Preceptor as an Educator

While it is no secret that the health care world is currently seeing high rates of turnover, for every nurse that leaves your practice setting, there will be another nurse (hopefully) coming to fill that open position. As new hires fill those open positions, there will be multiple aspects of onboarding education that need to be addressed. Even with the availability of a unit-based educator, it is often the preceptor who has the most frequent and longest contact time with the new hire. This results in the preceptor fulfilling many roles: coach, leader, influencer, facilitator, evaluator, socializer, protector, role model, and most importantly – educator.¹ So what does this mean for the preceptor?

This means that the preceptor has a lot of work ahead of them! They are responsible for ensuring that the orientee is receiving education related to their role as a nurse: the clinical skills required to perform independently at a competent level, the ability to identify available resources and how to access them, the expectations of professionalism, the standards for communicating with the interprofessional team, and enculturating the new hire. Wait, but what about showing them where the bathroom is and how to sign off their timecard? Yes, all of that, too!

Adult Learning Theory

With the growing need for preceptors to act as educators, there are a few key aspects of educational theory that the preceptor needs to understand. First, there must be some awareness of the Adult Learning Theory, which was developed by Malcolm Knowles in 1973 and has evolved over the years.¹ This theory outlines six basic assumptions of the adult learner that influence the ability to learn effectively. These six assumptions are that the adult learner has:

1. An understanding of why the information being taught is important to them
2. An ability to self-direct the education
3. An opportunity to draw from previous experiences
4. An openness to the education
5. A focus on problem-centered learning, which produces knowledge that is immediately applicable
6. A recognition of the personal benefit for learning this new information¹^,²
   

Secondly, it is important for the preceptor to understand and recognize that not all learners learn the same way. While some learners prefer to read journal articles or academic textbooks, other learners may prefer to learn by watching their preceptor perform the skill first or have their own opportunity to practice the skill in a nonthreatening environment.¹ Although there may be individual preferences for learning, it is important for the preceptor to incorporate a variety of teaching modalities into the new hire’s orientation.

Plan of Action

In keeping Knowles’ assumptions in mind, the preceptor should develop a plan of action for the orientation of each newly hired nurse they precept. Each preceptor should start the orientation phase by assessing the orientee’s learning needs: what were their previous experiences (educationally and professionally) and what does the orientee feel they need to learn? A transparent relationship where questions are encouraged also should be established. Next, the preceptor should plan learning activities, including by asking the orientee how they learn best, establishing goals with clear deadlines, and collaborating with the charge nurse to ensure patient assignments meet the needs of the orientee. After the preceptor has planned those learning activities, they should create and implement a learning plan. The preceptor should be sure to incorporate different educational modalities, such as journal articles, case studies, skills demonstration, role-playing, and review of hospital manuals. Lastly, the preceptor should evaluate the orientee’s job performance, including by providing close observation of clinical skills; identifying the orientee’s areas of strength and opportunities for growth (and providing concrete examples); and sharing honest, nonjudgmental feedback about their progress in real time.¹

Download sample action plan.

Reading all these responsibilities, and knowing that there are probably so many more, how else can the preceptor be better prepared for the role? Look into any preceptor resources that are available at your facility! Sit down with the unit-based educator, the nursing professional development specialist(s), and/or a representative from the human resources department and find out what tools are available to help with role development. Maybe there are recommendations for journal articles or textbook chapters to read or maybe there is a preceptor workshop. Preceptors also can consider joining the Association of Nursing Professional Development to gain access to preceptor resources at a national level. Just know that the work of the preceptor is important and valued, and that each person who fulfills the role is making a difference in health care!

References

1. Lewis N, Bryan V. Andragogy and teaching techniques to enhance adult learners’ experience. J Nurs Educ Pract. 2021;11(11):31-40. doi: 10.5430/jnep.v11n11p31
2. Ulrich BT. Mastering Precepting: A Nurse’s Handbook for Success. Indianapolis, IN: Sigma Theta Tau International; 2019.

AORN Resources

Open access:

• Preparing the Preceptor  - AORN Article
• Your Practice: 12 Tips for New Preceptors - AORN Article
• 6 Precepting Pearls for Onboarding Success - AORN Article
• Become a Great Preceptor - AORN Article