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DNP programs require a minimum of 1,000 clinical hours, as stipulated by the AACN and enforced by CCNE accreditation. Nurse anesthesia DNP programs require a minimum of 2,000 clinical hours and 600 clinical cases under COA accreditation. Many DNP clinical hours are completed at approved clinical sites under the guidance of a qualified preceptor. That means DNP students have to go through a complex clinical placement process in order to earn their doctorate.
This guide to DNP clinicals demystifies the entire journey, from understanding direct care requirements in each DNP specialty to tips on securing preceptors. Learn more about the pros & cons of guaranteed, managed network, and self-arranged placements. Use the clinical placement timeline to map out your steps. And get answers to FAQs about practical concerns such as simulation hours and physician preceptors.
How Many Clinical Hours Does a DNP Require?
The American Association of Colleges of Nursing (AACN) has set the standard of a minimum of 1,000 post-baccalaureate practice hours for all DNP graduates. This 1,000-hour standard includes both direct care and indirect care clinical hours. See the DNP Essentials guide for more info on what is expected from these in-depth experiences within practice environments.
In BSN to DNP programs, you’ll be expected to complete the full 1,000 hours set by AACN standards. In post-master’s DNP programs, you will supplement your existing clinical hours from your master’s degree with additional hours. In most cases, up to 500 hours can carry over into a DNP from your MSN.
- Direct Care Clinical Hours: Direct care clinical hours will involve hands-on patient encounters under the supervision of a qualified preceptor. You’ll complete these hours in practicums & rotations that are focused on your chosen specialty.
- Indirect Care Clinical Hours: Indirect care clinical hours cover non-patient activities such as care coordination, quality improvement, financial & operational planning, executive training & mentorship, and policy analysis. In a leadership-focused DNP, indirect care hours may make up the majority of the degree.
Aspiring nurse practitioners (NPs) should be aware that the National Task Force on Quality Nurse Practitioner Education (NTF Standards) has set a standard of 750 direct patient care clinical hours for NP training. See our DNP Clinical Hours by Specialty section for more on this matter.
How Many Clinical Hours Does a BSN to DNP Require?
CCNE-accredited BSN to DNP programs are designed to include 1,000 post-baccalaureate clinical hours, per the AACN’s requirement. Hours will be split between direct care and indirect care experiences; the ratio depends on which DNP specialty you’re pursuing.
- APRN Tracks: Students who enroll in a BSN to DNP program that’s focused on direct patient care should expect to complete a minimum of 500 direct care hours in a clinical setting, but most doctorates will exceed this threshold. Nurse-midwifery programs frequently contain 600+ direct care hours. Nurse practitioners should expect 750 direct care hours, as specified by NTF Standards. In a full-time, 3-year BSN to DNP program, practicums & clinical rotations are often scheduled in the second and third years.
- Indirect Care Tracks: Not every BSN to DNP track is patient-care focused. Leadership, executive, administration, and nurse educator tracks still contain the full 1,000 hours set by AACN, but these hours will be devoted to training in those areas. For instance, aspiring nurse leaders may be required to complete practicums or internships built around organizational, quality improvement, informatics, patient safety, and policy-level issues.
Note: ACEN-accredited programs in APRN specialties must also have 1,000 hours, but non-APRN specialties can have a minimum of 500 clinical/practicum hours at the DNP level.
How Many Clinical Hours Does an MSN to DNP Require?
After you have completed clinical hours in your MSN or the master’s-portion of your BSN to DNP degree, you’ll be expected to tackle additional clinical hours to meet the 1,000-hour standard set by the AACN. Clinical hours in a post-master’s DNP are overwhelmingly project-based and tied to DNP-level practice competencies (e.g. leadership, systems, informatics, quality improvement, and evidence-based practice).
- DNP Project Hours: Many DNP programs bundle all of their post-master’s hours into the DNP project process—needs assessment (e.g. stakeholder interviews), proposal development (e.g. literature review and methodology design), project implementation, project evaluation, and project dissemination (e.g. final paper, poster, and/or oral defense). These hours are often overseen by a faculty chair/DNP project committee in close collaboration with practice partners and mentors.
- Practicums & Internships: Some schools include an additional leadership practicum that’s devoted to organizational and systems-level training. You’ll see this element more frequently in nurse executive programs.
Post-master’s DNP hours are usually completed at an organizational/practice site, which can be your own workplace or an approved clinical agency. This is where you would be meeting with stakeholders, collecting data, rolling out new interventions or protocols, and the like. The work is systems-focused, rather than patient-encounter-focused.
DNP Clinical Hours by Specialty: At a Glance
This comparison table of DNP clinical hours by specialty provides a quick breakdown of required hours in each discipline, including direct care minimums. These minimums apply to CCNE-accredited DNP programs; ACEN-accredited programs allow 500 clinical hours for non-APRN tracks.
| Specialty/Track | Hour Type | Total Clinical Hours Minimum | Governing Standard |
|---|---|---|---|
| Nurse Practitioner (NP) | Primarily direct care under a qualified preceptor | 1,000-hour AACN total; 750 direct care hours (excludes simulation) | NTF Standards (6th ed., 2022) |
| Nurse-Midwifery | Primarily direct care under a CNM/CM-credentialed preceptor | 1,000-hour AACN total; no ACME minimum for direct care, but many programs exceed 600 hours | ACME accreditation standards |
| Nurse Anesthesia | Primarily direct care (case-based) | 2,000 clinical hours + 600 clinical cases | COA accreditation standards |
| Clinical Nurse Specialist (CNS) | Approximately 50% direct care | 1,000-hour AACN total; 500 clinical practicum hours for CNS role | NACNS Position Statement (2024) |
| Nurse Executive/Leadership | Primarily indirect/leadership-focused | 1,000-hour AACN total | AACN Essentials |
| Nurse Educator | Primarily teaching & education-focused | 1,000-hour AACN total | AACN Essentials |
Note: Follow the links in the specialty/track column to explore your field. Each specialty guide has a comprehensive state-by-state directory of available DNP programs. You can also use the directory’s curriculum links to learn more about the way clinical hours have been structured.
DNP Specialty Clinical Hours: Direct Care vs. Indirect Care
Nurse Practitioner (NP) Tracks
When it comes to direct care, AACN’s Essentials framework sets 500 clinical practice hours as the baseline for demonstrating advanced-level competencies. However, the 6th edition of NTF Standards from the National Task Force on Quality Nurse Practitioner Education (2022) now requires NP tracks to contain 750 direct patient care clinical hours. So you should expect to see this 750-hour standard applied across DNP programs. Direct care hours in a DNP NP program can include telehealth and global experiences, but simulation hours are deliberately excluded.
Nurse-Midwifery
The Accreditation Commission for Midwifery Education (ACME) doesn’t stipulate a direct care hour minimum for nurse-midwifery programs, but it does specify that 50% or more of students’ clinical experiences must come from a CNM/CM-credentialed preceptor. In its pre-accreditation criteria, it also recommends encounter targets by care category: primary care, gynecologic care, antepartum care, and intrapartum care (including access to at least 35 births). In reality, many Nurse-Midwifery DNP programs will exceed 600 direct care clinical hours.
Nurse Anesthesia
The Council on Accreditation of Nurse Anesthesia Educational Programs (COA) requires a minimum of 2,000 clinical hours for nurse anesthesia DNP or DNAP programs—well above the standards for other DNP tracks—along with a minimum number of 600 clinical cases that cover a variety of procedures, techniques, and specialty practice. Clinical rotations in a DNP or DNAP are typically full-time for the final 18 months to 2 years of a 36-month program. Due to the intensive nature of the clinical training, Nurse Anesthesia DNP programs are almost always hybrid or on-campus in nature.
Clinical Nurse Specialist (CNS)
The National Association of Clinical Nurse Specialists (NACNS) has stated it supports the requirement of a minimum of 500 clinical practicum hours for master’s degree and post-master’s certificate programs preparing CNS graduates. (DNP students fold this 500-hour requirement into their 1,000 hour minimum.) NACNS discussed raising the bar to meet the 750-hour NTF Standards minimum in its 2024 Position Statement on Clinical Hours, but it decided against it for various reasons (e.g. cost/access barriers, lack of outcome differences, etc.).
Nursing Leadership/Nurse Executive
Unlike specialty tracks that focus on direct patient care, there’s no specialty accreditation body for nursing leadership programs. The American Organization for Nursing Leadership (AONL) has developed competencies for leadership coursework, but AONL isn’t an accreditor and it doesn’t set a practice-hour requirement. So you can expect to complete at least 1,000 post-baccalaureate practice hours with a blend of direct & indirect care experiences. Before you apply, dig down into the curriculum to understand what’s expected.
Nurse Educator
The CCNE does not accredit DNP programs with education as the primary focus, since it states that the major focus of the education program should be on the area of practice, not the process of teaching (see the CCNE DNP Programs & Accreditation FAQs for more info). However, you’ll still find plenty of DNP nurse educator programs being offered. These types of programs can help you add teaching skills to your existing clinical knowledge. They may blend education-focused hours such as curriculum design & teaching practicums with DNP project work.
What Are the Different Types of DNP Clinical Placements?
Guaranteed DNP clinical placements mean that the School of Nursing and its faculty have taken on the responsibility of securing clinical sites and preceptors for students, usually through a network of partner sites. Managed network clinical placements mean that the school maintains a roster of pre-vetted contracted sites & preceptors for students to choose from. Self-arranged DNP clinical placements mean that the student bears the brunt of identifying, contacting, and securing sites and preceptors.
One of the major decisions that DNP students face is deciding between the three models—use our summary table to get a quick read on the issue, then take a look at our list of the benefits of each pathway.
| What to Consider | Guaranteed Placement | Managed Network Placement | Self-Arranged Placement |
|---|---|---|---|
| Who Finds the Site | Program identifies & assigns sites | Coordinator presents pre-vetted options; you select from the roster | You identify and secure sites, with faculty approval |
| Choice of Location | Limited—may mean relocation or a longer commute | Moderate—choice is limited to sites already in the network | Flexible—you choose the location, often close to home |
| If a Site or Preceptor Falls Through | School has backups in its network | Coordinator reassigns from the existing roster | You have to re-secure a placement yourself |
| Administrative Burden on You | Low—schools have a coordinator who arranges | Low-to-moderate—coordinator handles compliance, you choose from options | High—affiliation agreements, preceptor vetting, paperwork |
| Best Fit For | Students who want the school to handle logistics | Students who want some choice without doing the vetting/compliance work | Students with existing site & preceptor relationships or niche needs |
Note: It’s important to state that some school-arranged programs still don’t guarantee placement. Instead, they may state that they make every effort to secure sites and achieve 100% placement, but it’s up to the student to ensure they complete their hours.
Guaranteed Clinical Placements
Guaranteed clinical placements can be a godsend for busy DNP students. Instead of spending your time frantically searching for sites and preceptors, you can concentrate on your studies. Having said that, some DNP alumni point out that it can be frustrating to have no choice in where clinicals are conducted. And it may be an impossible dream for online and hybrid DNP students. Here’s where the guaranteed model shines:
- Guaranteed placement takes all of the administrative burden off your shoulders. Clinical placement coordinators will be responsible for logistics such as document and clearance requirements, site assessments and communications, student relocation compliance, and tech support.
- Guaranteed placements are designed to give you the full spectrum of clinical experience. Conducting clinical hours at sites in your area risks narrowing your exposure to a diverse mix of populations and needs.
- Guaranteed placements can help you build long-lasting and extremely useful career connections within the school’s site network (e.g. academic medical centers).
- Guaranteed placements can be a godsend for DNP students in certain groups, areas, and specialties (e.g. OBGYN & women’s health rotations). If you’re specializing in a niche area of interest, you may find it hard to secure placements without the school’s help.
- Programs that guarantee placement will have backup sites in their network for reassignment. If a self-arranged preceptor withdraws or a site loses accreditation, DNP students in that scenario have to scramble to re-secure a placement.
Managed Network Clinical Placements
The managed network model lies in-between the guaranteed and self-arranged models. It allows you some choice in clinical sites and preceptors while still retaining administrative support from the School of Nursing. If you’re interested in this type of model, ask the DNP program coordinator if you can see a list of sites and preceptors in the network before you apply.
- Unlike guaranteed placements, managed networks give you the option to choose from a carefully curated roster of sites—you’re not locked into a single unilateral assignment.
- In many managed network situations, a clinical placement coordinator will work with you to identify ideal work environments and preceptors.
- Since sites are pre-contracted, there’s no waiting around for 60-90+ days while schools and sites wrestle over affiliation agreements. That paperwork has already been done!
- You won’t have to worry about issues like state board approval since network sites are already pre-vetted and compliant.
- If your preceptor decides to withdraw, you’ll be reassigned from the existing roster, rather than have to re-secure a placement from scratch.
Self-Arranged Clinical Placements
Although self-arranged clinical placements in DNP programs can be challenging, they aren’t necessarily bad, especially if you have chosen a degree from a highly-ranked brick & mortar university. Self-arranged sites are still subject to ongoing faculty oversight—not just initial approval—and most programs require at least one site visit from the university per semester (often done virtually).
- DNP students can use self-arranged clinical placements to train close to home and build relationships in the community where they intend to work after graduation. School-arranged placements may mean much longer commutes and no choice in where students are placed.
- Some DNP programs will allow you to complete clinical practicum hours at your place of employment. Some will prohibit workplaces, but allow you to obtain placements in another setting within your work’s larger healthcare system. That means you could have direct access to sites and preceptors with no commute times.
- If you live in an area with unique healthcare needs, you may wish to focus on specific niche sites that are not included in a school’s established network (e.g. subspecialty clinics, underserved population clinics, particular birth center models, etc.).
- If you have already cultivated relationships with mentors, you can skip the matching/waitlist process entirely.
Keep in mind that securing self-arranged placement sites and finding qualified preceptors is a tedious process. Many programs require signed affiliation agreements 60-90+ days before a rotation starts; out-of-network sites can take even longer since the school’s legal/compliance team has to draft a new agreement from scratch. This may cause severe delays.
Another issue for self-arranging is preceptor shortages. Some DNP students are now turning to paid clinical placement services when they run out of options. Choosing to go down the paid preceptor route can add hundreds to thousands of dollars to your baseline tuition.
In addition, out-of-state online DNP students trying to arrange their own placements often have to navigate issues such as SARA reciprocity for the school’s distance learning authorization; state board of nursing approval for clinical placements; and licensure requirements. These areas can be a major source of frustration!
The DNP Clinical Placement Process: Typical Timeline
The DNP clinical placement process involves identifying, vetting, and securing authorized clinical sites and qualified preceptors for any required practicums. To help you plan your calendar, we’ve created a timeline of the typical milestones that take place in this process and who is responsible for each task. Tasks will vary depending on whether the DNP involves self-arranged, managed network, or guaranteed placements.
| Step | Typical Timing | Who’s Responsible | What Happens |
|---|---|---|---|
| 1. Confirm Your Program’s Placement Model | Enrollment | Student | Determine whether your program guarantees a clinical site, offers a managed network to select from, or expects you to self-arrange. This shapes every step that follows. |
| 2. Begin the Preceptor/Site Search | 6-12 months before clinical hours begin | Student (self-arranged) | Guaranteed-placement and managed-network students usually skip this step. If self-arranging, start contacting potential preceptors and sites. |
| 3. Select or Submit a Preceptor | Several months before rotations start | Student (self-arranged); School verifies | Self-arranging students submit preceptors’ credentials for full vetting—CV, license verification, vetting questionnaire, proof of clinical practice. |
| 4. Affiliation Agreement Is Confirmed | 2-3 months before rotations start for new/self-arranged sites; often immediate for in-network sites | School | A legal agreement between the school and clinical site must be in place before hours can begin. New or out-of-network sites require a fresh agreement drafted from scratch; managed-network sites already have a standing agreement, so this step moves much faster. |
| 5. Clinical Rotations Begin | Per your program’s plan of study | Student | You begin completing clinical hours at approved sites under your preceptor’s supervision. |
| 6. Ongoing Site Visits & Monitoring | At least once per semester; can be conducted virtually | School | Faculty or a clinical placement coordinator continue monitoring the placement, not just approving it upfront—typically through a site visit. |
| 7. Hours Are Tracked and Verified | Ongoing throughout each rotation | Student; School verifies | You log clinical hours, often through a system like Typhon or E*Value; the school checks them against program milestones. |
| 8. Final Verification for Graduation | Final semester, prior to graduation | School | The placement/credentialing office confirms your total hours meet the 1,000-hour AACN minimum before conferring your degree. |
What Happens If You Can’t Find a Clinical Placement?
If you can’t secure a clinical placement, you have a number of options, but they will depend on whether you’re dealing with a managed network model or a self-arranged model. In a guaranteed or managed network situation, schools will usually be able to reassign you. In a self-arranged model, you will need to be more proactive.
Before you apply for any DNP program with a self-arranged model, ask about the following issues:
- Preceptor & Site Availability: Some specialties and regions have documented preceptor & site shortages. How will the School of Nursing help you overcome these clinical placement challenges?
- Leave of Absence Policies: You may be placed on a leave of absence if you can’t complete a clinical rotation, so always check on the school’s leave-of-absence policies before applying to a DNP program. How will your DNP program handle this delay?
- Extension Agreements: You should also ask whether the DNP program allows you to extend your time to graduation without academic penalty and what the typical limits are for these extensions.
- Financial Implications: If you can’t secure a clinical placement, will you be liable for additional tuition & fees during those off-semesters? Will a delay affect your financial package and/or satisfactory academic progress (SAP) requirements?
The more time you give yourself to secure clinical sites and preceptors, the easier your life will be when things don’t work out. Self-arranged students who are struggling with clinical placements should contact the clinical placement office as soon as possible. Some Schools of Nursing will be able to connect you to placement services and third-party preceptor matching services when internal options have been exhausted.
On-Campus vs. Hybrid vs. Online DNP: What to Know About Clinical Placements
Regardless of the delivery format (on-campus, hybrid or online), clinical placements in a DNP will follow the same pattern—all DNP students must complete 1,000 clinical hours, per AACN standards. Any direct care clinical hours will involve in-person experiences at an approved clinical site under the guidance of a qualified preceptor. Indirect care hours can often be completed at your workplace or an approved organizational/practice site.
Where the delivery formats tend to differ is when it comes who is responsible for arranging clinical placements. Here’s a summary of the differences:
- On-Campus DNP Programs: Since DNP students are local to the institution, on-campus DNP programs are often able to guarantee clinical placement through university-affiliated partners (e.g. academic medical centers). This isn’t a hard-and-fast rule, however—you will need to check before applying. Some on-campus DNP programs may offer extensive help in securing placements, but won’t guarantee them.
- Hybrid DNP Programs: Hybrid DNP programs are mix of online coursework, periodic on-campus intensives & immersions, and clinicals. On-campus intensives in a hybrid DNP may include skills labs, clinical training, and/or simulation experiences, but clinical hours are still usually completed at local sites under a preceptor. You will often need to arrange these clinical placements yourself (self-arranged model).
- Online DNP Programs: In online DNP programs, didactic coursework is delivered online/remotely and clinical hours are completed at an approved practice site in your local area. Occasionally, online DNP programs will guarantee clinical placement, but most will expect you to find your own sites and preceptors (self-arranged model).
Who Can Be a DNP Preceptor?
The CCNE defines a preceptor as an experienced practitioner who guides a student’s hands-on learning within the preceptor’s own area of clinical expertise. In real-world terms, this means they meet the following baselines:
- Certification: DNP preceptors are usually national certified in their specific field of interest. The one exception is nursing leadership, where a leadership or executive certification is usually preferred, but not mandatory.
- Licensure: DNP preceptors often must hold active, unrestricted licensure in the state where clinical hours are being completed.
- Education: DNP preceptors typically have a master’s or doctoral degree (or the equivalent specialized qualification).
- Work Experience: DNP preceptors are actively working in their areas and have enough experience to train others.
Keep in mind that any preceptor must be approved by a DNP program before you can study under them. Schools of Nursing will usually expect preceptors to complete a vetting questionnaire covering credentials and experience, submit a current CV, and provide proof of at least one year of clinical practice. In some programs, schools have set a 2-year minimum requirement.
DNP Preceptor Requirements by Specialty
There will also be specific preceptor guidelines for DNP specialty tracks. Here is a table of common requirements across CCNE-accredited programs, but be sure to check with individual DNP programs to understand what’s expected.
| Track | Required Credential/Certification | Licensure | Minimum Experience | Distinguishing Feature |
|---|---|---|---|---|
| Nurse Practitioner (NP) | NP preceptors should have national certification in the NP specialty being precepted | Active, unrestricted state license | Typically 1-2 years (program-specific) | NP preceptor rules are governed by individual program policy and informed by NTF; interprofessional precepting is acceptable when aligned with learning objectives. |
| Nurse-Midwifery (CNM) | AMCB certification for CNMs & CMs; MD/DO for obstetrician-gynecologists; national certification for NPs | Active, unrestricted state license | Program-specific | Although a range of preceptors are allowed, CNM/CM students must be supervised 50% or more of clinical time by a CNM or CM. |
| Nurse Anesthesia (CRNA) | Only practicing CRNAs (or anesthesiologists for some case types) are allowed to be preceptors | Active, unrestricted state license | Program-specific | Preceptors must be institutionally credentialed to provide anesthesia care at the clinical site & immediately available for consultation. |
| Clinical Nurse Specialist (CNS) | ANCC or AACN Certification Corp. for CNS preceptors; national certification for others | Active, unrestricted state license | Preferably 1-2 years of independent clinical practice | Population-focus-specific certification may be required (e.g. ACCNS-P for Pediatric CNS). |
| Nursing Leadership | Master’s or doctoral degree in nursing or BSN with a master’s in a relevant field (e.g. MBA, MHA, etc.); national certification may be preferred, but not required | Active, unrestricted RN license (or another license appropriate to their executive role) | Typically at least 1-2 years in a formal leadership/executive role | Leadership preceptors have broader eligible degree fields; typical job titles include CNO, CNE, VP of Nursing, Nurse Manager, etc. |
Note: Thinking of studying under an MD or DO? Some DNP programs will allow physicians to serve as preceptors, but this will often be specific to the specialty and the state. For example, UNCW explicitly allows MD/DO preceptors for its FNP track—alongside NPs, CNMs, and PAs—provided they’re currently licensed and board certified in North Carolina.
Practical Tips for Finding a Preceptor for DNP Clinicals
Finding qualified preceptors for DNP clinical hours is one of the key pain points for students who are responsible for self-arranged clinical placements—so the trick lies in being prepared. Before you apply for a DNP program, here are some tips to help you understand how the preceptor process can be made easier.
- Learn whether you have to find DNP preceptors: Does the School of Nursing provide new DNP students with a list of approved preceptors? Or do you have to cold-call and solicit them yourself? If you already have existing relationships with potential preceptors, this may not be a big issue. But it can be extremely challenging for those without them.
- Understand what’s required of DNP preceptors: DNP programs will have to vet the credentials of your preceptors and ensure they meet requirements for your chosen specialty. Check out our section on Who Can Be a DNP Preceptor? for more info on this process.
- Get a firm number on how many DNP preceptors are required: Multi-rotation NP tracks and nurse-midwifery programs may expect you to have several preceptors who can cover the required practice areas. Map out the program’s required rotation types before you start searching.
- Reach out early—ideally 6-12 months before clinicals start: Seasoned DNP graduates suggest contacting officers in professional nursing organizations (e.g. AANP, state nursing association, etc.) and reaching out to past clinical instructors well before clinical hours begin. Veterans say that 6-12 months will give you some breathing room if your first choices don’t pan out.
- Talk to the school about DNP preceptor stipends: Some preceptors will be expecting schools to provide stipends or continuing education (CE) credits. What’s the school’s policy on this? Do they offer preceptor incentives? Will you have to negotiate stipends directly?
- Ask about your administrative tasks: Will a clinical placement coordinator handle the administrative paperwork for DNP preceptors or do you have to do it all? For instance, schools may make it your responsibility to personally check the preceptor’s license against the state board’s licensee-search database and provide proof of an active license.
- Make sure you have backups: If your DNP preceptor doesn’t meet the baseline requirements or drops out, what will you be required to do next? Will the school step in and help you secure a preceptor through their own networks? Or will they simply say—we’ll delay your graduation until you find a new one? Line up a few potential preceptors to shield yourself from this issue.
DNP Clinicals Glossary
| Term | Definition |
|---|---|
| Preceptor | A preceptor is a qualified, experienced healthcare professional who provides one-on-one supervision and acts as a clinical instructor and mentor during the clinical section of the DNP. In the case of an APRN program, this might be a licensed APRN. In the case of a leadership program, this might be a doctorally-prepared executive, CNO, or healthcare director. |
| Clinical Placement Coordinator | A clinical placement coordinator is responsible for helping DNP students secure clinical sites and preceptors for their program. They may be able to guarantee clinical placements or they may be able to provide valuable logistical support to students who are responsible for finding their own sites and preceptors. |
| Affiliation Agreement (or Clinical Site Agreement) | An affiliation agreement is a legal document between a school and clinical site that must exist before a DNP student is allowed to complete clinical hours at the site. Getting these agreements signed can be a real bottleneck when it comes to practicums. |
| Practicum | Practicums typically refer to clinical rotations that DNP students complete at an approved site. Just to take one example, an FNP student might be expected to complete 750 direct care clinical hours spread out over 3-5 practicums (pediatric, adult, geriatric, women’s health) in a BSN to DNP program. |
| Practice Immersion Hours | The AACN uses the term practice immersion hours to refer to both direct and indirect care hours. DNP programs, regardless of delivery format, must have a minimum of 1,000 post-baccalaureate practice immersion hours. |
| Clinical Hours | Universities frequently use the term clinical hours to refer to both direct care and indirect care hours. So when you examine the curriculum or plan of study, they may list the number of clinical hours after hands-on NP practicums (direct care) and the DNP project (indirect care). Then they’ll add together the total number of hours to signal they’ve met the 1,000-hour AACN minimum. |
| Direct Care Hours | Direct care hours can be defined as hours that involve hands-on training in direct patient care. DNP students complete these under the supervision of a preceptor. |
| Indirect/Non-Direct Care Hours | Indirect or non-direct care hours refer to practical training in areas like research, quality improvement, and administrative work. These hours will count towards the AACN’s 1,000 total practice hours minimum, but they do not involve work with patients. |
FAQs: DNP Clinicals
How Do Clinical Hours Work in a BSN to DNP Program?
BSN to DNP students are required to complete 1,000 post-baccalaureate hours in order to meet AACN minimum standards. These hours can be a combination of direct care hours involving patients and indirect care hours involving areas such as administrative and research work. Nurse Anesthesia DNP programs are the one exception—they have a minimum mandate of 2,000 clinical hours and 600 clinical cases.
How Do Clinical Hours Work in a Post-Master’s DNP Program?
Post-master’s or MSN to DNP students usually enter a program with preexisting clinical hours earned during their master’s studies. During their DNP studies, they will be expected to add to those hours with DNP-specific clinical hours to reach at least 1,000 hours in total. The DNP project will account for a large portion of these hours.
Are DNP Clinical Hours the Same for Every Specialty?
No. Although all DNP programs must have a minimum of 1,000 per AACN standards, DNP specialties have different mixes of direct care and indirect care clinical hours. For instance, nurse practitioner (NP) specialties will have more direct care hours than leadership specialties. See our section on DNP Specialty Clinical Hours: Direct Care vs. Indirect Care for more details.
Do Accelerated or Fast-Track DNP Programs Still Require the Full 1,000 Hours?
Yes. The 1,000-hour minimum for DNP programs (or 2,000-hour minimum for nurse anesthesia programs) is fixed, regardless of the length of the degree. Accelerated or fast-track DNP programs compress the time it takes to finish the degree, not the clinical hours or the coursework requirements.
Can You Use Simulation Hours for DNP Clinical Hour Requirements?
Check with the DNP program coordinator on simulation policies. For example, in a nurse practitioner (NP) program, simulation experiences can count toward the overall 1,000-hour AACN total required for DNP programs, but cannot be substituted for the direct-care hour minimum in NP tracks (750 under current NTF Standards).
What Is an Affiliation Agreement, and Why Does It Take So Long?
An affiliation agreement is a legal document between a school and a clinical site that covers issues such as liability, supervision terms, and EHR/facility access. DNP programs often require signed affiliation agreements 60-90+ days before a rotation starts. If the school has to draft an affiliation agreement for a new site that’s out of their network, that will extend the timeline even further!
Can You Complete DNP Clinical Hours at Your Own Workplace?
Possibly—DNP programs have different policies on clinical hours in workplaces, so you will need to check with the DNP program coordinator. If they do accept the workplace as a clinical site, they may specify that you cannot be precepted by a direct supervisor. Alternatively, they may specify that you complete your clinicals in a separate site that’s still within your larger healthcare institution.
What’s the Difference Between a Preceptor and a Clinical Placement Coordinator?
In a nutshell, a preceptor is responsible for supervising your clinical training in a DNP program; a clinical placement coordinator helps you handle the logistical process involved in securing clinical sites and preceptors. See the section on Who Can Be a DNP Preceptor? for more info.
What Kind of Preceptors Are Required for Direct Care Clinical Hours?
Direct care hours typically require a credentialed clinical preceptor—a licensed APRN, physician, or the equivalent—who is able to work one-on-one with you in a patient-care setting. See the section on Who Can Be a DNP Preceptor? for a useful chart of DNP Preceptor Requirements by Specialty.
Do DNP Project Clinical Hours Require a Preceptor?
Not in the traditional sense of direct care hours (see above). DNP project clinical hours still require oversight and documentation. However, you will typically be supervised by a faculty chair/DNP project committee and a mentor or organizational champion at the site where you are completing your DNP project (e.g. nurse leader, CNO, or department head).
Does a Physician Preceptor Count for DNP Clinical Hours?
The answer varies by program and specialty. A number of DNP specialty tracks are quite willing to consider MDs and DOs as preceptors. In the case of tracks like nurse-midwifery or nurse anesthesia, they may have to be doctors in specific fields (e.g. obstetrics, gynecology, anesthesiology, etc.). Check with the DNP program coordinator before you start approaching physician preceptors.
Can You Complete DNP Clinical Hours in a State Where You Aren’t Licensed?
Possibly—the answer will depend on your state laws, your DNP program policies, and the types of clinical hours you are completing. Some states allow DNP students to complete clinical hours without holding an RN or APRN license in that state if the experience is educational and supervised. Other states will expect students to obtain a temporary permit or hold a license before participating in clinical activities. NP students will usually need to have a state license for anything involving direct care hours.
How Are Clinical Hours Tracked, Logged & Verified?
DNP students are responsible for logging their clinical hours using systems like Typhon or E*Value to log hours. The clinical placement office will typically verify the totals.
Do You Need Malpractice Insurance for DNP Clinical Rotations?
Some Schools of Nursing will provide blanket malpractice insurance coverage for their students; others will expect DNP students to carry individual coverage.
Who Pays for Background Checks and Drug Screening for Clinical Sites?
Students are typically responsible for paying for background checks and drug screenings in a DNP program. Re-screening may be required if there’s a gap in enrollment or a new clinical site with different requirements.