The NP Preceptor Gap: Interview with an Expert
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“Clinics and institutions need to value and prioritize clinical education across the board so that NPs are given time to precept and the recognition they deserve for their efforts.”
Beth Heuer, DNP, Program Director of the PNP Specialty Tracks, The Ohio State University College of Nursing
NP education isn’t limited to the classroom. To build their clinical reasoning and real-world experience, NP students complete at least 500 hours of direct patient care. Those hours are typically completed under the supervision of one or more preceptors: experienced, licensed clinicians who observe the student’s work, provide feedback, and help evaluate whether the student is developing the competence to practice safely.
Preceptors are a critical element of the NP workforce. They’re not optional. But there’s a problem: according to the AACN, 16,355 qualified applications to MSN and DNP programs were turned away in 2025, with preceptor and clinical site shortages listed as a primary barrier (AACN 2026). The shortage of preceptors is creating a bottleneck in NP education and clinical training, with serious negative downstream effects. More needs to be done to incentivize NP preceptors and secure the future of NP education.
Meet the Expert: Beth Heuer, DNP, APRN-CNP, CPNP-PC, PMHS, FAANP
Dr. Beth Heuer is a clinical professor and program director of the pediatric nurse practitioner specialty tracks at The Ohio State University College of Nursing. She earned her MSN from the University of Pittsburgh and her DNP from Robert Morris University. She is certified as both a primary care PNP and a pediatric primary care mental health specialist.
Prior to joining the faculty at The Ohio State University, Dr. Heuer served as DNP program director at Temple University. She also served as executive board secretary for the National Association of Pediatric Nurse Practitioners (NAPNAP). She is co-chair of the National Organization of Nurse Practitioner Faculties (NONPF) Preceptor Development Committee. She is co-author of The Nurse Preceptor Toolkit.
The Importance of NP Preceptors
“Didactic and clinical learning go hand-in-hand in preparing NP students to practice,” Dr. Heuer says. “As practicing providers in clinical settings, preceptors share their knowledge, experience, and time with students, while modeling the role that the student is working towards achieving. Their input on student progress is a critical part of NP education.”
Preceptors help students put theory into practice. It’s one thing to read about the pathophysiology of an illness—and students will read plenty—but it’s another thing to bring all of one’s learning into a real-life setting, with real patients and real pressures. That’s why securing a preceptor is, for an NP student, mandatory. But it’s not as easy as it should be.
“NP programs are having increasing difficulty placing students at clinical sites each semester,” Dr. Heuer says.
Part of the problem is the competition for sites. Depending on the area, a clinical site may be inundated with not just NP students but also medical students, residents, and PA students all seeking clinical experience. The problem is unlikely to get better on its own: nurse practitioners are the fastest-growing occupation in the country, expected to grow 41 percent over the next decade, with 144,000 new NPs expected to enter the workforce by 2035 (BLS 2026).
“Other major factors include preceptor burnout and lack of preceptor incentivization,” Dr. Heuer says. “It takes a lot of time and energy to precept, and NP preceptors may not receive dedicated time to do so. They see their full caseloads each day, and still provide clinical education to students.”
Addressing the NP Preceptor Gap
Without enough clinical placements, NP programs are bottlenecked. Well-qualified applicants might not be accepted. Those students who are accepted may be burdened by trying to find their own preceptors: in 2020, around 14 percent of NP programs required students to locate clinical sites and preceptors themselves (Nursing Outlook 2020); a smaller 2022 survey in Texas found 46 percent of NPs were required to find their own clinical placements (JAANP 2022). But students might lack the knowledge of how to vet those preceptors and make sure they’re getting the best clinical experience.
“Downstream, this affects the NP workforce, leading to fewer providers in the areas where they are needed most,” Dr. Heuer says.
Many preceptors look at precepting as an honorable duty, and it is. It pays forward the education the preceptor once received themselves. It builds relationships with schools and students. It keeps one’s practice current and evidence-based. But it takes time. Good incentives are essential. Right now, there are very few, and they’re highly uneven. That’s led some preceptors to ask to be paid for their time, which increases costs for students and pushes graduate education further out of reach.
“Federal and state tax credits for precepting would be a huge boost for many preceptors,” Dr. Heuer says. “This has worked in a number of states. Universities could also offer benefits to preceptors like reduced tuition costs and other perks to offset the time and energy preceptors devote to clinical education.”
The Future of the NP Preceptor Landscape
As it stands, there’s been a trend towards a pay-to-play model for preceptors: students are charged thousands of dollars by companies each semester to be placed in clinical sites. A 2022 survey at an Illinois university found nearly 60 percent of PMHNP students were asked for payment in order to secure a preceptor, and 31 percent had used an online placement service (Lewis University 2022). This isn’t a scalable, sustainable fix.
The bipartisan PRECEPT Nurses Act (short for Providing Real-World Education and Clinical Experience by Precepting Tomorrow’s Nurses) was introduced in the Senate in May 2023 and the House in January 2025. Neither version has yet advanced beyond committee.
But, if passed, a clinician who provides at least 200 certified precepting hours in a health professional shortage area (HPSA) could claim a $2,000 tax credit. It’s a relatively small step—the maximum credit would come out to about $10 an hour—but it’d be something to build on and signal precepting as a critical piece of workforce infrastructure worthy of public investment.
“I would love to see broader incentives such as tax credits and tuition remission or other university perks,” Dr. Heuer says. “Clinics and institutions need to value and prioritize clinical education across the board so that NPs are given time to precept and the recognition they deserve for their efforts.”
Matt Zbrog
WriterMatt Zbrog is a writer and researcher from Southern California, and he believes nurse practitioners (NP) are an indispensable component of America’s current and future healthcare workforce. Since 2018, he’s written extensively about the work and advocacy of NPs, with a particular focus on the rapid growth of specialization programs, residencies, fellowships, and professional organizations. As part of an ongoing series on state practice authority, he’s worked with NP leaders, educators, and advocates from across the country to elevate policy discussions that empower NPs. His articles have featured interviews with the leadership of the American Association of Nurse Practitioners (AANP), the National Association of Pediatric Nurse Practitioners (NAPNAP), and many other professional nursing associations.