The University of TexasHealthScienceCenter at San Antonio

SCHOOL OF NURSING

Guidelines & Procedures for Graduate Students Registering for

NURE 5007- Clinical Applications in Nursing

CHECK ONE:

Purpose:

This course provides an opportunity for qualified students to work closely with a faculty member and/or preceptor who are actively engaged in direct and indirect clinical practice.

Prerequisite:

Core courses as requested for major.

Procedure:

  1. The student must make an appointment with faculty advisor to secure permission to enroll in course.
  1. Faculty advisor must verify that the School of Nursing has a current Memorandum of Agreement with the Clinical Agency were the student wished to do his or her clinical experience. This is to be coordinated through the Clinical Liaison.
  1. The student and the faculty member will complete the form.
  1. The student must make an appointment with the clinical preceptor to obtain an Intent of Relationship for the clinical experience and to discuss the student & preceptor expectations and clinical schedule.
  1. Student and faculty must indicate the following information on the form:
  • # of Credit hours being requested
  • Name & location of clinical agency
  • Name and credentials of preceptor
  • Minimum of 3 measurable goals that must be met during the clinical experience
  1. Faculty should specify types of activities that are expectations for successful completion of the course
  1. A letter grade will be awarded for the course work.
  1. Faculty and student must sign and date the form. Return the form to the Graduate Nursing Office prior to course registration.
  1. Faculty and student should each keep a copy of the form. The original will be placed in the student's Graduate Nursing Office file.

Recommended Due Date: Submit signed form two weeks before registration period closes for the semester in which the course will be taken.

Permit #: ______/ Section #: ______/ Class #: ______

The University of TexasHealthScienceCenter at San Antonio

SCHOOL OF NURSING

NURE 5007- Clinical Applications in Nursing

CHECK ONE:

TO BE COMPLETED BY STUDENT:

Student’s Name:______Student Badge #:______

E-mail address:______Telephone #:______

Major:______Minor:______Semester/Year:______

TO BE COMPLETED BY FACULTY AND STUDENT:

Credit Hours:______Current MOA Expiration Date: ______

Name & Location of Clinical Agency: ______

Name and Credentials of Preceptor:______

Title of Clinical Preceptorship (limited to 33 characters):

Goals of clinical experience:

______

______

______

Identify any special expectations of the student for successful completion of the course:

______

______

______

______

Student signatureFaculty signature

______

DatePrint name

______

Date

NOTE: 1) This signed form must be submitted before student can register for the course.

2) Only letter grades will be given for course work

COGS Approved 6-17-20111

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