Precepting PA Students

The short version

Programs are short of preceptors. Growth across PA, medical and nurse practitioner programs has left them competing for too few clinical training sites.
The cost is real, and front-loaded. The first week of each rotation is the slow one.
Precepting PA students earns AAPA Category 1 CME — 2 credits per 40-hour week, up to 20 a year, awarded through the program.
Structure beats charisma. A five-step model, the One-Minute Preceptor, fits the teaching inside the time a case presentation already takes.

Across my career I precepted more than ten PA students through orthopedic rotations and helped train more than fifteen newly practising PAs across orthopedics, spine and pain management. This page is for a PA deciding whether to take a student, or looking to do it better.

Why are preceptors so hard to find?

Because demand has outgrown supply. PA programs, medical schools and nurse practitioner programs have all expanded, and they need the same kinds of clinical placements. The result, as one analysis in the PA education association's journal set out, is a shortage of clinical training sites and growing competition between programs for the ones that exist.

Preceptors name their own barriers too. A recent scoping review in the same journal identified the lack of training in how to teach as one of the obstacles to recruiting and keeping preceptors — most rely on their own clinical experience to work out how to do it.

That second barrier is the one this page can do something about.

What does precepting actually cost you?

Time, mostly — and most of it at the start.

The first week is the slow one. Orientation, watching before doing, and case presentations that take nearly as long as the visit. By the third or fourth week, a good student is taking histories you would have taken anyway.
Some patients will decline. That is their right. Introduce the student and ask, every time.
Documentation is less of a burden than it was. Under Medicare, a PA who furnishes and bills a service can review and verify — sign and date — a student's notes rather than re-documenting them. Facility and payer policies vary, and the note is still yours.
The slower days show up somewhere. In a productivity-measured role, ask how your practice accounts for them before you agree, not after.

A structure that makes it faster

The model most often taught to new preceptors is the One-Minute Preceptor: five steps, published in 1992 for family physicians teaching in busy practices, and designed to fit inside the time a case presentation already takes.

The five microskills of the One-Minute Preceptor, from Neher and colleagues (1992). The example phrasing is illustrative. Evidence for the model rests mostly on preceptor and student ratings rather than patient outcomes.
Step	What you say	Why it works
01Get a commitment	“What do you think is going on?”	They reason instead of waiting for your answer.
02Probe for evidence	“What made you think that?”	You see their reasoning, not just their conclusion.
03Teach a general rule	One point that applies beyond this patient.	The teaching stays short and carries over to the next case.
04Reinforce what was right	“Checking the neurovascular status first was exactly right.”	Specific praise tells them what to keep doing.
05Correct mistakes	Specific, and privately where you can.	The error gets fixed without an audience.

The honest version of the evidence: a systematic review found 32 articles on the model, only 12 of them experimental, and concluded it is effective and preferred by students and preceptors alike — largely because it improves feedback and the assessment of clinical reasoning. It is a good structure rather than a proven intervention.

What do you get back?

CME. Precepting PA students earns 2 AAPA Category 1 CME credits per 40-hour week for each student, up to 20 per calendar year. The program awards it — only ARC-PA-accredited programs can, and preceptors cannot apply to AAPA directly — so raise it at the start of the rotation.
Sharper reasoning. Explaining why you are doing something is the fastest way to find out whether you know.
Better hires. A student who has rotated with you is the best-known candidate you will ever interview.
A tax incentive, in some states. Some states have legislated tax credits or deductions for preceptors, usually aimed at primary care teaching. Check whether yours is one.

What I tried to teach

The procedures largely took care of themselves — watched, then done under supervision, then done. What took longer, and where most of my teaching time went, was what to do when the picture does not fit: the examination that disagrees with the imaging, the patient whose story does not match the injury.

The habit that helped most was asking for the student's plan before giving mine. It made the first week slower and every week after it faster, because by then they had stopped waiting for my answer.

That is how I taught rather than a tested method — though it is, in effect, the first step of the model above.

Before you say yes

Clear it with your employer. Programs place students through affiliation agreements with a practice or facility, not with you personally.
Confirm liability coverage in writing — how the student is covered, and what your own policy says about supervising one.
Ask what the program expects — learning objectives, evaluations, and when it will check in mid-rotation.
Set expectations on day one — hours, how to present a patient, what they may do on their own, and how you will give feedback.

If you are a student reading this, the view from the other side of the table — what a preceptor notices in a student — is on the orthopedic career path page.

This article reflects one clinician's experience and published guidance. It is not legal, billing or employment advice. Documentation rules differ between Medicare and other payers and between facilities, and program requirements, affiliation agreements and liability arrangements vary. See the editorial policy for how this content is written.

Sources

Kayingo G, Gordes KL, Fleming S, Cawley JF. Thinking outside the box: advancing clinical education in an era of preceptor shortage. Journal of Physician Assistant Education 2023;34(2):135–141. Retrieved via PubMed.
Cushing R. Clinical preceptor development and the benefit of structured teaching techniques: a scoping review. Journal of Physician Assistant Education 2024;35(1):52–61. Retrieved via PubMed.
Neher JO, Gordon KC, Meyer B, Stevens N. A five-step “microskills” model of clinical teaching. Journal of the American Board of Family Practice 1992;5(4):419–424. Retrieved via PubMed.
Gatewood E, De Gagne JC. The one-minute preceptor model: a systematic review. Journal of the American Association of Nurse Practitioners 2019;31(1):46–57. Retrieved via PubMed.
American Academy of Physician Assistants. Category 1 CME for preceptors guide. Credit rate, annual maximum and program eligibility.
Centers for Medicare & Medicaid Services. Finalized policy, payment and quality provisions changes to the Medicare Physician Fee Schedule for calendar year 2020. Fact sheet, November 1, 2019. Review and verification of student documentation.
Woodall L, Smith G, Garr D, Hopla D, Kern D. Can state-supported interprofessional coalitions cure preceptor shortages? JAAPA 2018;31(6):1–4. Retrieved via PubMed.