DavidNP

The Duke FNP online program requires more than a once a year visit on campus. (http://nursing.duke.edu/modules/son_academic/index.php?id=97) There is an initial visit for a one day orientation. Then at the beginning of your second year the Advanced Assessment class requires three visits for 3 full day weekends spaced evenly throughout the semester. This is a class that obviously requires "hands on" teaching, practice, and evaluation. You are expected to have reviewed and practiced skills in advance. Incorporated into this are mock examinations with practice patients, case presentations, and SOAP notes. They were stressful, but in retrospect fun weekends. Since you are standing around in gowns for a total of 9 days it is a good time to get to know your classmates. Then during the other clinical semesters there may be one or two days required on campus. If you live out of state you must get approval before entry into the program because during your clinical rotations a faculty member will come to your clinical site for a review with you and your preceptor at least once a semester. Good luck! David FNP Duke '09

Know developmental milestones, the major diseases that cause rashes and how to distinguish them, cardiac defects and murmurs, ortho issues and diseases specific to peds. The references I listed cover these well. If I think of more I'll post more.

I passed the AANP last week and am now waiting for my "official" letter so I can apply to my BON. I had no glitches in the application process. I had everything submitted so that all that the AANP needed after graduation May 10 was my final transcript. I received my authorization letter from Prometrics the last week of May. There were many questions that I had to sit back and evaluate, I'm definitely glad reviewed a couple of weeks. Maybe I just barely passed, but I felt prepared. I was done in a little over 2 hours with taking time to review 15 or so questions I had marked. I changed only 2, then took a deep breath and clicked "end test". It then asked me if I wanted to take a survey on the testing experience! After that it "churned" for awhile and then the PASSED notification came up. I sat there for several minutes just looking at it and enjoying the moment. To prepare I went through the 2008 Fitzgerald review CDs and workbook, then followed up with the questions and material in the Fitzgerald FNP review book. It is more in depth than the review course workbook. They complement each other. (http://www.amazon.com/Practitioner-Certification-Examination-Practice-Preparation/dp/0803611595/ref=pd_sim_b_7) I would also look up diseases and drugs on Epocrates Online as I went through the review. I have it on my iPod Touch, but the online outline format is more indepth and will be a good clinical resource for practice. A few days before the exam I went through Maria Codina Leik's book linked below. It was perfect for reviewing key points. (http://www.amazon.com/Family-Nurse-Practitioner-Certification-Intensive/dp/0826102964/ref=ntt_at_ep_dpi_1) Now a few more days as a RN in the ED and then onto a new career in Internal Medicine!

Wunderkind, Since I have not posted 15 times yet so you can email me at "fnp2009 at gmail.com" and I'll reply with my normal e-mail address. (It was easier to create a new e-mail than post 8 more times!). My non-nursing online discussion is limited to woodturning, so I'm not used to so much anonymity. I've only posted here a few times since joining a couple of years ago. I have not had time for non-required discussion boards. I'll probably join as a premium member after money is not so tight. On an encouraging note, I took an elderly relative to see a specialist at a major academic med center yesterday. I interacted with the specialist a good bit during the encounter and as we were leaving he asked if I were in the medical profession. I mentioned I was soon finishing the Duke online FNP program. We talked a bit about the program and my background. He gave me the name another MD and e-mail to contact about a new position there that will be available there mid-next year. It would be a long commute, definitely out of the realm of primary care, and back into a very intensive environment. I mentioned my degree was a FNP, not ACNP and he said because of the age limitations an FNP would be more preferable and training was expected. I'll definitely pursue it farther. I'm keeping all options open.

Wunderkid, As I've made clear, I am very happy with Duke's program, but I can say I have had one preceptor and worked with another who both attended ETSU's FNP program and I hope to be one day to close as good as they are.

Bragging about working FT? Did I say it was easy? As for working full time, it is pretty common. Most "on-campus" MSN students at Duke work full time as well. I have known several MDs and one lawyer who worked all the way through school. Including my family MD. The online program at Duke is "part-time" with 2 classes per semester 3-4 credits each for at least 7 semesters. So for the past seven semesters my life has been as follows... Work 3-12hr days as an ER Nurse. Clinical for 8 hours 1-2 days a week (lunch excluded), and pretty much solid studying the other days 8-12 hours each. One 3-day family vacation during that time (rented an umbrella and studied). I had to go part time at work for my 2 final semesters to fit in the weekday clinical time and I am working every weekend. The 10 day or so semester breaks were for catching up on home and yard stuff. It takes me a week after exams to actually relax. I could have never done it had my wife not pretty much taken over all the household responsibilities.

Where are you going? Duke FNP What do you like/not like about the program? Online flexibility with working full time, organization or program, accessibility and quality of the faculty. The program is structured with discussion boards, and some on-campus time so that you feel part of the Duke SON community. I really have no complaints. Do you feel that your experience has short-changed you as compared to going through a traditional program? I work with Duke NP grads who were entirely on-campus students and I took one semester on-line due to scheduling (3-hr drive), so I have some idea for comparison. I feel in no way shortchanged and maybe at an advantage due to the resources available online that are sometimes not available in the same on-campus course. Though this is changing and even on-campus students often have lectures recorded and posted as Powerpoint presentations and MP3 downloads, etc. I actually felt from a learning standpoint, the semester I drove to hear lectures were somewhat of a waste of time. It was nice to have some on-campus time though, especially at the end of my program. If you had to do it over, would you have chosen the traditional path? No I'm happy to answer any questions I can. There is some more detail about my program in this post . David

Zenman, I look forward to being a preceptor... in a few years. N_G, I agree that national standards and control are very important. However the arguments I am reading here criticizing online programs seem to be based on anecdotal experience with students from single programs and a lack of understanding of how online NP programs are structured (thus the oft repeated "100% online" comments). There are at least 2 online FNP programs in my state (Duke & ECU) and I have never heard any practitioner speak negatively of them and I vetted both programs pretty thoroughly prior to committing my career to one of them. Though phrased as an "online" problem, the concerns expressed in this thread should not be generalized as such. The idea that clinical judgment can only be taught in a classroom with a blackboard and nice straight rows of desks is really archaic. From my experience, I wonder about the quality of NP programs that only have reading and weekly classes with 3 hour in person lectures with no online discussion, supplementary video, audio, or written material. Faculty can only be accessed in class or during limited "office hours" on 1 or 2 weekdays. Sounds pretty limited to me. Nursing is a second career for me after a long career in technical training and service. Throughout my nursing journey I am amazed that the adage "nurses eat their own" really is true in some settings. Unfortunately, this does not stop with conferment of an APRN degree. I started participating in this thread because I saw a statement from Duke's website being misinterpreted and I wanted to correct it, and because I am a predominantly online student there I felt I should try to engage and educate those detractors of online education. Comments expressing fear for the future of NPs and "the public should know" strike me as very uniformed and unreasoned. The Duke SON has a very strong commitment to online education. Last time I checked, Duke is a fairly well known school, the SON 13th in NIH funding, our faculty is top-notch, and our alumnus dean of nursing came back to Duke after being dean at some backwater school called Yale. An institution of this caliper does not institute an online program to make a few extra dollars or to boost enrollment. The argument is being made that MD, PA, or legal schools do not have online avenues and thus NP online education must be bad. Having worked at a large academic hospital in the past 4 years I can tell you that online and recorded lectures are definitely part of MD instruction. Pick a few well known schools and peruse their student web sites, you'll find lots of online content (some not accessible without login) and even (gasp!) online tests. The University of Virginia is a good example of this, also check out their iTunes videos. (There are a number of good medical resources on iTunes.) However most all Medical education is hospital based because it requires instruction in a more acute environment. Duke's ACNP, NNP, and Acute PNP programs are not offered online for this same reason. MD students training in primary care often have rotations similar to NP clinicals at out patient clinics. The legal analogy is just invalid. Though I'd surprised if most law schools do not have online content (never looked). The law school analogy just does not work because verbal argument is the basis of legal skills. From the first semester this skill is taught, honed, and challenged. The Excelsior RN program that lost accreditation in GA that is being touted as an example of the evils of online education. Again this is a specific program, and its loss of accreditation cannot be generalized to all online education. I really don't care to read about it more than has been posted here, but it sounds as if the GABON made a decision based on its certifying requirements for all SON. That is a good thing, however if one bad school were to set the standard there would be no ADN or BSN programs remaining in NC based on the past performance of a very few intuitions. This brings me back to my point in my last post. Concern for the quality of NP preparation is crucial and very important to our profession. As a soon to be FNP I appreciate the concern and oversight. If you are concerned about a particular program, call the faculty; then if not satisfied call the dean. Preceptors are valuable and their opinions count. If you know a program is turning out unprepared graduates get in touch with your state BON. But please do not judge based on preconceptions or prejudice. I've said enough. I'll shut up now... Happy Holidays to everyone!

I am one semester from completing the Duke SON Online FNP program. I take exception with several comments in this thread generalizing online NP programs as substandard and mischaracterizing the Duke program in particular. First, Duke has several online NP programs for BSN prepared nurses. A previous Masters degree is not required for any of the NP programs. The part of the sentence ANPFNPGNP bolded referred to the post master's certificate option. Second, there are no 100% "online" NP programs of which I am aware. All have a local clinical requirement. Thus "off-campus" or "distance" may be a better term for these programs. I too have had surprised reactions from patients and providers when I tell them I am in an online program, however once I explain how an online program works it makes sense to them. As for MD perceptions of an online program, many of my recently graduating classmates have been offered positions by their MD preceptors. Duke's distance program has the majority of the didactic content online. Clinical is arranged locally to the student (usually The online courses also have extensive group assignments such as case studies requiring virtual collaboration throughout the semester. You must be active, contribute, and willing to take initiative or faculty will quickly notice. Discussion boards in most courses required weekly input, graded for content. Tests are timed and depending on the instructor, open or closed book. The tests draw from a random bank of 100's of questions, multiple choice, short answer, and essay. If you need to look up something like a practice guideline you had better know exactly where to find it. There is no time for research. The faculty keeps close watch on grades and curves for the online and on-campus tests are consistently similar. In the FNP program there may be one "on-campus" day most semesters. However, in the semester prior to beginning courses with a clinical component, an advanced physical assessment course is required that does have three 3-day sessions on-campus for teaching and practice of the physical exam. These weekends are in addition to the semester's weekly lecture, exams, and readings. Students are expected to come to these weekends well prepared. There are individual skill demonstrations and checkoffs, thorough hands on instruction with male and female professional medical models, and an excellent 1/2 day orthopedic seminar. On the last weekend students must perform a timed complete physical and several randomly assigned acute and chronic exams. Obviously I had still had and still have a great deal to learn but I felt well prepared for basic physical exams after this course. I have been told by 2 experienced preceptors that their Duke online students have been the best prepared NP students they have taught. Because I had added a 2-semester cardiology component to my program I was required to drive to campus this fall to take 2 courses or wait an extra semester to complete my degree. The transition to the classroom was seamless other than the tedium of sitting through 6+ hours of morning and afternoon lecture. I had been used to watching a lecture, pausing to take notes or read about a specific point, web search, etc. and then continuing lecture (or mowing the yard). Just like my on-line courses, the on-campus classes had an extensive online Blackboard component, additional online lecture assignments, journaling, and discussion boards. Lectures are recorded and available on Blackboard in a narrated Powerpoint format and MP3 download by the next day for review. The main difference was there were less group assignments required than for the same online courses. The discussion board was not as active, but there usually were still one or two interesting threads a week along with case studies. The technology may sound advanced, but it is becoming the norm. My local community college has the same capabilities. If I were ever to teach in a similar environment I would require online lecture content to be reviewed prior to class. Face to face time is better used for interactive discussion, case studies, etc. The problems that ANPFNPGNP mentions with her local online NP program sounds as if it may be a poorly designed program. I have been told by my preceptors of a "brick & mortar" NP program in my area that similarly expects their students to get their assessment instruction in clinical. It puts a lot on the preceptor, but the online aspect is not the reason for a poorly designed program. I would recommend contacting the dean and letting him or her know your concerns. I think the criticism leveled at online programs is somewhat based on generational and technological perceptions as well as individual learning style. The Duke SON faculty have been encouraging, supportive, and sometimes forgiving. However the program requires a high level of motivation, determination, time management and organization. We were told that 15-20 hours/week of non-lecture study is expected for each 3-4 credit graduate class. Some weeks I did less, but usually I studied at least that much. Thankfully there are options for more than one type of learner and lifestyle. Some folks learn better in a person to person lecture, others require a weekly class to keep on course, and some watch lectures in their Blue Devil slippers at 11pm. The quality and standards of any program must stand on their own. I will always be very proud to have graduated from Duke's Online program.