Competence Verification & Learning Guide: Facility

Competence Verification & Learning Guide: Facility

Name (preceptor) Date Initiated Unit

Required competencies must be met regardless of preceptor’s experience.

The nurse preceptor being assessed will be signed off by the unit nurse director, education services staff or other designee (referred to as “Coach” in this document.

Self-Assessment: 1 – Identified Limitation (little or no experience); 2 –Capable (familiar but may need assistance); 3 –Independent - can perform these responsibilities effectively; 4 –Proficient - extensive experience*For further information, see instruction sheet at end of this form.

Learning Guide follows competency pages and contains items for each competency that need to be reviewed based on preceptor’s experience. These are not competency items, but are reminders of important teaching points that may otherwise be missed.

Self-assessment / Required Competencies
Main categories followed by associated competencies
and critical elements.
(Coach needs to verify preceptor capability for these items.) / Verification method
& facility specific requirements
D—Demonstrated; T—Test;
M—Module/class;
V—Verbalized / Date all met / Learner initials / Coach initials / References / Learning Guide # /
Section I. The nurse will incorporate relevant assessment & intervention skills in leading others:
Maintains safe environment for preceptee, coworkers, patients & visitors / I 1
Involves the preceptee in assessment of individual learning needs, recognition of opportunities and identification of outcomes using a variety of strategies / I 2
Section II. The nurse will incorporate facilitative communication skills while leading others
Communicates effectively interdepartmentally and with all levels of organization / II 1
Promotes a healthy working environment / II 2
Section III. The nurse will incorporate critical thinking skills in leading others
Promotes use of evidence based practice information by preceptee / III 1
Assists preceptee to integrate critical thinking skills into their practice / III 2
Assists preceptee to explore resources / III 3
Section IV. The nurse will incorporate human caring and relationship skills in their leadership interactions:
Provides feedback and guidance in a constructive manner / IV 1
Promotes team participation in preceptee’s development to increase the experiences of the preceptee. / IV 2
Integrates ethical principles in all aspects of practice / IV 3
Helps with socialization efforts by actively involving preceptee in unit/facility functions / IV 4
Section V. The nurse will incorporate management skills in all interactions to include the following:
Assigns work based on skill level and skill development / V 1
Encourages preceptee development, continuing education and involvement in professional entities / V 2
Maintains flexibility when managing multiple roles and responsibilities / V 3
Maintains required documentation and record-keeping system(s) / V 4
Manages difficult preceptee/preceptor relationship / V 5
Section VI. The nurse will incorporate leadership skills in all interactions to include the following:
Performs as a role model in professional conduct and development / VI 1
Facilitates change in a positive manner / VI 2
Establishes credibility & networking with other professionals throughout the organization. / VI 3
Section VII. The nurse will incorporate teaching skills in delivery of all nursing care to include the following:
Plans teaching opportunities consistent with preceptee’s needs/goals and those of the unit / VII 1
Designs educational activities using a variety of adult learning strategies, evaluates outcomes, revises as necessary / VII 2
Provides and monitors patient education opportunities for preceptees. / VII 3
Section VIII. The nurse will incorporate knowledge integration skills to include the following:
Uses resources to optimize preceptee development for patient care and staff utilization / VIII 1
Monitors nursing practice of self and preceptee and maintains legal boundaries, ethical frameworks and organizational guidelines / VIII 2

Comments/alternative learning plans:

All coaches are to sign & initial below.

Coach Signature / Initials / Coach Signature / Initials

Signatures at completion of preceptorship/orientation:

Preceptor Date

Primary Coach Date

Manager Date

LEARNER GUIDE: Reference content in the right-hand column that need review. /
Section I. The nurse will incorporate relevant assessment & intervention skills in leading others:
I 1 / Maintains safe environment for preceptee, coworkers, patients & visitors / Review safety policies and hazard notification procedures
I 2 / Involves the preceptee in assessment of individual learning needs, recognition of opportunities and identification of outcomes using a variety of strategies
Section II. The nurse will incorporate relevant communication skills while leading others:
II 1 / Communicates effectively interdepartmentally and with all levels of organization / Review resources/listening techniques
II 2 / Promotes a healthy working environment / Teamwork, conflict resolution, civility awareness
Section III. The nurse will incorporate critical thinking skills in leading others:
III 1 / Promotes use of evidence based practice information by preceptee / Familiarize with resources for EBP
III 2 / Assists preceptee to integrate critical thinking skills into their practice / Critical thinking skills include reflective judgment, problem solving, decision making, priority setting, etc.
III 3 / Assists preceptee to explore resources / Online resources, supervisors, charge nurses, specialists, P&P’s, process improvement methodology
Section IV. The nurse will incorporate human caring & relationship skills in their leadership interactions:
IV 1 / Provides feedback and guidance in a constructive manner / Review generational & personality differences and types of learners
IV 2 / Promotes team participation in preceptee’s development to increase the experiences of the preceptee.
IV 3 / Integrates ethical principles in all aspects of practice
IV 4 / Helps with socialization efforts by actively involving preceptee in unit/facility functions
Section V. The learner will incorporate management skills while leading others:
V 1 / Assigns work based on skill level and skill development / Review nurse practice act
V 2 / Encourages preceptee development, continuing education and involvement in professional entities
V 3 / Maintains flexibility when managing multiple roles and responsibilities
V 4 / Maintains required documentation and record-keeping system(s) / Competency forms
V 5 / Manages difficult preceptee/preceptor relationship / Conflict resolution
Section VI. The learner will incorporate leadership skills in all interactions:
VI 1 / Performs as a role model in professional conduct and development / Review organizational guidelines , shared governance
VI 2 / Facilitates change in a positive manner / Review organization’s change process
VI 3 / Establishes credibility & networking with other professionals throughout the organization
Section VII. The learner will incorporate teaching skills in all activities:
VII 1 / Plans teaching opportunities consistent with preceptee’s needs/goals and those of the unit / Preceptor as a model of patient education
VII 2 / Designs educational activities using a variety of adult learning strategies, evaluates outcomes, revises as necessary
VII 3 / Provides and monitors patient education opportunities for preceptees. / Patient education resources available
Section VIII. The learner will incorporate knowledge integration skills in leading others:
VIII 1 / Uses resources to optimize preceptee development for patient care and staff utilization / Learn facility and community resources
VIII 2 / Monitors nursing practice of self and preceptee and maintains legal boundaries, ethical frameworks and organizational guidelines / Review local policies and procedures as well as those of the profession
Other facility specific items to cover:

REQUIREMENTS: All new preceptors will complete these competencies. Some competencies may be reviewed annually. This form follows the Competency Outcomes and Performance Assessment (COPA) model.

NURSE PRECEPTOR INSTRUCTIONS:

Complete self-assessment: Rate your skill in each area to identify the areas where you need additional experience or access to teaching resources. . Discuss your results with your coach to help establish a plan and goals for your learning experience and to aid in choosing assignments. Scoring per instructions at the top of page 1.

COACH INSTRUCTIONS:

A. Review self-assessment with nurse preceptor to establish plan.

B. Required Competencies: These, along with any specialty area competency forms, are required for independent practice on specific units. This column represents the Alaska Statewide required competencies per ACE-HC and should not be altered. The coach will sign each one off when he/she, as coach and colleague, feels confident in allowing the preceptor to precept new staff with minimal oversight.

C. Verification Method & Agency Specific. Document comments/check marks for the competency and any agency specific requirements. The method by which it was verified which may be:

1. Demonstration – coach watches preceptor perform competency in safe and capable manner.

2. Test – The preceptor needs to pass a test provided by the facility to measure competence for this skill. (Minimum passing grade indicated. Initial only after test passed.)

3. Module – This indicates that the preceptor has completed a training tool (computerized or written module, class, video, etc.) provided by the facility to measure competence for this skill.

4. Verbalization - Preceptor explains to the coach the process and/or planning that evidences safe, reliable knowledge base. This may include case scenarios, discussion, and/or description of plan.

NOTE: some competencies may have the verification method specified per facility guidelines (e.g. “test only”)

Record N/A and initials only for items that never apply to this learner’s role or performance.

D. Sign-off: Sign and date when all elements of the competency are met. If unable to sign off an area due to unanticipated issues or if preceptor needs more time, document a plan in the comments section at the end of the form. Discuss alternative ways of meeting the requirement(s) as well as any additional time needed. Feedback on preceptor competencies may be obtained from multiple sources. All coaches assisting in competence verification of a new preceptor must sign and initial in the signature chart at the end of this document.

E. References: Competencies should be met in accordance with listed references. Add the references your facility approves here.

F. Learning Guide: These are memory ticklers. The amount of time spent on each of them depends on the preceptor’s experience.

REFERENCES COLUMN: List foundational documents to support the learning experience and to use as the official measure by which the competencies are assessed. The ACE-HC group recognizes the following as sources for evidence based practice that can be included in the reference list along with local policies, procedures and forms: Perry & Potter, Elsevier/Mosby, Lippincott, Kozier&Erb, ANA, nationally recognized hospital related regulatory organizations (CLIA, CDC, CMS, JC, etc.), and specialty nursing organizations’ scope, standards and core curricula. This column’s content may be changed to be facility specific.

NOTE: ACE-HC competency forms are intended to be used between facilities within Alaska.

Form based on Dr. Carrie Lenburg’s “Competency Outcomes & Performance Assessment” model.

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