We shifted one med–surg cohort to 1500–2300 this month and built in NGN-style clinical judgment notes after each med pass to keep the focus on bedside safety and thinking… Two weeks in on 4E, I’m seeing cleaner SBARs and fewer near-misses with insulin, but I’d love to hear how you’re keeping tight supervision without crowding the room when students are this early in the term.
On 3W we use a doorway SBAR + safety pause: the student gives a 30-sec brief at the threshold, I stay in line of sight with a timer and only step in if they miss the insulin double-check; the NGN note gets drafted on my phone template while they tidy so feedback is immediate. Small caveat: it fizzles if the preceptor isn’t looped in, so we front-load them with the TeamSTEPPS SBAR card (https://www.ahrq.gov/teamstepps/index.html). Think that would fit your 1500–2300 flow on 4E?
1500–2300 ‘pen-down’ check at the cart, 60–90 seconds. NGN cue→analyze→act debrief outside; step in only for insulin, @dclarkson_32.
Quick example: we run a rotating “safety spotter” with a green clip — one student shadows two peers from the threshold and is scripted to say “pause for risk” if MAR–vial don’t match or BG/vitals drift, and I only step in when that phrase is used. It keeps line-of-sight supervision without crowding, and the spotter runs a 60‑second debrief at the cart on cues and reasoning. Small caveat: in week 1 I hand them a laminated trigger list and rehearse the phrase twice so it feels supportive, not punitive.