post bsn dnp and post msn dnp programs making the recommendations real

Post BSN DNP and Post MSN DNP Programs

Making the Recommendations Real

Dr. Diane Wink Dr. Susan Chase

Dr. Christopher BlackwellCollege of Nursing

Post BSN DNP and Post MSN DNP Making the Recommendations Real

Objectives

1.Describe a post BSN NP curriculum that allows achievement of NP core competencies for the non NP and DNP outcome objectives for both the novice and expert NP completing only post MSN coursework.

2.Use a scaffolding learning approach to develop courses that help students develop core skills needed to achieve cognitive and clinical skill program objectives.


Greeting’s from the

University of Central Florida

College of Nursing


Outline•Post BSN DNP Curriculum for Non Nurse Practitioners – Dr. Wink

•Scaffolding Approaches to Post BSN DNP Curriculum – Dr. Wink

•Post MSN DNP Curriculum – Dr. Blackwell

•Lessons Learned from the Development, Implementation and Outcomes of a DNP Program – Dr. Chase

Part 1: Post BSN DNP Curriculum for Non Nurse Practitioners

Dr. Diane Wink EdD, FNP-BC, ARNP, FAANP

Professor, UCF College of Nursing

Coordinator Family and Adult NP tracks

Post BSN DNP Curriculum for Non Nurse Practitioners

Foundations for curricular design

Curricula must develop knowledge and skills (clinical and cognitive) traditionally addressed in the MSN curriculum as well as the additional outcomes for the DNP.

•Macro curricular design• Essentials and competencies• Course content alignment and sequencing

•Micro curricular design• Development and inclusion of focused

assignments


Foundations for curricular design•2015 – What are we being asked to do?•Post BSN NP DNP students, how they are different?•NP DNP curriculum to meet professional recommendations and future needs•DNP skill Development•Developing cognitive and clinical skills using a scaffolding learning approach


Curriculum Review:•Adult-Gerontolical Primary Care Nurse Practitioner Competencies (2010)•Consensus Model for APRN Regulation (2008)•Criteria for Evaluation of Nurse Practitioner Programs: Report of the National Task Force on Quality Nurse Practitioner Education Programs (2008)•Practice Doctorate Nurse Practitioner Entry Level Competencies (2006)•Nurse Practitioner Primary Care Competencies in Specialty Areas: Adult, Family, Gerontological, Pediatric, and Women’s Health (2002)

Post BSN DNP: Curriculum Review and Design

Foundations for curricular design

Problems Identified:•Gerontology Content •Clinical Practice Course hours

• At minimal level for MSN

•Needed 1000 hours to meet DNP criteria•Specific content areas (e.g. in health promotion) needed more depth and scope•Selected psychomotor sills (e.g. suturing, biopsy) needed enhancement


Core Courses Maintained “As is:”•Theory for APN•Research Methods APN•Advanced Health Assessment and Diagnostic Reasoning•Advanced Pathophysiology•Health Promotion


Added Course:•Gerontology•Gerontology Clinical Practice Course


Changes in Existing Core courses: •Evidence Based Practice

• Statement about eventual project

•Cultural and Legal, Health Care Systems, Professional Obligations & Activities in APN ->

• Legal and Professional Behavior in APN

•Pharmacology ->• More pharmacodynamics, pharmacokinetics, principles of safe

prescribing, pharmacology issues• In NP classes

• Continued review of pharmacodynamics, pharmacokinetics major drug classes

• Application of pharmacologic principles in the clinical context in NP focused courses


Changes in Existing NP Core Courses: •Adult 1 and its clinical

•Adult 2 and its clinical

•Pediatrics and its clinical

•Womens Health and its clinical -> • Gender Related with Women’s health Clinical

•Clinical Practicum

Post BSN DNP: Curriculum Review and Design “DNP Courses”

Developing leadership skills to meet DNP competencies•Nurse Leadership/Management

•Nursing Care Environment Management

•Healthcare System Policy

Expanded Practice as a DNP •Epidemiology

•Concepts, Measurement and Data Management

•Advanced Clinical Management for the NPN

•Advanced Clinical Practice Selective for ANP (clinical course)

•DNP Residency (two courses)

•DNP Project (two courses)


Issues, Problems and Solutions•Could move into DNP practice with little NP experience

• Clinical practice hours pre MSN increased from 530 to 630

•Desire for MSN and certification and start in NP practice

• MSN along the way


Issues, Problems and Solutions•Desirability for certification and start in NP practice

• MSN along the way• Start working as NP while finishing DNP

•Could move into DNP Project stage with little NP experience

• Assignments to build to DNP project

•Links to sample Full and Part Time Plans of Study for the UCF College of Nursing post BSN DNP curriculum can be found at:

http://www.nursing.ucf.edu/academics/BSN-DNP.asp



Part 2: Scaffolding Approaches for Post BSN DNP Curriculum

Dr. Diane Wink EdD, FNP-BC, ARNP, FAANP

Professor, UCF College of Nursing

Coordinator Family and Adult NP tracks

Scaffolding Approaches for Post BSN DNP Curriculum

General Considerations:•Competencies of students on entry •Novice to expert progression not expert to novice back to expert progression of many post MSN DNP students•Need for strong clinical and cognitive foundation for future practice as a DNP prepared NP•DNP targeted classroom and clinical experiences •Eye on the goal!

• Words do matter!


Principles of scaffolding in education:•Early in learning experience students need a great deal of support•Provide activities calling for skills just beyond what the learner can do•Can accomplish do future activities based on this new knowledge and skill•Support includes

• How learning organized• Way students helped to recall and use prior knowledge• Reading and other activities with the learning• Guide to how to use new knowledge or use new skill

(Eduplace (1997); http://www.eduplace.com/rdg/res/literacy/lit_ins4.html)


Goals:•Build on and expand ability to use knowledge from

• BSN education• Ongoing DNP courses and clinical

practice

•Move on to• Quality DNP project on topic

relevant to DNP practice• Quality DNP practice in which the

DNP role competencies demonstrated

•http://www.osha.gov/SLTC/scaffolding/scaffold_slides/scaffold_01.html


Requirements for Success:•Appropriately sequenced courses•Faculty collaboration•Ongoing staff discussion about

• Curriculum and courses• How the curriculum is an integrated whole

•Skill development in one course to prepare for the next step

• Theory -> Research -> NP Core -> NP classes -> Evidence Based Practice Paper -> DNP Project

•Assignments crafted to direct students to think of the next step


Examples:•Pharmacology

• Basic Principles -> Application to clinical situations in context which considers individual client

•Theory -> Research -> Evidence Based Practice Paper -> DNP Project•Activities in NP courses

• On-line post conferences• Supports EBP course and future project a• Adult 1 and Gerontology Courses

• Examination of EBP documents • Service Learning Project

• Adult 2, Pediatrics, Gender Related Courses• PICO question activity

On Line Post Conferences

All Clinical Courses•Clinicals which are not all at one location or time

•Promotes interaction

•Captures clinical experiences which could be lost

•Allows faculty and peer feedback

Adult 1 and Gerontology Courses:EBP Assignment

Objectives:• Examine source of EBP Practice Guidelines• Analyze issues related to guidelines development• Examine the levels of evidence used• Identify needed guideline updates• Present and discuss any disputes and/or issues

Preparation needed for assignment: • What are levels of evidence• What a practice guidelines is

Expected outcomes: • Application of principles learned in Theory and

Research • Preparation for Evidence Based Practice Paper; • Possible foundation for future DNP project

Adult 1 and Gerontology Courses: Service Learning Project

Objectives:• Identify a community based issue/problem• Collaborate with community partner• Review of the literature on issues r/t project• Complete community/ agency assessment• Analyze assessment data • Implement (design, carry out, evaluate) project• Formally report outcomes: written report and poster

Sample Projects:• Health Promotion program for local county

government• Evaluation of heart failure program outcomes• Promotion of breastfeeding friendly workplaces

Adult 1 and Gerontology Courses: Service Learning Project

Preparation needed: • From BSN program: How to do a community

assessment; collaboration with community members; sources and influences on health behaviors and outcomes beyond provider/ client interaction

Expected Outcome: • Ability to review literature, analyze data• Work collaboratively with individuals and agency

representatives• Plan, implement and evaluate project• Present outcomes in formal manner. • Possible foundation for future DNP project

Adult 2, Pediatrics, Gender Related Courses: PICO Project

Preparation needed:

• From BSN program, How to do a community assessment, collaboration with community members, sources and influences on health behaviors and outcomes beyond provider/client interaction.

Expected Outcome• Ability to review literature, analyze data

• Work collaboratively with individuals and agency representatives

• Plan, implement and evaluate project

• Present outcomes in formal manner

• Possible foundation for future DNP project

Adult 2, Pediatrics, Gender Related Courses: PICO Project

Sample Project: • Examine evidence related to the use of lubricants when

doing diagnostic (e.g. thin prep) gynecologic examinations.

Preparation needed: • Ability to do a good quality literature search • Ability to identify actual or potential EBP standard

deviation

Expected Outcome:• Increased ability to search, retrieve and review research

and EBP literature. • Increased level of preparation for EBP project• Possible foundation for future DNP project http:://www.olsoncenter.com/home/index.php?

option=com_content&task=view&id=7&Itemid=11

Part 3: Scaffolding Approaches to Post MSN DNP Curriculum

Dr. Christopher Blackwell PhD, ANP-BC, ARNP. CNE

Assistant Professor, UCF College of Nursing

Scaffolding Approaches for Post MSN DNP Curriculum

General Considerations:•Varied levels of Expertise as an Advanced practice Nurse

• Clinical background• ANP preparation• Years in practice• Involvement in clinical practice organizations• Involvement in health care issues and policy initiatives• Routine use of EBP in practice• Exposure to scholarly documents

Can not assume all NPs have strong clinical and cognitive foundation for future practice as a DNP prepared NP


Goals:•Build on and expand ability to use knowledge from

• Practice as an Advanced Practice nurse (NP)• MSN education

•Move on to• Quality DNP project on topic relevant to DNP practice• Quality DNP practice in which the DNP role

competencies demonstrated


Requirements for Success:•Appropriately sequenced courses•Faculty collaboration•Ongoing staff discussion about

• Curriculum and courses• How the curriculum is an integrated whole

•Skill development in one course to prepare for the next step

• MSN and NP Foundation -> Evidence Based Practice Paper -> DNP coursework ->DNP Project

•Assignments crafted to direct students to think of the next step

Revisions to Accommodate Post BSN Students in DNP Courses

• Deletion of pure PhD courses in DNP curriculum• New course which combined content from PhD

Concepts and Research Courses to single course which addresses data generation/ analysis and analysis

• Addition of EBP practice course to “refresh” student’s knowledge and skills in• Identification of scholarly materials • Completion of a scholarly writing project

• Addition of up to three electives to allow focus on content relevant to goals of practicing NP in DNP program

Revisions to Accommodate Post BSN Students in DNP Courses

Continuation of courses in: •Nurse Leadership/Management•Nursing Care Environment Management•Epidemiology•Concepts, Measurement and Data Management •Healthcare System Policy•Advanced Clinical Management for the APN•Advanced Clinical Practice Selective for ANP (clinical course)•DNP Residency (two courses)•DNP Project (two courses)

Core DNP Courses

Developing leadership skills to meet DNP competencies•Nurse Leadership/Management•Nursing Care Environment Management•Healthcare System Policy

Expanded Practice as a DNP:•Epidemiology•Concepts, Measurement and Data Management •Advanced Clinical Management for the APN•Advanced Clinical Practice Selective for ANP•DNP Residency (two courses)•DNP Project (two courses)

DNP Course Exemplars

Epidemiology•Thinking beyond view of the single patient•Mix of content/ mathematics/ application to health care system•Completion of CDC Epidemiology Course•Group writing project:


Advanced Clinical Management for the APN AND Advanced Clinical Practice Selective for ANP (clinical course)•Case based course addressing advanced diagnostic reasoning

•Analysis of clients with complex health maintenance, health promotion and illness issues at the individual, family and aggregate levels

•Application of principles of ethical decision making

•Examination of personal clinical decision processes

•Critique of peer clinical decision processes

•Clinical in area of interest; not own practice


DNP Residency (two courses): •Clinical management of clients with complex health maintenance, health promotion and illness management needs focusing on a continuum of care within health care systems or organizations•Implementation of clinical project can be component•Set own objectives for clinical practice component of course•Clinical in area of interest or site of project

• Can be their practice site


DNP Project (two courses): •Project which analyzes health care needs, develops an evidenced based intervention and evaluates outcomes for a specific population within an identified health care setting.•Development, writing, evaluation of project•IRB review commonly needed•Can be at practice site

DNP Project Exemplars

DNP Project Examples: •Comparative Assessment of Extracellular Volume Excess in Hypertensive Hemodialysis Patients Using Blood Volume Monitoring•Identifying Patients at Risk for Obstructive Sleep Apnea in Primary Health Care•Use of Spirituality in an Older Population with Chronic Illnesses•The Impact of Pre-Operative Mupirocin Prophylaxis on Surgical Site Infections in Same-Day Open Heart Patients •Effectiveness of Probiotics Preventing Antibiotic Associated Diarrhea and C Difficile in Long Term Care

Part 4: Lessons Learned from the Development, Implementation and

Outcomes of a DNP Program

Dr. Susan Chase PhD, FNP-BC, ARNP

Professor and Associate Dean for Graduate Affairs

UCF College of Nursing

Lessons Learned

Problems and solutions from a new large cohort of doctoral students:•Student lounges•Communication with student•Student organizations•Student support•Faculty bias

Lessons Learned

Staying on target: Admissions•Identifying quality candidates

• Admission rubrics• Competitive GPA• GRE• Letters of Recommendation (smallest component)• Statement addressing goals ands clearly reflecting

population specialty track preference• Resume (two-page limit) which reflects prior education,

recent clinical accomplishments, any scholarly work, activities with professional organizations

•Ongoing analysis of data to identify best predictors for success

Lessons Learned

Staying on target: Formative Evaluation and ongoing course review•Ongoing course review

• Full DNP faculty discussion of courses, content focus, texts, assignments and activities

•Moving students to completion• DNP student evaluation each year• Review of progression with advisor yearly

Lessons Learned

Formative Evaluation Exemplar•Original EBP course for all Post MSN to refresh learning/ knowledge and refine skills for identification of problem, literature search, writing and creation of practice recommendations

• Could not do it!!

•Solution: Evidence for Practice Course

Lessons Learned

Solution: Evidence for Practice Course1.Analyze contexts of nursing practice to identify gaps in practice quality.

2.Develop search strategies to obtain evidence related to practice problems

3.Critique studies as to applicability and rigor.

4.Synthesize knowledge from published evidence to recommend practice changes.

5.Consider perspectives of multiple disciplines in approaching health problems.

6.Align questions with national policy recommendations.

7.Demonstrate academic writing fluency.

Lessons Learned

Solution: Evidence for Practice Course: Assignments•Practice analysis in context•Bibliographic strategy•Skill Development

• Identification of clinical questions• Identification of publications which answer

question• Critique of studies• Synthesis of studies

•Formal paper summarizing EBP publicaiotns which answer a clinical questions (APA)

Lessons Learned

Staying on target: Formative Evaluation and ongoing program implementation•Challenges of Doctoral Thesis Committees

• Organizing Committees• Currently traditional MSN/ doctoral committee

approach• Issue related to number of students relative to number

of faculty• Issue related to high research focus of College of

Nursing with many undergraduate Honors in the Major paper needing faculty support

•Change from Doctoral Thesis to Project•Moving to cohort approach for DNP thesis

Lessons Learned

Staying on target Summative Evaluation of program outcomes•Student meetings with dean•Dean involved with development of thesis/ projects•Evaluation by multiple faculty of quality of DNP Theses on completion

• Evaluation of paper• Evaluation of presentation• Evaluation of end of program portfolio

Lessons Learned

Staying on target: Summative Evaluation of student outcomes:•Tracking of presentations, publications•Changes in earnings after the DNP earned•Changes in patient colleague responses to them•Changes in practice depth/ scope on individual patient and practice basis•Recognition from colleagues because of the additional competencies gained,•Implementation of quality improvement, evidence based practice and financial analysis of practice

Lessons Learned

Staying on target: Summative Evaluation of student outcomes:

• Tracking of presentations, publications• Changes in earnings after the DNP earned• Changes in patient colleague responses to them• Changes in practice depth/ scope on individual patient

and practice basis• Recognition from colleagues because of the additional

competencies gained,• Implementation of quality improvement, evidence

based practice and financial analysis of practice

QUESTIONS?

Post BSN DNP and Post MSN DNP ProgramsMaking the Recommendations RealDr. Diane Wink [email protected]

Dr. Susan Chase [email protected]. Christopher Blackwell

[email protected]

University of Central FloridaCollege of Nursing

12201 Research ParkwayOrlando, FL 32826

VOICE (407) 823-2744FAX (407) 823-5508

mailto:[email protected]



Thank you for attending

post bsn dnp and post msn dnp programs making the recommendations real

Documents

np dnp curriculum

enhancementpost bsn

post bsn np dnp students

post bsn np curriculum

winkpost msn dnp curriculum

post msn dnp programsmaking

msn curriculum

dnp outcome objectives