The National Organization for Nurse Practitioner Faculties (NONPF) developed two position statements of relevance to the practice aspects of postbaccalaureate DNP programs and post-master's programs preparing students for NP practice. NONPF's positions on clinical hours for NP preparation and the term 'residency' in DNP programs will be discussed in this column.
Clinical experiences are at the core of NP programs. NONPF considers clinical hours to be providing direct care to patients, families, and populations in a population-focused area of NP practice in a supervised situation. Hours in a skills or simulation lab, physical assessment course, or community projects are not considered clinical hours unless direct care is provided.
NONPF is a facilitating organization of the National Task Force on Quality Nurse Practitioner Education, which is responsible for developing and updating the Criteria for Evaluation of Nurse Practitioner Programs.1 This document includes the criterion that NP programs provide students with a minimum of 500 clinical hours. DNP programs, however, need to require significantly more than 500 clinical hours for students to obtain core and population-focused competencies. Post-master's students who are certified as NPs may also need clinical experiences to achieve DNP competencies.
The value of competencies
Core competencies and population-focused competencies have guided the development of NP education. NONPF recognizes that the ability to provide competency-based care to patients, families, and communities is far more important than the number of clinical hours required of the DNP student. Clinical hours must be augmented with other mentored experiences for the student to achieve the competencies detailed in the NONPF DNP Competencies and the American Association of Colleges of Nursing DNP Essentials. These competencies are necessary for the NP with a practice doctorate to provide leadership for interprofessional collaboration, implement evidence-based practice, apply clinical investigative skills to evaluate health outcomes, and influence health policy.2
Terminology important
Another aspect of DNP education relevant to clinical practice is the terminology for clinical experiences. In a review of DNP programs in various states conducted by a NONPF task force, the terms for clinical experiences included a residency, a mentorship with a faculty member, a clinical practicum, and clinical experiences. Residencies, a term used by some health professions (medicine, podiatry, and others), are postgraduate, salaried, certified, or accredited and focus on direct patient care. The NONPF Board of Directors has taken the position that the term 'residency' is confusing and should not be used to describe DNP clinical experiences. The term 'practicum' describes the experiences of the DNP capstone project, which should have a clinical focus.3
DNP educators and preceptors are committed to providing NP students with strong clinical experiences that serve as the foundation for NP practice. Student achievement of national NP competencies is more important than the number of clinical hours a student has completed in a program. The ability of the DNP-educated NP to provide leadership, engage in practice inquiry, and influence health policy is as important as the ability to provide direct patient care.
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