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The Role of the Preceptor in TSAM®

Sep. 16, 2026

The Role of the Preceptor in TSAM® | Creative Health Care Insight

Preceptors play an essential role in helping new clinicians translate knowledge into safe, confident practice. They provide clinical guidance, model professional behaviors, offer feedback, and help orientees progress toward greater independence.

Within the Tiered Skills Acquisition Model, those responsibilities are supported by a structured, competency-based approach to clinical orientation. Instead of advancing primarily according to a predetermined timeline, orientees progress through increasingly complex responsibilities as they demonstrate competence. This structure gives preceptors a clearer framework for guiding development, evaluating performance, communicating progress, and supporting readiness for independent practice.

How Preceptors Support Competency-Based Progression

Traditional orientation programs may organize an orientee’s experience around a fixed number of weeks or an extensive checklist of tasks. Although timelines and required competencies remain important, TSAM® focuses more intentionally on progressive development based on demonstrated competence. The preceptor helps connect that framework to daily clinical practice.

This includes observing how the orientee applies knowledge, manages responsibilities, communicates with the care team, and responds to increasingly complex clinical situations. Based on those observations, the preceptor provides guidance and helps identify whether the orientee is ready to progress or needs additional learning opportunities.

Progression should not be based on a single successful experience. Preceptors look for consistent performance and consider whether the orientee can apply their abilities safely across appropriate situations. The preceptor does not make progression decisions alone. Successful TSAM®-based orientation requires collaboration among the orientee, preceptor, nursing professional development practitioner, clinical educator, and unit leader.

Core Preceptor Responsibilities Within TSAM®

Although specific responsibilities may vary by organization, specialty, and clinical setting, preceptors working within TSAM® generally support several important functions.

Establish Clear Expectations

At the beginning of the orientation experience, preceptors should help orientees understand:

  • How tiered progression works
  • Which competencies and responsibilities are associated with each stage
  • How clinical performance will be evaluated
  • How observations and feedback will be documented
  • When formal and informal check-ins will occur
  • Who participates in progression decisions
  • How learning needs or concerns will be addressed

Clarity helps reduce uncertainty and gives orientees a better understanding of their role in the learning process.

Healthcare preceptor providing feedback to an orientee during competency-based orientation | Creative Health Care Insight

Connect Assignments to the Orientee’s Current Progress

Clinical assignments should provide meaningful opportunities for development while remaining appropriate to the orientee’s demonstrated abilities. Preceptors help make this possible by:

  • Selecting relevant learning experiences
  • Connecting patient assignments to current competencies
  • Gradually increasing responsibility and complexity
  • Providing support without taking over unnecessarily
  • Adjusting guidance as the orientee becomes more independent
  • Identifying when additional practice may be needed

This intentional progression helps ensure that assignments contribute to development rather than simply filling time during orientation.

Observe Performance in Practice

Competence cannot be determined by completed documentation alone. Preceptors must observe how the orientee applies knowledge, skills, judgment, and professional behaviors in clinical practice. Depending on the role and setting, observations may include:

  • Clinical skills and interventions
  • Prioritization and organization
  • Communication and collaboration
  • Clinical reasoning and decision-making
  • Recognition of changes in patient condition
  • Appropriate use of available resources
  • Understanding of organizational policies and standards
  • Recognition of personal limitations and when to seek assistance

These observations give the orientation team meaningful evidence of the orientee’s development and readiness.

Provide Relevant Feedback Frequently

Feedback is especially important in competency-based orientation. Orientees need to understand what they are doing well, what requires further development, and what they must demonstrate before assuming greater responsibility.

Effective feedback should be timely, specific, and connected to observed performance. Instead of simply telling an orientee that they are “doing well,” the preceptor can identify how the orientee appropriately prioritized care, communicated a concern, applied clinical judgment, or managed a more complex assignment. Preceptors can also encourage reflection by asking questions such as:

  • What influenced your decision?
  • What went well during this situation?
  • What would you approach differently next time?
  • What additional information would help you feel more prepared?
  • When would you seek support in a similar situation?

These conversations help the preceptor understand the orientee’s reasoning, not just the actions that were completed.

Document Meaningful Evidence of Progress

Clear documentation helps everyone involved in orientation understand the orientee’s progress, particularly when multiple preceptors or shifts are involved.

Documentation should provide meaningful information about:

  • Competencies that have been demonstrated
  • Progress within the current tier
  • Learning opportunities that have been completed
  • Feedback that has been provided
  • Areas requiring additional practice
  • Patterns observed across assignments or shifts
  • Readiness for greater responsibility
  • Concerns requiring support from an educator or leader

Consistent documentation creates continuity and reduces the likelihood that important information will be lost between preceptors.

Communicate With the Orientation Team

Preceptors should not be expected to manage the entire orientation process independently. Regular communication with educators and leaders helps the team recognize progress, coordinate learning opportunities, and address concerns before they become larger problems.

Communication is particularly important when an orientee works with multiple preceptors. Each preceptor should have access to a clear understanding of the orientee’s current progress, demonstrated competencies, and immediate learning priorities. A connected orientation team can make better-informed decisions than any individual working in isolation.

Support the Transition Toward Independence

The purpose of orientation is not simply to complete a checklist or reach the end of a scheduled timeframe. It is to prepare the orientee to practice safely and confidently with the appropriate level of independence. As the orientee develops, the preceptor’s approach should evolve. Direct instruction may gradually shift toward coaching, observation, reflection, and greater orientee ownership. Stepping back at the right time gives the orientee opportunities to exercise clinical judgment and demonstrate readiness while support remains available.

How TSAM® Changes the Precepting Experience

TSAM® does not eliminate the need for strong clinical teaching or professional judgment. Instead, it gives preceptors a more structured way to guide progressive development.

Within a TSAM®-based orientation, preceptors are asked to focus on questions such as:

  • What has this orientee consistently demonstrated?
  • What responsibilities are appropriate at the current stage?
  • What evidence supports progression?
  • Which learning needs remain?
  • What clinical experiences would support the next stage of development?
  • What information should be shared with the educator or leader?

This creates a more individualized experience without sacrificing consistency. Orientees may progress at different rates, but the competencies, documentation expectations, and criteria used to evaluate readiness remain clearly defined. For organizations seeking a broader foundation, read Precepting in Healthcare: Building Stronger Clinical Teams Through Effective Preceptorship.

What Preceptors Need From Their Organization

Clinical expertise alone does not automatically prepare someone to teach, coach, evaluate performance, document development, or navigate difficult conversations. Organizations implementing TSAM® should prepare preceptors to understand both the model and their responsibilities within it. Preceptor support should include:

  • Education on TSAM® principles and tiered progression
  • Clear competency and progression criteria
  • Training in clinical coaching and adult learning
  • Guidance for delivering meaningful feedback
  • Preparation for assessing and documenting performance
  • Consistent access to educators and leaders
  • Defined pathways for communicating concerns
  • Opportunities to provide feedback about the orientation process
  • Continued development and recognition

Preceptors should also be involved in implementation and improvement efforts. Because they experience orientation at the point-of-care, they can identify unclear expectations, workflow barriers, documentation challenges, and opportunities to strengthen the process. Organizations building the broader infrastructure around this work can also review How to Build an Effective Preceptor Program in Healthcare.

How Technology Supports Preceptors and Orientees

Technology should make the precepting experience more connected and manageable. It should not create an additional administrative burden. A platform designed and able to support TSAM® can help healthcare organizations:

  • Organize competencies into progressive tiers
  • Give preceptors visibility into the orientee’s current progress
  • Document clinical observations and feedback
  • Track completed and outstanding requirements
  • Improve communication across shifts and preceptors
  • Identify delayed progression or learning needs earlier
  • Give orientees greater visibility into their development
  • Provide educators and leaders with timely information
  • Evaluate orientation patterns and outcomes

Technology does not replace the relationship between the preceptor and orientee. It creates the infrastructure that helps the relationship function more consistently across people, units, and locations.

Preceptor reviewing tiered competency progress in the MyCHCI orientation platform | Creative Health Care Insight

Strengthening Preceptorship Through Structure and Partnership

Preceptors help bring TSAM® to life in clinical practice. Through thoughtful teaching, observation, feedback, documentation, and communication, they help orientees progress toward safe and confident practice. Their success depends on more than individual commitment. Preceptors need clear expectations, meaningful preparation, connected workflows, accessible support, and technology that aligns with the orientation model.

Creative Health Care Insight (CHCI) is more than a technology provider. We are a strategic workforce-development partner that combines the MyCHCI platform with expert-led TSAM® implementation education and consulting as well as preceptor development. CHCI is the only legally authorized platform and provider of education and consulting for implementing the authentic TSAM® framework. Led by Dr. Ellen Joswiak, co-innovator of TSAM®, this partnership helps organizations prepare their teams, operationalize tiered orientation, monitor competency development, and sustain meaningful change.

Explore How to Build a Sustainable TSAM® Implementation Plan or schedule a demo to learn how CHCI can help your organization strengthen preceptorship and create a more connected, competency-based orientation experience.

Frequently Asked Questions

The preceptor guides the orientee through a progressive, competency-based orientation experience. Responsibilities include clinical teaching, observing performance, providing feedback, documenting development, communicating with the orientation team, and helping evaluate readiness for greater responsibility.

TSAM® emphasizes progression based on demonstrated competence rather than relying primarily on a fixed orientation timeline. Preceptors connect clinical assignments to progressive tiers and help evaluate whether the orientee is prepared to assume increasingly complex responsibilities.

The preceptor provides essential observations and evidence, but progression should be guided by the organization’s established criteria and collaborative orientation process. Preceptors, educators, leaders, and orientees may all contribute to evaluating progress and readiness.

Preceptors should understand TSAM® principles, tiered progression, competency expectations, clinical coaching, feedback, documentation, performance evaluation, and the organization’s process for escalating concerns. They also need continued access to educators and leaders.

Technology can organize competencies into progressive tiers, document observations, track progress, improve communication across preceptors, and give educators and leaders greater visibility into orientation. It should simplify the workflow while supporting the relationship between the preceptor and orientee.

A thoughtfully implemented TSAM® process can create clearer expectations, more consistent communication, and better visibility into orientee progress. Its effectiveness depends on appropriate preparation, supportive workflows, organizational involvement, and technology aligned with the model.

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