Improving Nurse Practitioner and Physician Assistant Preceptor Knowledge, Self-Efficacy, and Willingness in a Hospital Medicine Practice: An Online Experience

Clinical Preceptor Development and the Benefit of Structured Teaching Techniques: A Scoping Review

INTRODUCTION

Physician assistant (PA) education in the clinical year is dependent on clinical preceptors. Recruitment of preceptors has been identified as a significant barrier for programs. As a result of the preceptor shortage, evaluation of the barriers to recruitment and retention has been considered. The lack of development and training was identified as a barrier to recruitment and retention of preceptors.The aim of this scoping review article was to identify structured teaching strategies to reduce the development and training barrier and improve preceptor efficacy and efficiency. Structured teaching techniques, such as the One-Minute Preceptor and Summarize, Analyze, Narrow, Probe, Plan, and Select (SNAPPS), are proven to be effective and efficient ways to train learners.

METHODS

Online databases were used to identify articles published from 2014 to 2022 using the following terms: "physician assistant" or "nurse practitioner," "preceptor development," "preceptorship," "teaching methods," "pedagogy," "clinical teaching," and "medical education." Seventeen articles formed the basis of the scoping review of the literature. A singular author reviewed the articles.

RESULTS

Training resources help ease student instruction burden that preceptors experience. Many preceptors rely on clinical experience to guide their teaching methods. Introducing formal, structured teaching strategies can improve preceptors' effectiveness. By implementing preceptor training using structured teaching strategies, PA programs can decrease barriers for preceptors and potentially increase preceptor effectiveness and efficiency.

CONCLUSIONS

Training preceptors on using structured teaching strategies through workshops, asynchronous learning modules, and podcasts could provide preceptors with the support needed to educate clinical phase PA students. Physician assistant programs must explore best practices in clinical teaching and the associated education and operational outcomes.

Effectiveness of an Online Preceptor Development Program Across Health Professions

Introduction

An online Preceptor Development Program (PDP) was developed to meet the needs of geographically dispersed preceptors across health professions. We aimed to measure the audience, their engagement, and effectiveness of an online PDP developed and implemented amid the COVID-19 pandemic.

Methods

The mixed methods study included survey and attendance data for live and asynchronous formats. T-tests compared overall session perception to self-reported session impact. Objective alignment and self-reported measures of impact were analyzed around Kirkpatrick's levels of reaction, learning, and behavior.

Results

Participants engaged in live and/or asynchronous PDP sessions from various professions, specialties, and geographical locations. Quantitative findings indicated significant associations between overall session perception and knowledge (session 2), competence (sessions 1, 2), and performance (session 1). Objectives were met, and key learning takeaways were reported. While most participants indicated no barriers to implementation, two barriers identified were a lack of time and uninterested students.

Conclusion

Participants were afforded flexibility and choice and likely benefitted in the areas of knowledge, competence, and behavior. This online PDP effectively addressed preceptor needs in common areas, including feedback. Future program development may include advisory group input and interactive learning opportunities.

A Psychometric Evaluation of the Nurse Practitioner Self-efficacy Scale

OBJECTIVE

In this study, a psychometric evaluation of the Nurse Practitioner Self-efficacy Scale (NPSES) was conducted.

BACKGROUND

Self-efficacy is an important concept for optimal nurse practitioner (NP) performance and retention. The NPSES may serve as a valuable instrument to support NP practice.

METHODS

This descriptive cross-sectional study evaluated the NPSES responses from 230 NPs. Confirmatory factor analysis, reliability, and t tests were used to analyze the results.

RESULTS

Confirmatory factor analysis revealed acceptable goodness of fit for an 8-factor model (root-mean-square error of approximation = 0.05, comparative fit index = 0.97, Tucker Lewis index = 0.96). Reliability estimates resulted in acceptable internal consistency (coefficient α = 0.94). The t tests comparing more and less experienced NPs resulted in higher scores in more experienced NPs.

CONCLUSION

This validation study showed that the NPSES is a psychometrically-sound instrument to assess NP self-efficacy. The NPSES is a cost-effective and convenient method to measure self-efficacy, a valuable concept for NP practice.

Competency-based evaluation: Collaboration and consistency from academia to practice

ABSTRACT

Competency-based evaluation is not a new concept in nursing education. The Essentials: Core Competencies for Professional Nursing Education (AACN Essentials), published in 2021, and the NONPF Nurse practitioner Role Core Competencies (2022) have provided us with the most recent roadmap for curriculum development and student evaluation. Using these two national guidelines and the Standards for Quality Nurse practitioner Education (2022), we examined ways to unify curriculum and competency in clinical practice. Through a review of the available literature, the lack of standardization in evaluating competency in clinical practice was evident. A framework for evaluation was developed including concepts from other health care discipline competency models. This article presents the resulting evaluation of a tool across academia and practice. Clinical preceptors are an extension of the faculty and play a significant role in developing practice competencies in advanced practice nursing students. Providing preceptors with a comprehensive framework we derived from the already existing PRIME model, and which we use with simulated patients, allows for the evaluation of clinical competencies in a variety of clinical settings. Consistency of evaluation across settings assures the attainment of the competencies necessary to perform safely and effectively in the practice environment.

Perceptions of motivating factors and barriers to precepting

BACKGROUND

Advanced practice registered nurses (APRNs) and physician assistants (PAs) are integral to health care delivery in the United States. However, the cultivation of APRNs and PAs relies heavily on the model of precepting. Advanced practice registered nurses and PAs frequently precept students or new hires, yet limited data are available to describe the motivations, incentives, and barriers associated with precepting.

PURPOSE

The purpose of this mixed-method, cross-sectional study was to better understand APRN and PA preceptors' perceived levels of support during precepting, facilitating factors, and barriers to the precepting process.

METHODS

An electronic survey was distributed via REDCap to a convenience sample of APRN and PA preceptors at an academic medical center. Data collected from the survey were analyzed using both descriptive statistics and qualitative thematic analysis.

RESULTS

One hundred fifty-four participants completed the survey. Motivating factors for precepting included "giving back" to the profession, and barriers included inadequate time to precept while in the clinical role. Participants indicated that financial incentives, heightened communication, protected teaching time, preceptor training, meaningful recognition, and organizational support could enhance the precepting process.

CONCLUSION

This study demonstrated that altruistic intentions frequently motivate APRN and PA preceptors, however, navigating multiple clinical responsibilities while precepting serves as a barrier to the precepting process. Preceptor training, ongoing education, dedicated time for precepting, enhanced communication, and organizational or professional incentives may optimize the APRN and PA precepting process.

IMPLICATIONS

Further research should focus on how to optimally incorporate education, professional development, support, and incentives into the APRN and PA preceptor role.

Nurse practitioner preceptor education to increase role preparedness

BACKGROUND

The public has become aware of the need for nurses and nurse practitioners in primary care with the widespread public health crisis. As the need for nurses and nurse practitioners grows, there is a need for the clinical educator and preceptor. However, preceptors have noted barriers to precepting such as time constraints, lack of preceptor role education, and role preparedness.

LOCAL PROBLEM

Currently, neither preceptor role development nor education has been implemented within a local institution. Preceptor vocalization led the charge for preceptor role development education within the institution.

METHODS

This quality improvement project focused on the preceptor role preparedness and education. A convenience sample was recruited from a large, diverse academic institution. The modified Clinical Supervision Self-Assessment Tool-Skills was utilized to determine the effectiveness of online education in preceptor role preparedness.

INTERVENTIONS

An online, self-directed, evidence-based preceptor education webpage with easily reproducible information related to collaborating with students and faculty situations. Literature, such as the One Minute Preceptor, Ask, Tell, Ask, and engaging student scenarios, was included from the literature review. A voice-recorded PowerPoint summarizing the webpage was included with a transcript for accessibility.

RESULTS

A paired t-test was used to assess the mean differences between the preintervention and postintervention periods. The results indicated the online preceptor education was effective.

CONCLUSIONS

Preparing nurse practitioner preceptors for their roles benefits the health care system. An online, self-directed, evidence-based preceptor education webpage can be beneficial in future preceptor education planning.