Perfect Preceptorship?

Jean Mason Mitchell, June 2018

MSc, PGCHER, RM,RGN

Lecturer Midwifery UoS

Lecturer practitioner, 2003–2011development and implementation of preceptorship programme

MSc Midwifery – evaluation of programme

Preceptoship Publications – 2009, 2013, 2016

NET Conference - 2015

• A period of structured transition for the newly

qualified practitioner

• Develop confidence as an autonomous

professional, refine skills, values and behaviours

• NOT a way to meet any shortfall in pre-

registration education(DH 2010:11).

Definition (DH 2010.11)

Barriers

And

Challenges

Lack of consensus between

regulatory and professional

bodies Skills & attitudes to

promote normal birth are focus of midwifery

education(NMC 2007)

NQM not fully conversant with skills to care for

women with complex needs

NMC - 2009 development

needed AFTER registration to

acquire skills to be lead carer for these

women

–“quality” of preceptor

pivotal to NQM development (Finnerty et al

2006)

No need for additional “course” or review & no

recognition for preceptor role

GAPS

MIND THE GAP

preceptorship variable -

months or up to 2 years – NHS Trust dependent

Hughes and Fraser (2011) differing skills & abilities of

NQMs on qualification

not recognized

SINK OR SWIM – culture / bullying

NOT JUST ABOUT CLINICAL

SKILLS

EVALUATION AND REVIEW

REQUIRED

EVIDENCE / POLICY

CHANGING WORKFORCE

• WHY?

• ? Lack of robust, formalized systems for development implementation & audit

↓ evidence of real growth despite being↑ on policy agenda – remains local responsibility

• WHY?

• ? Lack of quantitative evidence

• Qualitative studies don’t demonstrate cost or quality of care

Difficult to convince budget holders of value / need to fund provision & evaluation

Structured / evaluated / revised

Personalised and flexible – evidence based, content and

delivery, length, rotation

Supportive

Develop confidence & competence

NQM’s report feeling safe, able to achieve specific skills and

evidence their development

Mason, JM Davies, SE (2009,2013, 2016) / Hughes and Fraser (2011), Hughes AJ; Fraser DM (2011) / Currie,L.Watts, C (2012)

/ Hobbs, J. (2012), Currie,L.Watts, C (2012) / Feltham (2014), Power A, Ewing, K (2016) Irwin C, Bliss, J, Poole, K (2018)

Jones,K, Warren,A, Davies A,(2015) Mind the gap, Summary report from Birmingham and Solihull Local Education and

Training Council, Every Student Counts

Rankine,J, Symeonaki, M. (2018) Developing future midwifery, Empowering Preceptees

Qualitative evidence - effective

programmes need to be

• need to facilitate

supportive working

environment for NQM’s. Hobbs (2011) Mason Davies

(2013) / Good relationship

= reciprocal benefits - (Kirkham, 2007)

• Peers important in

learning (Rogers 2010) &

support helps address

emotional issues

surrounding transition

from student NQM (Ferguson and Day 2007).

Are we always supportive?

• A midwife is a midwife is a midwife….

shes paid as much as me…..soon

knock that out of her…

• ‘Stones can make people docile’:

reflections on how the hospital

environment makes us ‘good girls’

(Bosanquet 2002) / Bullying and

Horizontal violence – Curtis, Ball and

Kirkham (2013)

• Do we encourage peer support groups

within preceptorship programmes or

simply in day to day practice?

Provide supportive relationships

• “Mind the gap” – are we adapting / responding?

• Simulation in a supportive environment

• “…made such a difference when learning new skills ...

holding the instruments ....playing with the FSE, attaching it

through a torso to a grapefruit... mad but it so helped…”

• NB -utilize MDT for support

• How do we support development of leadership / decision

making etc - Practice based education & support facilitates development of decision

making expertise more effectively than traditional teaching (Kitson Reynolds 2009).

Develop confidence and competence

in our NQM’s

YOUR ACTION

BIG IMPACT

WHAT YOU CAN DO

Be that supportive colleague-

Coach / facilitate

recognize time

pressures of colleagues undertaking preceptor

role

Have a voice in

trust meetings

Demand local

evaluations of current provision

Lobby NMC – listening

events forums etc

RESPOND TO

CHANGE

Perfect preceptorship?

• Probably not in my lifetime!

• We can all be more effective in

supporting NQM’s at local level and

lobbying for effective change at national

level

• Thank you for listening!

• Currie,L.Watts, C (2012) Preceptorship and pre-registration nurse

educationhttp://www.williscommission.org.uk/__data/assets/pdf_file/00

11/479936/Preceptorship_and_pre-registration

• Department of Health (2004) Agenda For Change: Final Agreement.

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/Publicat

ionsPolicyAndGuidance/DH_4095943

• Department of Health (2008) A High Quality Workforce. NHS Next

Stage Review.

• Department of Health (2010) Preceptorship Framework for Newly

Registered Nurses, Midwives and Allied Health Professionals.

• Feltham,C (2014) The Value of Preceptorship for Newly Qualified

Midwives, British Journal of Midwifery 22(6);427-431

• Ferguson, L Day, R. (2007) Challenges for new nurses in evidence-

based practice. Journal of Nursing Management 15: 107 - 113

References

• Hobbs, J. (2012) Newly qualified midwives’ transition to qualified

status and role: Assimilating the ‘habitus’ or reshaping it? Midwifery

28:391–399

• Hughes AJ; Fraser DM (2011) 'SINK or SWIM': the experience of newly

qualified midwives in England. Midwifery 27(3):382-386

• Irwin C, Bliss, J, Poole, K (2018) Does Preceptorship improve

confidence and competence in Newly Qualified Nurses: A systematic

literature review, Nurse Education Today (60), 35 – 46.

• Jones, K. Warrren, A. Davies, A. Mind the Gap, (2015) Exploring the

needs of early career nurses and midwives in the workplace, Summary

report from Birmingham and Solihull Local Education and Training

Council Every Student Counts Project

• Kirkham, M. (2007) Retention and return in the NHS in England.

Midwives, the official journal of the Royal College of Midwives 10 (5):

224- 226

References

• Kitson- Reynolds, E. (2009) Developing decision making for students using

interactive practice. British Journal of Midwifery, vol 17 (4) p 238 -243

• Mason,J. Davies,S.(2009) Preceptorship, Time for a Change? British Journal of

Midwifery, 17(12),804 – 805

• Mason,J. Davies,S.(2013) A qualitative evaluation of a preceptorship programme

to support newly qualified midwives. Evidence based Midwifery, September 2013

• Mitchell, JMM and Davies, S (2016) Implementation of a structured

• programme of preceptorship for Newly Qualified Practitioners (Midwives) in one

North West England Maternity Unit, Nursing management

• Nursing and Midwifery Council (2007) Review of pre registration midwifery

education – decisions made by the Midwifery Committee. Circular 14 12/5/2007

• Nursing and Midwifery Council (2009) Standards for pre-registration midwifery

education

• Power A, Ewing, K (2016) Midwifery preceptorship: The next chapter . British

Journal of Midwifery, August 2016. https://doi.org/10.12968/bjom.2016.24.8.582

• Rankine,J, Symeonaki, M. (2018) Developing future midwifery, Empowering

Preceptees

References