Nurse Practitioner Programs Practicum Manual for the Master of Science in Nursing (MSN) and Post-Master’s Certificate:

Section 1: Introduction

Welcome to the field experience component of Walden University’s Master of Science in Nursing (MSN), Doctor of Nursing Practice (DNP) Nurse Practitioner specializations, and post-master’s Advanced Practice Registered Nurse (APRN) programs. This manual describes the structure and timing of the classroom-based and practicum experiences, as well as the policies students must follow to be successful in the nurse practitioner (NP) specialties.

This manual is intended to provide NP students with the information they need related to practicum policies and procedures, as well as to serve as a reference for practicum preceptors and others involved in NP practicum.

This manual refers to the Walden University Catalog and the Walden University Student Handbook for specific information on university policies and courses.

This document does not create a contract to provide any particular service or benefit.

Note: Walden University reserves the right to make program changes as needed to ensure the highest quality program.

Walden University

The MSN and post-master’s APRN certificate programs at Walden University are designed to promote Walden University’s vision, mission, and ongoing commitment to social change. These guiding principles serve as a framework for the program curriculum and outcomes and are included here as a reference.

Vision

Walden University envisions a distinctively different 21st-century learning community where knowledge is judged worthy to the degree that it can be applied by its graduates to the immediate solutions of critical societal challenges, thereby advancing the greater global good.

Mission

Walden University provides a diverse community of career professionals with the opportunity to transform themselves as scholar-practitioners so that they can effect positive social change.

Social Change

Walden University defines positive social change as a deliberate process of creating and applying ideas, strategies, and actions to promote the worth, dignity, and development of individuals, communities, organizations, institutions, cultures, and societies. Positive social change results in the improvement of human and social conditions.

College of Nursing

Vision

The College of Nursing will be recognized for its preeminent programs and innovative educational approaches that prepare distinguished graduates to advance the greater good of global communities.

Mission

The College of Nursing, dedicated to excellence in nursing education, provides programs to transform diverse nursing professionals into champions of change who will improve health outcomes and advance health equity.

Goals

The College of Nursing strives to:

• Empower diverse nursing professionals through academic advancement that enhances personal growth, professional development, clinical reasoning, and the desire for life-long learning.
• Create an inclusive teaching and learning environment where students expand on their existing professional nursing knowledge, to improve workplace and healthcare outcomes.
• Provide educational approaches that address the complex needs of adult learners and support academic quality and integrity.
• Prepare learners as scholar practitioners to use evidence-based practice that exemplifies and supports professional nursing standards.
• Prepare professional nursing leaders who are empowered to promote positive social change for individuals, families, and populations by addressing the social determinants of health locally, nationally, and globally.

At the end of the MSN and Post-MSN APRN programs, students will be able to:

• Synthesize organizational/systems leadership for cost-effective specialist nursing practice that contributes to high-quality healthcare delivery, advancement of the nursing profession, and social change.
• Critique evidence-based literature drawing from diverse theoretical perspectives and pertinent research to guide decision making that demonstrates best practices for specialist nursing practice in a global society.
• Integratively assess, diagnose, plan, implement, and evaluate cost-effective healthcare strategies that reduce health disparities by patient/population advocacy for access to specialist nursing care.
• Demonstrate the ability to effectively communicate using audience-specific oral, written, and information technology for professional delivery of specialist nursing care.
• Evaluate health needs of diverse populations for necessary teaching/coaching functions based on specialist nursing knowledge to restore/promote health and prevent illness/injury.
• Exhibit ongoing commitment to professional development and value of nursing theories/ethical principles (altruism, autonomy, human dignity, integrity, social justice) in accordance with ethically responsible, legally accountable, specialist nursing practice.
• Implement specialist nursing roles to promote quality improvement of patient-centered care in accordance with professional practice standards that transform health outcomes for diverse populations.

For the nurse practitioner programs, the College of Nursing uses the following guidelines and standards to inform the curriculum and professional behavior:

• The Essentials of Master’s Education in Nursing (AACN, 2011)
• The Nurse Practitioner Core Competencies (National Organization of Nurse Practitioner Faculties, 2017)
• Criteria for Evaluation of Nurse Practitioner Programs (National Task Force on Quality Nurse Practitioner Education, 2016)
• Guide to the Code of Ethics for Nurses with Interpretative Statements (American Nurses Association [ANA], 2015)
• Nursing: Scope and Standards of Practice (ANA, 2015)

For the purposes of this manual, the following terms are defined in this way:

Practicum

A practicum is a distinctly defined supervised clinical experience in which students develop applied skills and integrate professional knowledge in providing advanced practice nursing care. Practicum experiences provide first-hand opportunities for students to apply their newly acquired skills and what they are learning in their courses and develop competencies in their profession. The practicum experiences in the NP program are of particular importance because, in addition to the didactic coursework, it provides students with the opportunity to obtain the practice hours required for certification. Each practicum course requires a minimum number of hours as follows.

• All NP students with catalog years before Spring 2018 must complete four practicum courses, with a minimum of 576 hours of supervised clinical experience (144 hours in each course).
• All NP students with catalog years beginning Spring 2018 must complete four practicum courses, with a minimum of 640 hours of supervised clinical experience (160 hours in each course).
• Students who enter a Post Master’s certificate program with a certain approved ARPN licensure and certification and receive prior nursing credit for a practicum course must complete three practicum courses, with a minimum of 500 hours of supervised clinical experience (167 hours in each course) in the new specialization focus area.

Note: Students who changed specializations through enrollment and/or had to reenroll after a break in enrollment are readmitted under a newer catalog than the original catalog of admission. Students will be required to complete new program requirements under the assigned catalog upon readmission. To confirm which catalog you are enrolled under, please contact Student Success Advising.

The didactic (classroom) and clinical components of the courses are integrated. The courses vary by specialization:

• Students in the Adult Gerontology Acute Care Nurse Practitioner (AGACNP) specialization must complete NRNP/DRNP and PRAC/PRCM 6540, 6566, 6550, and 6560.
• Students in the Adult Gerontology Primary Care Nurse Practitioner (AGPCNP) specialization must complete NRNP/DRNP and PRAC/PRCM 6531, 6540, 6552, and 6565.
• Students in the Family Nurse Practitioner (FNP) specialization must complete NRNP/DRNP and PRAC/PRCM 6531, 6541, 6552, and 6568.
  • Walden AGPCNP Graduates in the FNP Post Master’s Certificate specialization must complete NRNP/DRNP and PRAC/PRCM 6531, 6541, 6553, and 6568.
• Students in the Pediatric Nurse Practitioner (PNP) specialization must complete NRNP/DRNP and PRAC/PRCM 6810, 6820, 6830, and 6840.
• Students in the Psychiatric Mental Health Nurse Practitioner (PMHNP) specialization must complete NRNP/DRNP and PRAC/PRCM 6635, 6645, 6665, and 6675.

Practicum Site

Students need a location where they will have the opportunity to see patients in the role, population, and specialty that align with their specialization and course. The practicum site provides that location (or locations).

A practicum site is a healthcare facility, health care agency, or other appropriate setting at which students have supervised, applied practice experiences that are consistent with their education and meet the requirements of their program. The practicum site enters into an Affiliation Agreement with Walden University to provide a safe and appropriate supervised learning experience. The practicum site also establishes the policies, procedures, and protocols that students are expected to follow while working at the site.

Primary Care

A primary care practice typically serves as the patient’s first point of entry into the healthcare system and as the continuing focal point for all needed healthcare services. Primary care practices provide patients with ready access to their own healthcare providers. These practices provide health promotion, disease prevention, health maintenance, counseling, patient education, diagnosis, and treatment of acute and chronic illnesses in a variety of healthcare settings. These practices are organized to meet the needs of patients with undifferentiated problems, with the vast majority of patient concerns and needs being cared for in the primary care practice itself.

Primary care practices are generally located in patient communities, thereby facilitating access to healthcare, while also maintaining a wide variety of specialty and institutional consultative and referral relationships for specific care needs. The structure of the primary care practice may include a team of physicians and nonphysician health professionals. Appropriate settings for primary care should be in outpatient primary care settings. All FNP, PNP, and AGPCNP students are required to have primary care field experiences. FNP students must complete all clinical hours in primary care settings. PNP students may complete clinical hours both in primary care and specialty care settings. AGPCNP students may complete clinical hours both in primary care and specialty care settings.

Acute Care

Acute care refers to a level of specialty care focused on the management of severe injuries, urgent medical conditions, exacerbation of chronic illnesses, and/or recovery after surgical procedures. Acute care settings provide patients with secondary healthcare services that address active healthcare problems. Acute care practices provide access to healthcare teams that span the gamut of nursing, medical, and surgical specialties. Acute care practitioners perform assessments, order and interpret diagnostic tests, formulate diagnoses, perform procedures, and develop and/or implement treatment plans.

The quintessential acute care setting is the in-patient hospital, but acute care is also provided in emergency rooms, urgent care centers, specialty clinics, and surgery centers. Essentially, comprehensive care of patients with acute, critical, and/or exacerbated, complex, chronic conditions fall under the realm of the acute care provider regardless of the practice setting. The acute care provider is specialized in addressing the needs of high acuity patients along the illness-to-wellness spectrum.

Onboarding

Onboarding is a specific set of pre-practicum requirements, established by the Walden College of Nursing and based on the most common practicum site requirements and, will enable students to potentially qualify for a wide range of practicum sites. These onboarding requirements vary from state to state; however, they generally include a background check, state-specific background screens (e.g., abuse screens, fingerprinting, etc.), drug screening, health requirements, required training, and professional liability insurance, as well as additional onboarding requirements that may be required by the practicum site. If an approved practicum site requires additional onboarding requirements to what is required by Walden University, an additional package can be obtained through CastleBranch at the request of the Office of Field Experience, to fulfill those requirements.

Preceptors

Students need to be supervised throughout this experience. This is accomplished by preceptors who guide students and provide feedback on their practicum work. Supervision by a preceptor is composed of a tutorial and mentoring form of instruction in which practicum preceptors monitor student activities in the practicum and facilitate learning and skill-development experiences.

• Preceptors are qualified practitioners employed by the practicum site
• Preceptors are responsible for supervising students during their practicum experiences. Note: Preceptor designees or administrative staff are not permitted to supervise students.
• Preceptors and Clinical Instructors collaborate throughout the practicum experience to ensure that the student is meeting the clinical outcomes and performance objectives.
• Some of the responsibilities of a preceptor include:
  • Orienting students to the facility, personnel, policies, and procedures
  • Guiding, directing, and supporting the student, to facilitate the achievement of practicum Learning Objective
  • Providing opportunities for role analysis, as well as the application of skills and knowledge
  • Providing feedback and evaluation, and supervising work
  • Completing evaluations to assess the student’s work during practicum
  • Meeting with the student’s clinical Instructor as required

The preceptor’s role is critical as they work in collaboration with the program Faculty to assist students’ transition from the learner role to that of scholar-practitioner. To achieve this transition, Walden NP students establish and engage in a professional relationship with their preceptor, focusing on the achievement of skills as outlined in each course’s Learning Outcomes and the achievement of individualized Learning Objectives.

A successful practicum experience requires collaboration among course Faculty, preceptors, practicum site officials, students, and Walden support teams.

Practicum Site

Students need a location where they will have the opportunity to see patients in the role, population, and specialty that align with their specialization and course. The practicum site provides that location (or locations), and.

• Is a healthcare facility, healthcare agency, or another appropriate setting at which students have supervised, applied practice experiences that are consistent with their education and meet the requirements of their program 
• Enters into an Affiliation Agreement with Walden University to provide a safe and appropriate supervised learning experience
• Establishes the policies, procedures, and protocols that students are expected to follow while working at the site

Students

Students at Walden are considered to be adult learners who are capable of seeking educational opportunities to meet their personal and professional goals. Walden expects students to collaborate with faculty members and be self-directed to meet educational requirements. Students work with faculty members, clinical Instructors, and preceptors to ensure they obtain a well-rounded educational experience.

Because each student and each practicum experience are unique, students play a critical role in the practicum placement process.

• At Walden, as in many NP programs in the United States, students begin the practicum process by identifying a possible practicum site and preceptor for each practicum course and for submitting a timely and complete field experience application for each of the required practicum courses.
• Students do not need to identify a preceptor before beginning their program. Once students begin their studies, Walden will provide them with information on how to identify a potential practicum site and preceptor.
• The practicum process is an important part of the student’s learning experience:
  • The identification of a site and preceptor provides students opportunities to hone skills needed as a competent and successful nursing professional. For example, by engaging in the practicum process, students can:
    • Develop and practice important networking skills.
    • Simulate a job search in their desired future role.
    • Explore various practice areas through the preceptor research process.
    • Learn what it might be like to work in a particular practice setting.
    • Interact with leaders in healthcare settings similar to those in which they may eventually practice.

Note on the importance of networking: Students should plan to engage in networking early in their program to identify potential preceptors. Some students may not fully understand what effective networking entails. Others may think that they can use one individual or site location from their existing network, not realizing the site or preceptor may not meet their program requirements, that the site may be part of a health system that does not affiliate with Walden, or that the site or preceptor are not available or a good match for other reasons.

Student Expectations

Students are expected to do the following (but note that this list is not exhaustive, and students are expected to meet all expectations set forth in this manual, the student handbook, and catalog for successful completion of the program):

• Develop a learning contract to meet course objectives and outcomes for the practicum.
• Adhere to the learning contract as established by the student, Clinical Instructor, faculty member, and preceptor.
• Comply with the policies, procedures, and protocols established by the practicum site.
• Seek and be receptive to direct and indirect supervision from the Clinical Instructor and preceptor.
• Be appropriately prepared for each laboratory and practicum experience.
• Incorporate theory and research into practicum practice to provide evidence-based care to patients.
• Provide safe, competent, and quality care under the supervision of the preceptor.
• Conduct themselves in an ethical and professional manner at all times.
• Use acquired knowledge and clinical skills for the appropriate practicum setting.
• Use various educational resources to provide evidence-based care to patients.
• Be on time at the practicum site during agreed upon schedule and be prepared for each practicum session.
• Develop a clear and concise plan to meet course outcomes.
• Be respectful and professional.
• Participate in regular conferences with the Clinical Instructor.
• Seek and be receptive to regular feedback from the Clinical Instructor and preceptor about progress in the practicum setting.
• Adhere to Health Insurance Portability and Accountability Act (HIPAA) guidelines at all times.
• Maintain truthful and accurate practicum journal, time logs, patient logs, and other pertinent practicum records as required by the clinical instructor and/or preceptor. Academic integrity policies must be adhered to for all journal, time log, and patient log entries.
• Be adaptable and flexible learners.
• Evaluate the course, practicum experience, and preceptor.
• Develop long-term and short-term goals individualized for each practicum experience during the program.
• Participate in group and individual conferences.
• Complete the required hours needed for the didactic and practicum portions of the courses.
• Satisfy all applicable academic standards and course expectations.
• Contact the Clinical Instructor and practicum site if unable to attend a practicum experience.
• Use critical-thinking skills and sound clinical judgment in providing patient care.
• Timely notify the faculty and the field experience coordinator if their preceptor or practicum site becomes unavailable for any reason.
• Timely notify the field experience coordinator if they move to another state or country while they are enrolled in the program.
• Notify the College of Nursing’s Director of Office of Certification, Licensure, and Compliance, immediately, if their license becomes encumbered for any reason.

Walden

Walden is responsible for incorporating a practicum experience into its programs and ensuring availability of adequate resources for students to participate in the practicum required for completion of the program. Walden provides support for students throughout the practicum process and students’ field experience. Walden’s practicum process meets Commission on Collegiate Nursing Education’s (CCNE) accreditation standards.

Walden Faculty

In each NP specialty, each of the NP practicum experiences are split into two courses: a didactic course with the prefix NRNP/DRNP; and a clinical course with the prefix PRAC/PRCM. Students are encouraged to contact their didactic Faculty and/or Clinical Instructor at any time throughout the duration of their courses if they have a question, require guidance, or in the event a concern arises.

Clinical Instructor for PRAC/PRCM Courses

Clinical instructors are either doctoral or masters prepared experienced, licensed APRNs. They are responsible and accountable for assuring that students meet the course objectives at a specific practicum site and work closely with preceptors. The Clinical Instructor is the student’s primary resource for any concerns or issues that may arise. Clinical Instructors monitor student work in Meditrek®.

Clinical Instructors communicate on a regular basis with NP students and their preceptors regarding student progress and learning needs; they are also available to resolve problems that may arise. Clinical Instructors make practicum site visits (virtually and/or physically) to review students’ experiences and the appropriateness of the setting. Clinical Instructors are responsible for evaluating the students’ clinical work. The Clinical Instructors and their assigned students should touch base very early in the quarter and arrange date(s) for the site visit(s).

Specific Clinical Instructor responsibilities include the following activities:

• Provide guidance to students in formulating the learning contract
• Confer with students individually and in groups
• Assign student grades following review of the learning outcome measures identified in the course and the learning contract
• Complete final student evaluations in Meditrek®
• Review and sign students’ clinical time logs and patient logs in Meditrek®
• Review the preceptor’s evaluation of clinical students in Meditrek®

Specialization Academic Coordinators

Specialization Academic Coordinators are doctorally prepared Walden faculty members whose primary role regarding the practicum is to oversee the experience for a given NP specialization (i.e., AGACNP, AGPCNP, PMHNP, PNP, or FNP). The specialization coordinators are an important resource for students during the program, especially if any problems arise during the practicum.

Practicum Coordinator

The practicum coordinator is a doctorally prepared Walden faculty member whose primary role is to address concerns related to the practicum experiences for NP students in all specializations. The practicum coordinator and clinical supervisors are essential resources for students if problems arise during the practicum.

Associate Dean 1/Program Director

The Associate Dean 1/ Program Director (AD/PD) is a doctorally prepared full-time academic administrator who reports to the dean and supervises the specialization coordinators. The AD/PD's primary role is to maintain the quality and integrity of the degree program and to oversee day-to-day program management. While working with specialization coordinators, the AD/PD supports students throughout the NP program, including during the practicum experience.

Office of Field Experience

Walden’s Office of Field Experience (OFE) in the College of Nursing is responsible for managing the practicum application process, ensuring that students’ practicum meets program requirements, and supporting students through the practicum process. Office of Field Experience staff are dedicated to supporting nursing students through the practicum process from the time students enter the program until their last practicum has been completed.

The Office of Field Experience also provides technological resources to assist students in identifying appropriate practicum sites. The Office of Field Experience maintains a database of active Affiliation Agreements (known as the Affiliation Agreement Module, or Module) with healthcare facilities across the world. The Module is searchable, and students are encouraged to explore sites where Walden has an existing Affiliation Agreement in place.

To ensure that Walden has adequate resources for students, Walden University actively pursues Affiliation Agreements with new and existing practicum sites. Walden has been successful in establishing new Affiliation Agreements with practicum sites for all of its programs as well as maintaining existing Affiliation Agreements with practicum sites as evidenced by the thousands of field experience agreements found in the Module.

Field Experience Coordinators

The Office of Field Experience is comprised of a team of field experience coordinators. Field experience coordinators are Walden employees who help students understand the practicum policies and procedures. Their role is to answer questions about the practicum application process; to assist students in identifying qualified practicum sites and preceptors; support students, when necessary, by conducting outreach to potential sites and preceptors on students’ behalf; to review materials to help students ensure that they have completed all required application and documentation; and, generally, to assist with the practicum application and approval process. The field experience coordinators serve as a conduit between Faculty, students, sites, and others throughout the process, and work collaboratively with the specialization coordinators and the program director throughout the practicum approval process. Once practicum applications have been approved, the field experience coordinators ensure that students are enrolled in their appropriate practicum courses.

Field experience coordinators are assigned to students by region and have expertise about possible practicum sites in areas where students are located or desire to practice. There are six Office of Field Experience staff members assigned to each region to assist and support students through the practicum application process. The staff are assigned by role, and each is responsible to review the various components of practicum applications. The Office of Field Experience staff are assigned to the following roles by region:

• Nursing field experience coordinator: Responsible for ensuring the preceptor and practicum site meet the course requirements. This coordinator approves the preceptor/practicum site section of the application. This coordinator holds student appointments to provide support and guidance on preceptor and practicum site course requirements.
• Verification field experience coordinator: Responsible for ensuring students have completed the onboarding requirements. This coordinator reviews and approves the onboarding section of the application and reviews student accounts in CastleBranch. This coordinator holds student appointments to provide support and guidance on onboarding requirements.
• Affiliation agreement field experience coordinator: Responsible for facilitating the Affiliation Agreement process with nominated practicum sites. This coordinator holds student appointments to provide updates and information on Affiliation Agreements. Please Note: that the actual contract negotiation is completed by a contract administrator on the Office of Student Experiential Learning Services’ Applied Learning Contracts Team at Walden.
• Assistant field experience coordinators: Multiple coordinators are responsible for reviewing applications to include license reviews and preceptor forms, and they complete a degree audit to verify course prerequisites have been met. These staff members also process registrations for practicum courses.
• Support field experience coordinator: Responsible for providing support for Meditrek® to include credentials, submitting applications, uploading documents, time logs, patient logs, and evaluations.
• Field experience coordinator: Responsible for assisting students with the application process in general along with providing students support and guidance on searching for preceptors. This coordinator meets with students to provide support in searching for and identifying a site and preceptor nominee and understanding preceptors and practicum site requirements and to address general questions about practicum.
• Field placement coordinator: Responsible for coaching and assisting students searching for preceptors and sites.  This coordinator provides 1:1 coaching support in search for and identifying a site and preceptor.  This coordinator works with students through the Practicum Pledge service. 

The field experience coordinators are available to students via live chat, email, phone, and personal phone appointment. Students are encouraged to contact the Office of Field Experience and talk with a field experience coordinator early in their program for guidance and personal assistance.

Students may contact field experience coordinators for support via the Contact Us page.

Career Planning and Development

Walden’s Career Planning and Development is one possible starting point for students to begin to learn strategies for networking. The Career Planning and Development website has a full range of resources focused specifically on networking, covering topics such as:

• Why is Networking Important?   
• Building Your Network
• Networking Tips

Career Planning and Development also has an entire list of associations and professional development groups specific to nurses.

Walden’s goal is to assist every student in identifying and securing a practicum experience that meets the requirements for their degree programs, while giving students flexibility to conduct their field experiences in locations and with preceptors that best meet their needs.

Walden commits significant human and technology resources to this effort. 

Additional Costs Associated with Practicum

Walden wants all students to be aware of the costs associated with practicum, which may vary depending on a number of factors. Generally, students will incur and are responsible for paying costs associated with completing practicum. Examples of costs include, but are not limited to, the following: travel to/from practicum site; relocation costs; living costs during practicum; books; course materials; professional liability insurance; onboarding/administrative fees required by practicum sites; health insurance; costs associated with completion/renewal of onboarding requirements (e.g., immunizations, physical exam, CPR certification, HIPAA and OSHA training, etc.); state licensing fees; photo ID badge; additional onboarding requirements of practicum site; lab coat, if required by practicum site; stethoscope (NP courses); additional equipment costs; etc.

Note: Walden does not expect students to pay preceptors, practicum sites, or site placement agencies and discourages students from doing so, due to conflicts of interest that can arise. Students who enter into payment arrangements with preceptors, practicum sites, or site placement agencies do so at their own risk.

Students who have questions about costs associated with practicum should contact Nursing Field Experience Office.