Curricular Enhancements to Prepare RNs for Primary Care Practice

The recent coronavirus pandemic has exposed the healthcare systems’ deficiencies in prevention and management of chronic illnesses. This resulted in devastating morbidity, mortality, and healthcare costs. The current reactive and episodic disease-oriented healthcare system must shift to prioritize proactive primary care for diverse populations through chronic disease management, and health promotion and wellbeing.

In primary care settings, registered nurses who work at their full scope of practice and licensure contribute to improved patient outcomes. Yet, many RNs are not aware of, or prepared for, primary care roles because undergraduate nursing education has traditionally focused on acute care. As recommended by the Josiah Macy and Robert Wood Johnson foundations, curricula enhancements to increase primary care nursing skills in undergraduate nursing education are needed. The purpose of this presentation is to describe the development and implementation of a new online primary care elective course offered to prelicensure and postlicensure nursing students.

In this online course, students learn about primary care delivery business models and expanded nursing roles, such as health coaching, chronic disease management, and coordination of care. Other topics include health promotion and education, oral health assessment, health literacy, patient-centered communication, mental health screening, medication adherence, patient empowerment, chronic disease self-management, social determinants of health, and integration of technology to improve health outcomes. The course includes a module on self-care and resilience building strategies. Students also participate in an experiential interprofessional telehealth workshop.

Interest in the primary care elective course has exceeded expectations with 49 students enrolling in the first semester offered. Student feedback has been overwhelmingly positive. 100% of the students who completed the end of course evaluation agreed or strongly agreed that the course enhanced their learning. They described the content as “useful, practical information that I can easily apply to my practice.” In a pre-test/post-test comparison of knowledge scores of multiple primary care topics, self-reported mean knowledge scores increased significantly. Students listed preventative care, vaccine recommendations, communication skills, depression screening, alcohol misuse screening, telehealth etiquette, self-care resources, health coaching, and more as specific skills and knowledge that directly applied to their clinical practice.

A discussion of content, resources, teaching strategies, and lessons learned will assist other educators in developing primary care content for their own curricula. A course outline and sample assignments to jumpstart course development are offered for distribution. Instructional videos using standardized patients to demonstrate screening for depression and alcohol misuse as well as telehealth etiquette and patient-centered communication are housed on a HRSA grant-supported website that will be shared as a free open access resource.