 If you’re considering going to school to become a Nurse Practitioner (NP), there are many factors to evaluate before making this important decision. (I refer to NP in this article, but it is also applicable to any potential Advanced Practice Registered Nurse- APRN degree, as well.) After speaking with numerous students, one common sentiment I hear is, “I wish I had known these questions before choosing my school.” That’s why I want to help guide you through the process of selecting the right NP or APRN program that aligns with you!
As a nurse practitioner (NP) with over two decades of experience and the founder of PreceptorLink®, I work closely with NP students. I’ve seen firsthand how crucial the right program choice can be to your success. Let’s talk about the different types of NP schools and help you understand the pros and cons of each. This is so important to think through! Don’t get suckered in by flashy or persuasive salespeople (that’s what they are oftentimes). Look for the best option for YOU! One very important caveat. Don’t just go to where you did your BSN, especially if you live in a different state than your alma mater. I can assure you that this can be a problem, especially if your BSN school was a brick-and-mortar or lesser-known institution. Affiliation agreements are very frequently a problem in this situation! Please take my word of advice here!! Let’s talk about the different types of schools and the pros and cons of each: 1. Brick-and-Mortar Schools These are traditional institutions with physical classrooms where you attend in-person lectures. Think of the old-fashioned model, which I experienced when I pursued my master’s degree. Although my doctoral program at Duke University was hybrid, my master’s education involved being in a classroom, face-to-face with faculty. Advantages:
Disadvantages:
2. Hybrid Programs Hybrid programs offer a combination of online and in-person education. For example, when I completed my doctorate, most of my coursework was done online, but I still had to attend in-person sessions for clinical skills evaluations and competency check-offs. Advantages:
Disadvantages:
3. 100% Online Programs Online education has become more common in the NP field, especially given the technological advancements that happened after the global pandemic. While convenient, these programs vary widely in quality. Choose carefully. Advantages:
Disadvantages:
Regardless of the type of program, all NP students are required to complete hands-on clinical preceptorships. (Take a look at my article on KevinMD about hands-on clinicals.) The minimum requirement for clinical hours is currently 500, but most programs far exceed this number. Clinicals are so important, so don’t shortchange yourself there! Less is not more when it comes to clinicals! Additionally, while some simulation and virtual experiences (like Shadow Health) may be incorporated, they are supplemental and not a replacement for in-person clinical education. Personally, I’d strongly suggest you pick a program with more clinicals and not less. Trust me! You’ll be so glad when you are out in clinical practice that first year! It’s a huge learning trajectory! Yes, the struggle is real when it comes to finding an NP preceptor, but it’s worth it in the end. Direct Entry Programs: An Alternative Path While most NP programs require prior nursing experience, there are some direct entry programs designed for individuals without a nursing background. These programs are more akin to physician assistant (PA) schools, offering an accelerated and intensive path to becoming a Nurse Practitioner. Although far less common, these programs are often offered by very reputable institutions (often Ivy League) and provide a comprehensive education. I’ve met some great direct-entry NPs. That said, I personally believe having nursing experience before becoming a Nurse Practitioner is invaluable. In my opinion, you should have at least three to five years of nursing experience before starting an NP program. This background allows you to gain crucial insights into the healthcare field and prepares you for the realities of clinical practice. I have seen posts on the nursing forums of graduates saying that they did not fully realize what they were getting into. Imagine going through all of that school only to find you really don’t want to become a provider!? However, if you have a really good idea of what to expect, a direct entry program may be right for you. Final Thoughts Choosing the right NP program is a pivotal decision that will shape your future career. Whether you opt for a brick-and-mortar school, a hybrid program, or a fully online option, it’s essential to evaluate the quality of education, the support system available, and the clinical opportunities provided. Do your research and ensure that your program aligns with your long-term goals as a healthcare professional. Please let me know if this information has been helpful or what advice or questions you might have. I wish you the best of luck in your journey. Feel free to reach out if you need assistance or further guidance. 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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 Ready for some real-world precepting tips? Let’s dive in! Here's an example of how one of our nurse practitioners precepts her students in a primary care office.
Meet Kate, FNP: This is how "Kate, FNP" precepts in her outpatient primary care practice. While this example is set in an outpatient primary care environment, these tips can apply to various outpatient settings. Observation vs. Jumping In How much observation is needed? This largely depends on the student’s experience level and the preceptor’s style. Some preceptors expect students to jump right in and start seeing patients on the first day. It's crucial to clarify expectations beforehand to avoid any surprises. Personally, I recommend allowing students to observe at least a few patients first. This approach allows them to understand the preceptor's style and helps the preceptor gauge the student’s interaction with patients. As for ongoing observation, hands-on experience is key for students, so observation should be kept to a minimum unless it’s a brand-new procedure or experience. Of course, patient care and safety are always the top priorities. Students, remember you are representing both your preceptor and the site, so you want to make a positive impression. But don’t be afraid to engage with patients when given the green light—it's the best way to learn. Kate’s Approach to Precepting Kate allows her students to observe for the first day or two. During this time, she speaks out loud as she charts and works around the office, which doubles as an orientation for the student. Then, she gradually allows the student to start to take the lead while she observes. Once Kate feels comfortable, she sends the student into the patient room to obtain the history and perform a focused exam independently. Of course, it's important to get the patient's consent for the student to be involved. This can be done by the preceptor or staff simply saying, "Kate is working with an NP student today. [Student’s Name] will start the exam, and then Kate will follow up afterward. Is that okay?" The front desk can also mention this during check-in. After the student sees the patient, they review the history and findings with Kate. Together, they develop differential diagnoses and probable treatment plans before going into the room to see the patient. Kate performs her own exam, clarifies any remaining questions or history, and they complete the visit as a team. Charting: The Next Step Allowing the student to learn how to chart is a vital part of the process. There are several ways to approach charting. Some options include:
It's important to follow facility guidelines and preceptor preferences. CMS permits students to chart as long as the preceptor reviews and signs off. Always clarify what is permitted for students at your facility. This is how one preceptor manages her outpatient practice. What about you? If you’re a preceptor, share some strategies that have worked for you. Or, if you’re a student, what have been some of your best (or worst) experiences? Keep on learning! Lynn McComas is CEO and founder, 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 health care 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.  You’ve decided to learn Medical Spanish! Perhaps it’s because you finally did find an NP preceptor (or you’re looking for an NP preceptor!), but the patients predominantly speak Spanish. Or maybe you work in a clinic or area with a large Hispanic population. Some people simply want to connect better with their Spanish-speaking patients. Regardless of the reason, this decision can make a significant impact on your practice and your patients.
As a healthcare provider, you understand the importance of building strong connections with your patients. However, language barriers can make this challenging, particularly with Spanish-speaking patients. You may feel like you’re missing out on the chance to establish the same rapport and trust you have with your English-speaking patients. If you’ve felt this way, you’re not alone. Learning Medical Spanish can help you bridge this gap, enhancing not only your physical care but also the emotional and mental support you provide. Additionally, being proficient in Spanish can set you apart in the job market, giving you a competitive edge even if you have less experience than other candidates. It might even help you negotiate a better salary. ***A note before we continue: Most hospitals and clinics require the use of a translator for legal reasons. Consider this and check with your site first for practice guidelines. I spoke with colleagues and scoured the blogs and posts to create a compilation of suggestions and resources from fellow medical professionals to help you enhance your Medical Spanish skills and build the confidence to communicate better with your Spanish-speaking patients. Whether you are a provider or a student, check out these resources and suggestions and see what fits your learning style. 1. Listen and Learn Spanish Radio, watch Spanish TV (progress from the closed caption in English to no closed caption), and Podcasts. Immerse yourself in the language by tuning into Spanish-language radio during your commute. Singing along and repeating after the broadcaster can help you internalize grammar and vocabulary naturally. You can also try out podcasts like "Coffee Break Spanish" and "Duolingo Podcast." These are fantastic for learning on the go and provide both conversational and medical terminology. Try them out on your next commute to work or clinicals! 2. Leverage Resources- Some are free! Several free resources are specifically designed for medical professionals: - Medical Spanish Language Survival Kit: Initially created for military doctors, this course focuses on essential communication for non-English speakers in medical settings. While it's more focused on speaking than listening, it's a good starting point. - Duolingo: A popular language-learning app that you can use daily to gradually build up your Spanish skills. - Canopy Medical Spanish: This platform offers comprehensive medical Spanish courses. Although there’s a cost involved, many find it worth the investment. - Learn conversational Spanish with Dreaming Spanish. - Etsy has several Spanish medical resources. Whether you need a pocket guide or flip chart, you may find some useful resources. 3. Try Google Translate Type out everything you want to say, paste it into Google Translate, and it'll even read it aloud to you. Show your preceptor to make sure it’s correct. 4. Interactive Learning: Apps and Courses If you prefer interactive learning, there are various apps and online courses tailored for medical Spanish: - Preply: Connect with native Spanish speakers from Latin America via video chat for personalized lessons or take an online class. - Coursera’s Healthcare Spanish Course: This is another excellent option that’s both accessible and structured. - Language Transfer and Spanish with Paul on YouTube are highly recommended by learners for their engaging and effective teaching styles. - MedicalSpanish.com was reported as simple and effective. - Rio Associates offers live classes or self-study CME courses in medical Spanish. - Here are two good apps for learning medical Spanish. They have medical terms as well as a Dialogue section that covers a full H&P. And it's free: iOS: https://apps.apple.com/app/apple-store/id1574202729?pt=123220161&ct=email&mt=8 Android:https://play.google.com/store/apps/details?id=com.rogers_dictionary&referrer=utm_source%3Demail 5. Books and Textbooks If you enjoy traditional learning methods, consider the McGraw-Hill Complete Medical Spanish textbook for a more structured approach to grammar and medical terminology. Another unique resource is Madrigal’s Magic Key to Spanish, which is great for natural method language learners. Or check out an oldy, but reported goody with Medical Spanish Made Incredibly Easy! (Search for this one online to find the best price available in used books.) 6. Supplement with Visual and Auditory Learning Watching children’s cartoons like "Pocoyo en Español" on YouTube can be surprisingly helpful. The simple language and visual cues make it easier to follow along and understand. 7. Learn Through Experience Sometimes the best way to learn is by observing. When working with an interpreter, listen closely to the conversation between the interpreter (or preceptor) and the patient. This can help you pick up on specific phrases and terminology used in real-life medical situations. 8. Learn Some Slang Learning doesn’t have to be all serious. Books like "Dirty Spanish" may sound humorous, but they can provide insights into slang and colloquial language that may come in handy. (Personally, I’d be a little careful with this one!) 9. Check Out the Library! As the daughter of a Librarian, check resources at your local public library! Resources are generally free! Remember the library!!??? There is usually one in every town, and if you have a library card, you can request things ahead of time and just go in and pick them up. (Your school library, too, if you have access to a school library.) 10. Stay Consistent Use resources like Mango, which might be available through your local library for free) to keep your learning consistent. Mango offers both general and medical Spanish lessons, making it a well-rounded tool for daily practice. 11. Connect with the Hispanic Community The best way to learn any language is through immersion. Try to engage with Hispanic friends or colleagues in casual conversation. The real-world practice can help solidify your skills and make you more comfortable using Spanish in your professional setting. Hispanic people are generally very appreciative of you learning their language. 12. Practice, Practice, Practice The best way to improve is to practice, even if you make mistakes. Start off your patient interactions with simple Spanish greetings and phrases. The more you try, the more you'll learn. Remember, improvement comes with trial and error. Learning Medical Spanish can seem daunting, but with the right resources and a bit of dedication, you'll be able to bridge that communication gap and establish the same rapport with your Spanish-speaking patients as you do with your English-speaking ones. Remember, every little bit helps, and your patients will appreciate your effort to connect with them in their language. What are your favorite resources and techniques for learning Medical Spanish? Let us know in the comments below! Lynn McComas is CEO and founder, 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 health care 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.  Imagine walking into a doctor’s office or hospital and being treated by someone who has never actually touched a patient before. Sounds absurd, right? Yet, this could become a reality if we continue to push aside the hands-on training of our future health care providers.
This may seem extreme, but it reflects a recent message sent by HR to one of our most dedicated preceptors. (Parts of the message are redacted to protect the institution’s privacy.) “I’m writing to clarify the role of students at our clinics: To clarify, this is a shadowing and observational experience … Students are not permitted to engage in any hands-on training or provide patient care at any time … No student—whether MA, RN, NP, PA—should provide patient care or be left alone with a patient.” Sadly, I’m seeing this kind of thing more and more in requests for preceptors. Providers who only allow “observation” during clinical rotations should concern every patient, doctor, and health care facility. The question isn’t just how we’ll prepare the next generation—it’s whether we’ll prepare them at all. I am completely baffled by this. Are we really okay with future providers lacking the hands-on experience they need to safely and effectively care for patients? These students aren’t just students—they are our future health care providers. They will be the ones taking care of our communities, treating our loved ones, and dealing with emergencies. Yet, despite how important they are, we’re not giving them the real-world training they need. Hands-on experience is crucial for their education. But let’s be honest: Hands-on training isn’t just about learning skills—it’s about gaining the confidence and experience that comes from working directly with patients. This is where students learn to make quick decisions and connect with people in need. Without this training, we’re sending them out into the world half-prepared, and that’s not fair to them or the patients they will serve. We understand the pressures to be productive, the limited resources, and the financial challenges that health care organizations and providers face. But when these concerns take priority over giving students real-world training, we’re heading for trouble. Do we want a future where providers know all the theory but lack the experience to make tough clinical decisions when it counts? This isn’t just an educational problem—it’s a patient safety issue. Skipping this crucial training isn’t just bad for students; it’s bad for every patient they’ll eventually care for. We can’t afford to focus on short-term productivity at the cost of long-term quality. While efficiency and saving money are important, the quality of care we provide is paramount. Imagine the consequences: providers who miss out on hands-on training may make avoidable mistakes, leading to patient suffering, legal issues, and higher costs for the health care system. This is a risk no one wants to take, but it becomes more likely if hands-on learning is pushed aside for short-term gains. The health care system depends on having well-trained, confident providers who are ready to step into their roles and do the job right. We’re weakening that system by denying students these real-world experiences and putting future patient care at risk. Health care facilities, doctors, and educators must come together to ensure that hands-on training remains a vital part of medical education. We can’t allow productivity concerns to overshadow our duty to properly train the next generation. Our future providers—and our patients—deserve better. The next generation of health care professionals is counting on us to make their education a priority. Let’s not let them down. Lynn McComas is CEO and founder, 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 health care 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. This article was originally published on KevinMD. You can find the original article here. |
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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