Elsevier

Nurse Education in Practice

Volume 8, Issue 6, November 2008, Pages 397-404
Nurse Education in Practice

A clinical internship model for the nurse practitioner programme

https://doi.org/10.1016/j.nepr.2008.03.002Get rights and content

Summary

Nurse practitioners in Victoria, Australia must be prepared to Masters level before seeking nurse practitioner (NP) endorsement. The challenge from a university curriculum development perspective was to develop a programme that prepares the NP theoretically and clinically for their advanced practice role.

The aim of this discussion paper is to outline how the internship model was developed and report the students’ opinions on the model.

The NP students complete the internship with a suitably qualified mentor which requires them to work together to develop and maintain a clinical learning plan, keep a log of the weekly meetings that shows how the objectives have been achieved. The internship includes advanced clinical assessment, prescribing, diagnostic and treatment skills and knowledge related to the nurse’s specialty. The clinical assessment tool incorporates the National Competency Standards for the Nurse Practitioner and allows students and mentors to identify the level of practice and set clinical objectives.

Students were asked to give feedback on the clinical internship and overall their comments were favourable, reporting benefits of a clinical mentor in their work and the clinical case presentations. The clinical internship allows the acquisition of knowledge and clinical skills in the clinical specialty with an expert clinical mentor in this innovative programme.

Introduction

Nurse practitioners (NPs) have been working in Canada, the United States of America (USA), and United Kingdom (UK) hospitals for a considerable length of time. The numbers of NPs in Canada is approaching 1000 (Canadian Institute for Health Information, 2006). In the UK, the number is close to 38,000 (NMC, 2006) and in the USA, there are 106,000 NPs (American Academy of Nurse Practitioners, 2006).

The role of the NP in Australia is relatively new but the numbers are increasing with approximately 140 NPs. These numbers are expected to increase as health service providers acknowledge the benefits of NPs. In the state of Victoria there are to date only 36 nurses NPs endorsed by the Nurses Board of Victoria (NBV website, 2006). In Victoria a nurse practitioner is defined as “… a registered nurse educated for advanced practice who is an essential member of an interdependent health care team and whose role is determined by the context in which s/he practices” (NBV website, 2006). An important issue from a curriculum development aspect is: what is the most appropriate method for preparing nurses for these types of advanced clinical practice roles? One approach is to develop a curriculum that incorporates clinical internship that will best prepare nurses for these advanced roles.

Section snippets

Literature

The introduction of the NP was a specific strategy aimed at increasing the number of health care providers who could provide a quality service that was able to meet the increasing healthcare delivery needs of the community in a cost-effective manner (McMullan et al., 2001). NPs provide a unique blend of nursing and medical care. In Australia, the main areas that health service providers have employed NPs are primary healthcare, emergency and more recently acute care. In one study, NPs have

Nurses board requirements

Those who wish to become NPs must fulfil certain criteria. In most instances nurses enrol in a Master’s degree programme and also seek employment as a nurse practitioner candidate (NPC). As the NP title is protected, a nurse cannot use the title without formal endorsement with the relevant Nurses’ Boards in Australia. The focus of the NP role is on health promotion, education, and the complementary nature of the advanced nursing role with five extended practice areas: limited prescribing,

The clinical internship model

The description of the internship programme will be presented followed by the students’ comments on the model. For the clinical internship to succeed, it is of paramount importance that the mentor has a clear understanding of the NP role within the clinical specialty. The role of the mentor will be outlined before the students’ evaluation of the model is presented. The role of the mentor is to assist the NPC to develop and apply advanced assessment, diagnostic and pharmacological skills to

Initial student evaluations

The overall feedback on the clinical internship programme that incorporates mentorship from NPCs has been positive. In total, four students have been enrolled in the internship: three from Emergency Departments (ED) and one midwife from an antenatal clinic. Three students provided feedback on the internship. The students were asked to give their opinions on the internship, in terms of did it work for them, any issues they had, what they would change about the model, did having one mentor work

Discussion

This discussion paper highlights the importance in developing and delivering a programme that meets the academic and clinical requirements for NPCs. We have highlighted the importance of a mentorship programme and have demonstrated the importance of NPCs keeping a clinical log and presenting clinical cases within the clinical environment. Secondly, the feedback from NPCs has been positive. There is no doubt that for the mentorship experience to be successful and productive, a collaborative

Conclusion

The clinical internship model appears to be a suitable method of assessment and allows NPCs to develop their scope of practice whilst integrating the theory with their specialist clinical practice. Important to the success of such a programme of clinical learning is the establishment of a flexible mentor–mentee relation that enables NP role development that is role specific. Equally, the benefits of a clinical internship within a Master degree course that focuses specifically on the acquisition

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