Commission on Accreditation for Respiratory Care
Managing Your Clinical Sites
Kathy J. Rye, EdD, RRT, FAARC
CoARC Commissioner
& President-Elect
Conflict of Interest
I have no real or perceived conflict
of interest that relates to this
presentation. Any use of brand
names is not in any way meant to
be an endorsement of a specific
product, but to merely illustrate a
point of emphasis.
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Objectives
Learning objectives for this presentation:
 Review strategies for identifying clinical
sites that enhance student experiences;
 Describe models for preceptorship of
students in the clinical setting;
 Discuss ways to maintain positive
relationships with the program’s clinical
sites;
 Questions & answers.
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Develop Collaborative Partnerships
 Collaborative partnerships between
educational and health service providers are
the cornerstone to successful clinical
experience for RC students.
 Provide opportunities in various clinical
environments.
 Seek Advisory Committee input.
 Develop strong RRT preceptors, supported by
organizational leadership is the essential
element.
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Why are collaborative
partnerships important?
 Skills, resources and expertise from both sectors are
needed to provide an optimal learning experiences
at the appropriate level.
 Competition for clinical slots & growing student
numbers;
 Increasing educational expectations, fiscal burdens,
and workplace pressures;
 Collaborative partnerships ensure the quality and
competence of the RT workforce into the future.
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The Collaborative Advantage…
 There is a strong need for greater links
between the education and health care
sectors
 Planning
 Implementation
 Evaluation
 These partnerships facilitate the
sharing of resources and expertise.
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Working with others is never simple!
Studies examining partnerships in the field of
health suggest that up to half do not survive
the first year and those that do often falter
prior to completion of their goals.
Lasker, Wiess & Miller, 2001
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Develop Best Practice Principles For
Effective Collaborations:
 Right reasons
 High stakes
 Right people
 Strong, balanced relationships
 Trust & Respect
 Good communication
 Formalization
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Right Reasons For Effective Collaborations
 Share the vision for what is
realistic.
 Create a positive learning
environment.
 Keep long-term focus on
the goal of preparing
competent RRTs who are
prepared for the workforce.
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High stakes For Effective Collaborations
• We have compelling reasons for both
organizations to ensure collaboration is
successful.
• Graduate Placement
• Stronger Workforce
• Ensures partner organizations to invest in each
other and in the partnership.
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Right People For Effective Collaborations
• Involve the best and most
appropriate individuals.
• Sufficiently empower them
to have a reasonable
degree of autonomy.
• Identify and include all
stakeholders.
• Discover a champion for
the process.
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Manage Relationships For
Effective Collaborations
• Create broad, integrative connections at many levels.
• Actively bridge organizational differences.
• Eliminate power differentials.
• Understand and allow for cultural differences.
• Develop trust & respect.
• Ensure open communication.
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Formalization For Effective Collaborations
 Develop strong affiliation
agreements.
 Support shared decision-making.
 Designate lines of authority,
accountability, confidentiality,
staffing, and process.
 Ensure work can continue beyond
tenure of individuals.
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2 Basic Models of Clinical Instruction
Paid Clinical Instructors VS Volunteer Preceptors
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Paid Clinical Instructor Model
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• DCE provides CI with learning objectives
for the rotation.
•CI chooses appropriate patients based on
course objectives.
•CI is responsible for care of specific
patient or patients for entire shift.
•No more than 6 students / CI.
•Care of patients must be appropriately
transferred back to staff RT at end of shift.
•Students learn safe practice of
comprehensive RC from the CI.
Paid Clinical Instructor Model
• May be recruited by either of the
collaborative partners.
•Appropriately credentialed to teach in
one or more clinical areas at that site.
• Appropriately oriented to clinical site
prior to taking students (i.e. 3 months).
•Effective in early clinical phases when
intensive supervision is needed.
•1st time exposure to general or critical
care.
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Volunteer Preceptor Model
•DCE is responsible for ensuring that
students get appropriate exposure to
allow completion of learning objectives.
•Assign a clinical liaison (CL) for
each site utilizing multiple
preceptors.
•CL may supervise more than 1 unit
and any # of students/preceptors.
•Appropriate for students in
specialized areas.
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Volunteer Preceptor Model
•Hospital-employed staff therapists of
diverse ethnicities and qualifications.
•Students assigned to selected RT
preceptors in consultation with the DCE
& CL.
•Must receive preceptor training.
•Preceptor is responsible to multiple
patients and 1 student.
•Aimed at increasing student
independence/ enhances selfdirected learning.
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Develop Clinical Instructors /Preceptors
 The expectation that health care
academics should be experts in
teaching, research, and clinical
practice is unrealistic.
 We often need qualified clinicians to
assist us in the bedside teaching of
our students.
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Supporting Preceptors:
A 3-Pronged Approach for Success
 Self-paced, modular, online preceptor course;
 Dedicated web page for preceptors & students;
 Relational database with information on clinical
sites and preceptors.
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Burns & Northcutt, 2009
Ethical & Accountability Issues
•Preceptors provide day-to-day teaching, supervision,
and guidance in the clinical setting.
•Program key personnel retain the ultimate
responsibility for the evaluation and final grading of
students’ clinical performance.
•Preceptors & faculty have an academic, legal & ethical
responsibility to ensure that graduates are competent
in providing the public with safe respiratory therapy.
Luhanga et al, 2010
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Develop Best Practice Principles
For Effective Collaboration.
 The quality of clinical education is clearly affected
by the quality of the relationship between health
services and education providers.
 The imperative for having competent, work-ready
RRTs at the end of your program is clearly in the
best interests of patients and health care service
providers.
 These intersectoral collaborations help to
minimize the theory-practice gap by increasing
collaborative partnership structures.
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In Conclusion
Managing Your Clinical Sites
Can Be Quite Challenging!
 Develop strong &
collaborative Relationships.
 Provide a strong support
system for your Clinical
Instructors/Preceptors.
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References:
 Burns HK & Northcutt T (2009). Supporting preceptors: A three-
pronged approach for success. J of Cont Educ in Nurs,40(11), 509513.
 Luhanga F, Myrick F, & Yonge O (2010). The preceptorship
experience: An examination of ethical and accountability Issues. J
of Prof Nurs, 26(5), 264-271.
 Omer TY, Suliman WA, Thomas L & Joseph J (2013). Perception of
nursing students to two models of preceptorship in clinical
training. Nurs Educ in Prac, 13. 155-160.
 Yonge O, Krahn H, Trojan L, Reid D & Haase M (2002).
Supporting preceptors. J for Nurs in Staff Dev, 18(2). 73-77.
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Questions & Answers
CoARC Executive Office
1248 Harwood Road
Bedford, TX 76021
(817) 283-2835 ext 101
[email protected]
[email protected]
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