Any preceptors??

[bayouchick02]

How have you all gone about finding preceptors for clinicals in the past?? We're responsible for finding our own, but I'm having a hard time. Most places have told me they're not affiliated with the university, so now I feel like I dont know what to do!! It seems as if my fellow classmates know someone who is already an NP/PA, so they aren't having much of a problem.

[pedspnp]

are you licensed in illinois if so try southern illinois healthcare foundation, in east st louis, also try grace hill community health center in st louis,

[linearthinker, DNP, RN]

I guess my concern would be making sure that students are exposed to what they need in the clinicals. My N is small but I've precepted 6 NP students and 4 PA students over the last three years. The PA students have been from four different programs, but it all works the same. The program or the studenty contacts me. I send them my CV and other information on the practice (types of patients, age breakdown, conditions seen etc). They get back to me with what the students needs are. I've had one student turned down because the program said he had two much inpatient experience and needed outpatient time (we hooked him up with one of the NPs that was doing primarily outpatient). 2-3 months before the student arrives I get information on the student including what the clinical advisors think that they need to work on. We then develop learning objectives for the rotation. For required rotations these are already developed but since rotations with me are elective I have to work with the coordinators to develop objectives (although I usually recycle them from other students and tailor them to the weaknesses). At the end of the rotation I have to do a detailed analysis of the student with strengths and weaknesses. They usually send my the Typhon logs to verify also.

For NPs its all over the place. For two programs that I work with its very similar to the PA process. Contact the school, information on the patients etc. For other programs its much less. I had one student ask me if they could do a rotation and the next thing I knew, they showed up. I asked if they had learning objectives- no. Specific thing they wanted to do - no. They just needed their hours logged. This has been my experience with the other half of the programs. The students are simply there to log their hours. My evaluation for these students consists of signing the log sheet. Nothing else. As a result I've become selective about which programs I will work with. If the program can't tell me what the learning objectives are (or work with me to develop them) then I have no interest. Add to that a blanket prohibition on MEPN students and I only work with 2-3 programs that I think do a good job.

The problem that I see is that among NP programs there is a dichotomhy. Some programs care about the product of the student they produce and some don't. For an employer its hard to tell the difference. Without true standards you get the situation you had in Texas where two students with the same degree had vastly different clinical qualifications. It also allows less scrupulous schools to dilute the brand as it were by turning out less than prepared students.

David Carpenter, PA-C

I think these are great points. My school is like that which you describe (requiring the specific objectives, etc). Neither of my preceptors in the first 2 rortations had ever had a student from my school before, though they had lots of others, and they both said they had NEVER had to do all the work to precept that they had to do for my school, and frankly they seemed to resent it. One said he would never take a student from my school again b/c it was too much work for him. He wants the other kind of student you described, the ones that just show up and log hours. Of course, he was a physician, and I think not terribly invested in the quality of NP education, lol, and in hindsight, the worst preceptor I had for several reasons. One of my later preceptors only takes students from my school and one other for the same reasons you describe. There seems to be a lot of agreement with your comments that the composition and quality of programs varies widely. I think all this could be solved by NP residencies run much like med school residencies.

My school assigned us, we didn't really get to choose, but we could make requests. We also had the option to refuse an assignment if we had a good reason. We were not permitted to do clinic hours in an urgent care or ED, they had to be primary care 100% of the time. I would have liked to do an ED though.

My school had specific requirements for the composition of the patient population, such and such a percentage of insured, medicare/caid eligible, etc, and had to have specific percentage breakdowns of the most common ICD-9 codes in the practice. They also had strict requirements for the preceptors re: years in practice, degrees, specific patient experience, etc. I did request a certain place for one roation in womens health, and it was such a gigantic PITA I regretted not just going wherever they sent me. It took almost 6 months to get the practice and then the preceptor vetted and "passed" by the school, and then get a legal contract in place. We were encouraged to participate in medical missions, but not allowed to count those hours toward clinic time. Nor were we allowed to do clinic time at any practice we had ever worked in, been a patient of, or worked with an affiliate of (such as the many primary care practiced owned by the conglomerate of the hospital I was working for as an RN). There were alot a hoops to jump through, and at the itme it was frustrating, but in retrospect it wasn't that big a deal and I got a great education. I do think coreOs thoughts are valid and these ideas need to be incorporated into some standardization of NP education.