NARM Preceptor/Student Agreements

Effective June 1, 2021, with initial preceptor registration or preceptor renewal, NARM requires that all Registered Preceptors develop a written work agreement that clearly defines expectations for the student, as well as for the Preceptor. NARM has found the most common difficulty in the preceptor/student relationship is typically poor communication about the responsibilities each person has over the course of the apprenticeship. A clearly written agreement is an indispensable resource to both the student and the preceptor if a dispute occurs.

NARM does not directly supervise the preceptor/student relationship. The NARM Preceptor/Student Accountability process is intended to address issues related to integrity, conduct, and the upholding of written and signed preceptor/student work agreements. NARM strongly suggests the student and preceptor adhere to these agreements, including regular review of the student’s progress, and address any issues in a timely fashion. If the student or preceptor identify deficiencies but continue to work under conditions contradicting the signed work agreement, NARM reserves the right not to address a related complaint through the accountability process.

There are many variations in preceptor/student relationships, however NARM has compiled a suggested list of topics that should be documented in the student’s work agreement to avoid misunderstandings. All preceptor/student work agreements are required to address the following five essential elements:

  • Job description for the student and the preceptor.
    • Number of days per week the student is expected to attend prenatal and postpartum visits.
    • Non-clinical student duties, if applicable.
    • Expectations for how the student will acquire their didactic education (e.g., educational program, self-study, preceptor-provided study plan, etc.).
    • Oversight of all student/client contact.
    • Attendance, punctuality, dress code, client communication, and on-call availability,
    • Grounds for dismissal and termination of preceptor/student agreement.
      • The preceptor and the student both have the right to terminate the apprenticeship at any time.
      • Some preceptors have an orientation period where the student and preceptor determine whether the apprenticeship is a “good fit.” The length of orientation period, if applicable, should be stated in the work agreement.
      • There should be clearly defined criteria for unacceptable behavior that could result in termination of apprenticeship. This may include things like punctuality, attendance, being unavailable when called to attend a birth, use of alcohol and drugs, breaches in confidentiality, or other unprofessional behavior.
    • Whether the preceptor requires the student to have specific training or certification, such as NRP, CPR, HIPAA, OSHA, and CLIA.
  • Plan for review of student progress and paperwork completion at least every 3 months.
    • The preceptor should be clear as to what they consider to be adequate progress in student skills. Students may need more than the minimum number of clinical experiences to demonstrate proficiency. If a student is not meeting the preceptor’s expectations for progress or proficiency, the student should be made aware of this, a plan should be made to help the student meet the preceptor’s expectations, and there should be a timeline for resolution.
    • The student and preceptor should set aside time at regular intervals for the review of the student’s progress, effectiveness of the preceptor’s teaching, and completion of paperwork for the student’s NARM Application. NARM encourages preceptors to sign application documentation for the apprentice at the time the skill is performed competently. The preceptor and student should have an agreed upon time for review of student progress and the completion of NARM paperwork. It may be impractical to complete paperwork immediately following the clinical experience however this should not be postponed for more than 90 days after the fact.
  • Financial compensation plan for the student and/or preceptor.
    • NARM does not have a policy regarding whether students or preceptors should be compensated financially for their roles during an apprenticeship, however any compensation should be clearly stated and agreed upon by both parties.
    • If there is an expectation as to the student performing any non-clinical duties for the practice, this should be clearly defined in the preceptor/student agreement.
    • Financial complaints outside the scope of the preceptor/student agreement will not be addressed by NARM.
  • Criteria required for the preceptor to sign off on NARM paperwork.
    • A preceptor must sign only for those experiences for which they were present, and they believe the student has performed competently.
    • Once a preceptor signs for anything on a NARM application form, it may not be retracted.
    • Preceptors who sign clinicals but refuse to complete the Final Verification Form without a justifiable reason, risk having their preceptor status revoked.
  • Information regarding the NARM Preceptor/Student Accountability Committee.
    • The NARM Preceptor/Student Accountability Committee’s work will be guided by the International Confederation of Midwives’ Code of Ethics and official NARM policies.
    • The preceptor/student agreement will include a statement that any recommendations derived as a result of this process are binding and may include probation, suspension, or revocation of NARM Registered Preceptor status, or suspension or denial of the student’s NARM application.

NARM has created a Preceptor/Student Agreement Template as a starting point. You can view the template here. The agreement can also be adapted to fit your practice by downloading and editing this Word document.