Background: Advanced Practice Professionals, APPs (Nurse Practitioners and Physician Assistants) often practice in variable, undefined capacities in teaching hospitals. APP roles are parallel to teaching faculty led teams, and function to accommodate clinical overflow and adjust to attending specific workflows. This impacts role satisfaction, professional advancement, and creates retention challenges. APPs’ inability to fit in amongst faculty colleagues is often a result of the lack of training to promote successful preceptor behaviors and align with faculty colleagues. As more practicing APPs are introduced into an university health system, the collaboration, even supervision of students from untrained APP preceptors is increasing, putting students and preceptors at risk for failure, and impacting peer perceptions. This phenomenon, among academic medical centers with centuries-old successful training programs commonly occurrs.
Purpose: To align the behaviors of non faculty (APP) preceptors with faculty colleagues, a preceptor curriculum was developed and implemented. The goal was to provide quick, preceptor training, with accessible resources that would meet the needs of clinical (APP) preceptors in the face of limited time for training. Additional objectives included improving student outcomes, providing respect and collegiality amongst peers, and advancing the professional practice and utilization of the growing APP presence in University Health Systems.
Description: An APP preceptor training curriculum was implemented among a 40 physician, 13 APP hospital medicine group, in a 700 bed teaching hospital, with an affiliated medical training program, and an advanced practice nursing school. 13 APP preceptors were surveyed prior to implementation, in which 83% were uncomfortable giving feedback (scoring 3 or less on a 5-point scale); 70% were unaware of learners’ roles, education levels, and clinical experience on their team; 80% did not set expectations with learners, nor were they aware of successful preceptor behaviors. The preceptor training was a one hour long didactic session, with resources for reference, and tailored to the clinical non-faculty preceptor. To easily refresh skills between long gaps of precepting experiences a Microsoft Teams site was created for preceptor updates and learner resources. Content included Successful Preceptor Behaviors, Establishing Goals, Confidence versus Competence, Successful Feedback, and resources for the preceptor and learner. Utilizing these two modalities, in-person training and virtual platform, together prepared the clinical APP preceptor with resources to have successful clinical sessions in congruence with professional preceptor behaviors amongst faculty colleagues.
Conclusions: Since the training, the professional perception of APPs amongst faculty colleagues has increased, as evidenced by the school of medicine’s recruitment and reimbursement of APP preceptors for medical students. Additionally, APP preceptors are being recognized as teaching faculty with the schools of nursing, medicine, and the center for interprofessional education and collaboration (a multidisciplinary training center). Lastly, the emergence of a pilot for structured, competency based, APP student clinical rotation in acute care, with trained APP preceptors, is underway to improve learner outcomes, and APP transition to practice.