Students Learning at a Distance Aided by Local One-on-One Mentors
From 1997 to 2000, the Research Foundation of the State University of New York (SUNY), Albany, created a computer-based distance-learning program designed to train clinical preceptors who work with student nurse midwives.
Clinical preceptors are key to advanced nursing training. They build a close, one-to-one relationship with each student, and guide students in applying nursing theory and techniques in practical settings.
- Investigators at the School of Nursing, SUNY Stony Brook, conducted two workshops for nurse midwife clinical preceptors in Buffalo, N.Y., in March and July 1998.
- Project faculty also visited more than 20 individual training sites in nine states, where they instructed students in a variety of clinical teaching theories and techniques.
- Project faculty developed a Nurse Midwifery Preceptor Manual, which addresses such issues as theories of learning, feedback and evaluation, and working with the student who has problems.
The Robert Wood Johnson Foundation (RWJF) supported the project with a grant of $102,915 between November 1997 and December 2000.
To ensure adequate numbers of health care practitioners in rural areas, interest has grown in educating students where they live and work using computer-based "distance-learning" programs and local clinical preceptors.
Additionally, medical, nursing, and other professional schools are turning to a range of community training settings as hospital closures, downsizing, and the productivity demands of managed care have forced schools to look beyond their traditional clinical training sites in hospitals and other patient care settings.
To address these needs, the School of Nursing at SUNY Stony Brook has implemented computer-based distance-learning programs in three advanced practice nursing fields: nurse midwifery, family nursing, and neonatal nursing.
The challenge now confronting the school is to build a dependable network of trained local clinical preceptors to ensure a strong clinical base for its regional distance-learning system. RWJF previously has supporting distance-learning programs through its Ladders in Nursing Careers (LINC) national program, which provided support to low income and minority hospital and nursing home employees to become licensed practical or registered nurses.
This grant from RWJF supported the design and implementation of a preceptor training program that includes workshops, seminars, and computer-based learning modules. The overall goal of the project was to complete the development of a statewide distance learning system for advanced practice nursing in New York.
Clinical preceptors are key to advanced nursing training because of their close, one-to-one relationship with their students, who they guide in applying nursing theory and techniques in practical settings.
Under the grant, project faculty designed and planned a series of training workshops for clinical preceptors in metropolitan Buffalo, N.Y. Similar workshops were not held in the Nassau/Suffolk County area of New York, as was originally planned. Instead, project faculty conducted visits to 20 nurse-midwife training sites in nine states throughout the country. (See the Appendix for a list of site visit locations.)
The second objective of the project was to transfer existing master's level training materials for preceptors to a computer-based format. To accomplish this, project faculty subcontracted with the Institute of Urban Family Health in New York, a nonprofit organization that works to develop ways to provide primary health services to under served urban populations.
In addition to the RWJF grant, the project received in-kind support from the School of Nursing, SUNY Stony Brook.
Under the grant, project faculty:
- Conducted two workshops for nurse-midwife clinical preceptors in Buffalo, N.Y. Twenty clinician educators, including 16 nurse practitioners and four nurse-midwives, attended. After initial training sessions, participants videotaped themselves in mock training sessions, and then divided into two discussion groups to assess each participant's teaching style.
- Completed visits to 20 nurse-midwife training sites in nine states. Each visiting faculty member covered clinical teaching methodologies with the particular student working at the site. Areas discussed included positive reinforcement techniques, the case study approach to teaching, and evaluation of clinical performance.
- Held a one-day workshop for Stony Brook nurse-midwife faculty. Approximately six faculty members attended, including one clinical preceptor.
- Established an online preceptor support network and discussion group. The site, which is no longer active, included an interactive on-line discussion group where preceptors could exchange information on topics such as compensation, techniques, and dealing with inappropriate student behavior.
- Developed a preceptor manual, which combines both theoretical and practical information, as well as exercises to be completed by readers. The manual addresses theories of learning, devising objectives with the student, feedback and evaluation, and working with the student who has problems. Preceptors can receive continuing education credits from the American College of Nurse-Midwives by completing the interactive case studies and post-test in the manual.
The project distributed 275 printed copies of the Nurse Midwifery Preceptor Manual to both former and current preceptors. Project personnel held informational meetings for preceptors at the American College of Nurse-Midwives annual meetings in 1998 and 1999.
AFTER THE GRANT
School of Nursing SUNY Stony Brook plans to:
- Increase dissemination of the manual through the American College of Nurse-Midwives document distribution center or as a special edition of the organization's official publication, Journal of Midwifery and Women's Health.
- Collect and record data to identify which preceptors successfully completed the continuing education project.
- Continue to expand its preceptor base.
GRANT DETAILS & CONTACT INFORMATION
Distance Learning Program in Advanced Practice Nursing
The Research Foundation of the State University of New York (Albany, NY)
Dates: November 1997 to December 2000
Lenora J. McClean, Ed.D., R.N.
Hearts & Hands
Boston Medical Center
Fallon Medical Center
St. Luke's Memorial Hospital
Bellevue Women's Center
St. Luke's Memorial Hospital
Bellevue Women's Hospital
Syracuse Community Health Center
Rochester General Hospital
Dautervive Women's and Children's Hospital
New Iberia, La.
Chinle Indian Health Service
Women's Health Center
Upstate Medical Center
OB/GYN Associates, Inc.
Community General Hospital
Betheny Birth Center
Alameda County Medical Center
Ft. Hood, Texas
Overland Park, Kan.
Middletown Family Health Clinic
St. Joseph's Hospital
Hill Medical Center
(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)
Lichtman R, et al. Nurse Midwifery Preceptor Manual. Stony Brook, N.Y.: State University of New York at Stony Brook, 2000. As of December 2000, 275 copies were distributed to previous and future preceptors.
"Preceptor Training Fellowship," March 31, 1998, and July 8, 1998, Buffalo, N.Y. Each attended by 20 clinician educators, including 16 nurse practitioners and four nurse-midwives.
"Training the Trainer," given by James Deary, September 1998, Stony Brook, N.Y. Attended by six faculty members and one clinical preceptor.
Presentations and Testimony
Judith Triestman and Lisa Jensen, "Preceptor Focus Group," at the American College of Nurse-Midwives Annual Meeting, May 23, 1998, San Francisco, Calif.
Ronnie Lichtman, Penni Harmon, and Denise Jurow, "Preceptor Focus Group," at the American College of Nurse-Midwives Annual Meeting, May 29, 1999, Orlando, Fla.
Report prepared by: Diane O'Connell
Reviewed by: Richard Camer
Reviewed by: Marian Bass
Program Officer: Terrance Keenan