Top NP Education Concerns

Throughout the country, faculty members are focused on three issues.

With the ranks of NPs rising rapidly, comprehensive, quality education is critical.

“Education is not only giving students knowledge, but also helping them develop the foundation for life-long competence through skill and knowledge acquisition,” said Sheila D. Melander, PhD, ACNP, FCCM, FAANP, president of the National Organization of Nurse Practitioner Faculties (NONPF) and assistant dean and director of graduate programs at the University of Kentucky College of Nursing. “NPs are knowledge workers who contribute to high-functioning interprofessional care teams and to achieving best practice outcomes.”

To guarantee students receive the education they need to become exceptional nurse practitioners and leaders, a number of issues must be addressed. Faculty members across the country shared their concerns while offering insight into the future.

Faculty Shortage

As the profession continues to grow, so does the need for qualified faculty. However, it can be a difficult task to find people who are prepared to take on this pivotal role.

“To ensure the success of the next generation of nurse practitioners, we must have a dedicated team of qualified faculty,” said Mary Ellen E. Roberts, DNP, RN, APN-C, FAANP, FAAN, assistant professor and director of the DNP program at Seton Hall University in South Orange, N.J. “The problem is that academia doesn’t pay.”

The salary discrepancies between education and clinical practice can be a deterrent, especially given rising expectations.

“The education requirements for NPs continue to increase and as a result, so do the expectations for faculty members,” noted Candace Harrington, DNP, APRN, AGPCNP-BC, NP-C, clinical associate professor in the DNP adult gerontology primary care and family NP programs at East Carolina University in Greenville, N.C. “While the Commission on Collegiate Nursing Education does allow new DNP programs to utilize some master’s-prepared faculty who have specialized clinical skill-sets, the majority should be doctorally prepared.”

“And therein lies the problem: Faculty members are expected to have more education, while receiving less compensation and continuing to practice,” said Laurel Halloran, PhD, APRN, professor at Western Connecticut State University. “I have had candidates walk out of an interview after learning the prospective salary.”

What can be done to combat this shortage? “We would certainly like to bring faculty in at higher salaries and establish faculty practice agreements, but that is not always an option for institutions,” Halloran explained. “In most instances, NP faculty members are given little leeway to balance their clinical and faculty responsibilities.

“They are hired as NP faculty, need to maintain practice to maintain certification, but teaching the full credit load comes first-and their NP practice is often seen as an ‘add on’ job,” she continued. “Teaching days may be adjusted to accommodate practice but often that is it. And given current salary levels, this makes a career in education a hard sell.”

One way to help fill gaps in education is through adjunct professors, but it cannot be the only solution. “Adjunct professors are a valuable resource that should be utilized; however, you cannot run a program without a full-time faculty,” Roberts said. “NP programs are rigorous for both students and faculty, which is why you need a faculty whose No. 1 priority is education.”

Federally funded reimbursement programs help alleviate the financial strain NPs face when transitioning into a faculty role. Harrington noted, “Federally funded programs that provide loan repayment through service can be a strong incentive. Ultimately, we have to find a way to bridge the salary gaps across organizations, both in the clinical and educational sectors.”

Clinical Placements

NP students face rigorous clinical expectations, but for those expectations to be met, both students and educational programs require the support of preceptors.

“Finding clinical placements for NP students is a huge issue,” noted Shelley Y. Hawkins, PhD, FNP-BC, GNP, FAANP, associate professor of nursing and director of the DNP & MSN NP programs at Hahn School of Nursing & Health Science at the University of San Diego. “A lack of clinical placements hinders not only our students, but also our education system.”

“The biggest challenge today to NP educators and programs is securing sufficient clinical education sites and preceptors,” Melander said.

Mentoring a student requires a significant commitment on the part of the preceptors. Many practicing NPs are hesitant to take on the responsibility without compensation.

“While some programs are beginning to pay their preceptors, many of us can’t afford to do so and/or don’t believe in offering financial compensation,” Hawkins said. “We believe that preceptors should want to share their time and expertise in order to help build and develop future leaders of our profession.”

Addressing this issue requires creative solutions and collaboration. “Creating a network of support is imperative,” Halloran said. “I believe that we could ease this growing problem if institutions and professional organizations were able to collaboratively place students.”

Incentivizing preceptors can take on many forms. “Some institutions may offer adjunct status or a title as well as library privileges or degree credits,” Roberts noted. “There are a lot of things you can do to enhance the students’ learning and help the preceptors want to be preceptors.

“It is our professional responsibility to help train future NPs; however, preceptorships aren’t just beneficial to students,” she added. “It helps practitioners maintain and improve their own clinical competence.”

DNP Debate

It has been 10 years since the American Association of Colleges of Nursing (AACN) called for a shift in entry-level education requirements for advanced nursing practice from the master’s degree to the doctorate level by 2015.

Today, more than 243 DNP programs are enrolling students, AACN reports. Between 2012 and 2013 alone, the number of students enrolled in DNP programs increased from 11,575 to 14,688. And enrollment numbers continue to rise.

“The NONPF Board of Directors recently reaffirmed our position that NP preparation should be at the doctoral level with the DNP degree,” Melander said. “We support the evolution of all NP programs to the doctoral level.”

Harrington noted that “It is a huge investment of time and money for institutions to implement DNP programs, but I wholeheartedly believe in this endeavor. The complexity of our healthcare system requires clinicians who are cognizant of every aspect of healthcare, which is what a doctoral education provides.”

While there is significant support for the transition to the DNP, a number of questions remain. “To successfully transition to the DNP, we must help practitioners and healthcare as a whole understand its importance,” Hawkins said. “We need more scientific evidence to support the value of the degree.

“I believe support of the DNP will strengthen when NPs nationwide have full practice authority.”

Education Evolution

Despite these ongoing issues, NP education continues to evolve and flourish.

“NP educators continue to look at new models and strategies for providing students with the breadth of experiences they will need to master competencies,” Melander noted. “Our students know apps and technology better than we do, and they welcome innovation beyond the traditional lectures and exams.”

NP faculties must continually adapt curricula and policies. “Education in and of itself is changing,” Roberts said. “We are moving in a direction that includes more simulation and online experiences.”

“Given the scope of the role and the complexity of the world in which we live, we must have more highly educated NPs,” Hawkins said. “And this is why we must be prepared to offer our students a comprehensive, cutting-edge education.”



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