From Bedside To Mountainside: Preparing New Nurse Practitioners For Advanced Clinical Skills In Remote Settings Using A Novel Training Program
type: CreativeWork
description: The purpose of this doctoral project was to develop and pilot an expert-panel validated training program specifically for nurse practitioners (NPs) in remote settings, and to evaluate how new remote NPs rate their self-efficacy (a measure of confidence) in performing specific advanced clinical skills and procedures (ACSPs) before and after completing this program. The practice of primary care in remote regions requires expanded clinical skills for high acuity scenarios given the isolation. With more new primary care NPs practicing in more remote locales, their preparation for performing ACSPs, (including in complex and high-acuity cases) is critical for safe and effective care. Such skills are not uniformly taught in academic programs, but are easily imparted via additional training and practice. After an extensive literature review and interviews with stakeholders, we compiled a list of ACSPs and utilized a diverse expert panel to validate the skills to be included in a pilot training program. After achieving consensus, the hybrid online-in-person curriculum was developed using standards from the International Nursing Association for Simulation and Clinical Learning. This training was conducted over 2 days using a “flipped classroom” hybrid model, and delivered to a class of 15 primary care NPs in their last year of their programs, who were bound for remote practice. All participants completed a pre and post-participation survey to assess their self-report of self-efficacy using a modified, validated questionnaire. Our expert panel process achieved consensus (>63% of respondents rating a skill as “very important” to the remote NP) and was successful at rank-ordering the skills amassed by our literature review. After implementation of the pilot, we observed significant increases in reports of confidence. Across all tasks, participants reported significantly higher confidence following training, as indicated by an increase in difference in mean scores from 1 to 6.15.…
abstract: The purpose of this doctoral project was to develop and pilot an expert-panel validated training program specifically for nurse practitioners (NPs) in remote settings, and to evaluate how new remote NPs rate their self-efficacy (a measure of confidence) in performing specific advanced clinical skills and procedures (ACSPs) before and after completing this program. The practice of primary care in remote regions requires expanded clinical skills for high acuity scenarios given the isolation. With more new primary care NPs practicing in more remote locales, their preparation for performing ACSPs, (including in complex and high-acuity cases) is critical for safe and effective care. Such skills are not uniformly taught in academic programs, but are easily imparted via additional training and practice. After an extensive literature review and interviews with stakeholders, we compiled a list of ACSPs and utilized a diverse expert panel to validate the skills to be included in a pilot training program. After achieving consensus, the hybrid online-in-person curriculum was developed using standards from the International Nursing Association for Simulation and Clinical Learning. This training was conducted over 2 days using a “flipped classroom” hybrid model, and delivered to a class of 15 primary care NPs in their last year of their programs, who were bound for remote practice. All participants completed a pre and post-participation survey to assess their self-report of self-efficacy using a modified, validated questionnaire. Our expert panel process achieved consensus (>63% of respondents rating a skill as “very important” to the remote NP) and was successful at rank-ordering the skills amassed by our literature review. After implementation of the pilot, we observed significant increases in reports of confidence. Across all tasks, participants reported significantly higher confidence following training, as indicated by an increase in difference in mean scores from 1 to 6.15.…
author: Woodard, Benjamin
keywords: Advanced Skills, Confidence, Nurse Practitioner, Procedures, Remote Practice, Self-efficacy
date published: 2021-01-01T08:00:00Z
date modified: 2026-07-24T06:16:14Z
provider: Yale University
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: Yale University