
Student Policy 4-Clinical Phase SCPEs. Sites and Preceptors
S4 โ Clinical Phase SCPEs, Sites, and Preceptors
Issue Date: 01/16/2019
Date Approved: 12/15/2025
Responsible Party: Program Director, Associate Director of Clinical Education
Minimum Review Frequency: Every 3 years
Approving Body: Program Faculty
Background and Purpose
The clinical phase of the University of Michigan-Flint Physician Assistant program encompasses the final 12 months of study. During this phase, students engage in direct patient care across diverse clinical practice settings, allowing them to apply the knowledge and skills acquired during the didactic phase. This structured approach to clinical education ensures students receive the necessary hands-on experience to prepare them for their future practice as NCCPA-certified Physician Assistants.
The purpose of this policy is to outline essential requirements and procedures related to the clinical phase, including:
- Requirements for Student Progression to Clinical Phase
- Clinical Schedule
- Clinical Training Requirements and Patient Population Exposure
- Student Orientation to Clinical Learning
- Student Progress During the Clinical Phase
- Student Assessment During the Clinical Phase
- Supervised Clinical Practice Experiences (SCPE) Clinical Sites
- Clinical Preceptors
- Program Evaluation of SCPE Sites and Preceptors
- PA Program Responsibilities
Clinical sites and preceptors play a crucial role by providing the necessary settings and expertise for PA students to develop and refine their knowledge, skills, and professional attitudes in the clinical setting. These clinical environments offer direct patient care experiences where students can apply the knowledge and skills previously acquired during the didactic phase. Under the guidance of the clinical preceptor, students have the opportunity to:
- Expand their medical knowledge through real-world application
- Refine their clinical skills in diverse practice settings
- Develop professional attitudes and behaviors essential for healthcare practice
This policy also outlines the processes for the clinical site and preceptor recruitment, program requirements of SCPE sites, program evaluation of SCPE sites and preceptors, and associated responsibilities as per associated ARC-PA Standards.
This policy is always accessible to students, faculty, staff, and instructional faculty through the class Google Drive and CORE-ELMS platform.
The University of Michigan-Flint PA Program Clinical Team comprises the Associate Director of Clinical Education, the Assistant Director of Clinical Education, the Clinical Coordinators, and the Clinical Administrative Specialist.
I. Requirements for Student Progression to Clinical Phase
Before beginning the clinical phase of the University of Michigan-Flint PA program, students must fulfill the following essential requirements to ensure their readiness and compliance with clinical training standards:
- Successful completion of all didactic courses as described in the “Requirements for Progression” section of the program’s Academic Standards Performance and Progression Policy S7A.
- Demonstrated proficiency in PA professionalism compliance.
- Successful completion of HIPAA and OSHA training.
- Completion and successful passing of pre-requisite or random drug screening and background checks when required by clinical sites. Any associated fees will be incurred directly by the student.
- Proof of updated immunizations.
- Annual health attestation form completed by a licensed healthcare provider.
- Successful completion of Basic Life Support (BLS) for Healthcare Providers course with current certification.
- Successful completion of Advanced Cardiovascular Life Support (ACLS) course with current certification.
- Signed Health Information Release form by student allowing University of Michigan-Flint Physician Assistant Department to maintain and release the following information to clinical SCPE sites: immunizations, TB screening status, drug screening, background check, and BLS/ACLS.
- Proof of Health Insurance coverage.
II. Clinical Schedule
The clinical phase schedule consists of 11, four-week Supervised Clinical Practice Experiences (SCPEs) with the final four months of the program for final review, testing, and remediation. The schedule includes 10 “core” SCPEs and one elective SCPE. Clinical preceptors will assist students in achieving the program-defined learning outcomes in the following areas:
Core SCPEs
- Internal Medicine I โ 4 weeks
- Internal Medicine II โ 4 weeks
- Family Medicine I โ 4 weeks
- Family Medicine II โ 4 weeks
- Emergency Medicine โ 4 weeks
- Surgery โ 4 weeks, including pre-operative, intraoperative, and post-operative care
- Pediatric Medicine โ 4 weeks
- Women’s Health โ 4 weeks, including prenatal and gynecology care
- Behavioral Medicine โ 4 weeks
- Geriatric Medicine โ 4 weeks
For Family Medicine and Internal Medicine, students complete two 4-week SCPEs. The two SCPE blocks may or may not be scheduled consecutively.
Elective SCPE
The program offers clinical phase students the opportunity to complete one 4-week elective SCPE in an area of their choice, subject to availability and Clinical Team approval. The Clinical Team collaborates with students to explore and identify potential elective opportunities that align with their interests. However, while the program makes reasonable efforts to accommodate student preferences, there is no direct or implied guarantee that students will be assigned to their requested preceptor or clinical site, including those already affiliated with the program. The Clinical Team has final approval over the SCPE schedule.
Personal and Professional Relationships
To maintain professional boundaries and the integrity of the clinical educational experience, the student must disclose any and all existing personal and professional relationships between students and potential preceptors before starting the Supervised Clinical Practice Experience (SCPE). Students are prohibited from completing clinical rotations under the supervision of family members or individuals with whom they have pre-existing personal relationships. Should a pre-existing professional relationship exist, the Clinical Team will review the appropriateness and, if necessary, investigate the type of relationship before granting approval.
III. Clinical Training Requirements and Patient Population Exposure
The University of Michigan-Flint PA program requires students to complete Supervised Clinical Practice Experiences (SCPEs) across diverse healthcare environments and patient populations to ensure comprehensive clinical training. These experiences are strategically designed to expose students to various practice settings, patient encounter types, and age groups throughout the lifespan, preparing them for the full scope of professional PA practice.
SCPE Practice Settings
Each UM-Flint PA student will meet the program’s learning outcomes in each of the following settings:
- Emergency Department
- Inpatient
- Outpatient
- Operating Room
Types of Patient Encounters
Each UM-Flint PA student will meet the program’s learning outcomes for the following types of patient encounters:
- Preventive
- Acute
- Chronic
Patient Ages
Each PA student will meet the program’s learning outcomes for individuals in the following age groups:
- Newborn/neonates (0 to 30 days)
- Infants (1 month to 1 year)
- Children (1 year to 11 years)
- Adolescents (12 to 18 years)
- Adults (19 years to 64 years)
- Elderly (65 years and above)
Progress Monitoring
The program monitors student progress utilizing a web-based tracking system and Clinical Performance Evaluations (CPE) to verify the acquisition of expected competencies and learning outcomes. Student progress is reviewed monthly to ensure students receive adequate exposure to the necessary types of patient encounters and clinical settings. This monitoring system allows for timely intervention if deficiencies are identified, enabling either reassignment or adjustment of future SCPE training. Students who do not achieve the required learning outcomes during the assigned SCPE may be required to complete a secondary SCPE or an additional clinical experience, including replacing their elective SCPE.
IV. Student Orientation to Clinical Learning
Identification as Students in Clinical Settings
- Students must identify and introduce themselves to patients, family members, and clinical site staff by stating their full name and position/title โ “Physician Assistant student.”
- Students must wear a short white lab coat emblazoned with the University of Michigan-Flint Physician Assistant Department logo during all assigned SCPE activities unless it is inappropriate based upon the activity being performed (e.g., within the operating room) or at the direction of the preceptor.
- Students must wear the University of Michigan-Flint Physician Assistant Department student identification name badge whenever they are participating in PA professional activities (e.g., health fairs, community service opportunities, etc.) and particularly whenever they are in a healthcare facility, clinic, or physician’s office in their official capacity as a student of the PA program. If a clinical education site requires a different type of ID badge, all badges will be worn as delineated in the Dress Code Policy S2. Students must dress and present themselves in a professional and appropriate manner for the SCPE to which they are assigned. Students should discuss the appropriate dress code with the assigned preceptor or clinical site coordinator. When the SCPE or preceptor mandates no specific dress code, students will dress according to the University of Michigan-Flint Physician Assistant Department dress code defined in the UM-Flint PA Program Dress Code Policy S2.
Required Documentation for SCPE Participation
It is the student’s responsibility to identify the documentation required for each SCPE, complete the required documentation, and upload necessary items to CORE ELMS and/or ACEMAPP no less than 10 days before the clinical site requirement deadline through email. Failure to complete and return the required documentation for the SCPE may result in the student not being allowed to participate in that SCPE and could delay their graduation date.
Student Attendance in SCPEs
Policy S1 (Student Attendance, Participation, and Inclement Weather) and the Clinical Handbook outline details regarding attendance expectations for SCPEs.
V. Student Progress During the Clinical Phase
Each SCPE is a unique learning experience with specific course goals, learning outcomes, instructional objectives, and associated student assessments published in each SCPE syllabus. These guide student learning during the clinical phase and support attaining program learning outcomes and, ultimately, the program-defined student competencies. The SCPE components, grading criteria, and remediation details are outlined in each SCPE syllabus. Students must successfully pass each SCPE to enroll in another SCPE type. SCPE syllabi are housed within CORE-ELMS. Students and clinical preceptors can access the SCPE syllabi online at any time through CORE-ELMS. Students must fulfill all clinical phase academic and professional expectations before graduation. The criteria for student graduation are included in the program’s Academic Standards Performance and Progression Policy S7A, section “Requirements for Graduation.”
VI. Student Assessment in the Clinical Phase
The assessment of student performance during the clinical phase incorporates multiple evaluation methods to ensure comprehensive monitoring of clinical competencies, attainment of learning outcomes, and professional development.
Assessment of Student Academic Achievement
The following components are utilized to evaluate student progress and identify any areas requiring additional support or intervention but are not limited to:
PAEA End-of-Rotation Examinations (EORE): Specialty Subject Exam
Students must complete an EORE at the end of these SCPEs: Family Medicine II, Internal Medicine II, Emergency Medicine, Pediatric Medicine, Women’s Health, Surgery, and Behavioral Health.
Additional Assessment Components:
- Preceptor completed Clinical Performance Evaluation (CPE) forms at the end of each SCPE
- Clinical Phase or SCPE-specific Assignments, such as:
- Patient and procedure log in CORE ELMS
- Student attendance and hour tracking in CORE ELMS
- Mid-clinical experience evaluation of student
- Student evaluation of the preceptor and clinical site
- Student self-assessment
- Other, as outlined in the SCPE syllabus
A remediation process has been developed to address deficiencies in the above components and assist the student with focused improvement. The remediation process is outlined in the SCPE syllabus, Clinical Handbook, and Student Policy S7A โ Academic Standards Performance and Progression.
The Clinical Team is responsible for monitoring the student’s standing and completion of the above requirements and their progress toward achieving the program-defined SCPE learning outcomes. The program utilizes a web-based tracking system to verify the student’s completion of SCPE and clinical phase requirements and progress toward achieving the program’s learning outcomes. Student progress is reviewed monthly to allow for timely intervention if deficiencies are identified, enabling either reassignment or adjustment of future SCPE training.
Learning Outcomes Completion
Students are required to meet all designated Learning Outcomes (LOs) for each Supervised Clinical Practice Experience (SCPE). If a student does not achieve a required LO within the assigned SCPE, the LO may be completed in another SCPE that has been formally mapped and tracked by the clinical team. In circumstances where the missed LO is completed in a non-mapped SCPE, the student must document the activity on a separate verification form. This form must be signed by the supervising preceptor and uploaded into Core for clinical team review. The clinical team will determine whether the documentation is acceptable and whether the LO has been satisfactorily met. If any required LOs remain unmet at the conclusion of the scheduled SCPEs, the clinical team will work with the student to arrange additional SCPE opportunities to ensure all LOs are achieved prior to program completion.
Assessment of Student Professionalism
The SCPE preceptor and the Clinical Team will monitor student conduct and professionalism throughout the SCPE and clinical phase. If a preceptor reports a student conduct issue, the student will need to meet with the Clinical Team to discuss the issue. Program Policy S7B Professional Standards Performance and Progression provides clear expectations, requirements, and procedures related to UM-Flint PA student professionalism and progression. The professional conduct of students in the clinical phase is reviewed and discussed each semester by the Professional Standards and Progress Committee.
If a student participating in a SCPE is suspected to be under the influence of any substance that impairs their clinical performance, the University of Michigan-Flint Physician Assistant Department reserves the right to remove the student from the SCPE. This is discussed further in Program Policy S3 Student Drug Screen.
Summative Evaluation
Summative evaluation of the student occurs during the final four months of the UM-Flint PA program and is discussed in Program Policy S5 โ Student Assessment.
Determination of SCPE Grades
The SCPE components, grading criteria, and remediation details are outlined in each SCPE syllabus and Clinical Handbook. Students and clinical preceptors can access the SCPE syllabi and Clinical Handbook online at any time through CORE-ELMS. The program retains full authority for the determination and assignment of the student’s SCPE grade. Outcomes related to SCPE grades are discussed in the Clinical Handbook and program Policy S7A Academic Standards Performance and Progression.
Documentation of Student Performance
Record-keeping processes for the aforementioned documents and forms will be maintained electronically by the UM-Flint PA department.
VII. SCPE Clinical Sites
Program Requirements and Processes for SCPE Sites
For students to participate in a SCPE, all clinical SCPE sites must have a current, signed affiliation agreement with the University of Michigan-Flint and the PA program. The program, with the support of the University of Michigan-Flint administration, assumes responsibility for recruiting and maintaining SCPE sites and preceptors in sufficient numbers for the program-mandated supervised clinical practice experience component of the curriculum for students to meet program learning outcomes.
In compliance with the ARC-PA Standards, the University of Michigan-Flint PA Program performs the following:
- Coordinates all activities associated with arranging SCPE blocks, including identifying, contacting, and evaluating sites and preceptors for suitability of student placement in accordance with this policy.
- SCPEs designated as core rotations must be completed within the United States. International clinical sites and preceptors may only be utilized for elective SCPEs, ensuring that foundational clinical education occurs within the U.S. healthcare system.
- Students are not required to arrange or solicit clinical sites and preceptors. Students are prohibited from contacting other PA programs or their students to solicit clinical placement opportunities. However, students wishing to suggest a new SCPE location or preceptor can follow the procedure outlined by the Clinical Team to enroll new preceptors or clinical sites so that all clinical placements meet program standards and are vetted through appropriate channels.
- UM-Flint PA program policies apply to all students regardless of location. However, students must recognize that some SCPE sites may have specific policies with requirements that exceed those of the PA program and its policies.
Housing, Transportation, and Travel
- During SCPEs, students are responsible for and must bear all costs associated with locating, securing, and utilizing housing, travel, and transportation options during the clinical year. Students are also fully responsible for financial consequences of housing, transportation and travel in instances of SCPE scheduling adjustments or cancellations for remediation and deceleration purposes, as directed by the program and in instances of SCPE cancellation by the clinical site. If available, the Clinical Team will provide students with information about housing options and other resources at or near the clinical site. Students are also responsible for arranging the start time and duration of housing, transportation, and travel as necessary. The program does not maintain housing or residency options for students.
- If issues arise related to housing, transportation, or travel, the student must directly inform the SCPE preceptor and the Clinical Team as soon as possible.
VIII. Clinical Preceptors
Qualifications
The UM-Flint PA program primarily uses state-licensed practicing physicians and physician assistants as clinical preceptors for its students. However, other licensed health care providers that are qualified in the area of instruction, such as nurse practitioners and midwives can also serve as clinical preceptors for SCPEs. The program does not recognize health professions students, nursing students, medical students, and residents as clinical preceptors.
Licensure and Board Certification
All clinical preceptors must be licensed within the state in which they will be providing SCPE instruction for UM-Flint PA program students. Verification of licensure status is conducted by the program personnel through queries of the Michigan Department of Licensing and Regulatory Affairs (LARA) database or respective state medical boards for out-of-state providers. All clinical preceptor licensure, board certification, and qualifications are requested and verified during the initial site visit and at the beginning of each SCPE when the clinical preceptor is assigned. A record of clinical preceptor licensure and board certification is maintained by the program.
Licensed Physicians serving as SCPE preceptors should be ABMS or AOA board-certified in their area of clinical practice and instruction. The UM-Flint PA program strives to schedule all clinical phase students to work with physicians who are board-certified in their area of practice. However, in rare instances, the PA program does permit non-board-certified physicians to serve as clinical preceptors if they fulfill the following criteria:
- State licensure in the area of practice: All non-board-certified physicians must carry a current license to practice medicine in the state of Michigan, with no history of infractions or professional misconduct.
- Educational background: All non-board-certified physicians must have completed an accredited post-graduate residency or fellowship program in the field of their practice. Special consideration is given to physicians with formal educational roles or titles held during or after completion of clinical training, such as chief resident, program director, fellowship director, dean, etc.
- Clinical experience: All non-board-certified physicians must have practiced for at least ten years following the completion of a residency or fellowship program in the specialty of their training and student instruction.
- Reputation as an educator: Additional consideration is given to non-board-certified physicians who are recognized within the local community as exceptional educators, such as serving as a clinical preceptor for learners from other PA programs, medical school, residency, and fellowship programs.
- Reputation as a community leader: Additional consideration is given to non-board-certified physicians who are recognized within the local community as leaders in their field of practice who align with the mission of the UM-Flint PA program, whose practice is in a health professional shortage area, an underserved medical specialty within the community, or provide care to a population in a medically underserved area.
Decisions regarding clinical preceptor placement are determined on an individual basis but must, at a minimum, fulfill the first three criteria above.
Licensed Physician Assistants must have current National Commission of Certification of Physician Assistants board certification to serve as a UM-Flint PA program student clinical preceptor. They must have practiced in the area of instruction for at least one year.
Licensed Nurse Practitioners and other qualified health professionals must have current board certification in an area related to their practice and instruction to serve as a UM-Flint PA program student clinical preceptor. They must have practiced in the area of instruction for at least one year.
Clinical Preceptor Responsibilities
The role and responsibilities of the preceptor are central to the clinical experience of the student. Along with the program, the preceptor plays a vital role in the educational process. The preceptor must be a licensed healthcare provider and is responsible for the on-site supervision, training, assessment, and evaluation of the physician assistant student. While on rotation, the physician assistant student must be supervised in all their activities commensurate with the complexity of care being given and the student’s own abilities. Rotations are designed to expose the physician assistant student to patient care in a variety of settings. The student shall be directly involved in the evaluation and management of patients to the extent that the clinical preceptor or supervisor is comfortable, based on the level of knowledge and skills of the physician assistant student. Preceptors are extensions of the program teaching faculty at the clinical site and are held to the same standards.
The following are the responsibilities of the clinical preceptor and their designees:
- Being familiar with the information in the UM-Flint PA program Preceptor Handbook and related program policies and procedures.
- Respecting and recognizing the role of PA students are learners. Students must not serve as substitutes for clinical or administrative staff under any circumstances, and all patient care activities must be conducted under supervision. The presence and oversight of a qualified clinical preceptor is mandatory for all patient interactions.
- Creating a conducive learning environment and maintaining a professional relationship with students.
- Disclosing and reporting any and all potential conflicts of interest related to a previous or current personal or professional relationship with a prospective student.
- Providing the student orientation information to the site/SCPE.
- Determine the students’ work schedule while at the site.
- Informing the program of any changes in their state license and board certification status.
- Notifying the program promptly of the clinical site’s inability to accommodate the student or fulfill the SCPE requirements.
- Provide the students opportunities for supervised hands-on active patient care experiences.
- Assisting the student in achieving the learning outcomes and instructional objectives for the SCPE.
- Providing early and frequent feedback on student performance, including completion of mid-clinical experience evaluations.
- Completing the end-of-rotation Clinical Performance Evaluations (CPE) preceptor evaluation of the student survey.
- Verifying and documenting student achievement of technical skills competency if demonstrated during the SCPE.
- Immediately notifying the program of any student behavior/performance issues.
- Returning completed forms to the program in a timely fashion.
Preceptor Development
The program provides preceptors with electronic (through Core ELMS) or printed copies of the Preceptor Handbook and SCPE syllabus to become familiar with the program curriculum, program-defined learning outcomes, instructional design, and student clinical practice experience expectations. Ongoing development opportunities are provided through annual updates to the Preceptor Handbook and Core ELMS. During clinical site visits and through program surveys, preceptors are invited to share ideas or suggestions for enhancing clinical experiences, which may lead to program modifications. If student evaluations identify specific needs for improvement, the Clinical Team will work with individual preceptors to create personalized development plans.
IX. Program Evaluation of Clinical Sites and Preceptors
The program’s Clinical Team is responsible for evaluating all clinical sites and preceptors initially and on an ongoing basis to ensure they provide adequate physical facilities, appropriate patient populations, and sufficient supervision necessary for students to achieve program learning outcomes. These evaluations assess the quality and effectiveness of both sites and preceptors in fostering student success, ensuring all clinical practice experiences meet educational standards. The processes for the initial and ongoing site evaluations are included below.
Initial Evaluation
- Initially, a site visit will be conducted by a program faculty member or designated clinician prior to placing a student at that location/site.
- The program will validate and verify with clinical site representatives:
- Sufficient resources: (physical facilities: workspace, patient exam rooms, references, support personnel)
- Patient populations: patient encounters of the designated specialty content, adequacy of encounters
- Site’s suitability to meet program learning outcomes
- Supervision of the student
- The program will maintain documentation of:
- Completed Letter of Intent form
- Completed Supervised Clinical Site Experience Evaluation Site Visit form
- A signed affiliation agreement or memorandum of understanding
Ongoing Evaluation
1. Frequency:
- The program will visit all active clinical sites in person every three years and as needed for their ongoing evaluation.
- At the time of the ongoing site visit, the program will evaluate clinical sites for the following:
- Sufficient resources (workspace, physical facility, patient exam rooms, references, support personnel)
- Patient encounters of the designated specialty content, adequacy of encounters
- Site’s suitability to meet the program learning outcomes
2. Evaluation Methods:
To evaluate the effectiveness of instruction at Clinical Sites, the program will adopt the following evaluation methods at the completion of each SCPE:
- Review of Student Evaluation of Preceptor and Student Evaluation of Clinical Site Form for ratings below established benchmarks
- Analysis of patient encounters reported by students through CORE ELMS and Clinical Performance Evaluations
- Monitoring of clinical sites to ensure consistent learning outcomes across different locations
- Re-evaluation prompted by concerns about preceptors and/or clinical sites, including direct communication with preceptors
3. Compliance Verification:
To ensure compliance with ARC-PA Standards, the program will verify and review documentation related to:
- Maintenance of current affiliation agreements
- Verification of preceptor credentials, including licensure and board certification
4. PA Program Clinical Site Oversight:
Through ongoing assessment of clinical sites and preceptors, the PA Clinical Team is responsible for the oversight of clinical sites and preceptors, and may choose to:
- Conduct a site visit prior to the placement of another student with the preceptor or site.
- Conduct a site visit in conjunction with the next student placement.
- Initiate telephone/video contact with the preceptor or site.
- Remove a preceptor or clinical site from future program use.
X. PA Program Responsibilities
The UM-Flint PA Clinical Team, with UM-Flint PA administration support, is responsible for:
- Providing student orientation, including reviewing learning outcomes and SCPE topics, use of local resources, clinical site patient care practices, safety issues, and access to patient health records.
- Ensure sufficient clinical sites and preceptors to allow all students to meet the program’s learning outcomes.
- Assessing the suitability of sites and clinical preceptors to meet learning outcomes.
- Helping students identify and providing the contact information of the designated SCPE clinical preceptor responsible for assessing and supervising the student’s progress in achieving the learning outcomes.
- Conducting initial and ongoing evaluations of all clinical sites and preceptors.
- Verifying licensure and certification status of preceptors.
- Clinical preceptor development to include orientation to specific learning outcomes.
- Monitoring student evaluations and patient encounters.
- Ensuring differences between clinical sites do not impede student accomplishment of learning outcomes.
- Performing ongoing evaluation of student SCPE performance and progress toward meeting learning outcomes and attaining clinical competencies that align with what is expected and taught.
- Performing ongoing evaluation of student SCPE performance and progress toward meeting program learning outcomes and clinical competencies to identify and address student deficiencies in a timely manner.
- Monitoring and ensuring compliance with telehealth/telemedicine standards per B3.01.
- Documentation: The program is responsible for maintaining copies of all records and documents related to clinical sites and preceptors in the department’s secure file system. This includes affiliation agreements, preceptor evaluations, site evaluations, student performance records, preceptor licensure and board certification information, and any other relevant documentation pertaining to clinical experiences.
Approval History
- 9/21/2020: Program Faculty
- 08/31/2021: Program Faculty
- 10/18/2023: Program Faculty
- 12/11/2024: Program Faculty (Consolidated S4, S11A, and S11B)
- 12/15/2025: Program Faculty
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