This post is meant to seek opinions on a few different aspects of APRN education. After doing a little research and observing the general trend I've noticed a few things and would like to generate discussion and/or argument.
It seems as though nursing academia is applying a very similar model of education which has worked for the RN-BSN craze to advanced practice nursing education through online based degrees with home based, self coordinated clinical experiences. It seems also that many schools make no requirement as to prerequisite clinical experience as an RN before admission into these programs. To me this seems driven primarily by quick profit as many ADN/BSN programs are now-a-days. Furthermore there doesn't seem to be a well established system for post graduation residency training which seems dangerous if the person is going to be practicing independently (another trend that is emerging).
What are your thoughts regarding the sustainability of this educational model? Its affect on the profession of nursing as perceived by other practitioners?
How do online programs regulate all students to make sure they are actually studying the material and not just open booking exams?
Is there a tangible difference between the online program and the brick-and-mortar program?
Do you feel APRN's need a residency? If we are going to practice with the autonomy of a physician (which is what is happening.) then shouldn't we follow a similar model of education?
Do you feel the online model is driven by greed with no consideration for patient safety/outcomes or is this a model that will continue to thrive as a convenient way for working RN's to advance their practice?
The first year of classes is based on a semester schedule (Fall, Spring and Summer), and then I believe they go onto block scheduling for each rotation. I want to say 4-6 weeks in each one but don't quote me on it.
As I am progressing through my own NP education, I too feel that my education is not up to par.
They require not one, not two, but a THREE part pharmacology course, a three part pathophysiology courses, multiple classes on clinical reasoning, in-depth diagnostic testing and an entire year's worth of full time clinical rotations.
Quite honestly, I am seriously considering switching.
I want to be the absolute best provider that I can be for my patients.
/end rant
How far along are you in your didactic? In clinical?
Most NP programs have at least two full semester of prescriber-level pharm. Most have at least one semester of advanced patho, which is less than a PA program but nurses also have had at least one patho class in undergrad plus all the integrated patho in undergrad and grad. Most quality programs have basic diagnostic interpretation classes though much of this is learned on the job to be honest, hard to do any other way. And PA programs do have full time clinical hours exceeding NP programs but they are also not 1on1 hours.
If you are still early on, then think about making the switch fast before you lose too much time/money as they likely won't transfer.
Being the best provide you can be means giving it your all, if your NP program isn't inspiring you to do that, maybe a PA program will. But either way you need to be motivated to go above and beyond.
How far along are you in your didactic? In clinical?
Most NP programs have at least two full semester of prescriber-level pharm. Most have at least one semester of advanced patho, which is less than a PA program but nurses also have had at least one patho class in undergrad plus all the integrated patho in undergrad and grad. Most quality programs have basic diagnostic interpretation classes though much of this is learned on the job to be honest, hard to do any other way. And PA programs do have full time clinical hours exceeding NP programs but they are also not 1on1 hours.
If you are still early on, then think about making the switch fast before you lose too much time/money as they likely won't transfer.
Being the best provide you can be means giving it your all, if your NP program isn't inspiring you to do that, maybe a PA program will. But either way you need to be motivated to go above and beyond.
I have never seen an NP program with more than one pharmacology class. Take out the BS fluff courses and most NP programs have very few courses overall. There is usually one pharmacology, one pathophysiology, and one physical assessment course. It truly does not compare to a PA program let alone an MD program.
I am very surprised how few people here wish to see NP programs offer more of an intense education. How anyone believes endless research and nursing theory courses serve patients more than actual diagnostic courses is beyond me.
As I am progressing through my own NP education, I too feel that my education is not up to par. I am blessed to go to a school that also offers a prestigious PA program, and comparing the two curriculums beside one another, truly there is no comparison. They require not one, not two, but a THREE part pharmacology course, a three part pathophysiology courses, multiple classes on clinical reasoning, in-depth diagnostic testing and an entire year's worth of full time clinical rotations. And that's just the brim of it. Plus, the school promotes study abroad internships as well as the multiple residencies in the area. There truly is no comparison.
I understand that the role of a nurse practitioner is based upon a registered nurse's experience, but truly, how much can we base our education on this? The roles and responsibilities of a home care nurse is much different than that of an ICU nurse, and both roles do not provide any experience to fully prepare for a provider role.
Quite honestly, I am seriously considering switching. I want to be the absolute best provider that I can be for my patients. That means I want to immerse myself in the diagnostic testing and truly understand what test is best for a situation, or which drug will be the best for my patient's condition. I want a residency program who will guide me through that first year. I do not need any more fluff; I got enough of that in my BSN program.
/end rant
If it makes you feel better I have seen some pretty good NP and PA hospitalists and very bad of both varieties.
NP school was very tempting because of it's part time and flexible curriculum and I can see how it works for a lot of people.I would say about half of my unit is in an online NP program, now whether they will make good providers is debatable but hey it fit what they wanted. However, for me I felt PA was a better fit and have decided to go per diem after saving quite some money to focus on PA school entirely (many schools require you to sign a no-work clause while in school).
If a quality program has less than one grad-level pharm course, than pharm is taught as part of an integrated clinical management class.
Take out the BS fluff courses and most NP programs have very few courses overall. There is usually one pharmacology, one pathophysiology, and one physical assessment course. It truly does not compare to a PA program let alone an MD program.
And you know that classes are "fluff" and "do not compare" based on what? Having never set foot in a graduate nursing classroom, I assume based on your opinion. Look at the schedule above and please point out the "fluff" classes. I will tell you how they directly relate to the board exam and to practice, having been through graduate education myself.
I am very surprised how few people here wish to see NP programs offer more of an intense education. How anyone believes endless research and nursing theory courses serve patients more than actual diagnostic courses is beyond me.
With some experience as a nurse, RN or NP, you may realize that research is incredibly important to practice and to the profession. I would be happy to share some of the key point about that if you are able to understand the importance.
Academic rigor is important. There has been a trend away from that based on some of the programs I have seen. This needs to be corrected via accreditation, but most programs are quality programs that produce quality providers. If an individual seeks the cheapest, easiest, and fastest route, no matter what program the attend, they will (likely) never be a good provider.
And you know that classes are "fluff" and "do not compare" based on what? Having never set foot in a graduate nursing classroom, I assume based on your opinion. Look at the schedule above and please point out the "fluff" classes. I will tell you how they directly relate to the board exam and to practice, having been through graduate education myself.
I am not quite sure where this "having never stepped foot in a graduate program" thing keeps coming from. I am in my second semester of a full time NP program. I see fluff constantly, in every class, and while I agree research is important it should not take precedence over science courses. Looking at most NP curriculums, they are devoting between 1/3 and 1/2 of all classes to non-clinical based stuff that will not be used by the vast majority of nurse practitioners. An immunology or genetics course would be a much better use of time, or more diagnostic courses.
Looking at Simmons, I see 15 credits out of 48 total are devoted to topics such as "Scholarly inquiry" and "research methods". I've sat through similar courses myself at this point and they were mainly a waste of time that distracted from studying important topics such as pathophysiology. Yes, research is important, but this is overkill. We do not need 3 or 4 separate classes teaching us how to develop a hypothesis or do a literature search. I've been reading research articles since undergrad, and these classes have not helped me read it any better than I did then. I would much rather have spent my valuable time learning something useful, and considering the huge scientific knowledge gap most nurse practitioners have, I think some actual science courses would be nice. What good is learning to read research if the science knowledge is so low no nurse practitioners can actually understand what is going on in the first place?
The real reason these classes are so prevalent is simple, it's the only way programs can pad their curriculum without hiring experts. Most of the nursing PhDs and EdDs on staff at nursing schools couldn't teach a genetics class or immunology class, so they come up with this stuff instead. It allows them to feel like the program is long enough and collect more tuition money without actually having to hire someone with PhD in the field of genetics, immunology, etc.
I am not quite sure where this "having never stepped foot in a graduate program" thing keeps coming from. I am in my second semester of a full time NP program.
Sorry, my deepest apologies. You started when, over the summer? Have you taken any of the diagnosis and management, pharmacology, clinical classes at this point?
I see fluff constantly, in every class, and while I agree research is important it should not take precedence over science courses. Looking at most NP curriculums, they are devoting between 1/3 and 1/2 of all classes to non-clinical based stuff that will not be used by the vast majority of nurse practitioners. An immunology or genetics course would be a much better use of time, or more diagnostic courses.
Please, explain exactly how you know what will/won't "be used by the vast majority of nurse practitioners"? Have you taken any of your diagnostic courses yet? Have you started clinical rotations yet so you have a general idea of what might possibly be used in practice?
Looking at Simmons, I see 15 credits out of 48 total are devoted to topics such as "Scholarly inquiry" and "research methods". I've sat through similar courses myself at this point and they were mainly a waste of time that distracted from studying important topics such as pathophysiology. Yes, research is important, but this is overkill. We do not need 3 or 4 separate classes teaching us how to develop a hypothesis or do a literature search. I've been reading research articles since undergrad, and these classes have not helped me read it any better than I did then.
These classes are of vital importance to nurse practitioners in practice and for the profession in general. How do you know what is overkill? From your years of experience in practice? Which graduate school did you take research methods at? What was your capstone? If nurse practitioners are going to be the future of primary care they need to be able to not only read, understand, and critique literature (undergraduate level) but generate, contribute, and progress the body of literature. The "research methods" you call fluff is the design, implementation, and presentation of a independent research project; the reason it is included as part of the master's level curriculum, aside from the aforementioned, is that feedback from local employers (which are largely major academic medical centers in this area) demonstrates preference for NPs prepared this way.
In short, an undergrad-level of comprehension does not equate mastery.
I would much rather have spent my valuable time learning something useful, and considering the huge scientific knowledge gap most nurse practitioners have, I think some actual science courses would be nice. What good is learning to read research if the science knowledge is so low no nurse practitioners can actually understand what is going on in the first place?
Please cite some evidence that NP "science knowledge" is "so low" that they "can't understand". Or is this just a wild accusation based on your expertise?
The real reason these classes are so prevalent is simple, it's the only way programs can pad their curriculum without hiring experts. Most of the nursing PhDs and EdDs on staff at nursing schools couldn't teach a genetics class or immunology class, so they come up with this stuff instead. It allows them to feel like the program is long enough and collect more tuition money without actually having to hire someone with PhD in the field of genetics, immunology, etc.
You know what also doesn't have a lot of dedicated genetics or immunology? Medical school.
stickit34
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The first year of classes is based on a semester schedule (Fall, Spring and Summer), and then I believe they go onto block scheduling for each rotation. I want to say 4-6 weeks in each one but don't quote me on it.