The Significance of Theoretical Foundations in Education for Nurse Practitioner Programs: A Graduate Nursing Curriculum Exemplar

Theoretical foundations remain an important aspect of advanced nursing education, perhaps even more so today with the increasing emphasis on research, especially evidenced-based practice (EBP) for the advanced practice nurse. Moreover, nursing science should utilize multiple paradigms in research drawing on the uniqueness and richness grounded in nursing (Polit & Beck, 2012). Given, is that nurse practitioner (NP) graduates must demonstrate competencies in order to provide safe, quality care to diverse populations in a complex health care system. However, at our institution of higher learning faculty posit that a solid theoretical foundation and framework is essential for all levels of nursing education and practice. Both the undergraduate and graduate master’s level nursing curricula are grounded in a theoretical framework from the works of Patricia Benner, Jean Watson, and Martha Rogers and the following four metaparadigms: human beings, health, environment, and nursing. All nurse practitioner students begin the curriculum with both a Theoretical Perspective of Role Development and a Theoretical Foundations course.  Several theories are examined and critiqued not only from nursing but also those borrowed from other disciplines such as Bandura’s Self-Efficacy Theory, Complexity Theory (Lindberg, 2008), Communication Theory and Leadership Theory. Assignments include a theory presentation in which the theory, the assumptions and concepts are described, critiqued and substantiated with the literature as well as a discussion of its applicability to advanced practice, research, and education. Moreover, students are required Nola Pender’s text (Pender, 2011) to critically examine and apply Pender’s Health Promotion Model (HPM) beginning in the theory course and continuing throughout the clinical courses, the evidenced-based practice course, and capstone project. Within the role development course graduate students apply Hagedron and Quinn’s (2004) “Theory-Based Nurse Practitioner Practice: Caring in Action” and examine how caring theory guides NP practice through the use of clinical exemplars.   Our faculty recognize that along with clinical competence grounded in empiric knowledge, ontological and epistemological ways of knowing such as Carper’s patterns of knowing (Carper, 1978; Chinn & Kramer, 2011) will guide advanced practice nurses in providing holistic, evidenced-based care with the ultimate goal of improving health outcomes for individuals, families, and populations.