Education and employment characteristics of nurse preceptors.

BACKGROUND: Nurse preceptors are vital linchpins, supporting the transition of new graduates to practicing registered nurses (RNs). This research clarifies similarities and differences among preceptors and nonpreceptors in an established statewide preceptor program. METHODS: A secondary analysis of relicensure data from all nurses working in Vermont hospitals in two years (2005 and 2009) was undertaken. RESULTS: There were no statistical differences by basic degree type, highest degree, RN experience, years in the current job, job satisfaction, and intention to leave. Statistically significant differences that persisted over time included: (1) being less likely to be employed per diem; (2) work site population density; and (3) being more likely to be enrolled in nursing education programs. CONCLUSION: Given the lack of obvious identifiers, organizations would benefit from a systemized approach to preceptor identification and development. Regulators, who hold the clear social and legal mandate for patient safety, must also be an enabling force toward change.

Implementing the COPA model in nursing education and practice settings: promoting competence, quality care, and patient safety.

The Competency Outcomes and Performance Assessment Model (COPA) prepares learners for effective role performance in the workplace by delineating comprehensive, core clinical behaviors that provide evidence of competence. This article explores the experiences of COPA model implementation in two nursing programs and a statewide nurse internship program. The article describes the challenges and benefits of implementation, discusses the transition from a traditional to an outcomes- and competency-based curriculum, and examines the process of assessment, with a focus on the faculty role. The influences of outcomes-based learning strategies and evaluation on competence, confidence, learning, and practice are discussed. In the statewide internship program, with 10 years of implementation experience in practice environments across the continuum of care, the COPA framework has provided significant benefits for preceptors, new nurse graduates, employers, and patient safety.

The COPA model: a comprehensive framework designed to promote quality care and competence for patient safety.

Patient safety and quality care are issues of major concern for nursing and all health care professions. Initiatives driven by these concerns have been undertaken during the past decade by organizations and agencies at the local, state, and national levels. One comprehensive framework used by many schools and agencies is Lenburg's Competency Outcomes and Performance Assessment Model (COPA). This article explores the basic concepts and related principles that are fundamental in refocusing the curriculum to promote practice-based competence. The framework emphasizes eight core practice competencies; competency-based outcomes; practice-driven learning; and competency performance examinations. The article also highlights Klein's doctoral research, which compares the effects on teaching and learning in a sample of diverse nursing programs, some of which use and some that do not use the model. Key findings are summarized with recommendations for further study. The COPA Model also is briefly compared to an emerging competency initiative.

Using the Delphi Technique to Determine Core Components of a Nurse Competency Program.

This modified Delphi study determined consensus on core nurse competency program components that apply across the continuum of transition to initial practice, to new specialty practice, to a new role, or within general nursing orientation. The literature review found no published agreement on support and systems for universal transition programs. This broad-based study addressed this gap by identifying core elements within a competency or transition program and then ranking their importance within program structure.

An Evidence-Based Approach to Precepting New Nurses.

While developing a standardized approach to orient new staff in the U.S. Army Institute of Surgical Research Burn Center at Fort Sam Houston in Texas, nurse leaders identified the need to also standardize preceptor selection and instruction. A multidisciplinary research team conducted a two-year pilot project based on the evidence-based Vermont Nurses in Partnership Clinical Transition Framework, which provides a structured method for preceptor selection, development, and evaluation. Minimum preceptor qualifications; preceptor validation processes; and modifiable, unit-specific coaching tools were established. The authors previously published a description of the preceptor program implementation process and their findings. In this article, they discuss lessons learned during the project, highlighting the challenges and obstacles encountered when implementing this preceptorship program.

Competence and innovation in preceptor development: updating our programs.

To meet the challenges inherent to the 21st century healthcare environment, preceptors require specific preparation for their teaching/mentoring role, as well as resource materials and policies that support this instructional work. One of the challenges facing the Vermont nurse leaders was teaching direct care providers how to develop critical thinking skills in novice staff members. The Vermont Nurse Internship Project approached this challenge in a collaborative manner and has "raised the bar" for preceptor development with statewide, standardized, research- and theory-based preceptor instruction and support. Based on 7 years of intensive work with preceptor development, the nurse leaders have added to the role and responsibilities of the preceptor by delineating the Protector and Evaluator components of the role and specifying critical thinking development, documentation of evidence, and team leading responsibilities.

Clinical Transition Framework: Integrating Coaching Plans, Sampling, and Accountability in Clinical Practice Development.

The clinical transition framework (CTF) is a competency-based practice development system used by nursing professional development practitioners to support nurses' initial orientation or transition to a new specialty. The CTF is applicable for both new graduate and proficient nurses. The current framework and tools evolved from 18 years of performance improvement and research projects engaged in both acute and community care environments in urban and rural settings. This article shares core CTF concepts, a description of coaching plans, and a professional accountability statement as experienced within the framework.

Impact of a Nurse Residency Program on Transition to Specialty Practice.

A nurse residency program can support transition for new-to-specialty nurses but requires commitment of time and resources. This implementation project used a specialty residency program shown to be effective in a Burn Center, and translated it into the Emergency Department and Maternal Child Health area located within the same medical treatment facility. Preceptor survey responses and leadership assessment of program suitability provided data related to intervention impact. The evidence pertaining to developing specialty knowledge, skills, competency, and clinical reasoning validated program efficacy. Project outcomes justify investment in building a standardized transitional support system.