Start the sentence with the behaviour
The behaviour goes first because it is the part she can verify. She remembers asking the question, so there is nothing to argue about, and the rest of the sentence lands on solid ground. Then the effect, because a behaviour without a consequence sounds like a preference of yours. Then the instruction, in the form of something she can do on Tuesday morning rather than something she should become over the next year.
Sentences that open with a judgment fail, and they fail predictably. Telling her she needs to be better organised gives her nothing to change. Telling her the history was scattered invites a defence instead of a change. The test is whether a stranger reading your sentence could say what the student actually did. If not, you have described an impression, and impressions are what evaluations are for.
Say it in the same session
Feedback ages badly. Twenty minutes after the visit she still holds the room, the patient and her own thinking in mind, so a correction attaches itself to a specific memory. Four days later she remembers only the correction, which turns it into a remark about her character. So say it before you both go home, and if you can find sixty seconds, before the next patient goes in.
Privacy is the other half, and private means out of hearing of patients, staff and any other learner. A workstation in an open corridor does not qualify. Neither does the doorway of a room with a patient sitting in it. If nothing else is available, use the walk to the lab, or your own office with the door shut. Correcting a student where a medical assistant can hear costs more than the seconds it saves.
Feedback and evaluation are different documents
Feedback is informal, private and aimed at the next patient. An evaluation is written, goes to the nursing school, and records whether she met the objectives of a course. Preceptors get into difficulty by mixing the two: saving observations for the form, or writing a form that contains something she is reading for the first time. Nothing on a midpoint or a final should arrive as news to the student.
The working rule is short. Anything you intend to write on an evaluation should have been said aloud a fortnight earlier, with a chance to act on it. If you notice you are holding a serious concern you have never raised, raise it first, then write it. A student who is failing an objective has a right to know while there is still time in the term to fix it.
The comment box on the midpoint form
The rating grid takes two minutes and communicates almost nothing. The comment box is what a coordinator, a course faculty member and the student herself will actually read. Use the same structure you use out loud: two things she does that work, written as behaviours, one change written as an action rather than a trait, and a closing line about where she should be by the final evaluation.
Some wording that carries weight. She takes a complete medication history without prompting, including over-the-counter products and supplements. She presents in a clear order and commits to an assessment before asking for mine. The area to work on is the examination: she should examine before presenting rather than going back afterward. Concrete enough that faculty who have never met her can picture her on a Tuesday morning.
When it is not landing
Sometimes you say it three times and nothing moves. Check three things before deciding she is not listening. Was it a behaviour or a trait. Did you say what to do instead, in words she could repeat back to you. And did you ever confirm she understood it the way you meant it, by asking her what she is changing this week. Most feedback that fails, fails at the third one.
If it is genuinely not landing, escalate on paper and early. Put the concern in the midpoint comment box, tell her you are putting it there, and ring the faculty contact before the halfway mark rather than after. A student short of hours or short of skills is a different problem, handled in when a student is behind. If you have never filled in one of these forms, the onboarding walks through them: preceptor orientation.
<a href="/apply/">Open your hours</a> and you get two evaluation forms and about a dozen chances to say something useful.
Apply to preceptQuestions
How do you give feedback to a nurse practitioner student?
Open the sentence with the behaviour, say what it produced, then say what to do next time. Deliver it in the same session and out of earshot of everyone else. Keep it to one or two items rather than a list. Feedback naming something she can remember doing gets acted on, and feedback about traits or general impressions does not.
What is the difference between feedback and evaluation?
Feedback is private, informal and aimed at the next patient. An evaluation is written, goes to the nursing program, and records whether the student met a course objective. Nothing on a midpoint or final form should be new information to her, so anything you plan to write should have been said out loud with time left to act on it.
What should I write in the midpoint comment box?
Three or four concrete sentences: two behaviours that are working, one change written as an action rather than a trait, and a line about where she should be by the final. Write it so a faculty member who has never met her can picture her in clinic. Then say the same things to her before you submit the form.
When should I give a student feedback?
In the same session, ideally within twenty minutes of the encounter, while she still remembers the room and her own reasoning. Waiting several days turns a technical correction into a remark about her character. Give it away from patients, staff and other learners, even when that means walking to your office and closing the door behind you.
What if a student keeps making the same mistake?
Check whether you named a behaviour or a trait, whether you said what to do instead, and whether you ever asked her to repeat back what she is changing. Most repeated errors survive because that third step never happened. If it continues, write it in the midpoint comments, tell her you are writing it, and call the faculty contact.
Tamsin R., DNP, FNP-BC
Reads every application and every midpoint evaluation. Has precepted FNP students in a rural family practice since 2014 and still takes one a term. Writes the teaching-method pieces in Off the Clock.