 We recently had a physician say that he would accept our student (Yeah!), but he added, “Sure! I’d love to be her preceptor. Please make sure she gives me report. In the past, I have had a few NP students who had never reported.”
Let’s talk about how to report because this is an essential skill. Ideally, this is something they should be teaching you in school, but, if not now’s the time! Clear, concise communication is essential to ensure patient safety, build trust with your preceptor, and demonstrate your growing competency. Reporting may feel intimidating at first, but it’s a skill you can master with practice and guidance! You’ve got this! Ask First: What Does Your Preceptor Prefer? How you report a patient is largely determined by your preceptor’s preferences and the clinical setting. On your first day, ask your preceptor how they’d like you to present cases. Some may prefer the SOAP format, while others might want a brief SBAR or problem-focused approach. Here are some common reporting styles to be familiar with:
By clarifying this early, you’ll ensure your reports meet your preceptor’s expectations and streamline communication. SOAP Presentation Template for Primary Care or Acute Care Patients Good morning, [Preceptor's name]. I'm reporting on [Patient's name], a [age]-year-old [gender] who presented with [chief complaint]. PMH includes [relevant conditions]. Physical exam reveals [key physical findings], vital signs are [vitals]. Labs revealed [relevant lab results]. Based on this information, I believe the patient is likely experiencing [diagnosis] and plan to [proposed next steps]." (Include proposed plan, patient ed, f/u instructions, referrals, labs, imaging as needed.) SOAP Presentation Template for Pediatric Patients [Patient's Name] is a [Age]-year-old [Gender] presenting with [Chief Complaint]. They are accompanied by [Caregiver Relationship], who reports [Relevant Observations or Concerns]. [Feeding Habits], [Sleep Patterns], and [Any Developmental or Behavioral Concerns]. Past medical history includes [Relevant History]. Vitals: [Weight Percentile], [Height Percentile], [Head Circumference Percentile, if applicable]. Physical Exam reveals: [Key Physical Exam Findings]. Based on this information, I believe the patient is likely experiencing [diagnosis] and plan to [proposed next steps]." (Include proposed plan, parent ed, f/u instructions, referrals, labs, imaging as needed.) Adapt to the Setting The clinical environment also plays a role in how you report patients. Below are practical examples tailored to different settings and scenarios: Primary Care Setting In primary care, focus on the patient’s chief complaint and relevant history. Example (SOAP): "Good morning, [Preceptor’s Name]. I’m reporting on Mrs. Jones, a 52-year-old female presenting with fatigue for three months. She reports waking up unrefreshed despite eight hours of sleep. No significant weight changes but notes mild hair thinning. Past medical history includes hypertension, controlled on lisinopril. On exam, her BP is 128/82, HR 72, and her thyroid is non-palpable. Labs are pending, but I suspect hypothyroidism and recommend ordering a TSH and free T4. Do you agree?" Acute Care Setting Acute care requires concise communication focusing on urgent issues and changes in condition. Example (SBAR): "Situation: Mr. Smith is a 68-year-old male admitted for pneumonia. Overnight, his oxygen saturation dropped to 89% on 2L NC, now requiring 4L. Background: He has a history of COPD and was stable until yesterday. Assessment: He has increased work of breathing, productive cough, and WBC increased to 14,000. Recommendation: I suggest increasing respiratory support and considering broad-spectrum antibiotics. Would you agree?" Pediatric Setting Pediatric reporting often includes developmental milestones, caregiver input, and growth metrics. Example (Developmentally-Focused): "Good morning, [Preceptor’s Name]. This is Emma, a 6-month-old female here for a well-baby visit, accompanied by her mother. The mother reports no major concerns but notes frequent night waking. Emma is exclusively breastfed, feeds every 3–4 hours, and is in the 60th percentile for weight and 55th for height. Developmentally, she can roll over, sit with support, and babbles. On exam, she has mild occiput flattening but is otherwise normal. I recommend tummy time and repositioning. Would you consider a referral for helmet therapy?" Psych Setting Psychiatric settings require a focus on the patient’s mental health history, presenting symptoms, and mental status exam findings. Students may also report on Intake Assessments that they perform on patients. Example (Focused Problem-Based Reporting): "Ms. Taylor is a 32-year-old female presenting for anxiety and difficulty sleeping. Symptoms began six months ago after losing her job and have worsened. She describes racing thoughts, irritability, and avoidance of social situations. No history of substance use or prior mental health treatment. Mental status exam reveals anxious affect and difficulty maintaining focus. Her PHQ-9 score is 15, indicating moderate depression. I recommend starting CBT and discussing pharmacologic options. Does this align with your approach?" Or after an Intake Assessment: "I’m presenting Mr. James, a 35-year-old male seen for an intake assessment. He reports intermittent auditory hallucinations—voices calling his name—and paranoia, believing coworkers are plotting against him. His history includes depression but no prior psychotic episodes or hospitalizations. He denies substance use, suicidal or homicidal ideation, but his affect is flat, and thought processes are tangential. Family history includes schizophrenia in a maternal uncle. I’m concerned about a psychotic disorder, possibly schizophrenia, and recommend baseline labs, collateral information from his employer, and referral for further psychiatric evaluation. Do you agree?" Final Tips to Shine in Your Rotations
By tailoring your reports to the setting and preceptor’s preferences, you’ll build confidence and leave a strong impression. Reporting isn’t just a skill—it’s your opportunity to show how you’re growing into a capable, competent nurse practitioner. You’ve got this! 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. Why PreceptorLink® Can Help You Succeed Finding the right preceptor can make all the difference in your NP education. At PreceptorLink®, we connect you with experienced, vetted preceptors who can help you grow and cross the finish line! With our streamlined process, quality preceptors, and dedicated support, we make it easier for you to succeed in clinical rotations. Visit PreceptorLink.com to find your perfect match today.
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 Whether you’re the NP owner of a practice, the Director of Advanced Practice, or just an appreciative patient, you might want to find ways to acknowledge NPs during NP Week. NP Week is an annual event held during the second week of November to recognize NPs' vital contributions to healthcare. And it’s this week: November 10 to November 16. Here are some ideas to consider:
1. Share Appreciation Posts on Social Media
3. Send Personalized Thank-You Notes
4. Feature NPs in Your Newsletter or Blog
5. Host a Continuing Education (CE) Workshop
6. Create a Recognition Wall
7. Nominate an NP for an Award
8. Organize a Community Health Event
9. Celebrate with NP Swag
10. Share Inspirational Stories
11. Support NP-Owned Businesses
12. Host a Virtual Networking Event
Celebrating NP Week is a great way to honor NPs' dedication, expertise, and impact on patient care while spreading awareness of their critical role in healthcare. PreceptorLink® wishes you a Happy NP Week!! 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.  A few years ago, my college-age sons utilized the Common App for college applications. It’s a logical and brilliant concept: one online application that students can use to apply to multiple colleges and universities at once. And it’s accepted by thousands of colleges and universities worldwide. I remember thinking, “Why aren’t we doing this for nurse practitioner (NP) programs?” It seemed like a great solution, so I decided to research it.
Anyone involved in NP education knows that securing clinical training sites with preceptors is challenging. One of the main culprits is the complex and often burdensome process of creating affiliation agreements between schools of nursing (SON) and clinical sites. Adopting a Standardized Affiliation Agreement (SAA) in the NP profession would alleviate this issue and unlock new opportunities for NP students and clinical sites alike. Affiliation Agreements: The Hidden Barrier While essential, affiliation agreements have become a significant bottleneck for NP education nationwide. These agreements define the legal, educational, and administrative terms between clinical sites and schools, but their school-to-school variability creates unnecessary hurdles. Many clinical sites, already overwhelmed by requests, are unwilling to establish new agreements due to the extensive legal review and negotiation required, often compounded by liability concerns. These factors have contributed directly to the national shortage of preceptor sites. Currently, schools and clinical sites must draft individualized agreements for each collaboration, a process that is costly, time-consuming, and highly variable depending on the legal requirements of the state and institution. For schools outside the clinical site’s state, the situation becomes even more complicated. The complexity of these agreements is one reason many students are unable to find clinical placements, leading to delays in their education or, worse, students leaving their programs entirely. Can We Create A Standardized Affiliation Agreement For The Np Profession? A standardized affiliation agreement (SAA) for NPs and advanced practice registered nurses (APRNs) could be a game-changer for the profession. With a consistent framework in place, clinical sites and educational institutions would no longer have to spend excessive time and money negotiating new agreements for every student. This would simplify the process, reduce legal costs, and, most importantly, open more doors for students to gain critical clinical experience. This concept is not without precedent. Medicine already has a similar solution in place. The Association of American Medical Colleges (AAMC) developed the Uniform Clinical Training Affiliation Agreement (UCTAA), which has significantly streamlined the affiliation agreement process for medical schools and clinical sites. The UCTAA has been widely adopted by medical institutions and has been instrumental in reducing both time and financial burdens. It’s time for the nursing profession to follow suit and create an SAA that works for NP and APRN programs. A Call To Action For The Nursing Profession As it stands, nearly 500 NP programs in the United States graduate tens of thousands of students each year. Yet many of these programs are constrained by a lack of clinical placements. The shortage of preceptor sites impacts not only NP students but also physician assistant (PA) students, medical students, and residents. It’s a cascading issue, one that a unified approach to clinical affiliation agreements could mitigate. By developing and implementing a standardized agreement, NP schools could save significant resources. According to a report to Congress on the Graduate Nurse Education Demonstration Project, having strong affiliations with clinical sites can save schools of nursing up to $582,000 per year. These savings come from reducing the time and human resources needed to establish clinical placements. Imagine the cumulative impact on our profession if even a fraction of that savings was realized across the nearly 2,000 nursing programs in the U.S. alone. The road ahead: Making the SAA a reality The groundwork has already been laid. Leaders in preceptor-matching for NP students have taken the lead on this issue. Legal experts in both nursing and medicine, along with leaders from key medical education organizations, have collaborated to develop a framework for a Standard Affiliation Agreement (SAA) tailored to NP and APRN programs. Similar to the Common App, addendums can be included for special circumstances. Whether the profession adopts this SAA or begins anew, let’s give it a try! However, support from academic institutions, clinical sites, and accrediting bodies is essential to move forward. Key stakeholders, including the American Association of Nurse Practitioners (AANP), the American Association of Colleges of Nursing (AACN), the National Organization of Nurse Practitioner Faculties (NONPF), and the National Council of State Boards of Nursing (NCSBN) can help drive this forward. The nursing profession must champion this initiative to ensure our students have the clinical training they need to become skilled providers. Here is the AAMC’s goal as listed on their website: Goal Our goal is to eliminate unnecessary time and resources currently spent negotiating (and re-negotiating) agreements, when a standard, predictable approach is sufficient. The AAMC Uniform Clinical Training Affiliation Agreement is a simple, one-size-fits-all agreement that resides on AAMC’s website. What a wonderful goal! The NP profession can have a similar goal. A Collective Responsibility This is not just an issue for schools or clinical sites – it’s a responsibility for the entire nursing community. Preceptors, schools, clinical sites, and professional organizations should work together to make the SAA a reality. Only through collective action can we break down the barriers preventing our students from gaining the education they deserve. This is one step in that direction. Nurse practitioner education is facing many challenges, but addressing one major barrier could make a world of difference. Implementing a standardized affiliation agreement has the potential to streamline the clinical placement process, open doors to more training sites, cut costs for both schools and clinical partners, and remove one of the biggest roadblocks in NP education. This single, impactful step could bring us closer to ensuring every NP student gets the hands-on training they need to deliver quality care. 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.  Dear NP Schools of Nursing,
I have to be honest. Some schools of nursing (SON) are making it worse for students and for the profession. As a long-time NP, a subject expert on “The Preceptor Problem for the NP Profession,” and with ten years of experience in helping students find preceptors, I understand the many complicated factors around this issue. However, we have been seeing some really concerning problems lately. I can no longer sit back and say nothing, so I want to speak directly to the SON. (And, of course, students, preceptors, the profession, patients, and NP-haters are listening, so please be thoughtful about any responses.) We know you’re working hard to meet accreditation standards and comply with evolving regulatory requirements, and we fully appreciate the importance of these standards. However, when preceptor requirements change abruptly, students and our team feel shocked and left scrambling. This sudden shift can frustrate preceptors who had cleared their schedules to take on students, leading to avoidable chaos. We see firsthand how these policy changes are creating significant, often unnecessary, obstacles for students and preceptors alike. Let’s face it—you know how hard it is find preceptors for NP students. This difficulty is why many schools require students to find their own clinical placements. It’s also why placement coordinator roles within schools often see high turnover. Clinical placement coordination is a difficult, time-consuming task, and that is exaclty the reason I founded PreceptorLink® ten years ago. As an experienced NP in the trenches, I wanted to fill this critical gap for students who otherwise face this responsibility alone (or want options beyond what their school can offer). (YES! Some schools do place students. To those schools: Thank you and God bless you! We’re here for you too if you need help.) Not a day goes by that we don’t receive a call from a student in tears, frustrated by the barriers they’re facing. We owe it to these students—the future of NP care—to do better. When students are declined for rotations they’ve already secured due to sudden policy changes, it sends a message to students that their dedication and hard work don’t matter. It sends a message to the preceptors and sites that agreed to accept these students that they don’t matter. Accreditation standards may require updates, but if students have met prior standards, they should be allowed to complete their planned rotations without last-minute disruption. They trusted the process and invested time, energy, and resources—let’s honor that by “grandfathering” in students who’ve secured placements in good faith. Additionally, communication about policy changes must be clear, timely, and accessible. Manuals students receive are dense, hard to follow, and constantly evolving. When policies change, students need a clear breakdown of how the changes impact their placements, with effective dates. Providing a concise, easily digestible format—a summary chart, FAQ, or simple checklist—can go a long way in helping students navigate requirements without combing through endless documents. Some manuals are 190 pages long! It’s no wonder students struggle to know their school’s requirements. A recent policy change at one school to reduce the maximum number of students per preceptor from three to two per term might seem minor, but it has created a domino effect that leaves one in three students without a preceptor, even after months of planning. Students who thought they had a secure plan are now scrambling. This isn’t just inconvenient—it jeopardizes their education and strains relationships with preceptors feeling unsupported and dismissed. We’re seeing the results with sites. Many clinical sites are closing their doors to students from certain schools, and some have stopped accepting NP students altogether because they’re unwilling to handle constant, unpredictable changes. Here’s another recent change we’ve seen: The recent blanket decision to disallow Family Nurse Practitioners (FNPs) to precept Adult-Gerontology Acute Care Nurse Practitioner (AGACNP) students in acute care settings. While we respect the need for alignment with regulatory and state guidelines, it should not be a blanket rule. Follow state BON guidelines and evaluate on a case-by-case basis. I read in one manual that made this change that an ANP, AGPCNP, or PA are allowed to precept an AGACNP in an acute care setting but not an FNP, even if they have years of experience, are hospitalists and the state BON allows it. Again, if it’s a state requirement, that is one thing, but to make it a blanket requirement and decline excellent preceptors makes no sense. By making this a blanket rule, programs are losing out on qualified, willing preceptors who could be a tremendous asset in acute care education. Let’s respect the nuance and experience these preceptors bring instead of applying rigid standards across the board. Declining non-board-certified physicians as preceptors is another extremely problematic and frustrating issue. Physicians are highly-educated providers who have met extensive training (well beyond an NPs) and continuing education (CE) requirements. Yet some NP schools deem them unsuitable for NP students due to administrative standards—not due to a lack of expertise or a state requirement. (If it’s a state requirement, that is different, but I have not found a state that requires physician preceptors to be board certified. Let me know if you know of a state that requires BC for physician preceptors. Not the school making the determinations, but the state BON making it.) Did you know that physicians have to retest for their Boards again? (Unlike NPs) Yes, physicians have to sit for the exam again every time they recertify. This is in addition to the CE they have to do for licensing. Did you also know that most medical boards charge $1,000 to $2,000 for recertification every 10 years? And board certification is often not required by states or hospitals. As a result, many physicians choose not to renew board certification due to high costs, time burdens, and the perception that recertification exams don’t reflect real clinical practice. By enforcing rigid standards, NP programs risk denying students access to seasoned mentors who could greatly enhance their practical training. Frankly, it’s embarrassing to tell a seasoned physician that the NP school has declined them because they did not renew their board certification. If schools continue requiring students to find their own preceptors while raising placement standards, it may be time to revisit the admissions process to better align with the availability of qualified preceptors. Students are tasked with securing their placements but face an uphill battle with fewer preceptors and increasingly complex requirements. Programs should support—not hinder—student success by ensuring admission numbers reflect the reality of available preceptorships. Phew! That’s my two cents. Thanks for allowing my vent! At PreceptorLink®, we’re committed to guiding and supporting students, preceptors, and the schools themselves. We’re happy to help place your students and share the knowledge we’ve gained over a decade in this field. We stand side by side with you in the trenches. Our team isn’t only exceptional at what we do—we truly care about students, preceptors, schools, and the NP profession. We want this process to work for everyone involved, so please, don’t make it harder for students, for us, and for the profession we all serve. Let us work together to improve the situation for the sake of the profession, NP care, and the students who are giving their all to become skilled providers. Let’s make it better. We owe it to the profession, to the students, and, ultimately, to ourselves. Sincerely, Lynn McComas, DNP, ANP-C President & CEO, PreceptorLink® |
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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