Developing a PMHNP Program with a Fully Integrated Neuroscience Foundation

Traditionally, PMHNP educational content focused heavily on the social sciences because of our limited understanding of neurology and psychopharmacology.  However, advances in the scientific underpinnings of behavior and actions of psychotropic medications require an extreme update of PMHNP curricula.  Other disciplines including psychology and psychiatric medicine responded to these scientific advances by increasing the neuroscience and psychopharmacology content in their educational programs, however PMHNP programs have not kept up.  According to Muse and McGrath (2010) APRN education falls last in hours of biochemistry/neuroscience and pharmacology training as compared with physicians (MD/DO) and psychologists (48/56, 316/59, 161/288 respectively).   

We developed a curricular framework with the overall objective of linking brain and nervous system functioning with the complexities of human behavior, psychopathology and PMH interventions.  Course 1 presents the basic foundations of neuroanatomy and physiology from brain and nervous system development to the integration of specific systems associated with the complex presentations of pain, anger/aggression, sleep-wake, language, memory and cognition. The didactic course also introduces students to the organization and structure of the DSM-V and broad classes of medications from a neuropsychopharmacologic perspective.  Utilizing both didactic and field experiences, Course 2 builds on the Course 1 foundation by expanding student understanding of diagnostic criteria, psychopathology and clinical presentation of neurological dysfunction.  The course focuses on the concepts and process of assessment, diagnosis and treatment of mental health disorders.  In Course 3, students explore complex PMH problems, comorbidity and begin to develop expertise in psychotherapeutic modalities.  We link neuroscientific concepts with psychotherapy by highlighting the impact of experience in creating psychopathology and the importance of utilizing therapeutic integration of positive experiences for recovery.  Students’ case conceptualizations and treatment rationales require inclusion of neuroscience perspectives.  The capstone, Course 4, solidifies student learning through intensive practice and supervision while preparing students to fully implement the PMHNP role using the most advanced science to date. Specific teaching methodologies include learning quizzes, interactive online content as well as simulation and in situ clinical evaluation.