Doctor of nursing practice (DNP) students should achieve competency in each of the 8 domains in the American Association of Colleges of Nursing (AACN) DNP Essentials.1 DNP practice hours are one method of demonstrating synthesis of expanded knowledge acquired in the DNP curriculum, a representation of how students meet the core competencies of the DNP degree as established by the AACN.1 Students should accrue at least 1000 postbaccalaureate practice hours or 500 hours post-master degree hours to complete a DNP program.1 Programs should document students' hours for accreditation. Academic programs set additional requirements based on students' specialty areas, and institutions validate students' development of competence in the DNP Essentials.2 The purpose of this article is to describe a newly developed database designed to streamline and simplify the process of tracking, evaluating, and reporting DNP students' practice hours.
The nature of DNP students' professional roles is varied and significant and may include direct patient care, organizational and executive leadership, and health care policy. Practice hours demonstrated in these different contexts may include in-depth collaboration with experts from nursing and other disciplines, meaningful student engagement within practice environments (eg, advanced practice case, role, and policy discussions), opportunities to build and assimilate knowledge for advanced specialty practice at a high level of complexity, opportunities for further synthesis and expansion of learning, and opportunities to integrate and synthesize the DNP Essentials1 and specialty requirements necessary to demonstrate competency in an area of specialized nursing practice.
While recommendations exist to meet quality outcomes and ensure the effective use of resources with attention to efficiency of faculty time and effort, little evidence is available to inform best practices for documentation of students' readiness to practice as new DNP-prepared nurses.2,3 Course faculty are responsible for tracking student progress and evaluating student outcomes in order for students to graduate. Yet, monitoring student progress in our program remained a challenge because of the lack of a systematic and efficient approach.
Previously, students documented practice hours via a spreadsheet template that faculty reviewed every semester to confirm the appropriateness of practice hours and evaluate progress.3 Variability in activity descriptions and student frustration with the template highlighted the need for change to support student success. Based on student and faculty feedback, we sought to standardize the process of documenting practice hours, classifying hours according to the DNP Essentials,1 facilitating faculty review, and tracking student progress.
Development
Faculty collaborated with research support team members to develop a database that would track students' progress and facilitate faculty evaluation. Further, we developed a system that mapped meaningful information about the types of activities that are integrated into doctoral education and aligned with each of the 8 DNP Essential1 domains. Supplemental Digital Content 1, http://links.lww.com/NE/A822, provides a template for building a DNP practice hours survey in Research Electronic Data Capture (REDCap), a secure web platform for electronic collection and management of data. Free for nonprofit organizations, REDCap4,5 was used to build and manage an online database for students to document and streamline project development.
Each course in the DNP curriculum was carefully reviewed to identify specific opportunities for practice hours that align with each DNP Essential.1 This information was programmed into REDCap as drop-down menus for every course. The opportunities function as prompts for students to select and document practice hours. To ensure that students record activities in a structured way, REDCap was programmed to require students to include activities from a minimum of 30 minutes to a maximum of 4 hours per entry.
REDCap generates unique participant links based on individual university email addresses that students use for the duration of their enrollment in the program. Students use their individual links to start a new entry for every unique practice hour activity they intend to document. After entering the date, students select the appropriate DNP Essential1 for the activity. Next, students choose from 1 of 2 options: a specific DNP course or to create a new individual entry. Branching logic ensures students are shown the required content after selecting either option. If students choose a DNP course, they will be presented with a list of course-specific activities that represent opportunities for practice hours. If students choose an individual entry, they will be presented with a textbox for free text. Students enter the hours and REDCap catalogs and reports cumulative hours to date in 2 ways, total hours and number of practice hours per DNP Essential.1
The following example further illustrates the process for documentation in REDCap. A DNP core course, Quality Improvement and Patient Safety, introduces students to improvement science and prepares them to design, implement, and evaluate evidence-based quality health care practices for patient populations. One of the course objectives, applying the core processes of clinical microsystems, is designed to meet DNP Essential 2,1 Organizational and Systems Leadership for Quality Improvement and Systems Thinking. Students demonstrate competency through successfully describing and analyzing a clinical microsystem using resources and ideas to select the appropriate analysis tools and worksheets. Students document practice hours in their individualized REDCap survey link by selecting the course, the associated learning activity, and the number of hours needed to complete the microsystem analysis aligned with DNP Essential 2.1
In a new individual entry, students are asked to describe the activity, input the number of hours, select a DNP Essential,1 and describe the relationship between the activity and DNP Essential. For example, students may lead a 1-hour monthly interdisciplinary journal club meeting at their practice site that they associate with DNP Essential 6,1 or students may meet with their DNP project stakeholders for an hour that they associate with DNP Essential 7.1 For all types of practice hours activities, REDCap catalogs and reports cumulative hours to date, overall, and per domain.
During development, faculty tested the database with a cohort of students (n = 10) who had experience using a spreadsheet template to log practice hours. Based on student feedback, the REDCap option to include a specific date for each data entry was enabled to allow for their own record keeping. They also expressed strong preference for the REDCap system and requested immediate use.
Implementation
All DNP students received a REDCap-generated email with individualized survey links associated with their unique email address. A 1-hour information session about using the REDCap practice hours database was developed and held during the first week of the semester when all students and program faculty members were on-campus.
Results
After introducing REDCap to the full cohort of DNP students, benefits of using a practice hours database were quickly realized via course evaluations, student curriculum feedback sessions, and anecdotal reports. The innovative change facilitated real-time tracking of students' progress, provided the opportunity to identify gaps in meeting certain competencies, and fostered the development of additional learning activities in the curriculum to ensure competency attainment in specific domains as needed. Students and faculty agreed that REDCap provides an efficient and user-friendly approach to documenting and tracking DNP practice hours. Students claimed that the ease of accessing the survey through the secure web browser link encouraged frequent documentation. They verbalized appreciation for a streamlined process with options embedded in the survey to easily select or enter their own text for all learning activities and domains. Faculty highlighted the efficiency of evaluating students' progress via the REDCap database during faculty meetings.
Adult learners need easily accessible methods that support their success and ensure efficiency. With strong student and faculty support, the REDCap practice hours database is a key aspect of measuring and documenting and describing how DNP students attain competency and meet the DNP Essentials.1 Other DNP programs may find it valuable to offer their students an efficient and effective method of practice hours tracking using this method within REDCap or another electronic database tool.
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