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NRS.

427 Clinical Practicum Nursing Practice Elective

Preceptorship Handbook

WINTER 2012
December 2011

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TABLE OF CONTENTS
Preceptee-Preceptor Document Checklist Contact Information Introduction and General Information for Preceptors and Preceptees Sample: NRS.427 Time Sheet for Work Schedule Roles and Responsibilities of the Practice Partners Accountability Preceptee Learning Profile and Learning Plan Guidelines for Preceptee Performance of Clinical Procedures Using the Decision Tree to Assess the Preceptees Ability to Deliver Aspects of Nursing Care Safety Learning Report Collaborative Assessment of Preceptee Abilities (CASA) Midterm/Final Assessment of Preceptee Abilities Pre-Requisites to Preceptorship Clinical Practice Preceptee Health Policies Preceptee Work Placement Injury Report UNB Humber Bachelor of Nursing Curriculum BN Program Abilities Curriculum Diagram References 3 4 5 8 9 12 13 19 22 23 27 30 37 39 44 45 48 50 51

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Preceptee Preceptor Document Checklist Name of Assignment Week Due Date Due Completed NB: All assignments are due ( ) by 6pm on the date indicated. January 13th, 2012 January 20th, 2012

Preceptee Learning Profile

Week 1

Preceptee Learning Plan

Week 2

Case Study Posting *Case Study Response #1 *Case Study Response #2 *Case Study Response #3 *Case Study Response #4 *Case Study Response #5 Midterm CASA

As Assigned As Assigned As Assigned As Assigned As Assigned As Assigned Week 7

As Assigned As Assigned As Assigned As Assigned As Assigned As Assigned March 2nd, 2011 April 20th, 2012

Final CASA

Week 14

*Number of responses depends on the number of group members

Reading Week: February 20th to 26th, 2012

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CONTACT INFO

Preceptee Name: ________________________________

Phone #: ____________________________________ Email Address: ______________________________

Preceptor Name: ___________________________

Phone #: ____________________________________ Email Address: _____________________________

Faculty Advisor: _____________________________

Phone #: ____________________________________ Email Address: ______________________________

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INTRODUCTION AND GENERAL INFORMATION FOR PRECEPTORS AND PRECEPTEES

NRS.427 Clinical Practicum: Integrated Nursing Practice Elective

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INTRODUCTION NRS.427 Clinical Practicum: Integrated Nursing Practice Elective is a thirteen -week nursing practice experience. The experience is intended to enable senior nursing preceptees (preceptees) to enhance their nursing practice through collaboration with experienced nurses within the health care system prior to graduation. The experience will help preceptees to increase their independence and autonomy in the coordination and provision of nursing care within a variety of health care settings. A concentrated period of clinical practice with an experienced nurse is one way to ease the transition from the preceptee to the independent nursing practice role. Such a clinical experience enhances professional socialization and facilitates retention and development of knowledge and skills (Griswald-Pierce, 1991). Clinical excellence is also better developed in the presence of someone who is familiar with the nursing environment, the clients, the routines and the reality of the clinical setting (Griswald-Pierce). The preceptor, a staff nurse who is one of the key players in the preceptorship experience can ease the transition from the preceptee role into the novice role in professional practice. The role of the preceptor includes components related to orientation, support, teaching, and sharing of clinical expertise (Bain, 1996, as cited in Wright, 2002). The total hours required for the thirteen-week experience will be 468. During their time on the unit, preceptees will be expected to follow their preceptors scheduled work hours/rotation. Preceptees may work a maximum of 75 hours in a fourteen-day period. Preceptees are not to be assigned shifts during Reading Week, February 20 26 2012 inclusive. It is expected that the preceptee will continue in the practice setting and pace their clinical hours so as to complete the course over the full semester in the clinical area. Please note: One shift is equal to 11.25 hours for a 12 hour shift and 7.5 hours for an 8 hour shift. 15 hours of the total 468 may used for educational opportunities external from unit responsibilities (e.g. organization workshops, conferences) these activities must be approved by the preceptees faculty advisor (i.e. if external activities are not approved prior, they may not be accepted towards the preceptee clinical experience)

The preceptee and preceptor will assume joint responsibility for guiding and facilitating learning within the clinical setting. The preceptee will also be responsible for developing personal goals for this experience, in addition to meeting the abilities outlined for the course. The clinical experience involves three key members or partners: the preceptor, the preceptee and the faculty advisor. This manual will familiarize the preceptor with the UNB Humber Collaborative Bachelor of Nursing program, explain the roles and responsibilities of the partners involved in the experience, and discuss the collaborative assessment process.

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GENERAL INFORMATION FOR PRECEPTORS AND PRECEPTEES 1. Faculty advisors can be contacted by email or voicemail from Monday to Friday (08:00 to 18:00) and will contact preceptors to discuss preceptees progress. Contact information for faculty will be provided prior to the beginning of the experience. For emergency issues only after hours (18:01-07:59) and on weekends preceptors and preceptees can contact Jennie Miron , Year 4 Program Coordinator at jennie.miron@humber.ca . Examples of when the faculty advisor must be notified: a. Clinical Practice Incidents: Drug errors, client falls, policy concerns, conflict situations, and WSIB situations. For any actual and potential patient safety issues including medication errors preceptees are required to complete an on-line Patient Safety Learning Report. (See package) b. Ethical Legal Situation: Witness to will or consent, left in charge of a unit, team leading without RN supervision, counting narcotics. 2. If the preceptor is unable to work or is ill, preceptees should be paired with another staff RN in your absence. Please let the preceptee know if you will not be working or of any change in your rotation, i.e. vacation day, workshop, etc. Do not assign responsibility for total client care during the first two (2) to three (3) days of the experience, or the first time the preceptee encounters a new shift. Use this time to orient the preceptee to the clinical practice area and develop a communication process with the preceptee. The preceptee should gradually assume an increasingly complex client assignment. Preceptees will complete learning profile, learning plan and develop an on-going case study related to their clinical experience. The case study will provide the preceptees the opportunity to self-reflect on the experiences they are having on the unit. These activities will ensure safe nursing care for clients, preceptees strengths and opportunities for development need be considered. Preceptors are required to read, provide feedback and sign each document. This nursing practice experience is to take priority over other preceptee obligations (eg: part-time employment schedules, family and social commitments). Preceptee clinical schedules are not to be changed without consulting the preceptor and faculty advisor. All changes to clinical schedules (for example: sick time, change of preceptor work schedules, workshop attendance, etc...) must be reported to the Faculty Advisor. Failure to notify the Faculty Advisor prior to the shift will result in the hours worked not counting in the total practice hours for the courses.

3.

4. 5.

6.

7.

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8.

Preceptees are expected to actively participate in all learning opportunities on the unit, eg: interprofessional rounds. Preceptee documents (learning profile, learning plan, case study) are the responsibility of the preceptee and must be readily available on the unit for each practice day. Preceptees must not exceed a maximum of 75 hours per fourteen-day period. A sequence of four (4) consecutive 11.25 hour shifts (i.e. 4 day shifts/4 night shifts) should not be scheduled. A schedule of four (4) consecutive 11.25 hour shifts (i.e. 2 day shifts/2 night shifts Is allowed). All shifts must be first approved by the faculty advisor. See timesheet that follows. SAMPLE - NRS.427 - TIME SHEET FOR WORK SCHEDULE

9.

10.

PRECEPTEE PRINTED NAME: _____________________________________________________________ PRECEPTOR NAME: CLINICAL/AGENCY: ______________________________________________________________ _______________________________________________________________

UNIT TELEPHONE NUMBER: _________________________________

Legend: N12 = 12 hour nights (11.25 hours), D12 = 12 hour days (11.25 hours), N8 = 8 hour nights (7.5 hours), D8 = 8 hour days (7.5 hours), E8 = 8 hour evening (7.5 hours) Total Hours Required = 468 Week M T W T F S
Week One - Shift Date: Preceptor Initials for hours completed Week Two - Shift Date: Preceptor Initials for hours completed Week Three - Shift Date: Preceptor Initials for hours completed Week Four - Shift Date: Preceptor Initials for hours completed

Preceptor Initials: ________

Preceptor Signature: __________________________

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ROLES AND RESPONSIBILITIES

OF

THE PRACTICE PARTNERS

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The NRS.427 preceptorship experience has three key partners: the preceptor, the senior nursing preceptee, and the faculty advisor. In order for the preceptee to begin assimilation into the work environment and to confront issues of role transition, both the faculty and the preceptor begin to assume a different relationship with the preceptee. During Semester 8, Year 4 the responsibility for the experience is divided among the three partners. Following are the role descriptions for the three main partners within the clinical practice experience. Preceptor The preceptor is a participant and a co-learner. The preceptor brings experience and background knowledge into the learning encounter as a starting point for preceptee learning and development (Chinn, 1989). 1. 2. 3. 4. 5. 6. 7. Reviews preceptees learning profile and facilitates learning through selection of increasingly complex client care situations to achieve the outlined clinical competencies. Provides the preceptee with ongoing daily feedback. Strives to maintain open and authentic communication with preceptee through clarifying and validating observations and perceptions. Reviews with the preceptee daily assignments and confers with the faculty advisor regarding the complexity of nursing care assigned. Engages in co-learning with the preceptee. Guides the preceptee in clinical practice. Serves as a role model, teacher and facilitator. Completes written assessments at midterm and at the end of the experience. Shares assessment with the preceptee and the faculty advisor. The preceptee, preceptor and faculty advisor will jointly determine final assessment of the Semester 8, Year 4 experience. The faculty advisor in consultation with the practice partners will assign credit for the course. Communicates and consults with the faculty advisor regarding the preceptees clinical practice on regular basis and as needed. If concerns arise regarding a preceptees performance please discuss this with the preceptee and contact the faculty advisor as soon as the situation occurs. When a concern arises with regards to a preceptees ability to meet the course learning outcomes. Preceptors and/ or Faculty Advisors will complete a Supplemental Record of Consultation. The Supplemental Record will become a permanent part of the preceptee file and the initiator of the record along with all parties to the triad will meet to discuss the issue as outlined. This record will contribute to the assessment of preceptee learning at Midterm and End of Term/ Participates in overall assessment of the experiences.

8. 9. 10.

11.

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Nursing Preceptee (Preceptee) 1. 2. Participates in preceptee orientation session. Prepares a learning profile, which outlines specific personal goals for the experience. The learning profile is shared with the preceptor and the faculty advisor. Participates in developing ongoing plans to meet these goals using the available resources. Practices in the health care setting with the preceptor and collaborates with other health care professionals as appropriate. Maintains open, honest and respectful communication with preceptor. Seeks guidance and support from preceptor. Takes responsibility for own learning and for developing nursing practice by being well prepared to assume increasing responsibility for patient care. Utilizes faculty advisor as a resource person. Participates in the assessment process using the clinical evaluation tool at midterm and at the end of the experience. Shares assessment with the preceptor and faculty advisor, for feedback. The preceptee, the preceptor, and the faculty advisor will jointly determine final assessment of the Semester 8, Year 4 experiences. The faculty in consultation with the practice partners will assign credit for the course. Participates in overall assessment of the experience.

3. 4. 5. 6. 7. 8.

Preceptorship Faculty Advisor 1. 2. 3. Assumes overall responsibility for the Semester 8, Year 4 experiences. Provides orientation sessions for preceptees. Works with the practice partners within the experience to: a. Discuss preceptee progress with preceptors on a regularly scheduled basis and to assist with problem solving. b. Assist with the assessment process. (Ultimate responsibility for assigning credit/no credit to the course rests with the faculty advisor in consultation with the preceptee and the preceptor.) c. Act as a resource and support person for all partners. Assesses the Semester 8, Year 4 experiences incorporating recommendations for improvement from all partners. When a concern arises with regards to a preceptees ability to meet the course learning outcomes. Preceptors and/ or Faculty Advisors will complete a Supplemental Record of Consultation. The Supplemental Record will become a permanent part of the preceptee file and the initiator of the record along with all parties to the triad will meet to discuss the issue as outlined. This record will contribute to the assessment of preceptee learning at Midterm and End of Term.

4. 5.

Achieving Excellence in Professional Practice: A Guide to Preceptorship and Mentoring 2004) is an excellent resource for all partners in the preceptorship experience. It can be accessed via the following URL.
http://www.cna-aiic.ca/CNA/documents/pdf/publications/Achieving_Excellence_2004_e.pdf

Preceptees are required to download and review this document for use during this experience.

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Managing the Assignment The goal of preceptorship is that by the completion of the thirteen weeks the preceptee is able to manage a reasonable assignment and is ready to begin as a novice practitioner. Managing an assignment involves skills of organization, prioritization and delegation. Delegation is a skill essential to managing the demands of most assignments. Preceptees have had limited opportunity to practice delegation in the clinical setting. Preceptors can assist preceptees to realize the need for delegating, how to and when to delegate. Self confidence is key to success and is built slowly over time as skills are successfully performed and appropriate decisions made (Baltimore, 2004, p.138-139). One of the most difficult parts of the preceptor role is being able to step back and let the preceptee take on an increasingly complex assignment Preceptors are resources and advocates.

ACCOUNTABILITY
The College of Nurses of Ontario has developed a practice guideline entitled Supporting Learners, which outlines the staff nurses role when working with preceptees. This has been included for Preceptor and Preceptee information in this package. The Supporting Learners (2005) document is available at the following URL. http://www.cno.org/Global/docs/prac/44034_SupportLearners.pdf Also provided in this package for Preceptors and Nursing Preceptee use is a copy of the College of Nurses of Ontario Professional Standards - 2002. (2009) The Professional Standards document is available at the following URL. http://www.cno.org/Global/docs/prac/41006_ProfStds.pdf

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PRECEPTEE LEARNING PROFILE AND LEARNING PLAN

An electronic version of the completed Preceptee Learning Profile is available on the course Blackboard site. The completed profile is to be emailed to the Faculty Advisor and shared with the Preceptor by Week 1.

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PRECEPTEE LEARNING PROFILE

1.

Description of Previous Clinical Experience(s) as they relate to the preceptorship placement:

2.

Strengths in Clinical Practice (reflect on previous clinical rotations):

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3.

Challenges in Clinical Practice (reflect on previous clinical rotations):

4.

Strategies for learning that have proven effective in the past: (include discussion of how you might incorporate these into this experience).

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5. Strategies for learning that have proven ineffective in the past: (How might you avoid these during this experience?)

6. Goal(s) for this Clinical Experience (to be transferred to the Learning Plan after discussion with your preceptor)

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7. Additional Comments/ Suggestions:

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PRECEPTEE LEARNING PLAN

Preceptee Preparedness a. The Student Learning Profile is a profile of preceptees past clinical learning experiences, preceptees strengths and areas for development in clinical practice as well an identification of teaching and learning strategies that best support their learning in clinical practice. The Profile is to be completed electronically and submitted to the Faculty Advisor and shared with the Preceptor by Week 2. (See link on Blackboard site for Preceptees use) Learning Plan Preceptees are required to complete and submit a Learning Plan which addresses the expected abilities outcomes for the course and includes the following: Ability--Learning Outcome Goals for each ability Objectives with a minimum of (Minimum three (3) objectives for each goal) Strategies and resources to support the learning that will occur Review date to assess achievement of the goals Evidence that will determine achievement of the goal. Goal must be S.M.A.R.T. (Specific, Measurable, Achievable, Realistic, Timely) Date of Review Strategies \ Resources to Support Learning and Goal Achievement Assessment of Goal Achievement

b.

Goal related to Ability

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GUIDELINES FOR PRECEPTEE PERFORMANCE OF CLINICAL PROCEDURES

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Guidelines for Preceptee Performance of Clinical Procedures Under the Regulated Health Professions Act, Registered Nurses are allowed to perform three Controlled Acts. Nursing preceptees are permitted to perform these controlled acts under supervision of a Registered Nurse. A preceptor from the clinical agency who is a Registered Nurse, holding a current certificate of competence and who regularly works in the clinical area may provide supervision (RHPA, Scope of Practice, Controlled Acts Model, 2011). The practice of nursing preceptees is guided by the principles of competence and client safety. Preceptees must only provide care where they have the necessary knowledge, skill and judgment to perform safely, effectively and ethically. Nursing preceptees are expected to identify aspects of practice requiring assistance, seeking appropriate assistance/ supervision. Nursing preceptees must be aware of all relevant agency policies regarding preceptee practice. To ensure maximum safety for clients and preceptees, the following guidelines are recommended. 1. Transcription of medical orders requires supervision and co-signature by a Registered Nurse. 2. A preceptee may assume a leadership role when directly supervised by a registered nurse. 3. The preceptee must follow hospital policy for the administration of all medications in addition the following medications require direct supervision by a Registered Nurse and co-signature by a Registered Nurse, if, co-signature is required by hospital policy. a. Anticoagulants b. Insulin c. Narcotics d. Digoxin e. Blood and blood products infusion 4. A Registered Nurse must check calculations for fractional dosages. 5. When guidelines call for signature of two Registered Nurses, the preceptee does NOT count as one of them. 6. Preceptees are NOT permitted to: a. Count narcotics b. Accept responsibility for carrying narcotic keys c. Accept verbal or telephone orders from a physician/surgeon d. Witness consents or other legal documents e. Be in charge of a nursing unit when a Registered Nurse is not present on the unit. f. Transfer a client who is critical, unstable or unconscious unless accompanied by a Registered Nurse.

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Using the Decision Tree to Assess the Preceptees Ability to Deliver Aspects of Nursing Care

The purpose of the decision tree is to assist the preceptee and preceptor to decide if the preceptee can safely provide nursing care when the type of care required has not been taught or may have been taught but not practiced as part of the preceptees undergraduate experience. The following are items to be considered when deciding whether the nursing care planned is appropriate for the preceptee to practice at this time. 1. The nursing care to be provided falls within the Scope of Nursing Practice and one of the three Controlled Acts that Nursing is authorized to perform. 2. The frequency of the skill needed in the clinical setting 3. The potential risk to the client 4. Approval from the nursing administration, unit manager, unit educator and preceptor 5. The required pre-requisite education and certification is completed. 6. The Preceptee will perform the skill with direct supervision by the unit nursing staff.

(adapted from Humber Institute of Technology and Advanced Learning and University of Toronto)

http://www.cno.org/Global/docs/policy/41052_RHPAscope.pdf

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http://www.cno.org/Global/docs/prac/41071_Decisions.pdf

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SAFETY LEARNING REPORT

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Safety Learning Report Purpose The purpose of this on-line form is to facilitate learning related to the identification and management of adverse events and near misses/ close calls; and to minimize risks and potential injury to clients and residents. This does not take the place of any institutional based reporting that must be completed but is an added feature to promote learning student regarding patient safety related to the adverse event and or near miss/close call. Reports will be collected and collated by the Humber BN Patient Safety Working Group and this will be used to inform curriculum and initiate curricular and student practice changes around patient safety. Where appropriate the information will be shared with Humber's partner agencies in an anonymous format. An additional benefit of completing the form will be an enhanced awareness of patient safety issues, a change in cultural perspective on reporting safety issues and compliance to care delivered in a safe manner. This form is to be completed in a timely manner as soon after the event as possible. It is to be completed by the student and anonymously submitted as outline by the program. Students are still required to complete the necessary reporting and documentation process that is required of the institution where their placement is located. The Safety Learning Reports are a process specific to your learning at Humber College. Below is the link to the on-line form. https://www.surveymonkey.com/s/VPHN7WL

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1.

2.

3.

4.

5.

Humber Nursing Programs Safety Learning Report Program Name: Clinical Course: Year in Program: Semester in Program: Date of Event: Date of Report: Obstetrics Rehabilitation How would you categorize this event? S chool health Near Miss \ Close Call Community Adverse Event Other ___________________________ The event involved a(n)? Fall For the following questions (6), identify Medication possible contributing factors and check off all Intravenous fluid that apply. Procedure _________________________________ 6. Communication Infection control Lack of knowledge and understanding of _________________________________ communicating effectively for patient safety S afe patient transport/transfer Non-communication to others the urgency of Allergic reaction a clinical situation Behaviour Management Inappropriate communication approaches _________________________________ (select from list below) Other Clinical crises _________________________________ Emotional situation Conflict situation Identify at what time during the term Miscommunication between the event occurred: Student and patient Beginning Student and health team member Middle Student and faculty\ clinical teacher End Student and preceptor Student and other health team Identify the time of day the event members (physio, pharmacist, etc.) occurred. Other ________________________ Morning (0700 - 1200 hours) Ineffective written documentation\ Afternoon (1200 1900 hours) such as: Evening (1900 2400 hours) _________________________________ Night (2400 0700 hours) _________________________________ Inappropriate application of Identify the clinical area the event communication technologies such as: occurred _________________________________ Long-term care _________________________________ Medicine S urgery Mental health Pediatrics

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7.

Resources Inadequate information gathering Lack of cross checking of information S taff or faculty\clinical teacher not available; staff shortage Lack Of S ecurity Written resources not available Current and credible information unavailable Inadequate policies and procedures Other ________________________________ Medical Device Malfunction Lack of availability Product labeling confusion Other _________________________________ Individual Felt pressure to perform task quickly Overwhelmed with workload Did not feel adequately prepared to manage the care or skill Fatigued Did not work within their own limitations Lack of adequate training provided Other ________________________________ Environment Work area layout problematic Need for rapid care management decisions Environment prone to distractions and interruptions Inadequate lighting Unsafe physical environment: _________________________________ Other _________________________________

12.

Client Confused Altered Perception / Thought Process Unsteady or weak Immobile Other ____ ____

8.

9.

11.

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COLLABORATIVE ASSESSMENT OF PRECEPTEE ABILITIES (CASA)


Self Assessment, Learning Plan, Case Study Discussions

Record of Consultation - CASA Supplemental Documentation Midterm and Final Assessment of Student Ability for NRS.427

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Collaborative Assessment of Student Abilities (CASA) The Collaborative Assessment of Student Abilities (CASA) is a process of assessing student learning and performance in light of the clinical practicums learning outcomes. It is an ongoing process familiar to nurses in their daily work. Assessment of learning reinforces strengths and identifies challenges presented to student nurses as they strive to improve and develop their nursing care and move toward independent practice. Assessment is an active process, involving continuous dialogue between the various Nursing Practice Elective partners. Responsibility for assessment of learning is shared equally between the student, the preceptor and the faculty advisor. Constructive feedback facilitates progress toward achieving the Nursing Practice Elective competencies and ensuring safe nursing practice. Constructive and honest feedback helps to identify strengths and challenges, and fosters ongoing growth. Assessment can help to pinpoint challenges and areas in which the student needs to develop. PROCESS OF COLLABORATIVE ASSESSMENT OF PRECEPTEE ABILITIES (CASA) Self Assessment, Learning Plan, and Case Study Discussions Students complete a Self Assessment which is a self-directed, two-part process that results in a Learning Plan. Through the Self-Assessment process, students identify their learning needs in relation to the two practice standards selected for the CNO Quality Assurance program. In addition students select one or further standards based on their own learning needs. A Practice Reflection assists the student in identifying their areas of strength and areas for improvement. A student obtains input from self and peers when completing their reflection. In addition as a result of student develop a Learning Plan which is a record of their ongoing participation in activities that help maintain their competence as a nurse. The plan outlines how the student relates practice standards to their nursing practice. It articulates learning goals based on their Practice Reflection, and the activities that they will undertake to achieve those goals. http://www.cno.org/Global/docs/qa/44005_qaGuide.pdf) Preceptees will actively participate in on-line case study discussions. Each preceptee will create one comprehensive case study based on a patient cared for in this preceptorship experience. As part of the case study, the preceptee will incorporate: 1) one CNO practice document, 2) one RNAO Best Practice Guideline, and 3) one peer reviewed theory/research nursing article. In addition, the preceptee will identify throughout the case study which abilities are being reflected and how. Finally, the preceptee will pose a critical thinking question related to the case study. Each preceptee in the group will respond to the critical thinking question posed for each case study. The preceptee will incorporate one peer reviewed theory/research article in the response. Moreover, the preceptee is encouraged to engage in further dialogue on-line with other preceptees about each case study. The faculty advisor and the preceptees will determine the composition of the group(s). The faculty advisor and the preceptees will negotiate a schedule for posting and responding to the case studies. Record of Consultation - CASA Supplemental Documentation If a student is experiencing difficulties in meeting the learning outcomes for the practice course the Faculty Advisors and\or Preceptor documentation of such difficulty will be completed on a Record of Consultation. This document will form the basis and a written record of student performance and discussion between the preceptor, faculty advisor and student with regards to student performance. It will include recommendations for improvement and agreement with the involved parties as to how to work towards achieving a satisfactory grade. The data, recommendations and agreement documented in the supplemental form will be included in the Midterm and Final Assessment of Student Learning. Students will have access to read and sign the information included in the record. The Record will become a part of the student file

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Midterm and Final Assessment of Student Ability for NRS.427 The preceptor, nursing student and faculty advisor will complete a midterm and final assessment. The student, preceptor and faculty advisor will discuss these assessments. The student-learning plan will be reviewed to determine attainment of goals and revised as needed to meet the end competencies of the course. During the final assessment for the Semester 8, Year 4 course the students overall performance will be discussed and a final grade will be assigned. The faculty advisor will assign the final grade.

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MIDTERM / FINAL ASSESSMENT OF PRECEPTEE ABILITIES

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NRS.427 Integrated Nursing Practice Elective Midterm/Final Assessment of Student Ability (circle one)
Student: Preceptor: Facility: Faculty: Email Address: Faculty Phone Number: Unit: Unit Phone Number:

Knowledge and Its Application


Preceptor Assessment: Indicted by * asterisk, Students Assessment: indicated by X, Faculty Assessment: check mark PRECEPTEE / PRECEPTOR
S

Final
ND U

1.1

1.2 1.3

Critically examines and integrates evidence informed knowledge from credible sources within nursing and other disciplines when planning and providing population-based care. Integrates the unique dimensions of health and illness in the planning and delivery of care. Engages in collaborative practice integrating legal, ethical and professional standards of nursing care consistent with national practice guidelines, provincial and federal legislation in the context of primary health care.

Comments: (Please use Word word-processing format) Please provide examples from practice. Use additional page if necessary. Contributor comments will be identified by the contributor adding their initials to the end of the observations and assessment recorded.

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Communication
Preceptor Assessment: Indicted by * asterisk, Student Assessment: indicated by X, Faculty Assessment: check mark PRECEPTEE / PRECEPTOR Final
S ND U

2.1 2.2

2.3

2.4

2.5

Independently documents in a concise, accurate and defendable manner consistent with the practice setting. Consistently uses therapeutic communication techniques and counseling frameworks in professional relationships that consider cultural and differing perspectives. Effectively communicates complex ideas in professional interactions with colleagues, administrators, and stakeholders to address challenges and build partnerships in inter/intraprofessional care. Consults with and utilizes contributions made by intersectoral partners to advocate and provide comprehensive client health care while considering cultural and differing perspectives. Applies available health technologies with increasing independence to support communication and delivery of health services in professional practice.

Comments: (Please use Word word-processing format) Please provide examples from practice. Use additional page if necessary. Contributor comments will be identified by the contributor adding their initials to the end of the observations and assessment recorded.

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Critical Thinking /Skills of Analysis


Preceptor Assessment: Indicted by * asterisk, Student Assessment: indicated by X, Faculty Assessment: check mark PRECEPTEE / PRECEPTOR Final
S ND U

3.1 3.2 3.3 3.4

Implements competent nursing decisions with increasing autonomy following a process of holistic inquiry and critical reflection. Synthesizes and uses analytical processes from past experience, nursing and other knowledge to plan and/ or deliver health care. Negotiates and collaborates with peers to bring about creative and innovative change. With increasing independence, critically examines and uses theoretical, evidence informed guidelines and experiential knowledge from multiple sources to plan, and provide population-based care in clients with complex health challenges in complex and unfamiliar environments.

Comments: (Please use Word word-processing format) Please provide examples from practice. Use additional page if necessary. Contributor comments will be identified by the contributor adding their initials to the end of the observations and assessment recorded.

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Professional Identity/Ethics
Preceptor Assessment: Indicted by * asterisk, Student Assessment: indicated by X, Faculty Assessment: check mark PRECEPTEE / PRECEPTOR Final
S ND U

4.1 4.2

4.3

4.4 4.5

Independently applies legal, ethical, and professional standards from a holistic perspective. Uses critical reflection to identify ones learning needs as well as assess and modify nursing practice to ensure the ongoing delivery of comprehensive nursing care. Adapts and uses personal leadership style to work effectively with clients, members of the health care team and intraprofessional / interprofessional / intersectoral teams. Provides culturally competent care honoring diversity among individuals, families, communities and populations. Recognizes the importance of balancing personal wellness and professional commitment.

Comments: (Please use Word word-processing format) Please provide examples from practice. Use additional page if necessary. Contributor comments will be identified by the contributor adding their initials to the end of the observations and assessment recorded.

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Social Justice/Effective Citizenship


Preceptor Assessment: Indicted by * asterisk, Student Assessment: indicated by X, Faculty Assessment: check mark PRECEPTEE / PRECEPTOR Final S 5.1 5.3 5.4 5.5 Collaborates with clients and others to identify health inequities for populations and to plan health options to improve health outcomes. Collaborates with others in determining how new approaches to the delivery of care may improve health care and address the disparities in health outcomes. Demonstrates the ability to form effective intradisciplinary and interdisciplinary relationships based on social justice and egalitarian relationships of power. Acknowledges and practices as a respectful, responsible and committed citizen collaborating with the client and others in the delivery of socially just, culturally competent and safe care in complex practice environments. ND U

Comments: (Please use Word word-processing format) Please provide examples from practice. Use additional page if necessary. Contributor comments will be identified by the contributor adding their initials to the end of the observations and assessment recorded.

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UNB-HUMBER COLLABORATIVE BACHELOR OF NURSING PROGRAM Contributor comments will be identified by the contributor adding their initials to the end of the observations and assessment recorded STUDENT COMMENTS Final Summary Areas for Development

Final Summary

PRECEPTOR COMMENTS Areas for Development

Final Summary

FACULTY COMMENTS Areas for Development

Date Reviewed Date Reviewed Date Reviewed

Student Print Preceptor Print Faculty Print

Signature Signature Signature

Initials

Student Grade:

(Only check at Final Assessment) Total hours of practice: ______________________________________________________

Credit (check)

Non-Credit(check)

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PRE-REQUISITES TO PRECEPTORSHIP CLINICAL PRACTICE

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Due to the expectations of clinical practice, students obtain certification in the following four (4) areas at the beginning of each clinical practicum experience. Failure to produce valid documentation will result in the student being unable to proceed to clinical practice. 1. Basic Cardiac Life Support (BCSL) Level C for Health Care Providers including AED in accordance with the Heart and Stroke Foundation of Canada 2005 CPR Guidelines. (valid for one (1) year from date of issue) 2. Immunization Record updated every year as required. 3. Criminal Reference Check (CRC) This is updated by the student every academic year 4. Mask Fit Testing- (valid for two (2) years) 5. ASIST: Applied Suicide Intervention Skills Training mandatory for all preceptees prior to entering Mental Health Clinical Practicum. Humber School of Health Sciences has partnered with ParaMed. ParaMed is the College's Occupational Health Nurse provider that reviews student confidential medical information and Pre-Requisites to Clinical Practice then gives notification of clearance status to the Academic Coordinator for clinical placement. Students must provide documentation for placements that meets the requirements of partner organizations/ agencies. This includes criminal reference checks, immunization records and other requirements that are specific to the program, or to the agency. Failure to complete the Prerequisites to Clinical Practice by the start of the semester will exclude students from their Clinical Placement. http://www.humberhealth.ca/RQSApp/Login.aspx

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PRECEPTEE HEALTH POLICIES

Revised by Carole Gionet RN(EC), BSc., BScN, NP cert., MN, Manager, Health Centres, Nurse Practitioner, Student Services, August 19, 2010

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Students should strive to maintain a healthy lifestyle to protect their own health and that of their clients. The Health Centre at the College is available to all students to help promote mental and physical well-being through health promotion, health education, counseling, assessment, and treatment. All visits to the Health Centre are strictly confidential. Registered Nurses are available five (5) days a week. 8:30AM to 3:45PM for drop-in visits and they can deal with most of your health care needs. A Nurse Practitioner / physician are available, by appointment for those who are from out-of-town, or for whom it is inconvenient to see their own family doctor. Responsibilities of the Student I. Immunization Record http://healthsciences.humber.ca/field-clinical-placement/paramed II. Serious Medical Conditions or Allergies Students who have severe allergies or a medical condition such as Diabetes or Epilepsy is strongly are strongly advised to inform the College Health Centre so that their medical status can be assessed and any emergency treatment plans discussed. III. Health Maintenance The student is responsible for her/his dental examinations, and visual and hearing acuity. IV. Injury or Accident It is the students responsibility to report immediately any accident or injury occurring on campus to the Health Centre. Injuries or. Injuries or accidents that occur offsite at a clinical placement must be reported to the occupational department of the agency. The student must return a completed injury form to the health centre. Students can obtain the injury forms from their clinical Coordinator. V. Treatment for Puncture Wounds General Recommendations a) Any nursing student receiving a puncture wound from a needle or sharp instrument must report the incident to her/his clinical instructor immediately. b) The next step is to complete the Student Workplace Injury Report Form, which will be provided by the clinical teacher, and or an Incident Report Form, which should be located on the nursing unit, and may be required by the particular agency. Outline the source of contamination, and, if the contact is with a client, indicate the name, age, and client diagnosis and hospital room number on the form. c) First Aid Procedure should include: i) Induce bleeding to cleanse the wound ii) Clean wound with antiseptic iii) Apply dressing iv) Check Tetanus status v) Follow Hepatitis B and HIV Exposure Protocol. Immune Globulin (I.G.) or Hepatitis B Immune Globulin (H-BIG) is a preventative measure and the cost will be covered by OHIP, or by the Hospital. Please report any needle stick injury to your clinical teacher immediately.

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VI.

Treatment for Puncture Wounds Notify the following: i) The clinical teacher / faculty advisor who will fax a copy of the Student Workplace Injury Report Form, and will provide the health centre nurse with a written copy of the form, after treatment has been given. ii) The student is to report to the health center the next time they are on campus to confirm that they are being followed by the occupation nurse/department at the agency where they sustained the injury. The facility where the incident occurred will perform the necessary tests according to their own protocol. In situations where the incident occurred on campus (i.e. flu clinic), the student will be assessed according to the health centres protocol for needlestick injuries. iii) Family Physician - to review treatment received in Hospital and for any further follow-up. Infection Control Students will follow Standard Precautions when handling all blood and body fluids. a) Tuberculosis Protocol i) Contact With a Potential Transmitter A potential transmitter is defined as a person with active respiratory tuberculosis, whose sputum shows acid-fast bacilli on direct smear, and who has been treated with appropriate chemotherapy for less than two (2) weeks. a) b) Students who are Mantoux negative should have a skin test immediately and a repeat test three (3) months from the time of contact. Students who are Mantoux positive should be referred to their family physician or health centre doctor for clinical management.

VII.

b)

Herpes Simplex Protocol Students with oral lesions, like cold sores, must wear gloves when touching patients and cover the lesions with a dressing or by wearing a mask until lesions are healed. They should also wash hands after removing gloves.

VIII.

Policy for Accidents or Injuries While on Clinical Placement Nursing students are covered under Workplace, Safety and Injury Board (WSIB) regulations during clinical placement. An injury while on placement must be reported to the placement employer usually the nurse/manager - and to your clinical instructor immediately. Appropriate first aid or medical attention should be given at the time of the injury. Documentation according to WSIB guidelines must be completed within 24 hours. Completed documentation must be immediately submitted to the Humber College Health Centre, North Campus, Room K137.

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Please follow the procedure as outlined below. Reporting If a student is injured while working in a clinical area of a hospital, she/he should: a) Contact her/his clinical teacher\faculty advisor immediately and report the nature of the injury. b) Notify the unit manager about the incident. c) Complete a Student Work Placement Injury Report. These forms can be obtained from your clinical teacher \ faculty advisor. (see the following form) d) Send report, after treatment is completed, to the Health Services at the North Campus, where it will be kept on file. Any student who is absent from clinical due to their current health status, pregnancy or injury may be required to submit to the program coordinator a letter from their physician stating that the student is fit to return to clinical practice. Treatment The hospitals Occupational Health Services for minor ailments or injuries may treat nursing preceptees who are working days. For more serious concerns, or when working evenings or nights, students may be referred to the Emergency Department or they may elect to see their family doctor instead. It is important to remember that the hospital is not ultimately responsible for treatment, as the student is not an employee of that institution. In most cases, it is advisable to report accidents or injuries to the family doctor, to review with her/him the treatment or advice given at the hospital. IX. Responsibilities of the Health Centre 1. The Health Centre will assist the student to maintain an optimal state of health while at school. 2. All health records are kept in locked files in the Health Centre and information from them will not be released to any individual without your written consent. 3. Registered Nurses are available five (5) days a week for drop-in appointments and can address most of your health care needs. A Nurse Practitioner / doctor are available on campus, by appointment. The Health Centre at the North Campus is open daily from 8:30 a.m. 4:30p.m and is located in A107. For more information about their services call 416-675-6622 ext. 4533 or visit their website at http://precepteeservices.humber.ca/health/.

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PRECEPTEE WORK PLACEMENT INJURY REPORT


Student Information: Name: ___________________________________ Address:____________________________________________________ ______________________ Phone: __________________________________ Social Insurance Number: _____________________ Student Number: ___________________________ Program Start Date: _________ Semester: ________ Date of Birth: Year:_______ Month:______ Day:_______ Gender M( ) F( ) Students Preferred Language: ( ) English ( ) French ( ) Other:_________________ Where did the injury occur? (Please be specific. Include building, address and room.)

Please complete and bring or forward to: Humber Health Centre North Fax: 416-675-6320 Phone: 416-675-6622 x4533

Placement Employer Information: Name: _____________________________________ Address:_________________________________________________ _____________________________ Phone: _____________________________________ Supervisor/Manager Information: Name: _____________________________________ Phone: ____________________________________ Date and Time of Injury: Year:___ Month:______ Day:___ Time:____ AM PM Date and Time Injury Reported: Year:___ Month:______ Day:____ Time:____ AMPM Who was this injury reported to? Name:______________________________________ Phone:_____________________________________ (If injury was not reported immediately explain delay.) __________________________________________ __________________________________________

Description and nature of injury (how the injury occurred, equipment or materials involved, body part affected):

Witness Information: Name: ___________________________________ Address:____________________________________________________ ______________________ Phone: __________________________________

Injury Treatment (Check as Appropriate) ( ) First Aid ( ) Health Care (Injury treated by Medical Practitioner) ( ) Lost Time (Student has lost time beyond day of injury and has sought medical treatment) Dates: From:___________ To:___________ Initial or emergency health care practitioner or facility: Name: _____________________________________ Address:_________________________________________________ _____________________________ Phone: _____________________________________ Report completed by: Name: ______________________________________ Signature:___________________________________ Date: ______________________________________

Pre-existing condition

Current Health Care Practitioner: Name: ___________________________________ Address:____________________________________________________ ______________________ Phone: __________________________________

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UNB-Humber CURRICULUM

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UNB HUMBER BACHELOR OF NURSING CURRICULUM The curriculum is defined as dynamic interactions between and among students, teachers, clients, and health care professionals as well as contents with the intent that learning takes place (Bevis & Watson, 1989). Students are equal partners in the educational process. The focus of learning is clinically grounded. The curriculum is directed toward helping the students to think critically, to problem-solve, and to question. To promote critical thinking, students are encouraged to examine the status quo, to question it in order to understand it and to attempt to create change. Such anticipatory learning uses techniques such as forecasting what if, simulations, scenarios, and models. A primary feature of anticipatory-innovative learning is participation and interaction in a milieu characterized by cooperation, mutuality, discussion, and empathy (Bevis & Watson). In the classroom, students work on developing relationships of trust, respect and equality, which are to be transferred into the client situation. Students are assisted in joint decision-making with the intent to assist clients to work toward goals that will help them to maintain a responsibility towards their own health. Students will see themselves as partners in the health care team, which is consistent with the principles of primary health care. The Bachelor of Nursing curriculum was developed in response to the changing, and unpredictable health care system. Trends in society have necessitated health care reform and consequently have impacted nursing education. The growing number of elderly and chronically ill in our population and the trend toward community-based care directly impact nursing education. Nurses are required to meet the health care needs of clients who have increased acuity of illness. Changing needs, rising costs of health care and economic constraints demand a shift from a focus on an expensive, curative, medical approach to health care to a focus on disease prevention and health promotion. Clients themselves are increasingly involved in health care decisions and matters, which influence their health. An increased emphasis on health promotion, to foster personal responsibility for wellness and to build healthy families and communities, is a component of health care reform. MAJOR CURRICULUM CONCEPTS Primary Health Care Primary health care is both a philosophy and a resource for health. It provides nursing education and practice with strategies to provide comprehensive, integrated, accessible, affordable, scientifically sound health services addressing priority or essential personal, family and community needs through their full participation (Curriculum Document, June, 1997). This understanding is based upon the World Health Organization (WHO) definition, which embraces the principles of social justice and equity and incorporates caring approaches. Essential health care includes preventive, promotive, curative, supportive, and rehabilitative services. Accessibility, affordability, and acceptability are informed by cultural, financial, linguistic, geographic, and many other considerations. Intersectoral collaboration requires partnerships among clients and professionals from many sectors, beyond and including health. Nursing is one appropriate point of access to health services in a primary health care system.

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Social Justice Social justice is a philosophical approach that recognizes that all persons deserve fair treatment, basic necessities, and freedoms or rights simply because they are human. Fair treatment involves equitable distribution of benefits and burdens among members of society. Basic necessities encompass access to health care, minimum standards of income, access to affordable housing, and environmental safety. Freedoms or rights that promote health include peace, shelter, food, education, income, stable ecosystem, justice, and equity. Caring Caring as a universal phenomenon is essential to human development and survival and is a moral imperative of nursing. Caring is a dynamic, informed, intentional process that requires a connection between individuals and/or groups. Caring may occur privately or within broad socio-political contexts. Caring responses can be enhanced, elicited, or inhibited by education and past experiences and by the presence or absence of role models. Curriculum Structure Nursing courses throughout the program cover a broad range of topics including health across the lifespan, health assessment, therapeutic nurse-client relationships, nursing theories, nursing research, community development, family theory, trends and issues in nursing practice, the Canadian health care system and the components of essential health care as identified in the literature on Primary Health Care. As well as the required courses in the biological and social sciences there are other courses from sociology, psychology, philosophy or womens studies.
YEAR 1 NURSING FOCUS Health Promotion Disease Prevention LEARNING ACTIVITIES Primarily community-based and include community assessment, health fairs. Care of the well elderly client in a long-term care setting. Care for a person in an institution as well as within a group context. Mental health, maternity and rehab rotations in the hospital. A four-week intersession experience at the end of second year integrates content and practice experiences of the first two years. Community and population health projects Medical, surgical and/or pediatric clinical experience practica in the hospital Fall term Acute Medical Surgical clinical experience. Final term Clinical Practicum: Nursing Practice Elective experience

Rehabilitative & Supportive aspects of primary health care Caring for Childbearing Family Maternal Child and 0 to 6 years School Placement Fall Semester: Health promotion perspective and an emphasis on community development. Winter semester: Curative and Supportive aspects of care within the acute care hospital environment Integration and development of previous experiences including various health care settings.

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BN PROGRAM ABILITIES

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The UNB-Humber Bachelor of Nursing program believes that Nursing encompasses five (5) interrelated abilities.

Knowledge and Its Application Nursing students integrate and apply knowledge, from nursing and an array of disciplines in the arts and sciences to provide comprehensive nursing care in times of health and illness.

Communication Nursing students communicate orally and in writing using structured coherent arguments to convey accurate and reliable information to diverse audiences in practice. Nursing students engage in authentic purposeful and collaborative communication using the concepts and techniques of the discipline.

Critical Thinking/Skills of Analysis Nursing students engage in critical, reflective, and holistic analysis to evaluate the strength of a wide spectrum of evidence to formulate decisions.

Professional Identity/Ethics Nursing students develop a dynamic and evolving professional identity and capability, incorporating personal and professional attributes and skills for practice in complex and unpredictable contexts

Social Justice/Effective Citizenship Nursing students become responsible global citizens, by engaging the principles of Primary Health Care and the ethics of caring and social justice in diverse contexts

The generalist preparation of the baccalaureate degree at UNB Humber prepares the graduate to work with clients in achieving affordable and accessible care in a variety of settings. The Bachelor of Nursing Degree fosters the development of a transferable skill set, including critical thinking, which ensures a commitment to lifelong learning.

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CURRICULUM DIAGRAM

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References Baltimore, J. (2004). The hospital clinical preceptor: essential preparation for success. The Journal of Continuing Education in Nursing, 35(3), 133-140. Bott, G., Mohide, A. & Lawlor, Y. (2011). A clinical teaching technique for nurse preceptors: The five minute preceptor. Journal of Professional Nursing, 27(1), 35-42. Canadian Nurses Association. (2004). Achieving excellence in professional practice. A guide to preceptorship and mentoring. Ottawa: Author Chinn, P. (1989). Feminist pedagogy in nursing education. In National League for Nursing, Curriculum revolution: Reconceptualizing nursing education, (pp. 9-24). New York: NLN. College of Nurses of Ontario. (2006). Practice standard: Decisions about procedures and authority, Retrieved from http://www.cno.org/Global/docs/prac/41071_Decisions.pdf College of Nurses of Ontario. (2009). Practice guideline: Supporting learners, Retrieved from http://www.cno.org/Global/docs/prac/44034_SupportLearners.pdf College of Nurses of Ontario. (2011). Reference document: Legislation and Regulation RHPA: Scope of Practice, Controlled Acts Model, Retrieved from http://www.cno.org/Global/docs/policy/41052_RHPAscope.pdf Hallin, K. & Danielson, E. (2010). Preceptoring nursing students: Registered nurses perceptions of nursing students preparation and study approaches in clinical education. Nurse Education Today, 30, 296-302. Happell, B. (2009). A model of preceptorship in nursing: Reflecting the Complex functions of the role. Nursing Education Perspectives, 30(6), 372-376. Myrick, F., Yonge, O., Billay, D. & Luhanga, F. (2011). Preceptorship: Shaping the art of nursing through practical wisdom. Journal of Nursing Education, 50(3), 134-139. World Health Organization (1978). Alma-Ata 1978: Primary health care. Geneva, Switzerland: Author: Wright, A. (2002). Precepting in 2002. The Journal of Continuing Education in Nursing, 33(3), 138-141.