Practice Residency Program Research Articles

The Impact of Accreditation on Nursing Transition Into Practice Residency Programs

The evidence is clear: transition to practice (TTP) residency programs are essential for new graduate nurses (NGNs) entering the profession, for effective organizational efficiency, and for enhanced, safe patient care. Meanwhile, some nurse leaders struggle to inspire others, including chief executive and financial officers, to invest in TTP residency programs, and some nurse leaders are not convinced of the value. In this article, we reinforce the case for TTP residency programs and the impact of their being accredited. We do so by offering an example of a health care system's experience standardizing a TTP across 7 states (53 acute care hospitals). Furthermore, we offer a model to demonstrate how accredited programs benefit nurses and organizations by having a significantly lower turnover rate than nonaccredited programs. Finally, this article offers concrete actions that nurse leaders can take to ensure a safe and meaningful journey for new graduate nurses entering our profession.

Advancing Post-Doctorate of Nursing Practice Residency Experience: First Year Reflections

An interprofessional team developed a yearlong post-doctorate of nursing practice (DNP) residency program funded by the Veteran Affairs (VA) Office of Academic Affiliations. As the VA’s first post-DNP residency, this multidisciplinary team sought to develop a mentoring environment that would provide DNP residents with increased clinical training, interprofessional networking, role transition, and dedicated mentoring. The authors discuss critical design elements for a successful residency design along with lessons learned. Initial findings support continuation and solidification of post-DNP residencies for new DNPs.

Is the Medical Home Approach Suited for the NP Role?

Mary Anne Putt, FNP, APRN, received an MSN degree from Saginaw Valley State University and has been employed as a family nurse practitioner at Bay Regional Medical Center Family and Child Health Clinic/Family Practice Residency Program in Bay City, MI, for the past 7 years. Prior to becoming a nurse practitioner, she had 28 years' experience in the acute care setting, from working within a rural family practice clinic to being a consultant for persons with disabilities living in the community. She is an adjunct professor at Saginaw Valley State University, teaching within the family nurse practitioner program. Since 2004, she has volunteered at the Helen M Nickless Volunteer Clinic, serving individuals and families in mid-Michigan who have no health care insurance.

Use of Handheld Computer Technology to Monitor General Practice Residents’ Clinical Experiences

The Commission on Dental Accreditation (CODA) requires that General Practice Residency (GPR) programs report a summary of each resident's clinical experiences. The goal of this study was to determine the effectiveness of handheld computer technology in tracking residents' clinical procedures. In the academic years 2004-05 and 2005-06, University of Kentucky GPR residents were provided a Palm M130 with customized forms. These menu-driven forms allowed residents to record procedures. Residents synchronized the data to a centralized database. A separate reporting system interfaced with the database to allow administrators to produce detailed reports on each resident. At the end of the academic year, data were tabulated, clinical procedures were correlated with respective costs, and annual production was determined. Data from fourteen residents were analyzed. Types and frequencies of various clinical experiences were tabulated, financial production summaries assessed, and percentage distribution of procedures by discipline was examined. Palm technology has proven to be an effective tool in monitoring each resident's clinical experiences. This methodology was beneficial to residency directors by allowing the examination of the experience distribution of each discipline in dentistry to determine the range of experiences that residents achieved.

Characteristics of Civilian Postdoctoral General Dentistry Programs

U.S. civilian (non-VA/non-military) Advanced Education in General Dentistry (AEGD) and General Practice Residency (GPR) programs were identified (n=208) and surveyed. The assessment evaluated infrastructure support, populations served, services provided, and trainee stipends. One hundred thirty-one programs responded (thirty-two AEGD, 64 percent/ninety-nine GPR, 63 percent). Sixty-nine programs were HRSA-funded (53 percent), and sixty-three (47 percent) were nonfunded. One hundred and five responses identified hospital/medical center resources; fifty-six indicated dental school support. Mean faculty support was similar regardless of program type or HRSA funding. Mean first-year positions in AEGDs were greater than GPRs. Mean first-year GPR positions were greater in funded than in nonfunded programs. A comparison of AEGD and GPR programs showed that residents in GPRs treated more children, medically intensive, economically/socially disadvantaged, and in-patient/same-day surgery patients (p<0.05). Residents in AEGDs treated more healthy adults (p<0.05). GPRs treated more lower fee (no pay, Medicaid, welfare/general relief, Medicare, and capitation/HMO) patients. AEGDs treated more insurance/private pay patients (p=.0001). No differences existed in comprehensive care and emergency visits between AEGDs and GPRs. GPRs treated more hospital-based patients. The mean stipends for GPRs ($32,055) and AEGDs ($22,403) were different.

An educational consultative model for general practice training programs.

A behavioral science consultant has been retained by two hospital-based general practice residency (GPR) programs and one advanced program in general dentistry at the University of Rochester, and Eastman Dental Center, NY. This consultant is available throughout the year and serves as an external consultant who knows the programs well, and can be used as a source of information on various existing and potential issues and problems. The model used by the consultant has been inductive and is based on the expressed needs of faculty members, trainees, and directors. A number of issues or problems were identified, including faculty member morale, evaluation of residents' growth, resident and supporting staff relations, curriculum development, cooperation with other departments and institutions, and dealing with patients' anxiety to dental treatment. For each, a specific plan was developed. Various types of experiential techniques were used, including brainstorming, role playing, and taping and feedback. Didactic activities included minicourses and workshops in which standard teaching methods were used, such as lectures, seminar discussions, literature study, and demonstration. The model has evolved, and as each activity has succeeded, more faculty members have sought help from the consultant.