ND Center for Nursing Preceptor Program

Meeting Notes

September 24, 2013

2:00 – 3:00 PM CST

Project Goal: Develop a process to identify nurse preceptors and to provide preceptor education to nurses in ND.

Group Co-Chairs- Barbara Diederick and Jane Roggensack

  1. Introductions: Barbara Matthees, Patricia Moulton, Rebecca Vigen, Kate Steinke, Jane Roggensack, Stacey Pfenning, Chris Harsell, Mary Smith, Beth Hetletved
  1. Brief Overview of Project and activity plan developed at August 23 (see current activity plan on next page): Barbara/Jane

We want to create a preceptor program for nursing and rather than trying to all of nursing all at once we thought we would start with APRNs and then work on RNs. Our goal for this year is to develop a pilot APRN preceptor program. So we would start with creating an online survey tool for APRN programs, collecting and analyzing that data. Get a list of the ND APRNs from the NDBON, then we would survey for APRNs regarding their ability to serve as a preceptor- find out who is available in order to utilize more sites and not saturating sites. We would then develop an RFP for a consultant to help develop the program. We also talked about the NurseTim curriculum.

  • When we talk about APRN and preceptors are we talking about APRNS precepting other APRN students or are we talking about APRNs precepting RNs? We are talking about APRNs precepting APRNs.
  • We have talked about the need to have APRNs that are interested in precepting so that we have them distributed throughout the state and don’t have a maldistribution.
  • We had done some mapping of clinical sites last year, we found that some of the areas didn’t have APRNs- want to spread out the opportunities.
  • One of the issues we are confronted with- many agencies now have a point of contact person that we have to go through. We might have a preceptor that is available, but the agency might say no. Not necessarily in ND- but it could be a trend.
  • Some hospitals do have point of contact person that we need to go through to get basic approval and then a preceptor is identified.
  • We do the same thing.
  • In addition, when we are gathering that data- who the point of contact people are and what are the procedures? We might have multiple people contacting those points of contact and driving them crazy.
  • We have some students in MSP-they have moved to a TCCP to coordinate the effort by having all of the hospitals to enter their clinical sites and education programs entering their clinical requests and are working right now on the undergraduate level- will be adding APRNS next year. In the Fargo/Moorhead area we have a more workable process. It is difficult to have multiple people contacting multiple point of contacts. Our school has moved to have only one person contact the program.
  • We have looked at the TCCP model- they have to request their placement for the next year and the calendar is made. Looking at the number of requests we get from within in ND and the requests that live in ND that are doing online program is huge. Lots of students are becoming more savvy and taking online programs.
  • The NDBON does monitor the students from the out of state programs. It does take some coordination with the programs and the education programs. We have 311 students from out of state programs and 15 out of state programs that we are monitoring.
  • As an out of state program, I appreciate the support from the institutions and the support that NDBON has provided. The ND legislature has enacted a fairly substantial fee and process for out of state programs
  • It is meant to help keep the programs at the same level as the in-state program and it is a quality issue.
  1. Examine list of members and determine what additional members are needed- volunteers to contact-
  • Jackie Roberts- Chris Harsell will ask
  • NDSU- Kate can ask Carla if Dean Gross would be able to participate
  • Center for Rural Health- Chris Harsell will ask Mark Barclay
  1. Discuss what the preceptor program would include. Would it be online? Would it be a list of potential preceptors that want to be matched, a list of program contacts that need preceptors, health care facilities that want students/preceptors? Would they go through a standardized preceptor training first? What kind of training/resources do preceptors need?
  • Our goal is to increase the number of APRNs students and that they understand their role.
  • It is really to increase the number of preceptors and have them more equally distributed- we have people that could be preceptors and haven’t really tapped into them. Make sure that for preceptors across the state that we have a unified standard and curriculum for them. Before we got started on this- we talked a lot about preceptor reimbursement. Do we want to talk about that?
  • That is a difficult discussion- we like to think of it as a professional duty- but if it is not supported by the organization to have a student. It is getting more difficult to have the support. I have seen some programs offer a faculty adjunct status for preceptors- then they can get access to the library and continuing education etc.
  • We have given adjunct status and we have been able to grant library access to our preceptors. We would not have the funds to pay for preceptors, unless we were able to pass it onto the students, which with the NDUS system this would not be possible. Perhaps the training could be CEUs so they could use it towards recertification.
  • We have had a lot ask about continuing education credits.
  • At a policy level, I don’t know if you are familiar with the medical education research and cost. MN has gotten permission from MA to redirect funds to help subsidize facilities that provide clinical education for MD and APRNS. It is an awkward process and use a magical formula that takes into account a number of parameters.
  • What will look at it at the end? What would be a reason for an APRN to take a student on? It might be a whole package, what are some of the funds they could tap into. We might need to go to legislators. What is this going to look like? Could it be the credits that I get? Could it be the educational part? What is the soft sell, besides that is something that we all should do? We keep tapping on the same people over and over again.
  • We have a fair amount of physicians that are precepting our students. It might be helpful for them to do have some training as well. It might be an opportunity to do some education on the role of the APRN.
  • It is getting more interdisciplinary.
  • Would it be an online program?
  • I would see it as online- something that is easy.
  • I would agree that it would be online.
  • Online and free.
  • Would it be a list of potential preceptors that want to be matched, a list of programs contacts that need preceptors, health care facilities that want students/preceptors? It would be a little bit of both. It could be a blend of all of that.
  • I agree on the standardized preceptor training. Looking at the RFPs- finding someone to help us develop curriculum so that we have some assurance that people are getting the same information. There are site specific things, but if we could have things standardized- that would be helpful. I think if we build some of the resources- that would help build the curriculum.
  • It has to be meaningful and useful information.
  • I think one of the issues with keeping practitioners in the rural areas is the sense of isolation. I could see having a preceptorship program to enhance those connections and to provide some reduction in isolation. It could be very beneficial.
  • I had recently done some literature review on preceptor training programs for undergrad practicum. Some of the essential things included the legal aspects, some of that is the recruitment and retention of students. When you have students in NP programs and they don’t find that they like the work- do you have much attrition?
  • We don’t have much attrition when they are clinicals- it would occur more so in the first year when they are taking their foundation classes.
  • Do we have any information on retaining FNPs in rural areas? I think it is a big issue.
  • I know that it is an issue with RNs, maybe not APRNS. Retention is an issue.
  • The HRSA program helps for the three years they are in it. We lose them after the cycle is up.
  1. Develop draft survey for APRN programs to determine their difficulty in placing students, factors and causes.
  • Do you have facilities that provide housing and feed the students? Is that something that is requested or required for a rotation?
  • Do you have language in your student handbook that the students would be expected to travel to a rural clinical placements? Do you require rural rotations?
  • Is there any money from the Center for Rural Health and AHEC for this? Chris will invite Mark Barclay to talk about this
  • Describe barriers in placing students.
  • Explain your process. Do you have a coordinators, does individual faculty set up the placements?
  • Do programs have a requirement that it be an advanced practice nurse or can they use a MD?
  • What are the reasons students opt not to do a rural placement? Is if family, job, transportation or housing?
  • What orientation do you provide for your preceptors?
  • How many preceptors does your students have over the course of the program- do they stick with one or do they have just one? How many hours do they spend with each preceptor?

We will finalize the questions for this survey via email and try and collect this by November. Patricia will send a draft to the workgroup for review and additions.

  1. Develop draft survey for APRNs regarding their ability to serve a preceptor- will this be used to recruit them as well?
  • Have you served as a preceptor?
  • Do you see precepting as valuable thing for them or a value to their profession? Is serving as a preceptor a value to you?
  • Do you feel your organization would support you as a profession?
  • What barriers do you perceive to your precepting? Multiple choice- Organizational, workload, lack of knowledge, not sure how to be a preceptor
  • If you haven’t been a preceptor- why they haven’t?
  • What would attract you to being a preceptor- CEUs etc.
  • If you have served as a preceptor and are not currently? Why?
  • Would you be willing to serve as a preceptor?
  • How often? 1x a year, 2x a year
  • Would you be interested in a preceptor training program?

We could start drafting this and finalize during the November Meeting. Patricia will work on a draft and send to the group.

  1. Review training courses available through NurseTim We have a statewide subscription to this- so all preceptors have this available. We do have some training courses available through NurseTim.

Group members will take a look at this before our next meeting.

  1. What do we need a consultant to do? We had indicated that the consultant would develop standardization for APRN preceptor qualifications and preceptor education curriculum. Is this still the case? What qualifications does the consultant need to have?

Members will think about this before the next meeting.

  1. Anything else?

Next Group Meeting is scheduled for November 26, 2013 from 2:00 – 3:00 PM.

Current Activity Plan

Year/Annual Goal / Activities / Month/
Responsible Person(s) / Activity Completion Status
2013-2014
Goal:
Develop pilot APRN preceptor program. / Create online survey tool for APRN programs regarding difficulty in placing students, factors and causes. Collect and analyze data. / Patricia
Workgroup
September-November / 25% / 50% / 75% / 100%
Obtain a list of current ND APRNs from NDBON. / Patricia and Stacey
November / 25% / 50% / 75% / 100%
Create a survey for APRNs regarding their ability to serve as a preceptor. Collect and analyze data. / Patricia
Workgroup
November-December / 25% / 50% / 75% / 100%
Develop RFP for consultant to develop standardization for APRN preceptor qualifications and preceptor education curriculum.
Disseminate RFP and select consultant. Administer contract. / Workgroup
November
Patricia
December / 25% / 50% / 75% / 100%
Work with consultant to develop program. / Workgroup
Patricia
January-May / 25% / 50% / 75% / 100%
2014-2015
Launch APRN program.
Program Evaluation.
2015-2016 Develop and Pilot RN program. Maintain APRN program.