Frequently Asked Questions by Preceptors

The Professional Practicum course is a five credit clinical course where senior nursing students in their last semester of nursing school spend 24 hours a week for the entire semester with an RN in a clinical setting learning and performing the role of the Professional Registered Nurse.

Preceptors are RN’s, preferably with at least a BSN, a full-time appointment in their respective institution, viewed by their peers as experts in the clinical area, and have an interest in working with students that are in the last semester of nursing school. Preceptors can be from any shift and have any combination of shift hours.

The KU School of Nursing admits 128 Baccalaureate seeking students in the Fall semester each year. Students are admitted after having completed at least 62 hours of approved college course work. Each year approximately 125 students enter the Professional Practicum course. To get to this course, the nursing student must have already completed all the junior and senior level clinical and classroom course expectations at a grade of C or better. This includes courses in Nursing Foundations, Maternity, Pediatrics, Adults, Mental Health, Critical Care, and Population Based health care. In each of these courses the students have had classroom and clinical expectations. Students must have demonstrated their ability in a laboratory to perform clinical skills like physical assessment, medication administration, catheter insertion, blood administration, cardiac monitoring, and ventilator management. Many students have also performed these skills in a clinical setting with instructor supervision. Additionally, students have had classroom courses in pathophysiology, pharmacology, computer technology, research, and healthcare law and ethics. Students graduate from the program when they have completed 124 hours of college credit. At this time they become eligible to take the NCLEX exam which, when passed, makes them a Registered Nurse (RN).

In addition to the Professional Practicum course, during the Spring semester of the senior year students are also enrolled in two other classroom courses. These are Leadership and Management, and Professional Issues. Both these classes meet most Mondays during the semester. Because of this, Mondays are usually not a day available for students to be in the clinical setting.

Since beginning in the Spring of 1998 this course has received excellent reviews from students, preceptors, faculty and many others as a method for students to transition from school to a productive workforce member.

The process of student enrollment in the Professional Practicum course is complex. The purpose is to match the student with the preceptor and clinical site that will best advance the student’s clinical career goals. To accomplish this, the student, course clinical faculty, and clinical institutions all take an active role in the enrollment process.

Student enrollment takes place during the last week of the KU Fall enrollment period. Typically this is about the middle of November. Students enroll by randomly assigned numbers. The random numbers are done by the Student Affairs Office at the School of Nursing and distributed to students approximately two weeks before enrollment. On the day of enrollment, students select a Practicum site from a list made available by the clinical faculty. This is done according to a randomly selected number with number one going first, number two second, etc, until the last student has completed enrollment. Following their practicum site selection the Fall enrollment process is completed with a member of the Student Affairs Office.

The random number method of enrollment is not perfect. One alternative enrollment method is to base the clinical site selection process on student achievement. A method we call competitive selection. In the past, faculty have chosen not to use this method because of the undue emphasis it places on course grades for the rank ordering.

No. The School has chosen to follow a process that makes all the positions available to all students. In this manner no favoritism or bias is shown and student ownership in the practicum selection process is promoted.

 The clinical faculty role in the enrollment process is to contact the institution or agency they are working with and request volunteers to be preceptors. Each clinical faculty member may be working with up to ten students. Once the clinical faculty identifies the preceptor this persons name, their hours of work, and a short description of the nursing unit is made available to the course coordinator. The course coordinator transfers this information to the course web page for review.

Ideally this information should be available by the middle of October. Therefore, it is not uncommon for faculty to begin contacting the agencies in September to start identifying preceptors. Contact the clinical instructor for information about how to access the course web site.

The clinical institution or agency role is to assist the clinical faculty in identifying qualified preceptors and help in developing unit descriptions that can be shared with the students. Because students are often coordinating family and work obligations with school expectations it is important that the information supplied be complete and timely. In addition to the preceptor and unit descriptions, students find that the hours or shift the preceptor works to be an important factor in their selection process.

The course coordinator is responsible for seeing that information about Practicum sites and preceptors are made available to the students in a timely fashion. This is accomplished by posting the preceptor and site information on the course web site no later than two weeks prior to enrollment and meeting with individuals or groups of students to answer questions about available practicum sites.

About one month prior to enrollment students are asked to complete a clinical site preference survey. Students choose 1st and 2nd preferences for their practicum from a list of available agencies and clinical specialties. This information is shared by the faculty with the institutions to help in their selection of preceptors. For example, if the survey shows that there is a high degree of interest among the seniors for critical care practicum experiences then the faculty and institutions can work together to develop more critical care types of experiences for the students. Student responses to the preference survey do not guarantee placement in a particular practicum site. The course coordinator develops, distributes, analyses and shares the results of the student preference survey with the students and faculty.

Occasionally students want to do their practicum in an institution or agency that has not been identified by the faculty. This is known as the alternative clinical site placement option. If a student wants to pursue this option they must meet with the course coordinator prior to the random number assignments. The student must have a clear idea of where they want to do their practicum and a contact person in mind. The student is responsible for contacting the clinical agency to see about the possibility of doing their Professional Practicum at the facility. If the clinical institution agency is willing, the course coordinator will contact them about having the student do their practicum in that site. If the institution or agency agrees, then the course coordinator will see that a written contract is established between the agency and the School of Nursing and work with the institution to identify a preceptor.

Kansas State Board of Nursing criteria require that the clinical faculty have a license in the State where the Student is doing their Professional Practicum. Students also need to be able to travel back to the School of Nursing to participate in the other two classes they must complete. This usually means they must be on campus at least one day a week. Clinical faculty must be willing and have the ability to travel to the alternative clinical sites to do regular visits. This usually amounts to three or four site visits by the clinical faculty member during the semester.

The Professional Practicum is a five (5) hour clinical course. Students receive a pass or fail at the end of the course and not a grade.

Many times students wish to meet their preceptor before the start of the semester often so they can coordinate schedules. Clinical faculty encourage this and will often help with arrangements. Students may not do any clinical activities during these visits.

During the first week of the semester students are not with their preceptors unless this has been approved by the clinical faculty. This is the time students are oriented to the clinical facility. Orientation varies from facility to facility and can take anywhere from three to 32 hours. Beginning in the second week students spend 24 hours per week with the preceptor. This relationship continues through the next to the last week of the semester. The last full clinical week of the semester is set aside for any makeup work, or to do project completion and presentation. The last week of the semester is finals week.

By following this schedule, students spend 312 hours in the clinical setting with the preceptor (13 weeks x 24 hours per week). The remaining eight (8) hours is allocated to orientation and clinical conference. Twenty-four (24) hours of clinical per week has been used because most preceptors work either an eight (8) or twelve (12) hour shift.

Having twenty four (24) hours of clinical and five (5) hours of class time per week during this semester also meets the Kansas State Board of Nursing requirement of not scheduling more than thirty two (32) hours of combined clinical and class time per week for any nursing student.

Generally, no. In addition to the State Board requirement, the student’s ability to use this time as a learning experience decreases when they do more than this amount of clinical per week. Time spent beyond the 24 hours per week many times is just for accumulation of clinical hours. If circumstances dictate that other arrangements be made then the clinical faculty needs to be included in this process and has the final approval.

Students are expected to be on the unit ready to start when the preceptor would normally start their responsibilities. Students need to complete the shift and should not leave until the patients they are caring for have another care provider who indicates they are ready to assume care responsibilities. Students, who are ill or unable to be at clinical, must contact the clinical faculty and the clinical unit according to guidelines supplied by the clinical faculty. You should notify the clinical faculty anytime a student is not meeting these expectations. All missed clinical time must be made up for the student to satisfactorily complete the course. Time spent by the student on the unit after the end of their shift is generally not included in the 312 hours of clinical commitment.

The student does not always have to be with the preceptor when they are doing clinical work on the unit. Students should not be arranging to work with other staff members without the approval or knowledge of the preceptor. If this is occurring then preceptors should clarify their expectations with the student and notify the clinical faculty.

Generally it is a good idea to have the student go with you. This is a judgment decision based primarily on where the student has the best learning opportunities.

Students can dress in a manner consistent with the dress code expectations of the nursing staff on the unit and the institution. They must wear a name badge from the School of Nursing identifying them as nursing students and wear the arm patch of the School of Nursing.

Students should be making entries in the medical record as if they were an RN on the unit. This does need to be consistent with Unit or Institution policy, so check. Students should sign each entry with: (their name), KUSN. The KU SON recommends that the preceptor sign these entries immediately after the student.

During the course of the semester the student should have developed enough confidence in their abilities to notify the physician or appropriate medical staff to explain a patient’s clinical status. The preceptor should follow the appropriate agency policy when this is done, but as a general rule, the preceptor, to insure accuracy of the content, should participate in the conversation between the student and the physician.

Preceptors should expect students to be able to administer PO, IM, IV, Topical, eye and eardrops, and suppositories competently. Preceptors should expect that the student have a working knowledge of all the medications they are administering. Knowledge of actions, interactions, and administration of medications is an ongoing process and students should feel comfortable interacting with the preceptor to increase their personal ability but also demonstrate personal initiative. Preceptors should not expect a student to be familiar with medications that are unique to the clinical unit or experimental (i.e. Chemotherapy). Preceptors do need to verify a student’s competency with medications.

Each year clinical faculty offer the students a variety of experiences they may chose to attend. Examples of these include, The Kansas State Nurses’ Association (KSNA) Day at the Legislature, The KU Student Research Day, and special classes at the Medical Center. Clinical faculty may also offer students the opportunity to participate in special events like, professional association meetings, disaster drills, or special teaching projects. If students chose to attend these they receive a set number of hours of clinical credit. Students need to keep the preceptor informed of their participation in these events. Student participation in these events does not alter nor replace the overall need to demonstrate clinical competency on the unit. If the preceptor feels the student is excessively creating activities that take them away from the clinical area then they should talk with the faculty. A schedule of these events is included in the course syllabus.

The course syllabus is available on the course web site. The syllabus contains the course description, course objectives, clinical performance expectations, general journal expectations, general case study or project expectations, sample student clinical schedule, PROFITS, preceptor-preceptee-faculty responsibilities, and the clinical evaluation tool. The syllabus can be printed from the web page. For information on how to access the course web site contact the clinical instructor working with you.

Clinical faculty coordinate student orientation to the clinical agency/institution during the first week of the semester. Different clinical agencies have different requirements for student orientation. Some have all day sessions. Some have multiple day sessions. Others have very little structured orientation. The clinical agency/institution orientation most often covers issues like documentation, dress code, parking, fire and safety procedures, etc. Information about each student’s health and insurance status, general fire and safety training, and clinical competency is kept by the School of Nursing and follows guidelines outlined by the Greater Kansas City Clinical Educators Council. This negates each student from having to repeat these activities at each clinical agency /institution. Arrangements for orientation should be finalized and students notified before the end of the fall semester immediately prior to practicum.

In addition to a clinical agency/institution orientation, students need orientation to the practicum course. During this part of the orientation process the clinical faculty review the requirements for the course and outlines their specific expectations for clinical performance, personal course objectives, journals, and the case study or course project. Examples of the types of information the clinical faculty have shared with the students are available from the clinical faculty.

Each clinical faculty is responsible for the orientation of the preceptors. This should include a discussion of what the student should be able to do by the end of the semester and the role of the student/preceptor/faculty in this process. It has been helpful to share a list of the clinical competencies the students have completed in the skills lab. The preceptor should feel that each student’s education in this course is a partnership between the faculty and the preceptor.

Since the clinical faculty cannot be ten different places at once, daily clinical supervision of the student becomes the role of the preceptor. Preceptors do need to be able to contact the clinical faculty should problems arise. Therefore each preceptor needs the phone or pager numbers for their student’s clinical faculty. Clinical faculty need to have a physical presence and visit the student while they are in the clinical area with the preceptor. The frequency of the meetings should be adjusted based on student ability, location of clinical site, and comfort the faculty and preceptor have with the preceptor/student relationship. If clinical faculty are going to be away and not able to respond to a call then they will make arrangements for coverage with other clinical faculty. At a minimum, with a student that is meeting all course objectives, this meeting should happen every week.

Each clinical faculty is responsible for conducting clinical seminars on a regular basis with their clinical group. This includes the scheduling of meetings times and rooms. Eight hours of clinical time is given in the course for these seminars. This clinical time is in addition to the 312 hours of student clinical time on the unit. Clinical faculty have the freedom to structure the content of the seminars in a manner that meets the needs of their group. Topics found helpful to review in seminar include: development of personal objectives, review of clinical activities, incorporation of research in clinical, discussion of areas of leadership and management where students are having difficulty. At the end of the semester, clinical seminars are the time when students present their case students or clinical projects.

Students are required to keep a journal of their clinical activities as part of this course. Clinical faculty are responsible for providing direction and guidance regarding the content and structure of the student’s journaling activities. As preceptors you may find students asking you questions about your professional background, unit communication patterns, the institutions nursing management, and other topics. Many times these are areas clinical faculty want students to include in their journals. As a preceptor you should feel free to question the student about their journal and to add to or supplement the journaling requirements from the clinical faculty.

Each time the preceptor interacts with the student they should be identifying and evaluating how the student is meeting the course objectives and expectations. Structured evaluations occur at mid-semester and the end of the semester. It is the faculty role to schedule and conduct the student evaluation. This is done in a meeting with both the student and the preceptor. Using the evaluation form, the preceptor, student, and faculty review what the student has done to meet each criteria. The criteria have been established to reflect the goals of the course. Written descriptors are included in the course syllabus if there are questions about whether the student has met the criteria. At the conclusion of the evaluation the preceptor and student should both sign it.

The evaluation form is a concise list of what each student must demonstrate to pass the course. Criteria with a * are those that the student must do at a satisfactory level. Failure to do any of these criteria can result in failure of the course. Those criteria that do not have a * are designated as non-critical. Students are strongly encouraged to demonstrate their ability to meet these criteria. There are no set criteria about how many of the non-critical criteria the student may fail and still pass the course. This is left to the judgment of the clinical faculty and the preceptor.

Placing a check in the appropriate box indicates how the student is meeting each criteria. If the student is satisfactorily meeting a criteria then the S box is checked.  If the student has not been able to demonstrate their ability to meet the criteria, despite repeated attempts, then the U box should be checked. At the mid semester evaluation there is also an option for N. This designates “Not Yet”. It is not expected that all students will be meeting all criteria at mid-semester. The N option indicates those criteria where the student has not had an opportunity to demonstrate their competence.

The determination of a student’s demonstrated competency is subjective and varies depending on the type of unit and the expectations of that unit. While we do expect that students will be able to satisfactorily perform the majority of the roles of an RN on that unit, we do not expect that students will perform at the level of an experienced RN. One criteria that preceptors have used to assess overall student competency is to ask themselves, how comfortable would I feel about this person’s ability if I had to work with them every day?

Copies of the evaluation can be given to the student and preceptor if desired. The faculty member keeps the original evaluation. Preceptors who are working with a student who is not demonstrating the ability to successfully complete the course should contact the clinical faculty member as soon as deficits are seen to discuss their concerns and develop a plan of action. The clinical faculty is ultimately the one who must decide if the student is performing at a satisfactory level.

The ability of all students to conduct themselves in a manner consistent with appropriate professional nurse expectations is expected by the clinical faculty. Students who fail to treat their patients, families, significant others, preceptors, nursing staff, fellow class mates and clinical faculty with respect are subject to not only course failure but also a further review of their activities by the School of Nursing PROFITS committee (See course syllabus about PROFITS). This same standard of behavior is expected when dealing with information of a confidential nature.

Preceptors who have any concerns about a students conduct in any of these areas should contact the clinical faculty member immediately.

Each year a formal evaluation of the Professional Practicum course is completed. Each student is asked to complete an evaluation of the course, their clinical faculty, preceptor, and the facility where they completed their practicum. In addition, each preceptor is given the opportunity to evaluate the student, clinical faculty, and course. The evaluations are standardized but do include areas for written responses. Course evaluations are compiled and appropriate copies returned to the clinical faculty and others as outlined by School of Nursing policy. Written feedback is also supplied to the various participating institutions for their review. Course clinical faculty are responsible for seeing that each student and preceptor have the opportunity to complete a course evaluation. As the opportunity for on-line course evaluations becomes available these will be reviewed and incorporated. All precautions are taken to insure that those people completing an evaluation remain anonymous.