P.R.A.C.T.I.C.E.: Geriatric Simulated Laboratory for Nurse Practitioner Students

Introduction - All students should have experience working with older adults during their educational program. The purpose of this project was to use the P.R.A.C.T.I.C.E. Geriatric Nursing Simulated Facility (PGNSF) to prepare students to address the primary care management of older adults. The four patient simulated clinic allows final semester NP students to accomplish the following: (P) promote Healthy People 2020, (R) reflect on practice, (A) acquire complex skills, (T) treat elders efficiently, (I) intervene with maximal outcomes, (C) conduct best gerontology practices, and (E) educate elders/families. Methods – FNP students signed informed consents to participate in focus groups regarding self perception of time management, assessment skills, diagnostic reasoning ability, capability to use electronic documentation, and health teaching skills in a timed simulated setting managing four patients. The intervention uses two SimMan3Gs, one VitaSim, and one standardized patient portraying influenza, respiratory infection, Parkinson’s disease, and hypertension scenarios. Following IRB approval, students work with each patient independently over 15 minutes in one hour intervals. Outcome measures include pre/post focus group assessment, reflective practice entries, and 10-item performance checklists for each scenario. Results – Pre focus group testing indicate NP students are not all having exposure to older adults in their course practica and many voiced a need for time management and electronic documentation practice. The PGNSF presents a unique learning environment allowing students practice with phlebotomy, starting intravenous infusions, and other complex skills; acquiring more in-depth assessment findings for patients with complex co-morbidities; and blending an holistic approach with the disease-model for high quality healthcare management. Discussion/Conclusion – Nurse practitioner students must practice managing elders efficiently prior to graduation since the average employment setting will involve older adults. Studying in the PGNSF with supervision by faculty wit gerontological expertise will enhance their competency in working with the elder population. Due to the unprecedented population shift in the United States today, there is a significant need for training all NPs the specifics of geriatric assessment and care management in a safe and realistic learning setting.