Precepting PA and NP Students in Dermatology: An Introduction
Clinical rotations are mandatory for the education of nurse practitioners (NPs) and physician assistants/associates (PAs). They are built from a set of core clinical rotations that must be met to satisfy criteria provided by the accreditation bodies of PA and NP programs across the United States of America. According to the American Academy of Physician Associates, PA students need to complete 2000 clinical hours to graduate from an accredited PA program, while NP students need a total of 500-800, depending on the program and degree. Additionally, depending on the program, some NP and PA students may be offered the choice of one or two elective clinical rotations, which can last anywhere from 4 to 6 weeks for PA students and a full semester or more for NP students. Elective rotations include specialties that may intrigue the student or may be a field of practice the student is pursuing for their career.
Dermatology clinical rotations are a vital part of the education of PA and NP students, allowing them to apply what they have learned during didactic sessions to real-life scenarios.
Clinical rotation sites must be sufficient to host a student, provide a variety of patients that reflect the clinical scenarios the student may be asked about during the dermatologic conditions board examination, and offer appropriate supervision.
Once a clinical site is deemed adequate, there must be preceptor availability. Does the clinical site have a preceptor in place who is willing to take the lead and teach? Often, a clinical site may require more than one preceptor in the event the lead or primary is not available. Successful clinical rotations require the precepting NP or PA to have experience and skills to teach to the objectives, types of cases, and procedures to fulfill the clinical requirements set forth by the NP or PA program.
Preceptors should be able to introduce and guide the development of various skills within dermatology, including, but not limited to, biopsy techniques, cryotherapy, simple excisions, KOH interpretations, and more. At the same time, preceptors must teach and model clinical reasoning, including building a differential diagnosis, as well as professionalism and ethics.
Outside of a dedicated residency program, the dermatology elective rotations are just like many of the core rotations and should serve as an introduction to dermatology, where a student can broaden their understanding of the field within a nurturing environment. By the end of the elective rotation, the student should feel prepared for any end-of-rotation exams and national certifying exams, which will allow them to practice medicine, hopefully in the field of dermatology.
Victoria Garcia-Albea, BSN, MSN, RN, PNP, DCNP, is a medical dermatology nurse practitioner at Lahey Clinic in Burlington, MA. She is the director of the Lahey Clinic Dermatology NP Training Program. She spends most of her free time with her husband and two school-aged boys, and volunteers at her public library.
Justin Love, MPAS, PA-C, resides in the blue zone of Loma Linda, CA. He works for the Loma Linda University Department of Dermatology. In his spare time, he enjoys any ocean-related activities and spending time with his family.