9/26/2014. Preceptors and Students: A Discussion Larlene Dunsmuir James Sims. Problem. Foundation

Transcription

1 Preceptors and Students: A Discussion Larlene Dunsmuir James Sims Problem Perception: Insufficient number of practicing NPs willing to serve as clinical preceptors for NP students Reported: Finding adequate numbers of clinical placements for a growing number of NP students Universities report difficulty identifying an appropriate clinical placement for NP students In-state programs compete with distance learning programs for willing and available preceptors Some programs abdicate responsible for locating appropriate preceptors to students, creating conflicts with some programs Foundation Precepted clinical experiences have been an essential component of NP education since the beginning EVERY currently licensed and certified NP practicing today worked with preceptors during their educational experience 1

2 Survey Performed by researchers: Judith Webb DNP ANP-BC Ruth Palan Lopez PhD GNP A. J. GuarinoPhD Affiliation: School of Nursing MGH Institute Permission was requested from study authors and granted to share information obtained from survey Original presentation date: 04/12/12 Survey Background Students Increasing Enrollments Increasing number of programs Increased number of required clinical hours Preceptors Increased productivity demands Results 64 items, 2 domains Incentives Incentive or barrier If available, how influential would these factors be in your decision to precept? (Rated Not at all influential to Extremely Influential) 17 items to be rated as barrier or incentive to precept (Rated strong barrier to strong incentive) 2

3 Demographics Web based survey N=521 Gender: 92% female Age: Mean 47 years Certification: 33% FNP, 32% ANP Race/ethnicity: 93% Caucasian Degree: MS 82% Practice type: 38% Primary Care Specialty: 17% Family, 14% Internal Med State: 76% MA, 11% NY Ever precepted: 83% Incentives to Precept Recertification Credit: ranked highest Financial remuneration: ranked 8 th (tied with Adjunct faculty status) Neither incentive or barrier Liability risks Administration attitude toward precepting Precepting other learners Faculty presence in site Geographic location of site Availability of space Level of student Barriers vs Incentives Rated: Strong Barrier, Weak Barrier, Neither, Weak Incentive, Strong Incentive 9 incentives (listed in order of impact) Professional Obligation Learning opportunities for preceptor Association with faculty Association with student Confident in clinical expertise Suitability of site Confidence in teaching Patient receptivity to students Supervision of student 2 barriers (listed in order of impact) Time factors Productivity Issues 3

4 But.. Survey conducted in two states on eastern seaboard What about Oregon? Comparison Nurse practitioners with clinical sites in Oregon, employed by large multistate healthcare system Reported difficulty finding willing NP preceptors for students seeking placement within the organization Decision to begin with NPs employed in Oregon initially, later to reach out to NPs in other states distribution list with 46 NPs, PAs and CNMs, requesting responses from NPs only 14 responses returned by survey due date (30% response rate) Modified survey utilizing questions and scales previously reviewed. Again, permission was requested and granted with stipulation to share deidentified data with original study/survey authors Oregon Demographics Certification FNP: 7 (50%) ANP: 4 (27%) Number of Years in Practice 1-3 years: years: 2 10 years or more: 9 Primary practice setting Primary Care: 7 Acute Care: 3 Specialization Family Practice: 5 Geriatrics: 2 4

5 Preceptor Experience Previously served as a preceptor? Yes: 64% Willing to precept a student in the future? Yes: 71% Influences Listed in descending order of importance Rated not at all influential to extremely influential (1-5) Most Influential Credit toward professional certification or recertification RVUs for the time spent precepting the student Increase in Pay Financial Remuneration; Process for evaluation of the student; process for dealing with student performance Preceptor Training Course syllabi and objectives; student s final evaluation of the experience Least influential Library Privileges; opportunity to guest lecture in classes Opportunity to audit courses (non-credit) Recognition at Faculty/Student Reception Publication of your name in school catalogs; featured article of you in school and/or professional newsletters; gift from school of nursing Gift from student Gift from faculty Barriers and Incentives Rated Strong Barrier Weak Barrier Neither a barrier or an incentive Weak Incentive Strong Incentive 5

6 Barriers Listed in descending order of impact Time factors Ability to meet productivity expectations; risk for liability Availability of space Administration s attitudes toward precepting Faculty presence during site visit Patients receptivity to students; Student s need for supervision; Suitability of the type of practice for student learning Drivers Listed in descending order of importance Professional Obligation Prior association or contact with student Prior association or contact with faculty member Learning opportunities as a preceptor Level of confidence in preceptor s clinical expertise; Geographic location of practice Level of confidence in preceptor s expertise in teaching and mentoring What drives you? Are you willing to precept? Why or Why not? What do you need to make you more willing to serve as a preceptor? What can NPO do? 6

7 Reminder As nurse practitioners, we have a professional obligation to help educate future nurse practitioners. If we abdicate this responsibility, we may lose what makes our profession different from that of other healthcare providers Thank you for your questions and comments 7