Clinical Placements

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All accredited graduate nursing programs, such as family nurse practitioner programs (FNP), nurse midwifery programs, and women’s health nurse practitioner programs (WHNP), require students to fulfill a minimum number of clinical hours in order to graduate. These clinical hours requirements give students the opportunity to apply the knowledge they gain in lectures and seminars to real medical scenarios.

Students complete their clinical hours, also known as clinical practicums, by performing actual nursing tasks in a medical setting such as a hospital or clinic. In general, these responsibilities include completing physical assessments, diagnosing patient conditions, advising patients, designing patient care plans, and discussing patients’ health issues with a larger team of health care providers. During their clinical practicums, students receive guidance and supervision from preceptors, who are medical professionals that work at students’ clinical sites, and who mentor them and monitor their progress. Preceptors also typically track students’ progress by logging the hours students spend performing certain tasks and grading their mastery of certain skills and concepts on the job.

Most graduate nursing programs require students to fulfill their clinical hours in medical settings that are relevant to their field of study. For example, accredited family nurse practitioner programs may have students complete clinical hours in a hospital, a private clinic, and a community health center, while nurse midwifery programs may have students fulfill their hours at hospitals, birthing centers, and women’s health clinics.

How Clinical Hours are Integrated into Nursing Programs’ Curricula

Accredited graduate nursing programs integrate clinical hours into their curriculum in different ways. For example, some nursing programs will spread students’ clinical hours evenly across three or four terms, while other programs may have students start with fewer hours per term and gradually increase the number of required hours per term as they progress through the program. In addition, while some nursing schools incorporate a portion of students’ clinical practicum hours into their on-campus intensives, others do not.

Many graduate nursing programs will include courses that have an academic and a clinical component, so that students complete clinical hours concurrently with lectures and discussions that are relevant to their clinical experiences. For example, a family nurse practitioner program may have a class titled Family Nurse Practitioner Practicum or Clinical Decision Making, in which students must fulfill clinical hours in a medical setting relevant to family nursing care, while also attending lectures and/or discussions about the key clinical competencies of FNPs. Similarly, in some nurse midwifery programs, courses such as Primary Health Care of Women may have a clinical element, in that students must attend lectures or seminars on women’s health, while also fulfilling a certain number of hours (for example, 150 to 200 hours) of clinical work with women.

Clinical Placements and Preceptors

The process by which students find clinical sites and preceptors varies across nursing programs. Some nursing schools match their students to clinical settings and preceptors; other schools require students to find their own preceptors and clinical sites, but offer support services for students during their search. Furthermore, some programs will match students to clinical sites, but ask that students find their own preceptors, and vice versa. For more information about how certain programs support students in clinical placements, prospective students should contact admissions advisors at the programs that interest them.

Clinical Hours Requirements and Types of Graduate Nursing Programs

Accredited graduate nursing programs must help their students qualify for certification and/or licensure as advanced practice registered nurses. As a result, these programs typically have clinical hours requirements that meet or exceed the number required by state boards of licensure and/or national certification organizations.

Both the American Nurses Credentialing Center (ANCC) and the American Academy of Nurse Practitioners Certification Program (AANPCP) require family nurse practitioners and adult-gerontology primary care nurse practitioners to complete 500 hours of supervised clinical practice in order to qualify for their national certification exams. State boards of nursing often have similar clinical hours requirements for APRNs. For example, the Texas Board of Nursing requires all RNs seeking APRN licensure in Texas to complete a graduate nursing program that includes 500 clinical hours in the specific area of advanced practice registered nursing that they wish to enter, whether it be adult-gerontology, family nursing, or women’s health. Similarly, California’s State Board of Nursing mandates that all registered nurses who wish to become adult-gerontology nurse practitioners complete 540 clinical residency/practicum hours to receive state certification. In order to address these national and state-based requirements, many accredited online APRN programs incorporate between 500 and 1000 clinical hours into their curricula.

Before enrolling in a graduate nursing program, registered nurses should thoroughly research the requirements they must fulfill to receive APRN certification from their state’s board of nursing in their desired specialty. APRN certification requirements can vary by state, and are also subject to change, so students should contact their state board of nursing to receive the most up-to-date information. Additionally, RNs who wish to earn national certification as an APRN from either the ANCC or the AANPCP should check the exact academic and clinical experience requirements that these organizations have for individuals in their desired specialty. Such careful research will help students select graduate nursing programs that qualify them for licensure or certification in their desired specialty within in advanced practice registered nursing.


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