You selected the application to host a Supervised Practice Experience (SPE) in your facility.

Before you begin the application, have you reviewed the SPE information, including the host responsibilities and requirements, here: Supervised Practice Experience Program? 

To apply, you must complete and submit the following form.  Submitted forms are sent directly to the CLPNS Registrar, who will review your application.

Agreement

By submission of this form, your organization agrees to the following: 

• Orient the SPE participant to the practice setting, relevant employer policies and procedures, and resources, and provide any other required training.
• Evaluate the participant and submit the required evaluation forms to the CLPNS.
• Offer a Supervised Practice Experience for a minimum of 240 hours where participants can apply nursing knowledge, skills and judgment, and demonstrate an understanding of the CLPNS’s Standards of Practice and Code of Ethics.
• Appoint a primary LPN, RN or RPN preceptor to supervise the SPE participant throughout the experience and provide preceptor training.
• Arrange for and appoint a replacement preceptor if the primary is unavailable.
• Provide the participant with feedback, both positive and negative.
• Request an extension if, in the organization’s opinion, the participant requires more time to successfully complete the SPE.

Additional Information: 

• Host organizations have the right to terminate an SPE at any time (e.g. due to lack of progress, unsafe practice, misconduct, etc.). The organization must immediately notify the CLPNS if an SPE is terminated.
• The assigned supervising nurse should not have any pre-existing relationships with the applicant (e.g. employment, family, social/ personal, business).
• Existing materials in the practice setting should be made available to the applicant, but the applicant is responsible for obtaining any additional texts or resource materials.