Preceptor Orientation Department of EMS

1. Preceptor OrientationDepartment of EMS

2. Welcome! • Thank you for becoming a preceptor for the UAMS Department of EMS Paramedic Program • The purpose of this orientation is to familiarize you with: • The preceptor role • Clinical training • How to provide feedback • How to evaluate students • Student right to privacy

3. Remember That You Weren’t Always Successful • Many new paramedics look at successful pre-hospital care providers & think they were always that way • Most professionals have had great mentors • We developed over time & through much trial & error • We received correction along the way

4. You Are Now The Mentor • You are now a preceptor and thus a mentor • Many times, you are the first medical professional that students will see “in action” • Do not underestimate the impact your attitude and actions have upon the paramedic student • The mentoring the student receives is just as important (maybe more so) as the training he/she receives in the classroom

5. Why Do Students Need A Preceptor? • Students need help coping with a totally new environment • They need to develop a professional identification • They need to understand that there are a variety of strategies that are effective • There is not just one way • They need to develop their own “style”

6. Preceptor Responsibilities • Provide a model for the student to emulate • Discuss “problem” calls, patients, or situations • Help the students find their tools to succeed • Supervise & guide clinical and field performance • Provide positive & correctional feedback that will allow the student to “grow”

7. Preceptor Responsibilities 20 U.S.C. § 1232g; 34 CFR Part 99 • Completely & honestly fill out & sign the students evaluation forms • Keep student records confidential • Family Educational Rights and Privacy Act (FERPA) • A Federal law that protects the privacy of student education records

8. Preceptor Characteristics • Knowledgeable in medicine • Possess good communication skills • Establish a “safe” environment that is conducive to learning • Share practical steps in patient care • Provide positive & correctional feedback, when necessary • Listen to the student

9. Remember Your Own Experience • What is a bad preceptor? • What is a good preceptor?

10. Preceptor Roles • Provide guidance and help when needed • Share knowledge • Allow enough “space” • So the student can treat the patient • While preventing the student from doing harm • Make mental notes about • Behavior you want to reinforce • Practices you want to correct • Review with the student in a private setting

11. Roles (continued) • Try to keep an open mind • there is more than one way to reach a certain goal • Allow the student to experiment • Remember that they are still in the learning process • Students should not be expected to perform to the level of an experienced EMT or Paramedic

12. If The Student Has A Different Style • Is it safe? • Does it meet the standard of care? • Would the Medical Director approve of the style? • Does it cause any harm? • Is it offensive in any way?

13. Clinical Practicum I & IIClinical Training • The beginning of the education • The student may be “book smart” • But may lack experience • The primary focus during this phase • To practice newly learned skills • Become more competent with them • Answer questions & “quiz” them • Be available to the student

14. Clinical Practicum III Clinical Training • Will begin gaining a better understanding of their role as a Paramedic • In clinical • Patient care autonomy should be increased over Clinical I & II • Paramedic students should be allowed to start taking the role of “team leader” • Non-complicated patients • Examples: chest pain or single system trauma • Be there to “oversee” the care

15. Clinical Practicum III Clinical Training • Includes Field Internship Phase I in Clinical Practicum III (48 hrs. of observation 3rd rides) • Student should be challenged to • Take a more global view of their role • Pay attention to details • Formulation of a care plan • Delegation of assignments (scene choreography) • Transportation needs • Re-assessment of the patient • Providing definitive care

16. EMS Field Internship Student Performance Expectations • Ratings should reflect a progression of increasing decision autonomy and confidence • The student should: • Manifest skill competence • Psychomotor • Cognitive • Did the student know what to do with a decompensated COPD patient, for example? • Begin to take charge of most ALS calls • Increasingly critical patients • Cardiac arrests • Multi-system trauma • Outcome goal for Field Internship • The form summary should indicate consistent ratings as a “team leader”

17. Start of Each Shift • Students are expected to be on time • Send the student home if the student: • Arrives late • Is not prepared • Is improperly dressed • Review with the student • How much field and clinical time has been completed? • What phase of field internship? • Determine the student’s perceptions of their abilities • Find out any issues or concern that student may have • Try to discuss and focus on possible solutions • Clearly convey your expectations to the student!

18. Equipment & Protocols • Make sure the student understands what is expected • Tour service area & receiving hospitals or departments, if necessary • Review daily routine/responsibilities • Review equipment check & department or ambulance layout

19. Problem Resolution • The lines of communication begin at the level of the student & preceptor • If an issue cannot be resolved, the Department of EMS clinical coordinator should be contacted at 501 686-6860 or tsrinehart@uams.edu • UAMS Paramedic Program Medical Director • Dr. Gregory Hall

20. Providing Feedback • Types of feedback: • Positive or correctional • Positive reinforcement • Qualities of feedback • Tips for less stressful feedback • Post-incident feedback

21. Types of Feedback • Positive / Correctional: • Correctional feedback that is given in a positive manner • Identifies areas of performance that require improvement or an area in which the student must change their behavior Example: Reminding a student of the importance of auscultating lung sounds after placement of an ET tube or reminding them to use end-tidal CO2 monitoring

22. Types of Feedback • Positive reinforcement: • Encourages desired behavior • Helps build self-confidence Example: Say to the student, “your calm & confident behavior really helped to relax the patient while you performed the procedure. You did a very good job.”

23. Qualities of Feedback • Timely manner: • Feedback should be provided as soon as possible after performance • Private: • Constructive criticism is always done in private. • Positive reinforcement can be done in private or • In front of others, depending on the personality of the person receiving the reinforcement

24. Qualities of Feedback • Direct: • Always directed at the person for whom it was intended • Constructive criticism should be conducted in private • In some situations, there may be no time. • Be as direct to the student as possible. • But at the same time, it should be difficult for those not involved to notice • Objective: • Your feedback should be conducted without any bias to race, gender, ethnic origin, sexual preference, or creed

25. Qualities of Feedback • Clarity is important • Is your message clear and specific? • Feedback should provide information the student can apply to improve patient care

26. Correctional Feedback • Can be unpleasant, but must not be avoided • Needs to be timely & specific • Vague feedback • Will not give the student a pathway for performance improvement

27. Providing Correctional Feedback • Ask the student what he/she thinks went well or wrong with the call • Talk about the positive aspects • Provide reinforcement for things that the student did correctly • Identify the weak areas of the call • Provide correctional feedback

28. Correctional Feedback(continued) • End the run or patient review with a summary of the positive aspects and tips for student improvement • Most people are more receptive to constructive criticism if positive feedback was provided first • A good example would be a student with good assessment skills but poor IV technique

29. What Do I Look For As A Preceptor? Look for students with the: • Ability to communicate clearly with patients • Ability to manage the scene efficiently • Ability to complete a thorough patient assessment • Ability to identify a patient’s chief complaint • Ability to formulate and provide appropriate treatment strategies at their level of training • Ability to provide clear direction & leadership for other rescuers on the scene

30. Evaluation of the EMS Studentduring Patient Assessment During the actual patient assessment: • Allow the student to complete their assessment before intervening • To ask questions the student failed to cover • Do not let the student do harm • Make mental notes about what they did right and how they could improve their assessments.

31. Evaluation of the EMS Studentduring Patient Assessment • Be positive, but honest • Remember that the patient is an audience to the process • Note weaknesses in skill competencies • Do not let the student do harm

32. Filling out the Forms Your comments are read and are very important to us! Verify with your signature

33. Preceptor Feedback • Student ratings of preceptors • Preceptor ratings of students compared to other preceptors

34. Bloodborne Pathogen Exposures • Contact the Department of EMS at • 501-686-5772 and ask to speak to one of the faculty members • General rule • Fill out the UAMS Employee/Student/Visitor Injury and Incident Report form in the preceptor manual • You can make a photocopy • On weekdays during normal office hours • The student needs to go to UAMS Student/Employee Health immediately call • Call 501-526-2000 • On nights and weekends • Send the student to UAMS Emergency Department • Call 501-526-2000

35. THANK YOU! • It is dedicated preceptors like yourself that allow us to educate and train quality EMS providers. • Policies and procedures for clinical education can be obtained by referring to the Department of EMS Preceptor Guide located within your department, EMS station or facility educator. You can also access it on-line at https://healthprofessions.uams.edu/programs/emergencymedicalsciences/ • Contact the Department of EMS clinical coordinator: 501-686-6860 or tsrinehart@uams.edu