How to Create a Successful Nursing Preceptorship Program

• Nurses value the mentorship they receive from their preceptors, as it helps to reduce the stressors of a new work environment.
• Nursing preceptorship programs address the problems within your practice and work toward resolving them.
• Nursing CE Central’s guide to developing a successful nursing preceptorship program can lead to stronger interprofessional collaboration and lower burnout rates.

Have you ever started a job in a new area of expertise and felt extremely overwhelmed? Did you have ample educational materials and tools to enhance your learning and training experience? Did you have a preceptor who helped you along the way, utilizing evidence-based practices, who was patient and helpful without being overbearing? In this article, we will discuss how to create a nursing preceptorship program to help nurses transition smoothly into a new role.  

Diagnosis 

As a leader, you must determine how to improve your program to meet your new hire’s needs. This includes asking questions like: 

• Why are staff leaving?  
• What are the unit turnover rates? 

The development committee of the nursing preceptorship program should establish what the priorities are to fix any problems that currently exist, and then work to develop a process that will change the status quo. 

In an interview with Brian Rogers, a seasoned clinical manager who has been instrumental in the development of many nursing preceptorship programs throughout his career, he states, “it is just as important to understand the underlying motivation as it is to be motivated to change.” 

Barriers To a Successful Program  

Some of the questions to ask in the implementation and development of a nursing preceptorship program should be: 

• Are supervisors or managers on board? 
• Are there skills checklists for clinical skills? 
• Can preceptors from all units meet on a regular basis? 

Are there time restraints that affect skills observation?  If any of the answers were “no,” you must find a way to make them “yes.”

Develop Your Plan  

You can’t have a successful nursing preceptorship program without amazing preceptors. So first, you should identify the preceptors you would like to utilize within your program. A highly credited medical and research institution, Vanderbilt University, outlines several qualities a preceptor should possess in its Nursing Residency Program’s Preceptor Guide for New Graduates.  

The guidebook claims that preceptors should be phenomenal leaders and be able to serve as a socializer, teacher, and evaluator to our new nurses. Simply put, they should be great coaches.  

Once you have identified several preceptors that possess these qualities or can be empowered to learn them, provide them with a job description and educate them on the importance of their new role.  

The plan in development should encompass the following components of a successful preceptorship program: 

• Preceptor selection criteria 
• Preceptor job description 
• Preceptor education program 
• Skills checklists identified for each nursing position 
• Lists of certifications required for each nursing position 
• Lists of degrees required for each nursing position 
• Job descriptions for each nursing position 

Sample Preceptor Education Program 

The following checklist is an example of how to take all these components and create action steps for a successful nursing preceptorship program: 

• Review the role and job description of the preceptor. 
• Determine how to review the new hire job description. 
• Compose the skills checklists – by job description. 
• Achieve inter-rater reliability for skills – role play. 
• Create a learning need assessment – adult learning principles. 
• Develop critical thinking skills – scenarios.
• Model behaviors – affective domain skits.
• Be a wingman – real-life scenarios. 

Your plan of action in developing your program should include both short and long-term goals.  

A short-term goal could be, “The required skills checklist is given to each nursing position within three months.“ An example of a long-term goal could look like, “Skills checklists will be 100% completed for all new hires within their first year of work.“  

Educating with the skills checklists should include practice sessions with one person demonstrating a skill and the preceptors checking off, then following up with comparing the checklists and discussing the results with their orientee. These discussions should always be conducted in a respectful, constructive manner.  

Facilitation  

In order to facilitate this new nursing preceptorship program effectively, it should not just be reading materials and pushing PowerPoint presentations down your students’ throats. Take the time to educate your preceptors on tailoring the orientee learning experience in determining their individual orientee’s learning style. There are multiple different types of learners: 

• Visual (spatial) learner 
• Aural (auditory) learner 
• Verbal (linguistic) learner 
• Physical (kinesthetic) learner 
• Logical (mathematical) learner 
• Social (interpersonal) learner 
• Solitary (intrapersonal) learner 

By properly training your nursing preceptors on the various styles of learning, you can increase the successful outcomes from your nursing preceptor program. 

A study evaluating the overall success of a nursing preceptorship program for newly graduated RNs displayed positive outcomes and an increase in critical thinking skills when effective teaching techniques were utilized.  

Developing Attributes 

There are many attributes that may need to be developed in both the preceptor and new hire to ensure mutual respect and a positive learning environment.

Some of the most important attributes are as follows: 

Development: The preceptor should assist the new hire in developing their professional identity.  

Clinical Mentor: The preceptor should demonstrate to their orientee how to access appropriate clinical resources such as the MD, pharmacist, respiratory therapist, chain of command, etc.  

Acceptance: Everyone involved in the program must be inclusive to all races, gender identities, and sexual orientations in order to create a comfortable and accepting environment of. It is important for both parties to be able to recognize that there may be diversification of backgrounds, opinions, and preferences. This understanding can help everyone involved to develop new ideas while also ensuring a safe and open place to learn.  

Self-Awareness: How do you get your new hire to understand their own strengths and weaknesses? When the learner understands what they are good at and what their struggles may be, the preceptor can maximize their usefulness.  

Generosity: The preceptor must accept that the new hire will make mistakes, and conflicts may arise. Teaching both parties the correct way to handle a mistake, helping to correct the error, and ensuring similar errors to not occur in the future is a crucial aspect of successful collaboration.  

Patience: When a preceptor is annoyed, it can create unhelpful conflicts and may cause the orientee to withhold ideas or opinions – causing them to potentially miss a diagnosis, make an error, or miss a treatment option. 

Flexibility: Be moldable. As a preceptor, know where to draw the line on protocol and open-mindedness. If a new hire produces their own way of doing something that is correct and meets standards, allow them to do so if it helps them learn.  

This list of attributes is by no means all-encompassing; however, it should give the preceptorship development committee guidance in preceptor selection.  

Implementation 

Implementation of a successful nursing preceptorship program will need a phased approach. 

1. Select new preceptors that have:

• Excellent clinical skills  
• Minimum of 2-3 years in their current role 
• Excellent performance reviews 
• Motivation to learn and succeed 
• Wonderful interpersonal attributes 

2. Educate preceptors and provide refresher courses:  

• Consider hosting several sessions per year. 
• Choose a facilitator with good educational experience. 
• Consider a preceptor handbook as a quick reference guide. 

3. Pairing preceptors and new hires: 

• Consider personality profiles. 
• Schedule their shifts together. 

4. Program evaluation: 

• New hires  
• Preceptors
• Nurse managers  

It is especially important to create a robust preceptorship program in our current healthcare system, where burnout and staffing are significant issues. With hurdles such as COVID-19, healthcare has been forced to adapt and nursing preceptorship programs need to be adaptive as well. 

A great nursing preceptorship program may prevent early departures, decrease nursing burnout, increase learning outcomes, and support a culture of interprofessional collaboration. 

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