I have the best job in the world for me! I enjoy what I do, I enjoy working with my patients and coworkers, and I love the opportunity to learn. Some of my greatest teachers have been my patients. Not far behind them are the students I precept. Precepting students helps keep me on my toes clinically and, more important, students give me insight, inspiration, and passion for my profession. Clinical teaching is a way to give back to our profession and benefits both students and teachers while perpetuating the NP profession.
The past 10 years or so have brought many new challenges to our work as NPs. Electronic health records, quality or performance measures, and demands for more productivity have changed how we practice. It is easy to put off precepting students because we are too busy (I did this for a while). Then, I heard a colleague say that the biggest threat to the profession is a lack of clinical preceptors. We cannot sustain our profession without participating in the education of our up and coming members. New NPs need us, but we also need them.
We can perceive many barriers to precepting NP students. It is easy to “create” barriers to the things we really need. My coworkers take a walk every day at lunch time. For many years, I did not think I had the time to take a walk with them. There was always more work I had to do. They continued to invite me and, one day, I decided to walk with them. I recognized the benefits were far greater than the time and energy I invested.
The work would always wait for me. The same thing happened with precepting students. I found it so easy to turn down requests. I always had too much to do, and adding a student into my work seemed too difficult. Now, with a regular schedule of students, I find so much more life and gift in my practice. It slows things down a little but increases my learning, my growth, and my job satisfaction. Many of my students even began to take that lunch walk with us, learning not only how to care for patients but to care for themselves while connecting with other members of the team.
Part of my work with students is to assign “homework.” The assignment is based on a clinical issue, guideline, or practice that we have worked with that day, and it becomes an opportunity to dig in a bit deeper. I ask the student to find the data, the research behind the guideline or practice. We both become enlightened as the student brings back information and analysis that often surprises us both.
We look at things like the absolute risk reduction of common practices or treatments as well as the number needed to treat and get a sense of the clinical significance. The students learn to use resources, to read the research, and to make clinical interpretations, which they can then share with patients when making decisions. Learning becomes more than learning guidelines and algorithms. Students learn how to interpret, judge, think, and, most of all, how to share clinical information with patients.
As a clinical teacher, I find great reward in seeing a student grow from a novice to a grounded learner. I discuss with students that learning is a process that will continue throughout their career, sharing that the way I practice now is far different than it was 10 years ago. It is dynamic, and the goal is to grow and change.
Many students, as they near completion of their education, feel that they do not have the knowledge that they need to practice. This thought process is a normal and healthy feeling. There will always be more information or knowledge that many of us do not know. Helping a student understand this and the process of learning is as important as any clinical skill.
Precepting students can bring other additional benefits. The best way to know a prospective employee is to help educate that person. If you have job openings at your practice, you now have firsthand experience about someone you could recruit to work with you. Another benefit of precepting is the continuing-education contact hours that can be earned. Some institutions even offer a monetary stipend for precepting students. My favorite fringe benefit of precepting has been meeting new friends and colleagues who will be carrying our profession forward. I have maintained a professional connection with some of my past students and have seen how they progressed in their careers, became preceptors themselves and leaders in healthcare.
A challenge I have found to precepting is dealing with the number of requests I receive. Some come from educational institutions, but most come from individual NP students either directly or through a list-serve request. It is important that there is a good “fit” between student and teacher. When I receive a request to precept, I always ask for a résumé or curriculum vitae from the student along with the student's career goals. I work in rural primary care and want to help educate students who have a desire to work in a similar setting.
Next, I make contact with students who interest me to discuss their goals in learning as well as my style of practice and teaching before agreeing to precept. This adds a little bit more time and effort but makes for a much more productive clinical rotation. Recently, I received a request from a student, which included an introductory letter outlining her goals, clinical background, and reasons she wanted to work with me during her clinical rotation. Far from the standard request, this helped build a connection and increased my interest in precepting her.
Passing on our culture
Passing on the culture of our profession is another key reason to precept. Our culture is who we are, where we came from, and where we are going as NPs. I require all of my students to become members of their state NP organization before I precept them. This gives them an introduction to the organization while demonstrating that I value participation in professional organizations as well as clinical practice. With reduced student rates for membership in these organizations, it is a small price to pay and a great investment. The state organization embodies the living history and culture of NPs in the state. In its members and history, the organization carries the impetus behind practice legislation that gives those students, as future NPs, the authority to practice, which is something that can easily be taken for granted.
There has been a dramatic growth in NP education programs accompanied by a demand for more preceptors. NPs play a unique role in healthcare, and we have something special to offer our patients. We also have something special to offer those preparing to be NPs. We perpetuate our profession through preparing more NPs, but we also perpetuate it as we grow in our own practice, our own styles of healing, communication, and relationship. Teaching is not something we do to others but rather with others. As it is said in Latin, “docendo discimus,” by teaching we learn.
I think back on how I got to where I am today in my profession. I had some of the most wonderful preceptors, giving of their time, sharing their knowledge, and caring about me. My preceptors guided and nurtured me to help me to be who I am today. Several are still friends to this day. Besides teaching me clinical skills, these preceptors connected me to others, taught me about the politics of healthcare, and showed me that what we do goes far beyond an exam room. Through them I learned and was inspired to create change while continuing to learn throughout my entire life. Teaching is an opportunity for us to grow, and in embracing this opportunity, we show our gratitude to our profession and to those who taught us. By nurturing our NP students, we keep our profession alive and thriving.