| Course | NUR-6340 Healthcare Professional Precepting Ensuring Career Success |
|---|---|
| Module | Module 3 |
| Paper type | Precepting paper: feedback and remediation |
| Length | About 1,052 words, 6 pages |
| Format | APA 7 student paper |
| School | Thomas Edison State University |
| Program | M.S. in Nursing, Nurse Educator |
| Updated | October 2026 |
Free sample paper for NUR 6340 Module 3
Week Ten and Still Missing Checks: Feedback and a Remediation Plan for an Orientee on an Elizabeth Telemetry Unit
Student Name
M.S. in Nursing, Nurse Educator, Thomas Edison State University
NUR-6340: Healthcare Professional Precepting: Ensuring Career Success
Mentor Name
Month Day, Year
Week Ten and Still Missing Checks: Feedback and a Remediation Plan for an Orientee on an Elizabeth Telemetry Unit
The Problem
The unit and its people are invented. A 30-bed telemetry unit at a hospital in Elizabeth gives new registered nurses twelve weeks of orientation with a preceptor. Priya, a nurse with two years of experience in a skilled nursing facility, is in her tenth week. She is kind with patients and her documentation is thorough, but three times in the past two weeks she has prepared a medication without checking the most recent laboratory value the order depended on, including a potassium supplement for a patient whose potassium was already high. Each time the preceptor caught the error. The preceptor's feedback so far has been general: "be more careful," "you're doing great overall." Priya's performance has not changed, and the end of orientation is two weeks away.
The preceptor, an experienced telemetry nurse completing her MSN, decided that her feedback needed to change before anyone decided whether Priya was ready.
What Feedback Should Be
Ende (1983) distinguished feedback from evaluation. Feedback is information given during learning, meant to help the learner improve; evaluation is a judgment made at the end. He argued that clinical teachers often avoid feedback because it feels uncomfortable, leaving learners unaware of problems until evaluation. He offered principles: feedback should be expected by both teacher and learner, well timed and close to the event, based on first-hand observation, limited to a manageable amount, phrased in descriptive rather than evaluative language and focused on decisions and actions rather than on assumed intentions or the person.
The preceptor's comments failed most of these tests. "Be more careful" did not describe a behavior, and "you're doing great overall" softened the message until it disappeared.
When Feedback Backfires
Kluger and DeNisi (1996) conducted a meta-analysis of feedback interventions across many settings. Feedback improved results on average, but more than a third of the effects they pooled pointed the other way. Their explanation was that feedback helps when it keeps attention on the work and on how to do it better, and backfires when it directs attention to the self, such as to the person's worth or to comparison with others, which can trigger anxiety or defensiveness.
The preceptor recognized that her occasional frustrated comments, such as "this should be second nature by now," pointed at Priya rather than at the task.
Remediation
Hauer et al. (2009) reviewed the literature on remediating deficiencies in physicians from medical school through practice. They found that remediation works best when deficiencies are identified early, assessed carefully to understand their causes, addressed with an individualized plan that includes deliberate practice and specific feedback, and followed by reassessment. They noted that the evidence base was limited and that programs often relied on expert opinion, but the principles were consistent across studies.
| Source | Key idea | Preceptor's change |
|---|---|---|
| Ende (1983) | Feedback should be timely, descriptive and about actions | Describe the missed check and its risk, right after it happens |
| Kluger and DeNisi (1996) | Feedback aimed at the self can lower performance | Focus on the medication process, not on Priya |
| Hauer et al. (2009) | Identify, diagnose, plan, practice with feedback, reassess | Find the cause; write a plan; set a reassessment date |
Finding the Cause
Before writing a plan, the preceptor asked Priya to walk her through how she prepares medications. In the skilled nursing facility, the pharmacist had reviewed laboratory values before each dose, and nurses gave medications from a printed record. On telemetry, the nurse is expected to check relevant values in the record before giving certain drugs. Priya had never built that habit because she had never needed it. This was a gap in a specific process, not carelessness.
The Conversation
The preceptor and the unit educator met with Priya in a private room. The preceptor described the three events factually, including the potassium order and what could have happened to the patient. She explained the expectation clearly and asked Priya how she saw it. Priya was upset, then relieved to understand what had been going wrong. She said no one had told her exactly what she was missing.
The Plan
The written plan has three goals for the next four weeks. First, before preparing any medication with a related laboratory value, such as potassium, digoxin, insulin, anticoagulants or diuretics, Priya will state the value and the safe range aloud to the preceptor. Second, she will use a pocket card listing these drug-laboratory pairs, which she helped write. Third, she will complete a short medication safety simulation in the skills lab with the educator. The preceptor gives brief feedback after every medication pass, describing what Priya did and what to change. Orientation is extended by four weeks, with a reassessment at week fourteen.
The Decision Point
At week fourteen, the preceptor and educator will review Priya's medication passes over the previous two weeks. If she consistently checks the relevant values without prompting, she will complete orientation. If not, the educator and manager will discuss whether another unit with simpler medication regimens would suit her better, a decision made openly and documented. Priya knows the criteria in advance.
What Happened
By week twelve, Priya was stating values before every relevant medication. By week fourteen, she was doing so without prompting, and she completed orientation. She later shared her pocket card with the next group of new hires.
What the Preceptor Learned
The preceptor reflected that she had delayed specific feedback because she liked Priya and did not want to discourage her. Ende describes exactly this reluctance. She now gives brief, specific feedback after every shift with every orientee, and she has found that orientees welcome it more than she expected.
Limits
The remediation evidence comes mainly from medicine and is based largely on expert opinion. One successful case does not show that the approach always works. Extending orientation has costs for the unit.
Conclusion
General encouragement had let a dangerous gap persist for ten weeks. Ende's principles showed how to give useful feedback, Kluger and DeNisi showed why feedback aimed at the person can backfire and Hauer and colleagues showed how to structure remediation. Finding the cause, giving specific feedback and setting a plan with a fair decision point protected patients and gave Priya a real chance to succeed.
References
Ende, J. (1983). Feedback in clinical medical education. JAMA, 250(6), 777-781. https://doi.org/10.1001/jama.1983.03340060055026
Hauer, K. E., Ciccone, A., Henzel, T. R., Katsufrakis, P., Miller, S. H., Norcross, W. A., Papadakis, M. A., & Irby, D. M. (2009). Remediation of the deficiencies of physicians across the continuum from medical school to practice: A thematic review of the literature. Academic Medicine, 84(12), 1822-1832. https://doi.org/10.1097/ACM.0b013e3181bf3170
Kluger, A. N., & DeNisi, A. (1996). The effects of feedback interventions on performance: A historical review, a meta-analysis, and a preliminary feedback intervention theory. Psychological Bulletin, 119(2), 254-284. https://doi.org/10.1037/0033-2909.119.2.254
What the NUR 6340 Module 3 instructions ask for
The preceptor-preceptee model's role in clinical judgment and retention is central to TESU's catalog description of NUR-6340, and since TESU does not release the syllabus, module three becomes a feedback and remediation paper. A paper like this describes a preceptee's specific performance problem, explains principles of effective feedback and evidence on when feedback helps or harms, uses a remediation framework to find causes and plan, shows the feedback conversation and the written plan and sets a fair, documented decision point. Some sections ask students to analyze feedback they received rather than gave. Check whether the brief expects a learning contract template and how to describe a real colleague without identifying them, and keep patient details general. Show the plan's outcome if your brief allows.
Inside the NUR 6340 Module 3 example
An invented telemetry orientee in her tenth week, still missing medication checks despite general encouragement, opens the paper. Ende's principles, Kluger and DeNisi's finding that a third of feedback interventions lowered performance and Hauer's review of remediation are explained, each matched to a change in the preceptor's approach. The preceptor finds the cause, a habit never needed in the orientee's previous job, and holds a private conversation. A plan with three goals, a pocket card and a week-fourteen decision point follows, along with the outcome, limits and conclusion. Annotations note the evidence-based response and the fair decision point that protects patients and the orientee. A short section on what the preceptor learned about her own reluctance closes the narrative before the limits.
NUR 6340 Module 3 rubric: what earns full marks
Feedback and remediation papers earn credit for a specific description of the problem, accurate use of feedback principles and evidence, a search for the cause before planning, a written plan with measurable goals, specific ongoing feedback and a decision point known to the preceptee in advance. Mentors notice when a writer recognizes that their own earlier feedback was too vague. Involving the orientee in designing tools such as a pocket card shows respect and builds ownership. Documenting the decision process shows fairness. Classic and review sources should be cited completely, including long titles. Reflection on the preceptor's own avoidance of feedback shows maturity.
Common NUR 6340 Module 3 mistakes, and how to avoid them
Feedback papers often describe being supportive without being specific; describe the behavior, its risk and the expectation. Another common gap is extending orientation without a plan or a date. Find the cause before you plan. Keep feedback on the task, not the person. Write measurable goals. Tell the preceptee the criteria for the decision. Record what happens. The desk drafts your own remediation case free from your brief, using the Elizabeth paper as a model for structure and depth. Notice when liking a preceptee makes you soften feedback until it says nothing.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Thomas Edison State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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NUR 6340 Module 3 questions, answered
Where can I find a free NUR 6340 Module 3 sample paper?
The feedback and remediation paper about an invented telemetry orientee in Elizabeth, from the missed checks to the week-fourteen decision, appears on this page.
What did Ende recommend for clinical feedback?
That feedback be expected, timely, based on first-hand observation, limited in amount, descriptive and focused on actions rather than the person.
Can feedback make performance worse?
Yes. In Kluger and DeNisi's analysis, feedback left people worse off in over a third of studies, most often when it focused attention on the person.
How should a struggling clinician be remediated?
Hauer and colleagues described early identification, careful assessment of causes, an individualized plan with practice and feedback and reassessment.
Why set a decision point in a remediation plan?
So that the preceptee knows the criteria in advance and the decision about readiness is fair, documented and safe for patients.