Health Nurse Practitioner Students Research Articles

Psychotherapy Skills for Psychiatric Mental Health Nurse Practitioner Students in the Age of Competency-Based Education.

As the field of nursing moves toward competency-based education, faculty need to adapt teaching and learning strategies to meet standards for assessing core behaviors of graduate psychiatric mental health nurse practitioner students. This article reviews a psychotherapy skills-based learning assignment at Frontier Nursing University that was adapted to meet developing competency-based learning standards. The assignment utilizes prerecorded video scenarios to provide students with opportunities to reinforce psychotherapy skills during didactic coursework. Assessment is conducted via an analytic rubric and specific feedback is given to each student in writing.

Stress Impact and Care for COVID-19: Pilot Education and Support Course Decreases Burnout Among Nursing Students.

Nurses and nursing students have been at the forefront of the fight against COVID-19, often working in conditions that produce stress injuries and burnout. Early recognition and mitigation of stress and emotional trauma help prevent burnout. To evaluate the effectiveness of an online 8-hour stress awareness course and associated 1-hour support group in reducing stress and burnout among nursing students. We conducted a program evaluation for an online stress awareness pilot course offered to nursing students. The course, and associated support groups led by trained psychiatric mental health nurse practitioner students, included a common language for talking about stress, screening tools for recognizing stress injuries, and strategies for improving self-care. Students completed pre- and post-course surveys. Outcome measures included changes on course learning objectives, level of burnout, health-related locus of control, and experiences of stress and coping. Nursing students (n = 360) enrolled in the course, and 224 (62%) completed pre- and post-course surveys. Sixty percent rated the course excellent or very good. Depression Anxiety and Stress Scales and Impact of Event Scale Revised scores were within established normal ranges. There was a significant increase in all nine course learning objectives (p < .001) and decreased signs of stress (p < .001). Students' level of burnout decreased by odds ratio = 0.58 (95% CI: [0.4, 0.9], p < .006). Nursing leaders can use psychoeducational strategies to mitigate the impact of stress, build confidence, and support nursing students entering the workforce during these unprecedented times.

Teaching Psychotherapy to Psychiatric/Mental Health Nurse Practitioner Students in the Virtual Classroom

The aim of this quality improvement project was to evaluate student satisfaction and achievement of select core competencies in psychotherapy by Psychiatric Mental Health Nurse Practitioner (PMHNP) students enrolled in a newly developed, and virtually delivered psychotherapy course. Both qualitative and quantitative data were collected to assess students’ competencies in five domains (i.e. professionalism, cultural diversity, ethical/legal standards of care, reflective practices, and application of knowledge and skills) and satisfaction with content and delivery using simulation and virtual sessions. Using pre- and post-training surveys, we found that competencies in the five domains increased from an average score of 3.1 to 4.5. Integrating a virtual psychotherapy course in advanced nursing education, bringing PMHNP students together to learn about interviewing clients, applying various psychotherapeutic modalities and techniques across diverse cultures, and maintaining ethical and legal standards of care is a challenging but achievable endeavor. We found that using a version of an APA self-assessment tool that was used in psychiatric residency training programs was an effective way to assess PMHNP students’ knowledge, skills, and attitudes on these core competencies. Although this training course proved to be effective in imparting appropriate skills, there is a need to develop sophisticated methods to evaluate how students use complex psychotherapy skills in the clinical setting.

Stakeholder perceptions of the efficacy, barriers, and facilitators of telemental health clinical experiences during COVID for nurse practitioner students.

Telemental health services grew during the COVID pandemic, resulting in psychiatric-mental health nurse practitioner students obtaining clinical hours through this modality. Although patient outcome data demonstrate the efficacy of telemental health services, data on the efficacy of learning through telehealth clinical experiences are lacking. To explore perceptions of learning through telehealth clinical experiences by students, preceptors, and faculty and to identify perceived barriers and facilitators to facilitating telehealth clinical experiences. Mixed-methods exploratory study using web-based, researcher-designed, cross-sectional surveys eliciting perceptions of learning and perceived barriers and facilitators to telemental health clinical experiences sent to current and former PMHNP students and their preceptors of a state university in the southwest along with PMHNP faculty in the National Organization of Nurse Practitioner Faculties. Students and preceptors were offered the option to participate in a semistructured interview. Twenty students (35.7%), 22 preceptors (24.7%), and 19 faculty (25.3%) participated in the surveys. Three preceptors and three students volunteered for interviews. Telemental health clinicals were perceived by students as equivalent to or superior to in-person learning. Preceptors rated the teaching/learning environment through telemental health as equivalent or better as compared with in-person clinicals with two exceptions. Faculty-rated greatest barrier to telemental health clinicals was telephone visits because of technology issues. Telemental health clinicals can provide a high-quality learning experience for students. Preceptors should be provided with resources for facilitating telemental health clinicals. Ongoing discussions regarding the number of clinical hours recommended through telehealth are needed.

Adaptation of the TEAM Mental Healthcare Delivery Model: A Mixed-Methods Evaluation

ABSTRACT We report on the adaptation and evaluation of an existing approach to multicultural education into an eight-session online, modular curriculum for psychiatric mental health nurse practitioner students (n = 6) and psychology interns (n = 10). Training participants were invited to complete verbal feedback, self-report questionnaires, and a high-fidelity patient simulation before and after the training. Self-report questionnaire results revealed no changes in knowledge or attitudes, but qualitative analysis of verbal feedback reflected improvements in attitudes and behaviors relevant to cultural competence. Results from the simulation also demonstrated an increase in measurable cultural competence behavioral indicators.

Health History Skills for Interprofessional Learners in Transgender and Nonbinary Populations.

Transgender and nonbinary peoplehave been identified as vulnerable and clinically underserved and experience health disparities. Lack of health care provider knowledge about transgender and gender diverse populations is a barrier to care, impacting health outcomes. The aim of this project was to develop, implement, and evaluate a simulation learning activity for midwifery and women's health nurse practitioner students and obstetrics and gynecology residents to interact with transgender and nonbinary individuals, with the goal of enhancing health history taking comfort and skills. A partnership was formed among University faculty and simulation educators, a community clinic providing gender-affirming care, and members of transgender and gender diverse populations who served as patient-teachers. Two cases frequently encountered in clinics providing care to transgender individuals were developed for the simulation. Learners were divided into interprofessional groups of 3 and completed one of 2 case scenarios with a patient-teacher. Learners and patient-teachers debriefed after the simulation to discuss and reflect on the experience. Thirty-three learners participated in the simulation, 12 midwifery students, 16 women's health nurse practitioner students and 5 obstetrics and gynecology residents. Significant differences were observed for all comfort and skills questions, showing increased perceived comfort and skills from pre- to postsimulation. There were no significant differences in attitude responses. We successfully created and implemented a new sexual and reproductive history taking skills simulation in partnership with community clinic staff and transgender and nonbinary persons. The session was well received by learners and patient-teachers. Learners demonstrated significant improvements in comfort and skills in history taking in this setting and provided favorable feedback about the experience. This simulation can serve as a guide to others providing education to future midwives, women's health nurse practitioners, and obstetrician-gynecologists.

SBIRT and MI Training among School Nurses and Psychiatric Mental Health Nurse Practitioner Students: A Pilot Study of Competency and Acceptability

Madridge Nursing Journal is an excellent investment for nursing professional, hospitals, libraries, and academic institutes. This journal include general publications of interest to all those working in the nursing field. Reports of original work, research, reviews, and policy papers focusing on professional nursing are published.

Psychiatric mental health nurse practitioner student perceptions of integrated collaborative care.

To explore the outcomes of threading the Patient-Centered Integrated Behavioral Health Care Principles and Tasks Checklist (AIMS Checklist) into the curricula and experiential setting. A qualitative exploratory descriptive method with a constructivist epistemology was used to obtain in-depth student perspectives about their understanding, experiences, and process of applying Integrated Collaborative Care within the clinical setting. 24 Psychiatric Mental Health Nurse Practitioner Students (PMHNP) were divided into focus groups that yielded seven main themes and seven subthemes. Three of the identified themes emerged as opportunities for curriculum enhancement. The checklist was found to be a valuable tool in not only evaluating collaborative care but in closing the gap between didactic and clinical education in fostering student-preceptor discussion.

Exploring Readiness for Teleprecepting in Psychiatric Mental Health Nurse Practitioner Training.

Telehealth offers a solution to many challenges in health care, including the shortage of psychiatric providers. Recently the need to limit patient and provider exposure to coronavirus disease 2019 (COVID-19) has escalated implementation of telehealth across the globe. As telehealth utilization expands, its role in nursing education and training requires systematic evaluation. Since publication of the National Organization of Nurse Practitioner Faculty white paper supporting telehealth in health care delivery and nurse practitioner education, several studies have demonstrated successful didactic instruction and training in telehealth. However, a recent literature review found no studies evaluating the use of telehealth technology as a means of precepting in clinical training. This small-scale qualitative study investigates the readiness of one behavioral health clinic to provide teleprecepting to psychiatric mental health nurse practitioner students. Two preceptors and one student were interviewed using a peer-reviewed semistructured interview guide using video chat. Responses were reviewed, coded, and categorized into themes. Thematic analysis of the interviews revealed three categories for consideration in establishing teleprecepting. Clinical factors, logistics, and comparison with traditional precepting are discussed. Interviewees viewed teleprecepting as a viable method of increasing access to clinical training. This project supports teleprecepting as a feasible strategy for improving access to clinical training and as a technological resource that merits systematic evaluation. Practice guidelines are needed for teleprecepting of advanced practice registered nurse students, and both preceptors and students may benefit from training to support best practices prior to implementation.

Advancing Racial/Ethnic and Cultural Sensitivity Among PMHNP Students Through Education, Practice, and Experience.

BACKGROUND: There is an increased need for mental health providers to be more attuned to behavioral health needs of racial/ethnic/cultural minorities and the role of social milieus. AIMS: We prioritized training and assessing racial/ethnic and cultural sensitivity among psychiatric mental health nurse practitioner students throughout coursework, clinical practice, and experiences in underserved settings. METHOD: Prior to beginning clinical coursework, students completed a course on culturally competent care where we measured their (n = 26) perception of their ability to be racially/ethnically sensitive providers at the beginning and end of the semester, demonstrating significant improvement. During clinical coursework, preceptors measured students' racially/ethnically and culturally sensitive clinical behaviors with patients. RESULTS: Sensitivity of students in clinical training significantly improved over a semester of clinical supervision. Our results indicated that placements in underserved settings improved students' racial/ethnic/cultural sensitivity but only among advanced students. At final evaluation, advanced students in underserved settings self-reported significantly higher racial/ethnic and cultural sensitivity than students not in an underserved setting. CONCLUSIONS: Our data suggest that we can produce more racially/ethnically and culturally sensitivity providers through coursework, supervised clinical practice, and experiences in underserved settings. These data are preliminary, and we plan to follow up these results and replicate this work with other cohorts in future semesters.

Simulation Clinical Experience of Veteran Care Competence for Psychiatric Mental Health Nurse Practitioner Students with Standardized Patients

Objective: The purpose of this simulation educational activity was to assist psychiatric mental health nurse practitioner students (PMHNPs) with identifying military veterans as a vulnerable group with health care disparities and provide competent military veteran care in the private sector. Mindful of all the varied terms for military service, this article will use the term military veteran. Methods: The simulation educational activity included applying the conceptual frameworks of the healthcare disparities framework (HDF) and nursing education simulation framework (NESF). The psychiatric nurse practitioner students participated in a mandatory clinical standardized patient (SP) simulation for veteran care competence. Results: The learning was assessed in the debriefing following the student’s performance in the SP simulation scenario. Anecdotally, the students reported that the activity was well received and a valuable learning experience for their practice. Conclusions: SP simulation may increase PMHNPs’ quality of assessment of military veterans and treatment to decrease healthcare disparities. Additionally, the education of PMHNPs with military veteran care competence will increase the availability of health care providers in the private sector, where many military veterans are seeking care.

Innovative Clinical Training Site for Psychiatric Mental Health Nurse Practitioner Students: Elementary School-Based Group Therapy (Manuscript ID UMHN-2017-0143)

ABSTRACTThe aim of this clinical training site innovation is to develop accessible pediatric mental health clinical training sites for psychiatric mental health nurse practitioner (PMHNP) students. Mental health services in school settings provide treatment in the child's community and create opportunities for innovation and collaboration with teachers, school counselors, and school psychologists. School settings provide opportunities for early recognition of anxiety symptoms and accessible treatment that can help close the gap in clinical training sites for this population. Mild and moderate symptoms of anxiety often go untreated and may affect academic performance negatively. Cognitive behavioral play therapy is an effective treatment modality provided by PMHNP students and supports the roles of school personnel.

Innovative Clinical Training Site for Psychiatric Mental Health Nurse Practitioner Students: Elementary School-Based Group Therapy (Manuscript ID UMHN-2017-0143)

Innovative Clinical Training Site for Psychiatric Mental Health Nurse Practitioner Students: Elementary School-Based Group Therapy (Manuscript ID UMHN-2017-0143)

Improving Quality and Safety in Graduate Education Using an Electronic Student Tracking System

The Institute of Medicine report on the future of nursing, the Quality and Safety Education for Nurses initiative, and the Technology Informatics Guiding Education Reform movement are among the most prominent forces guiding change related to information technology and informatics in nursing to improve quality and safety in practice. Informatics competencies are essential for psychiatric nurses to leverage and integrate information technology into education, practice, and research. This article examines informatics and information technology from the perspective of educational preparation of the psychiatric mental health nurse practitioner. Literature related to informatics, information technology, and quality and safety in advanced practice psychiatric nursing. Strategies for integration of information technology in educating psychiatric mental health nurse practitioner students are described. Informatics competency will result in safer and higher quality care.

Emergency contraception knowledge among nurse practitioner students

The purpose of this study was to ascertain the knowledge level of nurse practitioner (NP) students about emergency contraception (EC), and to explore attitudes about EC that may intersect with willingness to prescribe EC. Four hundred and sixty-seven NP students completed a 30-item web-based survey using Vovici survey software. Students who reported formal content on EC in their program of study showed significantly better mean knowledge scores (t= 5.279, df = 459, p < .001). Gaps in NP students' knowledge of EC mechanisms of action, understanding of indications and contraindications were apparent. Younger students (F(3,457) = 4.994, p < .002), those newer to nursing (F(4,456) = 6.641, p < .0005), and women's health NP students (F(4,445) = 3.488, p < .008), demonstrated significantly better knowledge. Attitudes regarding EC appeared to be tied to the respondent's knowledge about EC. Knowledge is an important factor in informing NP practice decisions. Clinicians need accurate, evidence-based knowledge to provide health education and counseling to reproductive age women if unintended pregnancies are to be reduced.

An Integrated Mental Health Clinical Rotation

The most common site for accessing mental health care is the primary care setting. Yet, primary care nurses are not adequately prepared to treat the complex mental health needs of these patients. Similarly, providers in segregated mental health sites do not adequately address physical health needs. New educational models are needed to better prepare nursing graduates to provide holistic care. The integrated mental health model, which colocates mental health specialists in primary care sites, is designed to do this. This article describes key curricular elements of a successful interprofessional clinical rotation within an integrated mental health team that included the use of case studies, a standardized mental health screening instrument, a quality improvement process, and a patient satisfaction questionnaire. Family nurse practitioner and psychiatric mental health nurse practitioner students learned to collaborate with each other and with other members of the interprofessional team to provide holistic care.

Standardized Patients: A Creative Teaching Strategy for Psychiatric-Mental Health Nurse Practitioner Students

In this article, a learning strategy for psychiatric nurse practitioner students in a research-intensive university is described. The strategy actively involved students in experiences with standardized patients. The course content included review of the causes, manifestations, assessment, and diagnoses of psychopathology across the lifespan. The goal was for students to build diagnostic reasoning skills so they could conceptualize case formulations and examine differential diagnoses related to mental disorders. Faculty simulated complex mental health disorders in a controlled environment where students practiced assessment and diagnostic skills with feedback from faculty, peers, and the standardized patients. On completion of the course with six different standardized patient situations and a final standardized patient scenario that involved assessment, diagnosis, and creation of a formal paper about the case, the students demonstrated excellent interviewing skills, confident assessment abilities, appropriate use of screening and diagnostic tools, and accurate diagnosis of the standardized patients.