A Team approach to Developing Newbies Susan A

A Team approach to Developing “Newbies” Susan A. Boyer Director, VT Nurses In Partnership www. vnip. org vt-nurses@earthlink. net

Building Relationships, communications, & capability Distinguish positive aspects of how you impact both technical and critical thinking skill development. www. vnip. org susan. boyer@hitchcock. org 2

Let’s establish the setting Any fool can make things bigger, more complex, and more violent. It takes a touch of genius – and a lot of courage – to move in the opposite direction. Albert Einstein www. vnip. org susan. boyer@hitchcock. org 3

Why is this an issue today? Nurses “eat their own” “Nursing literature reports that the inability to handle the intense working environment, advanced medical technology , and high patient acuity results in new grad turnover rates of 35% to 60% within the first year of employment. ” (Beecraft, Kunzman, & Krozek, 2001) VNIP turnover rate – less than 10% for new graduates completing the internship www. vnip. org susan. boyer@hitchcock. org 4

Vermont Nurse Internship Project History & background, Unique features of VNIP Target audience – team approach www. vnip. org susan. boyer@hitchcock. org 5

v. Workplace Culture – environment of nurture & support Preceptor development and support Preceptors Clearly defined expectations Interns Clinical Coaching Plan - Development of Critical Thinking www. vnip. org susan. boyer@hitchcock. org 6

Faced with a setting that is: . . . bigger, more complex, and more violent. It takes a touch of genius – and a lot of courage – to move in the opposite direction. Albert Einstein www. vnip. org susan. boyer@hitchcock. org 7

A Team approach People think better when they understand, like, and trust one another. Critical thinking is essential and requires collaborative thinking www. vnip. org susan. boyer@hitchcock. org 8

Development Defined as learning occurs, a change in behavior/ performance ◦ Growth – expansion, progress, advance, increase ◦ Training – education, advancement, promotion, expansion, enhancement Requires: ◦ Knowledge base, interpersonal, technical and critical thinking skills How is this development supported in your workplace www. vnip. org susan. boyer@hitchcock. org 9

How is it supported ? Your workplace – Your role - www. vnip. org susan. boyer@hitchcock. org 10

Technical skills Teach Experiential learning Safe environment www. vnip. org susan. boyer@hitchcock. org 11

Protector role Who to protect How to protect ◦ Define competence ◦ Determine what competent practice looks like ◦ Establish performance outcomes ◦ Observe practice Develop and validate competence www. vnip. org susan. boyer@hitchcock. org 12

Critical thinking? Think, Pair, Share: What does C. T. look like in your practice? How do we support the development of Critical thinking skills? www. vnip. org susan. boyer@hitchcock. org 13

Promoting C. T. in the Novice Questions ◦ Anticipate questions that might be asked ◦ Explore possible consequences ◦ Focus on outcome – what is the goal? ◦ Focus on the rationale – why? ◦ Explore alternatives – what else? what am I missing Case presentations, telling your ‘stories’, sharing experiences ◦ Turn them into “what if” discussions ◦ Continue with the questions listed above 14 susan. boyer@hitchcock. org © 2001 Vermont Organization of Nurse Leaders (VONL)

Promoting C. T. in the Novice Develop & use habits of inquiry ◦ Take enough time to explore situation ◦ Keep an open mind - Verify information Discuss ◦ What did I miss? How could this be made better? Why are we doing it this way? Thinking out loud ◦ Did you notice… How can I find out. . ◦ I could do x, y or z, …. but for this patient, I think this is best…. Why? 15 susan. boyer@hitchcock. org © 2001 Vermont Organization of Nurse Leaders (VONL)

Collaborative Workplace Understanding differences www. vnip. org susan. boyer@hitchcock. org 16

Differences include Ethnic, Religious, Socioeconomic Roles Educational background Personality, Learning styles Conflict management Generational Gender www. vnip. org susan. boyer@hitchcock. org 17

Activity: How is the role of the preceptor instructor, clinical coach impacted by generational, cultural, personality styles? Are there other influences to add to this list? What response or actions can bridge these issues? www. vnip. org susan. boyer@hitchcock. org 18

Culture the dominant set of behaviors, values, beliefs, and patterns of thinking that we learn as we grow and develop in our social groups. Culture determines how we think about and behave toward ourselves, others and the world. 19 susan. boyer@hitchcock. org © 2001 Vermont Organization of Nurse Leaders (VONL)

Steps toward Cultural Competency Be aware that differences exist Be sensitive to differences and the effect they have Try to understand the individual and the differences involved Consider what accommodations are necessary to make the relationship successful 20 susan. boyer@hitchcock. org © 2001 Vermont Organization of Nurse Leaders (VONL)

Generational Cohorts groups of people develop a different and distinct set of core values for their entire lifetime that are formed by socalled "coming-of-age experiences" between the ages of 17 and 23 21 susan. boyer@hitchcock. org © 2001 Vermont Organization of Nurse Leaders (VONL)

When generations collide If you understand where a person is coming from, it will help you predict their behavior. It will help to know how to communicate with them. Center for Generational Studies 22 susan. boyer@hitchcock. org © 2001 Vermont Organization of Nurse Leaders (VONL)

Collaborative Workplace Working effectively with different personality styles www. vnip. org susan. boyer@hitchcock. org 23

Myers-Briggs Inventory Extraversion vs. Introversion ◦ Direction or how you recharge your energy? Sensing vs. INtuitive ◦ Perception of world or how you collect data? Thinking vs. Feeling ◦ Judgment or how you make decisions? Judging vs. Perceiving ◦ How you deal with the outer world & make lifestyle choices

Collaborative Workplace Key teaching/learning issues or concepts www. vnip. org susan. boyer@hitchcock. org 25

Novice to Expert Novice Advanced Beginner Competent Proficient Expert Which makes the best preceptor?

Learning Styles Inventory of learning styes ◦ Reflective vs. Active ◦ Sequential vs. Global ◦ Sensing vs. Intuitive ◦ Visual vs. verbal VARK ◦ Visual, Auditory, Read/write, Kinesthetic, www. vnip. org susan. boyer@hitchcock. org 27

The Adult Learner is diverse and brings a wealth of experiences to the situation prefers to have some degree of control over their learning is an active process of construction of meaning needs to connect the content to their own meaning structures focuses on what they WANT to learn 28 susan. boyer@hitchcock. org © 2001 Vermont Organization of Nurse Leaders (VONL)

Pearls of teaching/learning 6 – 1 ratio ◦ 6 positives to offset 1 negative – shows the need for positive feedback Want to learn - Need to know ◦ Don’t try to teach if they aren’t interested in learning. You will waste your time and thiers. Pictures - See = remember Revisit 6 – 9 times to remember www. vnip. org susan. boyer@hitchcock. org 29

More pearls. . Interactivity is key – doing! Success builds success Build simple to complex High anxiety reduces retention Learners remember the odd & unusual Amount of learning that occurs is directly proportional to how much fun you are having www. vnip. org susan. boyer@hitchcock. org 30

Collaborative Workplace Communication skills www. vnip. org susan. boyer@hitchcock. org 31

The 3 V’s of communication Verbal – the words we use + Vocal – our tone and intensity “The music we play with our voices” + Visual – Everything the listener can see = the meaning received 32 susan. boyer@hitchcock. org © 2001 Vermont Organization of Nurse Leaders (VONL) 100%

Listening ! It is better to remain quiet and be thought a fool then

Collaborative Workplace Conflict Management www. vnip. org susan. boyer@hitchcock. org 34

Conflict Resolution Behaviors Treat the Other Person With Respect for another person is an attitude conveyed by specific behaviors. Listen Until You Have “Experienced the Other Side” They need to be understood and accepted. When the other person feels heard, you have earned the right to speak your point of view and express your feelings. State Your Views, Needs & Feelings State your point of view briefly. Use “I” statements

Respect For many of us, an act of willpower is needed to fight the gravitational pull into disrespect. A conscious effort must be made to convey respect and instill a sense of worth to all concerned parties.

Collaborative Workplace Interpersonal skills ◦ Combining effective use of all the previously discussed ◦ Plus theory related to skills development www. vnip. org susan. boyer@hitchcock. org 37

Positive Aspects – how we impact students & orientees Fill in your chart Current Practice What might be added www. vnip. org susan. boyer@hitchcock. org 38

Building Relationships, communications, & capability Distinguish positive aspects of how you impact both technical and critical thinking skill development Could you expand this list? www. vnip. org susan. boyer@hitchcock. org 39

VNIP resources support: Preceptor development ◦ Research and theory based ◦ Define & prepare for the role Competency development ◦ Clinical Coaching plans Competence validation ◦ COPA model – for allied healthcare team Staff development process & protocols ◦ Time to teach, time to assess capability ◦ Protector Role, competence assessment www. vnip. org susan. boyer@hitchcock. org 40