Types, Frequency, and Depth of Direct Patient Care Experiences of Family Nurse Practitioner Students in the United States

Background: Family nurse practitioners (FNPs) care for patients across their lifespans. Rigorous educational preparation that includes diverse clinical experiences is necessary to ensure competent and safe practice. During clinical experiences, learning outcomes are presumed to be met, yet exploration of what actually happens has not been conducted. Purpose: The purpose of this study was to describe the types, frequency, and depth of direct patient care experiences of FNP students in the United States. Methods: A cross-sectional, observational, complex samples survey design was used to collect data from students enrolled in accredited FNP programs. The survey included 84 specific tasks across the four domains of assessment, diagnosis, treatment, and evaluation in the populations of adult, geriatric, and pediatric clients. Results: The sample of 3,946 students who completed the survey were geographically distributed and representative of U.S. programs. Across all populations (adult, geriatric, pediatric), the most common tasks students reported never experiencing were performing a mental health assessment, ordering diagnostic tests, performing primary care procedures (e.g., wart removal, suturing, cerumen removal), and evaluating treatment and educational outcomes related to chronic pain. Although substantial numbers of students reported never experiencing some clinical tasks in each domain and/or with each patient population, others reported doing such tasks more than 10 times. Conclusions: Many FNP students' clinical experiences did not reflect the tasks deemed essential in the American Association of Colleges of Nursing's FNP Role Delineation Study. These gaps and inconsistencies in requisite learning experiences require a critical conversation among leaders in academia, regulation, and certification to examine competency expectations, clinical learning environment availability, and preparation for advanced practice, as well as to ensure the development of qualified FNPs who will provide safe, high-quality care across patients' lifespans.