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Field EMS Preceptor program
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FIELD PRECEPTOR ORIENTATION
2014
Purpose…
This Field Preceptor program endeavors to provide you with the essential tools and information to successfully fulfill your influential role of EMS preceptor.
Welcome! Thank you for being a preceptor for the VCU
Paramedic Program
The Objectives of this orientation is to familiarize you with:
• The Preceptor & Student Roles
• Adult Learning Theory Review• Training Objectives• How to provide feedback • How to evaluate students
Paramedic Program Goals:
To prepare competent entry-level health care providers in the cognitive, psychomotor, and affective learning domains,” at the Paramedic, Emergency Medical Technician-Intermediate, and Emergency Medical Technician-Basic levels.
You Are Now The Mentor
You are now a preceptor and thus a mentor
Your attitudes and actions has an impact on the kind of EMT or paramedic the student will eventually become.
The mentoring the student receives is just as important (maybe more so) as the training he/she receives in the classroom
Remember That You Weren’t Always Successful
Many new paramedics look at successful health-care providers & think they were always that way
Most professionals have had great mentors
We developed over time & through much trial & error
We received correction along the way
Why Do They Need A Preceptor? Students need help managing anxiety
They need to develop a professional identity
They need to understand that there are a variety of strategies that are effective – there is not just one way
They need guidance to develop their own “style”
Preceptor Responsibilities Provide a model for the student to emulate
Transmit knowledge and experience
Help the student manage anxiety
Supervise & guide skill acquisition and performance
Provide positive & correctional feedback that will allow the student to “grow”
Completely & honestly fill out & sign the students evaluations
Preceptor Characteristics Possess good communication skills
Establish a climate that is conducive to learning
Share practical steps in patient care
Provide positive & correctional feedback, when necessary
Listen to the student
Maintains proficiency in their clinical area
Paramedic Preceptor & Team The team must consist of three people.
The student cannot be the driver.
Preceptor must be a Paramedic
Must be a released provider for a minimum of 1 year.
Maintains proficiency and be in good standing with the department.
Thinking back to your orientation?
What makes a bad preceptor?
What makes a good preceptor?
Preceptor Role
Guides the student and provides help when needed
Creates opportunities for students to provide care for patients while preventing the student from doing harm to the patient or themselves.
Makes mental notes about the good & the bad aspects of care & reviews with the student in a private setting.
Preceptor Role (Cont.) Preceptors should keep an open mind that
there is more than one way to reach a certain goal
Remember students are still in the learning process
They should not be expect students to perform to the level of an experienced EMT or Paramedic
Student Role Come to station or field site enthusiastic, prepared, and
appropriately dressed.
Perform assessments and clinical skills under supervision with increasing competency and responsibility.
Paramedic students should actively seek out learning opportunities and be available to the preceptors when learning opportunities arise.
Demonstrate professional behaviors including: motivation, integrity and accurate self-assessment.
Requirements for Successful Completion (Paramedic level)
Patient Assessments 30- Pediatric
50- Adult
30- Geriatric
Airway management – 50+ Patient Complaints
8 – Pediatric Respiratory
10 – Change in Responsiveness
30 – Chest Pain
20 – Altered Mental Status
20 – Respiratory
20 – Abdominal Pain
Requirements for Successful Completion (Paramedic level)
Patient Impressions40- Trauma
10 - Obstetric
20 – Psychiatric
Skills Performed 25 – Medication Administration
50 – Successful IV Insertions
10 – Ventilations
3 – ET Intubations
Additionally, each student will be required to complete 50 team leads, of those team leads 20 must be ALS level transports.
Traits of Adult Learners
Self-directed & Autonomous Resistant to change Practical, Results or Goal Oriented Applies Personal Experience Motivation Multi-level Responsibilities High Expectations
EMS Version of Dreyfus Model
Novice: -- Has no experience at the present certification
level. This student must be directed in all aspects of patient care, and may require step-by-step directions. Protocols are considered absolute, and the student may not be able to combine protocols in complex patients.
EMS Version of Dreyfus Model
Advanced Beginner: -- has gained an understanding of individual
skills, but may not know when to use them in complex cases. This student functions well as a team member, and understands that protocols may not always fit every situation. However, they will need directions, and will seek permission for any “outside the box” issues.
EMS Version of Dreyfus Model
Competent: -- Still relies on protocols, but is able to
understand the value and purpose of each. This student can provide patient care, but still follows algorithms and may use references during patient care. This provider/student is able to function as a team leader, and requires minimal or no direction, possessing the ability to think critically, and find answers when needed. Begins to differentiate relevant from irrelevant information.
EMS Version of Dreyfus Model
Proficient: -- Experienced providers who have developed
pattern recognition, but still follow a systematic process during assessment and treatment of patients. Few students will ever achieve this level during an initial education program. Providers at this level make ideal preceptors, because they are easy to follow, and can identify the steps used to draw conclusions and make decisions.
EMS Version of Dreyfus Model
Expert: -- is exceptional in patient care, and uses vast
experience to make decisions. This provider does not rely on protocols and algorithms, and is able to follow “gut instinct,” and is usually right. Complex cases are not a problem, as creative problem-solving is natural. This level of provider is often a difficult preceptor for students, because they multi-task and rely on experience, rather than a systematic approach. The expert may have difficulty explaining “why” and “how” conclusions were drawn.
Our Dreyfus Goal…
It is important to understand that students
should not be expected to meet a proficient or
expert level of practice. They may need
resources that the experienced preceptors may not
find necessary, and they will need to follow a
systematic, step-by-step process when providing
patient care.
Start of Each Shift Review with the student how much field time they
have completed & what they currently studying.
Find out the student’s perceptions of their own strength & weakness
Find out any issues of concern that student may have and try discuss and focus on these areas
Relay your expectations of the student
Make sure the student understands what is
expected of him/her
Tour the station if this is their first shift at this location
Review and involve them in the daily routine and station responsibilities
Review location of supplies, equipment, & involve them in the process of checking the ambulance out.
During the Shift Under direct supervision assign students specific
tasks or skills. (e.g. IV, 12-lead, or ET)
During downtime or on slower days supervise skill simulations and chart them with the student in FISDAP (They can help you with this…)
With supervision allow the student to be team leader for certain calls.
Provide feedback
Providing Feedback Types of feedback:
Correctional Positive reinforcement
We understand all the time constraints you are under as you go about your shift, our hope is that you will find opportunities to provide feedback and suggest opportunities for improvement throughout the shift.
Types of Feedback Correctional:
Correctional feedback should be given in a positive manner
Identifies areas of performance that require improvement or an area in which the student must change their behavior
Example: Reminding a student of the importance of strict aseptic technique when starting an IV.
Example: You did a great job with that patient assessment and I think together we can identify some things we could do better …
Types of Feedback
Positive reinforcement: Encourages desired behavior Helps build self-confidence
Example: “Your calm & confident behavior really helped to relax the patient. You did a very good job”
Qualities of Good Feedback Timely manner:
Feedback should be provided as soon as possible after performance.
Private: Correctional feedback is always done in private Positive reinforcement can be done in private or In front of others, depending on the personality of the person receiving the reinforcement.
Qualities of Good Feedback Direct:
Always directed at the person for whom it was intended
Only discuss correctional feedback with those individuals that are directly concerned
Objective: Good feedback is conducted without any bias to race, gender, ethnic origin, sexual preference, or creed
Qualities of Good Feedback Clear:
Does the student understand what you as the preceptor said or meant to say?
Remember that feedback should not be general goals for improvement, but pinpointed actions that the student can take to improve patient care
Vague feedback doesn’t give the student any idea of how to realistically improve their performance
What To Look For As A Preceptor?Look for students with the:
Ability to communicate clearly with patients Ability to manage patient care efficiently Ability to complete a thorough patient assessment Ability to identify a patient’s chief complaint Ability to formulate and provide appropriate treatment
strategies at their level of training Ability to provide patient care in a safe and effective
manner.
Problem Resolution The lines of communication begin at the level of
the student & preceptor If an issue cannot be resolved you may contact:
Clinical Coordinator:
Basil Asay (804) 283-1483 or basay@vcu.edu
Paramedic Program Director: Ken Williams (804) 828-3687or kwilliams6@vcu.edu
Completing the Shift Students should report to their preceptor anytime
they leave the station or before the shift is to end.
Throughout the shift students will chart their assessments, patient contacts, and skills completed in a program called FISDAP.
To complete their shift they will need their preceptors assistance in the FISDAP program.
From this screen the student will be able to select from which assigned
shift he is working and begin completing assessments and entering completed tasks.
Students should report to their preceptor anytime they go off the unit or before the shift is to end.
Throughout the shift students will chart their assessment and tasks completed in a program called FISDAP.
Notice that multiple types of shifts have been assigned. This page will also
indicate whether you their preceptor have signed off on this shift. Note the pencil in the preceptor signoff column. The checkmark indicates that you, their preceptor, has electronically signed off on the work completed.
Students should report to their preceptor anytime they go off the unit or before the shift is to end.
Throughout the shift students will chart their assessment and tasks completed in a program called FISDAP.
Students should report to their preceptor anytime they go off the unit or before the shift is to end.
Throughout the shift students will chart their assessment and tasks completed in a program called FISDAP.
This is the shift signoff screen. The student will open this screen for you to signoff on at the end of the shift. However before you do you will need to have them first allow you to complete an evaluation and look over what they did…
Before signing off you should have the student show you this shift summary
it will identify the number of patients they assessed or skills performed. Under the intervention column it should show what skills/tasks they performed…
Students should report to their preceptor anytime they go off the unit or before the shift is to end.
Throughout the shift students will chart their assessment and tasks completed in a program called FISDAP.
This is the area of FISDAP where both you and the student can chart any
simulated skills practice done during the shift. This will really help the student if we can do this frequently throughout the program.
Students should report to their preceptor anytime they go off the unit or before the shift is to end.
Throughout the shift students will chart their assessment and tasks completed in a program called FISDAP.
By clicking on the link with the patient identifier, you can view what has been
charted on the patient and view the completed narrative. Student should not chart anything that would violate HIPPA or patient confidentiality.
Students should report to their preceptor anytime they go off the unit or before the shift is to end.
Throughout the shift students will chart their assessment and tasks completed in a program called FISDAP.
This section shows what evaluations have already been filled out for this
shift. Once you have completed the evaluation it should show up here. You will also notice the student can do a self-evaluation as well.
Students should report to their preceptor anytime they go off the unit or before the shift is to end.
Throughout the shift students will chart their assessment and tasks completed in a program called FISDAP.
This is where you or the student will select the evaluation that needs to be
completed at the end of the shift. It’s labeled: “Preceptor evaluation of student.” After selecting the correct evaluation form click the “GO” link…
Students should report to their preceptor anytime they go off the unit or before the shift is to end.
Throughout the shift students will chart their assessment and tasks completed in a program called FISDAP.
This screen should appear, either you or the student will have to change the
evaluator section to reflect you being their “Preceptor,” Student will assist… There will be evaluation sections for psychomotor and affective domains…
Students should report to their preceptor anytime they go off the unit or before the shift is to end.
Throughout the shift students will chart their assessment and tasks completed in a program called FISDAP.
Note the GradingScale. “We don’t expect exceptionalall the time…”
After you have scrolled down and answered all the questions there will be a
score provided, and a button to submit and close. The preceptor should be the person filling this form out.
Students should report to their preceptor anytime they go off the unit or before the shift is to end.
Throughout the shift students will chart their assessment and tasks completed in a program called FISDAP.
Students should report to their preceptor anytime they go off the unit or before the shift is to end.
Throughout the shift students will chart their assessment and tasks completed in a program called FISDAP.
At this time you can have the student bring you back to this signoff screen and you may add any comments you would like to this screen and electronically sign your signature on the line.
Students should report to their preceptor anytime they go off the unit or before the shift is to end.
Throughout the shift students will chart their assessment and tasks completed in a program called FISDAP.
The last thing you do is check the box lock shift and click save. Before doing so ask the student if they there is anything else they have forgotten, because they will not be able to go back and make changes to a locked shift…
Step one Step two
Once you click “Save” the shift is complete…
Completing the Shift Students have been authorized to use handheld
devices and the screen may be slightly adapted for mobile use.
Students should still be able to walk you through all the same information and you should still be able to complete the “evaluation form”
The responsibility of navigating the software is not left to the preceptor alone, but the preceptor should know what information they are signing off on.
THANK YOU!
It is dedicated preceptors like yourself that allow us to educate and train quality pre-hospital medical providers.
Paramedic Program Clinical Coordinator: Basay@vcu.edu Office: (804) 828-4917
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