Being a virtual preceptor

What teleprecepting is, and what it is not

Teleprecepting means a student joins your telehealth schedule as a learner while you remain the treating provider. The student may sit in your office or at home in another city. Either way the patient sees two clinicians on screen, hears who each one is, and agrees to the arrangement before anything clinical starts. Nothing about the encounter itself changes: you examine what can be examined, you decide, you document, you sign.

It is not remote chart review, and it is not a student watching a recording. Live participation is the whole point, because the hours a school counts are direct patient care hours. Whether a given course will accept them by video is the program's ruling, not yours and not ours, and that ruling is written into the placement before a start date is set.

Visit types that convert to video, and the ones that do not

Psychiatric medication management is the strongest fit in the whole catalogue. The encounter is conversation, mental status observation and a prescribing decision, all of which travel intact through a camera. Primary care follow-ups come next: hypertension and diabetes checks with home readings, results review, titration visits, contraception counselling, insomnia, refills with a real reassessment attached. Behavioral health intakes work when the student has been taught to run one at a slower pace.

Procedures do not convert. Neither does acute care, where the value of the hour lives in the bedside exam and the pace of a deteriorating patient. Sensitive exams belong in a room with a chaperone. Well-child visits with growth measurements and immunisations need hands. If your week is mostly those, a mixed rotation makes more sense than a video one, and coordinators will say so plainly.

• Converts well: psychiatric med management, chronic disease follow-up, results calls, titration, counselling visits.
• Converts sometimes: new primary care complaints where the exam is limited and history carries the diagnosis.
• Does not convert: procedures, wound care, sensitive exams, inpatient rounds, urgent same-day illness.
• Never counts anywhere: watching recorded visits or reviewing charts without a live patient.

A video half-day, hour by hour

Eight o'clock, ten minutes with the student before the first patient: today's list, who is complicated, what you want them to attempt. Eight fifteen, the first visit. You open, name the student, ask the patient's permission, and hand over the history. The student takes twelve minutes. You stay on camera and mostly silent. At the point where a plan is needed, you tell the patient you are stepping away briefly to confer.

You move to a private breakout room while the patient waits in the visit. The student gives you a short assessment and a plan, you ask one question, you agree or correct, and the two of you return together. That whole exchange runs two to four minutes and is the part where teaching happens. Repeat across five or six visits, close with fifteen minutes of feedback, and the morning has produced four countable hours.

Consent, the share your program allows, and pay

The consent moment is one spoken sentence at the top of the call: a student clinician is with you today, they will take part in the visit, and you may decline. Patients rarely refuse. When one does, the student leaves the call and rejoins for the next, and you note the refusal the way you would note a declined chaperone. Document that the permission was asked and given in the encounter note itself.

Programs cap how much of a rotation may happen by video, and the caps differ by course and by year. Some allow a quarter, some allow half, some require every hour in person. You will know the number before you accept a placement. Video hours pay what clinic hours pay, at the rate you set inside the twelve to twenty dollar band. For cameras, platforms and the room setup, read teleprecepting setup.

In order

• 01

  Ask permission out loud

  Name the student, say what they will do, offer the patient a way out. Then note it in the chart.

• 02

  Hand over the history

  Stay visible, stay quiet, and let the student work for ten or twelve minutes.

• 03

  Step out to hear the plan

  A private breakout for two to four minutes. Assessment, plan, one question from you.

• 04

  Return and close on camera

  You confirm or adjust the plan with the patient present, so nobody leaves confused.

• 05

  Sign the note, approve the hours

  Your documentation, your decision. The student logs the encounter and you confirm it that week.

Questions