1. (a) Faculty shall be responsible for student clinical practice evaluations. Clinical practice evaluations shall be correlated with level and/or course objectives including formative and summative evaluation. Students shall receive a minimum of three clinical evaluations during the program year.
2. (b) Clinical practice shall include actual hours of practice in clinical areas, clinical conferences, and/or simulated lab experiences.
3. (c) Clinical experiences shall include the administration of medications, health promotion and preventive aspects, nursing care of persons throughout the life span with acute and chronic illnesses, and rehabilitative care. Students shall participate in instructor supervised patient teaching. Students shall also be provided opportunities for participation in clinical conferences. The focus of clinical conferences shall be student experiences in the clinical setting. Simulated laboratory experiences may also be utilized as a teaching strategy in classroom and clinical settings to meet objectives.
4. (d) Scheduling of student time and clinical rotations shall be made by the program faculty. Selected clinical learning experiences will remain unchanged unless a client's condition demands reassignment. Reassignment must be approved with prior consent of faculty.
5. (e) The student's daily client assignment shall be made in accordance with clinical objectives/outcomes and learning needs of the students. The total number of daily assignments shall not exceed five clients.

6. (f) Consideration of selection of a clinical site shall include:

   1. (1) client census in sufficient numbers to meet the clinical objectives/outcomes of the program; and
   2. (2) evidence of collaborative arrangements in those facilities, which support multiple nursing programs.
7. (g) There shall be a written affiliation agreement between the controlling agency and the affiliating agency before the affiliation begins. The agreement shall outline the responsibilities of each agency entering the agreement. The agreement shall contain a withdrawal of participation clause indicating a minimum period of time to be given for notice of such withdrawal.
8. (h) Affiliation agreements are optional for those clinical experiences which are observation only.

9. (i) The affiliating agency shall:

   1. (1) provide clinical facilities for student experiences;
   2. (2) provide space for conducting clinical conferences for use by the school if classrooms are located elsewhere;
   3. (3) provide assistance with clinical supervision of students, including preceptorships, by mutual agreement between the affiliating agency and controlling agency; and
   4. (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.
10. (j) The faculty member shall be responsible for the supervision of students in clinical learning experiences.

11. (k) The following ratios only apply to clinical learning experiences involving direct patient care:

    1. (1) When a faculty member is the only person officially responsible for a clinical group, then the group shall total no more than ten (10) students. Patient safety shall be a priority and may mandate lower ratios, as appropriate. The faculty member shall supervise that group in only one facility at a time, unless some portion or all of the clinical group are assigned to observational experiences in additional settings.
    2. (2) Direct faculty supervision is not required for an observational experience. Observational experiences may be used to supplement, but not replace patient care experiences, and must serve the purpose of student attainment of clinical objectives.

12. (l) 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 or within a course after a student has received clinical and didactic instruction in the basic areas of nursing for that course or specific learning experience.

    1. (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. (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 (24) students.
    3. (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. (4) The preceptor shall be responsible for the clinical learning experiences of no more than two students (2) at a time per clinical group.

13. (m) When faculty use clinical preceptors to enhance clinical learning experiences and to assist faculty in the clinical supervision of students the following applies:

    1. (1) Faculty shall develop written criteria for the selection of clinical preceptors.
    2. (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. (3) Faculty shall be readily available to students and clinical preceptors during clinical learning experiences.
    4. (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. (5) Written clinical objectives, evaluation criteria, and written description of expectations shall be shared with the clinical preceptors prior to or concurrent with the experience.
    6. (6) The preceptor shall be accountable for evaluating the student using clinical objectives developed by vocational nursing faculty.

    7. (7) Clinical preceptors shall have the following qualifications:

       1. (A) competence in designated areas of practice;
       2. (B) philosophy of health care congruent with that of the nursing program; and
       3. (C) current licensure or privilege to practice nursing in the State of Texas.
14. (n) The total weekly schedule throughout the length of the program shall not exceed 40 hours per week including both class and clinical practice hours. Class and clinical practice hours shall be continuous. Students shall be assigned two consecutive non-class days off each week.
15. (o) Programs shall not permit utilization of students for health care facility staffing.

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.