Family Nurse Practitioner Students Research Articles

Improving Family Nurse Practitioner Students’ Confidence for Clinical Decision Making and Presenting Patient Information to the Preceptor

Family nurse practitioner (FNP) students often lack the confidence to develop diagnostic skills and convey patient information to their clinical preceptor. Preparing FNP students for these tasks is essential to their clinical success. To describe the adequacy of interactive case studies to increase confidence in making clinical decisions and presenting patient information to the clinical preceptor. The authors developed three interactive case studies for student analysis during an on-campus intensive week prior to the students' first clinical rotation. Student confidence was examined pre and post to determine if the interactive cases had any effects on their diagnostic reasoning and skill in presenting patients to the preceptor. The pretest survey found that students were least confident in presenting a patient to the preceptor (21% not confident). After the three interactive case studies, students demonstrated a significant increase in confidence. Interactive case studies and role-playing the patient presentation prior to an initial clinical rotation is a successful educational methodology for improving FNP students' confidence for the clinical environment. Faculty can implement interactive case studies in traditional and online courses to foster student confidence.

The impact of interprofessional education on family nurse practitioner students' and family medicine residents' knowledge and confidence in screening for breast and cervical cancer.

This study determined the impact of an interprofessional education (IPE) simulation on family nurse practitioner (FNP) students' and family medicine residents' (FMRs) self-reported confidence in counseling women reluctant to engage in cancer screening or evaluation and assessed knowledge of breast and cervical cancer risk factors. A multi-item knowledge survey on breast and cervical cancer risk factors was administered to 76 FNP students and FMRs followed by an IPE simulation with a pre-/postsurvey of self-reported confidence in counseling a woman reluctant to have breast and cervical cancer screening and evaluation. Data demonstrated knowledge deficits in breast and cervical cancer risk factors in both disciplines with the average risk factor knowledge score of 8.5/12 for breast cancer and 7.8/12 for cervical cancer. Following IPE simulation, confidence in counseling women reluctant to have breast or cervical cancer screening improved across both disciplines (p < .05) and debrief feedback findings suggest improved attitudes toward collegiality, communication, and understanding of other interprofessional roles among both disciplines. Knowledge gaps exist among both FNP students and FMRs in breast and cervical cancer risk factors. This study suggests IPE simulation is effective in building individual provider confidence and team collegiality.

Family Nurse Practitioner/Psychiatric Mental Health Nurse Practitioner Collaboration in Drug-Seeking Telephone Triage Simulation in an Advanced Practice Registered Nurse Curriculum

BackgroundMany advanced practice nursing programs incorporate interprofessional collaboration into the curriculum. Few combine intraprofessional collaboration between nurse practitioner (NP) students of different population foci. Telephone triage is a skill that is rarely covered in NP education. DescriptionWe describe a simulation program in which family nurse practitioner (FNP) students collaborate with psychiatric mental health nurse practitioner (PMHNP) students in a drug-seeking telephone triage scenario. The patient was portrayed by an improvisational actor. Forty-seven FNP students and 14 PMHNP students participated in the scenario. OutcomeStudents reported that the telephone triage scenario was useful and that they would be more likely to both collaborate with and refer patients to NPs from the other specialties. ConclusionsWith some modifications, combining FNP and PMHNP students in a telephone triage simulation scenario is beneficial to both groups of students.

Piloting a Short-term Volunteer Medical Mission as Clinical Placement for Family Nurse Practitioner Students.

Piloting a Short-term Volunteer Medical Mission as Clinical Placement for Family Nurse Practitioner Students.

Debriefing Virtual Simulation Using an Online Conferencing Platform: Lessons Learned

Debriefing is a critical conversation following simulation to reframe the context of a situation, facilitate students’ reflection, assess critical thinking, evaluate learning, and improve future performance. However, there is a significant gap in the literature regarding how to effectively debrief following immersion in virtual simulation. The International Nursing Association for Clinical Simulation and Learning (INACSL) Standards of Best Practice: SimulationSMDebriefing (2016) were developed to support effective simulation and learning when incorporated with design and development; yet, debriefing for virtual simulation may not have been fully conceptualized when the standards were established. Alternative debriefing methods specifically aimed at debriefing virtual simulation must be explored and implemented in order to “enhance learning and heighten participant self-awareness and self-efficacy” (INACSL Standards Committee, 2016, p. S21). This article provides an example of how a synchronous, Web-based Internet conferencing platform was used to conduct debriefing sessions following immersion in an asynchronous virtual learning environment with family nurse practitioner students in an online graduate program. The lessons learned and recommendations are generalizable for all simulation populations.

A longitudinal online interprofessional education experience involving family nurse practitioner students and pharmacy students

ABSTRACTInterprofessional education (IPE) continues to gain traction worldwide. Challenges integrating IPE into health profession programmes include finding convenient times, meeting spaces, and level-appropriate assignments for each profession. This article describes the implementation of a 21-month prospective cohort study pilot programme for the Master of Science in nursing family nurse practitioner (FNP) and doctor of pharmacy (PharmD) students at a private university in the United States. This IPE experience utilised a blended approach for the learning activities; these students had initial and final sessions where they met face-to-face, with asynchronous online activities between these two sessions. The online assignments, discussions, and quizzes during the pilot programme involved topics such as antimicrobial stewardship, hormone replacement therapy, human papilloma virus vaccination, prenatal counselling, emergency contraception, and effects of the Affordable Care Act on practice. The results suggested that the FNP students held more favourable attitudes about online IPE and that the PharmD students reported having a clearer understanding of their own roles and those of the other participating healthcare students. However, the students also reported wanting more face-to-face interaction during their online IPE experience. Implications from this study suggest that effective online IPE can be supported by ensuring educational parity between students regarding the various topics discussed and a consistent approach of the required involvement for all student groups is needed. In addition, given the students desire for more face-to-face interaction, it may be beneficial to offer online IPE activities for a shorter time period. It is anticipated that this study may inform other programmes that are exploring innovative approaches to provide IPE to promote effective collaboration in patient care.

Current Resources for Evidence-Based Practice, March/April 2017

Published simultaneously in the Journal of Midwifery & Women's Health, 62(2). Mary Kern, BSN, SNM is a nurse-midwifery and family nurse practitioner student at Emory University's Nell Hodgson Woodruff School of Nursing in Atlanta, GA. Nicole S. Carlson, CNM, PhD is an assistant professor at Emory University's Nell Hodgson Woodruff School of Nursing in Atlanta, GA.

Primary Care Health Professionals’ Knowledge of Sun Safety

ABSTRACT It is well known that sun and ultraviolet exposure can increase the risk of skin cancers in individuals (New York State Department of Health, 2014). However, there is a lack of guidelines in primary care regarding routine skin examination for adolescents and insufficient evidence regarding sun safety education for all patients and their families in healthcare settings. Our study aimed to assess knowledge on sun safety and sun damage among healthcare professionals by surveying 50 family nurse practitioner students enrolled in the course of Diagnosis and Management II at Columbia University School of Nursing in the Year 2015. We hypothesized that the knowledge of sun safety will increase with our intervention of an educational pamphlet to participants. Our results reflect a lack of knowledge regarding sun safety among healthcare professionals. Despite the limitations in our study, it did show that pamphlet distribution on sun safety education does increase healthcare professionals’ knowledge. With increased awareness of sun safety in primary care health, health professionals will have the ability to influence individuals on positive habits that can prevent the development of skin cancer.

If You Teach It, They Will Screen: Advanced Practice Nursing Students' Use of Screening and Brief Intervention in the Clinical Setting

In the United States, approximately 30% of adults drink at risky levels or meet the criteria for harmful or dependent alcohol use. Screening, brief intervention, and referral to treatment (SBIRT) in primary care settings is indicated. This study assessed whether knowledge, attitudes, and beliefs about SBIRT, evaluated after a three-part, mixed-methods training, predicted whether 21 family nurse practitioner (FNP) students screened for alcohol use during clinical patient encounters. After training, students completed a survey and documented implementation of SBIRT during their clinical practice-specific management courses. FNP students who reported higher levels of perceived competence in their posttraining surveys were more likely to screen for alcohol in the clinical setting. Screening for alcohol misuse and identifying patients engaged in hazardous drinking meet important nurse practitioner competencies. Further research is needed to explore training programs that specifically emphasize activities to increase perceived competence, knowledge, and comfort regarding SBIRT.

Preparing Nurse Practitioners for Competence in Providing Sexual Health Care

The preparation of the next generation’s workforce to combat the HIVepidemic will need to take a multipronged approach. Despite the fact that HIV medications have continued to be increasingly more effective, prevention is still an essential component for fighting the epidemic. For the nursing workforce of the future, this means that preparation of advanced practice nurses should not focus specifically on the specialty of HIV medicine, but also on knowledge, skills, and comfort practicing in the area of sexual health. Sexual health is defined as a condition of well-being in body, mind, and social functioning with regard to all aspects of sexuality, including gender identity and sexual orientation (World Health Organization, 2006). Health care providers frequently lack the necessary skills to deliver optimal sexual health care (Brennan, Barnsteiner, Siantz, Cotter, & Everett, 2012; Dorsen, 2012; Eliason, Dibble, & Dejoseph, 2010; Institute of Medicine, 2011). This includes the ability to perform a sexual history and physical examination; to demonstrate cultural competence with regard to the needs of sexual minorities such as lesbian, gay, bisexual, and transgender (LGBT) individuals; having current diagnosing, treatment, and prevention information regarding sexually transmitted diseases (STD) and HIV; and having the ability to provide appropriate contraception to patients. We describe a program for training Family Nurse Practitioner (FNP) students at the University of San Francisco (USF) that emphasizes developing competence in sexual health. This step is important to prepare a health care workforce that is equipped to provide effective HIV prevention as well as care to those already infected.

Transdisciplinary educational strategy for improving prescribing skills in family nurse practitioner students

Dermatologists must be familiar with the peculiarities of the micro-organisms that may affect the elderly, in order to optimize the diagnosis and treatment of infections, which may affect their skin, especially because the world population is rapidly aging. It is estimated that there will be 434 million individuals over 80 years of age in 2050.Since the elderly population is rapidly increasing and their infections are usually more severe and different from those observed in younger adults, it leads to a statistical increase of the rates regarding hospitalization and mortality caused by infectious diseases among people over 85 years.Other health issues may be involved in the older population. These include nutritional alterations, as malnutrition or obesity, which can aggravate the infections. Also the usual signs and symptoms of infection are subtle or uncharacteristic in elderly patients, and frequently, they are unable to report their symptoms, which can delay the diagnosis.Among the many infections that may affect the elderly we reviewed the most frequent and those that are different in this age group, as herpes zoster, cytomegalovirus, herpes simplex, bacterial skin infections, erysipelas, celullitis, impetigo, folliculitis, furunculosis and carbunculosis, secondary infections, intertrigo (body folds), fungal infection, and scabies.

Incorporating Standardized Patients Into an Interprofessional Oral-Systemic Health Practicum

Poor oral health and dental disease are major public health problems that are, in many cases, directly or indirectly linked with chronic conditions. Interprofessional collaborative teams are a way to address this problem. In this study we describe the development of an interprofessional education and interprofessional collaborative practice endeavor utilizing standardized patients to teach and evaluate clinical competencies in oral-systemic health and interprofessional collaborative practice settings. This pilot project paired family nurse practitioner students with student dentists to enhance the education of both groups. Standardized patients provided a safe and supervised environment to provide performance feedback and formatively evaluate student performance.

Evaluation of graduate nursing students' information literacy self-efficacy and applied skills.

Maintaining evidence-based nursing practice requires information literacy (IL) skills that should be established prior to completing an undergraduate nursing degree. Based on Bandura's social cognitive theory, this cross-sectional descriptive correlational study assessed the perceived and applied IL skills of graduate nursing students from two family nurse practitioner (FNP) programs in the midwestern United States. Results showed that although the 26 newly admitted FNP students demonstrated a high level of confidence in their IL skills, the students did not perform well in the actual IL skills test. According to Bandura, the students' confidence in their IL knowledge should allow students to be engaged in course activities requiring IL skills. Nurse educators teaching in undergraduate or graduate programs are in key positions to incorporate IL experiences into class activities to allow for skill assessment and further practice. Further research is needed on nursing students' IL self-efficacy and performance.

Online Learning: Integrating Interprofessional and Patient Safety Competencies Into Doctor of Nursing Practice and Doctor of Pharmacy Curricula

Although integrated interprofessional education is widely endorsed, few reproducible models for accomplishing this have been published. An online interprofessional team-based learning module focusing on patient safety was integrated into existing final clinical management courses for doctor of nursing practice family nurse practitioner students and doctor of pharmacy students. Medication error case studies, root cause analysis of the errors, and interprofessional communication formed the backbone of the module. Upon completion of the learning module, the majority of students agreed or strongly agreed that they had achieved competencies based on Interprofessional Education Collaborative Expert Panel core competencies.

Use of Mini-CEX tool to assess clinical competence in family nurse practitioner students using undergraduate students as patients and doctoral students as evaluators.

Use of Mini-CEX tool to assess clinical competence in family nurse practitioner students using undergraduate students as patients and doctoral students as evaluators.

The impact of multiuser virtual environments on student engagement

The purpose of this pilot study was to test the hypothesis that web-based synchronous instruction utilizing Multi-user Virtual World Environments (MUVEs) increases student engagement compared to traditional asynchronous learning methods. In a quasi-experimental two group posttest only study, a sample of Family Nurse Practitioner students (n = 21) received instruction using either a synchronous (n = 10) or asynchronous (n = 11) learning method. Engagement was measured using the Community of Inquiry survey. Results indicated that engagement scores were significantly higher for the synchronous learning platform (mean = 3.61, SD = 1.13) compared to the asynchronous learning platform (mean = 3.49, SD = 1.08, t(1766) = −2.21, p < 0.05). Increased student engagement with synchronous MUVE platforms have the potential to improve learning outcomes and offer nursing students a multitude of educational opportunities to practice new skills and behaviors in real life scenarios, all within the safety of a controlled environment.

Interprofessional education in community-based Alzheimer’s disease diagnosis and treatment

As the population ages and understanding of Alzheimer’s disease (AD) improves, the number of older adults diagnosed and treated for AD and related dementias is projected to increase. Dementia diagnosis, treatment and patient and family education are complex processes best done through collaboration among healthcare professions. The educational program described in this article aimed to create an interprofessional team approach to the diagnosis and treatment of dementia involving medical and family nurse practitioner students. A two-group treatment/control pretest posttest design was used to measure changes in knowledge, attitudes and appreciation for an interprofessional team approach to patient care. Findings from this interprofessional program demonstrated that nurse practitioner students gained higher levels of knowledge regarding AD, and medical students gained more positive attitudes toward these patients and their caregivers. Comments from students indicated that both medical and nursing students found the experience valuable. Understanding the roles that various providers play will help healthcare professional meet the challenge of caring for the increasing number of patients with memory loss and for their families.

Objective Structured Clinical Evaluation Effectiveness in Clinical Evaluation for Family Nurse Practitioner Students

BackgroundThis study examined the relationship between family nurse practitioner (FNP) students' scores on objective structured clinical evaluation (OSCE) and faculty assessment of clinical skills. MethodsRetrospective data were analyzed for FNP students (n = 52) who had completed six OSCEs and the three requisite clinical courses. Performance scores on OSCEs were compared with clinical course grades. ResultsA significant regression equation was found when testing between the clinical grade for the first clinical course and OSCE 1 and OSCE 2 (F(1, 50) = 10.086, p = .003), with an R² of 0.168. There were nonsignificant findings for the second and third clinical courses. ConclusionsOSCEs can identify student weaknesses and strengths and help faculty guide students in strategies to improve clinical skills. The results provide needed evidence for the use of OSCEs, especially in terms of graduate nursing education.

Family nurse practitioner student perception of journal abstract usefulness in clinical decision making: A randomized controlled trial

To assess family nurse practitioner (FNP) student perception of research abstract usefulness in clinical decision making. A randomized controlled trial conducted in a simulated environment with graduate FNP students of the Graduate School of Nursing, Uniformed Services University of the Health Sciences. Given a clinical case study and modified MEDLINE search tool accessible via an iPad device, participants were asked to develop a treatment plan and complete a data collection form. The primary measure was perceived usefulness of the research abstracts in clinical decision making regarding a simulated obese patient seeking to prevent type 2 diabetes. Secondary measures related to participant demographics and accessibility and usefulness of full-text manuscripts. The majority of NP students identified readily available research abstracts as useful in shaping their clinical decision making. The presence or absence of full-text manuscripts associated with the abstracts did not appear to influence the perceived abstract usefulness. The majority of students with full-text manuscript access in the timed simulated clinical encounter read at least one paper, but cited insufficient time to read full-text as a constraint. Research abstracts at point of care may be valuable to FNPs if easily accessible and integrated into clinical workflow.

Creative Approaches for Teaching Advanced Pharmacology Online to Family Nurse Practitioner Students

Creative Approaches for Teaching Advanced Pharmacology Online to Family Nurse Practitioner Students