Description of Methods:  Prior to implementing the curriculum change, the director of the school of nursing and faculty reviewed similar courses at other schools of nursing, the literature about the topic, the Board of Nursing guidelines related to clinical supervision, and discussed the changes with local hospital nursing administrators in the region.  Faculty interested in developing the course worked to develop a basic course description as part of the new curriculum. 

Course Implementation:  Agencies participating in the practicum experiences were sent copies of the course materials and a request for preceptors in various inpatient hospital units.  Students were able to request the hospitals and types of units they desired for their practicum experience and requests were granted when preceptors were available.  The course practicums were scheduled during the second half of the last senior semester. The course culminated with seminar presentations by the students of instances where they believed that they had made a difference in patient care outcomes.

Summary:  The course change was positively received by the hospitals, preceptors, faculty, and students.  Students were offered positions as new graduates on the units they had been with their preceptors and many students elected to stay in the region after graduation.  The development of the clinical practicum experience illustrated that to be successful; a change of this magnitude must be approached slowly and with networking to gain the support of the stakeholders.  

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