Where is family in the family nurse practitioner program? Results of a U.S. family nurse practitioner program survey

Though recent progress in family nursing science can serve the family nurse practitioner (FNP) to intervene in the regulation of family health, whether those advances are taught to FNP students has been unclear. All 266 FNP programs in the United States were invited to participate in a survey to assess the content and clinical application of family nursing theories in the curriculum. The majority of FNP programs frame family as the context of care for the individual. Though FNP students receive a foundation in family nursing theory in core courses, they are not usually expected to use family assessment methods in clinical practicum courses or to plan interventions for the family as the unit of care. The authors challenge educators to consider family nursing science as an essential component of the FNP program as the Doctor of Nursing Practice (DNP) evolves and becomes requisite for entry into advanced practice.     

Preparing the FNP Workforce for the Increasingly Complex Work Environment

In 1965, the University of Colorado became the first university to develop a curriculum for the nurse practitioner role, preparing clinicians to meet contemporaneous, across-the-life span, general-practice health care needs. However, in the succeeding 5 decades, individual- and population-level health care needs have grown both in scope and complexity (eg, management of multifaceted chronic diseases and behavioral health conditions). Therefore, family nurse practitioner (FNP) education programs must themselves evolve to match the current, evolving health care environment. This article reviews how an FNP curricular redesign at a college of nursing assisted the faculty in meeting this charge.     

Faculty preparation: is clinical specialization a benefit or a deterrent to quality nursing education?

This article presents a point of view regarding the impact of specialty preparation at the master's level on performance as a faculty member in an entry-level program. Essentially, the focus in depth on a particular branch of nursing practice restricts the perception of the individual to the role and demands of the beginning generalist nurse. Continued attention to the development of expertise in the specialty reduces the effectiveness of the faculty member to develop a comprehensive view of the knowledge required by the beginning generalist nurse. Because faculty prepared in this manner also frequently lack formal knowledge regarding teaching and curriculum, they continue to teach in the same manner as they were taught, often with an eye toward teaching the extensive content taught in the specialty program. More broadly based master's degree programs that couple advanced nursing knowledge with nursing education content and skill can foster in new nurse faculty a more comprehensive picture of the learning needs of beginning generalist nurses.     

Faculty mentorship: support for nurse practitioner students and staff within the rural community health setting

As pointed out in the introduction, there are certain practical concepts within our base of nursing knowledge that can only be taught through experience. Many things are easier to teach by example. As we turn back the clock in nursing, we can see how Florence Nightingale, Clara Barton, and Lillian Wald were role models to their nursing peers in their era. They taught nursing by example, by role modeling their clinical expertise. Today, this model is still effective and faculty mentoring of nurse practitioner students and CHNs in a compassionate and collegial leadership results in higher quality of health care for our nation's needy clients and their families. But greater yet are the opportunities for flexible nurse practitioner faculty practice and personal interactions on many levels for nursing faculty who wish to share their expertise. Mentorship by nurse practitioner faculty for nurse practitioner students and CHNs in a rural clinical setting has revealed many positive aspects in providing quality care for rural clients and growth for nurses. Exposure to the rural community health system helps us, as nurses, to identify the many strengths it possesses for innovative rural nursing practice.     

Radiologic Imaging Content in Family Nurse Practitioner Programs: A Needs Assessment

Our purpose was to assess radiologic imaging content in family nurse practitioner (FNP) curricula and FNP perspectives concerning practice needs. Anonymous, 5-item, Web-based surveys were distributed to FNP program directors (n = 21) That included items concerned FNP radiologic imaging needs in primary care. Anonymous 13-item Web-based surveys were distributed to practicing FNPs (n = 289 responses). Items assessed FNP confidence regarding radiologic imaging practice guidelines. Program directors reported radiologic imaging curricular content as critical for practice. FNPs reported radiologic imaging education was insufficient; 25% reported receiving none. Addressing FNP practice needs by enhancing FNP radiologic imaging curricula will facilitate FNP confidence and competence.     

The Structure, Content, and Quality of Family Nurse Practice

Relatively little data has been collected documenting the scope of family nurse practitioner (FNP) clinical practice, and virtually no research definitively describes the quality of that practice. Physicians have led the way in quantitative collection of practice content information. The resulting analyses have determined not only the most common diagnoses in primary care but also the content of teaching and research in family practice. Nurse clinicians, educators, and researchers have assumed this content to be pertinent to FNP practice as well. This article describes the major studies of family physician practice and the few studies of nurse practitioner/ FNP practice, and advocates intensified review of FNP clinical content as an empirical basis for practice, education, and research.     

Design and initial evaluation of a virtual pediatric primary care clinic in Second Life®

Purpose: To present an example of an innovative educational strategy using a theoretical framework for the design and evaluation of a virtual world simulation for family nurse practitioner (FNP) students. Data sources: The example arises from a primary care pediatric clinic developed for FNP students in Second Life? to supplement experiences in clinical practice sites. The simulation uses a case-based interactive format. The educational strategy is based on constructivist learning theory and experiential learning principles. Report of initial prototype testing of faculty and FNP students is reported. Conclusions: Virtual-world simulations have the potential to provide a safe environment for students to practice clinical decision making for pediatric patients. However, attention to the context, pedagogy, learner, and the capabilities of the technology is essential to provide a quality educational experience. Implications for practice: Preparation of FNP students can include quality educational experiences in a virtual world when guided by a theoretical framework.     

Family nurse practitioner clinical requirements: Is the best recommendation 500 hours?

Purpose: The purpose of the article was to stimulate further dialog around the recommended number of clinical hours required for students in family nurse practitioner (FNP) programs.
Data sources: Nursing literature was reviewed for research supporting the current clinical hour requirement. Both authors are faculty in FNP programs that provided experiential data for the article.
Conclusions and implications for practice: There are no scientific data upon which to base the number of required clinical hour. Researchers need to identify what type and how many clinical hours are needed to prepare competent new FNP graduates.     

Nursing students' and faculty members' knowledge of, experience with, and attitudes toward complementary and alternative therapies

This study was designed to describe and compare the knowledge, experience, and attitudes of nursing faculty and students (undergraduate and graduate) regarding complementary and alternative therapies (CAT). A cross-sectional survey (N = 153) of undergraduate (n = 41) and graduate (n = 57) students and faculty (n = 55) was conducted in one school of nursing. Most participants were White (87%) and female (78%). More than 70% of the students and faculty agreed that clinical care should integrate the use of CAT. More than 85% desired more education about CAT, especially in undergraduate nursing curricula. More than 65% agreed that the clinical nurse specialist or nurse practitioner role should include the use of CAT in their practice, and more than 50% agreed that they had some knowledge of CAT, but only approximately 30% had some experience with CAT. Faculty and students expressed positive attitudes toward integrating CAT into the undergraduate nursing curriculum and nursing practice. Faculty development and nursing research are needed to facilitate curriculum change and integrate CAT into nursing programs at all levels.     

Non-nurse college graduates: a new resource for future nurse practitioners

Non-nurse college graduates are admitted to the master's of science in nursing (MSN) degree program at the University of Tennessee, Knoxville (UTK). Over the years, a majority of these non-traditional students have chosen the family nurse practitioner clinical concentration. The purpose of this study was to compare non-traditional and traditional family nurse practitioner (FNP) graduates in terms of academic and career-development characteristics. The study population consisted of all 91 (48 non-traditional and 43 traditional) UTK FNP graduates from 1981 to 1986. Little difference was found between the two groups' academic success in the program, self-perceptions of clinical preparedness for practice, current participation in the workforce, and self-perceptions of acceptance from administrators, other nurses and physicians in current work settings. Several notable differences between the two groups were found. The non-traditional FNP graduates had higher Graduate Record Examination (GRE) mean scores. More non-traditional than traditional FNP graduates were employed initially as nurse practitioners. Similarly, more non-traditional FNP graduates were currently employed as nurse practitioners in primary health care settings. Fewer non-traditional FNP graduates expressed satisfaction with their initial or current nursing positions. In regard to career goals, however, more of the non-traditional FNP graduates stated their intent was to be functioning as nurse practitioners in the future. Non-nurse college graduates with an interest in health care are a rich resource from which to recruit practicing nurse practitioners for the future.     

Cognitive dissonance experienced by nurse practitioner faculty

Purpose: The purpose of this study was to explicate the concept of cognitive dissonance as experienced and reported by nurse practitioner (NP) faculty members. Data sources: Responses from NP faculty members to an online survey about their experiences with cognitive dissonance. Conclusions: The respondents detailed their experiences with cognitive dissonance, citing differences between expectations for which they are rewarded and those for which they are paid. Implications for practice: Expecting all faculty members to excel in practice, research, teaching, and service may create unrealistic workloads for NP faculty members. Examining expectations and considering creation of a clinical track for faculty who practice may be options administrators of NP programs might explore.     

Growing an innovative faculty-driven management team in a distance-delivery NP education program: Thinking outside the box to meet the nursing education and health needs of northern British Columbia, Canada

Purpose: The purpose of this article is to describe how one university in northern British Columbia (BC) dealt with the issues of nurse practitioner (NP) program administration in light of its geographic context. Data sources: Reflections of the management team during the first 2 years of implementation of the faculty-driven approach. Conclusions: Our experience reflects family NP (FNP) faculty shortages internationally, the challenge of attracting qualified candidates to centers outside the urban mainstream in today's competitive academic job market, as well as the need to develop NP faculty capacity in BC, Canada. The team management approach evolved organically, based on program need, available human resources, and the culture of the faculty. The team approach for program leadership and coordination is a good fit for this NP program. Implications for practice: Implementing the team management approach has allowed the continuation of an NP program situated in a northern Canadian community that is consistent with the program's unique focus in preparing NPs to practice in often-underserved northern, rural, remote, and Aboriginal settings. While the approach provides for continuation of a quality program, it also ensures the availability of graduates well prepared to take up practice challenges in rural and northern communities.     

Career Trends of Master''s Prepared Family Nurse Practitioners

The purpose of this study was to examine the career trends of family nurse practitioner (FNP) graduates of one master's program. A questionnaire was mailed to all FNPs (N = 113) who graduated 1-11 years earlier; there was a response rate of 83%. The survey revealed that for both first and present jobs the majority were providing direct patient care as a primary care provider or practicing in an indirect role. The study findings indicate that for these graduates there is a long term commitment (demonstrated through continued employment) as well as opportunity to practice in the nurse practitioner role in a direct or indirect capacity.     

Nurse Practitioners: Reevaluation of the Need for and Willingness to Hire by Nurse Administrators, Nurse Practitioners, and Physicians

A survey of all nurse administrators and advanced practice nurses and a simple random sample survey of licensed physicians in Nevada were completed to reevaluate the perceived need for and willingness to hire nurse practitioners (NPs). The reevaluation was deemed necessary based on a similar survey that was completed by these authors in 1990. At that time significant questions were raised concerning the lack of understanding of the role of NPs in and their contribution to the health care team.
The results of the study clearly indicate that the unique contributions of the NP to the health care team should be further publicized and clarified. In addition, for some physicians, a significant disparity continues to exist between the optimal, collaborative role and the more readily accepted dependent role of the NP. The family NP (FNP) continues to be the most desired specialty for those who hire NPs.     

Integrating practice issues in managed care into the curriculum: a Delphi survey

PURPOSE: This project evolved from a partnership between an advanced practice nurse (APN) graduate program and a care management insurer. The purpose of this Delphi survey was to identify (a) role components germane to the practice of APNs in managed care and (b) topics reflecting these components in the curriculum. DATA SOURCES: Data were gathered from two expert panels, clinician preceptors and faculty members. Each panel had 11 members: 11.3% and 100%, respectively, of the target populations of clinicians and faculty in the partnering agencies. CONCLUSIONS: There was considerable congruence between the panels on the survey. IMPLICATIONS FOR PRACTICE: Case vignettes could be used as a vehicle for discussion of the broader issues of population approaches to specific problems. Faculty could partner with clinicians to develop cases for discussion of evidence-based practice. Faculty and clinicians could create preceptorships focused on business management, postgraduate fellowships within managed care systems, and regular opportunities to dialogue about curriculum and essential attributes of APN graduates.