Susan A. Boyer Director, VT Nurses In Partnership

 Distinguish positive aspects of how you impact both technical and critical thinking skill development.

Any fool can make things bigger, more complex, and more violent. It takes a touch of genius – and a lot of courage – to move in the opposite direction.  Albert Einstein

 Nurses “eat their own”  “Nursing literature reports that the inability to handle the intense working environment, advanced medical technology, and high patient acuity results in new grad turnover rates of 35% to 60% within the first year of employment.”  (Beecraft, Kunzman, & Krozek, 2001)  VNIP turnover rate – less than 10% for new graduates completing the internship

 History & background,  Unique features of VNIP  Target audience – team approach

6 Preceptor development and support Clinical Coaching Plan - Development of Critical Thinking Preceptors Interns Clearly defined expectations

... bigger, more complex, and more violent. It takes a touch of genius – and a lot of courage – to move in the opposite direction.  Albert Einstein

 People think better when they understand, like, and trust one another.  Critical thinking is essential and requires collaborative thinking

 Defined as learning occurs, a change in behavior/ performance ◦ Growth – expansion, progress, advance, increase ◦ Training – education, advancement, promotion, expansion, enhancement  Requires: ◦ Knowledge base, interpersonal, technical and critical thinking skills  How is this development supported in your workplace

 Your workplace –  Your role -

 Teach  Experiential learning  Safe environment

 Who to protect  How to protect ◦ Define competence ◦ Determine what competent practice looks like ◦ Establish performance outcomes ◦ Observe practice  Develop and validate competence

Think, Pair, Share:  What does C.T. look like in your practice?  How do we support the development of Critical thinking skills?

 Questions ◦ Anticipate questions that might be asked ◦ Explore possible consequences ◦ Focus on outcome – what is the goal? ◦ Focus on the rationale – why? ◦ Explore alternatives – what else? what am I missing  Case presentations, telling your ‘stories’, sharing experiences ◦ Turn them into “what if” discussions ◦ Continue with the questions listed above © 2001 Vermont Organization of Nurse Leaders (VONL) 14

 Develop & use habits of inquiry ◦ Take enough time to explore situation ◦ Keep an open mind - Verify information  Discuss ◦ What did I miss? How could this be made better? Why are we doing it this way?  Thinking out loud ◦ Did you notice… How can I find out.... ◦ I could do x, y or z,…. but for this patient, I think this is best…. Why? © 2001 Vermont Organization of Nurse Leaders (VONL) 15

 Understanding differences

 Ethnic, Religious, Socio- economic  Roles  Educational background  Personality, Learning styles  Conflict management  Generational  Gender

 How is the role of the preceptor instructor, clinical coach impacted by generational, cultural, personality styles?  Are there other influences to add to this list?  What response or actions can bridge these issues?

 the dominant set of behaviors, values, beliefs, and patterns of thinking that we learn as we grow and develop in our social groups.  Culture determines how we think about and behave toward ourselves, others and the world. © 2001 Vermont Organization of Nurse Leaders (VONL) 19

 Be aware that differences exist  Be sensitive to differences and the effect they have  Try to understand the individual and the differences involved  Consider what accommodations are necessary to make the relationship successful © 2001 Vermont Organization of Nurse Leaders (VONL) 20

 groups of people develop a different and distinct set of core values for their entire lifetime that are formed by so- called "coming-of-age experiences" between the ages of 17 and 23 © 2001 Vermont Organization of Nurse Leaders (VONL) 21

 If you understand where a person is coming from, it will help you predict their behavior.  It will help to know how to communicate with them. Center for Generational Studies © 2001 Vermont Organization of Nurse Leaders (VONL) 22

 Working effectively with different personality styles

 E xtraversion vs. I ntroversion ◦ Direction or how you recharge your energy?  S ensing vs. I N tuitive ◦ Perception of world or how you collect data?  T hinking vs. F eeling ◦ Judgment or how you make decisions?  J udging vs. P erceiving ◦ How you deal with the outer world & make lifestyle choices

 Key teaching/learning issues or concepts

 Novice  Advanced Beginner  Competent  Proficient  Expert Which makes the best preceptor? © 2001 Vermont Organization of Nurse Leaders (VONL) 26

 Inventory of learning styes ◦ Reflective vs. Active ◦ Sequential vs. Global ◦ Sensing vs. Intuitive ◦ Visual vs. verbal  VARK ◦ Visual, Auditory, Read/write, Kinesthetic,

 is diverse and brings a wealth of experiences to the situation  prefers to have some degree of control over their learning  learning is an active process of construction of meaning  needs to connect the content to their own meaning structures  focuses on what they WANT to learn © 2001 Vermont Organization of Nurse Leaders (VONL) 28

 6 – 1 ratio ◦ 6 positives to offset 1 negative – shows the need for positive feedback  Want to learn - Need to know ◦ Don’t try to teach if they aren’t interested in learning. You will waste your time and thiers.  Pictures - See = remember  Revisit 6 – 9 times to remember

 Interactivity is key – doing!  Success builds success  Build simple to complex  High anxiety reduces retention  Learners remember the odd & unusual  Amount of learning that occurs is directly proportional to how much fun you are having

 Communication skills

Verbal – the words we use + Vocal – our tone and intensity “The music we play with our voices” + Visual – Everything the listener can see = the meaning received100% © 2001 Vermont Organization of Nurse Leaders (VONL) 32

 It is better to remain quiet and be thought a fool then to speak and remove all doubt  Mark Twain © 2001 Vermont Organization of Nurse Leaders (VONL) 33

 Conflict Management

 Treat the Other Person With Respect  Respect for another person is an attitude conveyed by specific behaviors.  Listen Until You Have “Experienced the Other Side”  They need to be understood and accepted.  When the other person feels heard, you have earned the right to speak your point of view and express your feelings.  State Your Views, Needs & Feelings  State your point of view briefly.  Use “I” statements

 For many of us, an act of willpower is needed to fight the gravitational pull into disrespect.  A conscious effort must be made to convey respect and instill a sense of worth to all concerned parties.

 Interpersonal skills ◦ Combining effective use of all the previously discussed ◦ Plus theory related to skills development

 Fill in your chart Current PracticeWhat might be added

 Distinguish positive aspects of how you impact both technical and critical thinking skill development  Could you expand this list?

 Preceptor development ◦ Research and theory based ◦ Define & prepare for the role  Competency development ◦ Clinical Coaching plans  Competence validation ◦ COPA model – for allied healthcare team  Staff development process & protocols ◦ Time to teach, time to assess capability ◦ Protector Role, competence assessment