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Competencies for Preceptorship in the

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Article in The Journal of Continuing Education in Nursing · September 2013

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Competencies for Preceptorship in the Brazilian
Health Care System
Carla D. Silva Rodrigues and Regina Rigatto Witt
abstract
Background: Preceptorship is an emerging compo-
nent of the Brazilian health care system for human re-
sources education. This study attempted to identify com-
petencies for preceptorship in this system.
Methods: An exploratory descriptive study was con-
ducted with the Delphi technique. The participants were
primary health care professionals from the South of Brazil
who were working in nine professional areas, including
nursing. The participants had served as preceptors in an
educational program promoted by the Ministries of Edu-
cation and Health.
Results: Forty-three competencies were identified and
classified into nine domains: education, professional val-
ues, basic public health sciences, management, health
care, teamwork, communication, community orientation,
and professional development.
Conclusion: The findings showed that preceptors
were committed to the education of future health care
professionals. The development of pedagogical skills was
emphasized, as was the necessity of education before
preceptorship. These competencies constitute a useful
reference for continuing professional education.
J Contin Educ Nurs 2013;44(X):xx-xx
A preceptorship is a mentoring experience that is
gaining importance in Brazilian human health re-
sources education. Preceptors are health professionals
who mentor students from varied educational programs
in their work settings. Both graduate and undergraduate
students can complete a preceptorship.
Since 1990, the Brazilian health system has regulated
human health resources education. This has led to the
The Journal of Continuing Education in Nursing · Vol 44, No X, 2013
challenge of effective adaptation and implementation of
undergraduate health care courses to comply with the
proposals of the Brazilian health system. Health educa-
tion and practice must be integrated to meet the expecta-
tions of the Brazilian health system. It is now common
for students to be placed in health services. In many in-
stitutions, health professional contracts include a pre-
ceptorship role.
Residency is an example of an education program
in which health professionals take part as preceptors.
Medical residency, regulated since 1977, was the earliest
of these programs, and programs in other health profes-
sional or multiprofessional areas were legally instituted
in 2005. For undergraduate students, a joint initiative of
the Ministry of Health and the Ministry of Education
created the Educational Program for Health at Work
(Portaria Interministerial n. 421, 2010). This program
served as a link between universities and health services
to expose undergraduate students to the health and liv-
ing conditions of the Brazilian population.
The participants in this program are students, faculty-
appointed tutors, and health professionals who serve as
preceptors. The role of the preceptor is to “supervise
within the specific area of practice or professional spe-
cialty” (Portaria Interministerial n. 421, 2010). The Edu-
cational Program for Health at Work is responsible for
preparing health professionals for preceptorship through
adequate education.
Ms. Silva Rodrigues is X and Ms. Rigatto Witt is X, Universidade
Federal do Rio Grande do Sul, Porto Alegre, Brazil.
The authors have disclosed no potential conflicts of interest, financial
or otherwise.
Address correspondence to Carla D. Silva Rodrigues. E-mail: carla.
rodrigues@ufrgs.br.
Received: October 30, 2012; Accepted: July 29, 2013; Posted:
doi:10.3928/00220124-2013
1
 One of the definitions of a preceptor in the scientific
literature is an excellent facilitator helping students to
navigate the transition into professionals, considering
that health professionals receive students and recently
graduated professionals in the workplace (Myrick &
Yonge, 2004).
Because preceptors act as teachers, some authors (Fa-
jardo & Ceccim, 2010; Myrick & Yonge, 2004) have em-
phasized the necessity of training them for educational
practice. This training should be developed in coopera-
tion with universities, although in health care, assisting
in practice is the preferred educational process. Some
universities offer specialized courses that emphasize
pedagogical practices in health services, demonstrating
the current relevance of preceptorship in the Brazilian
health system.
The identification of competencies is part of the pro-
cess of generating adaptable parameters to help to estab-
lish educational policies (Ramos, 2001). Recent studies
have defined competency as the capacity to articulate
and mobilize knowledge, abilities, and attitudes, setting
them in action to solve problems and face unpredictable
situations in a determined cultural and work context.
The preceptorship literature describes two ways to
identify competencies. The first was developed by the
Canadian Association of Schools of Nursing (2010),
which established competencies for preceptors, such
as time to support students effectively, a positive atti-
tude toward preceptorship and lifelong learning, and
the ability to help students apply theory to practice.
Within this context, the need for educational institu-
tions to prepare preceptors for this role was recognized
(Canadian Association of Schools of Nursing, 2010).
The second originated from a Cuban study (Sotolon-
go, Michelena, & Horta, 2005) that was conducted to
identify competency with respect to the contribution of
workers (someone who understands the objectives to
be achieved, organizes the group of students, acts as an
agent learning guide, recognizes students’ participation
in their own learning, and uses communication to en-
able learning).
In Brazil, studies of preceptors have identified char-
acteristics of the preceptorship. One study showed the
variability of preceptors’ practices in a residency (Fa-
jardo, 2011). Another studied the competencies that
preceptors considered necessary for residents in a multi-
professional program (Nascimento & Oliveira, 2010). A
third discussed the preceptor’s role in the education of
resident physicians (Botti, 2009).
With the understanding that the competencies neces-
sary for preceptorship are not the same as those needed
in professional health practice, the current study at-
2 Copyright © SLACK Incorporated
tempted to identify these competencies. This study was
conducted to contribute to the education of health pro-
fessionals and offer insights for preceptorship practice.
Specifically, the goal of this study was to identify the
required competencies for preceptorship in the Brazilian
health care system.
METHODS
A descriptive exploratory study using the Delphi
technique was conducted. This method structures com-
munication to allow a group of respondents to address a
complex problem and reach a consensus. This technique
has been used to allow reflection by a panel of experts
and to obtain consensus on issues that have received lit-
tle discussion (Wright & Giovinazzo, 2000).
The project was approved by the Ethics Committee in
Research of the Health Secretary of Porto Alegre (pro-
cess number 001.000568.11.2). Written informed consent
was obtained from all subjects. Each subject was sent a
separate questionnaire to collect professional and educa-
tional data. A code was used to identify questionnaires
to assure the anonymity of participants.
The field of the study was the educational program
in health practice developed through a collaboration
between the Federal University of Rio Grande do Sul
and the Health Disctrict Glória/Cruzeiro/Cristal, both
located in the city of Porto Alegre, South of Brazil.
Three questionnaires were used for this study. A pre-
test of the first questionnaire was completed by a group
of four nurses who worked as preceptors at another edu-
cational institution to verify its face validity and clarity
and to ensure that the instructions were easily under-
stood.
Participants were professionals in the health district
who were working as preceptors in the program. One
of the criteria for the selection of participants was ex-
perience. A minimum of 1 year of work experience was
required for inclusion in the study. Sixty-six preceptors
in nine areas (nursing, medicine, dentistry, pharmacy,
nutrition, physiotherapy, psychology, speech, and phys-
ical education) who met this requirement were invited
to participate. Of the invited professionals, 26 ultimately
enrolled in the study. This number was considered ad-
equate because the literature indicates that 15 to 30 par-
ticipants can generate relevant information (Wright &
Giovinazzo, 2000).
As recommended by the Delphi technique, the proj-
ect was presented to potential preceptors at a meeting
at which the objective of the project, the key concepts,
and the importance of their participation were explained.
At that time, the researcher contacted potential respon-
dents. Those who agreed to participate in the study
received their first questionnaire. The objective of this
questionnaire was to generate a list of competencies. The
questionnaire contained specific information to orient
participants to the concepts reported in this article. Par-
ticipants were asked to list three competencies and jus-
tify why they found them necessary for a preceptorship.
The second questionnaire contained a list of the 43 com-
petencies compiled from the answers obtained from the
first questionnaire. Respondents rated their agreement
with these competencies using a Likert scale with scores
ranging from 1 (strongly agree) to 5 (strongly disagree).
Content analysis of the data was used to build compe-
tency statements (Sousa, Frade & Mendonça, 2005). On
the basis of information contained in the questionnaire,
keywords were derived and used to group components
to describe preceptors’ competencies. The following
requirement for format was established: Every com-
petency should consist of a verb and a noun and could
include one or more qualifiers (World Health Organiza-
tion, 2003).
The data underwent statistical analysis to establish
consensus among respondents. The level of agreement
on ratings was used because it is a reliable indicator of
consensus. A mean of 4 or more and standard deviation
of 1 or less were established as the criteria for consensus.
As a result, 42 of the 43 competencies reached consensus
in the second round. Response rates were 84.6% (22 of
26) for the first round and 77.2% (17 of 22) for the sec-
ond round. Competencies were classified into domains
following the work of Witt and Almeida (2008) and the
International Council of Nurses (2003).
RESULTS
Participant Characteristics
Preceptors in nursing (9), medicine (1), dentistry (1),
nutrition (2), physiotherapy (4), psychology (2), and
physical education (3) agreed to participate in the study.
Of the 22 respondents, 63% (n = 14) had 16 or more
years of work experience and at least 1 year of experience
as a preceptor. Most of the participants (n = 16) were
specialists in public or family health, and two of them
held a master’s degree. None of the preceptors had al-
ready gone through preparation for preceptorship.
Competencies Identified by the Delphi Study
Forty-four competencies were identified in the first
round. In the second round, a consensus was obtained
for 43 competencies. Only the competency “uses elec-
tronic resources for the design and presentation of pa-
pers” (M = 2; SD = 3) did not obtain consensus in this
round. The remaining competencies were classified un-
der nine domains: education, professional values, basic
The Journal of Continuing Education in Nursing · Vol 44, No X, 2013
public health sciences, management, health care, team-
work, communication, community orientation, and pro-
fessional development, as summarized in the Table.
DISCUSSION
Domains of Education and Communication
Considerable emphasis was placed on the domain of
education. Health professionals serving as preceptors are
expected to provide problem-solving or competency-
based education that is centered on student needs. The
combination of multidisciplinary and interprofessional
skills is necessary for effective use of knowledge and in-
formation (Ruiz, 2001).
Pedagogical skills are necessary for this purpose, as
stated by physicians acting as tutors, who recognize that
although pursuing knowledge is necessary, it is not ad-
equate for the teaching process (Sotolongo et al., 2005).
On the other hand, experience was valued, indicating
that an understanding of everyday working situations is
beneficial for student learning. Preceptors’ professional
education experiences were mentioned as a guide for
preceptorship because students would be expected to
accomplish what the preceptors had already achieved.
Myrick and Yonge (2004) proposed that, on assuming
this role, preceptors should share their knowledge and
expertise with students, and they compared this practice
with the principles of teaching and learning that are used
in adult patient education.
Preceptors should identify moments in their practice
that are suitable for learning. The active role of precep-
tors in the process can be compared with that of
the teacher, who facilitates this process; he creates op-
portunities for learning situations, creates intense and
adequate experiences, is capable of awakening the stu-
dent’s questioning and investigating attitude, which in
turn justify the intervention in reality for which solu-
tions are searched. (Reibnitz & Prado, 2003, p. 440)
Preceptors were expected to guide students through
an integral and systematic analysis of the disease pro-
cess and its various dimensions (individual, family, and
collective) (Edital n. 24, 2011). When helping students
to build strategies, preceptors should consider individ-
ual needs (Perrenoud, 2000). In Cuba, competencies for
preceptorship in this domain included “select teaching
methods according to the class type” and “recognize the
students’ participation in their own learning” (Sotolon-
go et al., 2005).
The importance of the preceptor’s role in the tran-
sition from theory to practice was also identified. In a
study of nursing students, a participant commented, “I
think there should be a professional who could make
3
 TABLE
COMPETENCIES FOR PRECEPTORSHIP BY DOMAIN
Domain and Competencies M SD
Education
Recognizes learning opportunities for students 4.35 0.49
Offers students knowledge and experiences that are necessary for their professional education 4.65 0.49
Shares with students practical experience related to the community 4.71 0.47
Encourages students to identify a problem and search for practical and suitable solutions 4.65 0.49
Helps students to build action strategies 4.53 0.51
Articulates theory and practice, emphasizing the dynamics, diversity, and singularity of field situations 4.65 0.49
Provides students with assistance so that they can be confident in their actions and decision-making skills 4.65 0.49
Evaluates trainees, rethinking the dynamics adopted and proposing new interventions 4.41 0.51
Identifies with the educational activity 4.59 0.51
Professional values
Shows motivation to develop new perspectives in students 4.47 0.62
Commits to educational proposals developed during service 4.65 0.49
Collaborates for teaching-service integration 4.59 0.51
Meets professional responsibilities, guiding students to do the same 4.76 0.44
Acts professionally, providing a role model for students 4.59 0.62
Conducts activities ethically 4.88 0.33
Requires students to pay attention to health procedures, focusing on the patient 4.29 0.77
Encourages students to show commitment to the health team, the service, and the health system 4.65 0.49
Identifies with the public health practice 4.71 0.59
Basic public health sciences
Understands the health policies and the logic of the family health strategy 4.65 0.49
Understands the Brazilian health system and applies its principles 4.71 0.47
Places students in the context of the health system 4.71 0.47
Demonstrates technical skills to guide students 4.53 0.51
Encourages students to reflect and develop critical thinking skills 4.59 0.51
Management
Supervises and organizes services for adequate development of the work 4.41 0.62
Introduces students to the field of practice 4.65 0.61
Demonstrates leadership and teamwork for the development of activities in the health unit and the community 4.59 0.62
Articulates health care with preceptorship activities 4.59 0.51
Understands and helps students to understand the institutional demands of the health service 4.41 0.71
Health care
Promotes embracement, prioritizing clients at risk 4.35 0.79
Provides humane care, adapting procedures to the client’s reality 4.71 0.59
Provides professional consultation, using problem-solving skills 4.47 0.80
Requires patients to commit to their own health promotion 4.35 0.70
Teamwork
Interacts with students and preceptors in other areas to develop integrated and complementary activities 4.47 0.51
Encourages students to participate in multidisciplinary teamwork 4.76 0.44

4 Copyright © SLACK Incorporated

 TABLE (cont’d)
COMPETENCIES FOR PRECEPTORSHIP BY DOMAIN
Domain and Competencies M SD
Demonstrates flexibility in procedures 4.35 0.61
Communication
Communicates availability to meet with students 4.41 0.51
Listens, embraces, and supports students, providing space for expressions, transforming them into alternatives 4.65 0.49
Uses appropriate communication tools to allow learning 4.59 0.51
Community orientation
Knows the community and guides students through population problems and needs 4.35 0.61
Uses connections with the community to generate a commitment to health 4.12 0.70
Recognizes the potential of intersectoral work to solve problems and develop activities in the community 4.65 0.49
Professional development
Takes responsibility for professional training 4.53 0.51
Recognizes professional experience as a resource for preceptorship practice 4.71 0.47
Note. Rodrigues, C.D.S. (2011). School of Nursing, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.

the transition from theory to practice, making it easier
to learn” (Campos, 2007, p. 1229). The competency “to
recognize that theory underlies practice and that both
correlate “with real-life problem-solving” was indicated
by preceptors as necessary for residents in a multiprofes-
sional program (Nascimento & Oliveira, 2010).
Direct contact between preceptors and students was
also valued. The program recommends that students
should be accompanied by a professional in the same
area during health practice activities (Edital n. 24, 2011).
In the context of undergraduate education in Brazil, this
contact contributes comprehensively to the education of
students, and “decision-making” is a general competen-
cy established by the National Curricular Guidelines for
health professional education (Almeida, 2005).
Evaluation is also an important step in education.
Evaluating students can be a challenge. The precep-
tor must be fair, accurate, and gentle (Myrick & Yonge,
2004). Strategies for evaluating students in the clinical
setting have been discussed at workshops held in New
Orleans, Louisiana, to educate hospital nurses about the
clinical nursing preceptor role (Schaubhut & Gentry,
2010).
Communication, whether verbal or written, is im-
portant for health professionals and necessary to allow
them to establish bonds with clients, individually or col-
lectively, and to develop certain group activities (Ruiz,
2001).
The communication between preceptors and students
is an essential element of the success of the preceptor-
ship. Keeping the lines of communication open is key
to developing a good relationship. For example, it is im-
portant both to be available to meet with students and to
communicate this availability (Myrick & Yonge, 2004).
The preceptor is considered a model for students,
someone they can lean on when having difficulties.
Therefore, establishing a relationship of trust gives the
student more opportunities to express anxiety, difficulty,
and uncertainty so that the preceptor can help the stu-
dent to address them.
One way to develop good communication with stu-
dents and achieve effective learning is to provide written
or oral feedback on their performance (Myrick & Yonge,
2004). Preceptors showed concern about establishing
clear communication with students, work groups, and
clients.
Domains of Professional Values and Professional
Development
Within the professional values domain, health care
involves ethics and is based on certain values and prin-
ciples (Organización Panamericana de la Salud, 2002).
This was reflected in competencies that included values
such as commitment, ethics, and responsibility that are
expected of professionals participating in a health educa-
tion public program.
Commitment to the program is beneficial for health
care teams, services, and the community. The precep-
tor should arrange an appropriate environment for the
preceptorship experience and recognize that it is a criti-
cal factor in the teaching-learning process (Myrick &
Yonge, 2004).

The Journal of Continuing Education in Nursing · Vol 44, No X, 2013 5

 The program was conceived as a learning tutorial for
strategic areas of the health system and a tool for quali-
fication of those already in practice. Therefore, the pro-
gram requires new professional competencies and pro-
vides motivation for professional development to fuel
health education reform that integrates education and
practice (Brito, 2001). Preceptors were concerned about
consolidating the link between educational institutions
and health services. In this context, the relationship
between preceptors and faculty is an important deter-
minant in the development, implementation, and sus-
tainability of the preceptorship experience (Myrick &
Yonge, 2004).
The literature identifies being a model for students
as one of the roles required of a preceptor (Myrick &
Yonge, 2004) because students and novice professionals
expect to be mentored by professionals who can satisfy
their learning aspirations and motivate them to follow
their example.
Students’ involvement in the learning process is men-
tioned in the curricular guidelines of some health care
courses. These guidelines recommend that the education
of professionals enable them to act
in all levels of health care, with integration in programs
of health promotion, maintenance, prevention, protec-
tion, and recovery, so that they can be inspired and com-
mitted to the human being, respecting and valuing him.
(Resolução CNE/CES 2, 2003, p. 2)
Preceptors’ identification with educational activities
and expected public health practices confirms the em-
phasis on the identification of oneself with one’s work,
as recognized for nurses in primary health care by Witt
and Almeida (2008).
Professional development is a domain in which pro-
fessional enhancement, quality improvement, and con-
tinuing education are expected (International Council
of Nurses, 2003). Ongoing education is a general com-
petency established by the National Curriculum Guide-
lines for health professionals that is concerned with
promoting continuous learning through education or
practice:
Health professionals should learn to learn, take respon-
sibility, and commit to one’s own and others’ learning
processes as future professionals, offering conditions for
mutual benefit between them . . . (Almeida, 2005, p. 23)
The International Council of Nurses (2003) recog-
nized the importance of this domain, as observed in
these competencies: “carries out regular reviews of own
practice,” “assumes responsibility for lifelong learning
and maintenance of competence,” and “contributes to
6 Copyright © SLACK Incorporated
the educational and professional development of stu-
dents and colleagues.”
The role of supervisor requires solid professional
knowledge and experience to guide practice. Assad
and Viana (2003) considered accumulated knowledge
a means of giving new meaning to theory. At the same
time, competencies that support professional practice are
developed from life experience and professional social-
ization. The Canadian Association of Schools of Nurs-
ing (2010) emphasized the importance of a preceptor’s
professional experience.
Domains of Basic Public Health Sciences,
Community Orientation, and Health Care
The domain of basic public health sciences includes
competencies that allow health professionals to under-
stand health policy, population health status and its de-
terminants, and the factors that influence the use of ser-
vices (Ruiz, 2001).
Because these policies are still being developed in
Brazil, preceptors as well as all professionals involved in
primary health care must learn how to apply them in ev-
eryday practice and search for ways to improve popula-
tion health. As noted by Witt and Almeida (2008), nurses
in primary health care need to achieve the competency
“demonstrates understanding of the national health sys-
tem and policies.”
Preceptors identify themselves as health profession-
als whose technical competence depends on practice
and knowledge acquired through education. In the con-
text of primary health care in Brazil, Nascimento and
Oliveira (2010) highlighted the following competency
for family health residents, relating it to a comprehen-
sive perspective on the process of health and disease:
“demonstrates knowledge and technical/clinic abilities
acquired through specific education.”
The educational process includes a reflective exercise
in which the instructor stimulates the critical and creative
capacity needed to improve patient health (Reibnitz &
Prado, 2003). In this sense, the preceptor encourages the
student to reflect and develop critical thinking, thereby
developing the competency “commits oneself to critical
thinking and reflective practice,” described by Witt and
Almeida (2008).
Health care informs professional actions, such as the
principles and guidelines of the Brazilian health system.
In Brazil, the primary principles of health care are the
promotion, protection, and maintenance of health, as
well as diagnosis, treatment, and rehabilitation from dis-
ease. Services should be offered within delimited terri-
tories, with strategies that make family health a priority.
Universality, accessibility, link, continuity, humane ser-
vice, and social participation are principles of the Brazil-
ian health system (Ministério da Saúde, 2011).
In this context, Brazilian humane policy, established
in 2004, aims to improve health service processes and
achieve “critical and committed work with health prac-
tices and clients with consideration for their different
needs.” Embracement, mentioned in one of the guide-
lines, encourages
forms of welcoming and including the client in the ser-
vice, promoting its optimization, eradicating queues,
prioritizing care according to risks, and allowing access
to the other levels of the system. (Ministério da Saúde,
2004)
A study by Witt and Almeida (2008) identified the
competency “demonstrates ability for caring and sensi-
tivity,” which highlights the relationship with the client
and respect for and compliance with the principles of
universality in the Brazilian health system.
The same policy states that individual client care
presupposes attentive listening to the client’s problems.
Other elements of consultation were identified by Nas-
cimento and Oliveira (2010) and indicate that residents
should “apply knowledge to provide consultation, make
the diagnosis, prescribe, and refer to other levels of the
health system.” This highlights professional responsibil-
ity for one’s actions and efforts to resolve problems.
Community-oriented care implies that profession-
als should be committed to the community where they
work. They should attempt to reduce health inequities
between and within communities. Some environmental,
social, and behavioral factors should be considered as
determinants of the etiology and progression of disease
(Starfield, 2002).
Knowledge of the community is related to the devel-
opment of projects and action planning, which should
take into account the objectives and characteristics of the
program. The program encourages the development of
health services projects within communities. These proj-
ects should adhere to the following guidelines: “Plan-
ning and execution of activities should contribute to the
integration of teaching, community, and service . . . ac-
cording to the state and/or local health policies, and ac-
cording to the epidemiologic status of the region” (Edi-
tal n. 24, 2011, p. 268). This requirement was identified
for health professionals in primary health care by Witt
and Almeida (2008), as summarized in the competency
“knows the community [and] establishes and maintains
links with it.”
At the same time, primary health care should address
the complexity of health issues. Thus, health profession-
als must take an intersectoral approach in addressing so-
The Journal of Continuing Education in Nursing · Vol 44, No X, 2013
cial determinants and articulating professional practice
(Moretti-Pires, 2009). Campos (2007) recognized that
health care policy must be informed by the exchange
of knowledge with other social policy makers; in other
words, there must be open dialogue with other social
segments.
Domains of Management and Teamwork
The domain of management includes features of
health service organizations, such as supervision, deci-
sion-making, and leadership. According to the National
Curriculum Guidelines, health professionals are expect-
ed to possess competence in managing human, structur-
al, material, and information resources (Almeida, 2005).
With respect to work dynamics and existing adversi-
ties, the complexity of primary health care means that
there are few constant work situations. This presents a
challenge for the development of competence because
the success of a service organization in solving problems
or reaching objectives depends on repeated exposure to
similar situations that require the mobilization of re-
sources (Perrenoud, 1999).
Preceptors considered management of assistance and
educational activities a key element in the development
of the program. The difficulty of harmonizing these re-
sponsibilities was noted by preceptors from a profes-
sional residency, as described by Fajardo (2011):
I consider myself always investing in the exercise of pre-
ceptorship, understanding it as a continuous and chal-
lenging process. . . . However, I find myself dealing with
difficulties and contradictions of the work process in
education and care performance. (p. 137)
Leadership and teamwork were indicated as means of
preparing the service to receive students. The individual
dimension of leadership encompasses social aptitudes
(communication, persuasion, and conflict mediation).
Preceptors identified all of these as important for com-
munity mobilization (Gaidzinski, Peres, & Fernandes,
2004). At the same time, because leadership is a profes-
sional ability that should be developed continuously
(Gaidzinski et al., 2004), the leader should recognize
not only personal objectives but also the importance of
group factors and collective goals.
Preceptors also noted that students should understand
the context in which activities were developed. Students
arrive at health services with many expectations and pre-
determined concepts acquired from undergraduate the-
ory courses. Inevitably, they encounter the reality of the
health services environment and interpret the situations
they encounter. Preceptors need interpersonal skills to
successfully mediate the relationship of the student with
7
the institution. Further, they must lead students in learn-
ing about the reality of health services and institutional
dynamics while working to avoid estrangement or nega-
tive perceptions of the service or health professionals.
The teamwork domain recognizes the interdependent
character of professional autonomy, which is a presup-
position of the family health program (Peduzzi, 2001)
and the context of this study. It is considered one of the
most important presuppositions for reorganizing the
working process and establishing a more integral and
effective approach (Ministério da Saúde, 2001). Brito
(2001) also considered this one of the new competencies
necessary for educational reform in health care.
Because the preceptorship program is new, develop-
ment of the activities may include some uncertainty that
demands flexibility on the part of preceptors. “Flexibil-
ity for new organization modalities and work condi-
tions” is a general competency for health professionals
(Ruiz, 2001).
CONCLUSION
The competencies identified in this study apply to a
teaching-learning context, with emphasis on the edu-
cational performance that health professionals expect
in the preceptor role. Respondents indicated a need for
continuous education of health professionals so that they
can assume the role of preceptor, with consideration for
the health services settings in which students and novice
professionals are increasingly present.
The identified competencies for preceptorship in the
Brazilian health system reflect the values of health pro-
fessionals, such as ethics, commitment, responsibility,
motivation, and collaboration with programs proposed
by the government. Although the necessary compe-
tencies for preceptorship are not the same as those for
professional health practice, all general competencies
recommended by the National Curriculum Guidelines
for undergraduate courses in the area of health were con-
sidered (health care, decision-making, communication,
leadership, management, and continuing education).
Many of the identified competencies related to those
reported internationally, such as in studies conducted
in Cuba, Canada, and Switzerland. This contributes to
the process of establishing international competencies,
which should be broad yet specific enough to guide
decision-making as well as fundamental and relevant to
practice. For this reason, the competencies presented in
this study can be considered a reference for the practice
and education of preceptors in the Brazilian health sys-
tem as well as in other settings. It is important to con-
sider transformations that occur globally in health care
practice and education. These competencies should pro-
8 Copyright © SLACK Incorporated
vide a useful guide for the performance and evaluation
of preceptors in the education programs that are being
implemented by the Brazilian Ministries of Education
and Health.
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