Practicum Experience Plan

Practicum Experience Plan

• Review your Clinical Skills Self-Assessment Form you submitted last  week, and think about areas for which you would like to gain  application-level experience and/or continued growth as an advanced  practice nurse. How can your experiences in the practicum help you  achieve these aims? There may be overlap between your skills goals and  your PEP goals.
• Review the information related to developing objectives provided in  this week’s Learning Resources. Your practicum learning objectives that  you want to achieve during your practicum experience must be:
  • Specific
  • Measurable
  • Attainable
  • Results-focused
  • Time-bound
  • Reflective of the higher-order domains of Bloom’s taxonomy (i.e., application level and above)
• Discuss your professional aims and your  proposed practicum objectives with your Preceptor to ascertain if the  necessary resources are available at your practicum site.
• Select one nursing theory and one counseling theory to best guide  your clinical practice. Explain why you selected these theories. Support  your approach with evidence-based literature.
• Create a timeline of practicum activities that demonstrates how you  plan to meet these goals and objectives based on your practicum  requirements.Master of Science in Nursing  
   
   
   
  Practicum Experience Plan
   
   
  Overview:
   
  Your Practicum experience includes working in a clinical setting that will help you gain the knowledge and skills needed as an advanced practice nurse. In your practicum experience, you will develop a practicum plan that sets forth objectives to frame and guide your practicum experience.
   
  As part of your Practicum Experience Plan, you will not only plan for your learning in your practicum experience but also work through various patient visits with focused notes as well as one (1) journal entry.
   
  Complete each section below.
   
  Part 1: Quarter/Term/Year and Contact Information
   
  Section A
   
  Quarter/Term/Year:
   
  Student Contact Information
  Name:
  Street Address:
  City, State, Zip:
  Home Phone:
  Work Phone:
  Cell Phone:
  Fax:
  E-mail:
   
  Preceptor Contact Information
  Name:
  Organization:
  Street Address:
  City, State, Zip:
  Work Phone:
  Cell Phone:
  Fax:
  Professional/Work E-mail:
   
   
  Part 2: Individualized Practicum Learning Objectives
   
  Refer to the instructions in Week 2 to create individualized practicum learning objectives that meet the requirements for this course. These objectives should be aligned specifically to your Practicum experience. Your objectives should address your self-assessment of the skills found in the “PMHNP Clinical Skills Self-Assessment Form” you completed in Week 1.
   
  As you develop your individualized practicum learning objective, be sure to write them using the SMART format. Use the resources found in Week 2 to guide your development. Once you review your resources, continue and complete the following. Note: Please make sure each of your objectives are connected to your self-assessment. Also, consider that you will need to demonstrate how you are advancing your knowledge in the clinical specialty.
   
  Objective 1: <write your objective here> ( Note : this objective should relate to a specific skill you would like to improve from your self-assessment)
   
  Planned Activities:
  Mode of Assessment: (Note: Verification will be documented in Meditrek)
   
  PRAC Course Outcome(s) Addressed:
   
  · (for example) Develop professional plans in advanced nursing practice for the practicum experience
  · (for example) Assess advanced practice nursing skills for strengths and opportunities
   
  Objective 2: <write your objective here> ( Note : this objective should relate to a specific skill you would like to improve from your self-assessment)
   
  Planned Activities:
   
  Mode of Assessment: (Note: Verification will be documented in Meditrek)
   
  PRAC Course Outcome(s) Addressed:
   
  ·
   
  Objective 3: <write your objective here> ( Note : this objective should relate to a specific skill you would like to improve from your self-assessment)
   
   
  Planned Activities:
   
  Mode of Assessment: (Note: Verification will be documented in Meditrek)
   
  PRAC Course Outcome(s) Addressed:
   
  ·
  Part 3: Projected Timeline/Schedule
   
  Estimate how many hours you expect to work on your Practicum each week. *Note: All of your hours and activities must be supervised by your Preceptor and completed onsite. Your Preceptor will approve all hours, but your activities will be approved by both your Preceptor and Instructor. Any changes to this plan must be approved.
   
  This timeline is intended as a planning tool; your actual schedule may differ from the projections you are making now.
   
  I intend to complete the 144 or 160 Practicum hours (as applicable) according to the following timeline/schedule. I also understand that I must see at least 80 patients during my practicum experience. I understand that I may not complete my practicum hours sooner than 8 weeks. I understand I may not be in the practicum setting longer than 8 hours per day unless pre-approved by my faculty.
   
   

  	Number of Clinical Hours Projected for Week	Number of Weekly Hours for Professional Development	Number of Weekly Hours for Practicum Coursework
  Week 1
  Week 2
  Week 3
  Week 4
  Week 5
  Week 6
  Week 7
  Week 8
  Week 9
  Week 10
  Week 11
  Total Hours (must meet the following requirements)	144 or 160 Hours

   
   
   
   
   
   
  Part 4 – Signatures
   
  Student Signature (electronic): Date:
   
   
  Practicum Faculty Signature (electronic)**: Date:
   
   
  ** Faculty signature signifies approval of Practicum Experience Plan (PEP)
   
  Submit your Practicum Experience Plan on or before Day 7 of Week 2 for faculty review and approval.
   
  Once approved, you will receive a copy of the PEP for your records. You must share an approved copy with your Preceptor. The Preceptor is not required to sign this form.
   
   
   
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