Registered Nurse, Enhanced Education for Primary Care (Project REEP): Transforming Nursing Practice in Primary Care

Purpose: The purpose of this study is to examine the effect of Project REEP on faculty and student knowledge about MUC and student’s self-confidence in performing nursing-related tasks.

Theoretical framework: Nationally, there has been a call for innovative efforts to bridge clinical and community services, focus more on social factors that influence health, and increase the healthcare workforce with graduates who are knowledgeable about medically underserved communities (MUC). Clinical and experiential learning opportunities in community-based primary care settings are critical to these efforts.

Background: Hampered by poverty, rurality, and an escalating opioid crisis, providing adequate care to MUC in primary care settings challenges the health care workforce in the northeast. Rivier University Division of Nursing developed Project REEP, an HRSA*-supported multicomponent BSN program comprised of a new community health course, an intensive short- and long-term clinical experience in primary healthcare settings, preceptor fellowships, and faculty shadowing. Project REEP aims to prepare BSN graduates to enter careers in a community-based primary care setting by enhancing knowledge of MUC and increasing self-confidence in performing nursing-related tasks.

Methods: A mixed methods, repeated measures design was used. Measures of MUC knowledge and nursing self-efficacy were collected pre- and post-program participation with surveys. Focus groups were held with students and faculty at program end. Repeated measures ANOVA tested for increases in MUC knowledge and self-efficacy. Content analysis of focus group results identified primary themes.

Results: Survey results showed dramatic increases in students’ knowledge across numerous aspects of MUC (average d effect size=0.77, range 0.22-1.43). Student confidence and self-efficacy in performing different nursing-related tasks increased significantly after participation in REEP, with d effect sizes ranging from 0.18 to 0.88. Both faculty and students described numerous ways that the program increased their MUC knowledge and confidence.

Conclusions and implications: Project REEP is highly effective in increasing student’s knowledge of MUC and self-confidence in nursing related skills.

*Funded by the Health Resources and Services Administration (HRSA) under grant #UK1HP31700, Nurse Education, Practice, Quality and Retention.