Transforming Nursing Education: Incorporating Ambulatory Care Competencies

The healthcare system has shifted to increased prominence in primary care settings, resulting in a need for nurses prepared in leadership and complex care management. Nursing students are typically prepared in programs emphasizing acute care settings in preparation for the nursing licensure exam (NCLEX) that is focused on acute care scenarios. A nursing and health professions school developed two educational approaches with academic practice partners to prepare nurses for complex care management in primary care settings. The first focused on newly licensed nurses educated undergraduate and graduate nursing programs in a transition to practice program (TTP). The second, joint venture health initiative (JVHI), was focused on preparation of pre-licensure graduate nursing students with a prior degree in another field. Both options prepared students to use advanced knowledge, skills, and attitudes to assume leadership roles in interprofessional healthcare delivery in order to improve health outcomes at the system, population, and individual patient levels in primary care settings. To provide students with comprehensive understanding of the expanded nursing role in primary care, both clinical and curricula restructuring was prioritized.

Analysis: Descriptions of primary care didactic enhancements and clinical experiences based on the American Academy of Ambulatory Care Nursing (AAACN) core curriculum and standards of practice for both educational options are included. In addition, this presentation explores successful applications and barriers to expanding knowledge, skills, and attitudes of nurses needed in the primary care setting. Lessons learned in the conceptualization of primary care competencies into standardized educational redesign for expanding the nursing role in primary care are discussed.

Results and recommendations: Nursing students and new graduate RNs prepared with a balanced curricular and clinical education in primary care settings, based on the AAACN competencies, can develop the required skill set to provide comprehensive, coordinated, and continual care delivery. Gaps in the literature are identified with recommendations for further exploration.