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Some Tips for Effective Precepting

Preceptors are encouraged to also check-out our Preceptor Training and Development Page for additional resources for precepting skill development.


Tip 1
: Establish an Effective Learning Environment

  • Create a non-threatening learning environment, where the resident feels safe to explore and take risks
  • Clearly communicate expectations
  • Recognize and adapt to different learning styles—every resident is different in how they learn
  • Accept resident feedback and input


Tip 2
: Precept as a Coach
(adapted from The Hearing Journal 2011;64(5):20-27)

Throughout the rotation process, preceptors often fulfill many roles.  These include being a teacher, role model, mentor and evaluator.  One of the most important roles that a preceptor fulfills is that of a coach.  Through coaching the resident, the preceptor helps the resident to identify gaps between what they know and what they need to know and also helps them to fill-in these gaps in their learning.

Components of Precepting as a Coach

  • Active listening: being engaged and demonstrating true interest in what the resident is telling you, through both verbal and non-verbal language and cues.
  • Asking powerful questions: ask open-ended questions to stimulate deep, critical thinking and problem solving.  Questions can also help guide the resident through a situation or problem to allow them to come to a conclusion or set of actions. 

Powerful questions can include:
-“What would you do if this happened?”
-“What do you feel you need to focus on to be successful?”
-“What steps have you taken or what have you tried so far?”
-“What additional information do you need to be able to make an assessment or decision?”
-“Where will you look to get the information that you need?”
-“How will you know you have achieved your goals or objectives?”

  • Affirming or acknowledging behaviours to reinforce positive actions or performance to allow for growth and development
  • Providing opportunities to demonstrate the clinical skills and to apply the knowledge that the resident is developing.  This includes providing opportunities to meet the goals and objectives of the rotation, as well as the resident’s own objectives and providing opportunities that will challenge the residents to push the boundaries of their thought process and skills to allow for further growth and development.


Tip 3
: Ask Good Questions

Asking questions is an effective teaching method in that it promotes independent and active learning and can stimulate critical thinking and problem solving.

There are two main types of questions:

  • Closed questions: focus on recalling facts and are likely to promote lower order thinking.

Example: “What are three side effects associated with ramipril?”

  • Open questions: likely to promote deeper, more critical thinking and are the most effective at promoting active learning.

Example: “In your patient who is taking ramipril for heart failure, how would you monitor efficacy and toxicity?”

Some Effective Questioning Techniques (adapted from BMJ 2003;326:591-94)

  • Restrict the use of closed questions to clarifying facts and establishing baseline knowledge.  This may be done more frequently at the beginning of the rotation, in order to establish baseline knowledge.
  • Use open questions to probe and clarify most often
  • Allow adequate time for resident response
  • Resist the opportunity to answer the question yourself
  • Follow-up a poor answer with another question
  • Be non-confrontational, show that you are engaged and actively listening
  • Check-out the online precepting modules for other tips on asking good questions.


Tip 4
: Give Good Feedback

Feedback is an important component of the rotation.  When given appropriately, it allows the resident to reflect on their performance and it reinforces what they have done well and helps them to recognize what they can focus on for improvement.  Feedback is given informally, on a daily basis and formally at mid-point and final evaluations.  It has been demonstrated that learners who receive regular feedback, significantly improve their performance, develop better judgement and learn faster than those who do not.  In addition, feedback is rated as one of the most important qualities of a good preceptor.

Some Tips to Giving Effective Feedback (adapted from The Hearing Journal 2011;64(11):18-23)

  • Set the expectation on the first day of the rotation that regular feedback will be given throughout the rotation and explain its purpose
  • Ensure feedback is timely and given as soon as possible after the performance
  • Ensure it is given in private
  • When giving feedback, focus on specific behaviours and performance (not personality) and direct observation or first hand information
  • Use non-judgmental language
  • Be both constructive and positive
  • Allow for open discussion and further learning
  • Acknowledge and reinforce positive performance
  • Check-out the online preceptor modules for other tips on giving feedback


Tip 5
: Avoid Some Common Negative Precepting Behaviours

  • Allowing the resident to feel unloved or demeaned through the creation of a negative learning environment
  • Failure to give regular positive feedback.  Feedback should be balanced and should include both positive and constructive comments.  Failure to recognize when the resident has done a good job or failure to reinforce positive performance can negatively affect the resident’s learning and does not allow the resident to build on these positive actions.
  • Talking all the time; answering your own questions.  This does not give the resident an opportunity to develop and express their own thought process.
  • Asking questions that focus on recalling facts.  This does not allow for deep thinking and problem solving.
  • Failure to give the resident an opportunity to contribute, such as during rounds or patient care discussions with the team.


Tip 6
: Contact the Program Coordinator

The Program Coordinator is available to provide guidance, support and advice to preceptors before, during and after their rotations.  Below are some situations where contacting the Program Coordinator is a good idea:

  • Anytime, if would like guidance or support
  • If unsure about resident’s progress
  • If unsure how to evaluate the resident or address performance
  • Immediately if concerned about resident’s ability to meet rotation objectives or concerned about resident’s health or mental health or concerned about resident’s behaviour/reliability.


References and Good Resources for Additional Reading:

  1. Spencer, J.  ABC of learning and teaching in medicine: Learning and teaching in the clinical environment.  BMJ 2003;326:591-594.
  2. Hauer KE, Kogan JR.  Realising the potential value of feedback.  Medical Education 2012;46:132-142.
  3. Newman CW, Sandridge SA, Lesner SA.  Becoming a better preceptor.  Part 1: The fundamentals.  The Hearing Journal 2011;64(5):20-27.
  4. Newman CW, Sandridge SA, Lesner SA.  Becoming a better preceptor.  Part 2:  The clinic as classroom.  The Hearing Journal 2011;64(7):10-18.
  5. Lesner SA, Sandridge SA, Newman CW.  Becoming a better preceptor. Part 3: The adult learner.  The Hearing Journal 2011;64(9):29-34.
  6. Sandridge SA, Newman CW, Lesner SA.  Becoming a better preceptor.  Part 4: The evaluation process.  The Hearing Journal 2011;64(11):18-23.
  7. Burns C, Beauchesne M, Ryan-Krause P, Sawin K.  Mastering the Preceptor Role: Challenges of Clinical Teaching.  J Pediatr Health Care 2006;20:172-183.
  8. Barker ER, Pittman O.  Becoming a super preceptor: A practical guide to preceptorship in today’s clinical climate.  J of Am Aca of Nurse Pract 2010;22:144-149.

 

 

-Last updated June 8, 2018