by Mary Yglesia, Clinical Education Supervisor, Bastyr University Department of Midwifery
At Bastyr University, the Department of Midwifery is very fortunate to have a great deal of resources available to us, and one of those resources is the Department of Institutional Effectiveness. With the skilled assistance of the staff in this department, we created a Midwifery Preceptor Satisfaction Survey and now have two rounds of survey results — one in 2013 and a second in 2015. The purpose of these surveys is to learn more about the motivations of our preceptors, to gauge their interest in professional development as educators and their likelihood of precepting students in the future. Additionally, we wanted to have a baseline of information from which we could measure the effects of different strategic initiatives of the Department, namely paying stipends to some preceptors and hiring a part time staff person whose role is to support the work of our preceptors and cultivate new clinical sites.
In preparing our survey, I looked at previous research in this area. There is a fair amount of information on this topic and a list of very helpful, informative articles on the topic of community preceptors, their satisfaction and motivations can be found on the AME website. One of the most informative articles was “Satisfaction, Motivation, and Future of Community Preceptors: What Are the Current Trends?” (Latessa, Colvin, Beaty, Steiner & Pathman, 2013)
Below are some of the results of our surveys:
Sample size and confidence intervals: In 2013, a total of 33 out of 77 preceptors responded to the survey for a response rate of 42.9%. The response rate in 2015 was larger — 46 out of 76 (or 65%) — but still not sufficient to accurately represent the entire population.
Demographic statistics of the respondents: In the 2105 survey, 67% of the respondents were over 40 years old, 78% hold a bachelor’s or higher degree, 65% have been practicing for more than seven years (with 24% practicing for more than 21 years!) and 50% have been preceptors for more than seven years.
Overall comparison from 2013 to 2015: An independent t-test was conducted to compare preceptor satisfaction between 2013 and 2015 and there was no statistically significant difference. Because there was no real statistical difference in the two surveys, for the purpose of this article, I will focus on the results of the 2015 survey.
Below are some of the important “take home” messages from our survey:
Midwives are largely motivated by altruism. They teach students because of their connection to the community and their desire to support the profession of midwifery.
When asked what motivates them to serve as preceptors, the top two responses were “giving back to the profession” and “importance of expanding the network of midwife practitioners.” A close third was “enjoyment of teaching.”
What motivates you to serve as a preceptor? (choose all that apply)
Preceptors are not relying as much on students to serve as birth assistants as they have in the past. The symbiotic relationship of the traditional apprenticeship model is changing with the increasing use of paid birth assistants. I believe this is positive development in direct-entry midwifery, and anecdotally, I hear that midwives and students feel the use of birth assistants reinforces the roles of the student as learner and the midwife as educator.
Preceptors do not identify primarily as educators. This is not a surprise to us at AME. Over the years of attending MANA conferences and asking midwives if they are educators, we have frequently gotten the response, “No, I’m just a preceptor.” In the 2015 survey when asked which terms preceptors identify with the most, the descriptors of an educator are not the top choices.
Midwives feel more competent as clinicians than educators. This is understandable but presents us with a challenge. Our clinical educators are trained as midwives and their primary responsibility is rightfully for the safety and well-being of their clients. However, we know that a preceptor can make or break a student’s learning experience. It gives the educational community a lot to think about as we create the resources and opportunities for midwives to receive professional development as educators. In our survey, when preceptors were asked to rate themselves on a scale of 0-100 on their competencies, they strongly felt more competence as midwives.
Preceptors feel that their role is important to students and to the profession, but do not necessarily feel appreciated for their work. When asked to rate their level of agreement with four statements, all but one of the respondents were in “complete agreement” that their roles were important to the students and to the profession. However, when asked about their recognition as a preceptor, there was less agreement.
The most significant challenges to being a preceptor is by far the time commitment to teach. When asked to pick the top three challenges, the most frequent responses were about time.
Preceptors for our program are mostly satisfied in their role and will most likely continue to take students. When our preceptors were asked to rate their satisfaction on a scale of 0-100, the average was 76%. When asked how likely they were to continue as a preceptor for Bastyr, 79% were likely or very likely to continue. To me, I see opportunity for us to better support our preceptors and find ways to increase their satisfaction in their work as midwifery educators, which will increase their likelihood to have students in the future.
Most preceptors want help to be better teachers. 92% of respondents in our survey indicated their interest in professional development as midwifery educators.
When asked what type of training preceptors wanted, the responses were varied, but included the following and the top two were the most requested:
- Online or virtual training modules for ease of scheduling and accessibility
- Best practices in clinical training and most effective ways to teach clinical skills
- Practical ways to teach students with different learning styles
- Workshops on teaching difficult skills and complications (suturing, shoulder dystocia, hemorrhage, resuscitation, etc.)
In conclusion, I found that preceptors are highly skilled clinicians, truly interested in being preceptors and desiring of the support and training to be good educators. Intrinsic reasons are the biggest motivators to be teachers but we can offer them better resources and incentives to support them in their critical roles as the shapers of our next generation of midwives.
Bastyr has implemented several incentive programs for our preceptors, and when we repeat this survey in 2017, we hope to see greater preceptor satisfaction. As a community of educators we must invest in the precious resource of our preceptors. Their work is essential to the competence of our future midwives and critical to the health and credibility of our profession.
Latessa, R., Colvin, G., Beaty, N., Steiner, B.D. & Pathman, D.E. (2013). Satisfaction, motivation, and future of community preceptors. Acad Med, 88(8), 1164-70. doi: 10.1097/ACM.0b013e31829a3689.