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Relationship-Based Precepting: Defined & Why It Matters in Healthcare

By Traci Hanlon MN, RN, Consultant at Creative Health Care Management

I recently conducted a preceptor focus group of 35 preceptors at a hospital in the Southern region of the United States. Preceptors in this focus group, who came from multiple specialty areas, reported not feeling adequately prepared to teach or facilitate critical thinking or clinical judgment.

Of the 35 preceptors polled:

  • 40% stated they had never taken a preceptor course, but had learned how to precept by watching other staff and or being mentored by a preceptor on the job. 
  • Almost 70% stated they did not feel their work was recognized adequately or that their organization rewarded them for the work they did on a consistent basis.

Participants indicated that this perceived lack of preparation and reward contributed to their feelings of burnout and lack of desire to continue engaging in the preceptor role.

What is Needed for a Successful Preceptor Program?

Careful preceptor selection, preparation, reward and recognition, and a solid infrastructure that supports these elements are necessary components for the development and implementation of a comprehensive, structured preceptor program. Another often overlooked component necessary for a successful preceptor program and transition to practice is the use of a framework or model to guide the day-to-day practice of precepting. Below is an example of a precepting model: 

The Relationship-Based Precepting Model (RBP) integrates four core elements that must be addressed in the day-to-day application of precepting. These elements are: supervision, socialization, professional practice, and resiliency.

Supervision

Supervision is defined as the observation of preceptee interactions with patients, families, and clinical support staff; this includes direct observation of hands-on skills, as well as indirect observation (listening) to interpersonal interactions.

Socialization

Socialization is defined as inviting individuals to participate in the formal and informal processes and/or routines that create social networks, friendships, and attachments. Without this sense of belonging, individuals often have difficulty assimilating into new routines and environments without a significant amount of stress. High levels of stress can affect an individual’s ability to process new information, and learning can be delayed or even stunted. Precepting methods or strategies must include a thoughtful and formal process of integrating and socializing new staff into their teams.

Professional Practice

Professional practice is the commitment to owning your practice as a preceptor. Preceptors have an obligation to be competent in

  • assessing critical thinking,
  • teaching using effective adult learning strategies,
  • providing feedback using competent communication skills, and
  • modeling healthy interactions between co-workers.

Formal Leadership Role

In the Relationship-Based Precepting Model, preceptors are included as part of the unit leadership team. Preceptors receive the same leadership development as charge nurses and others who are considered part of the unit-based leadership team. Preceptors are socialized into this role by the unit manager in a way that staff recognize them as part of the leadership team and expect them to function in that role outside of the orientation process.

Resiliency

Resiliency is defined as the ability to navigate stress by engaging healthy attitudes, thoughts, communication strategies, and behaviors that build a healthy and emotionally safe working environment. When an individual’s capacity to handle stress is fully developed, he or she is able to more fully engage in a therapeutic relationship that inspires trust and healing.

The Relationship-Based Precepting Model

The Relationship-Based Precepting Model embraces all practices that build capacity and it inspires an authentic connection with others. However, it is the addition of the therapeutic practices contained in the work of Mary Koloroutis and Michael Trout’s Therapeutic Relationship Workshop and their book, See Me as a Person, that really ensure that resiliency is addressed. In the Relationship-Based Precepting Model, the therapeutic practices outlined in these two works are considered an interpersonal competency for both preceptors and preceptees.

Expected outcomes from implementing the Relationship-Based Precepting Model in conjunction with a comprehensive preceptor program are:

  1. Improved preceptor satisfaction
  2. Improved preceptee satisfaction
  3. Improved readiness to practice of orientee/preceptee
  4. Decreased orientation time
  5. Improved staff engagement
  6. Improved staff satisfaction

With today’s challenging healthcare landscape it is imperative that we continue to develop and retain a talented workforce. Relationship-Based Precepting provides a comprehensive model for preceptors to follow during the transition to practice phase. Providing a theory-based model founded on best practices ensures that preceptors have the tools necessary to provide a quality orientation and that staff ultimately experience a smooth, nurturing onboarding experience that facilitates improved staff retention and satisfaction.

Learn more about HealthStream's specialized learning courseware for nurses.

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Traci Hanlon MN, RN is a consultant with Creative Healthcare Management and specializes in preceptor, nursing orientation, and transition to practice program development.  

References & Permissions 

Koloroutis, M., and Trout, M. (2012). See me as a person: Creating therapeutic relationship  with patients and their families. Minneapolis: Creative Health Care Management. 

The Relationship-Based Precepting Model is used by permission of Creative Health Care Management, Copyright 2013, all right reserved.

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