Park Jeongyoung, Faraz Covelli Asefeh, Pittman Patricia
The George Washington University, School of Nursing, Washington, District of Columbia.
The George Washington University, Milken Institute School of Public Health, Washington, District of Columbia.
J Am Assoc Nurse Pract. 2021 Feb 15;34(1):32-41. doi: 10.1097/JXX.0000000000000563.
To prepare new graduate nurse practitioners (NPs) for transition to practice, postgraduate residency or fellowship programs have been spreading across the nation in the past decade.
We examined the effects of completing a postgraduate residency or fellowship program on role perception, practice autonomy, team collaboration, job satisfaction, and intent to leave among primary care NPs (PCNPs).
We analyzed 8,400 PCNP respondents, representing a total of 75,963 PCNPs nationwide, to the 2018 National Sample Survey of Registered Nurses. We conducted multivariate logistic regression analyses to examine whether completing a postgraduate training program was associated with increased role perception, greater practice autonomy, improved team collaboration, increased job satisfaction, and decreased intent to leave in their work, controlling for NP personal and practice characteristics.
About 10% of PCNPs completed some form of postgraduate training. Primary care NPs who had completed a residency or fellowship program were more likely to have a minority background (e.g., non-White and male) and also see more underserved populations (e.g., minority background, with limited English proficiency) than those without residency training. We found that PCNPs with residency training were more likely to report enhanced confidence in independent roles, greater practice autonomy, improved team collaboration, increased job satisfaction, and decreased intent to leave than those without residency training.
This study supports further expansion of such programs, which would have positive effects for NPs, health care organizations, and patients, necessitating a long-overdue conversation about real public funding for primary care graduate nursing education.
为使新毕业的执业护士（NP）做好向临床实践过渡的准备，研究生住院医师培训或进修项目在过去十年中已在全国范围内推广。
我们研究了完成研究生住院医师培训或进修项目对初级保健执业护士（PCNP）的角色认知、实践自主性、团队协作、工作满意度以及离职意向的影响。
我们分析了8400名PCNP受访者（代表全国总共75963名PCNP）对2018年注册护士全国抽样调查的回复。我们进行了多变量逻辑回归分析，以检验完成研究生培训项目是否与角色认知增强、实践自主性提高、团队协作改善、工作满意度增加以及工作中离职意向降低相关，并对NP的个人和实践特征进行了控制。
约10%的PCNP完成了某种形式的研究生培训。与未接受住院医师培训的PCNP相比，完成住院医师培训或进修项目的初级保健执业护士更有可能具有少数族裔背景（如非白人、男性），并且服务更多弱势群体（如少数族裔背景、英语水平有限）。我们发现，接受住院医师培训的PCNP比未接受培训的更有可能报告对独立角色更有信心、实践自主性更高、团队协作改善、工作满意度增加以及离职意向降低。
本研究支持进一步扩大此类项目，这将对执业护士、医疗保健组织和患者产生积极影响，有必要就初级保健研究生护理教育的实际公共资金进行早就应该进行的讨论。
