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PRECEPTOR PRECEPTOR ORIENTATIONORIENTATION

July 2006

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Welcome! Welcome!

Thank you for becoming a preceptor for the Thank you for becoming a preceptor for the Okaloosa-Walton College EMS Programs Okaloosa-Walton College EMS Programs

The purpose of this orientation is to The purpose of this orientation is to familiarize you with: familiarize you with:

• The Preceptor The Preceptor • Clinical Training Clinical Training • How to provide feedback How to provide feedback • How to evaluate studentsHow to evaluate students

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Remember That You Weren’t Remember That You Weren’t Always Successful Always Successful

Many new paramedics look at successful pre-Many new paramedics look at successful pre-hospital care providers & think they were always hospital care providers & think they were always that waythat way

Most professionals have had great mentors Most professionals have had great mentors

We developed over time & through much trial & We developed over time & through much trial & errorerror

We received correction along the wayWe received correction along the way

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You Are Now The MentorYou Are Now The Mentor

You are now a preceptor and thus a mentorYou are now a preceptor and thus a mentor

Many times, you are the first medical professional that Many times, you are the first medical professional that students will see “in action”students will see “in action”

Your attitudes and actions has an impact on the kind Your attitudes and actions has an impact on the kind of EMT or paramedic the student will eventually of EMT or paramedic the student will eventually becomebecome

The mentoring the student receives is just as The mentoring the student receives is just as important (maybe more so) as the training he/she important (maybe more so) as the training he/she receives in the classroomreceives in the classroom

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Why Do They Need A Why Do They Need A Preceptor? Preceptor?

Students need help managing anxietyStudents need help managing anxiety

They need to develop a professional identificationThey need to develop a professional identification

They need to understand that there are a variety of They need to understand that there are a variety of strategies that are effective – there is not just one strategies that are effective – there is not just one wayway

They need to develop their own “style”They need to develop their own “style”

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Preceptor ResponsibilitiesPreceptor Responsibilities

Provide a model for the student to emulateProvide a model for the student to emulate

Transmit knowledge of “problem” callsTransmit knowledge of “problem” calls

Help the student manage anxietyHelp the student manage anxiety

Supervise & guide field performanceSupervise & guide field performance

Provide positive & correctional feedback that will allow the Provide positive & correctional feedback that will allow the student to “grow”student to “grow”

Completely & honestly filling out & signing the students Completely & honestly filling out & signing the students evaluation formsevaluation forms

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Preceptor CharacteristicsPreceptor Characteristics

Possess good communication skillsPossess good communication skills

Establish a climate that is conducive to learningEstablish a climate that is conducive to learning

Share practical steps in patient careShare practical steps in patient care

Provide positive & correctional feedback, when necessaryProvide positive & correctional feedback, when necessary

Listen to the studentListen to the student

Knowledgeable in medicineKnowledgeable in medicine

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ReminisceReminisce

What makes a bad preceptor?What makes a bad preceptor?

What makes a good preceptor?What makes a good preceptor?

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EMS Preceptor Roles EMS Preceptor Roles

Guides the student and provides help when neededGuides the student and provides help when needed

Shares knowledge Shares knowledge

Must be able to sit back & let the student care for the Must be able to sit back & let the student care for the patient while preventing the student from doing harm to patient while preventing the student from doing harm to the patient or themselves. the patient or themselves.

Makes mental notes about the good & the bad aspects of Makes mental notes about the good & the bad aspects of care & reviews with the student in a private setting. care & reviews with the student in a private setting.

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Roles (continued)Roles (continued)

Preceptors should keep an open mind that there is Preceptors should keep an open mind that there is more than one way to reach a certain goalmore than one way to reach a certain goal

Allow the student to experimentAllow the student to experiment

Remember that they are still in the learning processRemember that they are still in the learning process

They should not be expected to perform to the level They should not be expected to perform to the level of an experienced EMT or Paramedicof an experienced EMT or Paramedic

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If The Student Has A Different StyleIf The Student Has A Different Style

Is it safe?Is it safe?

Does it meet the standard of care?Does it meet the standard of care?

Would the Medical Director approve of the style?Would the Medical Director approve of the style?

Does it cause any harm?Does it cause any harm?

Is it offensive in any way?Is it offensive in any way?

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Phase-1 of clinical study Phase-1 of clinical study

The beginning of the education (First Semester)The beginning of the education (First Semester)

The student may be “book smart,” but lack experienceThe student may be “book smart,” but lack experience

The primary focus during this phase is for the student to practice The primary focus during this phase is for the student to practice newly learned skills and become competent with them. newly learned skills and become competent with them.

Answer questions & “quiz” themAnswer questions & “quiz” them

Be available to the studentBe available to the student

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Phase-2 of Clinical Training Phase-2 of Clinical Training

The student will begin gaining experience in their role as an The student will begin gaining experience in their role as an EMT or Paramedic.EMT or Paramedic.

EMT students should start to integrate as a member of the EMT students should start to integrate as a member of the medical teammedical team

Paramedic students should be allowed to start taking the role Paramedic students should be allowed to start taking the role of “team leader” of non-complicated ALS & BLS calls, i.e., of “team leader” of non-complicated ALS & BLS calls, i.e., chest pain or single system traumachest pain or single system trauma

Be there to “oversee” the careBe there to “oversee” the care

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Phase-2 (continued)Phase-2 (continued)

Under the supervision of the paramedic preceptor, the student Under the supervision of the paramedic preceptor, the student should be encouraged to take a more global view of their role should be encouraged to take a more global view of their role by paying attention to such details as:by paying attention to such details as:

Delegation of assignmentsDelegation of assignments

Transportation needsTransportation needs

Re-assessment of the patient & providing care accordinglyRe-assessment of the patient & providing care accordingly

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EMS Field Internship EMS Field Internship

The student should be the “team leader”The student should be the “team leader”

He/she should take charge of most ALS calls, He/she should take charge of most ALS calls, including cardiac arrests & multi-system trauma including cardiac arrests & multi-system trauma callscalls

They should, by this point, show competence with They should, by this point, show competence with and comfort in their role as a future paramedicand comfort in their role as a future paramedic

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Start of Each ShiftStart of Each Shift

Review with the student how much field and Review with the student how much field and clinical time they have completed & what phase clinical time they have completed & what phase they currently studying. they currently studying.

Find out the student’s perceptions of their own Find out the student’s perceptions of their own strength & weaknessstrength & weakness

Find out any issues of concern that student may Find out any issues of concern that student may have and try discuss and focus on these areashave and try discuss and focus on these areas

Relay your expectations of the studentRelay your expectations of the student

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Equipment & Protocols Equipment & Protocols

Make sure the student understands what is Make sure the student understands what is expected of him/herexpected of him/her

Tour service area & receiving hospitals or Tour service area & receiving hospitals or departments, if possibledepartments, if possible

Review daily routine/responsibilitiesReview daily routine/responsibilities

Review equipment check & department or Review equipment check & department or ambulance layoutambulance layout

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Problem ResolutionProblem Resolution

The lines of communication begin at the level of the The lines of communication begin at the level of the student & preceptorstudent & preceptor

If an issue cannot be resolved, the EMS Programs If an issue cannot be resolved, the EMS Programs Manager should be contacted atManager should be contacted at

- 699-5824 or - 699-5824 or whites@owc.eduwhites@owc.edu

EMS Programs Medical Director: Dr. Chris Tanner EMS Programs Medical Director: Dr. Chris Tanner

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Providing FeedbackProviding Feedback

Types of feedback:Types of feedback: Positive or correctionalPositive or correctional Positive reinforcementPositive reinforcement

Qualities of feedback

Tips for less stressful feedback

Post-incident feedback

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Types of FeedbackTypes of Feedback

Positive / Correctional:Positive / Correctional:

Correctional feedback that is given in a positive mannerCorrectional feedback that is given in a positive manner

Identifies areas of performance that require improvement Identifies areas of performance that require improvement or an area in which the student must change their or an area in which the student must change their behaviorbehavior

Example: Reminding a student of the importance of auscultating lung sounds after placement of an ET tube or reminding them them to use end-tidal CO2 monitoring

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Types of FeedbackTypes of Feedback

Positive reinforcement:Positive reinforcement: Encourages desired behaviorEncourages desired behavior Helps build self-confidenceHelps build self-confidence

Example: “Your calm & confident behavior really helped to relax the patient. You did a very good job”

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Qualities of FeedbackQualities of Feedback

Timely mannerTimely manner:: Feedback should be provided as soon as Feedback should be provided as soon as

possible after performancepossible after performance

Private: Correctional feedback is always done in private Positive reinforcement can be done in private or In front of others, depending on the personality of the person receiving the reinforcement

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Qualities of FeedbackQualities of Feedback

Direct:Direct: Always directed at the person for whom it was Always directed at the person for whom it was

intendedintended Only discuss correctional feedback with those Only discuss correctional feedback with those

individuals that are directly concernedindividuals that are directly concerned

Objective: Your feedback is conducted without any bias to race, gender, ethnic origin, sexual preference, or creed

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Qualities of FeedbackQualities of Feedback

Clear:Clear: Does the student understand whatDoes the student understand what you as the preceptor said or meant to say?you as the preceptor said or meant to say?

Remember that feedback should not be general goals for improvement, but pinpointed actions that the student can take to improve patient care

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Correctional FeedbackCorrectional Feedback

Can be unpleasant, but must not be avoidedCan be unpleasant, but must not be avoided

Needs to be timely & specificNeeds to be timely & specific

Vague feedback doesn’t give the student any idea Vague feedback doesn’t give the student any idea of how to realistically improve their performanceof how to realistically improve their performance

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Providing Correctional Feedback Providing Correctional Feedback

Ask the student what he/she thinks went well or Ask the student what he/she thinks went well or wrong with the callwrong with the call

Talk about the positive aspects and provide Talk about the positive aspects and provide reinforcement for things that the student did reinforcement for things that the student did correctlycorrectly

Identify the weak areas of the call & provide Identify the weak areas of the call & provide correctional feedbackcorrectional feedback

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Correctional FeedbackCorrectional Feedback (continued) (continued)

End the run or patient review with a summary of the End the run or patient review with a summary of the positive aspects and tips for student improvementpositive aspects and tips for student improvement

Most people are more receptive to constructive Most people are more receptive to constructive criticism if positive feedback was provided firstcriticism if positive feedback was provided first

A good example would be a student with good A good example would be a student with good assessment skills but poor IV techniqueassessment skills but poor IV technique

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What do I Look For As A Preceptor?What do I Look For As A Preceptor?

Look for students with the: Look for students with the:

Ability to communicate clearly with patientsAbility to communicate clearly with patients Ability to manage the scene efficientlyAbility to manage the scene efficiently Ability to complete a thorough patient assessmentAbility to complete a thorough patient assessment Ability to identify a patient’s chief complaintAbility to identify a patient’s chief complaint Ability to formulate and provide appropriate treatment Ability to formulate and provide appropriate treatment

strategies at their level of trainingstrategies at their level of training Ability to provide clear direction & leadership for other Ability to provide clear direction & leadership for other

rescuers on the scenerescuers on the scene

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Evaluation of the EMT/Paramedic StudentEvaluation of the EMT/Paramedic Student Patient Assessment Patient Assessment

During the actual patient assessment:During the actual patient assessment:

Allow the student to complete their assessmentAllow the student to complete their assessment before intervening to ask questions the student before intervening to ask questions the student

failed to coverfailed to cover

Do not let the student do harmDo not let the student do harm

Take mental notes about what they did right and Take mental notes about what they did right and how they could improve their assessments how they could improve their assessments

Evaluation of the EMT/Paramedic Student

Skills Performance Be positive but honest

Remember that the patient is an audience to the process

Note weaknesses in skill competencies

Do not let the student do harm

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Evaluation of the EMT/Paramedic studentEvaluation of the EMT/Paramedic student Report Writing Report Writing

Make sure that the chief complaint, patient history, Make sure that the chief complaint, patient history, assessment, treatment & treatment outcomes are assessment, treatment & treatment outcomes are properly documentedproperly documented

Documentation of pertinent positives & negatives is Documentation of pertinent positives & negatives is key to developing critical thinking skillskey to developing critical thinking skills

Documentation of any variances or unusual aspects Documentation of any variances or unusual aspects of the run will help to enforce learningof the run will help to enforce learning

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THANK YOU!THANK YOU!

It is dedicated preceptors like yourself that allow It is dedicated preceptors like yourself that allow us us

to educate and train quality pre-hospital medical to educate and train quality pre-hospital medical providersproviders.

Policies and procedures for clinical education can be obtained by referring to the OWC EMS Programs Preceptor Guide located within your department, EMS station or facility educator. You can also access it on-line at www.owc.com/ems

Contact the EMS Programs Manager at: Whites@owc.edu