ArticlePracticeClinical residency training: Is it essential to the Doctor of Nursing Practice for nurse practitioner preparation?
Section snippets
Policies and Recommendations Related to Residency Training
In 2004, the American Association of Colleges of Nursing (AACN) published a position paper proposing that entry into advanced practice nursing become the DNP (American Association of Colleges of Nursing, 2004). This doctoral-prepared clinician would enhance quality of care via improvement science, increase safety and care coordination, and control costs as well as extend access to clinical care. Indeed, ensuring access to high-quality, effective expert care is the defining competency of the DNP.
Residency Programs
Although residency models now exist for NPs, physician assistants, dentists, and other health disciplines, the roots of residency education reside with medicine. The first formal residency programs for medicine were established more than 125 years ago, laying the foundation for the modern formal system of Graduate Medical Education (GME) for specialties. The historical foundation of funding for residency training in Medicine began after World War II. The GI Bill supported an increased number of
Nurse Practitioner Residencies
Even with the challenges inherent in developing residency programs, there are currently about three-dozen NP residencies in operation throughout the United States (Brown, Poppe, Kaminetzky, Wipf, & Woods, 2016). The first formal, postgraduate residency training for NPs was piloted in 2007 (Flinter, 2011). Based in Federally Qualified Health Clinics in Connecticut, the Weitzman Center of Connecticut's Community Health Center system developed a 1-year, full-time program whereby four family NPs
Benefits of NP Residencies
While large outcome studies regarding NP residencies have not been completed, there is support from graduates of NP residencies that attest to their importance. In a qualitative study based on reflective journals from 28 graduates of a primary care NP residency over the course of 8 years, graduates reported greater clinical proficiency (Hart & Flinter, 2015). In addition, they reported superior skill in interprofessional teamwork, an increased understanding of community health, and improved
Future of NP Residencies
This review of NP residency programs demonstrates that there is interest and movement toward NP residencies based on recognition of the benefits of having a structured experience as NPs transition to practice. The current policy environment supporting DNP education for NP practice and the recognition of the importance and usefulness of residency programs provide an excellent platform for stakeholders to grapple with critical issues related to residency programs and DNP NP preparation.
Several
Conclusion
The first year of practice as a novice NP is a critical period of professional development. The most challenging policy issues that must be resolved are whether NP residencies should be required for all DNP students or the BSN-NPs and whether the residency should be integrated into the DNP program or postprogram completion. It is important to raise questions related to residency programs to further clarify the need, direction, and program standards. NP residencies should be supported by
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