Nurse Practitioner Students Research Articles

Changes in Motivation, Barriers, and Student Impact on Preceptors Since COVID-19: A Mixed Methods Study

ObjectiveThe study aimed to examine factors influencing preceptors’ willingness to precept nurse practitioner students before and after COVID-19. DesignA mixed methods design followed up on an earlier survey exploring preceptor perceptions before the COVID-19 pandemic. ResultsTwo themes emerged for motivators: altruism and mentorship. Time commitment identified as a barrier was broken down into subthemes: personal time and student preparedness. Most participants reported that COVID-19 no longer had an impact on their willingness to precept students. ConclusionsMany preceptors accept students to give back to the profession. Increased time commitment continues to hinder the experience for preceptors.

Infographics: A Novel Approach to Improve Faculty-Preceptor Communication.

Communication between preceptors and faculty and the time to teach have been identified as common barriers for preceptors working with nurse practitioner (NP) students. Despite traditional preceptor orientation strategies in school of nursing NP primary care programs, preceptors continued to express uncertainty and lack of clarity regarding the expectations of the precepted experience. Data to support this innovation were obtained through preceptor-faculty interactions through surveys, site visits, and focus groups examining the preceptor's experience with precepting. Infographics were developed for each of the three clinical practicum courses in the NP primary care track, which address expectations for these precepted experiences. Preceptors reported being more likely to review infographics, kept them accessible/available during the semester, and experienced clarity on the expectations for the experience. Preceptors and students expressed a more thorough understanding of the expectations for the NP student's practicums with the implementation of the infographics. [J Nurs Educ. 2024;63(X):XXX-XXX.].

Enhancing Nurse Practitioner Student Knowledge Base and Self-Efficacy in the Care of Acutely Ill Obstetric Patients.

Enhancing Nurse Practitioner Student Knowledge Base and Self-Efficacy in the Care of Acutely Ill Obstetric Patients.

Incorporating Social Needs Screening in Simulation for Family Nurse Practitioner Students.

A pilot simulation was implemented at a private university school of nursing to provide an opportunity for family nurse practitioner (FNP) students to apply their knowledge of assessing and addressing social determinants of health (SDOH). The Social Needs Screening Tool (SNST), developed by the American Academy of Family Physicians, and SDOH content were incorporated into a tele-health simulation-based learning experience. Using Zoom [Zoom Video Communications, Inc.], students encountered a standardized patient who sought care for shoulder pain and shared concerns about transportation and finances. Thirty-nine FNP students individually completed the simulation. Evaluation was conducted via an adapted Simulation Effectiveness Tool-Modified and written feedback to assess confidence and skills. Eighty-nine percent of students reported they felt more comfortable using the SNST following the simulation. Incorporating SDOH content and the SNST within simulation-based learning is an effective learning activity to enhance FNP student confidence and skills in assessing and addressing SDOH. [J Nurs Educ. 2024;63(X):XXX-XXX.].

Oral Health Knowledge, Attitudes, and Learned Clinical Skills in Pediatric Medicine Residents and Nurse Practitioner Students: A Pre-Post Design.

(1) Background/Objective: California has one of the highest rates of pediatric dental caries in the nation. One way to combat this problem is through non-dental provider training programs that focus on prevention. However, there are limited data on healthcare provider training program integration and evaluation of oral health curricula focused on prevention of early childhood caries. This study will assess the change in healthcare providers' attitudes, knowledge, and skills by implementing an interprofessional educational (IPE) oral health curriculum in medicine and nurse practitioner programs at one university in Southern California. (2) Methods: A mixed method design was employed using a pre- and post-educational survey, and end-of-program focus group interviews. Descriptive statistics and paired t-tests were used to assess group differences and thematic analyses for the focus groups. (3) Results: A total of 81 students (14 pediatric medicine residents, 18 pediatric, and 49 family nurse practitioners) completed the curriculum and surveys. Attitudes related to oral hygiene remained unchanged, with the nurse practitioner group showing improved clinical skills (all questions; p < 0.021). Knowledge scores significantly improved across all groups (paired t-test; p < 0.001). All focus groups expressed the helpfulness of the educational modules, the usefulness of the skills learned, and the benefits of IPE activities. (4) Conclusion: Healthcare providers showed improved oral health knowledge and clinical skills acquired through the oral health program and can serve as a model to educate across disciplines on the prevention of early childhood caries.

To precept or not to precept: Perspectives from nurse practitioners.

Nurse practitioner (NP) preceptors are crucial to clinical education. Recent increases in the required direct patient care hours for NP students may worsen the current preceptor shortage. However, most studies of preceptorship only include NPs who are current preceptors and are therefore missing vital information from nonpreceptors. It is imperative to understand facilitators and barriers to preceptorship from the perspective of NPs who have stopped being or have never been preceptors. The purpose of this study was to understand the factors influencing NPs' decisions whether to precept. This was a descriptive, phenomenological study. Semistructured interviews were recorded in Zoom, transcribed verbatim, deidentified, and analyzed using thematic analysis. Sixty NPs participated in the study: 23 current preceptors, 22 previous preceptors, and 15 who had never been preceptors. Facilitators to preceptorship included institutional support of preceptorship, positive student characteristics, clear expectations from the educational facility, and incentives. Barriers to preceptorship included time constraints, specialty, negative student characteristics, no institutional support, and being uncomfortable in the clinical role. Preceptors and nonpreceptors shared similar themes-positive student characteristics and clear expectations as facilitators to preceptorship, and time as a barrier. However, other themes were unique to one preceptorship group. This provides new evidence for practice and research. Nurse practitioner programs can facilitate preceptorship by ensuring that students are well prepared and providing clear expectations. Strategies should be developed to manage the time burden of preceptorship. In addition, support for preceptorship by health care organizations and systems should be studied.

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.

Enhancing competency-based assessment: Implementing oral boards in nursing education.

Competency-based education, pivotal in nursing programs, emphasizes learning methods over knowledge accumulation, integrating ongoing assessments for performance and outcomes. The American Association College of Nursing introduced competency-based education, urging educators to explore diverse assessment methods. This article explores the implementation of mock oral boards as an assessment method to synchronize performance standards with competencies in nursing education, specifically in preparing nurse practitioner students for clinical rotations.

Engaging with the Community Before Deploying a Rural Mobile Health Unit

Before implementing health care services, such as a mobile health unit (MHU), it is essential to assess community needs and develop reciprocal community partnerships, develop a strategy for community engagement, and provide longitudinal service-learning opportunities for students. An MHU providing a comprehensive range of in-person health care services and telehealth capabilities was launched October 2023 in rural Tennessee. More than 100 undergraduate nursing and nurse practitioner students have rotated on the MHU and in nearby rural clinics. Assessing and engaging with the community before deploying a MHU can increase trust and establish relationships while providing learning opportunities in rural settings.

Effects of an Avatar-Based Simulation on Family Nurse Practitioner Students' Self-Evaluated Suicide Prevention Knowledge and Confidence.

Family nurse practitioners (FNPs) are often gatekeepers and can recognize the warning signs of suicidality yet may lack adequate education or self-confidence in identifying people in crisis. The purpose of this research was to evaluate the effectiveness of an online suicide prevention simulation with 53 FNP students. Pre/post responses were found to be statistically significant across all preparedness and attitudinal items following the Kognito© training (p < .001). Online, avatar-based suicide prevention training with FNP students may be effective in improving participants' perceived preparedness and self-confidence with patients at risk for suicidality.

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.

Nurse practitioner faculty attitudes about interprofessional education.

Nurse practitioner (NP) faculty attitudes toward interprofessional education (IPE) can be barriers to the shift in culture and successful implementation of IPE into nursing curricula. A paucity of studies exist comparing faculty attitudes of IPE with different educational modalities. The purpose of this research is to compare NP faculty attitudes toward IPE between IPE experiences and educational modalities in NP academic programs. A quantitative cross-sectional comparative design was used. An electronic survey was advertised to approximately 3,000 members of the National Organization of NP Faculties by email blasts to assess their attitudes toward IPE in the academic setting. Participating NP faculty (n = 208) completed the survey, with a response rate of 6.9%. The results showed that NP faculty reported positive attitudes toward IPE (M = 4.33). Nurse practitioner faculty attitudes toward IPE and participation in IPE experiences were not statistically significant (p = .126). Nurse practitioner faculty attitudes toward IPE did not differ with the educational modality. The main effect of the NP degree program educational modality was not statistically significant, F(2, 172) = 0.74, p = .479. Nurse practitioner faculty are optimistic about IPE in multiple educational modalities but still have some reservations about how to implement IPE activities successfully. The NP faculty attitudes and barriers to IPE curricular development in all educational modalities must be addressed to prepare NP students to be competent collaborative practice-ready providers on graduation.

Evaluating a Virtual Flipped Classroom Approach to Nurse Practitioner Telehealth Competency Development.

Evidence supports the use of multi-modal approaches to develop nurse practitioner (NP) students' telehealth competency. A virtual flipped classroom approach that included eLearning, interactive webinars, and virtual standardized patient (SP) simulations was implemented and evaluated to teach NP students to use telehealth and other connected health technologies to improve care for underserved populations. Analysis of data from multiple-choice quizzes, surveys, and SP evaluations indicated students achieved high levels of knowledge, met the learning objectives, demonstrated above-average competency during telehealth simulations that improved over time, and were highly satisfied with the learning experiences. The educational benefits of a flipped classroom can be realized within a fully online learning experience. Future research should examine the effects of repeated simulation opportunities on telehealth competency development. [J Nurs Educ. 2024;63(8):546-551.].

An examination of nurse practitioner students' perceptions of knowledge, confidence, and experiences related to caring for lesbian, gay, bisexual, transgender, and queer or questioning patients: A national perspective.

Lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ+) individuals are significantly less likely to have a primary health care provider, be uninsured, and postpone medical care. A health care provider's lack of knowledge in LGBTQ+ health needs, low confidence in discussing sexuality, and bias can result in LGBTQ+ patients choosing to delay or avoid seeking care. These are missed opportunities for health care providers to recognize their unique needs, provide education and preventive screenings and care, and manage chronic conditions. The aim of this study was to examine nurse practitioner students' perceptions of knowledge, confidence, and experiences related to caring for LGBTQ+ patients. Using a descriptive, cross-sectional survey research design, a 29-item online survey was distributed through email to nurse practitioner students (n = 419) across the United States. Overall, nurse practitioners (NP) students demonstrated infrequent questioning related to gender preferences, sexual terms, and clarification of relationships. Results showed that 77.9% of NP students within two terms of graduation had not received any LGBTQ+-specific training. Almost 75% of the NP students reported not routinely asking about sexuality, and 82% reported infrequently or never asking gender identity. Furthermore, 93.1% of respondents reported providers infrequently or never ask about preferred gender or pronouns, and 86% reported providers infrequently inquire about sexual identity in primary care visits. Study findings demonstrate the uniqueness of managing care for LGBTQ+ patients and importance for more detailed LGBTQ+ health training in curricula in NP programs. Closing the gap in health care for LGBTQ+ patients is paramount in addressing global health disparities and population care.

Development, Implementation, and Assessment of an Online Modular Telehealth Curriculum for Health Professions Students.

Several national health profession organizations endorse or have developed competencies for telehealth, yet there is no standardized curriculum for teaching telehealth to health professions students. Additionally, implementing telehealth curricula is challenging due to limited curricular space and differing needs of various health profession programs. We describe the development, implementation, and pilot assessment of an online, modular telehealth curriculum for health professions students. An online, modular telehealth curriculum for health professions students was developed in 2021-2022. Nine modules were created, focusing on the logistics of performing a telehealth visit and system-based virtual assessments. In academic year 2022-2023, course directors from the Duke doctor of medicine (MD), physician assistant (PA), and nurse practitioner (NP) programs utilized modules in their courses. For modules taken, students were surveyed and self-assessed their confidence, knowledge gained, and likelihood of utilizing the telehealth skills taught in the module(s). During the 2022-2023 academic year, MD, NP, and PA students at Duke participated in one or more of the telehealth modules in an existing course. The median responses to self-assessed confidence questions for all health profession students to be in the "moderately" or "very confident" range. Similarly, students reported a median response of "moderate knowledge gained" for each module taken. NP students reported slightly lower levels of confidence and likelihood of utilizing telehealth skills than other professions. No other significant differences in the remainder of responses were observed between health professions. Exposure of health professions students to telehealth through utilization of online, interactive modules may result in increased telehealth skill confidence and knowledge, and furthermore, a belief that they will utilize these skills in future practice. Larger scale implementation of the telehealth curriculum and development of outcome measures which assess clinical application of skills conveyed will provide more information about the efficacy of the curriculum.

Equipping Nurse Practitioner Students With Social Determinants of Health Competencies.

Social determinants of health (SDOH) cause significant burden on individuals living with acute and chronic disease. There are meaningful data to support screening for social needs, yet implementation limitations exist in the clinical setting. Incorporating SDOH education into nurse practitioner (NP) curriculum provides a framework for bringing these concepts into clinical practice. As NP education transitions from concept-based to competency-based instruction, NP programs across the nation are tasked with ensuring socially competent, practice-ready NPs. To help students understand the impact of SDOH in an applied way, a multisemester clinical and didactic dyad approach to SDOH competency was implemented. NP students (N = 521) in three separate cohorts completed the SDOH project between 2019 and 2021. Statistically significant results (p > .001) demonstrated increased knowledge related to SDOH in the clinical setting. Equipping NP students with SDOH competencies empowers them to optimize health, improve patient outcomes, and promote health equity. [J Nurs Educ. 2024;63(X):XXX-XXX.].

Weight bias reduction intervention among nurse practitioner students using simulation-based experiences.

Few nurse practitioner (NP) programs include obesity and weight bias education in their curriculum. However, NPs will likely provide care for people living with obesity, many of whom have been discriminated against based on their weight by previous providers, and many NP students may feel unprepared to navigate weight management competently. This pilot study included a weight bias reduction (WBR) intervention, which included a simulation-based experience (SBE) with a standardized participant (SP) and educational activities embedded within the NP curriculum. Nineteen NP students participated in this pilot study, but only seven students had matching data for preintervention to postintervention scores. There were no statistically significant differences in preintervention and postintervention Attitudes Toward Obese Persons (ATOP) or Beliefs About Obese Persons (BAOP) scores. Despite this small sample size and not achieving statistical significance, SBE-SP holds promise to depict realistic patient encounters to improve NPs' attitudes and beliefs toward persons with obesity and to reduce weight bias. Therefore, incorporating SBE-SP may be a feasible component of the NP curriculum.

Increasing Confidence of Nurse Practitioner Students With Continuous Glucose Monitoring

It is important for nurse practitioner (NP) programs to educate students about continuous glucose monitors (CGMs) so they are prepared to recommend and make treatment decisions using CGMs in future practice. Family NP students participated in an educational workshop and a user-wear experience with CGMs and completed presurveys and postsurveys. The 10 items on the survey had statistically significant differences in presurvey and postsurvey ranked scores. Four qualitative themes were revealed: knowledge, confidence, application to practice, and user-wear experience. The CGM workshop and user-wear experience improved NP students’ familiarity and confidence in the use of CGMs.

Verbal Case Reports for Adult Nurse Practitioner Students.

Verbal Case Reports for Adult Nurse Practitioner Students.

An Innovative International Telehealth Clinical Experience for Nurse Practitioner Students.

An Innovative International Telehealth Clinical Experience for Nurse Practitioner Students.