Enhancing NP student experience with on-call simulation

“Few nurse practitioner (NP) programs include an after-hours/on-call component in their clinical preparation of NP students. This role is expected in many primary and specialty care practices, and is one that students feel unprepared to competently navigate,” say authors Michelle M. Kelly, PhD, CRNP, assistant professor; Elizabeth Blunt, PhD, RN, APRN-BC, assistant clinical professor; and Kelly Nestor, MSN, ANP-BC, assistant clinical professor in their recent publication ‘After-hours/on-call experience during primary care nurse practitioner education utilizing standard scenarios and simulated patients’ in Journal of the American Association of Nurse Practitioners.

The College of Nursing, which has adult-gerontology, family and pediatric primary care NP concentrations in its Graduate Program, began using on-call simulation in 2012. The three faculty were awarded a Villanova Institute of Teaching and Learning (VITAL) Research Support Grant in 2016-17 to expand the program. “Very few programs do this kind of exercise with their NPs,” says Dr. Blunt who coordinates the NP tracks, adding that there will be an upcoming survey of graduates to ascertain whether or not the simulation affected their decision about taking a position and if it assisted them in the interview process.

“The assignment is conducted during last semester of the clinical year so students have as much content and experience as possible to handle the calls,” notes Dr. Kelly, “It is critical as taking call is a component of the advanced practice role. Because we are using simulated patients in a practice without electronic health record access, students need to rely on their history taking skills to assess, triage and treat effectively.”

The faculty designed the program utilizing simulated callers as patients or parents, NP students participated in a simulated after-hours/on-call experience that included receiving the call, managing the patient, and submitting documentation of the encounter. Students completed pre- and post-participation evaluations, and were evaluated by the simulated patient callers and faculty using standardized evaluation tools. “The students find it challenging but ultimately beneficial,” says Prof. Nestor. As the authors note in their article, “Several essential skills were identified including critical thinking, clear communication, self-confidence, and access to resources.”  They recommend that inclusion of this type of on-call simulation be included in NP curricula.