NUR 675 Module 6 Preceptor Paper Example

Learning From a Preceptor: Deliberate Practice, Effective Feedback and a Clear Agreement

[Student Name]

Southern New Hampshire University

NUR 675: MSN Seminar: Preparation for Practicum

Module Six Preceptor Paper

[Instructor Name]

[Date]

Learning From a Preceptor: Deliberate Practice, Effective Feedback and a Clear Agreement

A practicum's value depends heavily on the preceptor, yet students often treat the relationship passively, showing up and hoping to learn by watching. Preceptors, meanwhile, usually precept on top of full workloads. The student in this paper, a charge nurse planning a falls practicum at a composite hospital, has secured the hospital's director of quality as her preceptor. He leads twelve active projects, sits on several committees and can offer about one hour a week plus occasional time at meetings. This paper plans how to make that time productive. It argues that a student who designs challenging tasks, seeks feedback in a form that helps and agrees on expectations at the start will learn more and place less burden on the preceptor than one who simply shadows.

How Expertise Grows

Ericsson (2008) reviewed research on how people acquire expert performance in medicine and other fields and concluded that experience alone does not produce expertise; many professionals plateau once their work becomes routine. What distinguishes those who keep improving is deliberate practice: focused effort on well-defined tasks just beyond current ability, with quick feedback and the chance to try again and improve. Watching an expert, while useful, is not enough. For the practicum, this means that the student should spend most of her hours doing tasks she cannot yet do well, such as presenting data to a committee or facilitating a meeting of disciplines with different priorities, and getting prompt feedback on them, rather than observing the preceptor do those tasks.

Designing Stretch Tasks

Using this principle, the student listed the skills her practicum objectives require and rated her current ability in each. She is confident in clinical assessment and teaching staff one-to-one but has never analyzed quality data, written a recommendation for leaders or led an interprofessional meeting. For each weak skill, she designed a task with a clear standard: analyzing twelve months of fall data and presenting it to the falls committee in week four, drafting a one-page recommendation for the nurse manager in week six and facilitating the interprofessional huddle in week ten. Before each task, she will prepare and share a draft with the preceptor, and after each, she will ask for specific feedback and, where possible, try again. The first data presentation, for example, will be rehearsed with the preceptor two days before the committee meeting.

Seeking Feedback That Helps

Not all feedback improves performance. Hattie and Timperley (2007) reviewed research on feedback and proposed that effective feedback answers three questions: where the learner is going, how the learner is progressing and what the learner should do next. They distinguished feedback about the task, the process, self-regulation and the self, and concluded that comments on how the work was done, and on how learners monitor themselves, move performance most, while praise directed at the person does little for learning. General comments such as good job or that went well are pleasant but unhelpful.

The weekly meeting will therefore follow a simple structure. The student will begin by stating which objective she worked on and what she was trying to achieve, then describe what happened, then ask one specific question, such as how could I have handled the pharmacist's objection to the medication review more effectively. She will close by agreeing on one change to try the following week. This format keeps meetings short, focuses feedback on process and gives the preceptor a clear question to answer rather than asking him to generate feedback on the spot.

Understanding the Preceptor's Side

Preceptors experience the relationship differently from students. Omansky (2010) reviewed studies of staff nurses serving as preceptors and mentors and found recurring themes of role conflict and role overload, as preceptors tried to meet their own responsibilities while teaching, along with feelings that the role was undervalued and that they lacked preparation and support from their organizations. Although the review focused on staff nurses precepting new graduates and students, the pressures it describes apply to a quality director with a heavy portfolio. Recognizing them, the student will make requests easy to meet: sending drafts two days before meetings, arriving with specific questions, handling logistics such as scheduling rooms and asking before adding time. She will also make the preceptor's contribution visible by acknowledging it to the nurse manager and in the practicum evaluation.

A Written Agreement

At the first meeting, student and preceptor will review and sign a one-page agreement covering the practicum objectives and the evidence for each; a standing one-hour meeting every Tuesday, with the student sending an agenda the day before; the student's attendance at the monthly falls committee and quality council; the stretch tasks and their dates; how feedback will be given and how the student will seek it; confidentiality of patient and staff data; and how either party will raise concerns, including a check-in at midpoint with the faculty member. The agreement also clarifies that during practicum hours the student is a learner, not a charge nurse, so she will not be pulled into staffing decisions on the unit.

When Things Go Wrong

Even a good plan can falter. The preceptor may cancel meetings during a survey or a crisis, a stretch task may go badly or feedback may feel harsh. The student has planned for each. If two consecutive meetings are canceled, she will send a written update and a specific question by email so that feedback continues, and she will raise the pattern at the midpoint check with faculty if it persists. If a task goes poorly, as the first committee presentation might, she will treat it as the kind of performance deliberate practice requires, ask for one specific improvement and repeat the task where possible. If feedback stings, she will write down what was said, wait a day and return with a question about how to improve, which keeps the conversation professional. Naming these possibilities in advance makes them easier to handle when they occur.

Conclusion

A busy preceptor's hour a week can support substantial learning if the student uses it well. Designing stretch tasks based on deliberate practice, seeking specific feedback about process and next steps and respecting the pressures preceptors face, all captured in a written agreement, turns the preceptor relationship from shadowing into coaching and makes the practicum a place where expertise in a new role can begin to grow.

References

Ericsson, K. A. (2008). Deliberate practice and acquisition of expert performance: A general overview. Academic Emergency Medicine, 15(11), 988-994. https://doi.org/10.1111/j.1553-2712.2008.00227.x

Hattie, J., & Timperley, H. (2007). The power of feedback. Review of Educational Research, 77(1), 81-112. https://doi.org/10.3102/003465430298487

Omansky, G. L. (2010). Staff nurses' experiences as preceptors and mentors: An integrative review. Journal of Nursing Management, 18(6), 697-703. https://doi.org/10.1111/j.1365-2834.2010.01145.x