This article is a response to Randy D. Danielsen's editorial " Online Entry-Level Education: The Jury Is Still Out! " from the June 2015 issue of Clinician Reviews.
Dear Dr. Danielsen,
Thank you for addressing this latest controversy in PA/NP issues in the June 2015 Clinician Reviews . I appreciate your candor and your objectiveness in presenting this "hot topic."
I am a currently retired Certified Family Nurse Practitioner after more than 20 years in practice; I graduated from my RN program 40 years ago this month! During my career, I was a clinical instructor in an RN program, as well as a hospital nurse for most of my first two decades of nursing.
After obtaining my MSN/NP education, I preceptored NP students in a master’s prepared program for 20 years. The difference in students who were enrolled in the accelerated programs and those who were in traditional RN to BSN to MSN/NP programs were astonishing to me. They had little to no experience in how to relate to patients or how to take a history, and they certainly were not comfortable with patients.
Another concern is the growing number of "for profit" private schools now offering NP/PA programs, where enrollment seems to be at the price of well-qualified students. Those who cannot meet the requirements of a traditional university setting are now flooding these programs. Just look at the pass rates on exams and the attrition rates along with the high cost they charge.
I am concerned about the move toward e-learning programs. Anybody can memorize pathophysiology, statistics, and biochemistry, but not everyone can learn how to interact with patients and develop critical-thinking and problem-solving skills without direct supervision and experience.
Adequate clinical experience is imperative, and I suggest an internship for NPs and PAs fresh out of school. If we are going to advance our respect in the medical world with our physician colleagues, and continue to provide excellent care in this new era of medicine, then we need to make sure we do not jeopardize the hard work we have all done to bring the current high standards to PA and NP programs.
Janet Evans Emery, RN, MSN, CFNP
Irvine, California