Preceptorship in Nursing: Building Trust to Facilitate Learning
Published: 02 October 2018
Published: 02 October 2018
“The role of the preceptor is to provide valuable teaching and learning experiences and to role model safe patient care using evidence-based practice. Preceptors may be working with a nurse in her(his) first job or a nurse with 20 years of experience but is new to the unit.”
(Kaur Dusaj 2014)
There are always novice nurses or nurses new to the environment which need to build their skills and learn the written and unwritten rules of the workplace. The role of the preceptor is to facilitate that learning, to help build the confidence and competence of the novice nurse.
But what enables preceptors to effectively do this?
This article will outline why building a culture of trust and psychological safety will enable preceptors to facilitate learning and will also provide some key traits and characteristics that can streamline this process.
The best preceptor is a trusted ally. A trusted ally will give the learner the support they need to try new things, to fail and try again without fear of shame or judgement.
This trust is closely linked to the concept of psychological safety. Psychological safety describes an individual’s perceptions about the consequences of taking interpersonal risks in their work environment. It consists of “taken-for-granted beliefs about how others will respond when one puts oneself on the line, such as by asking questions, seeking feedback, reporting mistakes or proposing a new idea” (Edmonson 2002).
Working within a space of psychological safety reduces stress and improves the ability to learn and retain information.
However, a lack of psychological safety can create a stress response in the learner, where raised adrenaline and cortisol then affect their ability to learn and retain information. This is damaging to the learning and development process because:
“Short-term stress lasting as little as a few hours can impair brain cell communication in areas associated with learning and memory.”
Building a low-stress environment for learning relies of the development of trust between the preceptor and preceptee. Trust in a preceptor-preceptee relationship is vital for the success of both parties.
“Low trust causes friction and creates hidden agendas, interpersonal conflict, rivalries, win-lose thinking and defensive and protective communication. You can’t have success without trust. Trust is the glue that holds relationships and organisations together.”
Building rapport and trust should therefore be the foundation of the preceptor-preceptee relationship. It facilitates the creation of an environment of psychological safety where learning can more easily take place.
The competencies of emotional intelligence are important building blocks for both the preceptor and preceptee in building a trusting relationship of respectful learning.
Emotional intelligence is a set of skills popularised by Professor Daniel Goleman (1996) and is an important building block for the development of successful relationships. Understanding the emotions that affect us and how to manage those emotions is a vital part of human growth and development.
The domains of emotional intelligence, as defined by Goleman, include: self-awareness, self-regulation, motivation, empathy and social skills (1996).
Self-awareness is understanding what creates your behaviour. You have to develop an awareness of your own beliefs and values and how they affect you and the judgements that you make.
Is your attitude and behaviour conducive to learning for the preceptee?
Self-regulation is the ability to respond appropriately to a stressor. It is the ability to control your emotions and to be able to respond in a way that builds rapport, trust and psychological safety.
Teaching can be challenging. Controlling your emotions and maintaining an optimistic outlook will help facilitate learning.
Motivation is the ability to maintain focus and effort.
Motivation can sometimes be difficult to muster however, it’s important to treat your role as an educator with the respect it deserves. Understand that what you do is valuable.
Great teachers are remembered long after the teacher-student relationship is over. Be that preceptor who is remembered for their outstanding knowledge, great attitude, exceptional skill and exemplary behaviour.
Empathy is the ability to see the world from another’s point of view.
An empathetic leader (teacher) has a servant’s heart. Their focus is on how they can best help the learner. An empathetic teacher is someone that the learner can rely on. They are the trusted go-to person for help and advice.
Your preceptee should be able to rely on you to respond to events in a measured and respectful way.
Social skills include the ability to interact successfully with others and affect people and the workplace in a positive way.
People with great social skills are people that everyone wants to spend time with. They understand communication is more than the spoken word. They are skilled at building trust and rapport by using their emotions and body language.
So, what characteristics will enable preceptors to create an environment that is built on trust, emotional intelligence and psychological safety?
Using the framework of the KASH model I have outlined many of the desired traits of the preceptor. The acronym KASH stands for:
Each competency is not solely specific to a single domain.
Successful preceptors are able to create an environment of trust and psychological safety. Being able to build this culture and infuse enthusiasm and passion for nursing and learning in your preceptee should be one of your priorities.
It is not enough to have great knowledge and skills. You also have to develop the skills of rapport and trust to ensure your efforts as a preceptor are achieved.
Janette Cooper is a registered nurse, currently working as a gastroenterology procedure nurse at Noarlunga Hospital. She has a Bachelor of Nursing, a Graduate Certificate in Health Service Management from Flinders University, and a certificate in Gastroenterology Nursing from The Queensland University of Technology. In 2012 she began a life coaching course with The Coaching Institute in Melbourne. It has allowed her to combine her two passions of nursing and personal development. She divides her time between gastroenterology nursing and promoting personal development and leadership by means of frequently published articles through Ausmed, leadership presentations and workshops and coaching health professionals wanting to develop their leadership potential.