A common topic at my service is that of preceptors. Inevitably no matter what subtopic of precepting we may be discussing we circle around to the idea of whether certain people should be preceptors. I’m not directly tackling that topic as I’m not openly arguing against any one individual or person who is or isn’t in a preceptor role. Rather, I want to talk about precepting as a general concept and how I believe Paramedicine services should be treating that role.
To start with, at every service I have ever been with, a preceptor has been someone who met whatever the length of licensure system requirements were to be a preceptor and then was made a preceptor. That’s an important distinction to make because, in that approach, every single clinician can and does become a preceptor at one point or another. I fully understand that not every service the world over operates in this manner and to that I say, good. That’s the crux of the issue and why I disagree with every service I have worked for, not every clinician is meant to be a preceptor.
Before we get into how Communism ties into this topic, let’s discuss some simple facts of precepting such as, what is a preceptor. In American Paramedicine, it can be different in other parts of the world, a preceptor is generally a clinician who has been practicing at their license level for at least a year or two, sometimes more, and has been tasked with having students ride along with them. These can range from Emergency Medical Responder students to Critical Care Paramedic students, and everything in between. That aspect depends on the service, the schools in that service’s area, and the agreements in place for ride time. That brings us to the second part of precepting, ride time. Ride time is the idea that students need to encounter patients in a real environment and thus at a certain point in class, they are let loose upon the world to practice Paramedicine under the watchful eyes of a preceptor, or preceptors.
What is the job of a preceptor? In my mind, the job of a preceptor has always been to help nurture their student. It’s not simply to exist as a bulwark against error for the student on calls. You can be that preceptor, but that’s a very lazy preceptor. Rather, the preceptor should be a resource for the students at all times, not just in what they need to do on calls and with patients, but in what is expected of them while working in the field of Paramedicine. A preceptor is a teacher, an extension of the instructor/s attempting to help form that student into a field clinician in the classroom. This means that a preceptor should be working with their student on calls and working with them in the ambulance and around the station in between calls.
I fully realize that’s not how it always is, and that’s where looking at the role of the preceptor from the standpoint of materialism comes in handy. Interactions are what make a preceptor and thus it only stands to be the truth that someone who is not interested in taking on the role of a preceptor shouldn’t be in the preceptor role. Paramedicine has, by and large, conjured an idealistic view of the preceptor, and that has led to the belief that everyone should not just want to be a preceptor, but should enjoy being a preceptor. This take ignores the material reality of how some individuals simply do not want to interact with students, do not believe they should be teaching students, etc. We should not attempt to shoehorn these individuals into the role of a preceptor because ultimately that approach is damaging the Paramedicine field.
How is it damaging? It’s simple, if someone does not want to be a preceptor then they will become the sort of preceptor who puts in the bare minimum of effort. They will spend as little time with students as possible. Calls will be run, but there will be a minimal debrief, and as soon as they are back in quarters they will watch some TV and ignore their student altogether. Ask yourself honestly, if students are the future of our industry, why are we okay with them being precepted in such a way that they get very little out of the experience?
The reality is that this process also results in the don’t want to be preceptors finding reasons to not enjoy their job. They have had another task foisted upon them that they did not ask for and have no interest in undertaking. We are burning both ends of the rope, destroying careers before they begin and causing those in the field to enter the burnout stage earlier than if they weren’t preceptors. But, as is often the case in Paramedicine, we have always done it this way coupled with a healthy dose of hubris in the form of, “I was a preceptor whether I liked it or not, so these other people should be preceptors too and like it!” leads to us cannibalizing our ranks with a grin on our face the entire time.
What is the solution to a problem of our own creation? This is, by my account, yet again rather simple. We make it optional for individuals to be preceptors and we pay them for their time. It doesn’t need to be much, though based on the importance of the position, it should be. At the end of the day, whether you are working for a private service or a municipal entity, they can afford to pay people more in general and they can certainly afford a reasonable raise for preceptors. For my region I’d say $1 an hour is a good starting number. By taking this tact our industry should develop high-quality preceptors which will in turn help to produce high-quality clinicians coming out of schools.
Ask yourself a simple question, do you think a preceptor should be more than someone who checks some boxes on a form and hits send to make sure the students get their contacts? If the answer to that is yes, then you are someone who is in favor of preceptors who are paid to precept and take on the added responsibility and requirements that come with such a role. If your answer to that question is no, then you want things to stay the same as they are and don’t see how the services adopting the “everyone is a preceptor” approach are doing more harm than good to our industry. The former is naive and does not want to see the material conditions that make up the exchange of labor in the workplace. I know which category I fall into and it’s my hope that one day we will begin the process of allowing some people to not be preceptors while adequately rewarding those who want to nurture the future of Paramedicine.
Lead photo courtesy of Peel Regional Paramedic Services – X
