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

Section 5: Requirements for Success in Practicum Courses

All approved preceptors (e.g., primary, replacement and supplemental preceptors) must complete all responsibilities of preceptors to include video conference calls with faculty, signing of time logs in Meditrek, and completion of practicum evaluations in Meditrek.  It is the student’s responsibility to ensure their approved preceptor has access to Meditrek®, signs time logs in Meditrek®, and completes practicum evaluations in Meditrek®.  If the preceptor does not have access to Meditrek®, students or preceptors should contact the Office of Field Experience.

Individualized Learning Objectives

Walden expects that the practicum experience will allow students to focus on developing and strengthening discrete skills as well as integrating a range of skills into a coherent professional identity. Students set specific goals for the practicum experiences that are consistent with their professional preparation and coursework. These goals inform the evaluation of their competencies at the end of the practicum.

In the first week of the practicum, students formulate two to three individualized Learning Objectives that they want to achieve during their practicum experience; these objectives are based on their previous assignments, practicum experiences, practice setting, and interests. As students approach the practicum, they should reflect on their coursework and identify two to three areas in which they feel the need for further growth or with which they might want application-level experience. The individual Learning Objectives and areas of growth may build upon each other through program progression; however, the individual Learning Objectives and areas of identified growth must be different between each Practicum course. Students need new Learning Objectives and areas of growth for each practicum course.

Preceptor Communication & Video Conference Calls

Initial Preceptor Contact

During week 1 or 2 of the course, Clinical Instructors will initiate contact with preceptors, which is intended to ensure that:

• The clinical goals of the practicum are being addressed.
• Students and preceptors understand the key points of the practicum experience.
• An opportunity for questions is provided.
• Problems are identified and addressed.
• Review learning objectives for the course.
• Review calendar submitted by student to ensure hours and patient requirements are able to be met.
• Share faculty contact information. 

A video conference call must be completed between the clinical instructor and the preceptor during the midterm evaluation period.  Additional conference calls may be required to evaluate student performance during the practicum experience.    

If a midterm conference call and midterm evaluation is not completed by week 7, student cannot return to practicum site until its completion.

Change of Preceptorship After the Practicum Course Begins:  

Students who need to change preceptors and/or practicum sites for any reason after their course begins must:

• Contact the Office of Field Experience immediately. The Office of Field Experience staff will review possible options for the student for a possible replacement application depending on the time of term and if the student has a replacement application.  There are no guarantees a replacement application will be granted or approved.   If a replacement application is granted through the waitlist, students must meet all preceptor requirements and the application must be approved before the student can begin completing hours with the new preceptor.   If the new preceptorship requires relocation to a new practicum site, then it is likely the practicum experience will be delayed if an affiliation agreement is not on file or if the site requires onboarding.  Practicum hours completed prior to the replacement application being approved will not be allowed to count toward the practicum course requirements.  
• Contact the assigned Faculty Member immediately to discuss the impact of completing course requirements and the option of receiving an Incomplete (I) grade to gain additional time to log hours with a new preceptor depending on the time of the term and eligibility of a grade of Incomplete.

Completing Hours with Other Practitioners Under Approved Preceptor at approved Site:

If a Walden approved preceptor is unable to precept student for a short-term, (e.g., sick, short-term leave, serving jury duty) or would like the student to log hours with another practitioner to gain additional relevant experiences, students may log hours with another practitioner at the site under the direction of the Walden approved preceptor. The approved preceptor must give approval of this additional practitioner assignment to the student and agree to sign off on these hours in Meditrek®. Under these guidelines, students are permitted to log up to a total of 25% of the total practicum hours with other practitioners at the practicum site. If the approved preceptor does not sign off on these hours in Meditrek, the hours will not count towards the hour requirement for the course. Procedures for this additional assignment option are as follows:

• Students are only permitted to log up to 25% of the total practicum hours with other practitioners at the practicum site with approval from the approved preceptor. Examples as follows:
  • Students required to log 144 hours may log up to 36 hours with practitioners at the practicum site
  • Students required to log 160 hours may log up to 40 hours with practitioners at the practicum site
• The practitioner must be employed by the approved practicum site of the approved preceptor.
• The practitioner must see patients and provide services that meet the course requirements.
• The hours must be related to the course learning objectives and course requirements.
• Students must document the hours in the daily time log in Meditrek as follows®.
  • Select the approved preceptor’s name in the preceptor field
  • Put the name of the practitioner in notes section of the daily time log
  • Add the role of the practitioner in notes section of the daily time log
  • Include the reason for the assignment in notes section of the daily time log
• Students must communicate this additional assignment with another practitioner immediately to their clinical instructor.
• The Walden approved preceptor (the preceptor approved in Meditrek) must sign off on these practicum hours in Meditrek for the hours and logs to be valid. 

Logs in Meditrek®

Using Meditrek®, students keep a daily time log of the time they spend on practicum activities. Time logs are signed off by preceptors and Instructors throughout the course and by the end of the course after the completion of logs. Students are NOT permitted to sign off on time logs on behalf of the preceptor. Preceptor designees and administrative staff are NOT permitted to sign off on time logs on behalf of the preceptor.

Timeline for Preceptors and Field Sites Programmed in Meditrek®

• Week 1: Preceptors and practicum sites are programmed in Meditrek® for drop-down options in time logs at the end of Week 1 for approved applications.
• Each Friday: If an application is approved after the course starts, the preceptor and practicum site will be populated weekly on Fridays.
• Week 3: Preceptors are emailed their Meditrek® credentials on Monday of Week 3 of the course. Preceptors use their Meditrek® credentials to sign off on time logs and complete evaluations. For preceptors who have not received their Meditrek® credentials, they are encouraged to check their spam/junk email folders or submit a request for credentials to be resent by completing the Meditrek Credentials Request Form.

Note: If students are unable to find their preceptor or practicum site in the drop-down box after Week 1 and their application has been approved more than 1 week, they should email nursingfield@mail.waldenu.edu.

Beginning Practicum Hours After Course Begins

Students may NOT begin any practicum hours before (a) the start of the course, (b) they receive practicum application approval in Meditrek from the Office of Field Experience, (c) they are registered for the practicum course, and (d) they receive approval from the practicum course instructor once the course begins.  Students are only to complete practicum hours with preceptors and at practicum site locations that have been approved by the Office of Field Experience in Meditrek®.  If students log hours with an unapproved preceptor or at an unapproved practicum site, these hours will not count toward the practicum hour requirement of the course and program.

Practicum hours completed under a preceptor other than the approved preceptor who was identified in a practicum application submitted by the student will be rejected and students will be required to repeat the hours. 

Students completing practicum hours under an unapproved preceptor will be subject to Code of Conduct inquiry and may result in disciplinary action, including course failure and permanent dismissal from the university. For more information about the Code of Conduct, please refer to the Walden University Student Handbook, Code of Conduct.

Important Note: Concerns regarding truthfulness or accuracy of Meditrek® logs or preceptor approval of Meditrek® logs will result in a Code of Conduct inquiry. Students who are found to have falsified their Meditrek® logs or preceptor approval of Meditrek® logs will be subject to disciplinary action. Failure to notify the Office of Field Experience and assigned Faculty, as stated above, will result in a Code of Conduct inquiry and may result in disciplinary action, including course failure and permanent dismissal from the university. State Boards of Nursing may be contacted, and the student reported if a student is found to have violated Code of Conduct in the practicum setting for violations such as, but not limited to, falsification of practicum information. For more information about the Code of Conduct, please refer to the Walden University Student Handbook, Section 3: Student Conduct and Responsibilities.

Time Log

Using Meditrek®, students are required to keep a truthful and accurate daily log of the time they spend in practicum activities. Students must track their hours in Meditrek® and submit their daily time logs in Meditrek® within 48 hours of completing the practicum hours. If students do not log hours and/or patients within the required time frame, and it is after term, students are unable to enter logs and will have to make up the missed hours and patients.

Daily time logs are signed off only by approved preceptors and Clinical Instructors throughout the course and by the end of the course, after the completion of hours. The preceptor must be approved in Meditrek® for the correct term and course. Students are responsible to ensure the preceptor signs off on the daily time logs in Meditrek® by the course deadline.   Students are NOT permitted to sign off on daily time logs on behalf of preceptors. Preceptor designees and administrative staff are NOT permitted to sign off on time logs on behalf of the preceptor.

Students must submit actual hours completed for daily time logs. Student may complete and log up to 12 hours a day if not working the same day (PMHNP students need preceptors to verify any extended workday beyond 8 hours up to 12 hours a day with faculty prior to being in practicum setting). Students should have preceptors communicate directly with clinical faculty to verify extended workdays. Any student doing clinical hours on a day they work are not to exceed a maximum of 16 hours, combined, for work and clinical hours. The hours logged must be direct patient care hours, with only 8 hours allowed for shadowing per approved preceptor.

The time log must include the following:

• Dates
• Course
• Clinical Instructors
  Note: Be sure to include the Clinical Instructor, not the didactic Faculty Member, in Meditrek®.
• Preceptor
• Total time for the day
• Notes/comments (Optional)

Students are expected to have completed all clinical hours and entered their daily time log entries into Meditrek® within 48 hours of completion and no hours may be entered after Week 10 without faculty prior approval. If students are approved to log practicum hours after Week 10, with the Faculty Instructor’s approval, the time log entries must be entered in Meditrek® by the end of the last Sunday before the next term begins. Students will not be able to enter or edit time log entries after midnight on the Sunday before the first day of the next term. If students receive a grade of Incomplete (I) for the course and need to log practicum hours after the next term begins, they must submit a remedial practicum application.  Students must submit their request for a remedial application in Meditrek®.   

Students are responsible to ensure daily time logs are entered correctly and accurately. Students must ensure logs are accurate and correct by selecting the correct course, quarter, PRAC/PRCM course Clinical Instructor, and preceptor. Students are only able to enter logs on or after the date the preceptor was approved in Meditrek. Students may make changes and edits to logs until either the preceptor and/or Faculty signs the logs in Meditrek. If there is an error with the logs during the term and the logs have been signed during the term, students must contact the Office of Field Experience to invalidate the logs, and then the student will need to reenter the time logs.  The Office of Field Experience is unable to backdate logs after the term ends, Students will lose practicum hours if they are not logged by the end of the term in Meditrek.  Faculty may deduct weekly assignment points and/or reject time logs—or patient encounters—that are inaccurate, duplicative, or do not meet course requirements.

 

Important Note: Concerns regarding truthfulness or accuracy of Meditrek® logs or preceptor approval of Meditrek® logs will result in a Code of Conduct inquiry. Students who are found to have falsified their Meditrek® logs or preceptor approval of Meditrek® logs will be subject to disciplinary action. Failure to notify the Office of Field Experience and assigned Faculty, as stated above, will result in a Code of Conduct inquiry and may result in disciplinary action, including course failure and permanent dismissal from the university. For more information about the Code of Conduct, please refer to the Walden University Student Handbook, Section 3: Student Conduct and Responsibilities.

Patient Log 

Using Meditrek®, students keep a patient log of the time they spend with each patient. Students must submit original coursework for patient logs and only log patients who they actually saw during practicum. Students must follow all HIPAA and practicum site requirements when recording patient notes. All patients cited in SOAP notes must correspond to the patients logged in the student’s Meditrek® patient logs for the specific course and term and must also correspond to the practicum site’s patient records.

Note: Students must log all encounters and all patients seen during their practicum. However, only time spent with patients in the student’s population and specialty will be applied toward the required practicum hours. Students are responsible to ensure that they see the correct number of patients in the correct age ranges and specialty areas to meet the required number of practicum hours for successful completion of the course.

Also Note: Walden University reserves the right to audit any and all Meditrek® logs, SOAP notes, patient logs, and other practicum documentation at any time to verify hours completed, patients seen, and age ranges and specialty areas of patients seen. This will enable Walden University to verify practicum hours for certification purposes and help to ensure program quality and that graduates are adequately prepared for practice in an advanced role.

Students must enter their patient encounters in Meditrek® within 48 hours of completing the practicum hours at the site. If students do not log hours and/or patients within the required time frame and it is after term, students are unable to enter logs and will have to make up the missed hours and patients, these logs are also subject to the course late penalty policies.

Note: The Office of Field Experience is unable to back date logs after the term ends. Faculty may reject time logs or patient encounters that are inaccurate, duplicative, or do not meet course requirements. Inaccurate and/or duplicative logs may be subject to academic integrity inquiries.

AGACNP, AGPCNP, PNP, and FNP Patient Logs

The patient log must include the following:

• Date
• Course
• Clinical Instructor (Be sure to include the clinical instructor, not the didactic faculty member, in Meditrek®.)
• Preceptor
• Patient number
• Client information
• Visit information
• Practice management
• Diagnosis
• Procedure
• Treatment plan and notes
• IV medication, if applicable
• Notes section (Students must include a brief summary/synopsis of the patient visit—this is not where EMR SOAP notes and labs are placed.)

PMHNP Patient Logs

Students are required to log all patients they spend time with at their approved practicum site, as the individual course requirements only outline the minimum.

The patient log must include the following:

• Date
• Course
• Clinical Instructor (Be sure to include the clinical instructor, not the didactic faculty member, in Meditrek®.)
• Preceptor
• Patient number
• Client information
• Visit information
• Practice management
• Diagnosis
• Notes (Students must include a brief summary/synopsis of the patient visit. This summary must include enough information to describe how the patient presented and the student intervention. EMR SOAP notes should not be copied here.)

Note: Please see the Practicum Hour and Patient Encounter Requirements section of this handbook for specifics regarding additional documentation required, if an approved preceptor is sick, on leave, serving jury duty, or would like the student to log hours with another practitioner to gain additional relevant experiences—using the 25% policy, which students may log hours with another practitioner at the site under the direction of the approved preceptor.

Students are expected to have completed all clinical hours and entered their daily time log entries into Meditrek® by the end of Week 10. If students are approved to log practicum hours and patients after Week 10, with the faculty instructor’s approval, the patient log entries must be entered in Meditrek® by the end of the last Sunday before the next term begins.

Students will NOT be able to enter or edit patient log entries after the first Sunday of the next term. If students receive a grade of Incomplete (I) for the course and need to log practicum hours and patients after the next term begins, they must follow the directions for a remedial practicum application.  Students are not permitted to begin practicum hours until the remedial application is approved in Meditrek®. 

Note: Students are responsible to ensure patient logs are entered correctly and accurate. Students must ensure logs are accurate and correct by selecting the correct course, quarter, Faculty and preceptor.

Important Note: Concerns regarding truthfulness or accuracy of patient logs will result in a Code of Conduct inquiry. Students who are found to have falsified their patient logs will be subject to disciplinary action. Failure to notify the Office of Field Experience and assigned faculty as stated above will result in a Code of Conduct inquiry and may result in disciplinary action, including course failure and permanent dismissal from the university. For more information about the Code of Conduct, please refer to the Walden University Student Handbook, Section 3: Student Conduct and Responsibilities.

The practicum process is collegial, with the recognition that NP students are adult learners who are capable of critical self-reflection, open to constructive feedback, and responsible for their own learning. Expectations for practicum performance correlate with the stage of student learning (i.e., greater practicum expertise is anticipated as student learning progresses through the program).

Once students enroll in a practicum course, they are mentored and evaluated by their preceptor and a Walden Clinical Instructor who is assigned to them at the beginning of the quarter. Preceptors provide the field experiences, supervise students in the practicum, and provide evaluations of student progress in meeting practicum goals to the Clinical Instructors. Practicum course Clinical Instructors grade student clinical coursework and, in general, return student written work within Walden guidelines on returning grades. Students are encouraged to consult with practicum course Clinical Instructors by phone or email about their progress throughout the quarter as stipulated in the course Syllabus. Clinical Instructors also maintain contact with students and preceptors throughout the quarter to determine whether student learning needs are being met at their practicum site and to monitor student clinical progress. This culminates in a practicum evaluation that is completed by the Clinical Instructor in Meditrek®, toward the end of the quarter. Clinical Instructors arrange a time with students to evaluate their clinical performance. Students should make sure that the date and time of the evaluation is agreeable with the preceptor, and if this is an on-site visit, that an appropriate number and type of clients are scheduled. During these visits, Instructors provide students with mentorship and supervision during one or more patient encounters.

Per guidance form WA state NCQAC, practicum taking place in Washington State must include preceptor, faculty, and student conferral all three together at the beginning, midpoint, and end of the learning experience (WAC 246-840-533.)

During the first week of a practicum course, students develop a set of individualized Practicum Objectives for the field experience that supports the overall objectives of the course and is approved by the Clinical Instructor. During the Week 2, Clinical Instructors initiate contact with preceptors together with students to verify the clinical site and ensure students can meet the Learning Objectives of the course at the site. A virtual site visit with preceptors, students, and Clinical Instructors occurs at the midpoint of the quarter, and a final communication is held at the end of each practicum course. In the 10 weeks following the first call, Clinical Instructors closely follow student activities through guided, posted Discussions on the engagement of students with their preceptors to accomplish Practicum Objectives. Additionally, activities are reported to Clinical Instructors through clinical assignments. Also, Clinical Instructors review the daily time logs, patient logs, and journal entries to determine student progress three times during the 11 weeks.

Preceptors use a formal written evaluation to communicate student progress to the Clinical Instructor twice during the practicum—at midterm and at the end of the course. Clinical self-evaluation is required as part of the process at the end of the practicum experience, along with an evaluation of the entire process by the preceptor. Throughout the course, preceptors and Clinical Instructors communicate, as needed, by email and phone to meet the needs of the individual student. The Clinical Instructor determines the course grade for the practicum. Students and preceptors must follow guidelines for submitting evaluations as posted in each course.

At the midterm and end of each practicum course, students and preceptors are required to provide formal feedback by completing an online evaluation of their performance and the practicum experience in Meditrek®. During Week 3, both students and preceptors will receive an email from Meditrek® with directions on how to log in and complete an evaluation. Students will use the same username and password provided to them for the application submission. Preceptors will receive new login information or be reminded of their login information if they precepted a previous student.

Midterm evaluations are due by Week 7 and final evaluations are due Week 10. If a midterm conference call and midterm evaluation is not completed by week 7, the student cannot return to practicum site until its completion.

Students are responsible to ensure the preceptor has received login credentials, signed logs, and completed evaluations by the course deadline. Students should contact the Office of Field Experience if the preceptor has not received an email with access to Meditrek® after Week 3.

These practicum evaluations will not only provide information about the progress of individual students but also will help program leadership continuously improve the courses and the practicum experience as a whole. Students will receive a grade of Incomplete (I) if any of the evaluations are not received by the posted deadlines and/or the time logs are not verified and signed by the preceptors. Preceptor designees and administrative staff are not permitted to sign off time logs or complete midterm and final evaluations on behalf of the preceptor.

Dismissal from a practicum experience by a preceptor and/or practicum site may lead to a course failure.

Incomplete Grade and Remedial Applications

Grades of Incomplete (I) are given at the discretion of the Course Instructor if the student meets incomplete status eligibility. Incomplete (I) status may be granted only if students have already met the minimum criteria in a course and have acceptably completed approximately 80% of the course requirements, including practicum hours and patient encounter logs prior to the last day of classes.

Students must have a current passing course grade to receive an Incomplete (I). Students taking vacations and/or are unable to coordinate practicum time due to personal work schedules are not reasons for incomplete PRAC/PRCM approval.

Students must work directly with their Course Instructor to determine eligibility of an Incomplete grade. If the Course Instructor grants an Incomplete (I) grade, students must establish a plan to complete the practicum requirements directly with the Course Instructor.

If the Course Instructor does grant a grade of Incomplete (I) and students will need to complete practicum hours during the next term, students must have a remedial application approved in Meditrek® for the next term.

Once students are officially issued a grade of Incomplete (I) and must complete additional practicum hours during the next term, they must submit a Remedial Application Request Form in Meditrek to begin the remedial application process.

Students must NOT begin practicum hours until after the start date of the remedial application and the remedial application is approved in Meditrek®. Students must have an approved remedial application in Meditrek® in order to begin or continue logging practicum hours to finish the remaining hours for the course.  

Failing Grades

Students may obtain failing grades based upon clinical performance, behavior comportments, unsafe practice, course work, academic integrity, etc. If students fail a prerequisite course for a practicum course, it is the responsibility of the student to contact Student Success Advising to discuss the program of study and develop a plan. Students must also contact the Office of Field Experience to discuss options regarding practicum applications. Depending on timing of the next term start, students may not be approved to retake a practicum course if another application must be approved for the failed course and the student is using a different preceptor or site.