Editor’s note: The following is an excerpt from HCPro’s new book, Nurse Practitioner Fellowship: Program Planning and Curriculum Development. Click here to order your copy.
Over the past couple of decades, studies have consistently shown that structured programs have facilitated the development of the competence and confidence of postgraduate nurse practitioners (NP) when presented with extended, dedicated clinical time, mentorship, and focused experiences assimilating the role (Dillon et al., 2016; Bush, 2016). A small study of experienced primary care NPs explored whether there was a perceived need for NP fellowship programs and found that 86% of the respondents felt that there was a value and benefit of NP fellowship programs for future NPs and 80% indicated that they would have been interested if given the opportunity when starting the NP role. In contrast, 13% believed that having NP fellowship programs would cause it to appear that NPs were not prepared to practice after academic training. The main reasons cited for having a program were related to knowledge (66%) and clinical skills gaps (60%) (McKay et al., 2017).
Another survey of NPs practicing in various clinical settings found that 87% would have benefited from a postgraduate residency program and 51% were only minimally prepared upon graduation from their academic training (Hart & Macnee, 2004). Although there was no significant difference in the respondents’ ages or experiences as NPs, they felt a need for more clinically relevant content and experiences to improve their knowledge and skills in areas such as diagnostic interpretation and pharmacology and had feelings of fear, insecurity, and uncertainty during their role transition.
Studies have shown that higher levels of NP job satisfaction have been correlated to increased retention (DeMilt et al., 2011). Transition-to-practice programs have demonstrated positive outcomes for organizations, including increased job satisfaction and organizational commitment (Dillon et al., 2016).
Bush, C., & Lowery, B. (2016). Postgraduate nurse practitioner education: Impact on job satisfaction. Journal for Nurse Practitioners, 12(4), 226–233.
DeMilt, D. Fitzpatrick, J., & McNulty, R. (2011). Nurse practitioners’ job satisfaction and intent to leave current positions, the nursing profession, and the nurse practitioner role as a direct care provider. Journal of the American Association of Nurse Practitioners, 23(1), 42-50.
Dillon, D. L., Dolansky, M. A., Casey, K., & Kelley, C. (2016). Factors related to successful transition to practice for acute care nurse practitioners. AACN Advanced Critical Care, 27(2), 173–182.
Hart, A., & Macnee, C. (2007). How well are nurse practitioners prepared for practice: Results of a 2004 questionnaire study. Journal of the American Academy of Nurse Practitioners, 19(1), 35–42.
McKay, M., Glynn, D., McVey, C., & Rissmiller, P. (2017). Nurse practitioner residency programs and transition to practice. Nursing Forum, 1–5.