CMS counted 2,732,655 Medicare fee-for-service beneficiaries who used telehealth in Q3 2023, using Part B claims plus enrollment data for services from Jan 1, 2020, through Sep 30, 2023 (claims received by Feb 15, 2024).
That number’s important for preceptors because it’s a reminder that virtual visits are still part of everyday care, so whether you’re already precepting or currently lining up NP preceptors for rotations, teaching in telehealth can be a normal, well-run part of clinical education when it’s set up with intention.
This article offers a telehealth workflow you can repeat, teaching “microskills” that fit naturally into virtual care, and boundaries that protect your attention so precepting stays a professional joy instead of an energy leak.
The Two-Screen Sandwich
Teleprecepting gets easier when you stop treating it like a special event and start treating it like clinic flow.
The reason is straightforward: telehealth is no longer rare for clinicians. CDC’s National Center for Health Statistics reported telemedicine use among office-based physicians rose from 15.4% in 2019 to 86.5% in 2021. That report draws on the 2021 National Electronic Health Records Survey, which sampled 10,302 physicians, with 1,875 completing all key items (and it uses NCHS standards for reporting proportions).
So, what does “clinic flow” look like on video? Start by deciding where the student sits in the visit, and where you sit. The easiest model to run consistently is what can be called a “two-screen sandwich”: the student leads, you observe and step in at defined moments, and you both come back together for a short debrief.
A few small decisions do most of the heavy lifting:
- Decide how you’ll communicate privately during the visit (a secure chat channel, a brief pause, or a quick handoff).
- Decide when you’ll enter (start, mid-visit for assessment, or at plan time).
- Decide what “good enough” documentation looks like for this rotation.
CMS also clarifies that “telehealth visits” in its trends report are routine office visits via video and that it includes audio-only telehealth in the same service category for reporting. That’s useful for precepting because your student needs to learn how to do excellent medicine when the patient has video, and when they don’t.
Microskills with Macro-Results
Once the workflow is steady, the teaching telehealth becomes calmer, and the student’s growth becomes easier to see.
One reason teleprecepting can work well is that it naturally exposes thinking. In person, a student can get busy doing tasks; on video, the student’s words and structure are the focus. That’s a gift for teaching.
There’s also evidence that programs have been able to move to teleprecepting at a meaningful scale. A peer-reviewed report describing one NP program’s rapid teleprecepting approach noted that 72% of students (n = 151) transitioned to teleprecepting within seven months after COVID-related disruptions. That doesn’t mean teleprecepting fits every clinical objective, but it does show it’s operationally doable when expectations are clear.
Treat the telehealth platform as a coaching tool, not just a camera. Chat can support quick “next question” prompts, and screen-share can turn patient education into a shared task instead of a monologue.
To keep it simple, set one primary teaching target per session. Not per patient, per session. For example, you might choose:
- Agenda-setting in the first 60 seconds
- A clean, verbal problem representation before the plan
- A patient-friendly explanation of the “why” behind one recommendation
A small afterthought that tends to pay off: teleprecepting rewards pre-commitment. The same teleprecepting guidance that helped programs implement quickly also emphasizes preparation and explicit expectations, because clarity up front prevents confusion later.
Burnout-Proof by Design
Teleprecepting feels sustainable when it’s designed to protect your attention, not test your endurance. That’s realism with a plan.
Burnout is already a measurable issue in the workforce, including among nurse practitioners. A large Veterans Health Administration survey study reported nurse practitioner burnout at 39.6% in 2023, and it operationalized burnout using two Maslach Burnout Inventory items (emotional exhaustion and depersonalization), counting burnout when symptoms occurred once a week or more.
The goal here isn’t to squeeze more out of yourself. It’s to make teleprecepting predictable.
Use boundaries that are simple enough to repeat even on a packed schedule:
- Pin supervision to moments, not interruptions. Decide in advance when you’ll join the visit and when the student should pause for input, so your day isn’t a string of surprise pings.
- Make documentation rules explicit. Agree on when notes are due, what you will personally verify, and how attestation will happen, so “I wasn’t sure” doesn’t turn into extra work at 7 p.m.
- Standardize the tech backup. Decide what happens if the video fails (audio-only, reschedule, switch platform), and where each person will sit for privacy, so troubleshooting doesn’t become the emotional center of the rotation.
- Protect a real debrief. Keep it short, but make it non-negotiable, because that’s where clinical reasoning gets shaped into a habit.
This is where teleprecepting can quietly improve your precepting life: the boundaries aren’t cold, they’re kind. They reduce friction for the student, too, because students do better when the rules of the room are clear.
And a question worth sitting with at the end of a clinic block: if teleprecepting lets you observe more of a student’s reasoning in real time, what would change if “supervision” became more about coaching patterns than chasing details?
A Better Pipeline with Less Workload
CMS reminds us, through ongoing claims-based reporting, that telehealth use persists well beyond the early-pandemic surge, even as the agency cautions that the data are preliminary and subject to claims lag because claims are collected for payment and program purposes, not public health surveillance. That’s the honest frame: teleprecepting is worth doing because telehealth is still being used, and it’s worth doing carefully because time and attention are limited.
When teleprecepting works, it’s not because the preceptor works harder. It’s because the work is arranged better: a repeatable visit flow, small teaching targets that fit naturally into virtual care, and boundaries that keep the role sustainable.
There’s a forward-looking upside here that’s easy to miss. Teleprecepting can expand what “clinical access” means for students when geography or site capacity would otherwise narrow their options, as long as the teaching is structured and the expectations are explicit.
So, pick one workflow you can repeat, one micro-skill you’ll coach this week, and one boundary that protects your attention.
As with anything you read on the internet, this article on telehealth should not be construed as medical advice; please talk to your doctor or primary care provider before changing your wellness routine. WHN neither agrees nor disagrees with any of the materials posted. This article is not intended to provide a medical diagnosis, recommendation, treatment, or endorsement.
Opinion Disclaimer: The views and opinions expressed on telehealth in this article are those of the author and do not necessarily reflect the official policy of WHN. Any content provided by guest authors is of their own opinion and is not intended to malign any religion, ethnic group, club, organization, company, individual, or anyone or anything else. These statements have not been evaluated by the Food and Drug Administration.
