So You Want to Be a Nurse Practitioner? Choose the Right Program

Marie Napolitano, PhD, FNP; Tracy A. Klein, PhD, FNP

Disclosures

October 22, 2012

In This Article

Program Faculty, Students, Clinical Sites, and Preceptors

Faculty. The accreditation process for schools of nursing includes a review of program faculty with respect to level of education and clinical preparation. NP faculty should be in clinical practice to maintain certification, licensure, and current expertise.

Students. Student numbers are increasing overall, probably as a consequence of the shift to online programs. It is important to inquire about typical class size and consider how class size might affect the learning experience. It can also be helpful to determine the number of students in a specific cohort, which can speak to opportunities for faculty and peer interaction during the program.

Clinical Site Placement

Students are placed in clinical sites that match the population focus of their program. For example, at least 50% of sites for family nurse practitioner (FNP) students should be family practice/primary care sites. However, FNP students can be placed in internal medicine, pediatrics, urgent care, and prenatal and women's health sites because these sites serve populations that can also be seen by FNPs. Many state licensing boards will not recognize graduates of FNP programs that place students only in adult and pediatric settings but fail to integrate family practice knowledge.

Programs either arrange clinical placement sites and preceptors or require students to find their own clinical sites. Programs that place students should ascertain the preceptors' state licensure and national certification, years of NP experience, education, and previous preceptor experience as well as the clinical placement setting's receptivity to students and physical facilities for students (including patient exam rooms, desks, and computers). The applicant should inquire about the variety of clinical placements available, such as private offices owned by physicians or NPs, institutional primary care clinics, Native American and migrant clinics, rural practices, school-based clinics, and integrative health settings.

Contracts are required between clinical sites and universities for any student clinical experience and must be signed by both parties before a student can start the clinical experience. The applicant should inquire about timelines for contracts, person initiating the contract (student or NP program staff/faculty), and what happens if the contract is held up beyond the start date for the clinical experience.

When students are required to find their own preceptors, what role does the program play? Who vets the preceptor -- the student or the program? When NP students are required to find their own clinical placement sites, they may remain in those settings longer than 1 quarter or semester. There are pros and cons to long-term preceptor placements. The advantages include the ability of the student to get to know the staff and functioning of the clinical site in depth, follow patients for longer periods of time, and have a longer period of time to establish a relationship with the preceptor. On the other hand, changing clinical sites every quarter or semester offers the student more diversity in clinic settings and operations, patient populations, delivery of care methods, and preceptor styles and personalities.

Clinical evaluation by faculty is required by NONPF guidelines, which state that the program faculty is ultimately responsible for supervision and evaluation of the student's clinical performance.[3] In some programs, the faculty member of the clinical course visits once or twice each quarter or semester. Some programs hire NPs as adjunct faculty to travel to distant sites to conduct clinical evaluations. Other programs use the preceptor as the sole source of clinical evaluation.

Evaluations and reviews of an NP program by current or past students can be helpful in deciding where to apply. If student opinions would be valuable to the applicant in making a decision, the applicant can ask if student evaluation data are available for review. If such data are not publicly available, or the program's administrators decline to supply this information, the applicant can ask whether it is possible to speak with current or past students.

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