 Becoming a preceptor is an important professional milestone, whether you’re an NP, APRN, MD, DO, PA, therapist, or part of another clinical discipline. It’s both an opportunity to mentor the next generation of healthcare professionals and a chance to elevate your own practice through teaching and collaboration. You’re stepping into the educator’s shoes, and precepting can be incredibly rewarding, it also comes with a few key considerations you’ll want to keep in mind. Let’s provide some real-world examples to illustrate what you might expect. You’ll also learn the crucial questions to ask, so that everyone starts off on the right foot and remains on track throughout the rotation 1. Understanding Your Role and ResponsibilitiesMentor, Instructor, Evaluator At its core, your job is to mentor a student, help refine their clinical skills, guide them in critical thinking, and evaluate their readiness for real-world practice. What does that look like in an everyday sense? Sometimes, it means letting them perform patient intakes or histories and then asking them thought-provoking questions to hone their diagnostic skills. Other times, it may require stepping in with constructive feedback if they miss a critical piece of information during the assessment. Balancing Patient Care and Teaching Precepting isn’t always about giving the student a chance to do everything on their own. Often, the best lessons happen in real time—watching how you interact with patients, making clinical decisions, or switching gears when something unexpected arises (like a patient crashing or needing urgent care). It’s a process of “show, then do” with your student. Time Investment Most schools expect you to commit to a set number of hours per week tailored around your existing clinical workload. It can be challenging to juggle your time, but the end goal is to see your student grow into a more competent, confident clinician under your guidance. As they progress, the hope is that they might actually help your practice! 2. What to Expect from the SchoolOrientation and Resources Different schools have varied orientations and resources for preceptors. You may be provided with course objectives, clinical checklists, or even online modules. Some institutions also offer stipends or continuing education credits as a token of appreciation. (Here at PreceptorLink®, we do offer an honorarium to preceptors.) It’s worth asking your point of contact how to access these resources—and if there are any additional supports for complex scenarios, like students struggling with specific competencies. Faculty Communication Typically, a designated faculty member at the school (often referred to as a clinical coordinator or liaison) should be available if you need guidance or have concerns. Expect check-ins, either via email or phone, to ensure everything is running smoothly. Keep those lines open. If you notice a student having consistent trouble, talk to the student about your concerns. If the problem continues, reach out to the faculty to discuss your concerns. Early interventions can make all the difference. Administrative Support Schools often require documentation of clinical hours, student evaluations, and progress reports. Some preceptors find this tedious, but it’s a necessary step to ensure that the student meets the program’s requirements. Before the rotation starts, clarify how often you need to submit documentation and in what format. Save yourself future headaches by setting up a simple system—whether it’s a spreadsheet, calendar reminders, or notes in an online portal. 3. Essential Questions to Ask—Before and During the Rotation- What are the Course Objectives? There should be a syllabus or objective checklist from the student or faculty contact. Knowing the learning goals upfront helps you tailor clinical experiences. Example: If the objective is to master basic women’s health, you would prioritize shadowing experiences in women’s health patients. - What’s the Student’s Baseline? Each student arrives at your door with a unique background. Some have done prior rotations or related experience, while others might be new to your area of practice. It’s always good to ask about their prior experience/rotation to assess their level of experience. Example: If an Acute Care student has extensive experience in an ICU might be ready for more advanced tasks like complex medication titration or analyzing ventilator settings. - What’s the Preferred Communication Method? Clarify how you’ll interact with the faculty advisor and the student. Is it via phone, email, or an online portal? How quickly should they expect responses? You might want to note the date for evaluations and the faculty contact on a calendar reminder. Example: You might note that you prefer email for routine check-ins and phone calls for anything urgent. Communicating these boundaries early prevents misunderstandings. Some schools require specific methods of communication, such as logging into the school’s portal, which can sometimes be challenging. - How Will We Handle Feedback and Evaluations? I suggest providing constructive feedback consistently, not just at the midpoint or end of the rotation. Tell students how you do things so they are not surprised. Example: If a student struggles with patient communication, you might debrief them immediately after the encounter, highlighting what went well and identifying areas for improvement. - What Challenges Might Arise and How Do We Address Them? No rotation goes 100% smoothly. Patients cancel, the office is short-staffed, or unforeseen emergencies happen. Discuss with your student how to stay flexible yet proactive. Example: If you anticipate a low census for certain types of patients (like peds or women’s health), see if a colleague in another department can host the student for a day. Or, if it’s ok, have the student call some peds/WH patients who are due for follow-up and schedule them to come in on days when the student can be there. 4. Real-World Scenarios: Preparing for Common HurdlesScenario A: The Overzealous Student Sometimes, you get a student who’s eager to jump into every procedure without really understanding the rationale behind it. In this situation:
Scenario B: The Hesitant Learner This student is bright but lacks confidence. They hang back in patient rooms and rely on you to lead. Combat this by:
Scenario C: The Unexpected Clinical Twist Your practice or hospital might be busy, short-staffed, or dealing with an unusual patient population. While it may sound chaotic:
5. Setting Goals and Measuring SuccessEstablishing Clear, Measurable Objectives Early in the rotation, set goals that align with the program’s requirements but also cater to the student’s interests and needs. Revisit these goals at midpoint evaluations and again at the end of the rotation to gauge progress. Tracking Progress Many programs have rubrics or competency checklists. Keep these updated and share them with the student, so they know exactly where they stand. Feeling “in the dark” about performance is stressful for students, so a transparent approach helps build their confidence and encourages skill development. 6. The Rewards of Being a PreceptorDespite the added responsibilities, precepting is an incredible way to give back to the profession. Teaching forces you to stay up-to-date with current best practices, refine your own clinical reasoning, and cultivate a new generation of clinicians who can positively impact patient care. Plus, you’ll forge lasting professional relationships and possibly discover a newfound passion for education. Who knows? You may even find a new hire! 7. Ready to Take the Next Step?If you’re feeling inspired and want to make a real difference in someone’s clinical training:
By stepping up as a preceptor, you’re shaping the next generation of nurse practitioners or APRNs —and that’s a legacy worth investing in. About the Author Lynn McComas is the CEO and founder of PreceptorLink and a recognized expert in precepting nurse practitioners and advanced practice provider students. With over two decades in primary care, Lynn has served as a coach, advisor, mentor, and preceptor for countless healthcare professionals, including NPs, nurses, and medical assistants. She co-founded a successful skills and procedures business and speaks nationwide on NP-related issues. Lynn is also a regular contributor on LinkedIn, KevinMD, Facebook, YouTube, Instagram @preceptorlink, X @LynnMcComas, and her blog, where she addresses the growing NP and PA professions and the urgent need for preceptor sites. Her unique perspective, shaped by her business, clinical, and educational experiences, positions her as a key voice in tackling preceptor shortages. Lynn is committed to driving change—through a paradigm shift in NP education, reducing barriers, offering preceptor incentives, and advocating for reforms within the profession.
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 This was real feedback on a recent survey asking about our student’s performance:
Excellent. I have since hired her! That’s right! Clinical rotations aren’t just a rite of passage before graduation—they can be your gateway to securing a future job. You’re onstage every day: your preceptor and site are watching how you handle yourself with patients, staff, and other providers. Those observations often lead to job offers for standout students. Of course, clinical rotations give students the opportunity to decide if they might want to work at that site after graduation. Regardless, treat it as a potential opportunity because connections and WOM count. Why It’s More Than Just a Rotation Think about it this way: your preceptor invests time and energy to guide you through real-world patient care. If you prove yourself to be reliable and professional, you’re one step closer to being considered a future colleague. When healthcare organizations face staff shortages or expansion plans, hiring a known entity (like a well-performing student) often feels like the safer, smarter choice. Be Prepared Like You Would for an Interview Just as you’d prepare for a job interview, show up on your rotation ready to exceed expectations:
Not sure where to start? Check out our guide on How to Prepare for Your First Day of NP Clinical Rotations to ensure you're set up for success from day one. Maintain a Professional Demeanor In many ways, your clinical rotation can be your “audition” for a future role in that very clinic or hospital. Employers (including your preceptor) look for someone who not only has clinical knowledge but also demonstrates professionalism:
Embrace the Student Role (But Show Initiative) Yes, you’re there to learn, but you’re also a future colleague. Find a balance:
Showcase Adaptability Real-world healthcare rarely goes as planned, so your flexibility matters. If a patient's schedule changes or if you’re asked to help in a different department, go with the flow. Preceptors value NP students who can pivot quickly without complaining. Network with Purpose Your clinical rotation is one of the best places to build your professional network:
Real-World Example: Ashley’s Story Ashley was one of our NP students, and she completed her final rotation at a busy urgent care clinic. Our preceptor reported that he hired her because she was consistently punctual, often arriving 15 minutes early to organize charts and prep exam rooms. When her preceptor introduced new procedures, she’d do a quick literature review at home, then come back ready to discuss them the next day. Most importantly, she treated everyone with respect—she learned the front desk team’s names and helped clean up exam rooms when the clinic got swamped. By the time Ashley wrapped up her rotation, she had made a strong impression. The urgent care offered her a position before she even graduated. Her commitment, teamwork, and proactive approach told them she was a great fit. Real-World Example: Marcus’s Story Marcus was placed with one of our preceptors at a small family practice clinic. While he excelled academically, he often left tasks unfinished and arrived just on time or slightly late. At times, he would say things that the team did not feel were appropriate. Our preceptor reported that her team felt they had to watch him closely. Despite his solid clinical skills, the clinic wasn’t comfortable offering him a position afterward. When a job opening arose three months later, they chose another candidate who had rotated there, citing better time management and communication skills. Consider Your Online Presence In today’s digital world, preceptors often do a quick online search of their students. Make sure your social media profiles reflect the same professional image you display in the clinic. If you blog or maintain a professional Instagram or TikTok, ensure your content aligns with healthcare standards and patient privacy regulations. Document Your Achievements Some ideas to consider: Treat your clinical rotation like a portfolio project. If it feels appropriate (and you have time!), you may want to keep track of:
Secure Future References Ask your preceptor—and even other team members—to be a reference if you’ve built a good relationship. A positive recommendation from a seasoned clinician can hold a lot of weight in hiring decisions. Just remember to keep that relationship warm with occasional updates on your progress post-rotation. Final Thoughts A clinical rotation isn’t just another box to check off on your path to graduation—it’s a potential job interview. With the right preparation, attitude, and consistent professionalism, you can position yourself as the kind of new graduate that clinics and hospitals want to hire. Like Ashley, you could wrap up your rotation with a job offer in hand—or at least strong references and a professional network that can lead you to exciting opportunities. About the Author Lynn McComas is the CEO and founder of PreceptorLink and a recognized expert in precepting nurse practitioners and advanced practice provider students. With over two decades in primary care, Lynn has served as a coach, advisor, mentor, and preceptor for countless healthcare professionals, including NPs, nurses, and medical assistants. She co-founded a successful skills and procedures business and speaks nationwide on NP-related issues. Lynn is also a regular contributor on LinkedIn, KevinMD, Facebook, YouTube, Instagram @preceptorlink, X @LynnMcComas, and her blog, where she addresses the growing NP and PA professions and the urgent need for preceptor sites. Her unique perspective, shaped by her business, clinical, and educational experiences, positions her as a key voice in tackling preceptor shortages. Lynn is committed to driving change—through a paradigm shift in NP education, reducing barriers, offering preceptor incentives, and advocating for reforms within the profession.  So you got the “great” news that your school just got approved in a new state. Yeah!! Well, it may not be as good of news as you think. As I write this, the song by Meghan Trainor - All About That Bass came to mind. You see, it’s “All About That Affiliation!” (Sorry, now you’ll have that song going through your head all day!)
If you're an NP student looking for clinical rotations in a newly-approved state, there's one crucial question you need to ask your school before you even start your preceptor search: What sites does my school already have an Affiliation Agreement (AA) in place with in that state (near me)? Your school knows, but you may really have to insist on getting an answer to this question. You may have to give them the names of all the local hospital systems and ask about each of them. Many students don’t realize that just because a preceptor or clinical site is willing to take them, it doesn’t mean the school can make it happen. Affiliation Agreements (AAs) are legally binding contracts between a school and a clinical site—and getting a new one signed isn’t always simple. In fact, it can take months, and in many cases, it may never happen at all. This is especially true for a large hospital system. Why Getting a New Affiliation Agreement Can Be Difficult When you're the first student from your school attempting a clinical rotation in a state where your institution has no existing AAs, you're in for an uphill battle. Here’s why: 1. Hospitals and Large Healthcare Systems Are Increasingly Refusing New AAs. Many hospitals, health systems, and large organizations have put a freeze on new AAs due to financial constraints, legal complexities, administrative burdens, and a focus on the plethora of students from their already affiliated programs. Some simply refuse to add any new agreements, especially for out-of-state programs. 2. It Can Take Months (or Longer) to Get an AA Signed. Even if a hospital or clinic is open to a new AA (which they MIGHT be if they need new NPs), the process is slow. Legal teams must review, negotiate, and finalize contracts, which can take weeks to months. By the time it’s approved—if it ever is—your rotation deadline may have already passed. 3. Getting a new AA in place with local hospital systems is vital for your school. The incorporation of an AA could have significant financial ramifications for SON. Based on a quote from the Evaluation of the Graduate Nurse Education Demonstration Project: Report to Congress: "…having an affiliation with a hospital decreases the average SON costs by $582,000. This may be because close relationships with hospitals offer the SON reliable and sufficient clinical sites and preceptors which mitigates the fiscal and human resources needed for finding clinical placements for APRN students." Now if your school could only get that AA in place! 4. Some Schools Won’t Pursue New AAs. Not all schools will go through the effort of negotiating a new AA for a single student. Schools prioritize agreements that will benefit multiple students over time. If you’re the first student requesting a new state AA, your school may decide it’s simply not worth the effort. Remember, it costs a school lots of money to get an AA in place…Just saying. 5. Private Practices May Be Your Best (or Only) Option—But They're Disappearing. If hospitals won’t sign new agreements, private practices may be your only choice. However, private practices are becoming increasingly rare, as many are now owned by large healthcare systems—meaning they fall under the same no-new-AA policies as hospitals. What Should You Do? 1. Ask Your School About Existing AAs Before Starting Your Search Before investing time into finding a preceptor, confirm that your school has AAs in place in the state where you want to rotate. If not, you may need to rethink your options. 2. Be Open to Alternative Clinical Settings If hospitals and large clinics aren’t an option, consider smaller independent practices, federally qualified health centers (FQHCs), or concierge medicine practices that may be more flexible. 3. Start Your Search Early If your school does allow new AAs, start as early as possible. Expect a long approval process, 3-6 months, and be prepared with backup options. (I know, easier said than done!) Final Thoughts Being the first student from your school to attempt a rotation in a new state is challenging—and in some cases, nearly impossible. Many hospitals and large organizations won’t sign new Affiliation Agreements, and private practices are becoming harder to find. Save yourself frustration and lost time by confirming your school’s existing AAs before starting your search. If you're struggling to secure a preceptor, PreceptorLink® can help! We work with a network of vetted preceptors and can guide you through the complexities of Affiliation Agreements. 👉 Need help finding a preceptor? Contact PreceptorLink® today! |
About Lynn:As a longtime NP with a desire to help and make positive changes to her beloved profession, Lynn often writes opinion pieces about the NP profession. Archives
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