|(a) Faculty shall be responsible and accountable for
managing clinical learning experiences and observation experiences
(b) Faculty shall develop criteria for the selection
of affiliating agencies/clinical facilities or clinical practice settings
which address safety and the need for students to achieve the program
outcomes (goals) and course objectives through the practice of nursing
care or observation experiences. Consideration of selection of a clinical
site shall include:
(1) client census in sufficient numbers to meet the
clinical objectives/outcomes of the program/courses; and
(2) evidence of collaborative arrangements for scheduling
clinical rotations with those facilities that support multiple nursing
(c) Faculty shall select and evaluate affiliating agencies/clinical
facilities or clinical practice settings which provide students with
opportunities to achieve the goals of the program.
(1) Written agreements between the program and the
affiliating agencies shall be in place before clinical learning experiences
begin and shall specify the responsibilities of the program to the
agency and the responsibilities of the agency to the program.
(2) Agreements shall be reviewed periodically and include
provisions for adequate notice of termination and a withdrawal of
participation clause indicating a minimum period of time to be given
for notice of such withdrawal.
(3) Affiliation agreements are optional for those clinical
experiences which are observation only.
(d) The faculty member shall be responsible for the
supervision of students in clinical learning experiences and scheduling
of student time and clinical rotations.
(1) Selected clinical learning experiences will remain
unchanged unless a client's condition demands reassignment.
(2) Reassignment must be approved with prior consent
(3) The student's daily client assignment shall be
made in accordance with clinical objectives/outcomes and learning
needs of the students.
(4) The total number of daily assignments shall not
exceed five (5) clients.
(e) Clinical learning experiences shall include the
administration of medications, health promotion and preventive aspects,
nursing care of persons across the life span with acute and chronic
illnesses, and rehabilitative care.
(1) Students shall participate in instructor-supervised
(2) Students shall also be provided opportunities for
participation in clinical conferences/debriefing.
(3) When a high-fidelity simulation laboratory is used
to meet clinical learning objectives, the faculty shall be trained
in planning and guiding the experience and in debriefing and evaluating
students. Programs may use up to 50% simulation activities in each
(f) Faculty shall be responsible for student clinical
practice evaluations. Clinical evaluation tools shall be correlated
with level and/or course objectives and shall include a minimum of
a formative and a summative evaluation for each clinical in the curriculum.
(g) The following ratios only apply to clinical learning
experiences involving direct patient care:
(1) When a faculty member is the only person officially
responsible for a clinical group, the group shall total no more than
ten (10) students.
(2) Patient safety shall be a priority and may mandate
lower ratios, as appropriate.
(3) Clinical learning experiences shall be designed
for students to meet clinical objectives in all clinical activities
(skills and simulation laboratories and hands-on care).
(4) The faculty member shall supervise an assigned
group in one (1) facility at a time, unless some portion or all of
the clinical group are assigned to observation experiences or to preceptors
in additional settings.
(5) Direct faculty supervision is not required for
an observation experience.
(h) Clinical preceptors may be used to enhance clinical
learning experiences after a student has received clinical and didactic
instruction in all basic areas of nursing.
(1) In courses which use clinical preceptors for a
portion of clinical learning experiences, faculty shall have no more
than twelve (12) students in a clinical group.
(2) In a course which uses clinical preceptors as the
sole method of student instruction and supervision in clinical settings,
faculty shall coordinate the preceptorship for no more than twenty-four
(3) The preceptor may supervise student clinical learning
experiences without the physical presence of the faculty member in
the affiliating agency or clinical practice setting.
(4) The preceptor shall be responsible for the clinical
learning experiences of no more than two (2) students at a time.
(i) When faculty use clinical preceptors to enhance
clinical learning experiences and to assist faculty in the clinical
supervision of students, the following applies:
(1) Faculty shall develop written criteria for the
selection of clinical preceptors.
(2) When clinical preceptors are used, written agreements
between the vocational nursing education program, clinical preceptor,
and the affiliating agency, when applicable, shall delineate the functions
and responsibilities of the parties involved.
(3) Faculty shall be readily available to students
and clinical preceptors during clinical learning experiences.
(4) The designated faculty member shall meet periodically
with the clinical preceptors and student(s) for the purpose of monitoring
and evaluating learning experiences.
(5) Written clinical objectives shall be shared with
the clinical preceptors prior to or concurrent with the experience.
Written clinical objectives shall be shared with the clinical preceptors
prior to or concurrent with the experience.
(6) Clinical preceptors shall have the following qualifications:
(A) competence in designated areas of practice;
(B) philosophy of health care congruent with that of
the nursing program; and
(C) current licensure or privilege to practice as a
licensed nurse in the State of Texas.
(j) During clinical learning experiences, programs
shall not permit utilization of students for health care facility
(k) The affiliating agency shall:
(1) provide clinical facilities for student experiences;
(2) provide space for conducting clinical conferences
for use by the school if classrooms are located elsewhere;
(3) provide assistance with clinical supervision of
students, including preceptorships, by mutual agreement between the
affiliating agency and governing entity; and
(4) have no authority to dismiss faculty or students.
Should the affiliating agency wish to recommend dismissal of faculty
or students, such recommendation(s) shall be in writing.
|Source Note: The provisions of this §214.10 adopted to be effective February 13, 2005, 30 TexReg 545; amended to be effective May 2, 2007, 32 TexReg 2361; amended to be effective October 19, 2008, 33 TexReg 8501; amended to be effective October 21, 2012, 37 TexReg 8294; amended to be effective August 9, 2018, 43 TexReg 5072