The following article is a part of conference coverage from the 2021 American Association of Nurse Practitioners National Conference (AANP 2021), held virtually from June 15 to June 20, 2021. The team at the Clinical Advisor will be reporting on the latest news and research conducted by leading NPs. Check back for more from AANP 2021.
A quality improvement (QI) initiative identified incentives and barriers to precepting nurse practitioner (NP) students at Cleveland Clinic, according to a poster presented at the 2021 American Association of Nurse Practitioners (AANP) National Conference (AANP 2021).
Approximately 500 NP students rotated through Cleveland Clinic during the 2015-2016 academic year; by the 2018-2019 school year, there were 1500 students. However, less than a third of advanced practice registered nurses (APRNs) at Cleveland Clinic participated in the preceptor program. Shanna Botos, DNP, RN, CPNP-AC/BC and Jennifer Docherty designed the QI project to increase the number of NP preceptors at Cleveland Clinic.
The authors created a modified version of the 2015 AANP preceptor survey, which asked participants to pinpoint incentives and barriers to becoming a preceptor at the Cleveland Clinic that required change. Researchers distributed the survey in January 2020 and collected responses over 1 month. The overall response rate was 30%.
The majority of participants were between 30 and 50 years old and 91% were women. Participants who were preceptors had an average of 10 years of experience, while participants who were not preceptors had an average of 3 years of experience. Most participants had an average of 10 years of experience as a registered nurse (RN) before becoming an NP. Just over half (52%) of participants were inpatient providers and 41% worked in ambulatory care.
Incentives and Barriers for Precepting
Both preceptors and nonpreceptors identified several incentives for becoming a preceptor. In the preceptor group, participants mentioned continuing their education and learning of updated clinical practices through their preceptor teaching. In the nonpreceptor group, participants mentioned participating in preceptor training as an incentive, as well as having the ability to take courses at an affiliated university. Additional incentives included compensation, decreased patient load, and more student to preceptor feedback.
Conversely, participants noted that when done well, precepting takes time — a valued resource NPs do not always have to spare. Participants also raised concerns that they may not be able to meet heavy productivity requirements if they took time to mentor students.
One participant stated “there would be financial consequences if charts were not completed in a timely fashion,” and becoming a preceptor to a student would inhibit their ability to do so.
Space is identified as another barrier. Some participants indicated that they did not have access to enough exam rooms or desks to work with a student. Additionally, some participants stated that students’ poor attitudes were a factor in their decision not to become a preceptor.
The data indicate the need to create a preceptor database using ACEMAPP software, the authors concluded. This database will serve as a registry for preceptors and collect data such as documentation of hours to inform precepting processes in the future.
The authors also recommended the continuation of the APRN Preceptor Council, which will recruit new NP preceptors and represent them throughout the health care system.
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Botos S, Docherty J. Shortage of nurse practitioner preceptors: a quality improvement project addressing the state of crisis at one large healthcare system. Poster presented at: 2021 American Association of Nurse Practitioners National Conference; June 15-20, 2021. Poster 52.