Medical Executive Committee: Proctoring vs. Precepting

Premier Pulse     September 2020

Belcastro_336x336By Marc Belcastro, DO, system chief medical officer, Premier Health

As we balance the need for nimbleness in granting privileges to physicians and Advanced Practice Providers (APPs), it remains important to protect the integrity of this process to ensure that our patients are receiving great care from properly trained clinicians. While sometimes used interchangeably, precepting and proctoring are very different processes, but each may be equally valuable to physicians and APPs depending upon the situation.  

  • Proctor – to supervise or monitor a skill someone already possesses
  • Precepting – a “training up” for a skill not currently acquired

While these concepts may be more familiar to APPs, physicians do occasionally encounter situations that will utilize either or both paths. Precepting can occur in a formal course, a simulation, and/or at the bedside to gain a new skill. Proctoring occurs during the observation of real or simulated clinical scenarios.

When a physician or APP requires a preceptorship for new or additional privileges (i.e. the desire to acquire a new skill through training) that will take place with patients within the hospital, it is critical that these request(s) first be made to the medical staff office for further instruction. This is to ensure that forms have been completed and appropriate approvals have been obtained. Preceptorships must be approved through the medical staff’s privileging process before a physician or APP can begin training in the hospital.

Proctoring should be viewed as a peer review tool, and certain proctoring that takes place in a simulation or through a formal course does not require approval through the medical staff process. However, proctors will generally provide certificates and/or signatures attesting to competency, and these documents will be needed when the next step/level of practice is requested through the medical staff.

Following this process will provide consistent safe care for our patients, and allow our clinicians to be trained as rapidly as possible.

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