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Preceptor Handbook

Adult Gerontology- Primary Care Nurse Practitioner (AGPCNP) preceptor packet

Thank you for agreeing to precept this year! As a preceptor you have a unique opportunity to facilitate a student’s professional development

This information is intended to assist you in helping your student to meet clinical competency goals. Since evaluation is an ongoing process, it is recommended that both the preceptor and the student participate in open discussion throughout the semester regarding progress made towards meeting clinical objectives.

At the mid-semester and at the end of the semester you will be asked to perform an evaluation of the student. This will be done electronically, and you will be sent information during the semester regarding how to access the online evaluations. Please include validating and constructive comments in the sections provided. We recognize that it is impossible to be outstanding in all areas and hope to use the evaluation tool to build on the areas the student excels in and assist him/her to build strengths in other areas. Your input is a vital tool enabling the student to reach their potential.

NUR 558 Primary Care I Practicum (180 hours, Spring)

Course code: NUR 558
Credits/hours: 180 hours
Term: Spring

Course description

Extension of knowledge of primary care management of acute illness in the adult and older adult through precepted clinical experiences. Students assess and manage commonly occurring acute problems and acute exacerbations of chronic illnesses to promote health, assess and reduce risk, and guide adults and older adults who are experiencing acute illness. Student progression to an increasingly independent role as an Advanced Practice Nurse is required. Course development was guided by the NONPF Competencies (2022) and Adult-Gerontological Primary Care Nurse Practitioner Competencies (2016).

Objectives

  1. Synthesize relevant theories and research from nursing, social sciences, and biophysical sciences as the basis for advanced practice nursing. (PO: 1, 6, 7, 8)
  2. Identify advanced health assessment skills for health promotion and risk reduction with awareness of age, development, genetics, community, and culture. (PO: 2, 4, 6, 7, 8)
  3. Establish differential diagnoses and appropriate treatment modalities based on assessment data. (PO: 1, 2)
  4. Collaborate with patients, families, and an interdisciplinary team to coordinate safe, effective care from adolescence to adulthood. (PO: 1, 2, 4, 6, 7, 8)
  5. Implement the role of the entry-level adult nurse practitioner with increasing independence throughout the semester. (PO: 1, 2, 4, 6, 8, 9)

Prerequisites & co-requisites

Prerequisites

  • NUR 500 Pathophysiological Bases for the Advanced Practice Nurse
  • NUR 552 Advanced Health Assessment for the Advanced Practice Nurse

Co-requisites

  • NUR 553 Pharmacology for the Advanced Practice Nurse
  • NUR 557 Primary Care I for the Advanced Practice Nurse

NUR 657 Primary Care II Practicum (180 hours, Fall)

Course code: NUR 657
Credits/Hours: 180 hours
Term: Fall

Course description

In this practicum, students expand their management of acute illness and acute exacerbations of chronic illness in the adult client through a clinical placement with a nurse practitioner or physician preceptor. Students assess and manage commonly occurring acute problems and acute exacerbations to promote health, assess and reduce risk, and guide adults experiencing acute illness. Emphasis is on advanced assessment, diagnosis, and treatment planning, with progression toward increased independence. Professional, legal, and political dimensions of the role are addressed.

Objectives

  1. Apply relevant theories and research from nursing, social sciences, and biophysical sciences as the basis for advanced practice nursing. (PO: 1, 2, 4)
  2. Demonstrate advanced health assessment skills in obtaining health histories and focused examinations to aid diagnosis and treatment. (PO: 1, 3, 4)
  3. Provide health promotion and disease prevention services considering age, gender, community development, genetics, and culture. (PO: 3, 4, 6, 7, 8, 9, 10)
  4. Apply critical thinking in increasingly complex clinical situations requiring assessment, diagnostic, and decision-making skills. (PO: 1, 2, 3, 4, 5)
  5. Collaborate with patient, family, and interdisciplinary team to coordinate and provide safe and effective care. (PO: 1, 4, 5, 10)
  6. Implement the entry-level adult NP role with increasing independence throughout the semester. (PO: 1, 2, 10)
  7. Identify and integrate teaching/coaching activities in the care of adolescents through end of life and their families in the community. (PO: 8, 9, 10)
  8. Collaborate with patients, families, and the health care team to deliver holistic care to adolescent and adult through end of life and their families. (PO: 1, 8, 9, 10)

Prerequisites & co-requisites

Prerequisites

  • NUR 500 Pathophysiological Bases for the Advanced Practice Nurse
  • NUR 552 Advanced Health Assessment for the Advanced Practice Nurse
  • NUR 553 Pharmacology for the Advanced Practice Nurse
  • NUR 557 Primary Care I for the Advanced Practice Nurse
  • NUR 558 Practicum for Primary Care I for the Advanced Practice Nurse

Co-requisites

  • NUR 656 Primary Care II for the Advanced Practice Nurse

NUR 659 Primary Care II Practicum (180 hours, Fall)

Course code: NUR 659
Credits/Hours: 180 hours
Term: Fall

Course description

Through precepted clinical experiences, students assess and manage chronic illness and acute exacerbations of chronic illnesses to promote health, assess and reduce risk, and guide adults and older adults living with chronic illness. Continued development of adult/gerontology NP skills in patient assessment, diagnosis, and treatment planning is emphasized.

Objectives

  1. Apply relevant theories and research from nursing, social sciences, and biophysical sciences as the basis for advanced practice nursing. (PO: 1, 2)
  2. Use complex assessment, diagnostic, and decision-making skills in the care of individuals with chronic illness. (PO: 1, 2, 5, 6, 8)
  3. Collaborate with patient, family, and interdisciplinary team to integrate evidence-based strategies for lifestyle change and health promotion, including complementary interventions. (PO: 1, 2, 3, 10)
  4. Assumes increasing responsibility and accountability for continued professional development. (PO 1, 2, 10)

Prerequisites & co-requisites

Prerequisites

  • NUR 500 Pathophysiological Bases for the Advanced Practice Nurse
  • NUR 552 Advanced Health Assessment for the Advanced Practice Nurse
  • NUR 553 Pharmacology for the Advanced Practice Nurse
  • NUR 557 Primary Care I for the Advanced Practice Nurse
  • NUR 558 Practicum for Primary Care I for the Advanced Practice Nurse
  • NUR 656 Primary Care II for the Advanced Practice Nurse
  • NUR 657 Practicum for Primary Care II for the Advanced Practice Nurse

Co-requisites

  • NUR 658 Chronic Management for the Advanced Practice Nurse

Course evaluations & assessments

Clinical practicum, case study presentations, weekly logs, weekly clinical seminar, and OSCE comprise the methodology for the clinical practicum. Students must pass all evaluation methods to successfully complete this course.

Evaluations include:

  1. Clinical practicum
  2. Seminar with weekly presentations
  3. Objective Structured Clinical Examinations (OSCE) (Pass/Fail)
  4. Weekly logs/notes and documentation
  5. Completion of AG-PCNP Competencies
  6. Submission of all evaluations (including: self, site, preceptor, faculty and course evaluations)

Program goals for each student

  • Completing NUR 558, NUR 657 and NUR 659 with an average passing grade of 3.0 or above.
  • If students are not meeting these programmatic goals, clinical faculty will meet with students to develop a plan to achieve these goals. Each preceptor, graduate faculty, and student are expected to complete an evaluation and submit this at the end of the semester. The clinical faculty will determine the student’s grade for the clinical component with input from the preceptor.
  • Students are expected to complete 540 clinical hours for the spring, fall and spring semesters. Students are required to complete a minimum of 500 direct care hours to meet requirements to sit for national board certification exam(s). These hours are direct patient care only.
  • Students should contract with their preceptor(s) the number of days and hours per week. Students are expected to keep up with their hours. Please reach out to the clinical faculty and/or course faculty with any issues or concerns so that a plan can be instituted.

Guidelines for clinical placements

Students are expected to stay in the clinical sites assigned over the specified time period (unless otherwise negotiated with the clinical instructor and course coordinator). Students will be allowed to attend observational experiences at their site, or a designated contracted practicum site arranged with the approval of the clinical instructor. These will not count towards your clinical hours as clinical hours must be direct patient clinical hours. It is recommended that students keep such observations to one-time clinical experiences to a maximum of 16 hours each semester.

Placements must meet the following criteria:

  • Students will develop a plan for clinical hours/sessions per week at the clinical site(s) based on availability of preceptor.
  • Documentation of the clinical hours are tracked in Typhon.
  • Preceptors must have a minimum of two years clinical practice as an NP, PA or physician.
  • You may not have a placement or specialty experience with a family member.

Student clinical expectations

  1. The student will develop clinical objectives and share with their preceptor at the beginning of the clinical practicum. A copy of these objectives is to be given to the clinical faculty instructor. Objectives are to be reviewed over the course of the practicum to evaluate how they are being met. Objectives may need to be revised throughout the semester.
  2. The number of patients seen by the student daily will be determined by the preceptor in collaboration with the student. This decision will be guided by both patient acuity and student’s current skill level with that patient population. Concerns regarding this can be readdressed with the clinical faculty.
  3. The number of patients seen by the student daily will be determined by the preceptor in collaboration with the student. This decision will be guided by both patient acuity and the student’s current skill level with that patient population. Concerns regarding this can be readdressed with the clinical faculty instructor responsible for the student. As a guide, the student will begin with observation of preceptor for 1st 1-2 clinical days. The student will then be expected to see 2 patients in morning (AM session) and 2 patients in afternoon (PM session). As determined by preceptor and student competency, the student may progress to seeing a maximum of 4 patients per 4-hour session in the first semester and 4- 5 patients per 4-hour session in the second semester.
  4. Students should see patients from adolescents throughout the lifespan and according to the scope of practice of the preceptor.
  5. Students are expected to submit 1 clinical SOAP note weekly with appropriate ROS with pertinent positives and negatives based on the presenting complaint or focus (health maintenance). Bickley 12th edition is a great resource for this. No electronic medical records or checklists will be accepted. Details will be reviewed and reinforced in clinical seminar with instructors.
  6. If the student is unable to attend a scheduled clinical day due to illness or weather, the student is expected to notify the preceptor, the site and their clinical instructor prior to the session (phone or email is acceptable). Please identify the preceptors preferred contact at the beginning of each rotation.

Patient care expectations

  1. Expectations of the patient assessment includes performing histories (including pertinent HPI, medical history, surgical history, allergies, medications, family history, social history, ROS), physical exam, and laboratory or other diagnostic testing.
  2. The student will then make an assessment/diagnosis of the medical problem(s) and needs based on the H&P which will be presented in the history/physical exam format as described above to the preceptor for review.
  3. The student will formulate appropriate plan(s) of care with their preceptor. Plans should include: diagnostic testing, differential diagnoses, therapeutic interventions, education, and follow-up pertinent to the patient and their visit.
  4. The student will document a note of the patient interview/assessment based on whether the assessment is episodic or routine. All notes are to be reviewed in clinical by the preceptor. The preceptor is expected to see the patient after reviewing the findings with the student.

Guide to numbers of patients to be seen in clinical with preceptors for the AG-PCNP track: Students should begin in clinical progression to increase number of patients seen per session. The number of patients seen by the student daily will be determined by the preceptor in collaboration with the student. This decision will be guided by both patient acuity and the student’s current skill level with that patient population. Concerns regarding this can be readdressed with the clinical faculty instructor responsible for the student. As a guide, the student will begin with observation of preceptor for 1st 1-2 clinical days. The student will then be expected to see 2 patients in morning (AM session) and 2 patients in afternoon (PM session). As determined by preceptor and student competency, the student may progress to seeing a maximum of 4 patients per 4-hour session in the first semester and 4-5 patients per 4-hour session in the second semester.

Documentation

Students will track their clinical hours and patient encounters/SOAP notes using Typhon®. Typhon is designed specifically for advanced practice nursing programs where no patient identifiable factors are recorded. Students may need advice from preceptors on billing and diagnosis coding for their logs.

Clinical site visits

Preceptors will be contacted within the first or second week of the semester to discuss student integration into the clinical rotation. Each student will be visited by a UMass faculty at least once during the fall semester and once during the spring semester, as well as other times as needed. The preceptor is encouraged to contact the clinical faculty instructor with any concerns or questions related to the clinical experience.

During the site visit the student may be expected to perform any of the following activities under the observation of the visiting faculty member:

  • Take a comprehensive history
  • Physical examination
  • Formulate differential diagnoses
  • Present the above information to preceptor in an organized manner
  • Implement a plan of care, incorporating education and health promotion strategies

During an initial visit to a site, time will be set aside to:

  • Meet with the preceptor privately
  • Tour the facility
  • Review the program and/or objectives for the course
  • Meet with the preceptor and student together to discuss progress being made towards meeting DNP students

NP student clinical evaluations

Clinical evaluations