Four Focus Areas for Supporting Successful Preceptors

Staff at six children’s hospitals and one health system revealed that providing adequate support is a key component in developing and retaining successful preceptors. Thriving preceptor programs include four key focus areas: education and classes, paths to advancement, feedback and support, and recognition.

“We looked at our current preceptors, and we realized that at a time when they truly were needed most, we were losing them faster than we could train them right,” Jamie Talir, MSN, RN, NPD-BC, and RN program manager at SSM Health said of her team’s motivation to revamp the health system’s preceptor training program. “So, we pulled together a steering team of nursing professional development specialists to look into the program and revise it to become something that is more focused on nurturing, supporting, and empowering not just our current, but our future preceptors.”

The challenge of training and retaining preceptors in children’s hospitals was not unique to Talir’s team at SSM. Children’s Hospital Association’s Pediatric Learning Solutions hosted a three-part preceptor webinar series, which included insight from staff at six children’s hospitals in addition to SSM Health's system. These organizations revealed that providing adequate support is a key component in developing and retaining successful preceptors. Based on these organization’s efforts, thriving nurse preceptor programs should focus on four key areas.

Education and classes

As with any professional development or training program, education is a key piece in preparing preceptors for success. Preceptors at Children’s Health, Dallas, follow a clearly laid out pathway that uses a blended learning model.

The pathway to get preceptors started includes:

• Introductory online courses. Two courses prepare preceptors to move into their roles. The first course is designed to help preceptors prepare for an in-person class by presenting the roles and responsibilities of a preceptor, adult learning principles, learning styles, critical thinking, and effective learning practices. The second course reviews the hospital’s competency management program and gives access to document competency validation.
• In-person introductory training. A highly interactive in-person class builds on the foundation established from the prework online class by solidifying discussions and activities. The course covers the Tiered Skills Acquisition Model (TSAM) and where to find preceptor resources. After completing this course, learners can begin precepting.

Dallas continues the education with additional elements to the pathway:

1. Virtual, instructor-led classes. One class uses a scenario-based approach to cover how to have effective conversations between preceptors and orientees. Another provides advanced learning opportunities for experienced preceptors, including the differences between critical thinking and clinical reasoning, fostering those skills in orientees and how to respond when orientation does not go according to plan, and precepting orientees with learning differences.
2. Roundtables. Once preceptors complete the initial training, they are encouraged to attend at least one roundtable discussion in their first year and two every year after that. Topics covered include preceptor resiliency and the differences between competence, proficiency, and expert levels in skill validation.
3. Self-guided resources and learning opportunities. To ensure easy access to a large volume of learning resources, Children’s Health created a Preceptor Program Site, which had more than 4,700 visits at the time of their presentation. Additional materials are available on demand, covering preceptor themes including learning styles and leadership topics. “Often, precepting is the first step that our team members go through when they want to be a leader, so we like to offer all of those things in addition to our initial training,” said Martha Shaw, BSN, RN, CPN, NPD-BC, program manager of preceptors and mentors at Children’s Health.

Paths to advancement and growth

In addition to its online resources, Children’s Health provides a preceptor coaching program to give preceptors the opportunity to advance their knowledge and role. For preceptees, having a direct coach allows further opportunities to grow in their practice. It also provides an elevated professional development opportunity for those who become coaches. Responsibilities of these coaches include disseminating information at monthly education forum meetings, asking targeted development rounding questions to help the organization gather data on topics of interest, and providing direct support to preceptors working with clinicians at the bedside.

Similarly, SSM Health has interwoven their preceptor program with their clinical ladder program, a career development model that helps nurses advance their skills, education, and leadership within an organization. The health system has also made four continuing education credits available to staff who complete preceptor education courses. Additionally, the training is now available to any staff member who is interested, whereas it had only been available to acute care nurses previously. The initial training is available at least monthly, supplemented by advanced learning opportunities at least every other month to help preceptors stay engaged.

“Bodine's research highlights the importance of going beyond initial training and investing in reoccurring continuing education activities by fostering a culture that supports but also engages preceptors long after that training is complete,” Talir said. “So, every other month we have an informal gathering of preceptors to share experiences, highlight upcoming innovations, and provide some more advanced trainings.”

Some organizations require all nursing staff to go through preceptor training, while others, including Children’s Hospital of Los Angeles (CHLA), require staff to apply for their preceptor development programs. The hospital consistently receives more applications than the 50 spots available for each of their three annual training cohorts.

“There is always a need for preceptors, and we really try to encourage our leaders to not ‘voluntell’ their staff,” said Jessica Klaristenfeld, MSN, RN, NPD-BC, senior nursing professional development specialist in Clinical Education Services and Research at CHLA. “We really do want them to volunteer, they need that support and development to not be so burnt out.”

“We also really think about it as a retention and a professional development strategy for our preceptors and make sure we have a program they're proud to attend,” said Jennifer Baird, PHD, MPH, MSW, RN, associate chief nursing officer in professional practice at CHLA.

Feedback and support

In 2023, a survey of Children’s Hospital of Orange County’s (CHOC) preceptors revealed a strong desire to receive feedback from preceptees and an increase in leadership check-ins regarding their precepting performance. In response, the hospital implemented several solutions:

1. Preceptor evaluations. Preceptees complete a survey about their preceptor’s knowledge level, adaptability of their teaching styles, and ability to meet the learner’s educational needs.
2. Shadowing. Managers or educators observe the precepting process for full three-to-four-hour blocks, which allows them to provide feedback and mentorship.
3. Progress meeting check-ins. Check-in meetings are scheduled to get to know new graduates and fellows but also include 15 minutes designated to check-in with that preceptor, figure out their engagement, their willingness to precept and overall satisfaction, and needs with precepting.

Similar to CHOC’s preceptor evaluations, Akron Children’s Hospital uses a 360-evaluation process to gather precepting feedback from all perspectives. Laura Boggs, MSN, RN, CPN, nursing professional development coordinator, said all orientees give their feedback at the end of each orientation. Professional development staff then receive quarterly reports based on those surveys. At the end of the year, educators give their feedback, preceptors complete a self-evaluation, and the results are shared with management.

Phoenix Children’s Hospital has residency instructors who provide in-person support for their preceptors through bi-weekly check-ins, round on the units to connect with RN residents and preceptors, and assist preceptors with competency sign off and facilitation of skills for orientees.

“We like to say that we have an open-door policy with preceptors for questions, concerns, or advice,” said Shaelyn Brumfield, MSN-Ed, RN, CPN, clinical education specialist and residency instructor at Phoenix Children’s. “All of us have precepted at some point in our careers. Most of us within the organization as well, so we can speak to the resources and things available in that way.”

Recognition

While the presenting organizations had overlap in areas of education, advancement, and feedback, the strongest agreement came on the importance of recognition in preceptor development, satisfaction, and retention.

“Benefits, rewards, support systems — they're pivotal to the commitment of the preceptor,” Talir said. “And we know that when preceptor support and recognition fall short, it further compounds preceptor burnout. Sometimes, it leads to them stepping down as preceptors or leaving the organization altogether.”

Boggs shared that at Akron Children’s, preceptors receive a monetary stipend based on experience and unit involvement. New graduate nurses nominate preceptors to be recognized at Nurse Residency Graduation and during Pediatric Nurses’ Week. Those selected receive a gift card, and all other preceptors receive thank you cards.

CHLA also offers preceptors an hourly differential.

“That’s incredibly helpful,” Baird said. “We also have a Most Valued Preceptor ‘MVP’ award who’s chosen by our RN residents, so that's a lovely way to recognize some individuals. Even in the preceptor development program, we make a big deal about them having completed the program. They get a formal certificate and a PIN that designates they've been a member of this program.”

Children’s Hospital of Wisconsin offers merit-based awards, often centered around Nurse’s Week, where peers or leaders can nominate a preceptor.

“They can write something up in a little bit more of a narrative format, and we encourage them to give specific examples, and how they've kind of demonstrated those core roles, responsibilities that we really strive to teach in our education,” said Ally Johnson, MSN, RN, CPN, clinical education specialist at Children’s Wisconsin. “A panel reviews those narratives, and then ultimately there's a Preceptor Excellence Award. During our nursing week, we have an award ceremony, and smaller things like gift cards, special notes, and recognition in leadership meetings.”

Shaw echoed Talir’s sentiment about the importance of recognition in preventing burnout, including quarterly Star Preceptor awards and an annual Preceptor of the Year Award, and, like CHLA’s pins, leaned into the visible symbols of recognition with online badges that can be added to email signature and profiles acknowledging preceptor roles. Children’s Health also made nominations open for all preceptors to read so they could see the positive things their peers were saying about one another.

“We also work with our employee recognition and marketing team to nominate our preceptor of the year winners for external awards,” Shaw said. “So, for example, we have a Dallas Fort Worth Hospital Council preceptor of the year award, and we also have Dallas Fort Worth Great 100 Nurses awards, and lots of other external awards that we've nominated them for. We have a program manager for nursing recognition that I've partnered with to highlight and recognize preceptors specifically supporting nursing roles, and we love to provide preceptor kudos and recognition callouts at every preceptor education forum meeting.”

For more detail on how each of these organizations is tackling the challenge of training, supporting, and retaining preceptors, view the full webinar series:

• Enhancing the Preceptor Experience: Building and Supporting Our Bedside Leaders
• Empowering Preceptors: Advancing Communication, Mentorship, and Critical Thinking in Nursing
• Develop Next-Level Leaders: Preceptor Program Success