Schools that require you to find a preceptor (rant)

[Telenurse1990]

I'm currently applying for NP school and I need to vent about a few things.....

1. It's unacceptable that a school requires students to find their own preceptors. Ridiculous, unacceptable, they should not even be in business (traditional or for profit). If I'm going to pay over 30,000 (on the low end) for an education and have to find my preceptors, what is it i'm paying for exactly? For the love of god, stop applying to these schools. I know someone personally who literally cannot find a preceptor in his area and is about to quit the program due to this. His school offers very little if any support.

2. I hear nurses gloat about programs that don't require any campus visits and have no mandatory login times. You are training to do the same job as a physician. Literally. I would never attend a program that required as little as possible from it's students. You are training to operate in a similar fashion to a physician, but are excited about doing a fifth of the work.... I have only applied to schools with live class rooms and login times for actual classes. I don't understand the appeal of a school advertising that they expect almost nothing from you. Georgetown (despite it's outrageous cost) is an example of an online program I would deem acceptable (I also know a few of their grads that are working and very competent NPs) because of it's login times, finding clinical placement and campus visits.

3. For the love of god, get some experience. Stop filling up schools with new grad RNs with less than 1 year of irrelevant experience. I've been a nurse for nearly 8 years, and I still considering waiting until the 10 year mark. It's just so crazy that people with no experience go to NP school. I'm sure there are some great ones out there, but I haven't met any that weren't RNs for years.

I know this post comes across as "angry" but i'm just frustrated with the low standards that the NP profession has adapted. I was so excited to apply. I did my time on the floor, worked really hard in my specialty and I believe i'm a qualified candidate. When I started researching and seeing what the standards are, it just aggravates me. I know some wonderful NPs out there who are very capable providers. I feel that the low standards are ruining it for the future of the profession. It just seems like these programs care about the money rather than graduating competent NPs. This whole experience has had me considering re-taking my science classes and applying for PA school.

Anyways, any open discussion is appreciated.

[lwsoccjs]

Which boards did you take, out of curiosity?

The AANP and ANCC FNP pass rates are in the 75-85% pass rate historically. In comparison the USMLE step 1 is low-90%, step 2 is 98%, step 3 is 91-98%, but there is a much more competitive and rigorous admission criteria. I often worry (having taken both the AANP and ANCC exams) that the 20+% failure rate is indicative of a problem with grossly incompetent people qualifying to take the boards rather that rigorous examination.

There is another solution: practicing NPs start refusing to precept subpar program students. I sent one student away his first day and tbh it wasn't his fault (I had agreed to take a student from the program because the program paid $1500/semester): he showed up ad had never had a single graduate class on how to do a proper H&P. He couldn't do a physical exam or elicit a history. I don't have time in practice to teach that and see patients.

The ANCC in my eyes is in no way an acceptable way to judge a "provider" to tell the public you can provide care and are considered competent. With 50% of the test being non-clinical that is laughable. Excluding pilot questions, that leaves 88 questions on clinical and needing around a 63% to pass on those, you need 55/88 yikes. I will be taking the AANP in 2 1/2 months. So I preface my statements that yes I have not taken the test and will be more than happy to state the scores when I am done. But having already taken the PSI test, Fitzgerald, Rosh review, Hollier, Barkley, FNP mastery, pocket prep FNP,, Leik, and others so I have a solid foundation of the quality of questioning. I have also been working on the AAFP family medicine board review questions that are available if you know how to access them for comparison.

I would agree that continuing to limit preceptors is another answer to the over production of NP's. Actually a very effective one as the same procedure is used for Residency's for MDs. Finally, yes I 100% agree that the 20% fail rate probably is contributed by students that probably shouldn't have made it that far due to lack of barrier to the profession.

[BostonFNP, APRN]

The ANCC in my eyes is in no way an acceptable way to judge a "provider" to tell the public you can provide care and are considered competent. With 50% of the test being non-clinical that is laughable. Excluding pilot questions, that leaves 88 questions on clinical and needing around a 63% to pass on those, you need 55/88 yikes. I will be taking the AANP in 2 1/2 months. So I preface my statements that yes I have not taken the test and will be more than happy to state the scores when I am done. But having already taken the PSI test, Fitzgerald, Rosh review, Hollier, Barkley, FNP mastery, pocket prep FNP,, Leik, and others so I have a solid foundation of the quality of questioning. I have also been working on the AAFP family medicine board review questions that are available if you know how to access them for comparison.

I would agree that continuing to limit preceptors is another answer to the over production of NP's. Actually a very effective one as the same procedure is used for Residency's for MDs. Finally, yes I 100% agree that the 20% fail rate probably is contributed by students that probably shouldn't have made it that far due to lack of barrier to the profession.

Woah don't get that cart too far in front of the horse. It sounds like you are preparing well but the one student I have ever know that failed the board exam went into it way over confident (my n of 1). The AANP exam is more clinical (though the ANCC exam is not 50/50 as suggested) but is also statistically the easier exam. As you will discover in practice, there is more to being a competent as a provider than only clinical questions.

And you only get a score if you fail so let's hope you don't have a score to share with us!

[lwsoccjs]

Lol, fair. I'll be fine, but always appreciate the encouragement. And the pass rates are basically equivalent so let's not get into semantics.

[BostonFNP, APRN]

Lol, fair. I'll be fine, but always appreciate the encouragement. And the pass rates are basically equivocal so let's not get into semantics.

It could be a board question how you'd tell if there is signifance between the two!

[Jules A, MSN]

Even good programs really struggle with maintaining faculty. Quality programs know that they need their faculty to be practicing providers but most NPs can make (far) more in clinical practice than teaching and very few practicing providers have an "extra" 30-40+ hours a week to be a full time faculty.

Its a shame especially because the hours required to retain the NP license are minimal. A majority of the instructors I have worked with when I was teaching or precepting have minimal if any real practice experience. Your students are lucky if you are teaching and still actively working as a NP.

[Jules A, MSN]

The ANCC in my eyes is in no way an acceptable way to judge a "provider" to tell the public you can provide care and are considered competent. With 50% of the test being non-clinical that is laughable. Excluding pilot questions, that leaves 88 questions on clinical and needing around a 63% to pass on those, you need 55/88 yikes. I will be taking the AANP in 2 1/2 months. So I preface my statements that yes I have not taken the test and will be more than happy to state the scores when I am done. But having already taken the PSI test, Fitzgerald, Rosh review, Hollier, Barkley, FNP mastery, pocket prep FNP,, Leik, and others so I have a solid foundation of the quality of questioning. I have also been working on the AAFP family medicine board review questions that are available if you know how to access them for comparison.

I would agree that continuing to limit preceptors is another answer to the over production of NP's. Actually a very effective one as the same procedure is used for Residency's for MDs. Finally, yes I 100% agree that the 20% fail rate probably is contributed by students that probably shouldn't have made it that far due to lack of barrier to the profession.

Lol I can't vouch for your figures but I was ready to hit the Like? button. Although I accept the board exams are the only way they have to actually certify us the AANC, I took two, Boston FNP :) were ridiculously easy. Although no first hand knowledge I'm doubtful the AANP is markedly more challenging. I suspect the MD exams have a stronger gene pool to begin with so comparing their percentages to ours probably not a fair match. I really think we need to raise the bar.

[lwsoccjs]

Its a shame especially because the hours required to retain the NP license are minimal. A majority of the instructors I have worked with when I was teaching or precepting have minimal if any real practice experience. Your students are lucky if you are teaching and still actively working as a NP.

I have read the accreditation requirement stating you need to have faculty that are active providers. So let me ask everyone this. How exactly does that effect your education in a distance learning education with minimal or no interaction from instructors. If any interaction its regarding discussion boards etc. How exactly are you benefiting or gaining from the experience of the faculty with assigned readings as your educational tools. I would be curious someone argue or give me an opposing thought. I would go as far to say that the current NP curriculum that the higher ups would argue on behalf of "experience and actively working faculty" does little to nothing to actually help the student. I am talking in regards to the many schools that are distance/discussion/money=degree schools. It's sad. They include the fact that the teachers need to actual provide care to patients in hopes that it allows the passing of knowledge but I'm not quite sure it allows works like that.

[Jules A, MSN]

It could be a board question how you'd tell if there is signifance between the two!

Because God forbid they included more than the 6 medication and diagnostic questions, lol.

[Jules A, MSN]

They include the fact that the teachers need to actual provide care to patients in hopes that it allows the passing of knowledge but I'm not quite sure it allows works like that.

You make good points however the truly valuable things, the "pearls" if you will, I learned and continue learning from came from instructors and colleagues who were active and competent not from the book smart twits forcing impractical nursing fluff down our throats.

[lwsoccjs]

Lol I can't vouch for your figures but I was ready to hit the Like? button. Although I accept the board exams are the only way they have to actually certify us the AANC, I took two, Boston FNP :) were ridiculously easy. Although no first hand knowledge I'm doubtful the AANP is markedly more challenging. I suspect the MD exams have a stronger gene pool to begin with so comparing their percentages to ours probably not a fair match. I really think we need to raise the bar.

Thats funny. Yeah, I agree the opposing board is not the answer. My main point was if I am going for a clinical/provider career I would atleast liked to be certified by a clinical/provider test which I do not think really either represents well but atleast aanp does a little better. Finally, agreed on your settlement regarding your last two sentences :). Cheers.

[djmatte, ADN, MSN, RN, NP]

I have read the accreditation requirement stating you need to have faculty that are active providers. So let me ask everyone this. How exactly does that effect your education in a distance learning education with minimal or no interaction from instructors. If any interaction its regarding discussion boards etc. How exactly are you benefiting or gaining from the experience of the faculty with assigned readings as your educational tools. I would be curious someone argue or give me an opposing thought. I would go as far to say that the current NP curriculum that the higher ups would argue on behalf of "experience and actively working faculty" does little to nothing to actually help the student. I am talking in regards to the many schools that are distance/discussion/money=degree schools. It's sad. They include the fact that the teachers need to actual provide care to patients in hopes that it allows the passing of knowledge but I'm not quite sure it allows works like that.

I can't speak for other schools, but frontier used a solid mix of discussion, presentations, and group interaction to facilitate learning on top of self study. Instructors needed to offer a range of interaction from live sessions that were always recorded to study sessions. Group projects were common which facilitated learning through that method of interaction.

Looking back, there were few "discussion boards" we participated in and if there were it was regarding papers we wrote or some other form of presentation we created either solo or in groups. They had exceptional use of the community of inquiry framework in ensuring the school met educational needs.

Combined with in person requirements for orientation, bridge crossing, and clinical bound (pre clinical checks), we were able to put faces on our classmates/teachers and actually grow bonds with them throughout our education.

[BostonFNP, APRN]

I have read the accreditation requirement stating you need to have faculty that are active providers. So let me ask everyone this. How exactly does that effect your education in a distance learning education with minimal or no interaction from instructors. If any interaction its regarding discussion boards etc. How exactly are you benefiting or gaining from the experience of the faculty with assigned readings as your educational tools. I would be curious someone argue or give me an opposing thought. I would go as far to say that the current NP curriculum that the higher ups would argue on behalf of "experience and actively working faculty" does little to nothing to actually help the student. I am talking in regards to the many schools that are distance/discussion/money=degree schools. It's sad. They include the fact that the teachers need to actual provide care to patients in hopes that it allows the passing of knowledge but I'm not quite sure it allows works like that.

If your lectures aren't conveying real-world experience of the lecturer then you should ask for your money back because they aren't preparing you for practice. If a program is "teaching" NP students by having them read assigned readings and do discussion posts then those students are not being prepared for practice, at least in my opinion. Lectures should integrate what is covered in assigned readings applied into practice. Practice experience is incredibly important for that.