Effects of Preceptor Clinical Reasoning Training on Preparedness

Objective: To improve nurse preceptor ability to onboard and teach graduate nurses on the importance of and how to clinically reason. Framework and Design: Model for Improvement and PDSA (Plan, Do, Study, Action) Setting: An acute care hospital located in East Tennessee with a 408-bed capacity, that employs 80 new nurses each year, and is experiencing a high turnover. Participants: Nurse preceptors after attending a preceptor training session on clinical reasoning. Intervention/Measurements: Using PDSA (plan-do-study-act) cycles, the Preceptor Self Assessment Tool (PSAT) was selected, and clinical reasoning education was developed for preceptor education classes. All preceptors attended before training new nurses. The use of the Preceptor Self Assessment Tool (PSAT) was provided before and after the educational training using a Likert scale. The aim of this project was to increase preceptor preparedness to teach clinical reasoning by 80%. Results: The results of the presurvey result of the PSAT were mean of 4.29 and a standard deviation of 0.64, while the results of the post-survey of the PSAT were a mean of 4.31 and a standard deviation of 0.66. The p-value was 0.86, which was not statistically significant. Conclusion: With formally trained preceptors, clinical reasoning can be taught confidently and implemented early in the new nurse orientation leading to new nurses gaining the skill to clinically reason. While the results gathered from the preceptors were not statistically significant. The results were clinically significant for preceptor preparedness to train new graduate nurses on clinical reasoning due to the hospital adopting preceptor clinical reasoning training to policy for intensive care unit (ICU) nurses, floor nurses, and surgery nurses.