“Who Has Your Back” Defining: Key Characteristics of NP Residency Administrators

Background: Nurse practitioner residencies are rapidly increasing due to demand in response to both novice nurse practitioner demand and the Institutes of Medicine (2010) recommendation. As the largest employer of nurses and nurse practitioners, the Veterans Health Administration currently operates over 15% of all VA residencies in the country. While there is a shared understanding of these yearlong residency structures, there exists a gap needed for effective program administration and planning.

Purpose: The purpose of this review is to identify the key competencies needed for the unique position of NP Residency Program Director not traditionally seen in the role Nursing Director and/or Medical Director.

Methods: An online survey was conducted by the VA Center of Excellence in Primary Care (COE PCE) Co-Directors who oversee the NP Residency programs in their facilities (N=5). The respondents were asked to review the skills they possessed at the commencement of their residency program, the skills they felt they needed to be successful to management their residency program, and the skills they currently possessed one year later. the COE PCE offers a unique interprofessional residency experience that is intended to enhance understanding of interprofessional roles and remove silos.

Results: All five directors identified themselves as successful clinicians and critical thinkers but, believed that human resource, grant writing, curriculum development and conflict resolution skills were critical for the role of NP Director. Three felt that academic affiliation was critical to their success as a clinical director. Only one director believed they were prepared upon entry to the role to be NP director. All agreed that their unique role of NP Director could not be successfully leveraged within another role (i.e. Nursing Director) due to the vantage point needed to move the discipline forward.

Conclusions: The evolution of Nurse Practitioner Residencies continues to grow and is rapidly moving with the recent addition of an accreditation. As more residencies develop, it is critical that leaders of these residencies acknowledge and identify leadership qualities specific and unique to this profession. This will afford trainees and residents the ability to experience embedded leadership with the skills to develop programing that caters to their needs as well as advocates on their behalf.