With great interest, we read Dr. Rich's study regarding the relationship between the duration of prior RN experience and the level of NP clinical skills demonstrated in clinical practice (Does RN Experience Relate to NP Clinical Skills?The Nurse Practitioner. 2005; 30(12):53-56.) Although Canada has yet to have non-nurse college graduates entering advanced nursing practice programs, the Canadian Nurse Practitioner Initiative is currently underway to develop a national approach for NP education, regulation, and practice. The debate regarding the need for prior RN experience as a requirement for program admission is "hot and heavy." Therefore, this research study will be of special interest to this initiative.
Regarding the finding of a negative correlation according to collaborating physicians, we would like to add to the discussion based on our own research and team facilitation with family physicians and NPs in Ontario. In our study, "Improving the Effectiveness of Primary Health Care Delivery through Nurse Practitioner/Family Physician Structured Collaborative Practice" 1, qualitative findings stressed the correlation between physician perception of NP competence and the establishment of a relationship with that NP. This finding was also observed in the Ontario Medical Association/Registered Nurses Association of Ontario study 2 where recognition of expertise was based on personal experience with their NP rather than on a view of all NPs as primary health-care experts. We therefore support the statement that physicians may have been influenced by their personal relationships and also would like to ask if the collaborating physicians in Dr. Rich's study had served as preceptors to the NPs that they were now evaluating?
Linda Jones, RN(EC), BSN, CFNP
Clinical Instructor, University of Ottawa
Daniel Way, MD, BA, CCFP, FCFP
Associate Professor, Department of Family Medicine, University of Ottawa
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