Name of Preceptee w Name of Preceptor e Other useful names/contacts i v r Date initial interview Today’s date Approx. date of Today’s date + 3 months e interim review Approx. date final review Today’s date + 6 months t n GOAL HOW WILL THIS BE ACHIEVED? HOW WILL THIS BE EVIDENCED? I Professional Practice p Carry out documentation audit; Reflection, audit report Example: excellent review documentation policy documentation standard i h s r o t p e Clinical Skills c Undertake catheterisation Pass certificate; analysis of an Example: catheterisation e clinical skills training package; episode of learning r shadow Urology specialist nurse P l a i t i Other n I Signed Preceptee
I n i t i a l P r e c e p t o r s h i p I n t e r v i e w Name of Preceptee Name of Preceptor Other useful names/contacts Date initial interview Today’s date Approx. date of interim review Today’s date + 3 months Approx. date final review Today’s date + 6 months GOAL HOW WILL THIS BE ACHIEVED? HOW WILL THIS BE EVIDENCED? Professional Practice Example: excellent documentation standard Clinical Skills Example: catheterisation Other Carry out documentation audit; review documentation policy Undertake catheterisation clinical skills training package; shadow Urology specialist nurse Reflection, audit report Pass certificate; analysis of an episode of learning Signed Preceptee