Clinical residency training: Is it essential to the Doctor of Nursing Practice for nurse practitioner preparation?

BACKGROUND: The Doctor of Nursing Practice (DNP) degree positions nurse practitioners (NPs) and other advanced practice registered nurses, with clinical competencies similar to other disciplines requiring doctoral education (medicine, physical therapy, psychology, and pharmacy). In addition, all these disciplines also offer residencies. However, nursing is the only discipline that does not require a doctoral degree and/or have a systematic approach to residency training for advanced practice roles. The authors posit that there are critical policy issues to resolve within the nursing profession to clarify the role that clinical residencies should play in transition to DNP practice specifically related to NPs. PURPOSE: The purpose of this article was to (a) describe the context of NP residency models within NP curricula that strengthen the DNP Essentials with an emphasis on Essential VIII and a focus on distinctive clinical specialization, (b) describe the history and policy implications of NP residency programs as well as existing programs that assist transition to practice, and (c) recommend policies for consideration related to DNP NP residencies. METHODS: Literature on nurse practitioner residencies was reviewed. DISCUSSION: While nurse practitioner residencies continue to grow, research is needed regarding outcomes of job satisfaction, clinical competencies, and patient satisfaction. CONCLUSION: The first year of practice for nurse practitioners is a critical period of professional development. It is important to further clarify the need, direction, and program standards. Academically affiliated residencies will facilitate the development and standardization of curricula and competencies to enhance clinical rigor. The partnership between academic units and clinical agencies will pool resources and strengthen nursing in both settings.

Innovations in Academic/Clinical Partnerships During COVID-19 to Prepare a Ready Nursing Workforce.

Management of the COVID-19 pandemic required healthcare leaders and frontline workers to rapidly innovate and adjust to a new reality that has forever transformed nursing education and practice. Throughout the pandemic, key stakeholders in Alabama lobbied for transformations in clinical training practice that ultimately improved students' exposure to clinical environments and alleviated the pressure on practicing nurses and other healthcare workers during pandemic hospitalization surges. The present article highlights the key partners and regulatory innovations that led to these successes in Alabama.

An Innovative Approach for Graduate Education for Psychiatric Nurse Practitioners.

A major transformation in nurse practitioner (NP) education is the emergence of post graduate residencies; their foci include (a) educating NPs in population health; (b) increasing clinical proficiency; and (c) incorporating quality and safety into practice. We describe a psychiatric NP residency program supported by an academic-practice partnership, known as the Veterans Affairs Nursing Academic Partnership for Graduate Education (VANAP-GE) between the Birmingham Veterans Administration Medical Center (BVAMC) and the University of Alabama at Birmingham (UAB) School of Nursing (SON) for a population of Veterans with complex mental and physical health needs. Topics which are covered include risks of suicide among Veterans, post-traumatic stress disorder, depressive and anxiety disorders, and substance use disorders. During this one-year traineeship during the first year after NP certification, residents engage in development of crucial skills for improving the future of U.S. health care. All residents are newly licensed PMHNPs, but some are also pursuing DNP degrees. For residents who are simultaneously enrolled in BSN to DNP programs, the additional clinical training afforded by NP residency education provides a natural laboratory for their projects with foci of quality and safety, leadership, and clinical scholarship. Reduction in NP turnover as well as cost savings of orientation and recruitment are significant benefits for the practice partner with zero vacancies since the partnership's inception. These multiple successes predict increased establishment of residencies as viable post graduate pathways for NPs.