Structured preceptorships promote competence, confidence, and job satisfaction in new oncology nurse practitioners.
According to the American Association of Nurse Practitioners, over 36,000 new nurse practitioners (NPs) completed academic programs between 2019 and 2020, and licensed NPs reportedly increased from 325,000 in 2021 to 355,000 in 2022.1 As the number of new graduates continues to rise, so will the need for preceptorship, especially in specialties such as oncology.
Preceptors help novices navigate their new role as health care providers, coaching them on such core competencies as diagnostic reasoning, clinical judgment, and critical thinking skills.2,3 The transition from student to NP can be very difficult, and thus the importance of highly experienced preceptors, particularly in oncology, cannot be overemphasized.3-5
Precepting an Adult Learner in Oncology
To provide care to oncology patients, NPs need highly specialized training and education, which they usually receive during postgraduate fellowships.4,6
The preceptors’ primary goal is to help the novice bridge educational gaps and advance from entry-level competence to high-level proficiency.4,6,7 They share knowledge and clinical skills, facilitate experiential learning scenarios, and encourage the development of social, critical thinking, and clinical judgment skills. Preceptors provide this for the novice NP while simultaneously providing safe, high-quality, and holistic care to patients.4,7
Although preceptors are considered to be experts, they still need guidance themselves. According to Pleshkan et al,2 a structured preceptorship improves the process of training a novice NP. Preceptors share their knowledge with the NPs and teach them effective ways to analyze their clinical decisions and manage their workload.4,7,9
Preceptors must employ the teaching strategies that are best suited to each learner’s style4-9 and assess the preceptees’ depth of knowledge and level of clinical expertise to facilitate a positive experience.7 In addition, an open dialogue between preceptor and novice gives both the opportunity to become acquainted with one another, clarify goals and expectations, and give/receive constructive feedback. Open dialogue has also been shown to be an effective way to build the preceptor-preceptee relationship and create mutual respect and trust as well as a positive learning environment.7
Emotional Support and the Preceptorship Experience
Transitioning from new graduate to proficient NP in any specialty takes time and determination as the process can be intimidating and, at times, anxiety-inducing.5,10 However, having a guide who has been through the same process can make the transition a healthy and pleasant experience.5 Preceptors ensure the competence of novices. From them novices learn to provide safe, cost-effective care to patients with complex diseases.7 What may at first seem like a daunting journey becomes less so thanks to the preceptor’s ongoing reassurance. Preceptors are like personal coaches: they teach learners what to do and offer emotional support throughout.2-4
As I transition from an experienced RN to a novice oncology NP, I see that preceptors have been a critical part of my personal and professional growth. Although most preceptorships are short and not all encounters are positive, many of the connections are genuine. Several of my past preceptors have become lifelong friends and continue to be mentors of mine. Because of their willingness to share their knowledge and clinical expertise, I am confident that when my turn comes, I will be able to pass on what they taught me (plus some tips and tricks of my own) to the next generation.
Novice oncology NPs require a great deal of support as they transition to their new role.8 A structured preceptorship that caters specifically to them promotes a safe environment that is conducive to learning, builds competence, confidence, and job satisfaction and encourages intra- and interdisciplinary collaboration.2,8 To novice oncology NPs starting their journey in clinical practice, I say that to succeed, you must pay attention, ask questions, and maintain a flexible and positive attitude.
1. NP fact sheet. American Association of Nurse Practitioners. Updated April 2022. Accessed July 15, 2022. https://www.aanp.org/about/all-about-nps/np-fact-sheet
2. Pleshkan V, Boykins AD. Cognitive preceptorship: an emerging nurse practitioner role transition to practice model. J Prof Nurs.2022;39:194-205. doi:10.1016/j.profnurs.2022.02.002
3. Pleshkan V, Hussey, L. Nurse practitioners’ experience with role transition: supporting the learning curve through preceptorship. Nurse Educ Pract. 2020;42:102655. doi:10.1016/j.nepr.2019.102655
4. Bazzell AF, Jones T, Dains JE, Champion JD. Assessing the needs of oncology APRN preceptors. J Nurse Pract. 2018;14(4):296-301. doi:10.1016/j.nurpra.2017.12.008
5. Pirschel C. Competencies create expert, accountable nurses delivering quality care. ONS Voice.April 3, 2017. Accessed July 15, 2022. https://voice.ons.org/news-and-views/core-competencies-of-oncology-nurses
6. Alencar M, Butler E, MacIntyre J, Wempe EP. Nurse practitioner fellowship: developing a program to address gaps in practice. Clin J Oncol Nurs. 2018;22(2):142-145. doi:10.1188/18.CJON.142-145
7. Pearson T, Hensley T. Positive precepting: identifying NP student learning levels and needs. J Am Assoc Nurse Pract. 2019;31(2):124-130. doi:10.1097/JXX.0000000000000106
8. Thomassen A. Fellowship programs: reflections of an advanced practice nurse fellow. Clin J Oncol Nurs. 2018;22(4):383-385. doi:10.1188/18.CJON.383-385
9. Kelly DE. Initiation of a new nurse preceptor program in the era of COVID-19. J Contin Educ Nurs. 2022;53(5):221-224. doi:10.3928/00220124-20220407-04
10. Bazzell AF, Dains JE. Supporting nurse practitioner preceptor development. J Nurse Pract. 2017;13(8):e375-e382. doi:10.1016/j.nurpra.2017.04.013