Preceptor Preparation Online Course - Advanced

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Essential Competencies of Preceptors: A Focus on Working with APRN Students

Module 1: Preceptor Roles and Responsibilities


First Day of Preceptorship

Oftentimes, the first day of the clinical experience may be the first time the preceptor and student meet. It is recommended that the student arrive on the unit at a predetermined time to allow this meeting to take place. This is also an opportunity to let the student know where personal items can be stored and provides an opportunity to introduce the student to the unit and staff. Addressing logistics can alleviate anxiety that students may experience on their first day in the clinical setting. A formal orientation to the clinical unit is essential, and the preceptor may need to coordinate with other staff at the clinical site to best accomplish this experience. If the preceptor is involved in direct patient care, the preceptor should be provided a specific time to orient the student to the unit. Orientation can also be completed by another staff member, and should include time to orient the student to the location of necessary equipment and supplies (IV pumps, blood pressure cuffs, medications, etc.) These activities, along with a discussion of the patient population and potential learning experiences, may decrease student anxiety and foster a positive learning environment for the student.

Coordinating the Learning Experiences

To maximize the clinical learning experiences, it is important that health care personnel and staff understand the level of learning and learning objectives for the student. Precepted opportunities are designed for students to take responsibility for total patient care this includes prioritization, organization, and delegation of licensed personnel. If clinical setting personnel understand the students' learning outcomes, confusion and role conflict can be prevented.

The student will also have specific individual learning objectives. It is important that the preceptor review these objectives and use them as a guide to providing learning experiences. The preceptor can make suggestions regarding the student's objectives based on opportunities available at the clinical setting in order to enhance student learning. Finally, the preceptor can request updates by the student about content being presented in didactic settings to facilitate linking course/theory objectives with clinical opportunities. For instance, if didactic content is related to coordinating care for diverse patient populations, the preceptor can find opportunities for the student to interact with culturally or ethnically diverse patients. Incorporating these types of learning objectives also promotes independent learning for the student.

Examples of individual learning objectives for the student may also focus on communication and organizational skills. The following objectives may be appropriate for the first time on the unit or at a facility:

  1. Introduce yourself to staff members
  2. Review the primary disease process of assigned patients, this can also be done via development of a care plan
  3. Review research pertaining to medications for specific populations
  4. Complete and document history and physical examinations within a specified time frame
  5. Prepare/practice review of assessment with preceptor

These objectives provide the student with specific guidance about clinical expectations with clearly defined outcomes. Specificity of objectives guides the evaluation of the student's performance and can be used as the basis to provide effective feedback.

Evaluating the Nursing Student's Performance

Evaluation of student learning and performance in the clinical setting is another primary responsibility of the preceptor. From the first day in the clinical setting, the preceptor assesses, observes, inquires, and evaluates the student's performance. While standardized evaluation tools exist for evaluating performance, clinical evaluation is a subjective process "because it involves making a judgment about performance based upon the teacher's observations" (Gaberson and Oermann, 2010, p. 267). These judgments are based upon direct or reported observations of student performance including feedback from alternate preceptors and other staff. The preceptor not only provides feedback directly to the student, they provide feedback to faculty members on the student's progress. The following diagram describes how clinical evaluation can be both formative and summative and the importance of incorporating both into the feedback provided to students. Information is based on descriptions provided by Gaberson and Oermann (2010).


Formative Evaluation

Summative Evaluation


Provides feedback to learners about their progress in developing clinical competencies.

Summarizes a student's performance and is usually completed at the end of the clinical experience.

Equivalent to passing the clinical rotation with a grade.


To enable students to develop their clinical knowledge and skills and identify areas in which further learning is needed.

Goal of formative evaluation is not to "grade" students but to facilitate clinical performance.

Intended to assist the learner in addressing performance gaps and to improve performance.

Used to determine whether the student has met clinical objectives and displayed clinical competence.


Preceptor is able to target teaching to knowledge gaps in order to improve performance.

A drawback of summative evaluation is that they are often used at the end of the experience, leaving the student with no time to improve performance in order to meet learning objectives and clinical competencies.

However, if used at a midpoint, summative evaluation may be utilized to address areas in need of improvement and provide the student with time to make changes.

Clinical evaluation is subjective as it involves judgments based upon direct student observations. Gaberson and Oermann (2010) state that attending to this subjectivity in student evaluation addresses issues of fairness and requires the clinical faculty member to examine their own personal beliefs, values and biases about clinical evaluation, use an established clinical evaluation rubric, and foster a supportive clinical learning environment. It is important for the preceptor to provide a supportive environment and to ensure that the student understands that the purpose of formative evaluation is to improve their performance, not to determine a grade, as in the case of summative evaluation.

Timing is also important because anxiety can increase in the absence of feedback. The manner in which preceptors provide feedback to students is crucial in ensuring that students understand when their performance does not meet expectations or requires improvement. Students want feedback about what they are performing correctly, and it is important that feedback not be equated to "what is wrong." Clinical evaluation is an essential component of the role of the preceptor, and it is essential that the clinical instructor clearly explain the purpose and process for any type of evaluation to the student.

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