The health information technology program at Southern New Hampshire University prepares students at the baccalaureate level for a career in health information management (HIM). The program is accredited by the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM). To meet CAHIIM’s curricular standards, students must complete an externally supervised professional practice experience (PPE).1 Part of the challenge is placing students with preceptors prepared to serve in this role. Even though preceptors have the content expertise to train students, they may not be comfortable with the teaching aspects of precepting.2 The HIM program decided to address these concerns by developing an orientation and training program for the preceptors. The program was developed through a collaborative effort among faculty, the career services internship team, and the nursing professional development team.
Southern New Hampshire University (SNHU) Nursing is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission (ANCC) on Accreditation.3 The Nursing Continuing Professional Development (NCPD) team at SNHU was developed to provide relevant professional development activities to the university faculty and those in healthcare in the SNHU community of stakeholders and student preceptors who are considered integral members. Before the HIM Preceptor Orientation and Training proposal, an asynchronous activity was created and published by the NCPD team to orient the preceptors of nursing students in the Master of Science in Nursing (MSN) Clinical Nurse Leader or Nurse Educator tracks. The content, format, and evaluation process for this activity was shared with the HIM team. This provided a shared understanding of the functionality of the activity and the type of content presented in a related activity.
This shared understanding motivated the unique interdisciplinary collaboration that generated, presented, and continues to maintain the HIM preceptor orientation and training program. The disciplines involved in collaboration included nursing, counseling, and health professions faculty and various administrative associates from the clinical experiences team and the career services internship team within the university. This interdisciplinary collaboration is part of the NCPD team’s commitment to the presentation of “high-quality virtual synchronous and asynchronous, interdisciplinary educational activities to a diverse audience of learners in healthcare and education.”4
Since the HIM program at SNHU includes students across the country and is delivered entirely online, the PPE must be managed differently than traditional programs. For these reasons, the university’s career services internship team works closely with students responsible for finding their PPE site. The internship approval process begins once the student secures a PPE site, as shown in Figure 1. At that point, the career services internship administrator guides the student through an approval process. Students begin by creating three learning objectives to be accomplished during the PPE. They also identify the activities they will complete to meet the learning objectives and determine how they will measure their success. The preceptor, career services internship administrator, and HIM program director must approve these learning objectives. The career services internship administrator, student, and preceptor must also sign an internship agreement outlining everyone’s responsibilities during the experience. Some sites may require an affiliation agreement with the university. The career services internship administrator works closely with students to meet the affiliation agreement requirements.
In light of the desired student outcomes and to ensure preceptors have a positive experience, a preceptor orientation and training program was developed with input from key university stakeholders. As a result, preceptors are prepared for their preceptor role and will ensure students meet their pre-established learning objectives and goals. Once the approval process has been completed, the career services internship administrator sends the preceptor instructions to complete the orientation and training program.
Design and Development
The orientation and training program was designed using a narrated PowerPoint presentation that includes a downloadable PPE guidebook for preceptors to keep once the training is complete. The content consists of information about precepting, the theory behind experiential learning, and the purpose for completing a supervised PPE in HIM. To emphasize the importance of the preceptor role, the benefits of precepting are covered at the beginning of the training. The benefits explored within the training center on the preceptor’s ability to develop their leadership skills and contribute to the profession, participate in reciprocal learning, and earn continuing education units.5-8 For example, AHIMA awards HIM preceptors up to five continuing education units (CEUs) per year for serving in this role.9 The purpose of the PPE is explained so that preceptors understand the importance of students completing this requirement and the value they are serving in the preceptor role. A program overview is included in the orientation and training so that preceptors understand the student’s knowledge base. The PPE structure is described, which consists of a course and an on-site component. Students glean hands-on practice in a simulated electronic health record (EHR) and submit a final project in the course component. Tips for best practices for preceptors to consider for offering virtual experiences are included, as well.
Next, the importance of early and frequent communication between the preceptor, career services internship team, instructor, student, and pertinent staff is covered. Also, an overview of expectations for preceptors and students and how vital the preceptor’s role is in modeling professional behaviors is addressed. To ensure student success, tips are shared on preparing for the student’s first day, such as meeting and greeting the staff to help them feel welcome. Moreover, preceptors are encouraged to allow students to shadow them at meetings to glean a glimpse of a typical workday. The training includes examples of engaging students by including hands-on activities such as coding a chart or collecting data for a report. Lastly, techniques for giving constructive feedback to strengthen the student’s growth potential are provided.
Ensuring preceptors are prepared for potential student conduct issues is vital. Expectations and conduct of students are addressed, including how to address any problems. Using this proactive approach may mitigate potential issues. Equally important, the expectations for preceptors are covered, including any deliverables, such as the completed timesheet and student evaluation. The orientation and training conclude with a resource page containing contact information and a downloadable resource manual.
In anticipation of approval of the activity for one contact hour of credit, the NCPD team assigned a nurse planner to guide the process of proposal, approval, and development of the content and format. The determination was quickly made that an asynchronous activity that was presented with similar functionality and evaluation strategy to the MSN Nursing Preceptor Activity would be valuable. Objectives were outlined for the activity, and the nurse planner assisted in periodic review of the content as it was developed to maintain objectivity. This format included using a narrated PowerPoint presentation that was reformatted to MP4 (video) with closed captioning manually provided by the nurse planner upon final review. This format was replicated in the HIM activity. A knowledge check was utilized with three questions with unlimited attempts to reinforce the activity’s objectives. The NCPD evaluation tool captured feedback about the audience’s characteristics, response to the activity, and reported intent to change practice among participants.
The HIM preceptor content was built and housed within a continuing education platform utilized by the NCPD Team. This platform provides a place to host videos and complete the required knowledge check and evaluation. Using this platform, preceptors can seamlessly self-enroll in the continuing education activity, participate in the activity asynchronously, complete the evaluation, claim credit, and download a certificate of completion. The administrators of this activity benefit from the platform as well. An automated monthly report is emailed to the career services internship administrator to monitor the completion of the orientation and training. Additionally, the platform provides an easy avenue for evaluation results to be reviewed through a dashboard or spreadsheet.
To receive a certificate of completion and contact hour, participants must complete an evaluation of the orientation and training activity. The evaluation includes an attestation statement that participants have completed the training in its entirety. Additionally, the evaluation asks participants to verify that the learning objectives were achieved and that the presenters were knowledgeable in providing the information. Participants are also asked to provide their thoughts on the absence of bias in the content and delivery of the information. The evaluation also offers the opportunity for participants to share information about their content knowledge and to identify any potential areas for improvement. The evaluation concludes with a final assessment question inviting participants to share how they will apply knowledge and skills gained during the training session.
Since the inception of the preceptor orientation and training program, 68 preceptors have been invited to participate in the training. A total of 22 preceptors have completed the HIM preceptor orientation and training module and received credit since the launch date, yielding a 32 percent participation rate over eight months, reflecting a consistent enrollment of preceptors congruent with past enrollment volume.
All participants identified no bias in the presentation and indicated that the learning objectives were met. Figure 2 shows that all participants agreed or strongly agreed that the presenters were knowledgeable and effective in presenting the content. Figure 3 illustrates that 15 participants strongly agreed or agreed that their knowledge or skills had changed due to the presentation, and eight participants reflected a neutral change. Open-ended comments exploring the knowledge and skill change described participants’ increased understanding of healthcare issues and preceptor resources. Also, participants provided additional insights on how they intend to change their practice while precepting in Table 1. The preceptors’ observations from the orientation and training indicate that they better understand how to ensure students meet all of the learning outcomes and internship requirements.
Assuring that HIM preceptors are prepared for their role is crucial. By setting clear expectations and offering orientation and training, preceptors will be confidently precepting students. Moreover, students will complete the PPE successfully and be ready to enter the HIM workforce.
1. “Health information management standards.” Commission on Accreditation for Health Informatics and Information Management Education. Accessed September 13, 2022, https://www.cahiim.org/accreditation/health-information-management/accreditation-standards
2. Branda, D. (2021). Exploring the challenges and barriers of professional practice experience in health information management education (Doctoral dissertation). Retrieved from ProQuest. Paper 385. https://digitalcommons.acu.edu/etd/385/
3. “Nursing Continuing Professional Development.” American Nurses Credentialing Center (ANCC). Accessed September 13, 2022, https://www.nursingworld.org/organizational-programs/accreditation/ncpd/
4. Goss, L. and Gibbons, K. “Interdisciplinary collaborative relationships in professional development” Poster presentation ANPD Annual Convention, Chicago, IL, August 3-6, 2021.
5. AbuSabha, R., Muller, C., MacLasco, J., George, M., Houghton, E., & Helm, A. “Benefits, barriers, and motivators to training dietetic interns in clinical settings: A comparison between preceptors and nonpreceptors.” Journal of the Academy of Nutrition and Dietetics 118, no. 3 (2018): 471-480. https://doi.org/10.1016/j.jand.2017.08.009.
6. O’Brien, C., Anderson, R., Ayzenberg, B., Chute, P., Farnsworth, T., McLaughlin, R., Romig, B., Samonian, Y., Sample, J., Tynsky, T., Wallace, B., Weinstein, M., & O’Sullivan Maillet, J. Employers’ viewpoint on clinical education. Journal of Allied Health 46, no. 3 (2017): 131-137. https://pubmed.ncbi.nlm.nih.gov/28889161/
7. Recker-Hughes, C., Padial, C., Becker, E., & Becker, M. (2016). Clinical site directors’ perspectives on clinical education. Journal of Physical Therapy Education 30, no. 3 (2016): 21–27. https://doi.org/10.1097/00001416-201630030-00005.
8. Winham, D., Wooden, A., Hutchins, A., Morse, L., Shepard, C., Mayol-Kreiser, S., & Hampl, J. (2014). Attitudes and perceptions of the dietetic internship preceptor role by Arizona nutrition professionals. Topics in Clinical Nutrition, 29 no. 3 (2014): 210-226. https://doi.org/10.1097/TIN.0000000000000001.
9. “Certifications and Careers”, American Health Information Management Association, Accessed May 18, 2022, https://ahima.org/certification-careers/recertify/.
Darla Branda (email@example.com) is clinical faculty – graduate health professions at Southern New Hampshire University.
Elizabeth Christman (firstname.lastname@example.org) is clinical faculty – undergraduate nursing at Southern New Hampshire University.
Kimberly Cuetara Gibbons (email@example.com) is clinical faculty – graduate nursing at Southern New Hampshire University
Lyndsay Goss (firstname.lastname@example.org) is the director of continuing professional development, nursing at Southern New Hampshire University.
Hanna Royce (email@example.com) is an internship administrator and adjunct faculty at Southern New Hampshire University.