This is a question that has been bugging me. I'm currently in an FNP program and in a second semester that includes pathophysiology and health assessment.
I already have some background in A&P and the basic fundamentals of pathology from pre- and nursing school 2-3 years ago and from having worked in telemetry and the occasional step-down units. But, I don't necessarily remember every exact details (example: Frank-Starling Law of the Heart, annuli fibrosi cordis, the different enzymes & cytokines, MSU crystals, the different resting membrane potentials, ion channels, etc.)
I am concerned that I may come across as knowledgeably ill-equipped come clinical rotations as we're going through an entire (freakishly big) textbook fast and not really having enough time to realistically absorb everything.
--Question--
In any case, for those who are already in practice post 1 year or more as an NP, how much do you remember in detail about your pathophysiology class from NP school?
My plan is not to get stressed too much about not learning everything as long as I know the macro-pathophysiology of the more common diseases and focus more on diagnosing and treatment plan come clinical rotations. Review esoteric medical knowledge later on as needed and when encountered. Is this acceptable?
Lastly, I guess the overall question is, from your wisdom and experience, when learning pathophysiology, what should students focus on for best use of time?
In my mind, that should be a year of clinically applicable sciences, a year of general clinical training (medicine, peds, surg, neuro, etc) during which we are the provider and not a nursing student hand puppet, and a year of specialty coursework.
I don't believe anyone on any level really needs 4 semesters of chemistry and 2 semesters if physics. However, there are some relevant concepts to learn that would make learning other clinically relevant material easier and more enduring.
For example, since CYP was brought up? Who knows why the 450 is added, I.e. CYP450? Likely this group because we're into this stuff. Additionally, who actually knows what a substrate is? As you see a lot in physiology, who can actually tell us what it means when you read about oxidation and reduction? Rather than continuing to read about and not know why not have that as part of the required curriculum. In all seriousness, one combined course of relevant biochem, cell bio, and genetics would probably be sufficient for us - not to retain and regurgitate later in life but to provide the base knowledge requires to grasp physiology that we'll use to a further degree. Then use that to actually learn patho before trying to shove a patho wothout prereqs down our throats.
As it happens, those that champion nursing experience before NP training aren't retaking their little undergraduate A&P courses. They may not have had that in a decade.
Specializes in Family Medicine, Medical Intensive Care.
In all seriousness, one combined course of relevant biochem, cell bio, and genetics would probably be sufficient for us - not to retain and regurgitate later in life but to provide the base knowledge requires to grasp physiology that we'll use to a further degree. Then use that to actually learn patho before trying to shove a patho wothout prereqs down our throats.
This!
My FNP program has a class titled Advanced Physiology/Pathophysiology, which is kind of misleading. No instruction on medical physiology at all, just pathophysiology. So, I supplemented my studies by reading Guyton & Hall, which was a suggested but not required textbook. Half of the course was taught by a biochemist, which was pretty darn nice! I really appreciated the perspective and level of detail she brought to the material.
Like everyone has already mentioned, there definitely needs to be more basic medical science education in NP schools. It sometimes sucks having to supplement my required studies with extra readings from basic medical science textbooks, but overall it's not too bad. I'm mostly a self-directed learner, anyway. Luckily, my school has access to practice USMLE tests for Step 1 and Step 2 since we belong to an academic medical center.
PG2018
1,413 Posts
Here's how my NP program roughly panned out:
A year of vapid, base nursing mantra.
A year of 3 freaking P's and practice management.
A year of clinical training.
In my mind, that should be a year of clinically applicable sciences, a year of general clinical training (medicine, peds, surg, neuro, etc) during which we are the provider and not a nursing student hand puppet, and a year of specialty coursework.
I don't believe anyone on any level really needs 4 semesters of chemistry and 2 semesters if physics. However, there are some relevant concepts to learn that would make learning other clinically relevant material easier and more enduring.
For example, since CYP was brought up? Who knows why the 450 is added, I.e. CYP450? Likely this group because we're into this stuff. Additionally, who actually knows what a substrate is? As you see a lot in physiology, who can actually tell us what it means when you read about oxidation and reduction? Rather than continuing to read about and not know why not have that as part of the required curriculum. In all seriousness, one combined course of relevant biochem, cell bio, and genetics would probably be sufficient for us - not to retain and regurgitate later in life but to provide the base knowledge requires to grasp physiology that we'll use to a further degree. Then use that to actually learn patho before trying to shove a patho wothout prereqs down our throats.
As it happens, those that champion nursing experience before NP training aren't retaking their little undergraduate A&P courses. They may not have had that in a decade.