7 - Strong Foundation: Building Surgical Technologist Expertise Through Preceptorship​

Description:

Background: Safe surgery depends on the proficiency of surgical technologists (STs). However, variable precepting practices often yielded inconsistent competency development, directly impacting patient safety. Recognizing this critical gap, a multidisciplinary team was assembled, including an OR Nurse Manager, two Lead STs, a Nursing and Surgical Technology Education Specialist, and a Process Improvement Coordinator. This team identified widespread variability in ST competency progression and an over-reliance on ad-hoc mentorship. This deficit routinely led to prolonged orientation periods, heightened stress for novice STs, and discernible gaps in clinical practice, collectively compromising patient care quality. Compounding these issues were: high staff turnover rates due to military mission requirements, and a predominantly junior ST workforce averaging less than 18 months of experience. This contrasts the experienced mid-level managers and civilian employees, averaging 8-10 years of service. It became a strategic imperative to standardize training and mitigate these pervasive challenges.

Aim: Standardize ST training and enhance professional development through a structured, evidence-based preceptor-preceptee program grounded in Patricia Benner's "From Novice to Expert" adult learning theory.

Method: Employing a Lean Six Sigma A3 framework, this project used the Plan-Do-Study-Act (PDSA) cycle for iterative improvement. We began by identifying the problem of inconsistent ST competency development through staff surveys and observation. A dedicated team was formed, which then conducted a targeted literature review on adult learning theories and best practices in preceptor programs. The current ST orientation process was meticulously mapped to identify waste, inefficiencies, and opportunities for optimization. This analysis revealed a critical need for structured preceptor training and formalized preceptee progression. Countermeasures were developed, to create a standardized, competency-based preceptor-preceptee program with reassessment processes built-in.

Expected Outcomes: This project was launched in June 2025 and is scheduled for completing in January 2026. The project's key countermeasures included a robust preceptor training and competency assessment program. Preceptors now complete online modules covering adult learning theory, feedback techniques, and Benner's stages, followed by a practical assessment. For preceptees, a formal agreement form was implemented, alongside mandatory daily huddles for daily feedback. Crucially, pre-shift case studies foster critical thinking and procedural preparation. A new "ST Skills Acquisition Matrix" was developed to track and validate preceptee progression. Expected outcomes include an accelerated pathway to ST proficiency, improved preceptor confidence and teaching effectiveness, enhanced patient safety through reduced errors, increased ST retention, and a more engaged, competent workforce. Eight preceptees are scheduled to complete the program by January 2026. Four preceptors have been identified and training has begun.

Conclusion: This Benner-informed preceptor-preceptee program significantly elevates the standard of ST education and practice, directly contributing to enhanced quality and safety of surgical patient care.

Wow: We're not just training technicians; we're cultivating surgical excellence, one preceptee at a time.