Nurse practitioners and physician assistants work in very similar settings and in many cases are even used interchangeably. In the emergency department where I work, for example, NPs and PAs are hired for the same positions without a preference among management for one over the other. Although these medical providers work alongside each other performing the same job responsibilities and with similar scopes of practice, there are a few ways the nurse practitioner and physician assistant education looks different.
When I graduated from my NP program and accepted my first nurse practitioner position in a walk-in clinic, I often found myself wishing I had become a physician assistant rather than a nurse practitioner (gasp!). While my sentiments have changed, I do think there are a few benefits of the PA approach to education. As nurses we have a lot of pride in our profession. But, this shouldn’t leave us closed off to accepting best practices from other areas of business and medicine.
Nurse practitioner programs would do well to integrate the following approaches commonly used in educating physician assistant:
1. Focus on procedural skills and diagnostic tests over theory
As a nurse practitioner student I felt that I spent an excessive amount of time writing essays on nursing theory, completing group projects and sitting in lectures discussing content unrelated to direct patient care. I can appreciate that understanding the foundation of one’s profession is important. But, perhaps a brief overview would do.
In contrast, physician assistant program curricula often contain courses titled ‘Introduction to EKG’ and ‘Clinical Radiology’. These courses are specific to essential clinical skills, skills often lacking among new nurse practitioner grads. Integrating similar courses into the nurse practitioner education would help level the new grad NP learning curve.
2. More hands-on clinical hours
Sure, as an NP student I found clinical days exhausting and sometimes stressful. There’s nothing worse than a day of hands-on learning followed by the need to return home only to cram for an upcoming test or put the finishing touches on a research paper. But, frankly, I could have used more of these stressful days during my training.
Nurse practitioner programs typically include somewhere around 650-850 clinical hours. Physician assistant programs, in contrast, require students to complete closer to 2,000 hours of hands-on clinical training. This added experience is noticeable in the first years of practice. The playing field eventually levels out, but ramping up the number of clinical hours required of NPs would benefit new nurse practitioners.
3. Transparency in objective program data during the admissions process
The other day I was perusing a few physician assistant program websites. I was caught a bit off-guard when I noticed nearly every program listed pass rates on the NCCPA certification exam for their graduates. In contrast, nurse practitioner programs guard their stats a little more closely. Yes, some NP programs list certification pass rates for recent grads but most do not. If students think to inquire about such information during the admissions process, many schools will reveal their scores. I have encountered a few nurse practitioner programs, however, who refuse to share data regarding NP student certification rates among their graduates.
I recommend that every NP program applicant ask schools of interest what percentage of graduates pass the certification exam on the first attempt. Wouldn’t it be nice if aspiring NPs didn’t have to dig for this information, but rather it was posted outright?
I don’t mean to get down on the nurse practitioner education. I feel that my NP program prepared me well for practice. But, like most things in life, it could have been even more effective with a few modifications. Looking outside of the nursing realm to how other professions educate their students can lead to valuable insight and improvement.
Where do you think nurse practitioner programs stand to improve?
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