Background: The transition of an experienced Registered Nurse into a novice hospital-based Nurse Practitioner (NP) is frequently met with trepidation. The novice NP is often uncertain if s/he possesses the level of clinical competency and scientific knowledge required to provide high quality evidence-based care to complex hospitalized patients. How does one ease the stress associated with concerns over insufficient preparedness? For physicians in training, residency programs have relied on an assessment of performance based on six core competencies. Evaluation of performance is overseen by teaching attending and program directors, many of whom are hospitalists. Hospital medicine groups in both academic and community settings have a growing need for NPs for direct patient care. While NP residency programs are an emerging trend, they are not mandatory, have yet to be implemented systematically, and are burdened with financial and time constraints. To address the gap in education and clinical experience, NPs seek the direction and leadership of hospitalists in fostering a learning environment by developing an educational program tailored to hospital medicine.
Purpose: To create a hospitalist-led evidence-based lecture series for nurse practitioners and assess its impact on NP education and confidence.
Description: Leadership from the Division of Hospital Medicine collaborated with NP Leadership to design and implement a lecture series. One hour long lectures were given by hospitalists on a monthly basis on topics commonly seen in hospitalized patients. To assess the quality of the lectures, subjective assessments of attendees’ knowledge on each topic were administered pre and post lecture. Each test consisted of four items that assessed whether or not the participant felt they had a good understanding of the major learning objectives of the talk. Each item asked the NP to rate their knowledge of the learning objective on a 5-point Likert Scale (ranging from strongly agree to strongly disagree where agreement meant the NP felt he/she had a good understanding of the learning objective).
Conclusions: This project is ongoing. To date, 38 pre-tests and 36 post-tests have been completed. Before the lectures, 51 responses indicated an understanding of the learning objective (strongly agreed or agreed) compared with 130 in the post-test. The largest difference was seen in those who strongly agreed, going from 8 to 62. On the pre-test, 100 responses were either neutral or in disagreement compared with only 14 post-test (no responses of disagree or strongly disagree in the post tests). We are encouraged by our preliminary results and continue to be excited by our ongoing education series. The next steps are to emulate this model with other members of the interprofessional health care team and to assess retention of knowledge. Additional considerations would be to move to objective pre and post tests to better quantify NP preparedness and knowledge.