Advanced practice nurse (APN) as health and wellness coach: Teaching APN students to transform health and healthcare

Chronic diseases, with modifiable health risk behaviors, account for approximately 70% of US morbidity and mortality (Centers for Disease Control, 2008). Medicare recently set a precedent in preventive healthcare services with the approval of reimbursement for intensive coaching services for one major condition amenable to behavior change: the treatment of obesity.  If this initiative demonstrates positive outcomes, extension to other health behavior-related conditions (e.g., diabetes, smoking) could be expected.  Advanced practice nurses (APNs) are well positioned to provide such services; however, sufficient training in coaching is necessary to ensure best outcomes (Hayes, Kalmakis, 2007). 

The teacher-coach role is a core competency for advanced practice nursing (APN) (NONPF, 2012); comprised of two complementary, yet distinct, functions.  The APN as a traditional expert patient educator (teacher) is well established.  However, research confirms what APNs quickly learn; that increasing patients’ knowledge alone is rarely effective in changing behavior (Bodenheimer, Lorig, Holman, & Grumbach, 2002, Cooper, Booth, Fear, & Gill, 2001). By contrast, the APN as coach may teach patients, but such teaching is uniquely patient-driven and participatory. Moreover, the coach synthesizes knowledge of diverse theories and expertise in evidence-based strategies to support transformative (affective, cognitive, and behavioral) change (Hibbard, Lawson, Moore, and Wolever, 2010).   

What didactic and clinical opportunities best develop APN student coaching competencies?  How can faculty prepare APNs to deliver best practices in transformational coaching services?  

In this interactive session, panel members will explore core recommended content, strategies employed, exemplars, and experiences of faculty in facilitating coaching competency development into FNP curricula. Discussion will include:

• Compare/contrast the role of teacher verses coach;
• Foundational theoretical frameworks applied to individuals and families
• Evidence-based methods that support processes of change for individuals and families;
• Strategies for building coaching competencies into APN curriculum,
• Assessment of coaching competencies;
• Coaching resources for APN faculty.

APN education can substantially impact behavior-related preventable chronic disease outcomes by ensure graduates possesses a potent toolbox of synergistic teacher-coach knowledge and skills. Enhancing coaching competency will enable APNs to be the innovative leaders and change agents required for the transformation of health and healthcare in the 21^st century.