Question re: NP and clinical experiences...

The money should be going to develop more preceptors and ensure that the ones that are there are doing a good job. Preceptors should want to teach not simply look at it as a way to make more income. There are some PA (and MD) programs that reimburse preceptors but in my opinion it doesn't always lead to a good rotation.

I agree with most of what you say, but you sound like (I'm pretty sure it's not really what you mean) you're starting off with the ol' "martyrdom/calling" argument -- nurses (and other healthcare providers) should do their jobs simply for the love of helping others, and not expect any kind of compensation for it ... Of course preceptors should want to teach, and I assure you that adjunct faculty anywhere do not get paid enough for the effort required to "simply" see it as an easy way to make more money. But if teaching is an important, worthwhile professional function, then people should get paid for doing it! I don't see it as an either/or question -- either someone is a good preceptor and, therefore, willing to precept for free, or, if they want to get paid, they must not be doing it for the "right" reasons and must not be a good preceptor -- people who are good at educating/precepting and are willing to put forth the extra time and effort to do so should be compensated fairly for doing so.

To some degree I agree that people who are good at educating should be paid fairly. However, the key to this is the word fairly. In reality a program cannot compensate fairly but instead compensates at some lower rate. The concept in psychology is know as cognitive dissonance:
http://findarticles.com/p/articles/m...g=content;col1

The classic work on this was done in 1957. There is another industrial psychology article that worked this angle in different ways. Three groups of people were asked to do a task. One group was asked to volunteer. Another group was paid a dollar for the task. The final group was paid $20. Unsurprisingly, the group that was paid more did more work than the group that was paid less. However, the group that "volunteered" did the most work. It has its roots in social cognition and how we see ourselves. Similarly from the student side when the students were told that the teacher was either paid or volunteer. The students perceived the volunteer teacher as more motivated and a better teacher.
http://psp.sagepub.com/cgi/content/abstract/18/2/245

All of this is a long way of saying that there is good data that the best way to provide a good educational environment is to use volunteers that are there because they want to volunteer (in my opinion).

Ideally a person should volunteer because of duty to the profession and a duty to make sure that the students get a good educational opportunity. I have some extrinsic compensation in that I can add adjunct faculty or some such to my CV (which gets looked at every year). In addition my certifying agency gives me hour for hour category II CME every year for precepting students so there is some reward there. In the end I precept because in the past another PA or MD or NP took the time to precept me and I'm simply paying it forward. A financial reward would simply smack of desperation.

David Carpenter, PA-C

Well then, David, why stop with just precepting?? Why not do your "regular" job on a voluntary basis? Why don't we all provide our professional services on a voluntary basis and live off charity? We could beg on the streets in our spare time (our limited spare time, after we worked harder at our regular job than we would have if we were getting paid a reasonable wage). I see the dawning of a beautiful new world ...

If I work for free then I can't pay off my student loans. Then I can't precept. Its a vicious cycle. On the other hand I'm in a job which I like and where I am in the top 90th percentile in pay, and I'm considering applying for a job to help run a PA program in a foreign country at 2/3 the salary. What does that make me.

David Carpenter, PA-C