Write Preceptor Information
- Preceptor Roles and Responsibilities Overview
Preceptor Roles and Responsibilities - Overview
It is anticipated that each physician preceptor will play the roles of both clinical teacher and mentor for the student; these responsibilities include the education and training of a student, which begins with a clear set of boundaries and parameters and which can bring out the best in each student.
One or more of the clinic physicians will be designated as primary preceptor(s)/site coordinator(s), but it is not expected that they will be the only preceptor(s) teaching the student. Involve willing and available community physicians in the teaching process. Clarify with them the goals and objectives of the WRITE Program prior to their working with the student.
The primary preceptor(s) will be responsible for the following:
- Attending (or designating a member of the faculty to attend) the WRITE Orientation prior to the start of the on-site portion of the program. Expecations for WRITE session: Preceptor Submission Summary form (PDF).
- Discussing both the student’s and the preceptor’s/site’s expectations of the experience and orienting the student to the site (PDF).
- Providing the student with a comprehensive orientation to the clinical practices and hospital(s) in the medical community
- Introducing the student to staff and health professionals with whom they will be in contact (i.e., reception, security, attendings, etc.)
- Explaining and establishing effective practice routines for hospital, emergency room, nursing home and house calls
- Acquainting the student with site-specific procedures regarding exposure, needle-sticks, emergencies, etc. (see Universal Precautions).
- Directing and coordinating the student’s educational experience during the time that they are in the community and helping the student to integrate basic scientific knowledge with practical, clinical problem-solving skills
- Assigning patients “of their own” for the student to follow and observe treatment outcomes during their stay in the WRITE community (these can be nursing home patients)
- Designing and submitting to the WWAMI Regional Office a scheduling grid to ensure that the student receives experience in all areas and which will balance the professional and academic requirements with the student’s personal needs; arrange the student’s schedule so that he/she has call and time off at the same time as their assigned preceptor
- Spending time with the student outside of the “work” environment so that he/she is exposed to the lifestyle and community role of a rural primary care physician
- Working with the student to assist her/him in settling into the community; providing information on schools, restaurants, activities and all the other “jewels” within the area
- If possible, arranging with any local newspapers, radio stations or television stations to interview the student regarding the WRITE Program; this has been found to be an excellent way to introduce the student to the community and to advertise your practice--all of this with the student's permission (see FERPA).
- Assessing what types of clinical problems the student has not had an opportunity to observe and when possible, making these experiences available to the student as they arise
- Observing student on a regular basis and following up with daily integrated and scheduled weekly & monthly feedback, including completing and submitting the monthly Progress Report & Feedback Forms (and department mid-end clerkship review forms at mid-session).
- Assisting the student in coordinating and hosting two (possibly three) UWSOM faculty visitors
- Reviewing the student's progress on the Community Service Project to be certain that it can be completed by the end of the WRITE program
- Disseminating WRITE information to appropriate faculty and staff within the medical community
- End of session evaluations are to be done using UWSOM's E*Value system. More information will be sent from each department closer to the evaluation due date, including a link into the system.
- Being available for a WRITE close-out session with student and WWAMI Regional Dean.
- You can expect your WRITE student to request a letter of recommendation (PDF) from you upon completion of the WRITE program. It is important to complete this letter as soon as possible, while the details of your experience with this student are still fresh. Keep it on file for submission to the Student Affairs office once it is requested
- Supervisions and Limitations / Patient Awareness
Supervisions and Limitations / Patient Awareness
The student’s presence within a hospital or medical institution requires that medical education guidelines are followed and student documentation is present. The University of Washington School of Medicine has an Affiliation Agreement with the WRITE Sites that governs the student's activities and dictates that those actions must be consistent with hospital bylaws and medical staff rules & regulations. Participation in the medical care of a patient is a privilege that is dependent upon approval from the student’s preceptor and the patient.
WRITE medical students have limited clinical experience prior to arriving at the WRITE site and because they are not licensed physicians, cannot function independent of the direction, supervision, and guidance of an attending staff physician or other members of the medical staff.
The student should observe the preceptor’s style of interviewing, watch patient examinations, and view the basic office routines before actively participating in patient care.
Initially, the student will assume minimal patient responsibility under direct physician supervision (this does not imply a physician’s attendance at all times).
Students must discuss and receive their preceptor’s approval to carry out diagnostic or therapeutic plans.
As the student’s level of experience and clinical competency increases, they may, with preceptor supervision, perform technical procedures within their training level and demonstrated competence and write/dictate orders, histories, physicals, delivery notes, discharge summaries, and progress notes; all student documentation, orders, etc. must be reviewed and co-signed by a physician preceptor.
- EHRs and CMS (HCFA) Billing Guidelines
CMS (HCFA) Billing Guidelines
Current information is available on the CMS Web Page: Go to https://www.cms.gov/ and search key words “guidelines,” “teaching,” and “interns” for the Guidelines for Teaching Physicians, Interns, and Residents pdf. The following information is taken from the aforementioned pdf, page 3, at the above web site.
"Evaluation and Management Documentation Provided by Students--Any contribution and participation of a student to the performance of a billable service must be performed in the physical presence of a teaching physician or resident in a service that meets teaching physician billing requirements (other than the review of systems [ROS] and/or past, family, and/or social history [PFSH], which are taken as part of an E/M service and are not separately billable). Students may document services in the medical record; however, the teaching physician may only refer to the student’s documentation of an E/M service that is related to the ROS and/or PFSH. The teaching physician may not refer to a student’s documentation of physical examination findings or medical decision making in his or her personal note. If the student documents E/M services, the teaching physician must verify and redocument the history of present illness and perform and redocument the physical examination and medical decision making activities of the service."
All prescriptions written by students must be cosigned by a physician prior to giving them to patients. It is recommended that students not be given a pre-signed prescription pad for their use.
- Call & Duty Hours
Call & Duty Hours
Students will take night and ER call not more than every fourth night and every fourth weekend. They may not cover a preceptor’s practice unless another physician in the clinic or community can oversee the student in any patient care situation.
The University has adopted a Duty Hour Policy which can be found by going to http://www.uwmedicine.org and searching key words “call” and “duty” - then click on "UW Medicine Clerkship Duty Hours Policy".
- Managing BBP Exposures
Teaching Resources, Feedback & Evaluation
- Teaching Resources Links
- Letter of Recommendation
Letter of Recommendation
Toward the end of your WRITE student’s experience, a request for a letter or recommendation will come from the student. It is recommended that the preceptor create this letter soon after the student’s experience, so that his or her site time is still fresh in your mind. The letter will be used by the student when applying for residency programs.
Tips for the Student:
- Follow the instructions exactly as directed by the program being applied to
- Assist the preceptor in writing the letter by offering ideas and personal information
- Allow plenty of time for the letters to be completed
- Provide envelopes, stamps and address labels for their use
Tips for the Preceptor:
Keep complete notes and a photo on file
- When the student requests a letter, ask for a meeting and/or have the student provide a CV, a personal statement and/or a photo
- Write the letter as soon as possible after the student’s rotation.
- Be sure to describe your affiliation with the UWSOM somewhere in the letter
- Keep the letter on file; the student may extend their program
- The structure of the letter should include the purpose of the letter, what the student is applying for, the nature of the preceptor’s relationship with the student, the student’s academic achievement and personal attributes, and a closing paragraph summing up what has been stated. Additionally, the letter writer must also include a statement indicating whether the student opted to waive or not waive their right to see the letter. For more tips on how to write an effective letter of recommendation, click here for guidelines in a printable pdf format.
- The P/RIME Method
The P/RIME Method
The P/RIME table found at https://catalyst.uw.edu/workspace/medsp/30309/202889, offers preceptors guidelines when assigning a grade utilizing the P/RIME Method, which is based upon a student’s demonstration of increasingly advanced skills:
It begins with a foundation of professionalism and adds increasing levels of skills defined as:
- Interpreter & Integrative Problem-Solver
- Enhanced Communicator & Mastery of Patient-Centered Care.
Utilization of the P/RIME method will enable the preceptor to assess the level of a student's cognitive and clinical abilities as well as to assess their level of professionalism when completing the WRITE Preceptor Summary/Evaluation Forms.
Clinical Faculty Appointments
- Accessing UWSOM Online Resources
Accessing UWSOM Online Resources
Information on accessing the UW School of Medicine Library Resources can be found at http://hsl.uw.edu/; additionally, the faculty appointed preceptor may:
- Access https://uwnetid.washington.edu/newid/ to get a UWNetID
- Select, “I don’t have a UW NetID (I am not sure)”
- When asked to enter a category on the 2nd page, enter “UW Faculty”
- On the 3rd page, in the space for EID, enter the 9-digit # listed on the front of the Husky Card
- After the UWNetID and password are assigned, the faculty can log into the Library Resources at http://hsl.uw.edu/. Faculty can then log in using their UWNetID and password
- Appointment Benefits & Processes
Appointment Benefits & Processes
Community physicians that work with UW School of Medicine students as preceptors are encouraged to complete the faculty appointment process. Benefits garnered from a UWSOM faculty appointment include:
- access to online UW restricted resources such as Health links
- assisting with official credentialing of the program
- liability coverage for the physician preceptor while working with the medical student as stated in the Affiliation Agreement:
“The UWSOM will defend, indemnify and hold Training Site harmless from any loss, claim or damage arising from the negligent acts and omissions of its employees, officers, agents, and students, including negligence connected with performing its obligations under this Agreement, including the independent negligence of students. School maintains a professional liability coverage program under the authority of RCW 28B.20.250, .253, and .255. Through that authority, the School provides professional liability coverage for its employees, officers, agents, and students while training in a clinical setting at Training Site.”
Preceptors who have had a faculty appointment while working with previous UW Medical Students will have their appointment renewed yearly for as long as they work with UW students.
For new WRITE Sites or preceptors who are new to the WRITE Program, the WWAMI Regional Office will request completed UW faculty appointment forms and instructions from the site (see link below). The applicable UWSOM Clerkship Department will send a letter of confirmation and a Husky Card to the physician when the appointment is confirmed.
Click here for the Clinical Faculty Application (PDF)
- Clinical Faculty Application (PDF)