I would encourage new students be honest and brave in their conversations with the preceptors. Seek advice from your advisor and fellow classmates to help you resolve issues that arise in the course of your learning. Do not be afraid to communicate what you need to succeed.        

Keep your communication and expectations for communication simple. Be aware that, depending on your preceptor, processing of your feelings (and you will need to process your feelings) about your clinical experiences may best be done with someone else. Some preceptors are better equipped and willing to do this than others; you can still learn from someone who does not offer a great deal of emotional support. If that is the case, identify your support person or persons as soon as you can (other midwives, advisors, etc.), or ask your advisor or other faculty member or mentor for suggestions.

Identify your own strengths and weaknesses. When you do your checkin at the beginning of a rotation or shift, discuss these with your preceptor. Ask them about their own strengths and weaknesses as a preceptor and ask them what might be a helpful way for your to work with these qualities.

The multiple preceptor path is a rich, complex, and potentially fulfilling one, but it can be hard to keep track. It is worth the time to make a few notes for yourself and check in with senior students or colleagues who can give you advice about working with particular people and make notes about what particular midwives do or like (e.g., make a note that even though you learned in class that flexing the head during crowning is not evidence-based, Midwife N believes it necessary and will want you to do it in births). This is not necessary for your success as a practitioner and may seem unnecessarily tedious, but it may help you avoid some discomfort during rotations.     

Be open and honest with your feelings. Be willing to swallow your pride/embarrassment and speak up for what you know/don't know and where you feel comfortable and what you need. Start with the understanding that you bring something of value to the table and deserve the respect of one adult to another, regardless of the learner-teacher dynamic. Relationships and communication can only manifest what you invest in them. And don't take things too personally if your preceptor is having an off day - it probably has very little to do with you at all!      

Be clear from the beginning with preceptors about your learning style and what would be most effective for you. For example, if you know that you need to be recognized and praised for things you do well alongside any constructive criticism given, you should say that up front. I would also ask preceptors how they would like to receive feedback from you. It also helps to set up learning goals at the beginning of each shift.  

That everyone responds well to positive feedback - including preceptors. And it will go a long way to improve your relationship. Asking to discuss hypothetical cases for complications you have yet to experience. E.g., looking over strips together and discussing when and how to respond if it were to devolve, how it would change a plan, etc.         

Use goal setting as a way to direct interactions with preceptors, especially when experiencing friction in the relationship. This takes the personal out of the interactions when you can comment on past interactions or future ones based on your goals.                

Be forthcoming and specific about your learning needs not only in the written/email communication but also in person. You don't have to make a big deal of it, but find a way to work in what you want to say politely, neutrally, and kindly at your first meeting. For example: "Snacks are a big part of my day. Going forward, are there places where I should not be seen eating or times when I shouldn't snack ? I'd like to plan so that I can grab a bite, if possible, every so often."                          

I would suggest initiating a discussion early in your relationship with a preceptor about how you best receive feedback, your learning style, and your goals for each shift. This may take some extra time to figure out yourself before a shift, but really helps to guide the learning experience in a direction that is most beneficial for you. I would also advise students to ask for feedback early and often. If you feel you aren't getting enough feedback, speak up! I also think that it is helpful to ask about preceptors experience as a student midwife, as a new midwife, and how they balance midwifery with their personal lives. You will get lots of good advice, and learn a bit about your preceptor as well. This helps to build your relationship with your preceptor. Ask them about how they best learn and their teaching style. Be specific about what you need. (e.g. if you need more guidance with a repair, ask if they can use a pickup to point out where you should place a stitch. If you aren't feeling confident about your speculum exam skills, ask your preceptor if they can watch your technique and give you feedback afterwards. I have found that specific reasonable requests are always accommodated!            

Start early and step out of your comfort zone to communicate difficult things! It's easy to get in the habit of not giving feedback, especially when that has been your habit for most of the program. It really pays back if done in a diplomatic, sensitive way.  

I would recommend open communication from the beginning of the rotation. To set personal learning objectives prior to beginning the course, and have a mid eval/conversation to reassess if the rotation is going as expected. Also to check in with preceptors early and regularly about what part of the learning/teaching process is effective.       

(1) Don't be shy in asking for lots of feedback throughout the day, especially right after a birth or interesting case. I've gotten some of my best feedback by asking myself. Also when you ask, you're ready to hear what comes. (2) Set your own goals & communicate them to your preceptor before every shift. I usually say "Do you want to check in before/after report?" Then I tell my preceptor my numbers & what i'm working on. It helps them find opportunities to help me practice & it gives them an idea of where I'm at. (3) I've created 3 lists (a) goals, (b) accomplishments, and (c) lessons learned. If i get difficult-to-hear feedback, i try to write it into a few simple words on my goal or lessons learned sheet. It lets me release some of the negative energy & it means I will come back to it every shift. The next time i'm faced with a similar situation I can see if I improved.

I would remind them that preceptors are learning how to get better at something just as we're learning how to improve our skills. We all have to be trained when we get in a new environment or career. New partnerships like preceptorships require "training" on both ends. It's important to mention what was communicated well and what could have been delivered differently.  

I would encourage students to address challenges as soon as they come up, Dont allow anyone to break your confidence and Find support from other faculty, staff or the program director to support them when challenges arise. 

1. Advocate for yourself and your learning. State your goals, remind your preceptors of what you are working on both before, during and after a shift. Chime in and ask if you can participate in skills. 2. If you need support, ask for it. You aren't going to have this support post graduation. Now is the time to learn, and ask questions. Don't try to appear confident and be unsafe. If you've only done a skill once (6 months ago), and want supervision doing it now, don't be afraid to ask for help or ask them to intervene if you are doing something wrong/unsafe. 3. Recognize that there are some preceptors who simply can't let go - and you will get tired, and sometimes not feel like you can push back. And that's okay. But don't let it drag on too long because it will hurt your learning.         

Have a written list of goals. Discuss them at the beginning of the shift. Give a copy to preceptor. Be diligent about naming opportunities where those goals were facilitated and not facilitated by the preceptor. Strategize for the day, say how you would like for it to go, what particular experiences you are seeking, and how you think the preceptor can assist you. Have activities to do with preceptor when it is slow, suturing practice, quizzing, practicing counseling, and make it clear that you expect the preceptor to be involved in your day and not disappear to the office to get other things done if it is slow.

-Be open-minded! . Not everyone is going to jive with a preceptor and not all preceptors are going to jive with students...such is life!                 

Early on, figure out your learning style and how to assess and give an elevator-speech encapsulation of what your learning needs and goals are for any given shift. Make it quick and pithy, and create time at the beginning and end of each shift (even if it's busy - maybe go catch that baby that comes during report, but circle back sometime soon for this) for at least a quick conversation with your preceptor about where you are, where you're trying to go next, and what you need from her/him to support that. Give your preceptors a fair chance to meet the needs you express, then (at least if it's someone you'll be working with again), if they're not meeting your needs, speak up (professionally) and clearly identify what you need that you're still not getting.       

I tell students to talk a lot to other students -- to help them remember they are not alone in the challenges they are facing. It is so helpful to hear stories from other students and learn that you are all having trouble finding a cervix or that each of you has forgotten an important detail at some point during your learning process. It is also helpful to learn that your preceptors might not be the best at recognizing & reassuring you that you are in a normal place in your learning and you can get that from fellow students. I also would recommend that if you are having a challenge with a preceptor to communicate about it clearly right away with the preceptor and to immediately alert the clinical supervisor. While you may be able to work it out -- it is important to have early and frequent documentation if you are not able to work it out. If you are having challenges with a preceptor that you think are affecting your learning -- ask to change. Your learning is important and is a good enough reason to request a change.             

Be direct!! Even if you're not feeling confident, it is important to start each shift by clearly stating what you're working on and clarifying what experience you have had/not had so your preceptor can support you by meeting you where you are and help you seek out opportunities that help you to achieve your personal goals. Don't assume that the preceptor knows where you are and what you've done; preceptors work with multiple students and may not remember what your experiences have been so far. If your preceptor's teaching style doesn't work for you, discuss it. Don't just wait for it to improve over time. Use your advisor or other preceptors for advice on how to communicate your needs if you're unsure of how to do it in a respectful, effective, and constructive way.          

Set clear goals in the beginning of each shift, tell your precpetor how you learn best and what you would like to do that day in clinic/on the floor        

Really have like 3-5 "goals of the day" where you really focus on those and you make sure your preceptor gives you every opportunity to work on those goals. Maybe make a tally sheet to have a visual aid for you and your preceptor to keep track of your progress. Talk to them regularly, ask them about their struggles. Try to make the process more human by having an exchange of experiences rather than just having the talk be one sided critique which can often fall into a very negative space.                

Always remember that by precepting you, your preceptors are volunteering extra hours to teach you and to be grateful for this, even if you are put off by their teaching style or management style. Some preceptors that appear critical or "hard" on you, are this way because they know midwifery is steep learning curve and that you will be out on your own soon; many feel a personal responsibility as your teacher to prepare you to be a midwife. Just as its important for students to give positive feedback, find positive feedback to give to your preceptors too, as it gives them encouragement to teach you and helps them feel appreciated. One of the best things you can do for communication is to set goals and expectations at the beginning of the shift...even if you take 3 minutes to map out your day and plan, it is better than not having this discussion.           

State very clearly what your learning needs are at the beginning of each shift (if you know what they are - it's really tough to figure that out). Ask them to let you take a first try at complications - you can verbalize what you're doing the entire time so that they know you aren't just freezing - but they can give you verbal directions rather than just managing whatever comes up. Realize that preceptors are human, and they'll say things that really hurt and frustrate and offend you - take them with a grain of salt and assume best intentions (they're there!) Also, figure out what their strengths are and try to focus on learning from those.                 

Be very clear with preceptors about your goals for each clinical rotation and continue to check in to make sure you are meeting those goals. Be open to preceptors sharing tough feedback with you--don't take offense or be too hard on yourself. Learn from each preceptor, but work on developing your own style!

Humility, respect, open communication              

        

It's okay to not know everything! you will learn more and have a much better time if you come with questions and feel safe exploring hypothetical management situations. Ask for what you need from preceptors, they will be willing to meet you there.        

Be clear about what style of communication you prefer: direct, indirect, in the moment or later. Be realistic about what you will hear and how you will handle hearing it don't be afraid to say, "I don't understand this. Can you tell me or show me in a different way or show me again."    

Be more direct and clear about your level of experience and how you like to communicate. Don't be afraid to express your feelings even though it can be scary. Don't make assumptions, use "I" statements.  

Be humble and willing to take feedback and learn from it. Cont to seek out learning opportunities beyond your patients and ask all your preceptors their opinions on management, it is often different and all worth while to learn from. Be respectful, you might not agree with some management decisions but they are made for a reason and you as the student may understand those decision later **Be open to learning and open to changing your own practices, maybe more than once.

- Ask for specific feedback: am I where I should be? What do you think is the "next step" for me in my learning? (I think that last question has been most valuable for me...especially on shifts where everything has been really smooth...)           


Last modified: Thursday, July 27, 2017, 9:32 AM