I am writing to point out what I believe to be a real flaw developing in nurse practitioner education. More and more nurse practitioner programs are requiring students to keep a running log of the patients they see in clinical rotations in some sort of computerized database. This trend was just starting when I completed my Acute Care program, and was in full force by the time I went back to become dual-certified as an FNP a few years later. I now have precepted several students in clinical settings and what was a nuisance to me as a student, I know feel is really distracting to learning.
In order to become and remain accredited, nurse practitioner programs are required to show the numbers and types of patients students see in clinical rotations. Many have opted for a computerized database, such as Typhon or others. Students are required to keep a log of data pertaining to patients they see in clinical, mostly demographic and insurance information as well as diagnoses AND ICD-9 codes. This is ridiculous. Having to look up and document ICD-9 codes is something that you should only be responsible for once you are in practice, not while you are learning. The problem is that often part of these students’ grades depends on their participation in the database. I found it distracting from my clinical experience while as a student and now as a preceptor, quite frankly it angers me. I just recently had a student at the end of the day who opted NOT to see the last patient with me, but instead work to get her logging for the day finished. Keeping track of this information does nothing beneficial for the students, and it keeps them from having thoughtful and critical discussions about clinical experiences with their preceptors. In addition, instead of going home and possibly looking up and reading about a condition or diagnosis encountered in clinical that day while it is fresh on their minds, they are tired and still mostly likely have 1-2 hours of entering all this data into the computer!
I do not now, nor do I intend in the future, to work to promote the role of nurse practitioners in an academic setting. I enjoy my work with patients too much. And I enjoy precepting students and feel it kind of keeps me on my toes, so to speak. But I have to ask the academic institutions, administrators, and faculty, is there not a better way than this??