Helping Preceptors Help Students Helping Preceptors Help Students Access Evidence for PracticeAccess Evidence for Practice

Susan J. Zahner, DrPH, MPH, RNAssistant Professor

Wisconsin Health Information Outreach SummitSupporting Evidence-Based PracticeGreen Bay, WisconsinAugust 16, 2006

Funding Funding

Southwest Wisconsin Area Health Education Center

Preceptor DefinedPreceptor Defined

Preceptors are experienced practitioners who teach, supervise, and serve as role models for student nurses for a set period of time in a formal educational program (Usher et al., 1999)

Preceptor Model:Preceptor Model:

• Advantages:– Closer relationship allows for talking through decision-making

and rationale for actions (Crawford, et al., 2000)

– Closer observation allows effective evaluation of student performance (Yonge, et al., 1997)

– Cost of clinical education (Nehls et al., 1997)

• Challenges:– Lack education in evaluation (Yonge, et al., 1997)

– Lack education in teaching/constructive feedback (Atack, et al., 2000)

– Less effective in stimulating critical thinking (Phillips & Duke, 2001)

– Worthwhile benefits, rewards, and supports for the preceptor (Dibert &Goldenberg, 1995; Usher, et al., 1999)

– Time and energy (Rittman & Osburn, 1995)

UW-Madison School of NursingUW-Madison School of Nursing

• ~20 years experience

• Undergraduate

• Madison and Western Campus (Gundersen-Lutheran Hospital, La Crosse, Wisconsin)

• Senior level– Community Health Practicum (N419)– Nursing Care of Persons and Families

with Complex Health Care Needs (N449)

Literature review

Preceptor interviews

Summer Teaching Institute

Video ETeach

Consultation #1

WritingConsultation #2

Editing

Programming

Pilot-testing

Implementation

Adaptation

Course Development Process

Revisions

Plan

Do

Check

Act

Course modulesCourse modules

Module 1: Role of the preceptor

Module 2: Course expectations

Module 3: Policy/procedures for students in clinical course

Module 4: Learning population-focused public health nursing

Module 5: Learning styles and teaching strategies

Module 6: Learning critical thinking

Module 7: Learning cultural competence in community health nursing

Module 8: When difficult situations arise

Module 9: Feedback and evaluation

Pilot-test Knowledge: Gained and Sustained

0

2

4

6

8

10

Mean test score

Pre-testPost-testPost-semester

Pre-test (mean=5.69, SD=1.03, Range=4-7)Post-test (mean=8.38, SD=.65, Range=7-9)Post-semester (mean=7.54, SD=1.51, Range=5-9)

Repeated measures ANOVA Multivariate F=55.603; df=2; error df=11; p<.000

Paired t-testPre-test to post-test (t=-10.247, p<.0000)

Pre-test to post-semester (t=-4.95, p=.0003)Post-test to post-semester (t=1.94, p=.08)

Post-semester feedback

1 2 3 4

The content of the course was too limited to beof much help to me

This course did not teach me anything I did notalready know

Taking this course made me a better preceptor

The course helped me create a positivelearning experience for a student

This course prepared me for the challenges Ifaced while precepting a student

Taking this course increased my confidence inmy preceptor skills

This course was worth the time and effort

Taking this course increased my effectivenessas a preceptor

Strongly disagree Disagree Agree Strongly Agree

Course EnhancementsCourse Enhancements

• “Generic” version (available now)

• Acute care version (in pilot-testing)

• New modules

– Helping Students Learn Interdisciplinary Practice

Helping Students Use Evidence in Community Health Nursing

Helping students use evidence in Helping students use evidence in community health nursing practicecommunity health nursing practice

Purpose:

This module will provide an overview of evidence-based practice in community health nursing. In addition, the module will provide guidance on how a preceptor can assist a student nurse in formulating appropriate questions, searching for relevant evidence, appraising the quality of evidence, and developing plans for action based on evidence in community health nursing settings.

Objectives:

1. Understand the basic concepts and processes for evidence-based community health nursing practice.

2. Describe sources of evidence to guide community health nursing practice at individual/family and community/systems intervention levels.

3. Identify strategies for assisting students in using an evidence-based approach to community health nursing practice.

Course Content & MethodsCourse Content & Methods

• Introduction to EBP

• Steps for EBP

• Locating evidence

• Quality of evidence

• PICO

• Integrating EBP into student activities

• Thinking activities

• Case scenarios

• Handouts

• Links to resources and references

• CE quiz

Improving Evidence Based Practice: Improving Evidence Based Practice: Students and PreceptorsStudents and Preceptors

• Helps prepare preceptors for educator roles

– Common language and concepts for education– Contemporary language, concepts, and skills for

practice

• Access to information

– Teaching/learning– Course specific– Anytime

• Increasing quality and consistency