My name is Stephanie Kelly-Parks, and this is a two-part course on the art of precepting. Module 1 is going to be teaching the teacher, and that's what this one is on. Module 2 is going to be understanding the learner. The reason for this module is there's been identified knowledge gap in the lack of training and education the preceptor gets before they are precepting sRNAs when they come into your clinical site. When I started looking at the statistics behind that, very few sRNAs receive any kind of clinical instructor, any kind of teaching training before they are put into clinical preceptor roles. The statistics in the 2016 study showed that only 13% of sRNAs actually have formalized training on how to instruct and just being a clinical preceptor. The study also showed that sRNAs are happier, they have a higher workplace satisfaction score that are preceptors who receive preceptor training than sRNAs who are preceptors that haven't received any kind of precepting, any kind of instruction training to work with the sRNAs. Another thing that came out of the studies on preceptorship and the relationship between preceptors and sRNAs is how important that relationship is to establish between the preceptor and the sRNA. Most sRNAs, whenever they're working with an sRNA, they are going by what they know, what they've been taught in sort of the trial and error, let's see if this works. There's not a lot of formal, consistent approach to dealing with and establishing a teamwork with the sRNA. This education series is targeted to some of these knowledge gaps and we're going to go ahead and jump right into it and again this is module one of two. These are the objectives we're going to cover in this first module, this is teaching the teacher. We're going to talk about the roles of the preceptor, we're going to talk about strategies to create positive environments in the operating room with the sRNA, talk about some of the strategies that you can use to teach and instruct, we're talking about communication because that is so critical to the success of an sRNA at a clinical site is the communication between the preceptor and the student, we're going to talk about how to stimulate good conversation that leads to critical thinking and that's in the reflective reasoning part and then you're always going to have some kind of roadblock depending on the student and the student level but you're not going to be without some types of barriers to learning and we'll talk about that and then ultimately we want to try to resolve those conflicts whether it be communication or just a working relationship you have or something else is causing the student to not progress and just conflict resolution. These are all the topics that we're going to talk about in this first module. When you talk about the role of the preceptor, the first thing you may think about is this is like the role model, this is the anesthesia provider and they're going to show and tell the student nurse anesthetist how to perform that job. It's really a three-layered approach that the preceptor has. First and foremost, they are the anesthesia provider. This is the person who is ultimately responsible for the patient care. The preceptor has to balance the taking care of the patient, doing good anesthesia care and also trying to manage the expectations of being a preceptor. Second role that the preceptor has is the role of the employee. So this is the person, the employee is going to be the CRNA that integrates the student into the facility. This is going to be the role that they play when helps the student know where they can put their food in the refrigerator, know where all the integral things are in the operating room and such as like the coffee pot and where the bathroom and the cafeteria is. So that other role the preceptor plays is just the absolute employee. The relationship you would have with another CRNA when they come to work, you just sort of show them the ropes of the place, the integrator, I call this. And then the third role the preceptor has is the educator, which is what you think of when you think, oh, they're a preceptor, they're the educator, they're the role model, they're the person that shows them how to do anesthesia. And it's this third role, the educator, is really the primary focus of this module. In one study where they asked SRNAs what they consider a good environment for them to be or a good role model for the preceptor that they're following. And these are some of the things that came from that. They like the positive, upbeat preceptor. Students love feedback and feedback, and we'll talk more about this in this module, we'll talk about how important feedback is and how critical is that it happens in a timely manner. Students obviously like to be respected and students when they come into this arena, remember they were excellent critical care nurses. Often the SRNA is a critical care nurse that was at the top of their game, maybe even the lead for that team in that critical care unit. And then suddenly now they're put into a different environment. One is completely unique to them in an unfamiliar environment. So this is a fantastic critical thinker. They're just new to anesthesia. So one of the positive remarks that they said from their preceptor is a preceptor that shows them that respect. Students like to be challenged. They love to be challenged. They love to be stimulated with questions that promote critical thinking, promote them to think outside the box and tap into some of that ingrained knowledge that a front-loaded program has just given to them. They like preceptors to remain calm. They like a preceptor that even when things have gone drastically different from their plan, they like a preceptor that's able to remain calm and keep the room and situation calm. They like a preceptor that's able to communicate clearly. They like a preceptor that has given them clearly stated goals so then they know what is expected from them. And they also like a preceptor that allows them to expand their role and as their knowledge increases, they like the preceptor that allows them to venture out and do things more independently. You know we can't talk about the good preceptor without talking about that other preceptor. So the preceptor that is not well-liked amongst SRNAs is the preceptor that talks about other students with them. And you've probably heard this before. You've probably heard those discussions in the break room where the preceptor is talking about the worst case they just had with a student or they're discussing that student with another student the day after they were with a student that was just not doing well. So the discussion of fellow students in front of other students is poorly received with SRNAs. They don't like preceptors that make them feel like they're a burden and if you've ever precepted a student like most of us or nearly all of us have that is right out of those first few semesters of didactic learning, they've never been in the OR, you know how sometimes slow it can be and you know we all have our routines and we have our flow and when you introduce someone into that, even sometimes a very seasoned CRNA that's helping you manage a tough case, you know how quickly your space gets really small when you're working with someone who is very proficient. So add someone who is not very proficient into that small space and it does, the room gets small really quick. So the feeling that they're a burden to the preceptor is always negatively received. What about the preceptor that just really doesn't want a student and sometimes they're very vocal about that, I just really don't want a student. And then what about the preceptor that's expecting that first semester, first clinical experience student to have the knowledge and psychomotor skills of someone in their second year and so basically asking them or expecting them to be at a much higher level than they actually are. So there's some of the negative aspects that SRNAs have brought up in studies of the preceptor that is negatively received. So here's some teaching and learning strategies that we're going to talk about and there are multiple strategies out there. I went with some that are easy to understand, easy to implement and grasp and bring it into your clinical practice whenever you have an SRNA student with you. This teaching strategy has been around for several years. It was first named the one minute preceptor and then I guess we used it enough to realize you can't really do much in one minute. So anyway, it's now considered and named the five minute preceptor. And so this is a five step, this is a preceptor led approach. The student in this approach of teaching is really the active participant and does really the majority of the interaction of this. And so some examples that I put on this on the left side of the screen is what the preceptor leads with. So this is the five minute preceptor. This is where you first get a commitment. And get a commitment means you ask the student a question and something has happened or something is about to occur and you're trying to get the student's take on this and get a really good grasp on their knowledge base on this. So everything on the left side of the screen is what the preceptor is going to ask. And I put the quotes on the right side like an example of this. So get a commitment. So this is when you're going to ask the student, this is an example, how do you want to treat this blood pressure? So you just simply ask that question. And so what you're getting is the student to state or make a commitment to what they want to do to treat, for example, the blood pressure. And then after they state how they want to treat it, then you're supposed to, the second step is probe for supporting evidence. And for this, you're going to ask the student, well, why did you pick this plan or why did you choose that drug? And then the student's going to elaborate on why they chose one drug over the other, this course of action over the other. So the student's really describing and elaborating on why they went this direction. So then the third step of this is what they call like teach the rules. And so this is where the preceptor really shines on your didactic and your clinical knowledge. So this is when you state the rules or why something is done. Like, for example, like when you give this drug, it causes, for example, the heart rate to decrease when you're trying to treat blood pressure. So you sort of laid the foundation then of why the right step is the right step. And so if the student wanted to do the procedure that you felt was the most correct, or they selected a drug that you felt like was the best drug for that moment, then you praise the right. In other words, you encourage the student by saying, yep, you noted that the heart rate was this and you selected an appropriate drug and you managed their pressure appropriately. I think that was a great decision. If the student didn't pick maybe the best drug or the best course of action for that time, this is how you would then step five, which is the last step in the five minute preceptor. So correct the mistakes, said, yeah, this drug that you chose, yes, is going to increase their blood pressure, but it's going to cause a significant change in their heart rate, which maybe was already low. So this is it. When you first look at this, this may seem a little much and it may seem like it just got too many steps or hard to implement in your practice, but if you just look at it for a little bit and sort of commit some of these things to memory, you're probably doing something very similar already. But this is the five minute preceptor and this gets you huge gains and it lets you know how the student is thinking, gets them to think critically, and then you evaluate their thought process. And the whole goal is to really get them to work through something and seeing it more than just like one dimension, looking at the current situation, looking to see what the next step maybe in the procedure is and making the best decision based on their clinical and critical thinking. This is the five minute preceptor. The next learning strategy, learning slash teaching strategy we're going to talk about is modeling. And modeling is exactly what it sounds like. The CRNA, the preceptor, is doing like the work. They are demonstrating the skill. They are showing the student how it's done and they're explaining as they're going. This is a great technique for the very green, right out of didactic, maybe their first or second clinical site, very green student, very novice student. This is a perfect way to show them this is a great teaching strategy for the student who really just needs to see it first or maybe see it a couple of times before they're ready. It is also a good technique to use whenever you have an advanced student, but yet it's a new skill. So I'll show you how to do it. Like I'll place this first epidural, I'll do this first and then you get the next one. The one negative aspect of the modeling strategy is it doesn't allow the learner, the student, a lot of hands on. They're literally just watching you do it and there's little involvement of the student. That's one of the negative aspects, but that's modeling. The third learning and teaching strategy that we're going to discuss is coaching. On this one, the preceptor allows the student to do the task or perform the case and gives them just cues and basically just keeps the student like in line and just like subtle hints or maybe a little bit of assistance. But this is a great technique for the student who's been out for a little while, but still needs direction. One of the good positive things about the coaching strategy is it promotes a lot of good teamwork. It's two anesthesia providers working in a small space with the same common goal and it promotes a lot of good team building and fun experience and it really involves the learner a lot more than the modeling strategy does. So this is coaching and that's the last of the three learning and teaching strategies we're going to talk about. One of the most critical aspects of preceptorship is the ability to communicate. So we're going to talk a little bit about communication strategies and communication is very complex and we'll talk about in a second our communication and our verbal response and all the other nonverbal cues that go along with it. And it's complicated to communicate and also what we communicate as a preceptor can be difficult because you're going to be working with a very intelligent person who has ideas that are not sometimes congruent with your own and sometimes you're going to be working with a student that is an absolute contraindication to some of the ideas and views you have about doing anesthesia. This is where the preceptor needs to realize to separate your personal experiences or bias on something and be open minded to the ideas of the student to do things possibly a little bit different. I'm not saying to do something that is not safe Just something different because as you all know We get a little Ingrained in the way we do things and so when you have a student who comes into your room They may have heard of a new technique or they may have done in their previous Rotation an induction that is completely different than yours. So it's it's interesting It's also challenging for the preceptor to try to get outside of your own box and learn something new And get a different idea because it really is a knowledge share at some times It is a knowledge share between what they know They don't have the clinical skills you do but they do have a wealth of of anatomy and physiology Knowledge that they're bringing to the table So it's real important to understand and this goes back to the respect The SRNA when they come in here because they really bring a lot to the operating room More on how to communicate with the learner one of the biggest failures of communication is when The learner did not understand the expectation and they did not understand the goal of The the case or the maneuver or the strategy So when you communicate very clearly what the student is expected to do it makes the teamwork a lot stronger and it cuts down on a lot of the confusion and nonverbal communication is Often Uncommunicated and it's tough in the operating room because Nonverbal we'll see in one more slide is very powerful In our inflection in the way, we say it's very powerful and in if you think about it we're mostly covered up and our faces are mostly covered up with masks and We drive a lot of what we think was Communicated or spoken to us by looking at someone's body language and facial expression. So a lot of that sort of taken away from you when you're in the operating room and Always remember that the student is going to take more away from the experience and the student is going to have a much more impactful clinical experience from the instructor that Really grabs their attention that really makes learning fun. It really makes that case Spectacular in some way and just so remember that and and maybe remember back at some of the people that have inspired you and some of some of your Favorite preceptors or even co-workers whenever you come to work. It's usually the one that really Challenges you and inspires you to to think more or to read up on something more This is the 7% rule. This is an old study dating back to 1971. It first came out in a book called Silent Messages but the professor stated in this book that 93% of what we say to people we actually say without words so more specifically in communication In communication 55% is done through body language 38% of what we say is really perceived through the tone in which the preceptor says it and only the remaining 7% is actually What was told to us in spoken words? So I want you to think about this whenever you're communicating with the student your body language and how impactful it is and really how important that is to relay the message that you want to relay and so when you're asked, you know How how was my induction or how do you feel like I managed that case? Before you answer just realize that only 7% Your words are are going to come through but they're remaining in the majority of your Communication is going to be with your body language and the way in which you answer the student. So this is the 7% rule Communication doesn't just exist between the preceptor and the student communication also is critical between the organization the clinic the hospital whatever setting you're doing anesthesia and the educational facility the faculty at the university it is critical to have solid Communication and going back to that clear expectations and goals. It is so critical to have a good relationship with the faculty so it's the responsibility of the faculty to make sure that that student coming to your facility and You are aware of these student clinical policies, so if you don't have a list of the student clinical policies for that University for that nurse anesthesia program You should ask for that because then everybody's on the same page and they know what the student knows basically Before the student comes it's the responsibility of the faculty to have all the paperwork done So whether if you're if your organization your hospital requires students to do a background check And do fingerprinting all of that is on the the faculty's responsibility to have done prior to the student getting there the faculty needs to make sure that there's Established communication and that is via email phone numbers So the student student has at least some initial contact information to get them to the clinical site and establish with someone and Then after the student gets there, then they can network and get other contact information But that's the responsibility of faculty to provide that to the student coming into that organization Then the faculty needs to support the preceptor and when in the sense of the preceptor needs to know What level that student is at? Is it their first clinical experience? Is it their second? Are they one semester from graduating? It's really the responsibility of the faculty to let them know what level the student is That's coming there the faculty needs to be readily available for any kind of issues Involving the student and a preceptor or the student and the clinical site and they should be there For immediate consultation if there's any kind of problem at the clinical site The faculty needs to perform site visits and this is very very critical for the faculty To come in to make their presence known and this helps establish a very good Relationship between the preceptors and the faculty. This is someone who comes often this is someone that is is not a stranger to the facility and Also, the last thing on this is the faculty Needs to establish a learner feedback for the preceptor. We're going to talk about evaluations in more depth later, but it's not just the student who should be Evaluated. The preceptor is also Someone that could benefit from having student feedback as well and the faculty needs to be Responsible for setting that up and this is should all happen prior to the student arriving their first clinical day Now we're going to talk about two Communication Strategies and I call this reflective reasoning because it really brings out a lot of information and it allows Some cross-talk between the student and the preceptor About their clinical experience. So these are done at two completely different times of the day So the first one is called the educational timeout and this is done at the beginning of the clinical day. This is Typically done before the first case of the day this is that case that the student has done a care plan or some kind of written plan of action prior to starting the case and some of the things that the educational timeout has and should encompass is the patient assessment and discuss that their plan and how they're going to do it and this is so so critical and so important for the student in the preceptor to bring up all of these things about at least that first case and covers all aspects of that plan of care This is where there's no surprises You've you've talked through How like the induction sequence should go and what even type of anesthesia you're going to do and this keeps the preceptor from from becoming Shocked whenever they see a student doing something because they've discussed it they had that plan A and that's that's the first plan they're going to go to and the students are required I know by The the universities that I've worked with the students have and it may be called something in every site But a care plan so the student has gone through This patient's history or what what they do know about the patient may be very minimum But at least some of the aspects on them so basically H&P and usually some of the lab work So the student has usually prepared a pretty in-depth Form and it has a lot of things like their INO NPO status their maintenance stuff It usually has their allowable blood loss This is like the big stuff that that all students learn to do on a patient and prepare for prior to rolling with that patient and they usually put a Significant amount of work in this and as a preceptor I encourage you to ask them for that because it's It's a disappointing thing if a student has has thought of what they think of everything They've thought of everything for this case And if you don't ask about it, or you don't want to see what they've put together It's a little bit of a disappointment and some students are so proud of this care plan They are bringing it to you and like look at this You know, this is what I think of because they need some feedback They need some feedback because a lot of times they're very new to the OR and they need to see that They're in going in the right direction So I encourage you to get involved in this education timeout and really go through it with the learner and Help establish that Solid plan a before you roll back with that patient Another reflective reasoning strategy is done at the end of the day This is the gather, analyze, Summarize and again that's done at the end of each clinical day And this is where the preceptor and learner if they've discussed things throughout the day, that's fine. This is a great way to tie it all together and maybe recap on What the student did well and maybe further discuss things that they need to improve on This is where I like to Say give homework and it's it's not it's never a punitive thing. Usually students really encourage Or encouraged by a preceptor that asked them to look something up And so sometimes if I've asked a student something during the day and they really didn't know that's fine I just say hey, look, that's your homework and I tell them you know, we don't want to look it up now, but when you go home or later on Outside of here you just come back with the answer and let's talk about it next time you see me tomorrow or the next day and students really Respond very positively to that and when the homework assignment is usually nothing more than like something They just come back and tell me that they read and it's real quick. It's nothing formal like written it's usually just something they say hey, I found out you know what the Insensible loss is for this type of case with someone with this, you know Chronic kidney disease and they'll just come back and tell you and it is not uncommon For me to give myself homework so if something's come up and I didn't know the answer and this is where you have to be a human and you have to Be humble if you don't understand something or if the student asks you something and you don't know I encourage you to not try to fumble and make things up because the student knows So I give myself sometimes homework if I didn't know and it's always a fun way to show the student that you do not know everything and And so the these are two strategies. I call it reflective reasoning That are very positive and easy easy easy to implement with a student This is the last slide that we're going to talk on feedback and communication the timing of your feedback is critical and It should be done as soon as The case is over or at a moment in the case where you feel like you have Time to to talk about something and it's not not negative. It doesn't always have to be negative It could be positive feedback So it's very critical to address things soon after it happens and not like the next day or hey I was thinking about this maybe next time try to address things Pretty quick to when they occurred And also when you're making evaluations You are making evaluations based on What the goal is for that experience in other words when you make an evaluation You have to make sure that you are evaluating the student on their clinical performance based on What the goal was or what their learning goal was and it's different as the student gets further along in the program So just make sure that you are evaluating them only on what they are supposed to know and are Expected to be able to do for that level Now we're going to talk about some of the things that get in the way of learning Are things that we perceive is going on that's Not allowing the student to progress The way they should So some things to think about when the student comes in There is usually a lot going on in their lives at this time. So they They are now in clinical practice, and they still have a lot of Stuff they're responsible for and I'm not talking about home life so much. I'm talking about in the school itself. So They are coming to clinical practice and they are shuffling their time in the OR with the still classes that they have with exams that they are doing Still classes that they have with exams that they are doing and possibly going to sim lab and also now the the DNP or the doctoral project that is Required for now all nurse anesthesia programs. So there is a lot of information that they are processing Especially when they're new to clinical rotation, so it's overwhelming Also these Students that are coming in were likely the heroes of the ICU. They were the subject matter experts They were a lot of them the leads of their Units and they are coming in And they're critical care experts, but they are Absolute new to the operating room and the role of anesthesia and the practice of anesthesia Then there's some cultural differences and I'll just say there's also Possibly a big age variance between the preceptor and the student. So there there's definitely differences there that You know the way Certain generations talk to other people and the way they communicate is is different And then some of these students I just say plain old tired some of these students are just just plain old tired and they may not be The best at managing their time. So some of these sort of things can come Into play plus it's a new facility and just think Most of these students rotate to a different clinical site every two to maybe three months And so it's a constant new new place new environment Maybe new electronic medical record new charting system and a whole new batch of crnas that they're working with Some other things that may be perceived as a barrier to learning is The novice learner and this we talk about In more detail in the second module, but this is based on a nurse theorist Dr. Patricia Benner who first developed this the models of clinical competence and she wrote a book and it's from Novice to expert and I assume many of us are familiar with it But basically it talks about the the levels of competency and the first and most basic level is novice learner and that is exactly The learner in the student that you have that comes into the OR in their first Probably two semesters of clinical rotation is novice learner They are very one-dimensional They are very task saturated and they can only see just the one task in front of them They're not able to prepare for the like the next case and see past That next step in the in the case their time management is very very off They're very disorganized and very scattered for the most part they are starting to balance now the work life and most of these students are the average age of the student is almost at the age of 30. So there's a lot of personal life that they're balancing with now their professional slash education life. And then always front and center for these students, and I would speak totally for myself, the fear of dismissal. Even though I felt like I was a great clinical student, and and probably I was harder like most of us are on myself. There's the constant fear of dismissal. I always felt like I was just one day away from failure, at least like the first couple of semesters. So some of these things are barriers to learning and it's very overwhelming with the students come in here and most of these students are very much type A people and you know and most everybody who's listening this right now. I'm I guess I'm talking to all of us. So the fear of dismissal. So all these things can culminate in potential barriers to learning. This is another slide that talks about some of the perceptions of preceptors, and this is based off of a 2011 study where they interviewed 696 SRNAs that were in clinical settings and asked them about some of the aspects of their preceptors. And it's it's shocking to see some of these statistics, but 69% and again, this is an old study. So this is 13 years ago, 69% reported verbal abuse by their preceptor, 14% reported physical abuse, and 12% reported racial discrimination. So again, this is an unfortunate statistic talking about some of the lives of SRNAs as they're in clinical practice and and I'm sure there's a lot of people who are on this module now who who may can relate to some of this stuff and may can relate to that preceptor who had some of these qualities, negative qualities. But anyway, I think we've probably come a very long way now. I haven't seen anything recent on this, but this is why it's so important to communicate positively because it's it's a statistic. Some of these numbers are unnecessary. So we'll move on. Now we're going to talk about conflict resolution because conflict is just inherent to some situations and I say that because our environment is as a CRNA, our environment is at times hectic, very complex, very complicated at times and you can see where conflict could occur. You can see where sometimes actions happen and and very quickly because the situation, the patient condition changed and sometimes things need to occur quickly and it's difficult at times when you have a novice student who may not have even recognized that the situation has changed very quickly. So it's it's a very complex. It's a it's a very complicated environment at times. So conflict management is something that you have to you have to work on and managing the conflict can have positive outcomes. For example, you might find a better way to resolve issues by dealing with the conflict. You might find a better way to teamwork or collaborate more and also when you have conflict and you're able to resolve them, it does build a stronger relationship and when you have conflict and you're able to resolve it, you're able to see where your communication broke down and have a better and refined way of communicating for future events and and face it, we are probably excellent nurse providers. We are probably wonderful at that, but we might not be the best at dealing with tough situations with students or tough students. We weren't really taught that and we haven't had a lot of training or we've had no training on having to deal with the challenging student. So one of the recommendations is if you do have a tough situation, the challenging student is to make notes ahead of time and we've probably all learned through life, it's never a good time to address the problem when we're very emotional and we're very angry or it's very, very fresh. Sometimes this is a time when you need to take time and really formulate your thoughts and try to figure out what it is that you feel like the conflict is about and involving. So make notes ahead of time before you address the learner and when you do address the learner, that old saying of praise in public and reprimand in private is is very true here, unless there's a situation with a student where you feel like you need someone there like as a third person, you know, just to make sure everything is very clearly translated and nothing is lost in translation, but always, always pull the student aside and try to have that conversation when you have time to. Don't try to initiate that tough conversation when you only have a few minutes and be careful with the words that you do choose because we know that communication now is only 7%, but choose really good 7% stuff, like avoid using negative words like never and always because you have to be very specific when you're speaking to a student about, let's say, their induction sequence. You can't say you always do this when you're like that, be very specific and and that is too broad for a student to process and it won't be received well, so be very specific about what the conflict is about. Continuing more on the conflict resolution, be a good listener. If the student is explaining why they did something or trying to convey their response to you, listen, be a good listener for that student. If it has anything to do with patient safety, that trumps like everything. That is always first and it goes back to like the first slide that we talked about, the number one role of the CRNA is to be the anesthesia provider and to do good patient care, so handle patient safety issues immediately and talk later, like you don't need to have that big discussion while you're at the head of the bed and everybody else is in the room and can hear, which is that next point. Always try to pull the student aside and have these tough conversations in private where you won't be interrupted. Also, maintain professionalism. You don't want to talk about this student or what happened with other CRNAs and you don't want to be heard talking about this student by other students because you know bad news travels super fast and everybody knows that something happens at one facility, all the facilities knows if it involves like a student or a university, so maintain professionalism because we've all made mistakes and we've all benefited from that preceptor that handled it very professionally and got us back on track. So just remember that as part of conflict resolution, be professional. So here's an example of how to resolve conflict and so on the left side, it's the the goal of that comment and on the right side in the is the exact what what you can say. So for example, so conflict unresolved, start with the positive and on this you say this was really good. It was it was great. You had everything laid out. You're very organized. You could I could tell you had really prepared for this. So this is like the positive thing and then step two, but one thing that I noticed that you did or one thing I'd like to help you with is and this is where be specific. Just be very specific when you're you and you're addressing the problem and one thing that I have learned to do is ask the student how they think that induction sequence went or how they think that emergence went and sometimes it is shocking to hear what the student perceives their their actions to be and how you do. Okay, so addressing the problem and then I can't stress this enough. Listen, so this is a huge part of this because the the student is going to try to resolve the conflict because you've asked them about it. They're gonna try to resolve the conflict because they understand it's not going away. So we're still working through it. So if if you're still not getting in the it's it's not done. We haven't really addressed a problem. Then this is where you have to restate again. I still have this concern or I'm still concerned with with the way you did this and again, listen, so putting it back on the student to explain explain and maybe maybe they're not explaining it away or maybe they're adding to something and something maybe you missed. I missed that. I didn't see that you had done that. So if you still can't get resolution, there might be a point unless it's a patient safety issue unless it's just a dumpster fire. This is where you have to try to meet in the middle just said okay. Well next time you know, I want you know verbalize or explain or tell me that you're because if we're still confused on what happened or your rationale. So next time this is what we're gonna do. So we we're gonna do it different and or we've agreed to next time and so then end with a positive. So again, you know you your induction sequence was very smooth and very organized and this is you know, be very specific because this learner is taking all of this in and and a learner is is going to try to not be in the situation again. So they're going to think about this and try to analyze this this conversation in detail. So end with a positive start with a positive and this is some good ways for for conflict to be resolved. Here is something that I don't think a lot of facilities are doing. And if you are then kudos to you. Preceptor evaluation and this is the evaluation that the student gives the preceptors at the end of their clinical rotation. I think feedback is great for the student and I think feedback is great for the preceptor. The preceptor role some some feedback that I saw in some studies is the preceptor needs to stay consistent and one thing that I think I'm going to change in my future practice is when we get a student a new student to the clinical site try to instill more consistency in their first few weeks there. Normally, we have a student go with a different preceptor every day, but seeing some of the studies and how students need more consistency initially makes me want to try to provide that to them and in one way you might could could instill that is have the student follow the same CRNA for several days and not just like one day or maybe a week or if and I understand people are on call and some people have different schedules maybe assign them to one of two different preceptors and have them follow those two for a week or two to get that first clinical site foundation under their feet and to provide some of this consistency. Preceptors have to have certain competencies that that's the bottom line. Your preceptors should have they should they should be some of your more proficient educators and some of the things they the wheel on the right are things that one of the preceptor evaluations that I found evaluates the preceptor on their knowledge how they communicate with the student. How is their critical thinking? Are they a nice person? That human caring aspect. Are they a good leadership? Have they taught me? How is their teaching style and schedule and schedule being were they available for me? Like could I reach out to them if I had a question? So those are some things you might want to think about taking back to your facility the preceptor evaluation. So these are the last two slides in this module and I wanted to I wanted to ask questions and get you to think back. So go back to the days when you were a student in your anesthesia program and I want you to think of two different people right now that made the greatest impact on you. First, I want you to think of that that CRNA that had the most negative impact in your training. Maybe it was someone who communicated poorly with you. It was the CRNA that your morale meter just dropped off the chart when you realized that you were going to be with that specific CRNA that day. So what characteristics did that CRNA have that made you think of them right now? And I asked you for the the worst. And now I want you to think about the other CRNA. I want you to think about the CRNA that you consider was the most impactful anesthesia person in your career or maybe in your training. Maybe it was someone that showed you how to do something, made the task easier. Maybe it was someone that showed you that trick that that's it. That's what you needed and you've used it every day since then. Or maybe it was just someone that just believed in you. And so I want you to ask yourself, am I doing the same things for students that I precept? Am I going to be a CRNA that they remember when they're asked years down the road who was impactful to you? And are you going to be that negative CRNA that they always remember or that positive CRNA that they will always remember? So by serving as a preceptor, it is very impactful and it is a fantastic way to sort of pay forward that dedication and passion of those previous preceptors. And as a preceptor, you're bridging that gap between that theoretical, that didactic learning that these students are coming to clinical practice full of. You're bridging that gap between learning and that practice, clinical practice gap. Preceptorship can be challenging. It can be very emotionally challenging. It can be dragging at times. But preceptorship is also a way that you can help reconnect and rekindle that passion that you have for health care. And finally, adding the preceptor role in the preceptor designation to your job qualifications and your resume, it's going to strengthen your professional experience. Preceptorship shows when you're willing to be a preceptor, it shows that you're willing to lead, you're committed to lifetime learning, and you're dedicated to improving our anesthesia practice. In conclusion, knowledge share benefits everyone. It benefits the preceptor and it benefits the learner. So precepting for all of us is a new skill set. It's learned over time. It gets better over time. But it's really impactful when you have the support of the facility that you're working at and the support of the anesthesia program who's sending you the students. Just as the novice learner first comes to the facility and they're very uncertain, the preceptor has a similar journey and it's going to have a lot of uncertainty whenever you're new and novice to the teaching and precepting arena. But I assure you that the preceptor is going to learn and get new skills while growing in the clinical preceptor role. And I appreciate the attendance and thank you for the support in getting this module created.

preceptorship

healthcare education

nurse anesthesia students

structured training programs

relationship building

communication strategies

conflict resolution

feedback and evaluation

barriers to learning

professional development