ACNP without research, theory, etc

bsnanat2 · Aug 3, 2012

I agree with the posted responses. Believe me, I am no fan of theory, but without theory and research, you are just a technician. Do you really believe that a medical school operates without employing research? Would you go to that physician? They may not explicitly call these courses "research" or "theory" but you'd better believe they are there. BTW, Zenman is correct...without these courses, you are not a professional, you are a technician. Proficiency on the technical points does not make a professional.

As for PA school, talk to PA's who didn't get specific instruction in research and see how they struggle to decipher new info. There is an art and skill to reading research. The old saying that 'there are lies, damn lies and then there's statistics' is true. If you do not know how to determine the validity and integrity of research, you will be fooled like everyone else and will make mistakes. Drug reps no longer come to our unit meetings because the nurses/NP's who have had graduate research destroyed their presentations with questions about methods, sampling and the choice of statistical analysis tests, while the PA's sat quietly. The "books are cooked" in research all the time and you MUST know how to tell if you're getting the whole story.

BTW, as much as I hate to say it, I have actually benefited from theory (but still think it is over done). A surgeon who had always been a jerk, overheard me and another nurse debating Peplau, Swanson and the roots of humanism and other theories. This doc interrupted and said he was impressed and realized that all nurses must not be "just robotic pill pushers." Bottom line? No longer a jerk (to the two of us at least) and heard he hired a NP over PA for the first time ever.

bsnanat2 · Aug 3, 2012

One more 'high horse' comment......

You must learn that research proves nothing. It only demonstrates a relationship, the lack of a relationship, a correlation, the lack of a correlation and/or the probability of something happening or not happening. This is extremely dumbed down, but if you don't know this, you will be a victim of drug companies. The following example is a real headline but I will use bogus numbers to make my point...

Recently headline read something like, "Spanking leads to mental illness in children."

"Study of 20 mentally ill teens shows that they were all spanked as children."

This is already a garbage study because the sample is too small and too narrow. We know from previous research that this population is already likely to suffer violent physical abuse, which, depending on the author's bias, can be applied to spanking. What was their level of cognitive function? Can they dependably give a response? Were these children in the home or institutionalized? What was the SES status? What was inclusion/exclusion criteria? What was the p value? Is the chosen statistical test one that is formulated to demonstrate a correlation? And on and on.

The correct title should be "Mentally ill teens more likely to have been spanked as children."

The devil is in the details.

allnurses Guide · Aug 3, 2012

The more important thing is that you will be required to take classes that prepare you to sit the national certification exam. The ANCC exam is super heavy on research, theory, communication questions etc.

mammac5 · Aug 3, 2012

The more important thing is that you will be required to take classes that prepare you to sit the national certification exam. The ANCC exam is super heavy on research, theory, communication questions etc.

This is the point I was going to make, exactly. I could NOT have passed the ANCC exam without the courses in theory and research that I completed (grudgingly!) at Vanderbilt. I had no plan to ever do any research myself, nor do I plan to pursue a DNP or PhD in nursing. But my first job out of school just happened to be part of a research study. I didn't plan the research, am not keeping track of the numbers, and will not be part of writing up with study for publication. I take care of the patients involved in the study. But when we have meetings with the principle investigator and others involved in the actual research process, I understand what they're talking about and can participate in the discussions in a way that doesn't embarrass me. That's been very valuable to me in this job.

Advanced Practice Columnist / Guide · Aug 3, 2012

Unfortunately for me, I may need to go back to take some chemistry classes and go to PA school. Though we are in nursing, I believe that midlevel practice would be better off following a medical model where you study more of what you need in practice, not theory and research.

That's a personal choice you'll have to make. PA school, to me, is an alternative to those interested in a non-physician provider role without having to sit through courses in nursing theory and nursing research that accompanies all nurse practitioner nursing programs. But you can't have it both ways. If you want pure medical model training, you will have to sacrifice taking science prerequisites and being in school full time through PA school. If you want to stick to your nursing roots, you'll have to embrace nursing theory and the distinct body of knowledge nursing research offers even if all it entails is going through 6 credits of nursing theory and nursing research courses.

NPreform · Aug 4, 2012

OP, I eventually stopped reading every post in its entirety, partly because I couldn't stop rolling my eyes but also because it's typical nursing banter. Our educational model is broken, period, plain and simple. I know this is going to enrage some of the die hard rah-rah nursing types but it's the truth. There needs to be more science and more clinical hours and less "nursing theory/research" courses. Trust me I understand the holistic philosophy and while I definitely believe we (we as in all providers) provide better patient care when we approach the patient as a person rather than a lab value, those lab values are very important as well. We are prescribing medications, diagnosing illness, and managing patients overall care. In a lot of settings, with a lot of respects we play the same role as the physician. Therefore, our time would be far better spent on things that matter, like more patho/clinical/science classes. I have taken 2 research classes (in addition to 2 stats classes and too many theory classes to count) and gotten almost nothing out of them. I didn't need to spend 4-months learning the difference between qualitative and quantitative research designs (and the list goes on). It was a joke and a waste of my time and money. It would have been far better served on so many other classes. This may also be associated to a certain degree with my learning style (confounding variable lol) but we are graduating too many NPs without adequate preparation. Our curriculum should be more closely correlated with the medical, while integrating the theory/research components into each class. For example, it should be systems focused (4 weeks on cardio, neuro, etc), rather than a random set of mix and match subjects each week.

A few more important things on the agenda:

We should be required to complete a 1-year residency, though this will never happen due to financial constraints. The residency should be no longer than 1-year, otherwise you may as well go to medical school.

We need to put an end to online, for profit NP programs. They are undermining our profession and destroying our credibility.

The DNP is as much of a joke as the abundance of research/theory classes we have to take. If you are going to have a doctorate program committed to clinical practice, then it should be focused on clinical practice. If you look at the curriculum's as they stand, it's all about the application of research to practice. No additional specialty focus (though there are post-masters DNP programs that allow you to pick up a certificate in another specialty in addition to the DNP courses), no additional science courses, and no additional practicums. Nothing about this make sense. Not to mention there is no increase in pay and yes this should matter. Compensation seems to always be the elephant in the room in nursing. "Oh you mean you only got into it for the money...I don't care how much money I make." Well congrats. No it's not the only reason I decided to be an NP but I would like to be appropriately compensated for my work and right no the DNP doesn't pay.

Pick the program that accommodates your learning needs; don't let everyone on here tell you what you need to be a better NP. Everyone told me I needed RN experience before becoming an NP and they couldn't have been more wrong. My clinical reviews through school were always excellent and my NP/Physician colleagues now often find it difficult to believe I didn't have any experience prior to NP school. And no I'm not bragging, I'm just pointing the facts, you don't have to do what everyone else tells you, just because it's the way things have always been done (another problem plaguing nursing).

Advanced Practice Columnist / Guide · Aug 4, 2012

np reform,

your point is well taken about the need to restructure the np curriculum as well as setting a higher standard of quality in terms of program accreditation. however, before we derail this thread by getting off topic, let me just say that a few of your comments got me a bit puzzled. one, it is quite unusual for an np program to have 2 research classes in addition to 2 stats classes...

as you stated in your post. did you include your undergrad theory, research, and statistics courses in that total?

also, your comment,

it should be systems focused (4 weeks on cardio, neuro, etc), rather than a random set of mix and match subjects each week

begs for inquiry on my part. what np program did you attend? acnp programs are specifically structured using a body system-based approach in terms of didactics and clinicals.

if you see courses labelled as acnp i, ii, or iii (as in vanderbilt and upenn's curriculum as i posted a link to), those are sequential didactic courses with accompanying clinical rotations that deal with chronic, acute, and critical conditions in the adult patient. these are organized based in body systems, hence, acnp i could be neuro, heent, and musculoskeletal; acnp ii could be cardiovascular, pulmonary, and renal; and acnp iii could be gi, hematologic, endocrine, and id. i personally would attest that acnp programs are great at providing a system-based approach in patient management. now that those are out of the way, i do agree that changes need to happen and i'll tell you why. my acnp program had a total of 12 credits of non-clinical courses: 3 credits of research, 3 credits of statistics, 3 credits of theory, and 3 credits of professional issues.

i agree that it is a bit much to have nursing research and statistical methods (each of which are 3 credits) not combined into one course. the explanation we got from the school was that this curriculum was conceived at a time prior to the dnp agenda when the academic progression for a nurse is a bsn - ms/msn - phd. while the chance of an ms graduate securing primary investigator grant funding for research is slim, the phd program at the same institution required applicants to have already received graduate level courses in research and statistics. since we have created a dichotomy in doctoral education for nurses now (phd vs dnp), i too think that we need to revisit these research courses at the np level and make sure they're not taking too much from the overall credits and sacrificing much needed clinical training. of course, that will require a buy-in from ancc which traditionally have always had a significant number of research-related questions in their certification exams.

the other "fluff" courses that get a lot of complaints from students are nursing theory and health policy/professional issues. nursing theory goes hand in hand with nursing research. all research in nursing uses a theoretical framework as the basis of inquiry. again, to me this seemed like the ms programs were developed to prepare graduates for phd. but to be honest with you, i had no complaints with my nursing theory class. it's easy to have a sense of it being too "touchy feely" than scientific but i felt like the course is a reminder that medical therapuetics can only go far. being aware of concepts in self-efficacy, resilience, psychosocial and physical stress responses, human motivation towards health promotion, culture and diversity are just as important in becoming a well-rounded provider. but then again, do we need to have a 3-credit chunk of a course on it?

lastly, i think the courses in health policy and professional issues should remain in the np curriculum as it is for many reasons. one, i found this course extremely helpful in the political climate of healthcare when i was a student as well as now. two, i found that the course adequately prepared me to recognize the legal aspects of my future practice. and three, the course was instrumental in giving graduates the ability to evaluate job prospects and not risk being screwed over by unfair contracts and salary negotiations. at least that's the message i took home from it and i think those are extremely important.

Home Health Columnist / Guide · Aug 4, 2012

Look at Drexel's online MSN: Adult Acute Care Practitioner Concentration - Drexel ...

55-credit graduate track with a 640 clinical hour requirement.

allnurses Guide · Aug 4, 2012

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.

NPreform · Aug 5, 2012

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.

zenman · Aug 5, 2012

Zenman... while I can respect your opinion, I do not think that being a "professional" has anything to do with the quality of education or quality of care a person can give. I dont need my CPA to have studied research, I need him to be proficient at taxes. I may be in the minority of people that believe it is much more important to focus on what we need to do our job proficiently.
.

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..

ROLO · Aug 9, 2012

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.