Thank you for your response to the article outlining my research study, "Does RN Experience Relate to NP Clinical Skills?" I am pleased that it has reached an international audience and enthused that it could be useful in the implementation of the Canadian Nurse Practitioner Initiative. It is inspiring to see a unified national initiative to approach NP education, regulation, and practice; this is something that we lack in the United States.

Your study and the work of the Ontario Registered Nurses Association and the Ontario Medical Association regarding collaborative practice are impressive and informative. Of particular interest is the finding that physician trust for the NP takes approximately 3 months to develop if skills are perceived as good, but mistrust occurs much more rapidly if skills are perceived to be poor. You also note that physicians judge the discipline of NPs by "their" affiliated NP.

I am unable to answer your question about whether the collaborating physicians in my study precepted the NP participants, as that data was not collected. However, I did use alumni association mailing labels to access the NPs, and anecdotally, a large number were located at a distance from their universities. Additionally, a number of the NPs were in their second or later NP position, making it less likely that they were employed by a preceptor.

Thank you for your interest and thought-provoking question. Best wishes for success of the Canadian Nurse Practitioner Initiative.

Sincerely,

Ellen R. Rich, PhD, RN, FNP

Associate Professor and Director, Center for Nursing Research, Molloy College, Rockville Centre, NY