VCU Field Preceptor Orientation

FIELD PRECEPTOR ORIENTATION

2014

Purpose…

This Field Preceptor program endeavors to provide you with the essential tools and information to successfully fulfill your influential role of EMS preceptor.

Welcome! Thank you for being a preceptor for the VCU

Paramedic Program

The Objectives of this orientation is to familiarize you with:

• The Preceptor & Student Roles

• Adult Learning Theory Review• Training Objectives• How to provide feedback • How to evaluate students

Paramedic Program Goals:

To prepare competent entry-level health care providers in the cognitive, psychomotor, and affective learning domains,” at the Paramedic, Emergency Medical Technician-Intermediate, and Emergency Medical Technician-Basic levels.

You Are Now The Mentor

You are now a preceptor and thus a mentor

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

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

Remember That You Weren’t Always Successful

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

Most professionals have had great mentors

We developed over time & through much trial & error

We received correction along the way

Why Do They Need A Preceptor? Students need help managing anxiety

They need to develop a professional identity

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

They need guidance to develop their own “style”

Preceptor Responsibilities Provide a model for the student to emulate

Transmit knowledge and experience

Help the student manage anxiety

Supervise & guide skill acquisition and performance

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

Completely & honestly fill out & sign the students evaluations

Preceptor Characteristics Possess good communication skills

Establish a climate that is conducive to learning

Share practical steps in patient care

Provide positive & correctional feedback, when necessary

Listen to the student

Maintains proficiency in their clinical area

Paramedic Preceptor & Team The team must consist of three people.

The student cannot be the driver.

Preceptor must be a Paramedic

Must be a released provider for a minimum of 1 year.

Maintains proficiency and be in good standing with the department.

Thinking back to your orientation?

What makes a bad preceptor?

What makes a good preceptor?

Preceptor Role

Guides the student and provides help when needed

Creates opportunities for students to provide care for patients while preventing the student from doing harm to the patient or themselves.

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

Preceptor Role (Cont.) Preceptors should keep an open mind that

there is more than one way to reach a certain goal

Remember students are still in the learning process

They should not be expect students to perform to the level of an experienced EMT or Paramedic

Student Role Come to station or field site enthusiastic, prepared, and

appropriately dressed.

Perform assessments and clinical skills under supervision with increasing competency and responsibility.

Paramedic students should actively seek out learning opportunities and be available to the preceptors when learning opportunities arise.

Demonstrate professional behaviors including: motivation, integrity and accurate self-assessment.

Requirements for Successful Completion (Paramedic level)

Patient Assessments 30- Pediatric

50- Adult

30- Geriatric

Airway management – 50+ Patient Complaints

8 – Pediatric Respiratory

10 – Change in Responsiveness

30 – Chest Pain

20 – Altered Mental Status

20 – Respiratory

20 – Abdominal Pain

Requirements for Successful Completion (Paramedic level)

Patient Impressions40- Trauma

10 - Obstetric

20 – Psychiatric

Skills Performed 25 – Medication Administration

50 – Successful IV Insertions

10 – Ventilations

3 – ET Intubations

Additionally, each student will be required to complete 50 team leads, of those team leads 20 must be ALS level transports.

Traits of Adult Learners

Self-directed & Autonomous Resistant to change Practical, Results or Goal Oriented Applies Personal Experience Motivation Multi-level Responsibilities High Expectations

EMS Version of Dreyfus Model

Novice: -- Has no experience at the present certification

level. This student must be directed in all aspects of patient care, and may require step-by-step directions. Protocols are considered absolute, and the student may not be able to combine protocols in complex patients.


Advanced Beginner: -- has gained an understanding of individual

skills, but may not know when to use them in complex cases. This student functions well as a team member, and understands that protocols may not always fit every situation. However, they will need directions, and will seek permission for any “outside the box” issues.


Competent: -- Still relies on protocols, but is able to

understand the value and purpose of each. This student can provide patient care, but still follows algorithms and may use references during patient care. This provider/student is able to function as a team leader, and requires minimal or no direction, possessing the ability to think critically, and find answers when needed. Begins to differentiate relevant from irrelevant information.


Proficient: -- Experienced providers who have developed

pattern recognition, but still follow a systematic process during assessment and treatment of patients. Few students will ever achieve this level during an initial education program. Providers at this level make ideal preceptors, because they are easy to follow, and can identify the steps used to draw conclusions and make decisions.


Expert: -- is exceptional in patient care, and uses vast

experience to make decisions. This provider does not rely on protocols and algorithms, and is able to follow “gut instinct,” and is usually right. Complex cases are not a problem, as creative problem-solving is natural. This level of provider is often a difficult preceptor for students, because they multi-task and rely on experience, rather than a systematic approach. The expert may have difficulty explaining “why” and “how” conclusions were drawn.

Our Dreyfus Goal…

It is important to understand that students

should not be expected to meet a proficient or

expert level of practice. They may need

resources that the experienced preceptors may not

find necessary, and they will need to follow a

systematic, step-by-step process when providing

patient care.

Start of Each Shift Review with the student how much field time they

have completed & what they currently studying.

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

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

Relay your expectations of the student

Make sure the student understands what is

expected of him/her

Tour the station if this is their first shift at this location

Review and involve them in the daily routine and station responsibilities

Review location of supplies, equipment, & involve them in the process of checking the ambulance out.

During the Shift Under direct supervision assign students specific

tasks or skills. (e.g. IV, 12-lead, or ET)

During downtime or on slower days supervise skill simulations and chart them with the student in FISDAP (They can help you with this…)

With supervision allow the student to be team leader for certain calls.

Provide feedback

Providing Feedback Types of feedback:

Correctional Positive reinforcement

We understand all the time constraints you are under as you go about your shift, our hope is that you will find opportunities to provide feedback and suggest opportunities for improvement throughout the shift.

Types of Feedback Correctional:

Correctional feedback should be given in a positive manner

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

Example: Reminding a student of the importance of strict aseptic technique when starting an IV.

Example: You did a great job with that patient assessment and I think together we can identify some things we could do better …

Types of Feedback

Positive reinforcement: Encourages desired behavior Helps build self-confidence

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

Qualities of Good Feedback Timely manner:

Feedback should be provided as soon as possible 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.

Qualities of Good Feedback Direct:

Always directed at the person for whom it was intended

Only discuss correctional feedback with those individuals that are directly concerned

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

Qualities of Good Feedback Clear:

Does the student understand what 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

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

What To Look For As A Preceptor?Look for students with the:

Ability to communicate clearly with patients Ability to manage patient care efficiently Ability to complete a thorough patient assessment Ability to identify a patient’s chief complaint Ability to formulate and provide appropriate treatment

strategies at their level of training Ability to provide patient care in a safe and effective

manner.

Problem Resolution The lines of communication begin at the level of

the student & preceptor If an issue cannot be resolved you may contact:

Clinical Coordinator:

Basil Asay (804) 283-1483 or [email protected]

Paramedic Program Director: Ken Williams (804) 828-3687or [email protected]

Completing the Shift Students should report to their preceptor anytime

they leave the station or before the shift is to end.

Throughout the shift students will chart their assessments, patient contacts, and skills completed in a program called FISDAP.

To complete their shift they will need their preceptors assistance in the FISDAP program.

From this screen the student will be able to select from which assigned

shift he is working and begin completing assessments and entering completed tasks.

Students should report to their preceptor anytime they go off the unit or before the shift is to end.

Throughout the shift students will chart their assessment and tasks completed in a program called FISDAP.

Notice that multiple types of shifts have been assigned. This page will also

indicate whether you their preceptor have signed off on this shift. Note the pencil in the preceptor signoff column. The checkmark indicates that you, their preceptor, has electronically signed off on the work completed.





This is the shift signoff screen. The student will open this screen for you to signoff on at the end of the shift. However before you do you will need to have them first allow you to complete an evaluation and look over what they did…

Before signing off you should have the student show you this shift summary

it will identify the number of patients they assessed or skills performed. Under the intervention column it should show what skills/tasks they performed…



This is the area of FISDAP where both you and the student can chart any

simulated skills practice done during the shift. This will really help the student if we can do this frequently throughout the program.



By clicking on the link with the patient identifier, you can view what has been

charted on the patient and view the completed narrative. Student should not chart anything that would violate HIPPA or patient confidentiality.



This section shows what evaluations have already been filled out for this

shift. Once you have completed the evaluation it should show up here. You will also notice the student can do a self-evaluation as well.



This is where you or the student will select the evaluation that needs to be

completed at the end of the shift. It’s labeled: “Preceptor evaluation of student.” After selecting the correct evaluation form click the “GO” link…



This screen should appear, either you or the student will have to change the

evaluator section to reflect you being their “Preceptor,” Student will assist… There will be evaluation sections for psychomotor and affective domains…



Note the GradingScale. “We don’t expect exceptionalall the time…”

After you have scrolled down and answered all the questions there will be a

score provided, and a button to submit and close. The preceptor should be the person filling this form out.





At this time you can have the student bring you back to this signoff screen and you may add any comments you would like to this screen and electronically sign your signature on the line.



The last thing you do is check the box lock shift and click save. Before doing so ask the student if they there is anything else they have forgotten, because they will not be able to go back and make changes to a locked shift…

Step one Step two

Once you click “Save” the shift is complete…

Completing the Shift Students have been authorized to use handheld

devices and the screen may be slightly adapted for mobile use.

Students should still be able to walk you through all the same information and you should still be able to complete the “evaluation form”

The responsibility of navigating the software is not left to the preceptor alone, but the preceptor should know what information they are signing off on.

THANK YOU!

It is dedicated preceptors like yourself that allow us to educate and train quality pre-hospital medical providers.

Paramedic Program Clinical Coordinator: [email protected] Office: (804) 828-4917

mailto:[email protected]

VCU Field Preceptor Orientation

Healthcare

Transcript of VCU Field Preceptor Orientation