Nurse Practitioner Course Research Articles

Collaborative framework to assess achievement of American Association of Colleges of Nursing and National Organization of Nurse Practitioner Faculties patient-centered competencies using evolving case studies

BackgroundThe American Association of Colleges of Nursing (AACN) and National Organization of Nurse Practitioner Faculties (NONPF) emphasize the role of clinical reasoning in nurse practitioner (NP) competencies. Evidence-based clinical reasoning is vital to patient safety. Collaborative technology tools can aid in assessing progress towards achieving clinical reasoning competency. Purpose/aimsThe purpose of this article is to describe an electronic, collaborative learning framework to teach and assess second year NP students in systematically selecting and eliminating diagnoses and forming treatment plans. Design/methodsPost gap analysis, the collaborative learning framework was created. This visual, collaborative resource was scaffolded across two sequential advanced NP second year clinical synthesis courses and embedded with evolving case studies. Students identified pertinent positives and negatives from the history, physical, and diagnostic findings. Each student developed a unique differential diagnosis and plan of care and critiqued their peers. Result/findingsThe tool exceeded expectations. Faculty were able to visualize data, provide clarification on interpretation of data and pharmacology, and grade in small groups. ConclusionThe collaborative learning framework provided real-time visualization of students' work in clinical reasoning. It was easy to use and integrate into second year NP courses to meet learning objectives and assess clinical reasoning competency.

Practice pathways, education, and regulation influencing nurse practitioners’ decision to provide primary care: a rapid scoping review

Background/ObjectiveInitially established to improve access to healthcare, particularly for primary care, the full potential of the nurse practitioner role is yet to be realised in most countries. Despite this, most countries are working to meet an ageing population’s increasing healthcare needs and reduce healthcare costs and access disparities. Achieving these outcomes requires reform at multiple levels, including nurse practitioner practice pathways, education and regulation, and identifying the barriers and facilitators to optimising their primary care role.MethodsA rapid scoping review of nurse practitioner practice pathways, education and regulation inclusive of: (1) a systematic search of Medline and CINAHL for peer-reviewed English language articles, including opinion pieces published between January 2015 and February 2022; and (2) a web-based search of nurse practitioner program entry requirements of International Nurse Regulator Collaborative country members with a protected nurse practitioner title and prescribing rights, plus the Netherlands. The individually summarised search data was integrated and synthesised using Popay’s narrative approach.ResultsEmerging evidence from the included nurse practitioner courses (n = 86) and articles (n = 79) suggests nurse practitioners working in primary care provide safe, effective care and improve healthcare efficiencies. However, different regulatory and educational models are required if the primary care nurse practitioner is to meet growing demand.ConclusionsInternational variations in entry criteria, curriculum, and regulation shape the global profile of the nurse practitioner primary care workforce and their practice setting. For countries to grow their primary care nurse practitioner workforce to meet unmet needs, different entry requirements, program content and accredited post-registration transitional programs must be urgently considered.

Descriptive Analysis of Student Diagnostic and Documentation Skill Development in a low Fidelity Simulation in Psychiatric Nurse Practitioner Education.

Nursing educators face challenges in helping registered nurses prepare to be psychiatric nurse practitioners. Nursing educators must consider the variation of students' skill sets, experience levels, and the shortage of preceptors. Simulations can help overcome limited clinical sites and standardize skill acquisition. High-fidelity simulations can be helpful but are labor-intensive and expensive. Low-fidelity simulations are adaptable to fit the learning needs of psychiatric nurse practitioner students but little research has evaluated these simulations. This paper evaluates a series of low-fidelity interventions used to help students learn diagnostic criteria, treatment decisions, and documentation. A retrospective descriptive analysis was performed on the results of all students in five cohorts in a psychiatric nurse practitioner course (n=68) on 45 low-fidelity online simulations over five years during the course on advanced psychiatric nursing of adults. Diagnostic notes were graded on four criteria by a psychologist or a psychiatric nurse practitioner. A representative sample of grades on eight notes were analyzed for this manuscript. Survey responses from the students in one cohort were obtained to evaluate their confidence levels and perceptions of simulation utility and responses were analyzed using descriptive and qualitative methods. The overall mean of description, detail, completeness, and professionalism increased from 7.6 (out of 10) to 9 over the semester with statistically significant improvements in all four areas. The strongest correlation was between detail and completeness and the weakest correlation was between professionalism and description. Students reported that they found significant value in the low-fidelity simulation exercises. This analysis demonstrates one of the first efforts to analyze low-fidelity simulations for psychiatric nurse practitioner students. The data indicate these simulations can help students improve their confidence and skills in several areas.

Development and implementation of sexual and gender minority curriculum for advanced practice nursing: A feasibility study.

To explore the feasibility of development and implementation of an educational intervention addressing sexual and gender minority healthcare issues; examine recruitment processes and instrument appropriateness. Non-randomized feasibility study. The educational intervention was developed and implemented in family nurse practitioner courses with data collection from August through December 2022. Clinical preparedness, attitudinal awareness and basic knowledge were measured using the lesbian, gay, bisexual and transgender Development of Clinical Skills Scale. Development and implementation of the intervention was feasible but will require amendment before progressing to the pilot study. Clinical preparedness and basic knowledge increased post-intervention, but attitudinal awareness did not improve. Recruitment did not achieve the desired sample size. Instrument internal consistency reliability was confirmed. Feasibility was established but will require amendment prior to the pilot study. To prepare nurses and nurse practitioners to care for sexual and gender minority patients. This study addressed the feasibility of developing and implementing a sexual and gender minority healthcare education using an e-Learning platform. Findings confirm that the intervention was feasible but will require amendment. The intervention increased knowledge and clinical preparedness in caring for this population, but recruitment was challenging. This research will impact nurses, nurse practitioners and nurse educators. The authors adhered to the relevant EQUATOR guidelines. The Consolidated Standards of Reporting Trials guideline extension for reporting randomized and feasibility guidelines were used. Sexual and gender minority community members contributed to the intervention development. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: The feasibility of using interactive e-learning educational resources to provide sexual and gender minority healthcare curriculum. Evidence to support the use of the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale to measure learning outcomes. This study was not prospectively registered because it was an educational intervention involving graduate student nurses and did not assess clinical outcomes of patients.

Pathophysiology and pharmacology course grades and prediction of success in a graduate nurse practitioner program.

During a program review, faculty identified that nurse practitioner (NP) students who received a C grade in Advanced Pathophysiology (Patho) and Advanced Pharmacology (Pharm) appeared to perform poorly in the later NP management courses and on other program outcomes. The research aimed to determine whether grades in graduate Patho and Pharm courses could predict performance in NP management courses, program progression and completion, and certification pass rates. This research included deidentified student data from 2016 to 2018 across seven NP specialty tracks ( n = 4,575). Nonparametric and parametric tests were used in the analysis. A significant correlation ( p < .001) existed between Patho and Pharm grades. Lower grades in these two courses were significantly related to each other and to lower management course grades. Logistic regression showed that graduate pathophysiology grades significantly predicted certification examination performance, with lower grades associated with lower certification examination performance. Graduate pharmacology grades, pathophysiology grades, composite management course grades, and admission grade point average (GPA) significantly predicted final cumulative GPA, with lower grades associated with lower performance for all variables. Results of this research support the hypothesis that grades of C in Patho or Pharm courses significantly predict C performance in the management NP courses and lower certification success rates. The project model can be used in future research. Study findings can be helpful to NP faculty when considering curriculum decisions.

Incorporating social justice learning into competency-based graduate nursing: A discussion of integrating pedagogies.

The impact of social inequity on the collective health of a society is well documented and, despite decades of research, the problem persists on a global scale. Nurse practitioners are competent to treat the downstream health effects of social inequity, but nursing students may lack the structural awareness to accurately target primary prevention efforts. The authors discuss faculty preparation and pedagogical considerations when incorporating social justice learning into a graduate and post-graduate psychiatric nurse practitioner course. Guided by Walter's Emancipatory Nursing Praxis model, several pedagogical strategies were developed to enhance graduate nursing students' awareness of oppressive and unjust realities in the healthcare setting. Emancipatory pedagogical strategies in competency-based graduate nursing education can enhance the transformative social learning essential for the development of health equity praxis.

Implementation of an Online Breastfeeding Education Module Among Nurse Practitioner Students

Background:Lactation support for mother–baby dyads significantly impacts breastfeeding initiation and duration (Busch et al., 2014). Implementing breastfeeding-specific curricula for nurse practitioner (NP) students is fundamental for providing evidence-based lactation care (Webber &amp; Serowoky, 2017).Method:This quality improvement project evaluated the efficacy and satisfaction of an online breastfeeding education module implemented into NP courses. Surveys assessed the demographics, knowledge change, and satisfaction with the experience of online breastfeeding education.Results:Participants completed the optional module and two surveys. A 3% increase in knowledge scores was seen in the postintervention survey. Participants provided actionable feedback. Implementing breastfeeding education into the NP curriculum is feasible and desired by the students.Discussion:Population-focused NP core competencies and knowledge of current breastfeeding education in NP programs are obsolete. Innovation to establish breastfeeding education best practices is needed to produce NPs prepared to support the breastfeeding or lactating patient.

HUG Your Baby: Preparing Nurse Practitioner Students to Support Breastfeeding

Breastfeeding is known to have numerous benefits for both mothers and infants. Although the United States reports high breastfeeding initiation rates after birth, the rates of continuation are quite low at both 6 and 12 months. Breastfeeding support in the health care setting is shown to improve the duration and exclusivity of breastfeeding, yet clinicians do not receive adequate training to provide this support to patients and families. By adding the HUG (Help, Understanding, Guidance) Your Baby virtual breastfeeding education program into our women’s health and pediatric nurse practitioner courses, students showed significant gains in knowledge and confidence of breastfeeding support regardless of past personal or professional experience.

Video-Based Interactive Clinical Simulation: Preparing Nurse Practitioner Students for Clinical

Nurse practitioner (NP) education has transitioned over the years to a more robust curriculum that includes technology such as simulation. The purpose of this study was to develop and evaluate the effectiveness of a video-based simulation for clinical preparation. Students enrolled in an NP course participated in a video-based clinical simulation. Confidence and knowledge were measured by a pre, post, and post–6-month survey. Students reported more confidence in their ability to be effective on their first clinical rotation. Students also reported being satisfied with this learning experience. This study furthers our understanding of the benefits of simulation in NP education.

Flipping the classroom: An innovative approach to graduate nursing education.

Nurse educators must be prepared to adopt innovative, evidence-based teaching approaches that, like the flipped learning method, improve student learning outcomes and better prepare the nursing workforce of the future. The purpose of this paper is to provide a comprehensive plan and resources for faculty to transition a graduate nursing course from traditional lecture-based teaching to flipped learning. The flipped learning approach was fully implemented with 24 graduate nursing students in a primary care family nurse practitioner course. The process of transitioning from traditional lecture-based teaching to flipped learning is presented, including a detailed explanation of how flipped learning class sessions were facilitated. Nurse practitioner students who participated in the flipped learning course found that this method fostered engagement with the course content and improved students' confidence in their ability to apply knowledge and skills in clinical practice. The flipped learning method has the potential to increase active learning and student engagement, integration of classroom and clinical knowledge, and application of knowledge from the classroom to nursing practice.

Screen Capture Recordings Enhance Connectedness Among Students, Course Content, and Faculty.

The benefits of online education are well known and include increased access and flexibility. Despite the increased acceptance and availability of online courses, challenges exist related to increasing connectedness within the triad of students, course content, and faculty. Screen capture recordings (SCRs) are web-based audiovisual recordings that were used to deliver course materials in several nurse practitioner courses in two different educational settings. SCRs allow for meaningful feedback to be given in a warm and caring voice and were used to provide individual student feedback on assignments. Fifty students at a public university and 75 students at a private university received SCR course materials and faculty feedback. At both university settings, student response to SCR course materials and faculty feedback was overwhelmingly positive. SCRs enhance connectedness by conveying faculty tone, caring, and authentic human presence to students, thereby improving the student learning experience. [J Nurs Educ. 2020;59(9):531-535.].

Innovative strategies: Increased engagement and synthesis in online advanced practice nursing education

IntroductionThe struggle to maintain quality education in the online environment has brought about the redesign for the family nurse practitioner courses. BackgroundThe family nurse practitioner program uses graduate Health Education Systems Incorporated examination as a quality indicator and program benchmark. A downward trend in Health Education Systems Incorporated examination scores stimulated a need for change. Two strategies were implemented to enhance engagement and improve synthesis of clinical information. Case-based learning and gamification involves the use of game thinking and game mechanics in non-game contexts to engage users in solving problems while the case-based discussions act as formative assessment tool, providing information on student's progress and development. ObjectivesTo assess the implementation of innovative strategies on the Health Education Systems Incorporated examination scores and to enhance students engagement and synthesis of clinical information. MethodCase presentations were created in the Learning Management System an online program, for every module. Interwoven throughout the module are various game elements. The game elements include voluntary participation with immediate feedback that can be both positive and negative and provides a social connection. The student has the freedom to fail and the freedom to choose without significant repercussions. ResultsThe results showed examination scores increased significantly. Using a one-way analysis of variance to compare Health Education Systems Incorporated examination scores between semester cohorts of students, followed by a post hoc pairwise comparison a statistically significant difference (p < .001) between previous semesters was identified. ConclusionAlthough there are many approaches for online learning, using case presentations can mirror different social and cultural situations to challenge the learner. Case-based discussion and gamification strategies are effective in engaging students in a challenging environment. Student responded positively to case-base presentation with game elements. Using this approach is designed to challenge and add value to the learning experience.

Evaluating competency based education modules in an online nurse practitioner course

Competency based education (CBE) has been shown to improve academic performance and could help bridge the gap between education and clinical practice. There is a lack of evaluation data for new content added to courses, particularly CBEs and new technology. The aim of the study was to evaluate the use of CBE modules and GoReact technology in an online psychiatric nurse practitioner course. In a quality improvement study, four CBE modules were used to assess knowledge and clinical skills in an online psychiatric assessment course. Knowledge tests were used to assess student knowledge, adaptations of the Student Evaluation of Educational Quality Scale (SEEQ) and the Systems Usability Scale (SUS) were used to evaluate the students’ responses to the CBE modules. Faculty feedback and comparisons from prior years without CBEs were also examined. All students in the course successfully completed the CBE modules for course credit. The majority of the students who completed the surveys had a positive response to the CBEs and GoReact technology. Faculty were satisfied with using CBEs and the technology and overall student performance in the course and subsequent practicum course following the CBEs was the same or improved. CBE modules appear to be an effective and well received method of instruction in online clinical psychiatric nurse practitioner courses.

Boom in child health ANP courses is threatened by budget cuts.

Vicky Nash has been busy. She runs London South Bank University's children's advanced nurse practitioner course - the only Royal College of Nursing-accredited MSc dedicated to children in the UK.

A Phenomenological Study on Experience of Clinical Supervision by Psychiatric Mental Health Nurse Practitioners

Purpose: The main purpose of this study was to identify the essential meaning of clinical supervision for psychiatric mental health nurse practitioners. Methods: Data were collected in 2015 through individual in-depth interviews using open-ended questions from 9 women psychiatric mental health nurse practitioners. Each interview lasted about 90 minutes. Verbatim transcripts were analyzed using the Giorgi`s phenomenological analysis method. Results: The re-sults of the analysis showed the following four categories: `Barren mental health site alone`, `Enduring with reflective supervision`, `Professional competence enhanced by continuous supervision`, `Maintaining a healthy life balance as a psychiatric mental health nurse practitioner`. Conclusion: The findings in this study provide helpful insights for under-standing the need for clinical supervision in the psychiatric mental health nurse practitioner course. The results also provide support for the psychiatric mental health nurse practitioner course and practice development for psychiatric mental health nurses at the work site.

Implementing the Flipped Classroom to Enhance Nurse Practitioner Clinical Decision-Making in the Care of the Pediatric Asthma Patient

Abstract Pediatric asthma, while prevalent in primary care, relies heavily on the clinical decision-making process for diagnosis and management because of the common lack of observable symptoms on physical exam. The process of active learning through the “flipped classroom” has been shown to help engage students in the learning process. This pedagogy was implemented in a nurse practitioner course to improve clinical decision-making in the care of the pediatric asthma patient. A description of this method is described along with student feedback, methods of evaluation, and strategies for success.

Integrating Simulation into a Reflection-Centered Graduate Psychiatric/Mental Health Nursing Curriculum.

The purpose of this qualitative study was to explore reflections of student learning following a simulation experience integrated into a psychiatric/mental health nurse practitioner course. As the demand for clinical placement sites increases and availability of preceptors declines, students require experiences that will prepare them for competent patient care. This experiential learning activity was grounded in reflection-centered pedagogy, utilizing standardized patients. Three main themes emerged from the data: importance of feedback, insight gained, and improved confidence. Findings suggest that simulation is a promising approach to promote the development of competencies in graduate nursing education.

Do emergency nurse practitioners provide adequate documentation?

Documentation in healthcare services is important but often lacks detail. This article describes a pilot study of whether staff who have completed an emergency nurse practitioner course provide more detail in their patient assessments. Post-course audits demonstrate that standards of documentation had been maintained or had improved in some areas, but had declined in others.

An Advanced Practice Nursing Program for Foreign Medical Doctors:A Practical Approach

This article articulates lessons learned about an accelerated family nurse practitioner course offered to foreign medical doctors who also held baccalaureate nursing degrees (BSN). In the last decade, many physicians in the Philippines returned to school to obtain BSN degrees and licensure as registered nurses (referred to as nurse-medics) to emigrate to the United States in the hope of a better life. Once in the United States, many remain in nursing even though they prefer the practice of medicine. This fast-track master's degree program began in fall 2006 at a university in the southwestern United States in collaboration with St. Jude College in the Philippines. By the end of this program (2010), 76 students had graduated. All who sat for the FNP national certification exam passed on the first attempt. Due to a decrease in qualified applicants, the program eventually closed, but a number of important lessons were learned. Nursing programs planning to undertake accelerated programs to transition medical doctors to nurse practitioners should consider they retake courses such as physical assessment, pharmacology and pathophysiology.

‘Tech’ versus ‘Talk’: A comparison study of two different lecture styles within a Master of Science nurse practitioner course

Generation Y students have a strong preference for technology that has caused educators to re-evaluate their instructional techniques. Limited published literature exists evaluating the benefits of electronic lecture delivery to students enrolled within nursing degree programs, with no publications to date comparing traditional to blended learning modalities. To retrospectively compare student outcomes, including overall course grade and individual examination scores, between two cohorts of students utilizing two distinctly different methods of lecture delivery, traditional and blended. IRB approval was granted to retrospectively compare student outcomes from fifty-two students enrolled within Northeastern University's Master of Science Nurse Practitioner degree program. A total of 23 students were enrolled in the traditional section taught in 2010 and 29 students were enrolled in the blended section taught in 2011. Student'st-test was used to compare studied outcomes between each section. A p-value of ≤0.05 was considered to be statistically significant. The students enrolled within blended course scored statistically significantly higher than their counterparts within the traditional course for three of the four studied outcomes, including overall course score. This study demonstrates that nursing students enrolled within a more technologically advanced course may have improved performance over students enrolled in courses with traditional lecture styles given their generational preferences for learning.