Postgraduate Programs in Orthopaedic Surgery for Physician Assistants and Nurse Practitioners.

Postgraduate orthopaedic programs for physician assistants (PAs) and nurse practitioners (NPs) number 14 as of 2020. To better understand the characteristics of these programs a census was undertaken. The result is that most programs are 1 year in duration and in 2019 produced 40 graduates. The role of the orthopaedic PA and NP fellow is to gain an understanding of a wide range of musculoskeletal disorders, develop procedural skills, first assist in the operating room, and facilitate management of patients and discharge throughput. PA and NP fellows work alongside categorical orthopaedic physician residents. The number of graduates from PA orthopaedic training programs is estimated at 200, spanning 20 years. The other 11,145 + PAs (99%) are trained on-the-job. For hospital systems, the employment of orthopaedic postgraduate PA and NP fellows provides value through cost management and billable services.

Completion and attrition of nursing PhD students of the 2001 to 2010 matriculating cohorts.

PURPOSE: To examine completion and attrition of students in nursing PhD programs. METHODS: Total 5,391 students who matriculated into nursing PhD programs in 2001 to 2010 were selected from the AACN database. FINDINGS: The completion rate of the students was 74.2% and the attrition rate was 22.7%. On average, it took 5.7 years for the students to graduate and 3.7 years for the students who left without graduating to drop out. The mean age at matriculation and graduation was 42.4 and 47.5, respectively. Male students, part-time students, students of post-baccalaureate programs, students who were not faculty or held a part-time faculty position, students of the 2001 to 2010 matriculation cohorts, and students in PhD programs with 25% or more of the courses taught online were more likely to experience attrition. CONCLUSION: The study findings provide useful information for the nursing education community to better address the issue of nursing PhD shortage.

A study of statistics knowledge among nurse faculty in schools with research doctorate programs.

Statistics knowledge is essential for nursing faculty in both teaching and research roles. In the teaching role when discussing nursing research, nursing faculty are confronted with statistical concepts and statistical methods applications. Knowledge of fundamental statistical concepts is needed so that nursing faculty can understand and critically evaluate the literature. The purpose of this study was to assess nursing faculty knowledge of fundamental statistical concepts. A probability sample with a 7.7% response rate yielded participation from 164 nursing faculty from 26 accredited schools. Results showed that most faculty members (91.5%) read peer-reviewed health-related scientific journal articles. On average, nursing faculty answered 5.1 (SD = 1.6) out of 8 statistical knowledge questions correctly. Problematic concepts included randomization (43.3% correct), and interpreting a confidence interval (42.7%) and odds ratio (33.5%). The results of this study may be used to improve statistics education and training for future nursing faculty and strengthen scholarship for nursing faculty conducting research.

Seizing opportunity: Diverse early-entry nursing students' perceptions of seeking a PhD.

BACKGROUND: The aging and retirement of the current nursing professoriate and the increasing numbers of nurses pursuing practice doctorates has precipitated decreasing numbers of nurses, specifically diverse nurses pursuing a research doctorate, thus limiting the development of nursing science. PURPOSE: To describe factors influencing decisions about entering a PhD program from the perspectives of early-entry PhD nursing students. METHOD: A qualitative descriptive design using semistructured interviews to explore the perceptions of making the decision to pursue a PhD in nursing of the students who participated in two early-entry mentoring programs. FINDINGS: A model, entitled "Seizing Opportunity" was developed from the findings about the process of students deciding to pursue a PhD. DISCUSSION: Motivators and detractors that can help nursing educators understand how to successfully recruit diverse PhD students were uncovered. Providing knowledge and mentoring for early entry students can increase the numbers of diverse students pursuing a PhD in nursing.

Use of Course-Specific Open Educational Resources in a Graduate Nursing Course.

BACKGROUND: This article evaluates a single-institution educational innovation using course-specific open educational resources (OER). METHOD: This educational innovation uses a course-specific library resource guide of OERs and evaluates students' perspectives on the quality, integration, and experience with the resources. At the completion of a nursing graduate course, the OER Satisfaction Scale was administered to the course participants. The course-specific OERs were assessed compared to students' experiences with traditional course materials. RESULTS: The overall score on the OER Satisfaction Scale was 4.01 on a 5-point Likert Scale. Students appreciated that the resources were free and found that the information was manageable and easy to navigate. However, they were challenged with shutting out other distractions and taking useful notes. CONCLUSION: Using OERs enhanced student engagement with the course content by requiring learners to assume a more active role as course participants. Further work is needed to understand the effectiveness of OERs, particularly in graduate nursing education. [J Nurs Educ. 2020;59(10):577-580.].

Rigor in PhD dissertation research.

Recent reports from the Institute of Medicine document the increase in the number of nurses enrolled in doctoral education preparing for nurse scientist and leadership roles in the transformation of health care. This means that many doctoral students will acquire a knowledge of the research process, learn how to review and critique relevant literature, select appropriate research designs, and with the guidance of their dissertation chair and committee, design and conduct high quality, scholarly research studies that culminate in successfully defended doctoral dissertations. The health care profession expects that these dissertations, which include quantitative, qualitative, or mixed methods, will contribute to the knowledge base of the nursing profession and advance improvement in clinical and public health outcomes in the populations served by the nursing profession. This article reviews the concept of rigor in research, the rationale for rigor, various approaches that increase rigor, and the associated concepts that strengthen a research study.

Paths taken by Brazilian Nursing for the development of terminological subsets.

OBJECTIVE: to discuss the paths taken by Brazilian Nursing in the development of terminological subsets of the International Classification for Nursing Practice. METHOD: documentary research, carried out in master's dissertations and doctoral theses, which developed terminological subsets, available at the Bank of Doctoral Theses and Master's Dissertations of the Under-graduation Personnel Improvement Coordination. The variables were analyzed were institution, year; academic level, type of health service, methodological approach, clientele, theoretical reference, validation of terms, cross mapping, modeling of new concepts, validation of statements, method used for elaboration, term collection, finalization and dissemination. RESULTS: 124 doctoral theses and master's dissertations were found, 91 were excluded and 33 were included, 23 (69.70%) of which were master's dissertations, with the highest production in 2014 (n=10; 30.30%), with emphasis on the Northeast (36.36%); the 'Primary Care' scenario, with six studies (18.18%); and the predominant clientele was cancer patients. As for the methodological characteristics, in 96% of the studies, the quantitative approach was used; in 2%, a qualitative approach; and 2% associated the quantitative and qualitative approaches. As for the type of study, 60% were methodological and 24% descriptive-exploratory, with the Horta model being the most used (36%). CONCLUSION: the paths are successful, yet still permeated by weaknesses in the validations and potentialities to standardize the language.

The Validity and Reliability of Professional Self-Concept in Nursing in Accelerated Bachelor's and Master's Nursing Students.

BACKGROUND AND PURPOSE: Accelerated bachelor's and master's nursing students supported through the New Careers in Nursing program were surveyed (n = 3,506) using subscales from Arthur's Professional Self-Concept in Nursing Instrument (PSCNI). Reliability and validity of the instrument was assessed. METHODS: Factor analysis using a random split-half design were conducted and differences investigated based on characteristics. RESULTS: Four factors were revealed: leadership (α = .85), skill (α = .89), career positivity (α = .72), and career negativity (α = .72), with acceptable confirmatory fit. Gender and race/ethnicity differences were found in self-perceived leadership and skill and in career positivity by race/ethnicity. Accelerated bachelor's and master's students were different on skill and career positivity. CONCLUSIONS: Self-perceived leadership, skill, career positivity, and career negativity are distinct PSCNI concepts.

Academic and professional characteristics of Australian graduate emergency nursing programs: A national study.

BACKGROUND: Specialist graduate emergency nursing education programs are essential to the delivery of high quality and safe healthcare to patients with complex needs in emergency care. Little is known about tertiary emergency nursing programs in Australia. This study aimed to determine the academic and professional characteristics of Australian emergency programs. METHOD: This embedded mixed-method study examined the academic and professional characteristics of Australian emergency programs in two interdependent phases: (1) document and content analysis of Australian graduate emergency nursing program websites; and (2) semi-structured interviews with the associated convenors. The data underwent framework analysis using eight pre-identified categories of (i) course entry, (ii) fee arrangement, (iii) mode of delivery, (iv) volume of learning, (v) clinical assessment, (vi) employment requirements, (vii) graduate expectations, and (viii) influence of healthcare employers and professional engagement. RESULTS: Prior clinical experience and the requirement for concurrent practising in an emergency care environment influenced were common, however fee arrangements were not clearly articulated. The College of Emergency Nursing Australasia Practice Standards for the Emergency Nursing Specialist featured in part within 12 programs, principally to guide development of clinical assessments. CONCLUSION: Establishment of emergency nursing graduate practice standards could better inform the design and delivery of emergency nurse programs, and yield benefits in terms of graduate expectations and satisfaction and improved patient care.

Doctoral Degree Preferences for Nurse Educators: Findings From a National Study.

BACKGROUND: Current doctoral degree options may not meet needs of nurses desiring educator roles in academic or health care settings. PURPOSE: The purpose of the study was to assess preferences for existing terminal degree options for nurse educators and determine the need for a new doctoral degree in nursing education. METHOD: Nurses in practice, academia, and leadership nationwide (n = 826) answered a 19-item needs assessment survey regarding adequacy of and interest in terminal degree options. RESULTS: More than 60% reported current doctoral degrees available to nurse educators lack content in curriculum development and teaching-learning best practices in nursing. Most data supported a new terminal degree. CONCLUSION: A primary factor in nurses choosing not to enroll in a terminal degree program may be limited availability of education aligned with career goals. The doctor of nursing education, a practice degree parallel to the DNP, could prepare nurses for academic and practice educator roles.

Meeting preceptor expectations to facilitate optimal nurse practitioner student clinical rotations.

Preceptors are essential to nurse practitioner (NP) students' transition from being a student to competent entry-level NP graduate. The literature is replete with data pertaining to the benefits of and barriers to preceptors engaging in the clinical education of NP students, and little has changed in the last two decades in this regard. Therefore, faculty solicited preceptor input to enhance curriculum revision and clinical training preparation. This qualitative inquiry project derived data from interviews with 13 preceptors in a variety of clinical settings. Interviews were audio-recorded, transcribed verbatim, and analyzed using a content analysis method. Recruiting, training, and retaining qualified, willing preceptors are of paramount importance to NP programs. This article describes preceptor expectations of NP students' knowledge, skills, and attitudes for optimal clinical rotation experiences. The results have important implications for innovative NP educational models, developing trust in NP education programs and promoting competency development of the NP student using entrustable professional activities.

Meeting FNP students' and faculty clinical needs: Two perspectives.

Appropriate clinical practice sites with skilled preceptors are the backbone of family nurse practitioner (FNP) students' education. Faculty are also in need of practice sites to stay abreast of current clinical practice and maintain clinical hours for certification. The purpose of this article is to relate the process of developing a practice model to meet the needs of the FNP student and faculty. Academia and student life professionals collaborated to use an existing student health center on campus as an education site with an FNP nursing faculty member as a preceptor. This qualitative descriptive study presents reflections of the experience from the student perspective. Three main themes were identified: independence, confidence, and trust. Lessons learned from the faculty perspective are also reviewed. Benefits of the project ultimately outweighed barriers. The interdepartmental precepted practice experience completed its fourth successful year and maintains support through the university's student life division. The model may provide strategies, particularly for FNP programs and faculty in smaller universities, to increase and diversify clinical experiences and provide a faculty practice site.

Academic reawakening: Situated experiences of undertaking a post graduate masters course in dementia.

Master's level education can play important function in developing the knowledge and skills for nurses and allied professionals working in advanced roles in dementia care. However, little is known about the challenges experienced by professionals when making the transition to post-graduate study. This was a qualitative study comprising individual interviews with 15 graduates, nine of whom were nurses, who had experience of attending a part-time Master's in Dementia Care in the Northwest of England. Four sequential themes emerged from the data: 'Deciding what to do', 'Taking it on', 'Keeping going' and 'Endings and New beginnings'. Findings confirmed that Master's education for nurses and other professionals is significant in developing knowledge and instilling confidence in changing practice. Nevertheless, professionals experienced challenges in juggling the competing demands of education, family and work and were seen to navigate and negotiate their student journey by drawing on internal resources and external supports. The study adds to evidence that Master's level study is likely to benefit practice in dementia care; however, employers and Higher Education Institutions need to develop effective and flexible supports to enable nurses and allied professionals to engage effectively in part-time taught post graduate education.

An innovative course to prepare advanced practice registered nurses to spearhead quality and safety initiatives for older adults.

ABSTRACT: Current trends dictate that advanced practice registered nurses (APRNs) must be competent to address quality/safety issues specific to older adults. A gap analysis and review of key competencies in an adult-gerontology APRN-Doctorate of Nursing Practice (DNP) curriculum prompted the design and evaluation of an innovative online course, Quality and Safety for the Aging Adult. Course objectives align with key competencies, including graduate-level Quality and Safety Education for Nurses (QSEN) and the DNP Essentials. The course purpose was to prepare adult-gerontology APRN-DNP students as leaders to promote quality/safety outcomes for aging adults. The six-step Knowledge-to-Action Framework guided course development and evaluation. Select graduate-level QSEN competencies were used to construct a 20-item Quality and Safety Survey (4-point Likert scale) (Cronbach's alpha, 0.916). This survey was used during week 1 (pre) and week 15 (post) of the semester to evaluate students' preparation and confidence to perform key QSEN competencies. Significant improvements (p < .000) between pre/post scores on the Quality and Safety Survey were found across five classes. Students felt more prepared and confident to apply selected QSEN competencies on course completion. Moreover, nearly 60% (primary care) and nearly 35% (acute care) adult-gerontology APRN students selected the older adult population for their DNP projects. The Quality and Safety for the Aging Adult course positively influenced five classes of adult-gerontology APRN-DNP students. Integrating QSEN competencies with gerontology and quality/safety content is an effective strategy to prepare APRNs to lead quality/safety initiatives in aging adults. This innovative online course offers a successful model for innovative DNP education of adult-gerontology APRNs.

Educational characteristics and content of postgraduate nurse practitioner residency/fellowship programs.

BACKGROUND: Nurse practitioner (NP) residency/fellowship programs are an emerging industry across the country. PURPOSE: This study aimed to conduct an in-depth exploration about postgraduate NP residency/fellowship programs in the United States and to gain an understanding of program characteristics, educational content, and implementation methods to assist NPs to transition to practice. METHODS: This exploratory study used a quantitative design to conduct an online survey of program directors of NP residency/fellowship programs to collect data about program characteristics to assist graduates to transition to practice. Descriptive statistics were calculated for continuous variables, whereas frequency and percentage were calculated for categorical variables. RESULTS: Nurse practitioner residency/fellowship programs lack consistency in standards for educational content and delivery methods. Only 26% of the programs were accredited, and the programs were not consistently based on nationally recognized competencies. Ninety percent of the programs relied on didactic and clinical supervision delivery methods. More than 90% of the residents/fellows cared for adults older than 65 years of age and managed chronic diseases. Family Nurse Practitioner was the most commonly cited population track offered (73%). Nurse practitioner residency/fellowship programs are sparsely offered in the most rural states with underserved populations. IMPLICATIONS FOR PRACTICE: This study provides data and insight into the emerging industry of postgraduate NP residency/training programs for educators and employers. In addition, it informs regulators and decision makers about the quality and consistency of programs and the impact of programs on the care delivered by new graduate NPs.

Reports of three organizations' members about doctor of nursing practice project experiences and outcomes.

BACKGROUND: Holders of the Doctor of Nursing Practice (DNP) degree were envisioned to improve health and health care outcomes by implementing quality improvement initiatives, applying evidence-based practice changes (EBP), and influencing policy. Little is known about the nature of the DNP project experience and its relationship with subsequent experiences of graduates. Filling these knowledge gaps is important because of the investment of time, faculty and student effort, expense, and the projects' potential long-term effects on the organizations in which they were conducted. PURPOSE: (1) Describe the impetus for foci, outcomes and activities of DNP projects and (2) determine the extent to which project foci are a part of post-graduation experiences. METHODS: A cross-sectional descriptive survey design was used and a via mailed paper and online version was sent with return options to graduates of Doctor of Nursing Practice program. The sampling technique was designed to maximize the capture of DNP graduates. Three mailings were sent to 5,830 nurse members of three national organizations with memberships that included advanced practice registered nurses, nurse administrators and nurse educators. The 1,308 DNP prepared respondents were demographically and geographically representative of organizational members. FINDINGS: Most (65.2%) reported the topic of the project was their own idea and they sought out an organization in which to conduct it. Twenty-five percent indicated not all aspects of the reorganization/initiative/policy change were completed by graduation. Five project foci emerged with the majority reporting an EBP initiative or an EBP project involving reorganization in the setting (57.7%) There was also a wide variation in the number, types and combinations of activities reported to be a part of the project. There was wide variation in the relationship of project foci and activities with reports of post-graduation experience by position title. DISCUSSION/CONCLUSION: Findings suggest potential avenues for innovations during the DNP project experience innovations. Long term effects of projects on organizations in which they were conducted and the relationship of project activities with post-graduation roles should be considered.

Does improved postgraduate capacity shift the balance of power for nurse specialists in a low-income country: A mixed methods study.

AIM: To explore nurse specialists' experiences of change and influence on practice two years after graduating with a postgraduate degree. BACKGROUND: In the absence of further study opportunities for nurses in their own country, a master's degree was introduced to train the first group of nurse specialists in Mozambique. DESIGN: Within a hybrid evaluation framework an exploratory, sequential mixed methods design was followed. METHODS: Qualitative data from focus group interviews with nurse specialists (N = 12) led to five thematic data sets from which survey questions were formulated for the sequential quantitative component. FINDINGS: "Change expectations", "Ambiguous practice environments", "Feeling powerless", "Having some influence" and "Workplace support" were emergent themes from interview data. Areas of positive change occurred in research (100%) and the use of evidence (88.9%) and involvement in decision-making (77.8%). For some change did not happen as anticipated-reasons included lack of nurse mentors to support new graduates (55.6%); lesser respect compared with doctors (44.4%) and poor understanding of the value of a master's degree (44.4%). Improvements in service quality and elevating the status of nursing were areas of greatest influence (77.8%). CONCLUSION: Several enabling and limiting factors were identified in the experiences of change and influence on practice of newly qualified nurse specialists. Tacit change with respect to the value of the degree in improving the status of nursing seems not to have affected nurse specialists' own ability and power to influence practice. Improved postgraduate capacity on its own does not empower nurses in their role as specialists. IMPACT: The findings point to a two-tiered strategy to be developed to dismantle barriers to the empowerment and advancement of nurse specialists. The identification of designated nurse mentors is essential to induct and sustain newly graduated nurse specialists. A clear research policy should be developed that supports the conduct of relevant research and the use of evidence in specialist practice.