Your first student: a week-by-week guide

Before day one

A great first day is set up the week before:

• The affiliation agreement is in place and the school’s forms are complete; with Preceptorate, our team handles both.
• You have the school’s orientation packet, which NP programs provide to every new preceptor.
• You both know the schedule: the days, the start time and where to arrive.
• Access to your records system is arranged, or you know how the student will document.
• You have read the course objectives, so you know what the school expects the student to practice.

Week one: watch and learn the clinic

The student shadows you and learns the flow of your day, your templates and your patients. Think out loud on a few visits: why you asked that question, why you chose that test. By the end of the week, let them take part in simple parts of the visit with you in the room, such as vital signs, medication reconciliation or part of the history.

Weeks two and three: histories and presentations

The student starts seeing patients first: history, examination, then a short presentation to you before you go back in together. This is where the One-Minute Preceptor helps most, a five-step model published in 1992 for teaching inside a busy clinic:

1. 1Get a commitmentAsk what they think is going on and what they would do.
2. 2Probe for supporting evidenceAsk what led them there, to see their reasoning.
3. 3Teach a general ruleOne take-home point they can use on the next patient.
4. 4Reinforce what was rightName one specific thing they did well.
5. 5Correct mistakesOne thing to do differently, and how.

The midpoint

The midpoint evaluation is a check on progress against the course objectives. Be specific: what they do well, and the one or two things to work on in the second half. Students value a midpoint that gives them a clear plan, and the final evaluation is easier for both of you when the midpoint set the targets.

The second half: leading visits

The student leads more of each visit and proposes the plan, while every order and prescription stays with you. Give them a mix of visit types so their log reflects the course: new problems, follow-ups and preventive care. As their presentations sharpen, try SNAPPS, a model where the student summarizes, narrows and analyzes the differential, asks you their questions, proposes a plan and picks a topic to read about.

For services paid under Medicare’s physician fee schedule, you can review and verify a student’s note by signing and dating it rather than rewriting it, which saves real time in the second half.

The final week

Complete the final evaluation, confirm the hours in the school’s clinical log and sign them off. Ask the school for your preceptorship letter while the dates are fresh: 120 precepting hours complete ANCC’s preceptor category and convert to as many as 25 CE hours with AANPCB.

Many preceptors end with a short conversation about what the student will take into their next rotation. It is often the part students remember most.

Small habits that make it easy

• Start each day with a two-minute look at the schedule and pick the patients the student will see first.
• Teach one point per patient, not five.
• Give feedback the same day, briefly and specifically.
• Review the hours log on the same day each week.

Planning around the course objectives

The course objectives tell you what the school wants the student to practice. A quick look at them before day one lets you point the student toward the right visits:

Your first day, hour by hour

1. 1ArrivalA quick tour: where to sit, where supplies are, who is on the team.
2. 2SystemsRecords access and the visit template the student will use.
3. 3MorningThe student shadows; you think out loud on two or three visits.
4. 4AfternoonThe student takes part in simple parts of a visit with you in the room.
5. 5End of dayFive minutes on what stood out and one goal for tomorrow.

Questions