Petition to Force NP Programs to Provide Preceptors

[futureeastcoastNP]

I've been reading through some threads, and it seems a large number are people desperately looking for preceptors so they can complete clinicals. I wondered how widespread this problem is, and starting searching online - my results were astounding. There are literally hundreds (maybe thousands) of stories online of people having to drop out of their NP program because they cannot find preceptors. This is absolutely unacceptable. Why is it okay for a program to take your money and not actually provide your education? It's bad for education quality, it's bad for professional perception, and it's just deplorable.

I would like to start a petition to the AACN/CCNE asking them to require NP programs to set up clinical rotations for students in order to gain accreditation. The whole purpose of accreditation is to ensure programs are competent and teaching what needs to be taught, and they are doing potential students a huge disservice by allowing programs to exist that do not meet these standards.

Would anyone else be willing to sign this petition?

[zmansc, ASN, RN]

What med/PA school? You aren't talking about North Dakota are you?

Nope, not ND. UNM.

[zmansc, ASN, RN]

I agree that there is a chance that someone can have lackluster clinical but not because you have to find your own clinicals, but more so because the preceptor is not a good or willing teacher or time constraints of the preceptor make it impossible to provide a good experience. I kind of favor finding your own clinicals as an option instead of a requirement because it allows you to tailor your clinical experience, I just wished schools provide better support for those that find it difficult to find a willing preceptor. I know my program had a 3 step approval process for approving preceptors, to make sure therapy were appropriate for an adult health primary care np experience p, with the advisors checking their credentials before approving them. Going to a school that finds preceptors for you does not guarantee that you will get an appropriate experience either. I know of people who were in primary care np programs and did not have any primary care clinical placements; every placement was in an acute setting. I also know people who were placed by their school with preceptors who gave them no oversight at all.

Exactly. It's not how the preceptors are identified, it how they are vetted and the clinical setting is managed by the school.

Furthermore, there are schools that run the gamut, on one end they provide the preceptors and do all the work for the students. In the middle they provide preceptors within certain distances, with certain restrictions but students can find their own preceptors and if approved use those. On the other end, the program requires the students to find their own preceptors. I'm sure that each of these has it's own affect on the cost of the program as well. So the students can pick the program that meets their needs.

[futureeastcoastNP]

So, in fact, the way my program and the med school and PA programs I'm talking about find preceptors is in fact very similar.

With one very, very important distinction: with the PA and MD programs, selecting your own preceptor is simply an option. With most of the NP programs, it is a requirement and the student must either do it or leave the program. That's an important point. I would have no issue with NP programs allowing students to find their own preceptors if they could ALSO choose to simply let the school set everything up....but 9 times out of 10 the school refuses to lift a finger - if the student fails to find their own site, they do not graduate. A professional program training healthcare providers should not be run like that.

[Dranger]

Nope, not ND. UNM.

So one program out of hundreds? I have tons of PA/med school friends and not ONE of them had to set up their own clinicals or preceptors. Everything was rigidly laid out in structured clerkship fashion.

I don't see how one anecdote is enough to suddenly say you can even sufficiently start comparing med school rotations to online/formal NP programs without preceptors...I mean really?

[zmansc, ASN, RN]

With one very, very important distinction: with the PA and MD programs, selecting your own preceptor is simply an option. With most of the NP programs, it is a requirement and the student must either do it or leave the program. That's an important point. I would have no issue with NP programs allowing students to find their own preceptors if they could ALSO choose to simply let the school set everything up....but 9 times out of 10 the school refuses to lift a finger - if the student fails to find their own site, they do not graduate. A professional program training healthcare providers should not be run like that.

And since there are many programs that do not require a student to put in any effort towards finding preceptors, that distinction is irrelevant. If you don't want to go to a program that allows you this option than don't, but there is no reason why you should try to take this option away from me.

Oh, and since you continue to rant without any facts, please provide facts on this 9 out of 10, or any of the many other factless claims you have made in this thread that I have asked for fact on. For example, that this leads to poorer outcomes?

[zmansc, ASN, RN]

So one program out of hundreds? I have tons of PA/med school friends and not ONE of them had to set up their own clinicals or preceptors. Everything was rigidly laid out in structured clerkship fashion.

I don't see how one anecdote is enough to suddenly say you can even sufficiently start comparing med school rotations to online/formal NP programs without preceptors...I mean really?

You said that no MD programs would exist that did this, a statement that has been proven false like most of your other claims.

I also requested that you provide data to prove your claim that the current NP model is inferior to the MD model. I see that you ignored that request because there is no data that proves this or anything of that nature. Therefore, it seems ridiculous that you wish to take this option away when there is no evidence to prove that it has any negatives and it does offer a level of flexibility that allows schools like mine to provide an education to students who reside in locations they would otherwise be unable to offer that education to.

I'm sorry that some have applied to programs that do not provide preceptors, knowing, or at least having this information available to them, and then been surprised that preceptors are not provided. That is too bad. But it is not a reason to take that option away from those of us who researched our schools and looked for schools that would allow us to utilize this feature of NP education so that we can obtain our education in our home community.

[chartreuse]

You said that no MD programs would exist that did this, a statement that has been proven false like most of your other claims.

I also requested that you provide data to prove your claim that the current NP model is inferior to the MD model. I see that you ignored that request because there is no data that proves this or anything of that nature. Therefore, it seems ridiculous that you wish to take this option away when there is no evidence to prove that it has any negatives and it does offer a level of flexibility that allows schools like mine to provide an education to students who reside in locations they would otherwise be unable to offer that education to.

I'm sorry that some have applied to programs that do not provide preceptors, knowing, or at least having this information available to them, and then been surprised that preceptors are not provided. That is too bad. But it is not a reason to take that option away from those of us who researched our schools and looked for schools that would allow us to utilize this feature of NP education so that we can obtain our education in our home community.

It's called common sense. Just because something doesn't have mounds of data behind it doesn't mean you can't logically compare facts and come to a conclusion. A program that thoroughly vets its preceptors vs a program that allows you to pick any NP you want... Let's logically think about which choice has a greater likelihood of higher caliber clinical experiments.

I'm interested in eventually becoming a NP, and of course I think the current NP model is inferior to the MD model. How is that even a question? Disregarding the whole 11+ years of education and training thing, MD programs have much stricter requirements for accreditation than NP programs.

And yes, it would be an ideal world if event could obtain the level of education they desire in their current residence and not have to sacrifice to obtain NP licensure by moving, but that's just not realistic. The question shouldn't be about a students desire to obtain education in their home community, but what is best for both the patients whose lives are in our hands and also the future of the NP role and viability as a solid career option.

[Dranger]

You said that no MD programs would exist that did this, a statement that has been proven false like most of your other claims.

I also requested that you provide data to prove your claim that the current NP model is inferior to the MD model. I see that you ignored that request because there is no data that proves this or anything of that nature. Therefore, it seems ridiculous that you wish to take this option away when there is no evidence to prove that it has any negatives and it does offer a level of flexibility that allows schools like mine to provide an education to students who reside in locations they would otherwise be unable to offer that education to.

I'm sorry that some have applied to programs that do not provide preceptors, knowing, or at least having this information available to them, and then been surprised that preceptors are not provided. That is too bad. But it is not a reason to take that option away from those of us who researched our schools and looked for schools that would allow us to utilize this feature of NP education so that we can obtain our education in our home community.

My claims are false? Lol... K.

It's common sense just as another poster said. If the NP model was just as good or better why would anyone go to med school except to practice surgery:

NP:

-Close to 0 barriers to entry (GRE, cash, RN or not), if you have the cash you can get into a program

-A large and growing percentage are online, for-profit diploma mills with find your own clinicals

- One board exam

- No required residency, with only a handful of 12-15 months residencies available

-If NP programs required the same pre reqs as pre-med I guarantee a large percentage of candidates would be weeded out

MD:

-Rigorous science pre-req curriculum with MCAT as equalizer

-2 full years didactic learning in medicine with all major topics covered

-Provided clinicals, clerkships and predictable rotations at participating hospitals

-3 board exams COMLEX/USMLE for MD license and residency

-3-7 year mandatory residency (RESIDENCY IS NOT EVEN GUARANTEED)

-Fellowships, externships ect

The above comparisons aren't to say NPs are not good provides as the ones I have met were pretty good after years of experience, however even they admitted major faults in the growing NP "industry"

Everything about the current NP trend screams flexibility and quickness. How many thread on here focus on cost, barriers to entry/experience and length of program alone compared to quality?

Therein lies your facts.

[futureeastcoastNP]

Its so bizarre to me that people defend lackluster NP programs. These issues - online for profits, self administered clinicals, etc - are the reason physicians don't respect NPs. Its the reason many educated patients request only MD providers. Its the reason the field is becoming over saturated with poor providers.

Absolutely nothing good comes from supporting these joke practices. I understand why for profit school stockholders support it, but why NPs and students? Are you people honestly incapable of understanding what happens when you flood a field with thousands of inexperienced, inept, poorly trained graduates?

[BostonFNP, APRN]

It's called common sense.

I'm interested in eventually becoming a NP, and of course I think the current NP model is inferior to the MD model. How is that even a question?.

Common sense and science don't always go hand-in-hand. The truth is in practice, common sense, can lead you to a false conclusion and may endanger yourself or your patients.

What does the research show about NP vs MD outcomes? Is there a statistically significant difference in outcomes as a result of the educational and training difference between NP and MD?

[BostonFNP, APRN]

I don't like the way NP education is headed. Quality programs are starting to be overshadowed by the "trifecta" programs and I have some serious reservations about education model some program now use, and I have serious reservations about the clinical experience aspect of programs that do no find preceptors and/or control preceptors. I also have a problem with the shear number of students being admitted to these programs (when I went to school my NP program had more applicants than and accepted less than the medical school across the street).

But there is a issue here on AN of those without any experience in the education or practice of NPs fabricating facts, and this doesn't help the issue.

[chartreuse]

Common sense and science don't always go hand-in-hand. The truth is in practice, common sense, can lead you to a false conclusion and may endanger yourself or your patients.

What does the research show about NP vs MD outcomes? Is there a statistically significant difference in outcomes as a result of the educational and training difference between NP and MD?

I certainly don't apply the common sense argument to the intricacies of diagnosis and treatment in practice. From my latest research on the topic, outcomes from NP providers have passed the muster test. My argument for common sense was directed toward the apparent argument that there has to be mounds of statistical data to prove some of the "benefits" of some NP programs (mostly online education, little oversight in selecting preceptors, minimal clinical hours) are not as beneficial as more rigorous requirements offered at the vast majority of PA and MD programs. There are several reasons I am not pursuing either of those options, but most are logistical and not because of the quality of education or format of instruction, which I do believe is superior.

I appreciate the emphasis on having data and statistics to prove this, but I'm not sure who/what organization would pay to gather this type of information on a statistically significant large scale. If anyone knows of any studies related to this, I'd be interested to see them.

I hope this response makes sense. I'm on my phone and I woke up too early today. ?