Transition to a Student-Driven, Competency-Based Clinical Placement Model for Advanced Practice Registered Nurse Education

Saturday, 28 October 2017

Pamela W. Slaven-Lee, DNP
School of Nursing, George Washington University, Washington, DC, USA
Marilyn Oermann, PhD, MSN, BSN
School of Nursing, Duke University School of Nursing, Durham, NC, USA
Donna M. Nickitas, PhD
Nursing, The Graduate Center, City University of New York, New York, NY, USA

In 2011, the Institute of Medicine’s Future of Nursing report described the potential for advanced practice registered nurses (APRNs) to contribute to the provision of high-quality healthcare as part of comprehensive healthcare reform. Schools of nursing have responded with the expansion of APRN programs. However, challenges exist with providing high quality APRN clinical education that meets all state, agency, and specialty certification requirements.

Securing sufficient clinical placements for APRN students is a significant challenge that limits the capacity of educational programs to meet current and projected workforce demands. These challenges mandate exploration of innovative and efficient ways to ensure clinical placements that offer opportunities for students to meet clinical objectives and develop APRN competencies. It is imperative that programs establish processes that ensure verification that all clinical placements meet regulatory and contractual requirements, thus minimizing risk to the student, clinical site, and institution by clearly stipulating the responsibilities and liabilities of each party.

Licensure to practice in the United States requires successful program completion demonstrating clinical competency and preparedness for safe entry into practice. Those eligible for licensure have completed a minimum of 500 supervised direct care clinical practice hours during their program of study. A rapidly growing number of institutions now offer distance education APRN programs, with a subsequent demand for nationwide clinical placements. The Alliance for Nursing Accreditation Statement on Distance Education Policies recognizes this proliferation and calls for maintaining high standards of quality assurance with the provision of resources for successfully attaining all program objectives.

This project outlines the evolution of a student-driven distance education APRN clinical placement model designed to address the challenges associated with rapid national expansion, regulatory requirements, and maintenance of high quality educational standards. Three phases of the project evolution are presented in the context of a Faculty Leadership Progression Plan with emphasis in each phase on 1) short and long-term goals, 2) barriers and strategies to overcome them, and 3) lessons learned. Project feasibility, value, impact, and sustainability are also explored.