The RAST-NP Pilot

Preparing New Graduate Nurse Practitioners for Emergent Procedures in Remote Settings Using a Novel Training Program

Abstract

With more new graduate primary care nurse practitioners (NPs) practicing in remote locales than ever before, their preparation for performing emergency procedural skills (EPSs) is critical for safe and effective care. Emergency procedural skills are not uniformly taught in primary care academic programs but are easily imparted via additional training and practice. The purpose of this project was to develop and pilot an expert panel–validated training program specifically for NPs bound for remote practice and to evaluate how the participants rated their self-efficacy in performing specific EPSs before and after completing the training, called the Remote Advanced Skills Training for NPs (RAST-NP). A diverse expert panel rated EPSs to determine skills to be included in a pilot training program. After achieving consensus on skills to be taught, a hybrid online-in-person curriculum was developed using standards from the International Nursing Association for Clinical Simulation and Learning. This training was conducted for more than 2 days and delivered to a class of 15 primary care NP students in their final year of education. All participants completed a pre- and postparticipation survey to assess their self-efficacy using a validated questionnaire, modified to address the EPSs taught. The participants reported higher confidence following training on all EPSs taught, as indicated by an increase in difference in mean scores from 1 to 6.15 on an 11-point scale. For each EPS, the difference was statistically significant by both a paired t test and a Whitney–Mann U test with probability of 0.01 or less. Results indicate that the methods utilized (i.e., psychomotor practice) increased confidence in NP students, and they also suggest that the amount of time spent practicing skills is associated with interval increases in confidence. A combination of didactic and psychomotor methods was uniformly effective at increasing confidence, and thereby self-efficacy, and higher success is associated with more time practicing the kinesthetic skills in situ.