Inside Clinical Preceptorship: What Counts as Quality Experience

A clinical preceptorship is a period of supervised clinical learning in which you care for patients one-on-one with an experienced clinician, your preceptor. Nurse practitioner (NP) students complete their clinical courses this way, and many nursing students and newly licensed nurses do too. Here’s how a clinical preceptorship works, how long it lasts and what makes it a quality experience.

TL;DR

• A clinical preceptorship is a supervised clinical learning arrangement. Your preceptor is the experienced clinician who teaches you one-on-one during the preceptorship.
• NP clinical courses use preceptorships, and so do some nursing programs’ final courses and many new-graduate nurse orientations.
• Your faculty approve the placement and evaluate your progress, drawing on your preceptor’s feedback, your clinical logs and their own observation.
• The 2022 national standards set a minimum of 750 direct patient care hours across an NP program.
• Signs of quality include hands-on care that fits your track, a variety of patients, close supervision and regular feedback.

What is a clinical preceptorship?

A clinical preceptorship is a planned arrangement in which an experienced clinician supervises and teaches you while you care for patients. The arrangement includes the placement, its learning objectives, its hours and how you’re evaluated. Your preceptor is the person who teaches you, and our guides explain what a clinical preceptor is in NP education and what a nurse preceptor is in hospital nursing.

California’s nursing regulations define a nursing school preceptorship as “a faculty-planned and supervised experience comparable to that of an entry-level registered nurse position.” In NP programs, the 2022 national standards for NP education describe a preceptor who “collaborates with faculty to facilitate and supervise NP student clinical learning experiences in a faculty approved clinical setting.”

Where do you complete a clinical preceptorship?

Preceptorships are part of NP programs, the final course of some nursing programs and many new-graduate nurse orientations.

• NP programs. In each clinical course, you work with a preceptor at a site your faculty approve, including sites and preceptors you find on your own. Your program also includes a concentrated clinical experience near the end that prepares you for the full scope of NP practice.
• Nursing school. Some programs end with a preceptorship, such as the capstone course at Northwest Nazarene University, where students apply what they’ve learned “under the mentorship of a nurse preceptor.”
• Your first nursing job. At UMass Memorial Medical Center, for example, new graduates in the nurse residency program orient on one unit with RN preceptors before they work independently.

What about nursing preceptorship jobs?

If you’re a new graduate searching for nursing preceptorship jobs, look for RN positions that start with a precepted orientation or residency. UMass Memorial’s residents, for example, work up to 40 hours a week while they orient with their assigned preceptor. Ask each employer how long orientation lasts and whether you’ll work many of your shifts with the same preceptor.

If you’re an NP student hoping to complete clinical hours at your current job, check your program’s rules first. United States University says “Clinical hours must be separate from students’ normal job duties and hours.” The University of Colorado Colorado Springs (UCCS) may allow students to complete hours at their workplace, but only in a different location or unit, and with approval.

How is a preceptorship structured?

Your faculty, your preceptor and you each have a defined role. Here’s how the work is shared under the 2022 standards and the American Association of Colleges of Nursing’s Clinical Preceptor Guide:

• Your faculty approve the site and preceptor, then give your preceptor your course objectives, required hours, evaluation forms and competencies. They also tell your preceptor your level and how your skills should progress.
• Your preceptor supervises and teaches you in a safe setting. Preceptors who are new to your program receive a formal orientation.
• You stay in touch with both of them, meet the site’s requirements, such as HIPAA, and share your learning needs and the objectives your faculty approved.

Your program also keeps a current agreement with the site or preceptor and puts your preceptor’s responsibilities in writing. In a California nursing school preceptorship, your preceptor must be “present and available on the patient care unit the entire time” you give care, and faculty hold periodic on-site meetings with both of you.

How are you evaluated during a clinical preceptorship?

Your faculty evaluate you, using your preceptor’s feedback, their own observation and the patient encounters you log. Under the 2022 standards, evaluation includes:

• Preceptor feedback on your performance, using your program’s forms.
• Faculty observation through site visits, recorded encounters, simulation or remote observation.
• Clinical logs of your patient encounters, which show your progress.
• Joint meetings with your faculty and preceptor, plus your own evaluation of the preceptor and site.

At UCCS, for example, preceptors rate skills such as taking a history, building a differential diagnosis, planning treatment and applying feedback, on a scale from “needs significant improvement” to functioning “at or near independent level,” and that evaluation counts toward the course grade.

How long does a clinical preceptorship last?

Each preceptorship lasts as long as the course or orientation it belongs to.

• NP programs. The 2022 national standards set a minimum of 750 direct patient care hours for every NP population-focused track, and ANCC and AANPCB certification require at least 500 faculty-supervised clinical hours. Programs divide those hours among clinical courses. United States University, for example, requires 135 hours per clinical course. Our guide to how long clinical rotations are covers typical schedules.
• Nursing school. Northwest Nazarene University’s capstone preceptorship is 180 hours.
• New-graduate orientation. Your hospital sets the length. The National Council of State Boards of Nursing’s (NCSBN) Transition to Practice study linked better outcomes for new nurses to programs that included a preceptorship and lasted 9 to 12 months.

For NP students, only direct patient care counts toward the 750 hours. Care you give through telehealth can count, while simulation can’t. Learn more about what counts as clinical hours.

What makes a clinical preceptorship high quality?

A high-quality clinical preceptorship gives you hands-on care at your level, a variety of patients that fits your track, close supervision and regular feedback tied to your course objectives. Here’s what to look for, based on national standards and research:

• A placement that fits your track. The 2022 standards require placements “aligned with the program role and population focus.” In a family NP track, for example, expect to care for patients across the lifespan.
• A variety of patients. Your faculty review your logged encounters “for breadth, depth, and type.” UCCS caps the hours a student can spend with one preceptor or at one site at 330 “to offer a variety of experiences.”
• Hands-on care. Clinical hours are time spent giving direct clinical care, so expect to take histories, examine patients, suggest diagnoses and present cases to your preceptor.
• Close supervision. In NCSBN’s study, new nurses whose preceptorship was one-on-one, with shared patient assignments and many of the same shifts, received significantly higher competence ratings and left their jobs at a significantly lower rate.
• A preceptor prepared to teach. The standards require a formal orientation for new preceptors, and NCSBN linked better outcomes to “a preceptor who was educated for the role.”
• Feedback and time to reflect. NCSBN also linked better outcomes to giving new graduates time to receive feedback and share their reflections.
• An early check-in. Your faculty, your preceptor and you evaluate the placement together early in the rotation, so there’s time to make changes.

How can you get more from your preceptorship?

Take an active part from the start:

• Before you accept a placement, use our list of questions to ask a preceptor to learn about the patient mix and how students take part in care.
• Share your course objectives and evaluation form with your preceptor in your first week.
• Ask your preceptor for brief feedback at the end of each clinical day.
• Log your encounters as you go, so you can spot gaps in patient variety early. Our guide to clinical goals for NP students shows how to turn your logs into a plan.
• If you’re mostly observing, or your patients don’t match your course, tell your faculty at the early check-in.

Clinical preceptorship questions

Do all nurses do a preceptorship?

It depends on your nursing program and your first employer. California, for example, lets each nursing program “choose to include a preceptorship in its curriculum,” and orientation for new graduates varies from hospital to hospital. NCSBN found that some transition programs for new nurses “were sparse, with little or no support for the new graduate.”

What is the difference between clinicals and preceptorships in nursing?

In traditional nursing clinicals, a clinical instructor from your school may supervise several students at once. In a preceptorship, you work one-on-one with a clinician who practices at the site. At the University of Miami School of Nursing and Health Studies, for example, a clinical instructor “may supervise multiple students at one or more clinical sites,” while a preceptor “typically works one-on-one or with a small number of students.”

Do clinical preceptors get paid?

It depends on the arrangement. Through Clinical Match Me, preceptors earn $1,000+ per rotation, and the price you pay us includes their honorarium. You’ll never pay a separate fee to the preceptor.

How do you find an NP preceptor for your preceptorship?

Start with your school, and if you need more options, use a preceptor placement service. Clinical Match Me is a preceptor placement service for NP and PA students in every clinical specialty. Our founder is a nurse practitioner who struggled to find a preceptor as a student, and since 2014 we’ve helped more than 10,000 students find preceptors.

To find a nurse practitioner preceptor with us, submit a placement request with your specialty and rotation dates. Preceptors review your placement request and send you offers, so you choose your preceptor instead of being assigned one. Then compare offers and choose the best preceptor for your schedule and learning goals. Many students receive their first preceptor offer within 24 hours of registering. Still, try to submit your placement requests as early as possible.

Free to join and no credit card required. Pay nothing until you accept an offer. Once you do, you’re protected by our Money Back Guarantee. If your school rejects your preceptor for any reason, or your preceptor cancels, you get a full refund or a replacement preceptor at no extra cost.

Sign up free and start receiving offers from preceptors who meet your requirements.