Symposium Overview: Nurse Practitioner Residency Programs in the West

As the US population ages, the prevalence of chronic illnesses is increasing.  Multiple co-morbidities are becoming more common in the primary care setting.  Medicine has established residency training, funded largely by CMS, to prepare physicians for entry to practice in a variety of specialties as well as in internal medicine and family medicine. Nursing has well-established residencies for new nurses orienting in hospitals and some outpatient settings that facilitate practice for those completing the AD or BSN degrees. Indeed, the Institute of Medicine (IOM) Committee on the Future of Nursing recommended that residencies be provided for entry to practice for nurses with undergraduate and graduate degrees, including preparation as nurse practitioners.  With the infusion of Patient Protection and Affordable Care Act (PPACA) funding to expand innovative nursing training, include NP residency programming, designing effective and sustainable transition-to-practice programs is even more critical. As the American Academy of Colleges of Nurses (AACN) ushers in the residency program accreditation this year, three pilot programs are currently serving as pioneering pilot sites. Over 80 residency/fellowships currently exist with nearly a dozen in the Northwest. Largely relying on Margaret Flinter’s design, empirical analysis of program effectiveness and sustainability is missing. In addition, little is known about sources of support for NP residency programs. A recent IOM report, Graduate Medical Education that Meets the Nation’s Health Needs, recommended shifting some funding for residency education from hospitals to community-based sites.  In 2013, the Seattle VA convened a regional forum on NP residency programs in anticipation of their future development of an interprofessional opportunity for primary care post-DNP residencies in the western region.  This forum posed several questions, including:  key residency program design needs, ideal resident competencies to insure success and sustainability planning. 

Given the rapidity of development of residency programs for Nurse Practitioners and the changing patterns for funding medical residency programs, this is an opportune time for investigation of the status of these programs.  The purposes of this symposium are to:

1. Examine the availability of residency training for NPs in the WIN region and patterns of curricula for these programs
2. Determine “Who Has Your Back” by defining key characteristics of NP Residency Administrators
3. Evaluate the impact of NP residencies using self-reflective journaling
4. Make the Business Case for Transition-to-Practice Programs for Nurse Practitioners using a cost analysis of the Seattle VA DNP Residency Program

Project future needs for residency programs for NPs in the West, including need for training resources and research