Student Nurse Practitioner Perceptions of Participating in the Graduate Nurse Education Demonstration Project Dr. Robert Hanks, GNE Project Manager Ms. Cheryl Loudd, GNE Clinical Coordinator UT Houston School of Nursing

Introduction The Graduate Nursing Education Demonstration (GNE) is a federally-funded 4 year demonstration project Directed at increasing the number of primary care nurse practitioners in concert with the implementation of the Affordable Care Act Oversight provided by Centers for Medicare/Medicaid Services (CMS) Five demonstration sites across the United States are currently funded. Gulf Coast Region includes a partnership between: Memorial Herman Hospital System University of Texas Health Science Center at Houston School of Nursing (UT Houston) University of Texas Medical Branch School of Nursing Texas Women’s University-Houston School of Nursing Prairie View A&M School of Nursing NP students are placed in clinical agencies that have agreed to precept the students, and the clinical agencies receive funding based on preceptorship hours

Background GNE Program funded in 2012: currently no published literature about the perceptions of student participants Similar federal program for comparison is the Graduate Medical Education (GME) program used in medical education GME is in contrast to the GNE in which the students are currently enrolled in the NP program (pre-graduation). Medical residents are post-graduates. Review of the literature surrounding NP education reveals a paucity of knowledge regarding graduate level NP student’s satisfaction with clinical agencies, clinical rotations, or preceptors Research study will help illuminate the student perceptions of clinical rotations and the overall perception regarding the innovative GNE program

Study Aim and Research Questions To explore the student nurse practitioner perceptions regarding participation in the Graduate Nurse Education (GNE) Demonstration Project What are the students’ perceptions of participation in the GNE? What are the students’ perceptions of the benefit of the GNE? What are the students’ perceptions of the negative aspects of participation in the GNE?

Design Exploratory descriptive research design to ascertain the students’ perceptions of the GNE encountered during clinical courses in the curriculum Post experience survey using a 17 item scale (5 level: strongly disagree-strongly agree with neutral category) 2 narrative questions relating to positive impact and negative impact 1 open ended narrative question 1 narrative question about the impact of the GNE on the profession

Analysis Quantitative survey results uploaded into the Statistical Package for Social Sciences (SPSS) for descriptive statistical analysis Narrative data analyzed using a qualitative content analysis design

Results: Sample 56 Participants responded—49% response rate All participants in last semester of program 87.5 Female Large portion in FNP

Survey Item Statistics Statement Mean S.D. I clearly understood that I was a participant in the GNE project 4.05 1.166 I understood the clinical placement process used for the GNE project 3.34 1.392 I felt that the GNE project facilitated my clinical placements 3.22 1.343 I felt that clinical agencies accepted my clinical placement due to the GNE payments for precepting me 3.69 1.184 I felt my clinical agencies understood the GNE project 2.91 1.210 My preceptors understood the GNE project 2.76 1.228 The GNE project is helping to grow the numbers of NPs in this area 3.78 .875 There were questions from my preceptors about the GNE payments 2.80 1.432 I understood why I completed a student profile for the GNE 3.23 1.427 I felt treated fairly by the GNE placement process 3.71 1.107 My clinical education was enhanced due to the GNE 3.18 1.266 My clinical placements with GNE were timely 3.21 1.411 My GNE clinical placements were appropriate to my learning needs 3.58 1.243 My GNE clinical placements were straightforward and clear to me 3.48 1.279 I felt Memorial Hermann had my best interest in mind with my GNE placements 3.29 1.031 I felt Gateway to Care had my best interest in mind with my GNE placements .896 I understood the overall goal of the GNE project 3.68 1.193 Results-Scale Items

Results: Positive Impact on Clinical Education 41 Responses Positive Good Incentive and Opened Doors Preceptors Receptive and Accepting Less Stress and Saved Time Negative Self-Place/GNE Not a Help

Results: Negative Impact on Clinical Education 30 Responses No Effect Confusing and Last Minute Site Not Convenient or Appropriate Clinics Taking Students for Money

Results: GNE Impact on NP Community in the Future? 40 Responses Affirmative/Negative Themes Is Positive or Will be Positive (23 responses) Not Positive or Uncertain (4 responses) Other themes: More Information and Streamlining Needed (2 responses)

Results: Other Comments 27 Responses Not a Help Need Preceptors Not Focused on GNE Money Need Preceptors That Can Teach Research GNE Participating Sites Thoroughly

Conclusions Provides for baseline data with GNE project Illuminates NP student perceptions Item means neutral or agree Narrative themes indicate that GNE was seen as positive, but confusion with process. GNE seen as a positive impact on NP community Subsequent surveys will be performed for each graduating class (2014, 2015, 2016)