Clinical Education for Advanced Practice Nursing Students: Do Nurse Practitioner programs really care?
Clinical education is a major contributor to advanced practice nursing students’ learning and perhaps more importantly, their readiness for practice. During clinical practice, students are provided with the opportunity to care for real patients, an avenue to transfer what they learned in class and the skills they developed through simulation to actual patient care. APRN (advanced practice registered nurse)students practicing in clinical settings get to use and develop on their skills as professionals, in the process, they also gain awareness of the competencies they may need to improve on while simultaneously learning how to interact with other health care providers in the system. All in all, the value of clinical nursing education in the clinical, professional and personal development of students is indisputable. However, as essential as clinical education is for nurse practitioner students, the practice is heavily reliant on preceptors and we can not overlook the clinical preceptors who facilitate clinical education.
The decline in the number of clinical preceptors
The role of clinical preceptors is critical in the clinical training of an advanced practice nursing program. The clinical preceptors are in essence, the link between the clinical practice and the graduate nursing programs for the students. Students generally learn better in a supportive and positive environment and for nurse practitioner students, beyond helping them develop as professionals, the clinical preceptor is vital to establishing and fostering that environment. However, despite the undeniable importance of clinical preceptors, there seems to be a shortage of these teachers in the community. This is due, in part to a large ratio of APRN students to preceptors in the system.
According to reports, between 2015–2016, and by extension every year, about 23,000 new graduates from graduate nursing programs are released into the community and every one of those graduates would need at least 600 hours of clinical education. Apart from the fact that there aren’t even enough nurse practitioners or other healthcare providers in practice to cater for the preceptorship needs of APRN students, these programs are quite time demanding and the practitioners who are willing to take up the role of clinical preceptors may not be able to help students sufficiently fulfill their hours.
Incentives and/or compensation for preceptors: the real gap in the current process
There is no denying the fact that the role of the clinical preceptor is a demanding one. These preceptors are expected to help the students learn and develop professional skills, prepare them for real practice, stay updated with clinical skills and knowledge, manage the time commitment while balancing their personal responsibilities as well. For such a rather exhausting role, it is only right that clinical preceptors are at least well compensated for their service.
According to reports, there has been a decline in the number of practitioners willing to precept the graduate nursing students. Although most preceptors are hesitant or refusing to take compensation, there continues to be a shortage and those same practitioners who don’t want payment don’t precept. So what’s the issue? Unless practitioners and other healthcare providers are incentivized to take students there will continue to be a shortage in clinical preceptors. So what kind of incentives and compensation are offered to the practitioner or healthcare providers who also serve as preceptors?
In some states, Maryland, Colorado, and Georgia to be specific, tax incentives of up to $1,000 tax credit are offered to health care practitioners who serve as clinical preceptors to graduate nurses. In some states, like Kentucky, preceptors are also paid just a little more than their colleagues. Each of the three states has it’s own unique needs nonetheless it still hasn’t been motivation enough to increase the participation of preceptors in the community.
Even though, it may be expected for APRNs and other HCPs to personally invest in the education and training of students, the days of giving back because it is our professional duty are long gone. The daily schedule of APRNs are now filled with chart audits, RVUs (relative value units- a measure of value used in the United States Medicare reimbursement formula for physician services), and increased productivity, leaving no time to train students. The nursing graduate programs need to recognize that their model of not paying for and arranging clinical sites does not work; and the model of physician assistant programs and medical schools does. Maybe the colleges of nursing should be using the ever-increasing amount of money they charge graduate nursing students for tuition and fees to compensate preceptors and quality clinical sites, and fund staff to handle the legwork involved, just like physician assistant programs do? Has the plethora of student complaints not been motivating enough to move the needle? Or has the increased number of companies created to help connect students to clinical sites not motivation enough to change the current process?
The role of education technology in the management of clinical placement systems
While certain clinical placements sites are overcrowded, there are others that are badly underutilized owing to the inefficient clinical placement system. Fortunately, the learning management systems available today can provide facilities and schools with an organized approach to clinical placement opportunities. This system allows clinical agencies and schools to attain higher levels of operating performance by increasing the number of clinical placements for the students for the primary purpose of expediting the expansion of healthcare programs. Automated clinical placement systems can help to address the pain points and gaps in which clinical placement coordinators at academic institutions endure.
Studies show that APRNs have a greater opportunity than ever to expand their role in healthcare delivery and can provide care similar to or better than physicians; however, quality cannot be maintained with the subpar clinical education student placement process.
Conclusion
It is necessary to understand the factors that are capable of influencing the clinical education of graduate nursing students in order to have an understanding of how to solve the problems associated with it. Overall, incentives and compensation for preceptors are highly recommended. It tells them that they are recognized and valued for the work they do. Also, managing the clinical placements of patients, improving the clinical placement process and providing an excellent clinical environment should be prioritized in nursing schools and facilities.
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References
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