- If office policy permits, student documents findings in patient chart to preceptor s satisfaction
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1 PRECEPTOR SUMMARY INFORMATION Thank you for agreeing to be a preceptor for a USF nurse practitioner student during a clinical rotation. This information is designed to introduce the goals of a clinical rotation and to assist you in deciding how to interact with our students. The students are expected adhere to the schedule agreed upon between the two of you, present a professional appearance, take an interest in your patients, and to actively participate in clinical learning and patient care. Purpose of the Clinical Practicum: The clinical rotation facilitates the student s growth into a primary care provider role. The majority of nurse practitioner students nursing practice occurs in a hospital setting or ambulatory care environment. Traditionally baccalaureate-prepared nurses are not educated in a primary care environment, but many choose to continue their education in a graduate program to be educated as a nurse practitioner in one of several concentration areas, including pediatrics, family, or adult/gero care. The practicum experience helps the student apply classroom knowledge in a real-world setting. The practicum should include the target populations and focus on wellness, health promotion and disease prevention, early identification of health problems, and management of stable chronic illness. Students should be able complete an appropriate history and physical, describe a reasonable differential, discuss and evaluation and management plan and present the preceding to the preceptor. A student just beginning practicum will be at an early stage in the process compared with a student completing their final practicum. Design of the Clinical Practicum: The practicum is 16 weeks in length (Fall and Spring semester), and 12 weeks in length (Summer semester) incorporating 180 hours of clinical hours with Primary Care Physicians and Nurse Practitioners. We want our students to be exposed to a variety of patients and problems in the clinical setting, enabling them to experience the issues relating to a number of populations. We don t expect them to become experts in management of all problems and needs; we do expect them to improve their comfort levels in caring for patients, and learn about the resources available to improve patient care. Expectations of Preceptors: Considering the above information, we appreciate the preceptor welcoming our students to their practice, providing them a brief overview of the practice philosophy and rules, and introducing them to the staff. It is reasonable to have the student shadow you for a few patients, so they can learn your style. The student may then be sent in to see a patient, to gather a history and perform a physical, then present the patient to you. It is expected that you will revisit the patient with the student and confirm or guide their findings, differential, and plan. If the student is not allowed to document in your records, they will be expected to complete a certain amount of de-identified documentation for their academic progression. First Practicum Students 1. Days 1-2 Observational experience of provider and patient interaction (may vary based on student s prior experience and your comfort with precepting and your comfort with the student) - Preceptor style and patient interaction - Discussion of the differential diagnosis, and evaluating and management rationale - Discussion of methods to obtain labs, diagnostic imaging, referrals and consults - Observation of practice culture and documentation methods 2. Days 2-4 Preceptor should observe the student perform a patient history and physical exam - The student should discuss the findings, offer a tentative differential diagnosis and propose an evaluation and management plan at a novice level - Preceptor refines plan and offers rationale to the student - Preceptor recommends further practice-related further study by student (ongoing) - If office policy permits, student documents findings in patient chart to preceptor s satisfaction 3. Subsequent clinical time - Student independently and unobserved performs history and physical exam - Student reports findings to preceptor, offers proposed differential diagnosis and plan - Preceptor and student finalize visit with patient including any repeat examination and additional history deemed appropriate by the preceptor - Preceptor recommends further practice-related further study by student (ongoing)
2 Second Practicum Students - Day 1 :Observation of preceptor style, practice culture and documentation methods - Arrives with a semester of clinical experience, including completion of many history and physicals, initial efforts at developing differential diagnoses, and development of treatment plans - Should demonstrate synthesis of didactic learning with initial clinical experience. - Is likely to ask an increasing number of clinically appropriate and insightful questions. - Having the student research certain questions and provide you with a one minute summary may provide an excellent learning tool for the student in this and later practicums. - Preceptor recommends practice-related further study by student Third/Final Practicum Students - Day 1 :Observation of preceptor style, practice culture and documentation methods - Has completed at least two semesters of clinical experience at varied sites - Should be able to obtain an appropriate history with minimal reminders, perform a relatively smooth exam, identify a broad differential, and develop an evaluation and treatment plan - Identify health promotion and disease prevention strategies appropriate to the patient. - While concluding the final practicum the nurse practitioner student will be eager to see patients independently, present the patient to you, and collaborate with you to complete the plan of care. Patients will still need a brief revisit from you to confirm findings, discuss the plan, and add your own perspective to the visit. - At the end of the clinical day, time allowing, it may be beneficial to review any of the challenging patients and discuss issues related to those types of patients or concerns. - Preceptor recommends practice-related further study by student Evaluation Process Clinical Faculty Role - At least once during the semester, generally by mid-term, a clinical faculty member will visit your practice when the student is in attendance - The clinical faculty will o meet privately with the preceptor to discuss the student s progress o observe the student with a patient (after obtaining the patient s permission) o evaluate the student from a faculty perspective - Any concerns will be addressed jointly with the preceptor and the student o Remediation needs will be documented and contracted with the preceptor and the student o Any follow up visits will be planned with the preceptor and the student by the clinical faculty Preceptor Role - Preceptors are asked to complete a midterm and final evaluation each semester on a tool provided by USF College of Nursing - Any U or unsuccessful score means the student fails the clinical and the course o We ask that if you have any concerns that the clinical faculty be contacted immediately, not waiting for the planned evaluation time Student Role - Provide name and contact information for clinical faculty early each semester - Inform preceptor and office staff promptly of clinical faculty s visit date - Provide evaluation tools to the preceptor for midterm and final evaluation - Notify clinical faculty and course director of any problems immediately and upon request - Complete an evaluation of their experience - All evaluations are scanned into the students records and the originals retained by the student after scanning For detailed information, follow these links: Inquiries, Assistance and Comments? Please CLINICAL@Health.USF.edu
3 NGR 6202C: Primary Care of Adults II (first practicum for adult and family nurse practitioner students) This course is designed to provide the student with the didactic basis and direct care clinical experience for diagnosing and managing acute and chronic health conditions of early, middle and late adult life stages. 1. Utilize knowledge, theory, and research findings to promote health and reduce the risk of illness for adults across the lifespan 2. Conduct assessments appropriate to the patient s presenting condition, stage of development/maturation, and culture. 3. Identify physical findings and aspects of subjective data associated with chronic health care problems of adults. 4. Compile and analyze data to develop a differential diagnosis chronic health problems of adults. 5. Order and interpret appropriate laboratory tests and diagnostic studies 6. Develop an evidence based, comprehensive management plan of care consistent with results of data analysis that includes the physical, psychosocial and cultural needs/resources of the patient as well as quality indicators, patient safety and nticipatory guidance and educational needs 7. Appropriately prescribe pharmacological and non-pharmacological therapy for chronic health problem. 8. Evaluate clincial data and therapeutic options to differentiate between problem situations requiring nurse practitioner management, collaborative management, or referral to other providers. 9. Apply principles of collaboration with other health care professionals for patients. 10. Incorporate community resources into the plan of care. 11. Function within the parameters of the ANP/FNP role and legal scope of practice. 12. Demonstrate the ability to critique research literature. 13. Use evidence based research, best practice guidelines and standards of care in diagnosing and treating adults with common and chronic health problems 14. Delineate appropriate expected outcomes for the patient
4 NGR 6302C Primary Care of Children and Adolescents II (first practicum for pediatric nurse practitioner students) This course is designed to provide the student with the didactic basis for diagnosing and managing chronic health conditions of the child and adolescent. Attention will be paid to the needs of culturally diverse and vulnerable populations. Emphasis is on compiling and analyzing data, developing and implementing a plan in conjunction with the individual, the family, and other providers, and evaluating both patient/family response to the care and the effectiveness of the plan. The use of lecture, case studies, and examples from faculty practice will focus on assessment, differential diagnoses and treatment, maximizing the use of available resources, making appropriate referrals, and attending to the importance of family dynamics. Students have the opportunity to build on previously acquired primary care skills, and to apply the concepts of family and self-care to children and adolescents. In addition, concepts of health promotion and health maintenance are integrated throughout the course. 1. Conduct assessments appropriate to the client s presenting condition, stage of development/maturation, and culture. 2. Identify physical findings and aspects of subjective and objective data associated with acute health care problems of children and adolescents. 3. Compile and analyze data to develop a differential diagnosis for common and acute health problems of children and adolescents. 4. Order and interpret appropriate laboratory tests and diagnostic studies for common and acute health care problems. 5. Develop a regimen of care consistent with results of data analysis that includes the physical, psychosocial and culture needs/resources of the patient as well as anticipatory guidance and educational needs. 6. Appropriately prescribe pharmacological and non-pharmacological therapy for common and acute health problems of the child and adolescent, 7. Apply principles of collaboration with other health care professionals for patients with specific diagnoses or psycho-social concerns. 8. Incorporate community resources into the plan of care. 9. Function within the parameters of the advanced practice role and legal scope of practice. 10. Demonstrate the ability to critique research literature applicable to evidence based practice
5 NGR 6305L: Primary Care of Children and Adolescents I Practicum (middle practicum for FNP students) Focus on application of the knowledge gained in the classroom in Primary Care: Children to the patient/client population between birth and pre-adolescent years. Screening, health maintenance, and management of health problems will make-up the clinical experiences of this course. 1. Demonstrate a complete health assessment for culturally diverse clients between birth and preadolescence through: a. Formulating a complete or interval health history and physical examination. b. Recording a problem oriented health history and physical examination. c. Determining the functional assessment of each patient/client. d. Constructing a list of differential diagnoses based on elicited data. e. Prioritizing health problems after considering all data and resources. f. Identifying, ordering and analyzing necessary diagnostic studies to support elicited data. g. Developing a comprehensive cost-effective management plan that includes Rx, Tx, Patient Education and follow-up care. 2. Counsel a patient/client and family on health promotion and maintenance including: a. Health screening examinations as recommended. b. An individual plan based on health assessment data. c. Evaluation of this plan on a periodic basis during follow-up visits. d. Teaching about health needs and risks frequently encountered in this age group. e. Demonstrate advanced practice role when providing services. 3. Integrate advanced nursing practice into the services provided the patient/client and their families while encouraging involvement in their care and collaboration with other health professionals. 4. Complete clinical performance evaluations at the level of progress in the program. 5. Demonstrate professional demeanor as an APN in all activities and clinical settings.
6 NGR 6343C Primary Care of Women (middle practicum) Please note: While students need 180 clinical hours for this semester, not all hours must be in a women s health setting. Often students are placed in a general setting for the bulk of their hours and in a women s health site for about 40 hours. This course presents the management of common episodic and chronic health problems in women. Developmental stage, psychosocial strengths, lifestyle variations, environmental stresses, cultural diversity and the available resources of the patient/client will be incorporated in the student s approach to this population. Critical analysis of these problems will form the foundation for advanced practice nursing intervention and health promotion. For the clinical experience, focus will be on application of the knowledge gained in the classroom in primary care of women. 1. Determine the health status, risk profile, health maintenance and health promotional needs for women in relation to lifestyle, family, occupation and current social environment. 2. Identify risk factors and behaviors associated with common health problems and disorders of women. 3. Assess and diagnosis of common health problems among women. 4. Develop evidence based advanced practice interventions, pharmacological regimens, management protocols, teaching in conjunction with the patient and collaborative health care team. 5. Demonstrate knowledge of the advanced practice role through the collaboration and referral of patients/clients with health problems which exceed scope of advanced nursing practice. 6. Analyze the care of the patient/client with respect to management outcomes, cost-effectiveness, cultural sensitivity, and available resources.
7 NGR 6700C Transitions (Final Practicum) This course completes summative process for students to design and develop their roles as Advanced Practice Nurses (APN). It provides an opportunity for integrating professional knowledge with clinical skills as well as negotiating and marketing this role in the professional community. The clinical portion will focus on the cumulative knowledge gained in the previous courses. This is a synthesis course for professional and clinical development. The final result of this course is application of advanced practice knowledge at entry level to practice. 1. Utilize evidenced based research as a foundation in the design and development of an innovative role as an APN. 2. Demonstrate competence and accountability as an APN in the management of patient/client health maintenance and related problems in their area of concentration. 3. Collaborate effectively with multi-disciplinary providers to ensure the continuity of care for all patients/clients regardless of socioeconomic status, culture or ethnic diversity. 4. Monitor quality and cost-effectiveness of practice as an APN. 5. Demonstrate leadership in the APN role through the development and marketing of a unique position and articulation of an issue related to APN practice. 6. Demonstrate proficiency in performing a complete or focused health history and physical examination on all patients/clients, appropriate to the specialty area of practice, encountered in the clinical setting regardless of cultural origin or socioeconomic status. 7. Formulate plans that include assessment, diagnostics, management and continuity of care of the patients/clients in the clinical setting with respect to cost-effectiveness and available resources. 8. Demonstrate leadership in the APN role through collaboration and planned application of scholarly work to the selected clinical setting.
8 The student will bring this form with them when they begin their clinical. Please keep a copy. Clinical Site Confirmation University of South Florida College of Nursing This Student-Preceptor-Faculty Clinical Site Confirmation should be signed on the first day of each clinical rotation and forwarded to the Clinical Site Coordinator via mail, scan, fax, or to the following: Mailing address: Fax: University of South Florida sthomaso@health.usf.edu (813) College of Nursing Selena Thomason Bruce B. Downs Blvd, MDC22 Clinical Site Coordinator Tampa, FL ************************************************************************************************************************************ Student Section I confirm that: RN LICENSE (check ONE) My RN license is current and unencumbered OR My RN license is conditional and/or restricted (documentation attached) BACKGROUND CHECK I have shown a copy of my background check to this clinical site SCHEDULING of CLINICAL TIME I understand that I must comply with the preceptor s availability for clinical scheduling (U#) (Term) (Course) (Concentration) (# of Hours at this Site) (Print Student Name) (Signature) (Date) Preceptor: ARNP PHYSICIAN The student has shown me a copy of his/her background check (Print Preceptor Name) (Signature) (Date) Clinical Site Name: Clinical Site Address: City, State, Zip Code: Clinical Site Phone #: Adult Concentration Director (Interim) Family Concentration Director Pediatric Concentration Director (as of 1/3/12) Athilingam, Ponrathi, PhD Debra Friedrich, DNP Susan Kennel, PhD pathilin@health.usf.edu dfriedri@health.usf.edu contact information TBD
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