"Because of this rotation, this is what I want to do": Implementation and evaluation of a telehealth opioid use disorder clinical placement for nurse practitioner students.

ABSTRACT: The lack of clinicians comfortable prescribing buprenorphine is a barrier to access for people with opioid use disorder (OUD). Accordingly, a telehealth OUD treatment clinic, Ophelia, launched a clinical training program for nurse practitioner (NP) students. The goal of this study was to assess a telehealth-based model of OUD clinical training. To evaluate the program, we (1) identified students' knowledge related to providing OUD care to patients before and after their clinical rotation with Ophelia and (2) characterized students' attitudes about providing OUD care following their clinical rotation with Ophelia. Online pre- and postsurveys were conducted with 57 and 29 students, respectively, and semistructured interviews were conducted with 19 students who completed clinical rotations with Ophelia. We used quantitative descriptive analysis to compare presurvey and postsurvey results and conducted thematic analysis to analyze qualitative interview data. We identified three themes from the interviews: the continuum of learning opportunities, the comfort providing OUD treatment following participants' clinical rotation, and the relevance of a substance use disorder clinical rotation for all NP students. The survey also supported these findings. Of note, there were descriptive differences between presurvey and postsurvey responses related to an increase in knowledge, preparedness, and acquisition of skills to treat OUD. Using a telehealth clinical rotation for NP students to learn about OUD treatment may represent an important step in increasing the number of clinicians who can prescribe buprenorphine. These findings can inform interventions and policies that target clinician training barriers.

Population-based advanced practice nursing: where does oncology fit in?

A national work group met in 2004 to discuss the future of advanced practice nursing. The representatives were nursing education, certification, accreditation, and regulation experts, and the goal was to develop a consensus model for advanced practice nursing regulation (Nevidjon et al., 2010). As a result, a set of recommendations was published in an article that defined a new consensus model for advanced practice registered nurse (APRN) regulation (APRN Consensus Workgroup, 2008; Goudreau, 2009). The new model included six population-based focuses of practice (i.e., family and individual across the lifespan, adult and gerontology, neonatal, pediatrics, women's health- and gender-related, and psychiatric and mental health) (Johnson, Dawson, & Brassard, 2010). A goal of the new model was to standardize the licensure, certification, and regulation of nurse practitioners into specific focuses. State boards were facing an increasing number of requests to recognize nurse practitioner specialties (e.g., organ specific, body systems, diseases) (Johnson et al., 2010). The new model helped standardize education programs, which may help certifying agencies set up curriculum review processes to ensure appropriate credentials for APRNs (Johnson et al., 2010). It also supported the mission of nursing to meet future healthcare needs of the public and to protect the public (Johnson et al., 2010). Some advantages exist to delineating into population-based focuses, but the new model leaves out many specialties (e.g., oncology) that encompass the whole person as well as concentrate on certain diseases.