64B9-2.022 Clinical Training

64B9-2.022 Clinical Training.

(l) Clinical learning experiences shall be an integral part of the total curriculum plan and show relationship to concurrent theory.

(2) Clinical training must be in the United States, the District of Columbia, or a possession or territory of the United States.

(3) Clinical training must include experience in:


(a) Acute Care: Care for patients who are acutely ill with a wide variety of medical issues or are recovering from surgery. Care may be provided in hospital units, subacute care facilities, home care agencies, ambulatory care clinics, outpatient services, residential facilities, skilled nursing facilities, private practice, adult day care agencies, primary care and specialty practices, schools, insurance companies and private companies.

(b) Long Term Care: A continuum of medical and social services designed to support the needs of people living with chronic health problems that affect their ability to perform everyday activities.

(c) Community-based Care: Where health care is provided to the community as a whole, providing nursing care to individuals, families, and groups, to promote wellness, maintain health and prevent illness.

(4) Supervision:

(a) A clinical instructor is a faculty or staff member responsible for an assigned cohort of students in a clinical environment.

(b) A clinical preceptor is a registered nurse supervising a student in the clinical setting. The preceptor provides oversight of the student’s patients and gives feedback to the student and the clinical instructor. The clinical preceptor may be a licensed practical nurse if supervising students for a practical nursing education program.

(c) The clinical instructor must directly supervise no more than 12 students, unless, by written agreement the clinical training site allows more, not to exceed 18 students.

(d) Direct supervision means the clinical supervisor is within the health care facility while the students are providing care to the patients.

(e) Indirect supervision is allowed in a hospital setting if:

  1. There is no more than 18 students.
  2. There is direct supervision by an assigned clinical preceptor.
  3. The clinical instructor is available by telephone.
  4. The arrangement is approved in writing by the clinical training site.

(f) Indirect supervision is allowed for community-based clinic experiences when the clinical instructor is available by telephone, unless the clinical experience is an invasive or complex nursing activity. Supervision for invasive or complex nursing activities must be approved by the community-based clinical site.

(5) Up to 50% of each clinical training category: acute care, long-term care, and community-based care may be simulated when accompanied by traditional clinical experience.

(a) Traditional clinical experience consists of activities that include observation, hands-on experience with patients, and interaction with an interdisciplinary team.

(b) Simulation consists of activities or events replicating clinical practice using scenarios, high-fidelity manikins, medium-fidelity manikins, standardized patients, role playing, skills stations, and computer-based critical thinking situations.

  1. High-fidelity simulation is experience using full scale computerized patient simulators, virtual reality or standardized patients that are extremely realistic and provide a high level of interactivity and realism for the learner.
  2. Medium-fidelity simulation is experience using two-dimensional focused experiences to problem solve, perform a skill and make decisions, or the use of mannequins more realistic than static low fidelity ones having breath sounds, heart sounds, and/or pulses.

(c) Debriefing is a part of the simulation that follows the experience. Participants’ reflective thinking is encouraged, and feedback is provided regarding the participant’s performance in the simulation experience. The purpose of debriefing is to move toward assimilation and accommodation in order to transfer learning to future situations.

Rulemaking Authority 464.006, 464.019 FS. Law Implemented 464.019 FS. History–New 3-20-18, Amended 4-14-19.


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