Clinical Placement Request Instructions Education Partners, It is a pleasure to work with you to meet the clinical needs of your students.

Key Terms Education Partner- The school designates one person responsible for ensuring on-boarding requirements are met and submitting clinical placement requests. Going through one person enhances communication and decreases errors. Clinical Placement Request Form (CP Request form)- arranged by tabs for each campus. School Information section – complete all categories for requested campuses. A blank top portion signifies no requests for that campus. Base-Unit section - departments where student groups are assigned. Out- Rotation section - departments where individual or small numbers of students are assigned with the instructor not on the department.

Key Terms Site = Department / Day / Shift. A department available 24/7 has 14 available sites. Ex. MC 2000 Monday 7a – 7p = 1 site. Instructor on Site (OS)- Instructor on site, responsible for a group of students in Base-Unit and Out-Rotations. Instructor Not on Site (NOS)- Pre-arranged Out-Rotations with responsible instructor on campus but not on the Out- Rotation department with the student. Faculty/student group- Clinical instructor with a specific group of students.

Clinical Placement Request Process Clinical Placement Request Process General Information The Clinical Placement Request The Clinical Placement Request Form is located on Cone Health’s Clinical Placement web page: The School Education Partner The School Education Partner completes the Clinical Placement Request Form and submits to prior to the deadline (see form). – Note a tab for each campus. Complete the school and contact information at the top of only the campuses where you are requesting placement. – Leaving the top portion blank indicates no requests for that campus. – 1 st choice clinical placements will be confirmed whenever possible, however, providing us with an alternative 2 nd choice site is advisable. – Faculty will receive confirmation of approved clinical placement within 30 days of the clinical request deadline date.

Clinical Placement Request Process Specific Points Complete information at the top of every campus that is being requested. School information section not filled in indicates the campus is not being requested. Each component is important and must be included. Total number of sites requested (count each department, day, shift) Total number of students (understood as close approximation). Multiple Requests for the same Department When requesting a department for several Faculty/Student groups at different timeframes, assign a number to each group and transfer that number to requested day/time and any other applicable cell.

Clinical Placement Request Process Specific Points Fill in all pertinent information in Base-Unit section. Faculty Name/ address and contact #; Type/Level of program/course number/#of students; Start date; End date; Alternative (2 nd Choice); Identify the # of out-rotations; day(s) and hours requested. Fill in all pertinent information in Out-Rotation section Instructor on site (OS) Instructor on site (OS) – Indicate Base Unit location and # of student(s) that will go to the Out-Rotation Department each time. The Instructor information is to be found in the Base Unit area.

Confirmation Process The confirmed request will be returned within 30 days. Carefully review the confirmed request; modifications may have been made. Approved requests remain unchanged when confirmed. Subtle changes may have been made (ex. timeframes slightly adjusted). Unable to Approve requests will have a strike through. 2 nd choice alternative may have been assigned If the 1 st & 2 nd choice is not available, the school Education Partner will be notified and encouraged to access the web site to select alternative options from the posted schedule.

How to Add / Cancel Requests Additional Requests - Submit changes and additional requests via . These changes will be manually made to your original request. These should be kept to a minimum. Due to complications that typically arise from late requests, they will no longer be accepted. Exceptions may be made from time to time, but should not be expected. Cancellations - Cancellations - Send notification of a cancellations to The Cancellation should be sent as soon as possible and by the 2nd week of the semester at the latest.

Additions / Cancelations Format Subject line: School /Semester/ Clinical Placement Addition Request or Cancellation In the body of the list: – Department(s) adding or canceling – Days / times – Faculty / contact information A confirmation will be sent back to you.

Undergraduate Preceptor Request Send the request using the following format: Subject Line: Semester / School / Program / Preceptor Request Example: Fall 2020 Best University BSN Nursing Preceptor Request In the body of the list: Number of preceptors needed Start Date/ End Date Number of hours Campuses: General type of department / patient population preferences Additional Comments: Confirmation Upon receiving confirmation of the preceptors, submit a list of the students and the corresponding assigned preceptor / clinical site to This is due prior to the Start date. Contact the department director and preceptor to set up a meeting as needed to discuss the details of the preceptorship and to provide pertinent information. Preceptors will provide information that can be used in the student’s clinical evaluation but will not be responsible for the overall evaluation. Due dates are the same as for the group requests Please refer any nurse who expresses interest in being a preceptor to their department director. Cone dos not support recruitment of preceptors for a particular school.

Questions? Contact Contact: or Connie Lewter, RN, MSN, CNE Clinical Education Coordinator All Clinical placement information and forms can be found at