Preceptor Orientation Program

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Preceptor Orientation Program

• Developed by the
• Kirksville College of
• Osteopathic Medicine
• for
• health professions preceptors
• and staff members

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THANK YOU for your interest in our preceptor
training program!

• KCOM appreciates all the contributions preceptors
  make to the education of tomorrows practitioners.

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Module One

• This is the first module in a 3-part preceptor
  orientation program which provides information to
  help you, your staff, and the student
• Get off to a good start,
• Effectively manage common teaching and learning
  tasks, and
• Collaborate to improve the feedback and
  evaluation process.

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FYI

• With the program file saved to your computer and
  in Power Point slide show view, slides 7-18
  may advance on their own.
• Red print on a slide means theres something for
  you to think about or do.
• To download forms shown in this program,
• go to the Preceptor Orientation Module page,
  right click your mouse, and choose save target
  as.
• Windows will then ask you to choose a folder to
  save the file in (remember where you put it!)
• You will then be able to store the forms and
  print them as MS Word files.

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The deep breath before you jump into
the water . . . .

• Whether its formally written or has simply been
  accumulated through living, each of us has a
  personal philosophy of teaching that guides our
  interactions with students.
• Examination of that internal guidance system can
  help us significantly enhance our efficiency and
  effectiveness as teachers.

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On the following 12 slides

• are some trigger phrases to stimulate and
  guide your reflections in preparation for this
  first module of the preceptor orientation
  program. Please take a moment to view these
  phrases and reflect on your experiences and ideas
  about precepting. (The slides
  are programmed to show for
  6 seconds each.)

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• As a student, my worst experience with a
  preceptor was when . . . .

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The best preceptor I ever had . . . .
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Many Preceptors need training on/about . . . .
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If a colleague asked how to get ready for his
or her first student, I would tell them . . .
.
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• To make the most
• of my teaching time,
• I hope students will . . . .

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To get the most out of a rotation, students
should . . . .
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The staff in my office think students should . .
. .
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The worst student I ever had . . . .
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• The most difficult thing about being a preceptor
  is . . . .

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To help me as a teacher, the school should . . . .
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To enhance my office as a training site, the
school could provide . . . .
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The most rewarding things about being a
preceptor are . . . .
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Warming up for the race

• Your reflections on the preceding slides should
  have helped focus your thoughts on the
  teaching-learning interaction. One further
  preparatory concept is
• How do you make what you know
  more available
  to you (and your
  students)?

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The Reflective Practitioner

• Physicians constantly reflect-in-action, but
  seldom reflect on and articulate their
  reflection-in-action.
• Until practitioners learn to deconstruct and
  articulate their intuitive actions, students must
  guess at much of what appears to be the art of
  medicine.
• As practitioners become more fluent about their
  intuitive skills, they can teach and mentor
  students in a more deliberate, effective, and
  efficient manner.

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Reflective practice

• Is a complex and deliberative process of thinking
  about and interpreting experience (negative or
  positive), in order to learn from it.
• Is commonly used by professionals as they meet
  new and different situations and
  challenges.
• Results in a changed perceptual perspective.
• Can enhance practice standards by
  avoiding situations that were poorly
  managed in the past.

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Keys to reflective practice

• Nurture mindfulness (attending to the ordinary,
  the obvious, and the present).
• (Be aware of barriers to mindfulness
  fatigue, dogmatism, focus on doing (not being),
  unexamined negative emotions, failure of
  imagination, and literal-mindedness.)
• Use reflection or metaprocessing (thinking about
  thinking or feeling) in a nonjudgmental way to
  become increasingly aware of the tacit knowledge
  and skills you use daily (and the biases you
  hold).

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• Some questions to guide meta-processing
• What skills and knowledge did I use in this
  interaction? How can I describe them clearly?
• Did I hear all the patient had to say?
• Is there a relationship between what I did and
  how the patient responded? If so, what?
• What are my blind spots or biases about this
  patient? This family? This diagnosis?
• Recognize the goals and outcomes of mindfulness
  and reflection
• goals -- clarity and learning from the tasks at
  hand
• outcomes -- enhanced knowledge of processes used,
  and ability to communicate that knowledge.

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Preceptor Orientation Program Overview
Initial conference with preceptor
Teaching
Adult
Master Plan for student training
Methods
Learning
Theory
Time and Work Savers
The first day(s)
Facilitating
Getting
the
Started
Learning
Questions
Process
Feedback and Evaluation
Demonstrations
Contributors to
Stages of the
Evaluation
Evaluation Process
Sources of Information
for Evaluation
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To help focus, place yourself in the following
situation

• You are serving as a preceptor for a 3rd year
  student who is completing a 4-week primary care
  rotation. The student approaches you in the
  middle of the second week of the rotation to make
  an appointment for an evaluation conference at
  the end of the clerkship.
• Here in MODULE ONE of this program, we will look
  at things you, your staff, and the student could
  have already done to prepare to meet the
  students request.

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Introduction to section content

• In this section of the module, we will look at
  ways to get started in a manner that will help
  you and the student have the most positive and
  productive experience possible.
• These suggestions will also help you avoid or
  successfully manage problems that occasionally
  arise in a training situation.

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Getting Started
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Ready! Set! GO!!!

• Ready Clarifying roles and responsibilities
• School roles and responsibilities
• Preceptor roles and responsibilities
• Student roles and responsibilities
• Set Establishing rotation objectives
• School objectives
• Preceptor site objectives
• Student objectives
• GO Planning and coordinating the students
  first day in your practice

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READYClarifying Roles and Responsibilities

• School Role and Responsibilities
• Preceptor Role and Responsibilities
• Student Role and Responsibilities

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School Role and Responsibilities

• Role Education program designer
• Provide students with stage-appropriate basic and
  clinical science education and training
• Provide preceptors with course objectives,
  student profiles, evaluation guidelines and
  materials
• Provide formal training opportunities to
  interested preceptors
• Provide Continuing Medical Education (CME) credit
  for preceptors.

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Preceptor Role and Responsibilities

• Role Teacher/Mentor/Role Model
• As appropriate for their educational stage, help
  students begin to integrate theory and basic
  skills
• Provide increasingly independent skills practice
  opportunities as the student demonstrates
  readiness and competence
• Encourage the student to work with and learn from
  others including other health care providers,
  office support staff, patients, and community
  agencies
• Give feedback and evaluate student on the above
  skills.

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Student Role and Responsibilities

• Role Student practitioner
• Perform clinical skills under supervision with
  increasing competency and individual
  responsibility
• Demonstrate professional behaviors including
  motivation, integrity and accurate
  self-assessment
• Utilize available resources for preceptor- and
  self-directed learning, i.e. staff, electronic
  tools, computer, books, and journals
• Participate fully and enthusiastically in office,
  hospital, and community activities

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SETEstablishing Rotation Objectives

• School objectives
• Preceptor site objectives
• Student objectives

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School Goals and Objectives

• KCOM learning objectives encompass the knowledge,
  skills, and attitudes required for successful
  performance as an entry-level intern or first
  year resident. (Print copies are available upon
  request.)
• Select the school objectives which you and your
  staff believe you can most appropriately and
  effectively teach during the students rotation.
  Summarize them in PART A of the Master Plan for
  Student Training Form. (See form and sample on
  slides 36 and 37. Forms may be downloaded from
  Preceptor Orientation Module Page.)

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Preceptor Site Goals and Objectives

• Every office has special staff or equipment
  resources, unusual patient populations, or
  practice procedures that the student would
  benefit from learning about.
• Work with your staff to decide which resources or
  unique practice features youd particularly like
  to highlight with students.
• Summarize the 3 or 4 most important on the PART B
  of the Master Plan for Student Training Form.
  (See form on slide 36)
• Make copies of this form (like slide 37) and
  keep on file for future students.

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Student Learning Objectives

• KCOM Student Information Forms
• Biographical data will come from the school in a
  variety of forms a biographical data form,
  skills self-assessment, or resume/curriculum
  vita. (Forms can be downloaded from the Preceptor
  Orientation Module page for gathering
  biographical and professional histories.)
• Most forms ask the student what he/she hopes to
  accomplish on the rotation. (See sample
  questions, sample student responses, and sample
  2nd year student skills self-assessment
  next 3 pages)

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Ambulatory Care Student Self-Assessment (Key
items from questionnaire)

• Students can respond to the questions below
  prior to meeting with the preceptor. This
  information will be helpful through the initial
  goal-setting meetings.
• List the clinical rotations you have taken that
  have included an outpatient service.
• What do you specifically hope to accomplish by
  the end of this rotation?
• In addition to the basic curriculum, what types
  of patients would you like to see or what areas
  of medicine would you like to emphasize?

• What interviewing or physical examination skills
  would like to develop or improve?
• What educational resources do you use most often
  to answer clinical questions?
• Describe your ideal format for supervision and
  teaching during this rotation.
• What are your long-term goals?
• What other information should I/we know about
  you?
• Adapted from the work of Lesky, L.G. and
  Hershman, W.Y. Practical Approaches to Major
  Educational Challenge Archives of Internal
  Medicine 1995897-904

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Ambulatory Care Student Self-Assessment (Sample
student responses)

• List the clinical rotations you have taken that
  have included an outpatient service.
• I have observed approximately 20 surgeries
  including orthopedics and general surgery. I have
  also shadowed medical and radiation oncologists,
  a thoracic surgeon, a general surgeon and a
  pediatricion.
• I volunteered for 3 months in a pediatric war in
  which I assisted doctors, nurses and patients.

• What do you specifically hope to accomplish by
  the end of this rotation?
• By the completion of the preceptorship, I hope
  to be competent in basic history taking and
  physical exam skills and have a quality
  introduction to some more advanced practice
  techniques. I am interested in a well-balanced
  introduction to everyday clinical medicine and I
  wish to get plenty of hands-on experience.

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Just before the student arrives . . . .

• Prior to the students arrival, review the Master
  Plan for Student Training Form with your summary
  of achievable school objectives and site-specific
  objectives.
• Review the students biographical data,
  self-assessments, and written goals (and/or
  determine what information forms you want the
  student to complete when he/she arrives).

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GOThe students first day in your practice

• Orientation activities by staff
• Initial conference with preceptor on their first
  day in the office

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Student Orientation

• Discuss with your staff the Ground Rules and
  Expectations Form (slide 45). (Download from
  Preceptor Orientation Module page.)
• Add, delete, adapt, and edit items as needed.
• Determine which items should be handled by whom.

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Initial preceptor-student conference

• VERY early in the rotation, discuss with the
  student and agree upon specific student
  objectives for this rotation.
• Enter those into PART C of the Master Training
  Form.
• Display the completed Master Training Form (see
  sample, slide 47) in a location where you, the
  student, and the staff can refer to them easily
  and check off objectives as they are completed.
  (This will be a very helpful reference when its
  time for mid-rotation and final feedback and
  evaluation.)

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Many thanks and much recognition to

• Terri Spear, Michelle Mollick, and Lori Schuerman
  who conceived, articulated, and pilot-tested
  KCOMs site-based training program
• KCOM administrators, Dixie Rawlins, D.O., Mike
  Kuchera, D.O., Barry Robbins, D.O., who have
  strongly supported the idea of training resources
  for community-based preceptors.
•  
• Linda Heun, Ph.D., Julie Lochbaum, Ph.D., and
  Jeanne Kangas, Steve McKernan, D.O., Nancy
  Miller, and Michelle Mollick, for serving as
  original audiences before we took the revised
  materials on the road.
• Phyllis Blondefield,Ph.D. David Patterson Julia
  McNabb, D.O. and Stephen Laird, D.O. for
  assistance with development and review of these
  materials.

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References

• Epstein, R. M., (1999) Mindful Practice. JAMA,
  Vol. 282, No. 9, pp. 833-839.
• Lesky, L.G. and Hershman, W.Y. Practical
  Approaches to Major Educational Challenge
  Archives of Internal Medicine 95897-904.
• Society of Teachers of Family Medicine, Preceptor
  Education Project Instructors Manual. Kansas
  City, Missouri.
• Schön, Donald, The Reflective Practitioner How
  Professionals Think in Action.

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• Development of this module was supported by
  KCOMs Faculty Development in Family Medicine
  grant from DHHS, HRSA, Bureau of Health
  Professions, Grant Number 5D45HP50086-06.