. In other words, a goal that is very clear and easily understood. SPECIFIC The goal must clearly state what is to be achieved, by whom, where and when it is to be achieved. Sometimes it may even state why that goal is important. Not all of these questions will apply to every goal, but it is important to ask all the questions in order to assess how specific your goal is and make it as clear as possible. MEASURABLE Measurability applies to both the end result and the milestones along the way to attaining a goal. It answers the question of quantity – how much, how often, how many? The milestones are signs along the way that will tell you that you are on the right track to achieving your goal. For instance, your ultimate goal may be to make 60,000 dollars in a year, but the milestones may be to make 5,000 dollars every month, which will add up to 60,000 in a year. So by focusing on making the 5,000 dollars every month you will ultimately reach your goal of 60,000 dollars. This makes the goal more attainable because it is easier to think of ways to make 5,000 dollars every month than 60,000 all at once. It has been said that what cannot be measured cannot be managed. This is often true when it comes to goals. Sometimes it is difficult to measure a goal, but at such times there is usually an indirect measure that can be applied. ATTAINABLE You should ensure that the goals you set are achievable. Firstly, you must believe that you can manage to do what you are setting out to do. If you set goals that re unbelievable even to yourself it is very unlikely you will achieve them. This is equally important when setting goals for a group, such as in the corporate setting. If the people for whom the goals are being set do not believe they are attainable, it is unlikely they will work wholeheartedly towards achieving them. Agreement and participation in the SMART goal setting process is important in such cases to ensure that most people are happy with how realistic the goals are. Secondly, the goals must be possible, all things being equal. There is no point setting a goal to float in the air and defy gravity using only your mind, for instance. No matter how hard you try this won’t be achievable.

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Be careful however, that you do not limit yourself based on what other people believe to be achievable or not. Set your own standards by understanding your own abilities, strengths and weaknesses. RELEVANT Your goals must be relevant to what you want to achieve in the short term and the long term. Understanding your organizational or personal vision, mission and purpose is critical in this respect. Sometimes you can be tempted to do something simply because it is easy and sounds great, only to discover later on that is has no long term importance to what you want to achieve as an individual or an organization. Do those things that are most important and in line with your long term vision and mission TIME-BASED This sometimes overlaps with the goal being Specific, but it aims to ensure that you put a time-frame to your goals. Someone said a goal is a dream with a time-frame to it. Simply deciding by when you want to achieve something can be a good motivator. It can prevent you from procrastinating because you know that you are working to a deadline.

“Failing to plan is planning to fail”

If you find yourself unable to set a SMART goal it is more than likely that your future plans are not clear enough and need to be worked on. Furthermore do not get tempted to skip the process of SMART goal setting and “get on with it” without fully analyzing your goals. Doing this careful planning at the beginning will save you lots of time and disappointment at a later stage and you will avoid making costly mistakes. INSTRUCTIONS Work through the worksheet that follows, including as much detail as possible under each heading in the columns. Clarify your goals to yourself as much as is possible. When you are done with the table you will be able to write SMART goals based on this.

www.executive-and-life-coaching.com ©2008 All Rights Reserved. This document is free to download and use unmodified.




Name:______________________ Date: ______________________

Intention Goals

Specific Measurable Attainable Relevant Time Based

What is it that you want to achieve?

Who? What? Why?

Where? When?

How much? How often? How many?

Achievable?

Is it important

to what you want to

ultimately achieve?

By When?



Phrasing your SMART goals In the spaces below, develop a statement defining your specific goals, incorporating as many of the elements that you worked on above as possible into the statement. Also indicate what types of additional skills and resources are necessary to facilitate this goal. Goal 1: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Goal 2: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Goal 3: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Goal 4: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________



Overcoming Reality Shock

The following action plan can be used with new employees as a way to make sure the new behaviors and skills learned during orientation are applied on the job quickly so that preceptees can immediately break through their natural resistance and make the needed changes.

Have preceptees select the objectives that are most important to them and complete an action plan for each one to reach orientation and competency verification goals.

DISCUSSION POINT COMMENTS/ACTIONS NEEDED OBJECTIVE: (What skill or ability do you want to change or improve? It must be specific, attainable, and measurable.)

GOALS ACHIEVED: (How will you know what you have accomplished? Be specific.)

PROBLEMS: (What barriers, resistance, or obstacles might you anticipate?)

SOLUTIONS: (How do you plan to avoid or deal with these problems?)

RESOURCES: (What people, time, equipment, and materials will you need?)

BENEFITS: (What’s in it for you and for the organization?)



Phases of Reality Shock Ways to assist preceptees

Phase Ways to assist preceptees

1. Honeymoon Develop the initial bonds between preceptors and preceptees, created by a mutual sense of trust, respect, and honor.

Harness their enthusiasm for learning new skills and routines. Be realistic but do not stifle their enthusiasm. Introduce them to new staff and coworkers.

2. Shock Anticipate that preceptees may experience some dissatisfaction with new positions, peers, or employers.

Listen attentively. Model the ideals of professional nurses. Help preceptees find appropriate supplies and functional

equipment when needed. Provide opportunities to vent frustrations in a constructive

manner. 3. Recovery Always treat preceptees kindly.

Help them view situations realistically. Ask them to keep a journal of improvements they would like to

suggest and what outcomes they expect or would like to see. Help them recognize positive aspects of their current work

settings, as well as areas where improvements might be made. Ease them into their roles and responsibilities. Do not release

preceptees to take full patient assignments until they are ready. Protect them in times of adversity. Always speak kindly about nurses and other healthcare

providers. Help preceptees regain their sense of humor.

4. Resolution Identify and manage any conflicts and confusions that persist. Assist them in constructive and creative problem-solving. Describe mechanisms and processes available to resolve

perceived problems or confusion. Give simple, easy-to-follow directions for tasks. Help them combine the best aspects of their prior school or

work expectations with their current work situations. Caution: Help preceptees retain the positive aspects of their

nursing values/belief systems from school and from the practicing nurses.

Adapted from American Association of Critical Care Nurses, A Preceptor Training Program (2000).



Helping the New Employee Overcome “Reality Shock” Reality shock refers to the disillusionment and disorientation that can occur when new employees perceive that the job they have is different from the job for which they thought they were prepared for. How can the shock phase be avoided? Use the following table to record one to two weaknesses, obstacles, and inconsistent practices you’ve identified in your deparment.

Weaknesses Obstacles Inconsistent practices

What can be done in that department to change the situation? Who needs to be involved in this change process?



Orientation, Competency Assessment, and Verification What is orientation? Orientations cover information about organizational culture, job descriptions or functional statements, policies and procedures, equipment operations, and initial competencies. What is competency? Competency is the goal of the precepting process. The preceptorship program is effective if the orientee attains competency on the required elements of the unit orientation. Competency consists of three elements: technical competence, interpersonal competence, and critical thinking/decision-making competence.

Technical skills Interpersonal skills Critical thinking/Decision-making skills

Tasks performed efficiently and safely using the following:

Cognitive skills Knowledge Psychomotor skills and

abilities Technical

understanding (ability to follow directions and carry out procedures)

Communication Customer service Conflict management Delegation facilitation Collaboration Directing others Articulation (e.g.,

expectations and boundaries)

Appreciating diversity Team building Listening Respecting Caring

Problem-solving Time management Priority-setting Planning Creativity Ethics Resource allocation Fiscal responsibilities Clinical reasoning Reflective practice Learning/teaching Change management

What is a job-specific competency-based orientation? The job-specific competency-based orientation is a time for preceptors to introduce preceptees to their new jobs, practice settings, managers, and coworkers. Preceptors help design orientation outlines, skills checklists, reflective discussions, and other verification methods to provide positive preceptee experiences that are specific, measurable, actionable, realistic, relative, and timely. What are the required competencies for your orientees? How do you assess the preceptee’s current level of skill and knowledge?



What is technical competence? This is the most familiar and objective skill domain. Elements are traditionally found on checklists and competency is measured by direct observation of psychomotor tasks. Efficiency components are often added to assess advanced competency.

Can you identify other tasks that will be needed for your department? Use the checklist below to record the tasks and measure whether preceptees meet the technical competence required. Technical competencies checklist:

Task Met Not Met

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SOP

Comments

Familiar with on-site requirements for tissue recoveries

T.5.1 Quiz

Familiar with traffic patterns through tissue suite

T.5.35 Quiz

Surgical hand scrub T.5.11 Gowning and gloving T.5.12 Maintains aseptic technique T.5.13 Familiar with cleaning and maintenance of instruments and equipment

Q.10/CU-01 Quiz

The advanced level of technical competence is to add the component of efficiency. In healthcare today, performing technical skills safely and effectively is the minimal expectation. Performing them with the minimal expenditure of time and supplies is also necessary.

What is interpersonal competence?

This skill domain refers to the effective use of interpersonal communication when working with others. These competencies, too, are often found on checklists and are measured by direct observation of interactions and behaviors that consistently convey caring and courteous attitudes. Team-building, conflict resolution, and customer relations are the key elements of interpersonal competence. These skills can also be listed on an orientation checklist.

Can you list others?



Demonstrating a Caring Attitude

Calling the donor family member by his or her preferred name Introducing yourself to the family or nurse and explaining your role in the process Sitting down, at eye level, and collaboratively planning or reviewing process Touching the family appropriately with a handshake, with a comforting pat on the shoulder or

forearm, or by holding the person’s hand, if you are comfortable doing so and are permitted to do so Listening—listening—listening Anticipating family or customer needs Expecting family or customer anxiety and offering information, reassurance, and comfort as

appropriate. What is critical thinking/decision-making competence? This skill domain addresses preceptees’ abilities to apply principles of critical thinking, creative problem-solving, and decision-making to evidence-based practice: assess facts, recognize problems, identify alternative actions, anticipate outcomes, and make choices. To measure competencies in this skill domain, preceptors must be more creative in their verification methods. Competencies are predicated on preceptees’ abilities to recognize problems, identify alternative actions, anticipate outcomes, and make choices based on the most current best practices. Asking questions helps them get beneath the surface of problems, generate more questions, and increase the number of possible solutions.

Ask “why” questions. Look for patterns and trends. Be open to possibilities. View events as part of a larger whole. Use intuition and “hunches” when problem–solving. Seek advice.

Preceptorships provide a safe environment during orientation for preceptees to explore the challenging problems found in complex healthcare systems. Guided questions can stimulate critical thinking and enhance preceptees’ decision-making skills.

Given these lab results, how will you change your nursing care plan? How will you prioritize your care today? What alternative nursing measures would work in this situation? What else could be causing your patient’s symptoms? How will you determine the effectiveness of that intervention? How will you document your patient’s outcomes related to that treatment?

Traditional versus Critical thinking

Preserves status quo Accepts norm and routine Treats each event in isolation Does not connect events and knowledge Has limited scope Accepts the obvious Solves problems alone

Asks why Is open to possibilities Views events as part of a larger group Uses intuition and hunches Has a wide scope Looks for patterns and trends Seeks advice

Critical thinking is a skill that can be learned. The mind is a pattern-making system. It creates, stores, and recognizes patterns. We learn by assimilating experiences and grouping them into ordered patterns.



Many times you have to generate a lot of ideas to come up with a few that will solve the problem. The problems in healthcare are usually complex and seldom do they have one right solution. Challenge your orientee to think beyond the obvious right answer and identify additional “right” answers. What are competency verification methods?

Competency verification methods are approaches to competency assessment that preceptors can use to complement the unique ways preceptees access and process information. 1. Tests/exams—measure cognitive skills and knowledge only; for competencies that require an outcome of the retention or understanding of information (e.g., written tests, quizzes, oral exams, surveys, worksheets, calculation tests, crossword puzzle tests, some word games)

2. Return demonstrations—measure technical skills only (e.g., CPR; ACLS; use of new equipment; skills checklists; direct observation)

3. Evidence of daily work—measure skills in the technical domain; assess the actions demonstrated on a daily basis to do the job (e.g., verify ability to use Bar Code Medication Administration [BCMA] by observing the final product ; medications are given and entered correctly into the BCMA system during daily work; direct observation)

4. Case studies—measure critical thinking skills (e.g., performance-based interviews)

5. Exemplars—measure both critical thinking skills and interpersonal skills that are difficult/impossible to observe (e.g., grief counseling, customer service, learning on the fly, professionalism)

6. Peer reviews—measure both critical thinking skills and interpersonal skills (e.g., professionalism, 360-degree assessments, customer service)

7. Self assessments—measure critical thinking skills associated with values, beliefs, myths, and assumptions; assess the affective domain of learning (e.g., coping with change; pain management; career development)

8. Discussion/reflection groups—measure critical thinking skills; when linked with mock events, may measure technical and interpersonal skills (e.g., debriefing after a code or crisis intervention; discussions using case studies or exemplars; root cause analysis after a sentinel event)

9. Presentations—measure knowledge and understanding (e.g., debriefings; grand rounds; shift reports; journal clubs; review boards; inservices)

10. Mock events/surveys—assess responses in daily work or practice; reflect individual performance; important to debrief after MEs (e.g., simulations; mock codes; simulated disaster drills or other emergency situations; mock surveys for accreditation agencies; mock surveys of proper equipment use and maintenance)

11. Quality improvement monitors—measure any of the three skill domains (cognitive, affective, psychomotor) anytime they reflect individual performance; check compliance with policies and protocols; benchmark desired outcomes and achievement of those outcomes (e.g., chart/documentation audits; medical records; compliance with policies and protocols; appropriate equipment set-up/teardown/clean-up)

Is there a difference between competency assessments and performance reviews or appraisals?



Personality traits that should not be included in competency assessments Cooperative Committed Conforms to policies

Assertive Decisive Codependent

Aggressive Creative Shows initiative

Passive Flexible Is a team player



LOPA Phase I Orientation Review

EMPLOYEE: _________________________ DOH: _________________________ POSITION TITLE: Tissue Recovery Coordinator REPORTING TO: Manager of Tissue Recovery Services LOCATION: 4441 N. I-10 Service Road Metairie, LA 70006 504-837-3355 504-837-3587 fax Instructions: The Reviewer must check if the employee has completed each of the tasks listed below

Task

Dat

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Initi

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Safety: o General Safety Information o Medical Waste Management o Formaldehyde o Packaging Medical Waste for

Disposal o Waste Segregation Guidelines

Medical Chart Review/Hemodilution: o Chart Review Presentation o Hemodilution Presentation o Understanding Serology Panel

Presentation

Preparation for Tissue Case: o How to pack for tissue case o Documentation of Supplies

Special Considerations: o Review Staff Conduct & Code of

Ethics o Review Post-Autopsy

Recoveries o Review post-organ tissue donors o Review procedure for handling

tissue recovery observation o Review shared serology testing o Review obtaining biopsies

Physical Assessment/Photographic Documentation:

o Physical Assessment Presentation

o Review photographic documentation procedures

Required Paperwork/Tissue Recovery: o Review recovery

paperwork/tissue chart o Tissue and Skin Recovery

Process Presentations



Task

Dat

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Donor Chart QA/Data Entry: o Hands on review of tissue donor

charts o Observe chart review process o Review data entry of charts into

R3

___________________________ ____________________ Employee Signature Date ___________________________ ____________________ Reviewer Signature Date ___________________________ ____________________ Manager Signature Date



Tissue Department Phase II Orientation Review

EMPLOYEE: _________________________ DOH: _________________________ POSITION TITLE: Tissue Recovery Coordinator REPORTING TO: Manager of Tissue Recovery Services LOCATION: 4441 N. I-10 Service Road Metairie, LA 70006 504-837-3355 504-837-3587 fax Instructions: The Reviewer must assess if the employee meets each of the tasks listed below. If employee meets the expectations, place a mark in the “Met” column. If the employee does not meet the expectations, place a mark in the “Not Met” column. Progression to Phase III cannot occur unless all tasks are met.

Task Met Not Met D

ate

of

Rev

iew

Rev

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Initi

al

SOP

Retraining

(if applicable)


T.5.1 Quiz


T.5.35 Quiz


Q.10/CU-01 Quiz

Comments: ___________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _______________________________________ ________________ Employee Signature Date _______________________________________ ________________ Reviewer Signature Date _______________________________________ ________________ Manager Signature Date



Tissue Department Phase III Orientation Review

EMPLOYEE: _________________________ DOH: _________________________ POSITION TITLE: Tissue Recovery Coordinator REPORTING TO: Manager of Tissue Recovery Services LOCATION: 4441 N. I-10 Service Road Metairie, LA 70006 504-837-3355 504-837-3587 fax Instructions: The Reviewer must assess if the employee meets each of the tasks listed below. If employee meets the expectations in the tasks required, place a mark in the “Met” column. If the employee does not meet the expectations in the tasks required, place a mark in the “Not Met” column. Progression to Phase IV cannot occur unless all tasks are met.

Task Met Not Met D

ate

of

Rev

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Rev

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Initi

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SOP

Retraining

(if applicable)

Donor preparation/draping T.5.10

Obtaining blood samples T.5.8

Wrapping and labeling of tissue

T.5.15

Musculoskeletal recovery procedures and related anatomy

T.5.19

Skin recovery procedures and related anatomy

T.5.26

Vascular recovery techniques and related anatomy

T.5.18

Heart for Valve Recovery Procedures

T.5.16

Liver recovery procedures Comments: ___________________________________________________________ ______________________________________________________________________ ______________________________________ ________________ Employee Signature Date _______________________________________ ________________ Reviewer Signature Date _______________________________________ ________________ Manager Signature Date



Tissue Department

Phase IV Orientation Review

EMPLOYEE: _________________________ DOH: _________________________ POSITION TITLE: Tissue Recovery Coordinator REPORTING TO: Manager of Tissue Recovery Services LOCATION: 4441 N. I-10 Service Road Metairie, LA 70006 504-837-3355 504-837-3587 fax Instructions: The Reviewer must assess if the employee meets each of the tasks listed below. If employee meets the expectations, place a mark in the “Met” column. If employee does not meet expectations, place a mark in the “Not Met” column. Employee will not be allowed off orientation unless all tasks are met.

Task Met Not Met D

ate

of

Rev

iew

Rev

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Initi

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SOP

Retraining

(if applicable)

Familiar with proper procedure for aborting tissue recovery

T.5.31 Quiz

Demonstrates proper donor reconstruction and post-recovery preparations

T.5.22

Demonstrates proper cleaning of recovery site following recovery

T.5.33

Demonstrates preparation and packaging of blood and tissues for shipment

T.5.23 T.5.24

Comments: ___________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _______________________________________________________________ ______________________________________ ________________ Employee Signature Date _______________________________________ ________________ Reviewer Signature Date _______________________________________ ________________ Manager Signature Date



Tissue Department Final Orientation Review

EMPLOYEE: _________________________ DOH: _________________________ POSITION TITLE: Tissue Recovery Coordinator REPORTING TO: Manager of Tissue Recovery Services LOCATION: 4441 N. I-10 Service Road Metairie, LA 70006 504-837-3355 504-837-3587 fax Instructions: The Reviewer must assess if the employee meets each of the tasks listed below. If employee meets the expectations, place a mark in the “Met” column. If the employee does not meet the expectations, place a mark in the “Not Met” column. Progression to Phase III cannot occur unless all tasks are met.

Task Met Not Met D

ate

of

Rev

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Rev

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Initi

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SOP

Retraining

(if applicable)


T.5.1 Quiz


T.5.35 Quiz


Q.10/CU-01 Quiz

Donor preparation/draping T.5.10

Obtaining blood samples T.5.8

Wrapping and labeling of tissue

T.5.15

Musculoskeletal recovery procedures and related anatomy

T.5.19

Skin recovery procedures and related anatomy

T.5.26

Vascular recovery techniques and related anatomy

T.5.18

Heart for Valve Recovery Procedures

T.5.16

Liver recovery procedures



Task Met Not Met D

ate

of

Rev

iew

Rev

iew

er

Initi

al

SOP

Retraining

(if applicable)

Familiar with proper procedure for aborting tissue recovery

T.5.31 Quiz

Demonstrates proper donor reconstruction and post-recovery preparations

T.5.22

Demonstrates proper cleaning of recovery site following recovery

T.5.33

Demonstrates preparation and packaging of blood and tissues for shipment

T.5.23 T.5.24

Comments: ___________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _______________________________________ ________________ Employee Signature Date _______________________________________ ________________ Reviewer Signature Date _______________________________________ ________________ Manager Signature Date



Recommendation for Completion of Orientation Notice of Competency

Date: To: Division Manager From: Preceptor Cc: Training File Cc: Employee I would like to recommend employee to be considered proficient as a job title. I feel that the criteria for determination of competency has been met based upon completion of a comprehensive orientation program and effective performance of their job duties. Sincerely, ____________________ (signature) ____________________ (printed name) Preceptor

Approval After reviewing the above mentioned documents and recommendation I agree that this employee has met the necessary requirements for the release from orientation. This employee will be required to demonstrate competency of these skills on at least an annual basis. Sincerely, ___________________ (Education Manager Signature) ____________________ (Division Manager Signature) ____________________ (printed name) Division Manager ____________________ (signature) Division Director



Louisiana Organ Procurement Agency

Orientation End of Program Survey We are interested in your evaluation of your experiences during your orientation. We will use this information to improve and enhance future orientations programs and processes. Please take the time to complete the comments section below each question. Position Title: _________________________________ Orientation dates: _____________________________ Preceptor: ____________________________________ 1. I received a/an: a. Orientation Plan Outline Yes No b. Orientation Binder Yes No Comments: 2. I was informed of the process and length of my orientation program. Yes No Comments: 3. I felt the length of my orientation was: Too long Too short Just right

Comments:

4. My orientation program was individualized to meet my learning needs. Yes No

Comments:

5. There was clear identification of the individual preceptor(s) responsible for coordinating and overseeing my orientation. Yes No

Comments:



6. My preceptor or manager met with me to discuss his or her expectations of my job. Yes No

Comments:

7. Answers were provided to my questions regarding my job during my orientation. Yes No Comments:

8. Appropriate resources were identified to assist me in my job (e.g., educators, phone lists, online resources, support staff, etc). Yes No Comments:

9. Classes and job experiences were appropriate to my job. a. Could have used more information on: Yes No

b. Could have used more time with: Yes No

c. Could have used less: Yes No

10. Feedback was provided during my orientation that allowed for evaluation and improvement of my performance. Yes No

Comments:

11. Please provide additional comments that would help us improve the orientation program. Comments:




Evaluation of Preceptor Orientees are to complete this form to provide feedback/evaluation on their experience with their preceptor. Each evaluation will be reviewed by the department manager and Education Manager.

Preceptor: ___

Preceptee: Title: _______________________

Dates of Orientation: to ____

Legend: 1= excellent, exceeded expectations 2= satisfactory, met expectations 3= unsatisfactory, did not meet expectations

Topic Evaluation

I. Preceptor (circle one)

• Preparation 1 2 3

• Organization 1 2 3

• Motivation skills 1 2 3

• Care of patients 1 2 3

• Availability 1 2 3

• Reliability 1 2 3

• Job-specific skills 1 2 3

• Knowledge of policies/procedures 1 2 3

• Interest in my needs/welfare 1 2 3

• Ability to create a nonthreatening environment for learning 1 2 3

• Teaching/learning skills 1 2 3

• Feedback/evaluation skills 1 2 3

• Communication skills 1 2 3

• Interpersonal skills 1 2 3

Comments:



II. Assumption of responsibility (circle one)

• Amount of independent working time 1 2 3

• Timeliness of assistance/guidance when needed 1 2 3

• Rate of increasing responsibility and duties 1 2 3

Comments:

III. Communication of progress (circle one)

• Verbal and written feedback regarding my progress 1 2 3

• Real-time feedback of my performance 1 2 3

Comments:



*Complete and return this evaluation form to Stacy Landry, Education Manager

Preceptee signature: Date:

Manager signature: ____________________________________ Date: __________________

1. Ways, if any, that this precepting partnership could have been more effective: 2. Recommendations for improvement I would make to my preceptor : 3. Other observations/comments:



Critical Thinking

Traditional vs. Critical Thinking TRADITIONAL vs. CRITICAL THINKING • Preserves status quo • Asks why • Accepts norm and routine • Is open to possibilities • Treats each event in isolation • Views events as part of larger group • Does not connect events and knowledge • Uses intuition and hunches • Has limited scope • Has a wide scope • Accepts the obvious • Looks for patterns and trends • Solves problems alone • Seeks advice



Professional Communication Communication Patterns

Passive Characteristics Allows others to choose for you Emotionally dishonest Indirect Self-denying Inhibited

In an interaction, you may feel Anxious Ignored Helpless Manipulated

Other’s feelings in an exchange Guilty Superior

Assertive Characteristics Choose for yourself Appropriately honest Direct Self-respecting Self-expressing Straightforward

In an interaction, you may feel Confident Self-respecting Goal-oriented Valued

Other’s feelings in an exchange Valued Respected



Communication Patterns

Aggressive Characteristics Choose for others Inappropriately honest (tactless) Direct Self-enhancing Self-expressive Derogatory

In an interaction, you may feel Righteous Superior Controlling

Consider other’s feelings in an exchange Humiliated Defensive



Written Communication Tips

Do orient your message around the reader’s interests Do determine the level of formality based on your audience Do maintain a professional tone, even in less formal writing Don’t forget to take cultural and language differences into

consideration Do invite the reader to respond

Write with a purpose. Why are you writing? Knowing the purpose will help you organize your writing, assess what kind of evidence or information you need to back up your statements, and determine the style and tone of your writing.

Striking the right tone. Where you are writing to make a request or to persuade, remember that tremendous good-will is generated by including three magic words: Please and Thank You

Revising and Editing: Reread written messages several times before sending Double-check spelling of unusual words Consult a colleague on important documents Check spelling of names and titles



Communication via E-mail Self-Assessment Quiz

E-mail Format

o I always organize my thoughts before composing e-mail

o I make time to personalize each message

o I always type the recipient’s e-mail address last

o I prepare thoughtful subject lines to elicit the best responses

o I make sure my message is concise and direct

o I pay strict attention to grammar

o My intended audience is always foremost in my mind

o I commonly use please and thank you in my e-mail

Recipient: Should be the last thing you complete before sending your message. Selecting the recipient first could result in accidentally sending a message prior to proofreading. Always double check the recipient address prior to sending to avoid sending the message to the wrong person.

Subject Line: Always include a header or subject line to catch the recipient’s attention. Correlate the topic of your email to an item your reader will recognize. Subject lines can also help you track communication on a specific topic.



Remember K.I.S.S “Keep It Simple, Stupid”

The phrase coined by Kelly Johnson, lead engineer at the Lockheed Shunk Works, states that simplicity should be a key goal in design, and that unnecessary complexity should be avoided.

Greeting: Address the recipient by name, formally as well as informally. Courtesy and professionalism should always be your watchwords. Use a colon or comma to separate the greeting from the body of the message.

Body of Message: Don’t elaborate the point in excessive detail. Devote no more than two sentences to the main point of your message. A second paragraph may be necessary to reiterate/clarify you points. Be clear about the priorities and action items that need immediate attention. Conclude by offering a phone number, email address, or website where readers can obtain more information. Accuracy in language and grammar is paramount. Use spell-check and grammar check features.

Signature: Conclude your email with your signature. Include your title, company name, mailing address, and phone and/or fax number. You can also include your email address, and a hyperlink to the company website if desired.



Tips for E-mail Communication

Notes:

Do keep your messages brief and make each word count Do clearly identify the topic in the subject line Do address recipients by name Don’t discuss sensitive or proprietary information Don’t discuss personnel matters with preceptee in e-mail Don’t send unsolicited e-mail Do request people’s participation with courtesy Don’t click “Reply to All” unless you know for certain that

everyone needs to read your message Don’t include defamatory or threatening language Do check spelling, punctuation, and grammar Do reread your message before sending Do type-email addresses last and check that they are correctly

spelled before sending Don’t type in all caps or use excessive punctuation. Be careful with

underlining and bold text Don’t make every email ‘high importance’



Effective Feedback

Evaluating Performance and Providing Effective Feedback Feedback must be specific, factual, descriptive, clearly understood by the preceptor and preceptee, timed to be most useful, sensitive to the preceptor and preceptee, constructive, and directed at behavior rather than personality traits. Whenever possible, provide positive feedback. When necessary, provide constructive feedback. Avoid giving negative feedback if at all possible. Complete the evaluation form at each agreed-upon time interval (e.g., every week during the preceptorship) and at the termination of the preceptoring relationship. When giving feedback

describe specifically what was observed: who, what, when, where, and how avoid generalizing or making assumptions relate how the observed behavior or actions made you feel suggest an alternative behavior or action

Preceptees need frequent feedback on the things they are doing well, the areas they need to work on, and their progress toward orientation and competency assessment goals. Continuous feedback allows preceptors to

motivate and positively reinforce learning diagnose the nature and extent of any problem areas offer constructive criticism when needed identify areas for remediation determine the effectiveness of the learning activities

ATTRIBUTES OF EFFECTIVE FEEDBACK Specific, not general Descriptive, not

judgmental Timed to be most useful Constructive, not

destructive

Factual, not opinionated

Clearly understood by the receiver

Sensitive to preceptee’s feelings and needs

Directed at behavior, not at personalities

Share information, not give advice

Based on mutual rapport and trust

Allows for preceptee’s perspective

Leads to positive outcomes



Elements of feedback: Describe what was observed: who, what, when, where, and how.

Description: “After loosening the dressing, you put on sterile gloves and removed the old dressing.”

Relate how the observed behavior made you feel.

Reaction: “I felt that the sterile field had been violated. This is the reason I suggested that you discard the clean dressing.”

Be as specific as possible. Avoid judging and generalizing.

Specifics: “The gloves you used to pick up the new sterile dressing were the same as those you used to discard the old soiled dressing. A nonsterile surface came into contact with a sterile surface.”

Suggest an alternative action, behavior, or response.

Alternative behavior: “Another way to manage this situation is to double-glove and remove the outer gloves when you discard the soiled dressing. You could also discard the contaminated gloves and then put on a second pair of sterile gloves before handling the new sterile dressing.”

Principles of providing feedback: Positive: Whenever possible, provide positive feedback.

Constructive: When necessary, provide constructive feedback.

Negative: Unless an emergency situation arises, avoid giving negative feedback.

B.E.E.R. feedback method

One way to provide feedback is to follow a four-step model for criticizing and correcting behavior and performance problems. This model is based on a four-step process that involves asking yourself questions about the preceptee’s behavior. Remember the acronym “B.E.E.R”:

B.E.E.R. feedback model: B: Behavior What is the preceptee doing or not doing that is unacceptable?

E: Effect Why is the behavior unacceptable? How does it hurt productivity, impact safe patient care, breach policies and procedures, bother others, and so on?

E: Expectation What does the preceptor expect the preceptee to do or not do to change?

R: Result What will happen if the preceptee changes (positive tone) or this behavior continues (negative tone)?



Evaluations Evaluations should be affirming and future-oriented. It is important to identify things that are positive and encouraging. You will also want to identify what has been accomplished and suggest ways to build on those areas in the future. Evaluations should be educative and enhance self-esteem. There should not be surprises in evaluations if you, the preceptor, have been giving daily feedback and opportunities to correct behaviors. As each required competency is successfully demonstrated, tell the preceptee that an objective has been completed. Review the documentation form each day and check off the day’s accomplishments. This exercise helps the preceptee see progress and feel successful. It is also important to communicate to the preceptee the areas that need further experience or improvement. Be direct and address negatives first. Do not sandwich negatives between two positives; it dilutes the effectiveness of both. Do not be apologetic about constructive criticism. As a preceptor, you have both a right and a responsibility to require good performance. You will want to collaborate with preceptees to develop a plan to improve these areas. Areas for improvement must be discussed as they are identified. Do not wait until the last day of orientation to tell preceptees everything they are not doing correctly! You will also want to keep the manager updated on any areas in which the preceptee is failing to progress as expected. When you sit down with the preceptee for an evaluation, do the following:

Find a quiet, controlled environment without interruptions. Maintain a relaxed but professional atmosphere. Put the preceptee at ease. Review specific examples of both positive and negative behaviors. Discuss future needs and goals. Express confidence in the preceptee’s ability to do the work. Be sincere and constructive in both praise and criticism. Ask the preceptee how you, as a preceptor, can improve the learning experience.

Notes:




Orientation Performance Feedback Record

Orientee Name: ________________________________ DOH: ________________________ Position: ____________________________________ Strengths: Tasks or procedures demonstrated: Areas needing experience and/or development: Action plan: Orientee signature: _______________________________ Date: _____________________ Preceptor name (print): ____________________________ Preceptor signature: _______________________________ Date: _____________________



Letting go

Increased responsibility indicators

Besides a perceived mutual increase in trust between the preceptor and preceptee, the following

indicators suggest that the preceptee is ready for the increased responsibility associated with becoming a

staff nurse. The preceptee:

• Proves that they will not miss important items

• Demonstrates that they can use past clinical experiences and apply them to a current clinical problem

• Recognizes their own limitations of knowledge

• Asks appropriate questions

• Displays self-starter qualities

• Seeks more challenging experiences

Keys for “letting-go” success

Moving forward from this point of the preceptorship program will require three keys for success:

1. Setting expectations for all future performance

2. Motivating the orientee by focusing on their strengths

3. Helping the orientee to find his or her “right fit” within the organization

Setting expectations for all future performance

Setting expectations for orientees’ future performance will not involve outlining exactly the steps they

need to take in all performance activities. By this time, orientees should be developing a core of values

for every aspect of their personal performance. These values involve integrity, honesty, the ability to

admit mistakes, quality communication, and a genuine caring attitude toward patients and coworkers. So

how does one set the expectations?



Expectations are set by reflecting the standards created by organizations that regulate health care. In the

new role of mentor, the neophyte nurse needs to be informed when it comes to learning new rules or

regulations as they are published.

TIP: After a new policy is posted, take the time to find the new employee and discuss the implications

for your unit and practice.

Motivating orientees by focusing on their strengths

Motivating orientees involves focusing on their strengths. You want to release each new employee’s

potential within the organization. Not every new nurse can start an IV successfully, insert a catheter

without contamination, or change a sterile dressing and have it look correct. However, these skills are

necessary within the workplace, so focus on rewarding new nurses with assignments that will allow

them to use their best skills and work with others to provide a complete care team.

Helping orientees find their “right fit” within the organization

Preceptors can play an important role in finding the “right fit” within the unit or organization for new

nurses. Preceptors can help new nurses find roles within the organization where their unique

combination of strengths (skills, knowledge, and ability) match the distinct demands of a nursing role.

Ideally, you will want to encourage growth within the current unit nursing role.

Role of the Mentor



Give encouragement and praise OFTEN Don’t allow them to nurture self-doubt after a mistake Role-model professional behaviors Help them set goals and measure their progress Show confidence, pride, and encouragement to them Exceed their expectations Provide leadership, guidance, and emotional support Encourage and facilitate stress management Give and receive constructive criticism and feedback Encourage and facilitate time management skills Guide them in handling new responsibilities Encourage them to balance personal and professional commitments Provide them with coaching and precepting at change points and learning opportunities Listen and communicate with empathy, insight, and wisdom Provide professional and career-counseling information Follow through on all your commitments Encourage them to search and seek out for professional avenues or experiences he/she might

not have known or discovered

Louisiana Organ Procurement Agency Preceptor Program Workshop



End of Workshop Discussion What 3 things will you start doing after completing this workshop?

_________________________________________________________________________________________________________________________________________________________________________________________________________

What 3 things will you stop doing after what you have learned today?

_________________________________________________________________________________________________________________________________________________________________________________________________________

What can we do to improve on the preceptor program in the future?

_________________________________________________________________________________________________________________________________________________________________________________________________________

What topics would you like to see offered via ongoing training opportunities for preceptors in the future?

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Any other comments:_______________________________________________________________________________________________________________________________________________________________________________________________

Tips for Effective Precepting



Make your preceptees feel welcome; introduce them to others

Remember how you felt the last time you were started a new job? Think about how scared, lost, or insecure/incompetent you felt. Did you feel alone? If you can remember how overwhelming everything was when you were new to a job, you will be better able to empathize and connect with your preceptees.

Clearly and immediately discuss the expectations each of you has for the preceptorship. This decreases anxiety and helps you and your preceptees begin to establish trusting professional relationships. You can use the Preceptor-Preceptee Interview document as a guide.

Every person is unique and challenging. Tailor the preceptorship to fit each of you individually, as well as in partnership.

Help them find experiences and learning opportunities to address any limitations they may have in their knowledge, skills, and abilities.

Listen carefully to them. What do they want or need to learn? Do not focus so completely on your prepared material that you miss important cues from them.

Encourage them to share their experiences and stories. They bring a wealth of information with them and are often eager to share. This helps build their self-confidence in their new role and their trust in their new preceptors

Be patient and considerate. Allow them time to grow comfortable in their new position and responsibilities.

Create a non-threatening environment that is friendly and accepting to help reduce the stress.

Give them expanding amounts of independence. Help only if needed; encourage them to try it themselves first. Start with only a few duties. Gradually add more as they demonstrate ability and skill.



Facilitate learning; do not “teach.” Remember that preceptees are professionals too,

and they already come with myriad lived experiences and knowledge. Let them use it.

Communicate. Communicate. Communicate. Then communicate some more.

Encourage them to ask for help when they need it. Other team members can also provide advice/experiences/consultation if they are unsure of their decisions.

People frequently learn from their mistakes. Allow them to risk making mistakes if possible.

Be open and honest in both word and action. Feedback must be trusted to be effective.

Ask and encourage questions. The only “stupid” questions is the one not asked.

Debrief at the end of each day. Review what they have learned, answer questions, problem-solve as needed, and set goals for the next day.

Take it one step at a time. They are novices in their new position. They often need to learn their new roles in structured routines and guided assignments.

Build their orientations and competencies on previously gained knowledge, skills, and abilities

Provide constructive feedback at least one a day and as often as needed. Final several positives to share with them. Don’t wait until evaluation time to review problem areas or areas needing improvement.

Set clear goals with them. Allow time for discussion and feedback.

Remain available to them after the they are off of orientation. This might be the time to transition into a mentoring role.

Keep a list or daily record of their progress. Have them keep notes too. Discuss these together and any needs or requests they identify during their assignments.




Make sure they spend time with subject experts. Discuss their experiences and how

they will use what they learned to improve their performance.

Everyone has something to contribute. Help them find what they have and celebrate their “moments of excellence.”

Take a “laugh break” as often as you can. Appropriate fun and laughter are healing. They reduce stress, relax the mind, allow us to process more information, and can improve any situation. Laughter is the medicine for the soul.




Preceptor Workshop Evaluation Form Please answer the following about the workshop:

The program could have been enhanced by:

The section of the program that I liked the most was:

The section of the program that I liked the least was:

My suggestions for future programs:

Additional comments:

Presenter: Stacy Landry Date: Please rate the following statements with a circle around the appropriate number:

Exce

llent

Goo

d

Fair

Poor

The presenter demonstrated mastery of the subject matter.

4 3 2 1

Rate the presenter for each of the following criteria: a. Organization 4 3 2 1 b. On time and using time well 4 3 2 1 c. Clarity in presenting information 4 3 2 1 d. Preparedness 4 3 2 1 e. Responsiveness to questions 4 3 2 1 f. Presentation skills 4 3 2 1 g. Ability to hold attention of audience 4 3 2 1 h. Audio/visual materials easy to see or hear 4 3 2 1

Comments and Recommendations for Improvement:



Presenter: Beth Harvey Please rate the following statements with a circle around the appropriate number:

Exce

llent

Goo

d

Fair

Poor


4 3 2 1



Presenter: Joanne Ault & Anne Dours Please rate the following statements with a circle around the appropriate number:

Exce

llent

Goo

d

Fair

Poor


4 3 2 1





Presenter: Ashley Garfield & Lynette Lamarque Please rate the following statements with a circle around the appropriate number:

Exce

llent

Goo

d

Fair

Poor


4 3 2 1



Presenter: Kitt Smith Please rate the following statements with a circle around the appropriate number:

Exce

llent

Goo

d

Fair

Poor


4 3 2 1





Presenter: Chrissy Hagan Please rate the following statements with a circle around the appropriate number:

Exce

llent

Goo

d

Fair

Poor


4 3 2 1


Comments and Suggestions for Improvement:



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