ACNP without research, theory, etc - Page 3

My ACNP program at Pitt was 47 credits and 700 clinical hours. I ended up completing around 820 hours as I did extra electively. We had Research I, Research II and Statistics. We also had a Healthcare finance and a Leadership & Ethics course. Can't say I enjoyed the theory classes, but I did learn, and I do use them in practice. My new NP job is going to be fairly heavy in QI projects and I will need that research and EBP info every day.

Juan,

Sorry about the confusion, my post was getting a little long and I didn't elaborate on some items as thoroughly as I should have.

To answer your question about my 2 research and 2 stats courses, that does include my undergraduate coursework as well. I completed a direct entry BSN-MSN program and the overlap in my research courses made the second go around almost unbearable. Much to what you alluded to, I also believe many of these courses would be better integrated into our curriculum by combining them, such as stats and research. There is also no need to have a separate 3-credit health promotion class (a class in which I actually managed to take nothing useful away from). It's not that I don't feel health promotion is important, it's just that you can integrate this philosophy into other classes without devoting an entire 3-credit course to it. I also agree that courses covering the legal/practice framework for NPs is important. We need to understand contract negotiation and statutes that affect our practice.

Now to the other point of confusion. Unfortunately for me I guess (and all my old classmates), my curriculum was not organized like your ACNP program. We would have three week stretches where we covered CV, neuro, and musculoskeletal, as well as, any other random combination of subjects you can imagine. I personally don't believe the random delivery of these subjects provided us with the depth that should be afforded to each system.

Taken as a whole I believe our educational philosophy is severely flawed from the top down. In a lot of ways it's a classic case of old school meets new school thinking.

We have criteria about who we consider professionals to be. That is diluted when we have "professional" fireman, policemen, bricklayers, auto mechanics, and fry cooks, etc..

To “8mpg”:

I would venture to say that no one is excited about taking research and theory, but those courses are required by the “powers that be,” and so every NP program has to have them. If you find a program that does not have research and theory, turn and run in the opposite direction, as I am thinking it is probably not “legit”/accredited. Individually, a school can add to the required courses. I started out at a school that had two research courses, instead of the usual 1. I think they went on to add a leadership course, too, that was not required by the “powers that be,” but just a course that they thought would benefit their students (whatever, right?).

I did great in my courses, even got a decent score in that first research course, BUT I DID NOT PASS IT BECAUSE I DID NOT GET ENOUGH POINTS IN THE INDIVIDUAL PART OF THE COURSE (there were group projects AND individual projects). So, even though I had enough points for a grade of B, I received a C in the course and was told that I had to retake the FIRST research course again....

I transferred.

Though I had finished a year of grad school, I saw this as a HUGE “red flag” against this program. I transferred to my first choice of schools --the University of South Alabama (GO JAGUARS!). Ironically, the first course I had to take (or re-take) was research. Research was not easy, and historically it was not known for being easy, BUT MY GROUP AND I ACED IT! The instructor, on our last paper, which was a group paper, wrote, “CONGRATULATIONS, YOU UNDERSTAND RESEARCH!” It was so cool.

Chances are you are going to have to take research and theory. Spend your time finding out which school “fits” you. Like me, you might hate research (and/or theory) at one school, but LOVE it at another school. Start asking “why did you like/dislike your research course" at the University of South Alabama, or USC, or Indiana Wesleyan University, or whatever. When a program/school sounds good, then research it a little more. You WILL find your school.

OH, and I needed to add, I used/use research and theory every day. I am sort of scared of those who do not (or think they do not). Evidence based practice, best practice guidelines, new treatment modalities, patients perceptions of their caregivers, spirituality in breast cancer, the theory of caring...as an advanced practice nurse, SERIOUSLY, how can you not use research or theory to some degree?! The parts of research and theory (mostly research) that I do not care for are the parts that I did not truly master. One of these days I will re-visit those areas that I did not entirely grasp, and I am thinking I will find them interesting and even helpful.

Ha, that study sounds like the researchers learned study design from Andrew Wakefield.

Unfortunately no one really knows how many 'Wakefields' are out there, unexposed. This is even more reason to be able to critically examine research, to be able to raise the proper questions before accepting and acting on research. Part of this is knowing to some degree how research should be conducted. I used to feel that my undergrad research was enough, that is, until grad research proved otherwise.
We cannot and should not get away from research courses, but perhaps the manner in which they are taught should be improved.

OP, a good ACNP program incorporates research evidence in the entire program especially in terms of the sequential ACNP didactics and not just from a single graduate level "nursing research" course. It is important that a review of evidence from the literature is what's driving lectures on how to treat ARDS for example, how levels of evidence are used in the current management of ACS, and how PPI's are not superior to H2 blockers in stress ulcer prophylaxis.

A hallmark of a good research finding is if the results are replicated in other similar studies, hence, the overwhelming support of evidence. Evidence-based medical practice is never typically taught in a graduate "nursing research" class but should be part of the ACNP didactics. It is important in ACNP practice more than anything else. Hopefully, you'll find a school that makes this a priority.

I think it is ridiculous to say that NP students could not critically examine research without going through a nursing research class. The Wakefield example was fueled by sensationalism and was not widely supported by the medical community. It did not result in a practice change as far as recommendation for vaccination in kids from both CDC and the Academy of Pediatrics, all it did was scare parents on both sides of the pond.

Juan and NPreform, I could not agree with you more. We need comprehensive ACNP education reform that actually reflects what ACNP's do on a day-to-day basis. I have suffered through one year of ACNP education so far, have just started my second year. Today, in my ACNP III class, I sat through 3 hours of basic oncology lectures that were aimed at prelicensure students. The speakers didn't even know who they were presenting to--they asked us midway through if we were FNP students. Not even a mention of how to manage an inpatient oncology patient, oncologic emergencies, or anything relevant for the ACNP. Then, in the afternoon, I sat through my "clinical conference" class where the instructor basically walked us through the syllabus AGAIN (she did this last week at the first class, too) and the five different writing projects we're doing for a CLINICAL CLASS this quarter. Every quarter is the same--write at least 3-5 "scholarly papers" aimed at prepping you to write a comprehensive exam which is basically just another paper. Don't get me wrong, I am a huge fan of research and evidence-based practice and am a major believer in using practice guidelines to deliver the best care. But since when does "writing scholarly papers" prepare RNs to become NP's? I can see a few papers here or there. But 5-6 a quarter?

Meanwhile, we got exactly 1 quarter of patho, 1 quarter of pharm, 1 class each on CV, respiratory, endocrine, GI, and neuro. But 3-4 classes each on standardized procedures, issues facing NP's, ethical dilemmas, use of theory in practice, etc. etc. Not to mention an entire REQUIRED class on how to build powerpoint presentations and make sure that any health education materials you produce meet the American public's 5th-8th grade reading level (easily done by using the Word Count feature in MS Word).

It is time to absolutely DEMAND that future NPs (too late for us, alas) receive the education that will actually prepare them to be functioning NPs when they graduate. And yes, I think residencies are absolutely necessary. But this may just encourage schools of nursing to slack off more on clinical hours (which they already do at the prelicensure level--reassuring students that "the hospital will teach you everything you need to know").

NP's are great and we definitely bring a fresh perspective to patient care. But let's not pretend that for the most part, NPs practice medicine. We need to be trained as such. NPs and PAs should join forces and create a combined midlevel curriculum. Just look at the CRNA curricula--it is so much more focused on the biomedical model of caring for patients--because that's what they need to do!