Preceptor Orientation Module

Precepting Nurse Practitioner Students

Objectives

By the end of this PowerPoint, the participant can expect to: 1. Develop an understanding of Oklahoma City University’s (OCU) Doctor of Nursing Practice (DNP) program, students, and curriculum.

2. Understand the roles and responsibilities of nurse practitioner preceptors.

3. Review evaluation methods utilized for nurse practitioner students, clinic sites, and preceptors.

Oklahoma City University Doctor of Nursing Practice Program

• Located in Oklahoma City, Oklahoma • Brick and mortar campus with a rich history.

Learn more about OCU • Kramer School of Nursing (KSN) is fully accredited by the Accreditation Commission for Education in Nursing (ACEN).

• Offers the following nurse practitioner specialties: • Adult Gerontology Acute Care • Family Nurse Practitioner, • Psychiatric Mental Health Nurse Practitioner • Pre-licensure options are offered in both the BSN-DNP and Post-Master Certificate tracks

• MSN-DNP (DNP completion) tracks for • Clinical • Community Based Public Health • Executive Leadership • Nurse Educator

Curriculum • The Doctor of Nursing Practice program prepares students for contemporary practice by ensuring curricular content is aligned with national standards and criteria to facilitate student achievement of program learning outcomes (PLOs).

• The curriculum for pre-licensure nurse practitioner tracks aligns with the following competencies: • National Organization for Nurse Practitioner Faculties Nurse Practitioner Role Core Competencies (2022), the Scope and Standards for Adult Gerontology Acute Care Nurse Practitioners from the American Association of Critical Care Nurses (2021), and the American Nurses Association’s Psychiatric-Mental Health Nursing Scope and Standards of Practice (2022).

• The curriculum includes the advanced practice core courses of advanced pathophysiology, pharmacology for advanced practice, and advanced health assessment and diagnostic reasoning, which are standard for nurse practitioner education and required before beginning clinical rotations.

• Students also complete a skills course specific to their specialty track before beginning clinical rotations.

Competencies

• American Association of Critical Care Nurses • https://www.aacn.org/nursingexcellence/standards/aacn-scope-andstandards-for-adult-gerontology-andpediatric-acute-care-nursepractitioners • National Organization of Nurse Practitioner Faculties (NONPF)-Nurse Practitioner Role Core Competencies • https://cdn.ymaws.com/www.nonpf.o rg/resource/resmgr/competencies/20 220825_nonpf_np_role_core_.pdf • American Psychiatric Nurses Association• https://www.apna.org/publications/sc ope-standards-2/

DNP Program Learning Outcomes The DNP graduate of the Kramer School of Nursing will function as a professional nurse able to: • Create and sustain environments exemplifying professional, ethical, and legal nursing practice.

• Design, implement, and evaluate comprehensive education, advanced clinical practice, administration, and/or research programs based upon advanced theoretical knowledge, national practice standards, and/or clinical practice guidelines that promote health, enrich the environment, and advance the nursing profession.

• Examine, implement, and evaluate nursing research and clinical practice guidelines to establish evidence-based advanced clinical practices using critical thinking frameworks for problem solving and making effective advanced clinical, educational, administrative, and/or evidence-based clinical practice policies and procedures.

• Integrate the scholarship of nursing through the promotion of physical, mental, social, and spiritual health across the life span within diverse cultures.

• Integrate research, advanced clinical practice guidelines, and theoretical knowledge to promote interprofessional collaboration and provide transformational leadership within healthcare systems.

• Guide, mentor, and support individuals and groups to create advanced clinical practice environments that exemplify the caring behaviors of acceptance, respect, and empathy.

Oklahoma City University Doctor of Nurse Practice ProgramDiversity, Equity and Inclusion

• KSN’s values align with those of OCU in support of creating an equitable and just educational community.

• OCU is committed to doing the work to create spaces that are diverse, equitable, inclusive, and reflect our position of leadership in the community.

• KSN Students are trained to provide care to patients while celebrating the multiple identities they hold including race, ethnicity, religion, language, ability, place of origin, gender, sexual orientation, socioeconomic status, and other identities.

What is a preceptor?

• A preceptor is typically one, meeting qualifications as determined by the Oklahoma Board of Nursing (OBN) and KSN based on their knowledge, skills, and experience in a specific area, to assist an advanced practice registered nursing (APRN) student with competency in the skill and knowledge of philosophies, goals, policies and procedures, expectations, physical environment, and services in learning the chosen specialty, in a set period of time, determined by institutional requirements.

Who can be a preceptor?

• A preceptor for the KSN nurse practitioner student shall have the following minimum qualifications, as outlined by the Oklahoma Board of Nursing: • At least one year of experience in an appropriate specialty; • Current, unencumbered license in the state of Oklahoma, as an APRN (nurse practitioner (NP) or clinical nurse specialist (CNS)), Medical Doctor (MD), or Doctor of Osteopathy (DO) and practices in a comparable practice focus.

• APRNs, MDs or Dos practicing within federal facilities such as the Veterans Administration or Indian Health Services who hold active, unencumbered, out-of-state licenses may precept NP students.

• PAs cannot precept NP students (per OBN rules).

Additional Preceptor Qualifications • A preceptor for the KSN nurse practitioner student shall have the following minimum qualifications, as outlined by the OBN: • Function as a supervisor and teacher and contribute to the evaluation of the individual’s performance in the clinical setting; • Have demonstrated competencies related to the area of assigned clinical teaching responsibilities; • Or be other credentialed professional as deemed appropriate by the faculty.

What is expected of preceptors?

• Experienced professionals in the health care community possess invaluable talents, knowledge and abilities. When these skills are shared with students, opportunities for learning develop that are unique to the clinical experience.

• The role of preceptor should be undertaken with consideration for the following: • The preceptor, functioning as an employee of the preceptor agency, acts as a teacher and role model for the student. Otherwise, the preceptor is not expected to perform outside of their professional role.

It is the sharing of the reality of this role that is the value of the experience for the student.

• The preceptor experience is best facilitated when the preceptor maintains open communication with the student and faculty. The student should be provided with a verbal appraisal of performance each day they spend with the preceptor.

• At the completion of the clinical experience, the preceptor will provide a written evaluation of the student's overall performance to the course.

Why become a preceptor?

• As a preceptor, you have the unique experience of connecting with and influencing the next generation of clinicians.

• Many preceptors find that while building on their leadership skills, they also reenergize their clinical practice.

• Preceptors are invited to attend KSN continuing education conferences and workshops.

• Preceptors may receive continuing education credit for career ladder advancement and re-certification purposes.

• Preceptors for KSN nurse practitioner students have the opportunity to mentor future healthcare providers who will likely live and work within the same community, enhancing local healthcare quality.

Why Precept KSN NP Students?

• KSN students are closely evaluated, on campus, by faculty dedicated to providing quality education.

• KSN students are equipped with knowledge and skills from didactic courses to prepare them for clinical courses. The curriculum design enables students’ professional readiness for clinical rotations.

• KSN’s NP programs require more clinical hours than are required for certification.

• The majority of KSN nurse practitioner students continue to work full- or part-time in the nursing profession while obtaining their degree/certification. These students are confident and have high levels of clinical competence and willingness to learn and be challenged.

• Our faculty and staff members work closely with students to help ensure a smooth clinical experience through effective communication, useful schedule tracking system, and clinical evaluation.

• Faculty are readily available to preceptors and view preceptors as partners in preparing graduates to provide quality healthcare within our community.

Overview of the Preceptor Process

Clinical Requirements• Students must fulfill all requirements prior to starting clinical rotations per the clinical handbook and course requirements.

Student Preparation

Preceptor Profile Submission • Students may request a resume or CV from the preceptor to supply information for submission of the formal preceptor request to faculty.

Clearance for Clinical • Students receive communication that they have been cleared to start clinical and may began accruing clinical hours.

Affiliation Agreement • Once a preceptor request has been submitted by the student, an affiliation agreement between KSN and the cooperating facility where the preceptor practices.

• These agreements are initiated by the program specialist and are based upon information provided by the student.

• If your workplace has a parent agency, please inform the student.

• The affiliation agreement must be completed prior to the student is cleared to begin the clinical rotation.

Preceptor Packet • Once a student is cleared to begin clinical, they obtain and deliver the Preceptor Packet.

• The Preceptor Packet includes: • Preceptor Orientation Letter • Preceptor Policies • Course Description • Preceptor Letter of Agreement • Evaluation of Student Competencies

Letter of Agreement • Once the preceptor reviews the Preceptor Orientation Letter, Preceptor Policies, the Course Description, they will be asked to sign a Letter of Agreement.

• This process delineates the functions and responsibilities of all parties involved. The Letter of Agreement validates receipt and understanding of responsibilities and must be signed before the preceptorship experiences begin.

• Once the Letter of Agreement is signed, on the first day prior to student interaction with patients, a copy is submitted to course faculty by the student.

Clinical Expectations

• Nurse practitioner students act under the direct supervision of their assigned preceptor and may perform only those duties allowed by the preceptor and which fall within the student’s training.

• No student is to accept or volunteer for any activity for which they are not qualified.

• KSN students are required to have one-on-one supervision with preceptors.

• All procedures shall be done under the direct supervision of the assigned preceptor.

• Each student must meet established clinical requirements and competencies through the formal clinical experience in primary care or specialty area as designated within the course.

• Clinical expectations are graduated and correlated with the student’s level in the program.

Clinical Hour Expectations • Clinical hours per course vary depending on the course and specialty. However, all students at KSN complete 780 face-to-face hours before graduation.

• Expectations of number of patients evaluated per day vary by course and specialty track.

• Students will keep a daily log of interactions with patients.

• Hours and patients are tracked via Medatrax.

• Medatrax is a platform utilized to track patient hours and patients encountered by the student during clinical rotations.

• Faculty routinely monitor student documentation and will contact the preceptor if abnormalities arise.

Expectations of Students • The student should arrive on time and when scheduled.

• If a student is to be absent or late, they should notify the preceptor and clinical faculty prior to the absence.

• Students should be dressed professionally, have their own materials, name badge, lab coat (if required), and necessary reference guides.

Expectations of Preceptors • Preceptors should let the student know of any changes in their schedule as early as possible.

• To facilitate learning, KSN asks preceptors to allow the student to gather patient information, assess the patient, determine diagnosis(es), formulate a treatment plan, and present to the preceptor for discussion.

• The preceptor is asked to provide and expect increasing levels of independence as the student becomes more experienced in the setting.

• We expect that the preceptor will see notable progression, growth, and skill development over the semester.

Communication between students and preceptors should occur often.

Communication Between Students and Preceptors

Communication should include frequent feedback including areas to improve, resources, tips to include but not limited to improve history taking, physical exam assessments, and plan and management.

Communication should occur daily and as need to address student and preceptor concerns and to provide frequent support.

Medical Records • KSN expects our students to manage the health care of clients within current legal, ethical, and professional standards that meet accepted standards of care.

• Students must have access to the patient’s full medical records, including electronic medical records.

• Students are evaluated on the ability to chart as well as having accessing to Medical records on the faculty evaluation form.

• Nurse practitioner students are expected to formulate a working diagnosis and treatment plan, then report their findings to the preceptors.

• Thus, developing critical thinking and decision-making skills.

Patient experience

• Early in the clinical rotation, students should be interviewing and examining patients independently.

• This may differ based on specialty and rotation expectations.

• Any questions around expectations should be relayed to curse faculty/course coordinator/Chair of Advanced Practice Programs.

Contacting Clinical Faculty • Each student has a designated clinical faculty member responsible for overall supervision and evaluation of performance.

• We encourage you to contact us if you have any questions or concerns about a student’s performance, skills, and competencies, or your role as a preceptor.

• Your student’s clinical faculty contact information (phone number and email address) is included in the Preceptor Packet provided to you by the student, prior to or at the beginning of the clinical rotation.

• In addition, any questions about expectations should be relayed to course faculty/course coordinator/Chair of Advanced Practice Programs. This information can be found within the Preceptor Packet provided to you by the student.

Telehealth Policy • Telemedicine offers unique opportunities for students to engage in clinical practice and contribute to patient care remotely.

• To maximize the educational benefits of telehealth experiences, it is essential for students to be active participants in telemedicine visits with time for debriefing with the preceptor.

• All students are required to complete Telehealth Basic Training.

• Students in the AGACNP or FNP tracks may have the opportunity to complete a certain percentage of their clinical hours, in specified courses, with a preceptor who cares for patients via telemedicine. These opportunities will be addressed on a case-by-case basis and must have prior approval.

• Teleprecepted experiences can be valuable with appropriate technology and expertise.

• PMHNP students may participate in teleprecepted clinical experiences with prior approval.

• Preceptors supporting students in this fashion will receive the Telehealth Implementation Checklist for Psychiatric Mental Health Providers.

• Preceptors are asked to review and complete the items on the checklist prior to the student first day of clinical.

• Teleprecepted clinical experiences are not approved for either the AGACNP or FNP track students at this time.

Telehealth Policy PMHNP Student Expectations • PMHNP students requesting to participate in telehealth with a remote preceptor (teleprecepting) must verify the following prior to submission of the preceptor request: • The preceptor’s videoconferencing platform is HIPAA compliant and allows group videoconferencing • The preceptor’s patient panel is located and cared for in the State of Oklahoma.

• The preceptor agrees to provide orientation to the clinical site, telehealth platform including access, security, and process standards of practice for managing patient safety/emergencies.

• The preceptor agrees to provide orientation to specific processes for patient permission, documentation, and consultation.

• The preceptor agrees to provide personal cell phone contact or other means of communication in the event of system failure.

• The preceptor agrees to meet with the student before first patient encounter to test learner and preceptor equipment, and ensure both know the process for troubleshooting audio, video, and internet stability (e.g. turn off camera briefly if audio unstable) • The student has a dedicated, private space that is free from distraction, in which to complete clinical hours.

• The student is able to fully dedicate themselves to the learning experience during clinical hours. This includes having minimal distractions that might impede their ability to focus on patient care and learning outcomes.

Evaluations

Faculty Visits to the Site Faculty will visit at least once per rotation.

This visit will include observation of at least one patient at the site.

This visit will be scheduled with the provider’s convenience in mind.

The faculty will directly observe the student’s interactions with the patient.

This includes a review of the patient’s medical records, history and physical exam.

The student will then report the findings and proposed treatment plan to the preceptor as they typically do.

Faculty visits ensure that the student is developing skills with patients, getting what they need from preceptors and site.

Faculty Visits to the Site cont.

Faculty do not examine patients.

The faculty member will talk with the preceptor at the end of the visit regarding how the student is progressing in the clinical setting.

Additional clinic site visits will be made for students who need additional support, who are not performing to the expected level of practice competency, or for whom the preceptor has communicated concerns to the faculty member.

Faculty Evaluation of Student Clinical Competencies Key Elements evaluated by the faculty include observing the student’s: • Interaction/communication with preceptor/office staff and with patient/family; • Subjective data collection, physical exam, diagnostic testing/procedure determination; • Medical diagnosis(es) and nursing/health promotion disease prevention interventions and rationales, management including pharmacologic management, establishment of goals, referrals, evaluation/follow-up, community resources, and cost considerations • Documentation and Medatrax logs; • Self appraisal.

Evaluation of Site and Preceptor At the end of the rotation, faculty and students evaluate the site and preceptor to determine: • Student received an adequate orientation to the clinical site.

• Student learning opportunities were available, which include student being allowed to obtain subjective/objective data and engage in visits that were appropriate for student education and growth.

• Students were allowed to participate in patient evaluation and planning of the patient and were given access to patient clinical records, • Preceptor provided guidance, feedback, and learning opportunities to the student.

• Preceptor was knowledgeable of nurse practitioner’s role and utilized evidence based clinical practice.

How will the preceptor know if the student is meeting program expectations?

• Prior to clinical rotation, preceptors are provided with detailed descriptions of KSN’s clinical courses that the student is enrolled in.

• This includes course perquisites and credit; course learning outcomes; communication process; practicum hours; attendance and expectations; and suggested learning strategies.

• Students are required to demonstrate competency of specialty-related skills prior to beginning clinical rotations.

Additional Information

Preceptors MDs/DOs: • May receive CEU credit pending approval by certification board.

Nurse Practitioners: • You can receive credit toward your re-certification as an NP by serving as a preceptor.

• Thank-you letters are generated at the end of each semester.

• The following information will be included: • Student, course, semester, and number of hours.

• If lost, please contact at

Resources Preceptor and Faculty Expectation Checklists Clinical Preceptor Guide Resources for Continuing Education: • Pri-Med – Primary Care Focused CME/CE • Psych-U – Psychiatric topics • American Psychiatric Nurses Association • American Psychiatric Association Learning Center • American Association of Critical-Care Nurses • Nurse Practitioner Associates for Continuing Education (NPACE) • HMP Global Learning Network

Thank you!

• Thank you for all you do to facilitate our NP students’ growth and success.

• Please share feedback by completing the evaluation. A certificate of completion should be sent to your email automatically.

• Click Here to complete the evaluation.

Questions?

• If you have any questions or concerns, the phone numbers and email addresses are included in the Preceptor Packet provided to you by the student.

• We value your communication.

Please feel to contact the clinical faculty at any time.