Preceptorships

ND Preceptorship Syllabus

Doctor of Naturopathic Medicine

Course Syllabus

ND Preceptorship ― Experiential Learning

Instructor name
Kelly Baltazar, ND, DC, MS (program oversight)
Preceptors vary according to site
Email & Phone
kbaltazar@nunm.edu
503.552.1860
Office hours & location
Drop-in or by appointment
Administrative building

Course Schedule and Location

This course is year-round and is located at the respective preceptor’s office, clinic or hospital.

Course Description

Students participate in external clinical rotations (“preceptorships”) throughout the duration of their education under the mentorship of licensed preceptors outside NUNM. Students will observe and may participate in medical interviewing, physical examination, diagnostic techniques and analysis, and application of therapeutic modalities. Students will also observe routine clinic policies and procedures, doctor/patient communications, coding and billing practices, and referral management.

Definitions

  • “Preceptor” means the licensed and NUNM-approved healthcare provider with whom the student will work or observe in the community.
  • “Rotation” means the total number of hours a student works with a preceptor during one quarter.
  • “Shift” means one single day of a rotation.

Credit Hours

Nine credits (five credits are given in the required summer term, and four in the student’s final spring term prior to graduation)

Course Prerequisites

  • Passing grade in all first-term ND coursework
  • Attendance at ND preceptorship orientation (winter term of first year)

Course Competencies

Upon successful completion of this course, students will be able to achieve the following:

Medical Knowledge Competencies:

  • Observe or elicit the taking of a complete and accurate medical and biopsychosocial history.
  • Observe or perform complete and appropriate physical examinations.
  • Demonstrate increasing proficiency in case presentation skills.
  • Observe the creation of, or demonstrate the ability to write, progress notes in a standard format with pertinent content.
  • Recognize the appearance of varied clinical pathologies and formulate differential diagnoses.

Patient Management Competencies:

  • Provide evidence-informed ideas in discussion of treatment protocols that are consistent with naturopathic principles.
  • Observe or participate in the formulation of therapeutic interventions, and assess their effectiveness.

Communication and Collaboration Competencies:

  • Demonstrate the ability to function as part of a patient care team.
  • Demonstrate the ability to establish patient rapport.
  • Recognize strategies for dealing with difficult encounters, increasing patient compliance, and encouraging return visits as appropriate.
  • Demonstrate or observe the delivery of diagnostic findings and diagnoses, and provision of patient education around those findings.

Practice-Based Learning and Improvement Competencies:

  • Demonstrate a commitment to independent learning.
  • Demonstrate acceptance of critical feedback.
  • Demonstrate integration of basic science and clinical knowledge.
  • Demonstrate ability to accept uncertainty.
  • Demonstrate clinical curiosity.

Ethics and Professionalism Competencies:

  • Demonstrate respect, compassion and integrity in patient and professional interactions.
  • Demonstrate a commitment to ethical principles of medicine.
  • Adhere to NUNM clinic and preceptor handbook requirements of professional conduct and attire.
  • Demonstrate sensitivity to patients with a variety of cultural, ethnic, and financial backgrounds.

Practice Management and Business Skills Competency:

  • Observe business strategies for the creation of a fiscally viable practice.

Systems-Based Practice Competency:

  • Observe and develop an understanding of the process for patient referrals and consultation with other healthcare providers as required.

Program Outcomes Met by this Course

  • Medical Knowledge
  • Patient Management
  • Communication & Collaboration
  • Practice-Based Learning & Improvement
  • Ethics & Professionalism
  • Practice Management & Business Skills
  • Systems-Based Practice

Required Textbooks, Articles and Other Information Resources

ND Preceptorship Student Manual

Recommended Textbooks, Articles and Other Information Resources

  1. Bates’ Guide to Physical Examination and History Taking, current edition
  2. Ferri’s Clinical Advisor, current edition
  3. Differential Diagnosis in Primary Care, Collins, current edition
  4. UpToDate clinical database

Assignments

  1. Experiential Learning Objectives Overview
    1. Completed once by the student―a brief, but thoughtful big picture assessment of short- and long-term goals, required before they begin the course. Must be submitted on MyCareer.
  2. Learning Goals/Placement Form
    1. Completed by the student in collaboration with the prospective preceptor. The preceptor may optionally add their own goals for student learning. Approved through MyCareer by NUNM and by the preceptor, prior to or on the first shift of each rotation.
    2. Student is responsible for form completion and submission on MyCareer.
  3. Student Evaluation and Hours/Patient Tracking Log
    1. Evaluation is completed by the preceptor for all rotations of greater than eight total hours. The preceptor confirms the hours completed during the rotation and submits an evaluation of your performance through a link to a MyCareer form.
    2. It is helpful if the student reminds the preceptor to complete the evaluation, as credit for the hours completed is dependent upon submission of this form to the Clinical Education office.
    3. The student maintains a tracking log of all shift dates, times, and patient contact numbers. This log is approved by the preceptor at the completion of the rotation.
  4. Self-Reflection/Goals Assessment and Preceptorship Program Evaluation Forms
    1. Student is responsible for completion and submission to the Director of Career Services through MyCareer following the end of each rotation.

All forms must be completed and submitted through MyCareer to the Director of Career Services no later than Friday of week two of the quarter following the completed rotation. For example, if you complete your rotation anytime in fall quarter, submitted forms would be due by week two in the winter quarter of that same academic year. These online forms are required for each preceptorship rotation that a student completes. Note:

  • If your rotation with a single preceptor proceeds continuously throughout more than one quarter, you need only to submit the required forms one time at the end of the rotation.
  • If you work with a single preceptor more than once, but not continuously (you skip six or more weeks), this would be considered two (or more) separate rotations, and documentation must be submitted for each rotation.
  • Credit will only be given for rotations with approved preceptors. It is the student’s responsibility to ascertain if the preceptor is approved by completing one or more of the following steps:
    1. Check the MyCareer database.
    2. Email Emma Britton at ebritton@nunm.edu to determine if the preceptor is approved.

    Retroactive credit will not be given if the preceptor was approved after the student began working with the preceptor

Late Documentation Policy

Credit will not be given for documentation that is submitted after the due date.

Scheduling your preceptorship rotations

ND preceptorship rotations must be completed only with healthcare providers who have been previously approved by the program. It is your responsibility to ascertain if a provider has been approved prior to beginning your rotation. If the student is listed on the MyCareer website with a preceptorship job listing, they are approved. This does not guarantee availability! If the provider has not been previously approved, you will not receive credit for hours completed in a rotation.

There are three ways to schedule a preceptorship:

  1. Utilize the MyCareer Preceptor Database or contact the Director of Career Services to find an approved preceptor.
  2. Create your own preceptorship (preceptors must always be approved in advance of beginning your rotation or credit will not be awarded).
  3. Complete the online Lottery Request form. (for students in their final year only).

Specific instructions for each scheduling method can be found in the ND Preceptorship Student manual beginning on page 11.

Remediation Policy

Students receiving low final evaluation scores of 1 or 2 (out of 5) will have additional preceptorship hours assigned as determined by the number of hours in the rotation.

Attendance Requirements

All preceptorship shifts must be attended as scheduled with the individual practitioner. Tardiness and absences without notification are unprofessional and are detrimental to both your own reputation as a student clinician and to the program as whole. Absences with no or late notification, or chronic tardiness will result in assignment of up to 10 additional hours and/or a referral to the Honor Council.

Requirements for Passing this Course

There is no grade given for this course. Student matriculating in fall 2015 or after are required to complete 216 preceptorship hours (240 hours for students who matriculated prior to fall 2015), 145 of which must be with an ND, and the remainder of which can be with any of the following licensed practitioners: ND (Naturopathic Doctor), MD (Medical Doctor), DO (Osteopathic Doctor), DC (Chiropractor), DPM (Podiatrist), NP or CNM (Nurse Practitioner or Certified Nurse Midwife), PA (Physician Assistant), DPT/PT (Doctor of Physical Therapy, Physical Therapist), or Clinical Psychologist (LCSW, MFT or PsyD). All documentation must be completed and submitted on time in order to receive credit for the course.

Grading Scale

There is no grade given for this course, however you will be evaluated on the following 1–5 scale and receive feedback from your preceptors.

1
Unacceptable performance
2
Below expected level of performance
3
Expected level of performance
4
Performing above expectations
5
Superior performance
NA
Not Assessed/Not applicable

Students receiving low final evaluation scores of 1 or 2 (out of 5) will have additional hours assigned as determined by the number of hours in the rotation.

Instructional Philosophy

It is our sincere belief that you will take away from ND preceptorships and experiential learning opportunities what you invest in them. The process of creating your learning goals at the beginning of your rotation is your opportunity to tell the preceptor what you can do and specifically what you would like to obtain from this experience. Reflection on your experience is an integral part of the learning process, and the reflection and goals assessment is your opportunity to consider how and if you achieved your goals.

Study Strategies and Classroom Participation Guidelines

The amount of engagement you have in this experience is related to two main factors, but there are a myriad of ways to get the most out of your preceptorship rotations:

  1. If your preceptor is practicing in an unlicensed state or does not have malpractice insurance coverage, your only option is to observe that preceptor with their patients. However, you should challenge yourself to engage in active discussion with your preceptor about all aspects of cases.
    1. Challenge yourself to summarize the pertinent aspects of the case for your preceptor.
    2. Challenge yourself to provide differential diagnoses for the case and your ideas for evaluation and management.
    3. Do literature searches on interesting presentations, diagnoses, or treatment options.
  2. If your preceptor is licensed and is covered by malpractice insurance, your preceptor has the option to include you in patient care at their discretion. Let them know that this is possible, and volunteer to help when you feel ready and comfortable to do so.
    1. Ask if it is appropriate for you to “room” patients (take their vital signs, basic chief complaint, meds and allergies). If your preceptor is comfortable with it, ask to take the history (established patients or patients with acute concerns might be good candidates for this).
    2. Ask if you can perform or repeat a physical exam.
    3. Ask if you can perform in-office tests like urinalyses, wet preps, or rapid strep tests.
    4. Ask if you can provide patient education around certain topics that you are comfortable with (tobacco cessation, therapeutic diets, child safety).
    5. Ask if you can help with documentation to help you become familiar with different electronic records systems.
    6. Ask to give an oral case presentation on an interesting patient you have seen.

Academic Integrity

All students are required to be familiar with and adhere to the academic integrity policy. For further information on cheating, plagiarism, misconduct, etc., please refer to the “Student, Clinic and Preceptor Handbooks” found at https://studentservices.nunm.edu/.

Citation Requirements

When referring to other sources of work, students are required to cite their sources. NUNM uses the American Medical Association (AMA) standard.

Academic & Student Resources – Quick Guide

Library Resources

Most of the required and many of the recommended textbooks for courses are available in the NUNM library for checkout. Required texts are typically on reserve and may be checked out for six hours. Recommended texts may be available for longer checkout periods. Library staff are also available to assist with research assignments and locating course and assignment resources.

Tutoring

Tutors are available for students who are seeking additional help in any subject. Please see the Associate Dean of Academic Progress to request tutoring.

Excused Absences

For NUNM’s excused absence policy, please see the current student handbook.

Technical Help

For assistance with email, please contact the IT department: 503.552.1585 or ITSupport@nunm.edu. For assistance with Moodle, please click the link for Moodle Support Page.

Students with Disabilities

Students with documented disabilities are encouraged to work with the Office of Student Life to access academic accommodations.

NUNM Commitment to a Healthy Learning Environment

NUNM is committed to providing a healthy learning and work environment free of all forms of discrimination and sexual harassment, including sexual assault, sexual harassment, domestic and dating violence, and gender-based stalking. All NUNM employees are required reporters unless, at the time of your report, you are being seen in a counseling session or at a patient visit at our clinic.

Additional local, regional and national resources can be found on the NUNM Sexual Assault and Interpersonal Violence page.

For more information about services available to students, please visit the NUNM Student Life Center.