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  1. #1
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    Doc is offline Administrator 9363 points
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    Nurse Practitioner (NP) Student Precept

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    As an M.D. Family Medicine practice, we've been preceptors for a number of Physician Assistant (PA) students as well as Medical Residents and Students (MD and DO). But whenever Nurse Practitioner (NP) students asked to rotate with us, being unfamiliar with their program, we always said, "sorry, we don't take NP students".

    That changed when a friend in NP school asked if she could do her "Family Medicine" clinical rotation in our clinic. Since this was a friend, we decided to make an exception. We filled out the necessary paperwork and agreed to precept for her. I honesty didn't read the packet of papers in detail since I mistakenly assumed it was similar to the other students/residents we had. Although she was in the latter part of her program, we immediately noticed that she had much less fundamental medical knowledge than ANY other Med or PA student we had ever had, essentially equivalent to a 1st year med student. So we began teaching her as we did any other student, and she was extremely eager and quick to learn saying she had learned more in her first couple of visits at our clinic than she had in all of her other rotations combined. But then her school noticed that she was spending more than her designated time at our clinic and they took action.

    As per their instructions, she was to come in 1 morning (no more than 4 hours) per week for 12 weeks, but ONLY when there are patients scheduled. Anyone who has worked in a medical clinic will know that patients are seen back-to-back, with no downtime, but staff (including students) still work before and after the patients are seen. So my first question was, when are we supposed to go over what the student observed and what she will need to look up for homework if she can't stay before or after the patients are there (i.e. why we ordered whatever labs/imaging/scripts, what's the differential diagnosis, etc)? The answer was that we should just allow the student to observe how we perform the physical exam and "they" (the NP school) will take care of the rest since "they" will be grading the student (normally the preceptor teaches and grades). Curiously, I asked how? The answer was, as per the contract, "they" will send "faculty" unannounced to observe the NP student working up our patients with the preceptor.

    What?? Isn't the preceptor on faculty? The answer was no. I mistakenly assumed it was a money issue, so I said we'd be on faculty for free since we already agreed to precept this student free of charge as a favor anyways. They said no, it's that "they" don't have preceptors on faculty. Ok, fair enough, but I find it rather insulting that they wouldn't trust the "Board Certified Family Medicine" M.D.'s ability to teach and grade the NP student for the "Family Medicine" rotation. The answer was that is the way they do it.

    So my final question was, what in the world is the preceptors' role in this process besides allowing access for the students to practice on our patients?? I couldn't seem to get a satisfactory answer, so I told them we couldn't allow their students to treat our patients without our ability to teach them how and why to treat what they are treating, and we certainly couldn't allow whatever faculty to show up unannounced to enter into patient exam rooms (HIPAA red flags everywhere).

    We agreed to disagree and the NP student did her rotation elsewhere under a licensed NP. Because this student had boasted so much about how much she had learned at our clinic, we constantly get NP students and their faculty asking us if we'll precept for them. Maybe this was just a bad experience, but our answer has sadly defaulted back to, "sorry, we don't take NP students".
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  2. #2
    Raycallier is offline Newbie 510 points
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    good to hear this.

  3. #3
    leadsled is offline Senior Member
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    ahhh forget it!
    Last edited by leadsled; 09-29-2018 at 03:50 PM.

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