Clinical Course Expectations and Objectives

Clinical courses build on one another and the role of the clinical preceptor varies with course expectations.  The following describes the responsibilities of preceptors for each clinical course and the culminating internship.  Course materials are coded by color so that specific course expectations can be easily matched with preceptor evaluations for that course.

NURS 615:  Advanced Health Assessment:  Fall Semester, Year I

This course is the first clinical course in which the student enrolls.  At this point the student has either taken or is concurrently taking pathophysiology and pharmacology.  The student is prepared to elicit a complete health history and physical examination but is not prepared to develop a differential diagnosis.

Preceptors should:

• Allow the student to assume increasing responsibility and independence in taking the history, performing the physical examination, and completing other appropriate assessment activities. 
• At the end of the clinical experience, the student will be able to demonstrate the techniques of a physical examination to gather objective data, report, and document his/her findings based on the history and physical.
• If certain diagnostic, lab tests, and procedures are done in the office setting, allow the student to participate, i.e., throat cultures, immunizations.
• Assist the student in differentiating between normal, deviations from normal, and abnormal physical assessment findings associated with health problems across the life span.
• Be available to assist the student in developing and refining his/her history and physical examination skills and verify physical findings and point out deviations from normal.
• At the end of the clinical experience, evaluate the student's professional development and growing ability to function independently with the provided evaluation form.
• Inform the faculty of concerns regarding student's performance.

NURS 620:  Clinical Decision Making I:  Spring Semester, Year I

This course emphasizes clinical data-gathering skills, diagnostic reasoning, and clinical problem-solving.  The student has completed Advanced Health Assessment, pathophysiology, and pharmacology.  The student must also begin to identify differential diagnosis with the assistance of the preceptor.

Preceptors should:

• Allow the student increasing independence to elicit the history, physical examination and chief complaint, and report and document the finding.
• Based on the elicited history and physical examination, confer with the student developing a list of differential diagnosis, applying clinical research findings and standards of care.
• Allow the student to begin identifying differential diagnosis and assist him/her as needed. At the end of the clinical experience, the student should be able to arrive at a differential diagnosis based on the elicited history and physical examination.
• In the beginning of the clinical experience, the student will have learned the process of identifying the differential diagnosis.  At the end of the clinical experience, the student should be able to formulate possible diagnoses for common complaint.
• Assist the student in selecting appropriate diagnostic tests and procedures essential to the differential diagnostic process.
• Be available to confer with the student about plans for treatment or management of continued care after diagnosis has been confirmed.
• At the end of the clinical experience, evaluate the student's professional development and growing ability to function independently with the provided evaluation form.
• Inform the faculty of concerns regarding student's performance.

NURS 630/631:  Clinical Decision Making II:  Fall Semester, Year II

This course focuses upon birth through adolescence in regard to health promotion, wellness maintenance, disease prevention, early detection of problems, and prompt treatment of acute illness.

The student has completed Advanced Health Assessment, Clinical Decision Making I, and may be concurrently taking Nursing Intervention with Families.

Preceptors should:

• Allow the student increasing independence in eliciting the history, performing the physical exam, and reporting and documenting the findings in the young client.  By the end of the clinical experience, the student should be able to perform the history and physical, arrive at a differential diagnosis, and recommend treatments based on the elicited information.
• In the beginning of the clinical experience, the student should be able to perform a complete history and physical and formulate a possible diagnosis for common complaints.  During this clinical experience, the student should begin to refine his/her ability to form a diagnosis in the young client.  The student should be increasingly capable of recommending treatments based on diagnosis.
• Be available to hear the student's presentation of the patient and confer with the student about the making of the differential diagnosis and integrate research findings into the development of the diagnosis involving the care of young clients.
• Assist the student in synthesizing social, environmental, and scientific knowledge and clinical skills in the identification and management of common and more complex health problems of the young client.
• Assist the student in developing skills in selected therapeutic interventions that are specific to the young client.
• At the end of the clinical experience, evaluate the student's professional development and growing ability to function independently with the provided evaluation form.
• Inform the faculty of concerns regarding students' performance.

NURS 640/641:  Clinical Decision Making III:  Spring Semester, Year II

This course focuses on the adult client (young, middle, and older years) in regard to health promotion, wellness maintenance, disease prevention, early detection of problems, and prompt treatment of acute illness.

Preceptors should:

• Assist the student in identifying and comparing the developmental characteristics of young, middle age, and older adults in assessment, diagnosis, and interventions.
• In the beginning of the clinical experience, the student should be able to perform a complete history and physical and formulate a possible diagnosis for common complaints.  During this clinical experience, the student should begin to refine his/her ability to form a diagnosis in the adult client.  The student should be increasingly capable of recommending treatments based on diagnosis.
• Allow the student increasing independence in eliciting the history, performing the physical examination, and reporting and documenting the findings.  By the end of the clinical experience the student should be able to perform the history and physical, arrive at a differential diagnosis and recommend treatments based on the elicited information.
• Be available to confer with the student about the making of his/her differential diagnosis. Assist the student in developing a more complete list of differential diagnosis, if necessary, integrating recent research findings.
• Assist the student in synthesizing social, environmental, and scientific knowledge and clinical skills in the identification and management of common and more complex health problems of the adult client.
• Assist the student in developing skills in selected therapeutic interventions.
• At end of the clinical experience, evaluate the student's professional development and growing ability to function independently with the provided evaluation form.
• Inform the faculty of concerns regarding student's performance.

NURS 750:  Internship:  Summer Term, Year II

This culminating supervised clinical experience provides the student with the opportunity to synthesize learning in order to gain competency in the multiple roles of the nurse practitioner.

Preceptors should:

• Orient the student to the agency and establish a schedule of clinical experiences.
• Allow the student increasing independence in performing the history and physical and reporting and document findings.  Solicit the student's plan for further diagnostic strategies and therapeutic interventions.
• Be available to confer with the student, emphasizing the rationale for the preceptor's  approach to therapy for common acute and chronic conditions.
• Be willing to share with the student recommendations for areas on which he/she should focus additional emphasis during the internship, keeping in mind that this is the culminating clinical experience for the student.
• At the end of the clinical experience, evaluate the student's professional development and ability to function as a beginning clinical with the provided evaluation form.
• Inform the faculty of concerns regarding the student's performance.