4 - Clinical Coaching: Unlocking Success with Impactful Conversations

Description: Assessment and Background
Orientation to the operating room is a complex and lengthy process. New graduate nurses may have a steep learning curve during orientation due to limited exposure to perioperative services in nursing schools and a lack of practice-ready preparation. Experienced nurses transitioning to the operating room face challenges changing from expert to novice as they learn new skills and workflows. In both cases, the nurses may face impostor syndrome, culture shock, or feelings of low self-confidence that could impede their progress in orientation or increase the likelihood that they will transfer to another position.

Description of a Team
Educators at a level one trauma center identified common challenges novice nurses face in their transition to practice.

Planning and Implementation
This clinical coaching initiative employed a multi-model approach, leveraging the GROW Model, One-Minute Preceptor, and Clinical Transition Framework. Recognizing the enhanced efficacy of integrated coaching models, these frameworks were selected to address specific clinical challenges. The GROW Model simplifies complex learning through goal setting, reality assessment, options exploration, and action planning, proving particularly useful in the high-pressure operating room (OR) environment. The One-Minute Preceptor framework promotes rapid skill refinement via immediate, concise feedback. The Clinical Transition Framework facilitated personalized remediation plans and the collaborative creation of SMART (Specific, Measurable, Achievable, Relevant, Time-bound) goals. Rather than direct instruction, reflective questioning encouraged the novice nurse to identify opportunities for improvement, prioritize areas, and develop structured action plans with realistic timelines.

Outcome
Educators and preceptors utilized coaching frameworks to foster empowerment and engagement in the learning process, thereby building self-confidence and setting the novice nurse up for successful orientation. Through coaching, we empower our orientees to achieve success by integrating knowledge and skills through reflection. The outcome is improved competence, improved job satisfaction, and increased nursing retention.

Implications for Perioperative Practice
Increasing numbers of graduate nurses are directly entering perioperative practice upon graduation. Nurse educators and preceptors have navigated challenges in building novice nurses' confidence and competence during the transition to practice phase related to experience gaps from COVID-era curriculum changes. Clinical coaching is a valuable tool in the orientation process, as it helps build self-awareness and self-confidence. Clinical coaching has been shown to enhance interpersonal relationship skills, tailoring goals and skill development to the needs of novice nurses in complex environments, as documented in the literature and our practice. This poster describes coaching models and provides examples of their application.