Stop 5 of 7 · Weekly
Precepting
An orientation plan from the competency list, sign-offs somebody can actually observe, and a weekly note that is fair on a bad week.
The part of precepting nobody trained you for
Rana has a new graduate for twelve weeks. The teaching is the easy half. The other half is documentation: an orientation plan that lines up with the department's competency list, sign-offs that mean something to a manager who was not there, and a weekly note that stays fair on a week when vague would be easier.
Two rules carry over from stop 1 and one is new. No patient detail, still. Name the source, still. New: the orientee is a person with a job at stake. Initials or the orientee, behaviours rather than adjectives, and anything that could touch their employment goes through the clinical educator rather than through a chat or a group message.
The orientation plan
The attached file is my department's respiratory therapy competency list for new graduates in critical care. Build a twelve week orientation plan for one orientee, called the orientee throughout. For each week give me the competencies in focus, what the orientee should be doing independently by the end of it, and what I as preceptor have to observe in order to sign it. Order the weeks so anything with an airway or emergency competency comes after the basics it depends on, and name the competency each row comes from. Leave staffing and assignments out of it entirely.
Sign-offs somebody can observe
| Vague | Observable |
|---|---|
| Understands ventilator alarms | States the likely cause and the first action for each alarm type, unprompted |
| Good with families | Explains the plan for the shift in plain words and checks that it landed |
| Safe with circuits | Sets up, checks and troubleshoots the circuit, and names when to call for help |
Here are the sign-off lines from our competency form: [paste the lines]. Rewrite each one as an observable behaviour a preceptor can watch and initial: what the orientee does, in what situation, to what standard. Add a level column with observed, assisted and independent, and define each level in one line. Keep the original wording beside each rewrite so I can take both to the educator.
The weekly note
Rana writes five bullets on her phone at the end of the week. Behaviours only, no case detail, no names. That is the whole input.
Here are my notes on the orientee this week: [paste your five bullets]. Turn them into a weekly feedback note with three parts: one specific strength and the behaviour that showed it, one thing to change stated as a behaviour with a next step for next week, and one question for the orientee to answer when we meet. Fair and plain. No adjectives about the person, nothing about attitude or confidence. If any of my bullets is a judgement rather than something I watched happen, tell me which one and ask me what I actually saw.
That last sentence is the one that earns its place. It sends the vague bullet back to Rana while she can still remember the shift, which is the only time the honest version is available.
Here is this week's note: [paste the note]. Give me a fifteen minute structure for the meeting: what I open with, the two questions I ask before I give my view, how I introduce the thing to change, and how we agree the next step. Include the sentence I use if the orientee disagrees with the observation, and the sentence I use if they get upset.