Tuesday July 23rd 2019

Interprofessional task force tackles barriers to clinical training

Lisa Summers

Whether you are a practicing advanced practice registered nurse (APRN), an educator or an administrator, you are likely aware that one of the most significant challenges to increasing the number of APRNs is clinical experience. While the changing health care environment presents opportunities for APRNs, it also presents increasing challenges. Educators and practicing clinicians are keenly aware of the strain on clinical sites and schools of nursing, and understand the urgent need to decrease barriers to quality clinical training in order for schools to meet enrollment goals. Fortunately, educators and other stakeholders are coming together to seek solutions.

The American Nurses Association (ANA) was recently invited by the American Association of Colleges of Nursing (AACN), an organizational affiliate of ANA, to attend an APRN Clinical Task Force Invitational Stakeholder Meeting to provide feedback on and input to the work of the task force. AACN established the APRN Clinical Task Force in April 2013 to re-envision clinical training for APRNs, and it has done an impressive amount of collaborative work. The task force includes representatives from each of the four APRN roles, and while there is an understanding of the unique challenges to each, the goal is to develop solutions that can be utilized across APRN curricula. Recognizing the importance of relationships with practice partners, the task force has also worked with the American Physical Therapy Association, American Association of Colleges of Pharmacy and American Association of Medical Colleges.

The task force recommendations will be aimed at maximizing clinical resources to prepare APRNs with the full graduate, role and population-focused competencies, while taking into account the many current and potential financial implications. There is an emphasis on highlighting opportunities and innovations for interprofessional learning and practice.

The task force presented its observations and preliminary recommendations in an April webinar (see resource below). An online survey of webinar participants who were APRN leaders in membership, certification, licensure and regulation provided key findings about the current state of APRN clinical training.

Along with increased demand for APRN services, many programs report being at capacity, with clinical training and faculty shortages cited as major constrictions in the pipeline. There is competition for clinical training sites and preceptors, a recognized need for preceptor training, and questions about how best to minimize the productivity impact on preceptors. While distance learning has provided an important opportunity to educate new providers in rural and underserved areas, there are mounting regulatory issues for distance-learning and in-state students. There was widespread support for moving to competency-based education, a trend occurring across higher education and especially in health.

One item that resonated with many stakeholders was the need to establish common definitions for competence and competency. In keeping with the focus on interprofessional education, the task force is considering interprofessional definitions that are broadly recognized and used across health professions.

ANA will continue to work with our members and our APRN partner organizations to identify innovative solutions and to press for policy and regulatory changes that will ease the barriers to clinical training.

— Lisa Summers is the senior policy fellow in Health Policy at ANA.

Resources

AACN webinar: Current State of APRN Clinical Training
https://www.aacn.nche.edu/webinars/info-page?sessionaltcd=WF14_04_30


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