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OTP4PA

NP education: simulation hours?

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Just heard that because NP programs are having issues finding acceptable preceptors, they have now changed their 750 hour clinical requirements. 50% of those clinical hours can be done on simulated patients in sim labs. If you thought their education could not get any worse. This is a joke. This news has to start spreading in public and in hospitals.

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3 minutes ago, OTP4PA said:

Just heard that because NP programs are having issues finding acceptable preceptors, they have now changed their 750 hour clinical requirements. 50% of those clinical hours can be done on simulated patients in sim labs. If you thought their education could not get any worse. This is a joke. This news has to start spreading in public and in hospitals.

I float around different clinics and the NP quality I encounter varies greatly.

 

Just yesterday, I was at my desk and the NP next door called a pharmacist to ask what she should use for a hemorrhoid because preparation H didn't work.... The pharmacist was a bit confused but then recommended a topical steroid. She didn't comprehend this I guess because she then asked if she should prescribe fluconazole. Pharmacist was again confused and stated that this was an antifungual to which the NP responds "ooooohhhhh. Well maybe it's fungal because it has been pretty hot outside."

 

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Doesn't she know that proctosol-HC  which is commonly used for hemorrhoid contains hydrocortisone,  topical steroid?

she could have at least looked  it up on uptodate or something.

Edited by OTP4PA

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1 hour ago, SoCal_PA said:

I float around different clinics and the NP quality I encounter varies greatly.

 

Just yesterday, I was at my desk and the NP next door called a pharmacist to ask what she should use for a hemorrhoid because preparation H didn't work.... The pharmacist was a bit confused but then recommended a topical steroid. She didn't comprehend this I guess because she then asked if she should prescribe fluconazole. Pharmacist was again confused and stated that this was an antifungual to which the NP responds "ooooohhhhh. Well maybe it's fungal because it has been pretty hot outside."

 

Pathetic! Remember how much "our PA Leaders" think we need to be concerned about NPs and their alphabet adorned lab coats. They should be educating the public on the difference in our training and academic rigor versus the "fluff" that passes for NP education!! But I realise spinelessness and non confrontational cowering seems to be a PA Leadership trait.

 

Edited by CAdamsPAC
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4 hours ago, OTP4PA said:

Just heard that because NP programs are having issues finding acceptable preceptors, they have now changed their 750 hour clinical requirements. 50% of those clinical hours can be done on simulated patients in sim labs. If you thought their education could not get any worse. This is a joke. This news has to start spreading in public and in hospitals.

Is there a source for this or was it overheard in a conversation?

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Is there a source for this or was it overheard in a conversation?

One of the NP schools I precept for is starting to do this as well. My current student told me about it last week.  I have been out for some disability and I was trying to reschedule her time with me. She said "it's ok I can go to the school and just do Sim patients..."  I didn't exactly know what she meant by that at the time. 

Are we really surprised though?

 

Sent from my SAMSUNG-SM-G891A using Tapatalk

 

 

 

 

 

 

 

 

 

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1 hour ago, OneDayAPA_Maybe said:

Is there a source for this or was it overheard in a conversation?

https://www.npjournal.org/article/S1555-4155(15)01107-1/abstract

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Hear ye hear ye all new grads. Next job interview for "PA/NP" and someone asks the "why you" question, you can say "because I did my training on real patients in real clinics with real problems." 3x the amount of training. Spin that to your advantage. 

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6 minutes ago, CoastalPalm said:

So that article states that 50% of NP clinical hours can be done on sim patients?

Or does it say something else?

"The development of these skills is often dependent on the availability and teaching readiness of the clinical preceptor. This article describes a different model for teaching assessment skills and for mentoring new nurse practitioner students. "

it does not mention how many hours are done in sim vs live, but it implies fewer live contact hrs due to the use of sim. I have no problem with sim, but think it should complement live clinical hours, not replace them. I don't have a dog in this fight. I am happy to work with a well trained pa or np, and in fact we just hired an np grad of a well known em residency that takes both pas and nps.

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There are fantastic NPs out there. But this is insane. NP education is fast becoming what EMT education used to be. Patch factories with non-existent entry requirements and no universal requirements for graduation. Now we an see the direction this is going: primarily online, with as few clinical hours as possible. I feel bad for the good folks in their profession. 

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This article doesn't say anything about replacing patient encounters with simulations.  All it says is that for a semester during the physical assessment course, they practice in the sim lab.  NPs are absolutely not allowed to count 50% of their contact hours in the sim lab.  The 2019 CCNE accreditation standards have recently been released and there is no allowance for simulation to replace actual patient contact hours.  

The OP is a brand new registrant on this site and I'm thinking s/he seems an awful lot like someone who was recently banned...

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10 minutes ago, Kaepora said:

The OP is a brand new registrant on this site and I'm thinking s/he seems an awful lot like someone who was recently banned...

Probably doesn't matter. This'll be the new headline across the forum for the next year, implicit nods from mods and all.

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I don't think the article posted above is addressing what's being claimed by the OP. I also couldn't find any evidence that 50% of clinical hours can now be replaced by simulation, at least not as it's worded.

However, according to the Criteria for Evaluation of Nurse Practitioner Programs (NTF, 2016), it is allowed for NP programs to use clinical simulation to replace some clinical hour above the minimum required for accreditation. Basically, NP programs are required to have a minimum of 500 hours to be accredited, and clinical simulation can't replace any of that baseline 500 hours.

But simulation can replace clinical hours above that 500 hour baseline requirement -- for instance, if a school says they require 750 clinical hours for their program, technically up to 250 of those hours could be completed in simulation. 

"Simulation is recommended to augment the clinical learning experiences, particularly to address the high-risk low-frequency incidents; however, simulation experiences may only be counted as clinical hours over and above the minimum 500 direct patient care clinical hours." From the Criteria for Evaluation of Nurse Practitioner Programs: see Page 12 http://www.acenursing.net/resources/NTF_EvalCriteria2016Final.pdf 

So it is possible for clinical simulation hours to replace clinical hours, but the percentage of clinical hours that could be replaced would depend on the specific school's clinical hour requirement. 

 

I'm fine with highlighting areas where PA education is stronger than NP education, which I think in general, it is. But we should be careful not to spread unsubstantiated claims about NPs or their education. Facts are our friends, rumors and hearsay are not.

 

(The above site was found by looking at the 2018 Standards for Accreditation of Baccalaureate and Graduate Nursing Programs, which outlines on page 13 that all Master's NP programs must incorporate the Criteria for Evaluation of Nurse Practitioner Programs. Link here: https://www.aacnnursing.org/Portals/42/CCNE/PDF/Standards-Amended-2018.pdf

 

Post edited for formatting & clarity.

Edited by ProSpectre
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Local NP schools banned PAs from being preceptors because we didn’t have doctorates....

Now they have changed their minds and that WHOPPING 80 HOURS of Primary Care can be with a PA.

80 HOURS OF PRIMARY CARE.

Try six MONTHS at one bloody site PLUS other nationally mandated PA rotations.....

I declined. If I wasn’t good enough six months ago - never mind.

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3 hours ago, Kaepora said:

This article doesn't say anything about replacing patient encounters with simulations.  All it says is that for a semester during the physical assessment course, they practice in the sim lab.  NPs are absolutely not allowed to count 50% of their contact hours in the sim lab.  The 2019 CCNE accreditation standards have recently been released and there is no allowance for simulation to replace actual patient contact hours.  

The OP is a brand new registrant on this site and I'm thinking s/he seems an awful lot like someone who was recently banned...

Yea, actually can the OP post their source?

I know I jumped on the bandwagon but also whether or not this is true, it doesn’t change the fact that their are NP and DNP programs around me that I know of requiring 750 cinical hours which is around 30-40% of the hours a typical student local PA student gets. 

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the article I posted above mentions the difficulty in finding preceptors and implies that some of the hours can be replaced by sim. it does not list a %. like I said, I am not trying to stir the pot, I am responding to someone who asked about sim hours and found this article fairly quickly. there was a concern above about the direction this thread was taking, so I will change the title to reflect the subject of sim.

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14 hours ago, mcclane said:

Probably doesn't matter. This'll be the new headline across the forum for the next year, implicit nods from mods and all.

I changed the title to reflect the discussion of sim. Hope that was a reasonable compromise vs closing thread.

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14 minutes ago, EMEDPA said:

the article I posted above mentions the difficulty in finding preceptors and implies that some of the hours can be replaced by sim. it does not list a %. like I said, I am not trying to stir the pot, I am responding to someone who asked about sim hours and found this article fairly quickly. there was a concern above about the direction this thread was taking, so I will change the title to reflect the subject of sim.

I think the problem is that the article does not support the claim the OP was making, that's all.  The article is specifically about teaching physical assessment skills in the first semester of NP school, utilizing simulation.  From what I understand, other types of health professional programs also utilize simulation/standardized patients to teach exam techniques as well.  This article is not about what the OP was talking about.  

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8 minutes ago, CoastalPalm said:

I think the problem is that the article does not support the claim the OP was making, that's all.  The article is specifically about teaching physical assessment skills in the first semester of NP school, utilizing simulation.  From what I understand, other types of health professional programs also utilize simulation/standardized patients to teach exam techniques as well.  This article is not about what the OP was talking about.  

read what I quoted. they specifically mention difficulty in finding preceptors to teach these skills and imply sim is an alternative. that was all I intended to show.

"The development of these skills is often dependent on the availability and teaching readiness of the clinical preceptor. This article describes a different model for teaching assessment skills and for mentoring new nurse practitioner students. "

read between the lines. A different model than learning in clinic on live patients. I didn't say anything about a % of contacts, but the article implies this replaces some clinical encounters with sim because the program does not have enough well-trained preceptors. I didn't write the article, I am just quoting it. 

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ok, found another article with this conclusion:

"a national simulation study by the National Council of State Boards of Nursing on replacing clinical hours with simulation in prelicensure nursing education concluded that up to half of traditional clinical hours could be substituted with high-quality simulation experiences and yield comparable end-of-program educational "

Educational Changes to Support Advanced Practice Nursing Education

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4972483/

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22 minutes ago, EMEDPA said:

read what I quoted. they specifically mention difficulty in finding preceptors to teach these skills and imply sim is an alternative. that was all I intended to show.

"The development of these skills is often dependent on the availability and teaching readiness of the clinical preceptor. This article describes a different model for teaching assessment skills and for mentoring new nurse practitioner students. "

read between the lines. A different model than learning in clinic on live patients. I didn't say anything about a % of contacts, but the article implies this replaces some clinical encounters with sim because the program does not have enough well-trained preceptors. I didn't write the article, I am just quoting it. 

I already read what you quoted (nor did I say anything about mentioning a percentage of contacts either).  The abstract is very explicit on what it is talking about: teaching physical assessment skills to first semester NP students.  This article was brought up after someone asked if there was a source for what the OP was talking about.  My point is simply that the article does not support what the OP stated, and the abstract is clear on what it is talking about, as I've mentioned.  As well, the use of simulation in teaching physical exam techniques, amongst other areas, is not unique to NPs.  That's all.  

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22 minutes ago, EMEDPA said:

ok, found another article with this conclusion:

"a national simulation study by the National Council of State Boards of Nursing on replacing clinical hours with simulation in prelicensure nursing education concluded that up to half of traditional clinical hours could be substituted with high-quality simulation experiences and yield comparable end-of-program educational "

Educational Changes to Support Advanced Practice Nursing Education

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4972483/

What you quoted and bolded is not in reference to APRN/NP education.  It is in reference to "prelicensure nursing education", which refers to undergraduate RN education.  The article states that there is a lack of research on the amount of clinical hours that could be transferred to simulated experiences, and research on evaluating student competency, relevant to advanced practice nurses

And again, simulation is not novel to NP education.  It can be found in virtually all types of health professional programs.  Finally, the CCNE released new accreditation standards for NP programs in 2019, which would apparently mandate that NP programs must provide clinical sites and practica to all students (allnurses had a discussion on this recently).

That's all.

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Just because I'm lazy (and at work) can anyone provide a quality reference on the number and type of clinical hours a NP is required to have? It has been a bit of a punch point but I have never read anything authoritative. I'd just like to know.

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10 minutes ago, sas5814 said:

Just because I'm lazy (and at work) can anyone provide a quality reference on the number and type of clinical hours a NP is required to have? It has been a bit of a punch point but I have never read anything authoritative. I'd just like to know.

quoted above already by someone else. 500 hrs minimum. most programs offer 500-800 hrs that I am aware of with some outliers to 1500 hrs.

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