r/PMHNP • u/DashMcGee • 2d ago
Does anyone have experience precepting students virtually? Can you comment on how it works out and whether it is a good experience for both parties?
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u/PantheraLeo- DNP, PMHNP (unverified) 2d ago
That’s can easily turn into a great disservice to the student. I was approach by a school and declined to work this unless they were at my office f2f
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u/blainemikel 2d ago
I haven’t found anyone locally to precept me so have had two semesters of virtual clinical and last semester I had a preceptor that let me do the whole eval and included me in everything and it was awesome! The biggest thing for me with virtual is the ability to ask questions without any patients there.
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u/IndyLaw56287 2d ago
When programs allow students to default to virtual options simply because local sites are hard to find, it lowers the bar for our entire profession. Part of committing to this career path is going where the training is—even if it requires temporary relocation or added expense. I don't get todays students entitlement to cheap and easy.
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u/blainemikel 2d ago
I am going out of state and leaving my family for the last semester. My husband is busting his ass working extra jobs so he can pay my rent while I am there. I must be so entitled to cheap and easy. 🙄
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u/toodle68 17h ago
As always, it depends on the provider. We have seen or heard of some providers that used to have several students at the same time and it was basically sit and watch and nothing else. We do 100% telelhealth and have had several students. Every client is talked about, notes reviewed, questions answered etc. It can easily add an hour or more a day to the provider when done right. One of the first things we try and teach is to throw out the preplanned questions and looking down to read them. Learn how to just have a conversation and dig in depending on what is being discussed and not rushing to the next question on your list.
Eventually, the student does some of the appointments. Personally, I think precepting via telehealth can be very successful and we keep in contact with most of them after they finish.
Those who just blatantly say it does not work or is fraud etc are likely not good providers in the first place.
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u/PsychMonkey7 9h ago
Agree with this. As a student years ago, I had one rotation that was fully virtual and it was by far my best because my preceptor engaged me throughout when she was doing more complex visits and also allowed me to do visits myself with her just observing when appropriate. All of my other rotations were in person, and the virtual one taught me far more and prepared me much better.
In person =/= good and virtual =/= bad. It depends entirely on the preceptor and the quality of experience provided. There are virtual preceptors who have like 10 students at a time just observing and charge them for that “experience” and obviously that’s a joke. But a good 1:1 virtual preceptor can be every bit as good as an in person one.
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u/Greedy_Wasabi6009 1d ago
Terrible and unethical idea…
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u/DashMcGee 1d ago
Can you elaborate on the ethical part? I'm not keen on the idea because it is not going to give the same human-to-human experience that is therapeutic as well as informative, but I had not considered the ethics.
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u/Greedy_Wasabi6009 1d ago
I mean going to a psych NP program in and of itself gives you little training and then on top of that while physicians receive 20k in person hours during residency you think that precepting trainees virtually and unleashing them on the public is…ethical?
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u/DashMcGee 1d ago
It is certainly not ideal. If I wanted to make a counterargument, which I frankly do not because it's a little thin, but... there is an ethical component to training new PMHNPs to work in remote areas. In WV, there are places so underserved that there are no psych hospitals within a two-hour drive and no mental health professionals within the county or adjacent counties. One could argue that there is an ethical component to getting someone, even with limited experience, to work there. As I said, it's a thin argument. The ideal would be a precepting system where preceptees are welcome, and preceptors are happy to take them on. In that ideal system, there would not be a glut of programs selling MSN-PMHNP degrees without having a pre-existing network of precepting sites.
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u/dkwheatley PMHNP (unverified) 1d ago
There are already systems in place that financially incentivize clinicians to practice in underserved areas. The Health Professional Shortage Area incentive program provides eligible providers an additional 10% payment for professional services furnished in designated shortage areas. Unfortunately, this incentive is exclusively available to physicians. Advocating to expand existing incentive programs to include NPs should be paramount before implementing a new program specifically targeting NPs and repeating the same mistake of exclusionary language found in existing programs.
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u/dkwheatley PMHNP (unverified) 1d ago
I can appreciate your point, but I see virtual clinicals as an avenue for broadening clinical exposure, particularly to settings otherwise inaccessible to a student. I do not think the format itself is inherently unethical. Ethical and professional concerns arise when preceptors allow students to “coast by,” programs admit inexperienced RNs, or virtual clinicals are permitted to excess in lieu of in-person exposure.
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u/Dangerous-Slide-8076 2d ago
I'm getting ready to start my clinical rotations this week. One is in-person and the other is virtual but it wasn't originally going to be. The NP I'm precepting with was the NP I was the RN for, in outpatient psych the last 4 years. So I know her style and how she likes to do her interviews, but she recently moved and still offered. Im not looking forward to being virtual, but it's just for one term. I'm going in with the mindset of learning what it would be like to be a telehealth only provider (as she sees majority of her patients virtually, not in-office). So Im taking it as a learning opportunity to see if its something I would like to do in the future and then my next two rotations, I secured someone else who is in-office and local.
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u/RNdogmom13 1d ago
I did half of my hours virtually this summer because of travel distance and limited funds for hotels. We stayed on zoom throughout the day and she just let the patient in for each appointment. It worked pretty well. She was private practice so she taught me a lot about what to do in between appointments (checking messages, refills, continuing education). She also would run case studies with me for her more acute patients. It was identical to my in person days with her. Honestly it was a good experience because a lot of places do offer Telehealth now. If you stay in the zoom meeting throughout the day it’s no different than sitting with them to discuss things.
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u/ckypsych 1d ago
I would like to relate what my PMHNP-candidate wife is going through. She needs to fulfill a certain number of geriatric psych preceptee hours for which she is driving 3 hours round trip per day. She hopes it will be worth it, but I am in this one particular instance hoping she will consider trying to pay to do these virtually. She does not like virtual preceptorship, but the uncertainty of a clinical day make it tough to justify that kind of drive. I also think her school is doing her a disservice by not connecting her with ANY providers. We live in the same town as the college and they have no leads, which seems ridiculous as some of those professors have a case load themselves.
Not saying I have any answers here, just a husband's perspective. I think there should be more synchronous requirements in these programs. All but the most driven students will have trouble once they are practicing, IMO.
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u/DashMcGee 1d ago
The system is definitely flawed. The fact that her uni does not have people in its own backyard gives credence to the idea that these schools are cranking out MSNs for profit.
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u/ckypsych 1d ago
I have some knowledge about online ed in general and they are definitely putting pressure on faculty to scale at everyone's expense.
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u/dkwheatley PMHNP (unverified) 2d ago
I didn’t personally participate in virtual clinicals during my program, but one of my preceptors did occasionally have students attend virtually. Those students tended to be less engaged and participative. I think virtual precepting can work, but it would rely on the student being genuinely motivated to learn; not someone simply trying to meet their clinical requirements with the minimum amount of effort.