Describing Curriculums Across Primary Care Nurse Practitioner Postgraduate Education and Training Programs

Background and Significance

Within the field of nursing, there is a rich and growing tradition of structured, comprehensive on-the-job training programs to help licensed, novice nurses orient and transition from student to field nurse (Goode, Lynn, McElroy, Bednash, & Murray, 2013).  In turn, these training programs facilitate recruitment and retention, quality care and patient safety, and cost-saving practices in the host organization (NCSBN, 2013; UHSC-AACN, 2015; Wiltse Nicely & Fairman, 2015).  Since 2007, a concentrated number of transformative nursing leaders have started creating structured postgraduate training programs specifically for nurse practitioner (NP) workforce development.  This nursing evolution has been stimulated by our challenging healthcare climate where novice clinicians are often expected to more rapidly translate academic knowledge to unsupervised skill application (Broyhill, 2015; Flinter, 2012; Hart & Macnee, 2007; Zapatka, Conelius, Edwards, Meyer, & Brienza, 2014).  This can be a daunting task.

These programs are often referred to as residencies, internships, or fellowships (Krugman et al., 2006; Wiltse Nicely & Fairman, 2015).  They work to enhance role-transition while responding to the mounting primary care challenges, including high provider turnover (Benham & Geier, 2014; Flinter, 2012; Goudreau et al., 2011; IOM, 2011).  This study classifies these programs under the larger rubric of “postgraduate education and training” (PGET). 

The Institute of Medicine (IOM) and the Affordable Care Act (ACA) explicitly recommend intensified development and expansion of PGET programs for primary care providers, including NPs (AACN, 2010; Carrier et al., 2007; Institute of Medicine, 2011).  Further, the IOM urges appropriate nursing, federal, and accrediting organizations to work collaboratively to evaluate and standardize postgraduate education and training programs (IOM, 2011, Recommendation #3).  There are approximately 23 primary care postgraduate education and training programs nationally, each with at least one graduating NP trainee cohort (M. Flinter, personal communication, July 21, 2015).  Nevertheless, there is a paucity of literature regarding such programs, specifically as it relates to curriculum objectives and design.   

Poster Presentation Purpose/Goals

The purpose of this poster is to present a scholarly project that analyzes congruencies and variances of curriculum design among primary care postgraduate education and training programs for NPs.  Learners will gain insight about employer-perspective factors (e.g., educational, organizational, and political) that promote the ongoing development of postgraduate education and training programs.  Further, learners will be able to describe some common curriculum design features across these programs.  Lastly, learners will be able to identify the current, employer-driven, evolving dynamics of NP postgraduate training in primary care.

Methodology

 

Data Collection:

The study is a descriptive project using semi-structured interviews and document review methods.  The investigator employed a purposeful, convenience sampling approach to identify directors of primary care-focused postgraduate education and training programs that are members of the two leading postgraduate education and training associations in the United States.  The poster will focus on those programs that agreed to participate in the audio-recorded telephone, in-depth interviews with the researcher.  It is expected that approximately 10 programs will participate, and will represent hospital systems, community health centers, and the Veterans Health Administration. 

Inclusion and Exclusion Criteria:
Postgraduate education and training programs included in the study will have (a) a primary care focus, (b) at-least one graduating class by September 2015, (c) English-speaking directors, and (d) directors with access to telephone and internet services.  Programs excluded from the study will not meet the inclusion criteria.

Human Subjects Research:

This study was approved by the institutional review board (IRB) at Northeastern University in September 2015. 

Implications

 

NPs represent an exponentially growing workforce that is expected to dominate primary care (Institute of Medicine, 2011; Rauch, 2013). Mostly employer-driven, postgraduate education and training programs are evolving at a rapid pace to help cultivate a workforce prepared to meet the complex health challenges of patient care upon graduation. This poster presentation hopes to provide insight about this emergent education and training medium for our nation’s increasing primary care NP graduates.  It also may serve those who are working on standardization and accreditation of NP postgraduate education and training programs.