1 1 Regents Online Degree Program Master of Science in Nursing Regents Online Degree Program (MSN RODP) Preceptor Manual November 2010
2 2 Table of Contents Page Welcome Message from Program Coordinator 3 Message from Concentration Coordinator 4 General Information 5 Introduction 6 Contact Information 12 Online Course Delivery 13 Program Overview 17 Program Purposes/Outcomes 18 Program Design 19 Credit and clock hour requirements for clinical courses by 20 concentration FNP Concentration Required Clinical Hours 21 Clinical Participation Requirements 22 Clinical/Practicum Placements 23 Overview 23 Process for Initiating Clinical Affiliation Agreements 23 Preceptor Selection 23 Site Requirements 24 Preceptor Appointment Agreement 25 Responsibilities in the Preceptor Partnership 25 Student Responsibilities 26 Concentration Coordinator/Faculty Responsibilities 26 Contract Liaison 27 Preceptor Responsibilities 27 Program Evaluation 28 Resources/Benefits for Preceptors 28 Virtual Library Access 28 Instructional Aids 29 MSN RODP Website Resources 30 Web Resources for Preceptors 31 Appendices A - MSN RODP Guiding Principles of Online Teaching/Learning 33 B - MSN RODP Consortium Communication Network 38 C - Curriculum Plans for the MSN and Graduate Certificate Offerings 39 D - Sample Contract 45 E Preceptor Forms 50 Intent of Relationship Form 50 Preceptor Information Form 51
3 3 Preceptor s Professional Profile Form 53 F - History and Physical Examination Form SAMPLE 54 G - Clinical Forms 58 Clinical Log 58 Clinical Skill Inventory 59 Clinical Performance Evaluation Form 62 Preceptor Evaluation of Student Form Informatics 64 Preceptor Evaluation of Student Form Education 65 H - Program Evaluation Forms 66 Student Evaluation of Preceptor/Site Form 66 The program reserves the right to make changes to this manual as necessary. Updates and/or corrections may be accessed at the MSN RODP website:
4 4 Dear Preceptor: Thank you for agreeing to precept a student in the Master of Science in Nursing Regents Online Degree Program. Your expert guidance in providing students the opportunity to apply their clinical skills and knowledge is critical to preparing them for their future practice roles. As a busy professional with numerous demands and responsibilities your commitment to this process demonstrates personal dedication to the continuing development of the nursing profession. The student will gain confidence and validation as you provide teaching, coaching, and role modeling opportunities. It would not be possible to prepare our graduates for practice without your collaboration. Contents of this manual are provided to introduce you to the program and the role of the preceptor. Updates and additional resources are available at the MSN RODP website: The Tennessee Board of Regents (TBR) values your service as a preceptor and welcomes your recommendations for making the preceptor role more effective and satisfying. Please feel free to call me or the course instructor if you have any questions or concerns. On behalf of all TBR Universities, I thank you for your service and continued support. Sincerely, Director, Nursing Education (615)
5 5 Dear Colleagues: As the concentration coordinators for the Master of Science in Nursing Regents Online Degree Program, we would like to thank you for sharing your expertise with our students as a preceptor. The overall goal of the preceptorship is to allow students to gain advanced practice experience while working with experts in the field. The benefits obtained from precepted assignments cannot be underestimated. The use of preceptors is a viable and important part of advanced practice nursing education. Learning from the experiences of a cadre of experts is one of the most effective ways to advance professionally, or develop the skills needed to be an effective Family Nurse Practitioner. As a preceptor, you serve a very important function in the education of our students. The faculty values your service as a preceptor and welcomes your recommendations. The student s clinical faculty will contact you during the semester to discuss the student s performance and progress. If at any time, you need assistance or have questions, please contact either of us. Thank you again for your commitment to nursing education. Carol G. Bompart, EdD, APRN, BC Coordinator, MSN RODP, FNP Concentration TSU, MTSU, APSU Jo-Ann Marrs, EdD, MSN, MN, FN Coordinator, MSN RODP, FNP Concentration ETSU, TTU Doris Davenport, DSN, RN, PNP Coordinator, MSN RODP, Nursing Education Concentration Lynn Parsons, DSN, RN, NE-BC Coordinator, MSN RODP Nursing Administration/Informatics Concentrations
6 6 GENERAL INFORMATION: 1. Program Type Master of Science in Nursing Post-masters Certificate: Family Nurse Practitioner 2. Name and address Master of Science in Nursing Regents Online Degree Program The Tennessee Board of Regents 1415 Murfreesboro Road, Suite 350 Nashville, TN On behalf of: Austin Peay State University 601 College Street Clarksville, TN East Tennessee State University P.O. Box Johnson City, TN Middle Tennessee State University 1301 E. Main Street Murfreesboro, TN Tennessee State University 3500 John A. Merritt Blvd., Box 9590 Nashville, TN Tennessee Technological University 805 Quadrangle Cookeville, TN University of Memphis 610 Goodman Street Memphis, TN Name and title of the administrator of the nursing unit Director, Nursing Education, ROCC Phone: Fax:
7 7 Introduction The State of Tennessee has two systems responsible for public post-secondary education - The University of Tennessee System and The State University and Community College System of Tennessee, officially known as the Tennessee Board of Regents (TBR) System. Both systems are entirely separate units, but are coordinated by the Tennessee Higher Education Commission (THEC). TBR is the largest public system of higher education in Tennessee and the sixth largest system of higher education in the United States. The TBR is composed of six universities, 13 community colleges and 26 technology centers. The six universities are Austin Peay University (located in Clarksville, TN), East Tennessee State University (located in Johnson City, TN), Middle Tennessee State University (located in Murfreesboro, TN), Tennessee State University (located in Nashville, TN), Tennessee Technological University (located in Cookeville, TN) and the University of Memphis (located in Memphis, TN). The Tennessee Board of Regents is recognized as a collaborative system in which universities, community colleges, and technology centers work together, each with a distinct role, to provide seamless educational opportunity to all Tennesseans. Together these universities represent an unduplicated head count of 81,680 students in higher education in the state of Tennessee for Fall In 2000 TBR enacted a statewide collaborative to offer courses online. This was in an effort to meet the ever demanding need for higher education of people in the state. The Tennessee Board of Regents initiated development of a system wide web based program at its meeting of July 11, On September 22, 2000, the TBR approved a framework for the development of the proposed Tennessee Regents web based degrees.
8 8 On December 8, 2000, the board approved a description of major parameters of the Regents Online Degree Program (RODP) which included both associate and bachelor degrees. The first online courses were offered by RODP in Fall Since its inception, degree options have been added to include graduate education and selected certificates in areas that address statewide needs. RODP currently offers six associate s degrees, two bachelor s degrees, and three master s degrees. Additionally a variety of endorsements and certificates are available through RODP. Students enrolled in RODP courses and programs have a home campus designation. Students apply and register at their home campus and the home campus awards their degree. Students are advised by their home campus and adhere to all policies of the home campus. Courses are taught online by faculty from all participating colleges/schools (delivery school) and are transferable among all participating institutions. Courses have been designed for a fifteen (15) week semester--in an interactive, asynchronous (accessing courses at their convenience 24/7) format. All courses contain the same content and rigor as courses offered in the place based on campus format. All new courses and programs undergo the same review and approval process required for each participating campus plus a required RODP curriculum review and approval. The current student enrollment (Fall 2005) of 10,668 and headcount of 6,221 speaks to the outstanding growth and success of RODP. RODP has been recognized for excellence in the online delivery of academic programs by a variety of professional organizations. For example, RODP was rated as one of the top three virtual programs in the nation by The Center for Academic Transformation Rensselaer Polytechnic Institute, 2003, recognized by the Southern Regional Education Board (SREB) Electronic Campus for online student services, and showcased as an exemplary system wide model at the national WebCT International Conference, RODP has full SACS approval; and all institutions are fully accredited. As described above, the Tennessee Board of Regents' colleges, universities, and technology centers joined to offer the Regents Online Degree Programs (RODP) in fall This highly successful model provides the infrastructure for the delivery of online programs and courses throughout the system. The addition of noncredit course offerings
9 9 has been accomplished through Regents Online Continuing Education (ROCE). This continued growth has resulted in the development of the current structure which is identified as the Regents Online Campus Collaborative (ROCC). ROCC includes credit courses and degree granting programs (RODP) and noncredit courses (ROCE). ROCC demonstrates TBR s commitment to cooperation and collaboration among its campuses while reducing duplication of programs and services. The mission of ROCC is to improve access, through the use technology, to high quality, affordable student learning opportunities. This mission is achieved through the cooperation and collaboration among TBR institutions and the provision of state of the art resources for online instruction and delivery. Based upon the proven foundation and infrastructure of RODP, ROCC provides the vision for addressing the workforce development and educational needs of the citizens of Tennessee. The resources of all TBR institutions are pooled to provide high quality education using innovative technology and delivery methods appropriate to the nature of the programs. As a participant of the ROCC, the campuses have access to resources essential to the viability and effectiveness of distance education programs. This collaborative model permits cost effective delivery of online educational offerings and assures that well-established essentials of quality found in regional and disciplinespecific accreditation standards are achieved. History of the Program Baccalaureate prepared registered nurses in Tennessee have consistently indicated their desire to obtain their graduate degree in nursing from a public university in Tennessee. Many are forced to travel to surrounding states to attend MSN programs and online programs available to them are not their preferred choice. Until 1992, there were three master s programs in Tennessee that were respectively located at Vanderbilt University, UT-Knoxville, and UT-Memphis. In 1992, the Tennessee Board of Regents approved an MSN program at East Tennessee State University and in 1996, at Tennessee State University, a historically black university in Nashville, TN. Most recently (June 2003), TBR approved the MSN program to be offered at the University of Memphis. In fall 2003, the Tennessee Board of Nursing (TBN) reported that there were nine master s programs in Tennessee serving approximately 500 enrolled students. There were no public institutions of higher education in Tennessee that offered a Master of Science in
10 10 Nursing program online. There were only two (Union University and University of Memphis) programs in Tennessee with a nursing education focus. Recognizing the need to address a critical shortage of advanced practice nurses, and nursing faculty in particular, in the state of Tennessee, the deans and directors of the schools/colleges of nursing in the TBR universities joined to collaborate in the development and implementation of the Master of Science in Nursing to be offered through RODP (MSN RODP). In March 2004, the Tennessee Board of Regents (TBR) and the Tennessee Board of Nursing (TBN) approved the MSN RODP proposal. In April, 2004, the program was approved by the Tennessee Higher Education Commission (THEC). The Southern Association of Schools and Colleges (SACS) also approved the program in September Students were admitted and began classes fall The MSN RODP is designed to address the needs of the adult learner and full time nurse employee through a 24/7 asynchronous online delivery model. All didactic courses are taught online. Clinical courses are arranged for local delivery through an approved preceptor in consultation with course faculty. Each institution offers the same curriculum and all courses are taught by qualified faculty from the participating university. Students are admitted to their respective home campus and the degree is awarded by this institution. MSN RODP students are afforded all rights and privileges of their respective institution available to every student. The colleges/schools of nursing at the six TBR universities [ Austin Peay State University (APSU) School of Nursing, East Tennessee State University (ETSU) College of Nursing, Middle Tennessee State University (MTSU) School of Nursing, Tennessee State University (TSU) School of Nursing, Tennessee Technological University (TTU) School of Nursing, and the Loewenberg School of Nursing at the University of Memphis (UoM)] offer the MSN RODP as a consortium. The consortium is defined as the nursing education unit. The respective deans/directors of the colleges/schools of nursing serve as the Executive Committee (EC) of MSN RODP. The Executive Committee provides primary oversight and decision making authority of all aspects of the Master of Science in Nursing Regents Online Degree Program and Consortium activities. The EC is responsible for identifying degree requirements, setting program standards and
11 11 guidelines, and monitoring accreditation requirements and standards. The EC also addresses issues related to faculty workload. A coordinator for the program has been employed at TBR through a dual services agreement with one of the participating institutions. Current members of the Executive Committee include: Dr. Francisca Farrar Director, School of Nursing Austin Peay State University Dr. Wendy Nehring Dean, College of Nursing East Tennessee State University Dr. Lynn Parsons Director, School of Nursing Middle Tennessee State University Dr. Kathy Martin Dean, School of Nursing Tennessee State University Dr. Sherry Gaines Dean and Director, School of Nursing Tennessee Technological University Dr. Lin Zhan Dean, Loewenberg School of Nursing University of Memphis Director, ex officio Director, Nursing Education Regents Online Campus Collaborative All six TBR universities are fully accredited by SACS and each college/school of nursing holds full approval of the Tennessee Board of Nursing. Each college/school is also accredited by NLNAC and/or CCNE. The MSN RODP consortium is currently a candidate for re-accreditation by NLNAC and will host a site visit in 2011.
12 12 Contact Information Updates are available at the MSN RODP web site: Director of Nursing Education, RODP/ROCE phone: Fax: Asst Coordinator, Nursing Education (615) Executive Committee Dr. Francisca Farrar, Director APSU Dr. Wendy Nehring, Dean ETSU Dr. Lynn Parsons, Director MTSU Dr. Kathy Martin, Dean TSU Dr. Sherry Gaines, Dean TTU Dr. Lin Zhan Dean UoM MSN Graduate Curriculum Committee Dr. Doris Davenport Committee APSU Chair Dr. Nancy Granberry ETSU Dr. Linda Wilson MTSU Dr. Carol Bompart TSU Dr. Kim Hanna TTU Dr. Robert Koch UoM MSN-RODP Concentration Coordinators Nursing Education Dr. Doris Davenport APSU Nursing Administration/Informatics Advanced Practice- FNP option (MTSU,TSU,APSU) Advanced Practice- FNP option (ETSU,TTU) Dr. Maria Smith, MSN-RODP Program Mentor Contract Liaisons Dr. Lynn Parsons MTSU Dr. Carol Bompart TSU Dr. Jo-Ann Marrs ETSU Dr. Doris Davenport APSU Ms. Amy Bower ETSU Dr. Leigh Ann McInnis MTSU Dr. Vanessa Briscoe TSU Dr. Melissa Geist TTU Dr. Judy Jenkins UOM
13 13 Online Course Delivery A major consideration in the development of the MSN RODP is the philosophies of TBR, RODP, and the participating universities in relation to distance education. The Tennessee Board of Regents Policy (No. 2:05:00:00) related to distance education may be found at the TBR website at: demic+policy This policy clearly identifies distance education as an established and effective method for extending educational opportunities. TBR s philosophy is further supported in this policy by the following recommendation: To provide the citizens of Tennessee with greater access to postsecondary education, the Board of Regents affirms the effectiveness of distance education, recommends the use and development of distance education technologies, and encourages institutions to take advantage of such opportunities in carrying out their individual missions (TBR Policy No. 2:05:00:00, initially approved 1983, revised 1993). The Tennessee Board of Regents initiated development of a system-wide webbased program at its meeting of July 11, The TBR philosophy of distance education is reflected in this Board mandate and the framework for the development of the proposed Tennessee Regents web-based degrees which were approved by the Board on September 22, On December 8, 2000, the Board approved a description of major parameters for the RODP. The Regents Online Degree Program was established to increase Tennesseans access to higher education by using technology to deliver entire degree programs asynchronously throughout the state. The Board further described the initiation of RODP as a mechanism to maximize both effectiveness and efficiency by selecting and training exemplary faculty from all 19 institutions to develop online courses that will be offered collaboratively by system institutions. The goals of RODP are: To increase access to higher education for adult Tennesseans, especially those with some college experience. Census data document that Tennesseans lag behind both the national and regional averages of educational attainment.
14 14 Further, attainment is uneven across the state, with rural areas lagging far behind urban areas. Economic development of the state depends on increasing the skill levels of the population. To maximize the effective use of technology for delivery of college-level instruction. Distance delivery through the use of technology will increase access to higher education, especially in remote areas of the state and for adult learners for whom time flexibility is a critical resource. To provide student access to web-based courses and degree programs. Webbased courses will reach populations not currently enrolled in higher education and will also permit students who are currently enrolled in oncampus courses to take additional courses, thus completing their programs sooner. To encourage and support collaboration among TBR institutions. Course development and delivery will be cost-effective, because courses will be developed by one institution and used by all. The philosophies of distance education of each participating University as well as the College/school of nursing are considered in the Guiding Principles of Online Teaching/Learning established by the MSN RODP Executive Committee. The Guiding Principles are included in its entirety in Appendix A. The Executive Committee established these guiding principles to ensure high quality in the delivery of graduate nursing education online. The principles are derived from a set of commitments reflective of the beliefs and values of the Executive Committee. These include commitments to (1) the traditions, principles, and values which guide high quality nursing education programs; (2) cooperation among the six colleges/schools; and, (3) to supporting good practice in the delivery of online education. The curriculum for the program arises from the combined philosophies of the participating colleges/schools. The collective beliefs and principles about online teaching and learning also guide the development and implementation of this collaborative program.
15 15 Basic Beliefs about Teaching and Learning Teaching involves both learner and teacher where the teacher acts as a facilitator and a resource person. Teaching assists the learner to develop, organize, and structure knowledge; promotes desirable attitudes and skills; and fosters a spirit of inquiry. Learning is a dynamic process of personal and professional growth. It builds on prior experience, stimulates critical reflection, and enables the student to problem solve and practice independent decision-making. Teachers and learners are partners in the educational enterprise of lifelong learning. Beliefs about Online Teaching and Learning The online environment supports the development of a community of learners who bring valuable knowledge and experience to the classroom. Online teaching is a mode of educational delivery. Teaching and learning online is not better or worse than traditional education. Teaching online is not a technical discipline. Instead, the technology used for teaching online is simply a teaching tool. When used appropriately this technology serves as a resource to support and enhance the learning environment. Teaching and learning online is not for all faculty or students. Nursing education will always require a certain level of direct human interaction for the teaching and learning of psychomotor skills specific to the discipline. Clinical/practicum courses can not be taught 100% online. Online resources may provide support to faculty, students and preceptors in communicating expectations and evaluating student performance in the clinical/practicum courses. Furthermore, the Executive Committee agreed that the following requirements/expectations must be met in the development of an online program: The program must comply with the standards and criterion of accreditation. Course requirements must ensure comparability to campus-based courses.
16 16 Faculty who teach in the program must receive appropriate training. Policies concerning ownership of materials, faculty compensations, and copyright issues must be clear. Students must have adequate access to the range of services appropriate to support the program. The need to expand graduate nursing education in the State and TBR s commitment to collaboration among its institutions provided the impetus for cooperation and collaboration among the six colleges/schools of nursing in the development of MSN RODP. To meet the educational needs of aspiring nurse faculty and practitioners, the Executive Committee capitalized on the infrastructure and success of the Regents Online Degree Program to make quality learning opportunities more available and convenient for a steadily growing population of nursing graduate students. The development of the MSN RODP has resulted in a beneficial expansion of graduate education opportunities for nurses and a greater optimization of assets of the individual campuses. The Executive Committee is committed to supporting good practice in distance education. Doing so is in keeping with the commitment to ensure high quality in the delivery of graduate nursing education online. Good practices are identified through the process of ongoing and systematic assessment and evaluation. A best practice statement provides a comprehensive and demanding expression of what is considered current good practices. Based upon the expertise and substantial experience of RODP, the MSN RODP subscribes to and supports the best practices for electronically offered degree and certificate programs identified by the Southern Regional Accrediting Commission (The Commission on Colleges, Southern Association of Colleges and Schools. Best Practices for Electronically Offered Degree and Certificate Programs: Supplement to Guidelines for Distance Education. Decatur, GA. at These Best Practices complement the principles of distance education and considerations for implementing distance education required by the National League for Nursing Accrediting Commission (NLNAC). The SACS Best Practices and NLNAC Standards serve as the basis for
17 17 identifying principles which guide the development and implementation of the MSN RODP. For the purpose of establishing these guiding principles, distance education is defined as an educational process in which the majority of the instruction occurs when a student and instructor are not in the same place (NLNAC, 2005). In compliance with RODP policies and procedures all online instruction is asynchronous. The following guidelines support MSN RODP course development and delivery. Courses provide for timely and appropriate interaction between students and faculty and among students. Faculty assumes responsibility for and exercises oversight of the curriculum, ensuring both rigor of the program and the quality of instruction. The technology used is appropriate to the objectives of the program and expectations concerning the use of such technology are clearly communicated to students There is currency of courses and materials Policies are clear concerning ownership of materials, faculty compensations, and copyright issues. Faculty support services are appropriate and specifically related to online instruction. Faculty who teach in the program receive appropriate training. Admission and recruitment policies and decisions take into account the capability of students to succeed in online courses. The integrity of student work and the credibility of courses credits are ensured. Students have access to and can effectively use appropriate library resources. Courses requirements ensure that students make appropriate use of learning resources. Students have adequate access to the range of services appropriate to support the program. Course requirements ensure comparability to campus-based courses. Students have an adequate procedure for resolving their complaints.
18 18 The referencing of these particular guidelines in this statement does not imply that they are the only requirements/principles that apply to distance education and/or the MSN RODP. Additional requirements for course development and specific faculty expectations are found at the RODP website. As technology impels the health care delivery system, nursing education must follow. As Internet use increases within the health care delivery system so does its emphasis in online teaching and learning. Online education prepares students to be active participants in an increasingly technology-driven world. Using technology, the MSN RODP improves access to high quality, affordable, student-centered graduate nursing education opportunities through cooperation among the six TBR Universities. Program Overview The goals of the Master of Science in Nursing (MSN) Regents Online Degree Program are to prepare nurses to: teach in a variety of academic and practice settings; provide advanced nursing care to rural, urban and underserved populations practice in collaborative and interdisciplinary relationships; assume positions of leadership in the health care delivery system; contribute to the current and evolving body of nursing science; and continue study at the doctoral level. With this in mind, the purposes of the MSN RODP are: To increase access to graduate nursing education, especially for those nurses aspiring to teach in entry level nursing programs, manage professional practice work settings, and practice as advanced clinicians in a changing health care delivery system. To maximize the effective use of technology for delivery of graduate-level instruction. Distance delivery through the use of technology will increase access to graduate education, especially in remote areas of the state and for practicing nurses for whom time flexibility is a critical resource. To provide student access to web-based courses and degree programs. Web-based courses will reach populations not currently enrolled in graduate education, and will also permit students who are currently enrolled in on-campus courses to take additional courses, thus completing their programs sooner.
19 19 To encourage and support collaboration among TBR institutions. Course development and delivery will be cost-effective because courses will be developed by one institution and used by all. The use of national guidelines and standards is an important component in program development, review and evaluation. The Essentials of Masters Education for Professional Nursing Practice (AACN, 1996) was used to develop program outcomes and will provide a framework for review and revision. In addition, specific standards for concentrations within the Master of Science in Nursing program are incorporated into course objectives as appropriate. The Southern Regional Education Board (SREB) Council on Collegiate Education for Nursing (CEN) Nurse Educator Competencies (2002) provides the bases for the development and review of the nursing education concentration. The Criteria for Evaluation of Nurse Practitioner Programs (NONPF, 2002) provides standards for the development and review of the family nurse practitioner concentration. Outcomes Graduates of the program will: 1. Demonstrate knowledge and competencies in advanced nursing practice, teaching (in the classroom and in clinical settings), informatics, and administration; 2. Integrate specialized knowledge and theories from nursing and related disciplines into advanced nursing roles; 3. Use research to validate and refine knowledge relevant to advanced nursing roles; 4. Practice advanced nursing roles in collaborative relationships across disciplines and in partnership with communities (ie: nursing education, nursing administration, nursing informatics, and advanced clinical practice); 5. Manage the health care of clients within legal, ethical, and professional standards; 6. Improve the health of clients among diverse population groups; and 7. Promote positive changes in health care delivery, health policies, and nursing practice.
20 20 Faculty supervision of students in clinical/practicum courses may be direct or indirect. Direct supervision occurs when program faculty function as on-site clinical preceptors. When nurse practitioner faculty provide direct supervision of students the on site faculty/student ratio is 1:2 if the faculty is not seeing their own patients. If the nurse practitioner faculty is seeing their own patients the on site faculty/student ratio is 1:1. Indirect supervision has three components: (1) to supplement the preceptor s teaching, (2) to act as a liaison to a community agency, and (3) to evaluate the student s progress. The ratio for indirect faculty supervision, which encompasses coordinating the clinical experience, interacting with the preceptor, and evaluating the student, is 1:6 for nurse practitioner students and 1:8 for students in other concentrations. However, ratios may vary relative to certain practice areas and the individual faculty member. Whether through direct or indirect roles, the faculty are responsible for all students in clinical or practicum courses. Clinical Participation Requirements Registered Nurse Licensure The student must meet Registered Nurse licensure eligibility requirements in the state in which the practicum takes place. Advanced Practice Student Liability Insurance The graduate student practices under his or her own license and is required to maintain current advanced practice student liability insurance for course-related incidents. Health/Immunization Requirements All students must document physical and/or emotional fitness to meet the essential requirements of the program. Current physical examination and immunization records are required. A sample Health History and Physical Examination form is included in Appendix F. Student health records may be provided to clinical affiliates upon request in compliance with Clinical Affiliation Agreements. Background Checks Criminal background checks may be required by clinical affiliates. It is the student s responsibility to make timely arrangements for the background check and to pay all costs associated with such checks. Basic Life Support (BLS) Health Care Provider