Incorporating a Health Policy Practicum in a Graduate Training Program to Prepare Advanced Practice Nursing Health Services Researchers

Abstract

Health services research benefits from the active engagement of researchers and policy makers from generation through to application of research-based knowledge. One approach to help graduate students learn about the policy world is through participation in a policy practicum. This is an opportunity to work for a defined period of time in a setting where policy decisions are made. This article focuses on the integration of the policy practicum into graduate nursing education for advanced practice nurses. Ten graduate students and two postdoctoral fellows who had recently completed their practicums and three policy makers who had recently supervised students in provincial, federal, and international practicum projects were invited to submit a narrative about the experience. Based on qualitative analysis of the narratives, this article outlines objectives of the practicum, the policy practicum journey, student learning, and finally, the benefits and challenges of the experience.

Health Policy Training: A Review of the Literature

“…The majority of articles identified from the literature search were targeted toward medical audiences—medical students, residents, or medical school faculty [ 4 , 8 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ] (39%, n = 13) or nursing audiences—nursing students or nursing school faculty [ 5 , 6 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ] (36%, n = 12). Fewer articles were directed to public health professionals and students [ 7 , 39 , 40 ] (9%, n = 3), health administration and management faculty and students [ 41 , 42 ] (6%, n = 2), psychology faculty and students [ 1 ] (3%, n = 1), public policy and public administration faculty and students [ 43 ] (3%, n = 1), and a combination of business, public policy, and health administration faculty and students [ 44 ] (3%, n = 1).…”

“…These programs varied in intensity and time commitment, ranging from a single “Health Care Reform Day” for medical students [ 4 ] to a three week intensive [ 20 ] or two year-long integrated curriculum [ 23 ] for medical residents. Similarly, nursing programs ranged from policy-oriented service learning programs over 2–3 semesters [ 31 , 32 , 36 ] to multidisciplinary programs in health policy for nursing masters and doctoral level students [ 34 ]. As discussed in the Evaluation section below, 75% of these (12 of 16) included evaluation results, though they were generally quite limited in scope.…”

Implementation of a State Legislative Fellowship for Doctor of Nursing Practice Students

“…[8][9][10] In addition, the legislative fellowship provides students exposure to a broad array of state officials, policy makers, district constituents, lobbyists, advocacy groups, and leaders of professional organizations. [11][12][13][14][15] There are several foundational aspects of legislative fellowships that faculty should be aware of to create successful fellowships. Key to creation of such fellowships is that nursing faculty must first identify legislators who are willing to sponsor fellowships.…”

“…During the legislative fellowship, students should have the opportunity to build on knowledge and skills learned in the prerequisite health policy course and gain practical experience working with policy makers. 13 For example, students might attend House and Senate Health Finance Committee meetings; analyze and evaluate bills related to health care, nursing practice, and education; prepare briefings; attend legislative proceedings; meet with their district's representatives and senators; communicate with legislators, legislative assistants, stakeholders, and lobbyists; attend speaking engagements with the sponsoring legislator; and participate in special legislative events. There also may be other opportunities for students such as attending the Governor's State of the State address or assisting with drafting resolutions to celebrate an anniversary of a nursing school or the contributions of a nursing leader to health in the community.…”

“…13 Other considerations are the number of credits, prerequisites, length of the course, number of days per week or clinical hours, number of students assigned to each legislator, total number of students placed with each faculty member, and length of the General Assembly session. 13 The authors of this article were involved with the creation and implementation of a state legislative fellowship for DNP students that could serve as an exemplar for nursing faculty. The state legislative fellowship we developed is a variable credit course, primarily taken as 2 or 3 credits for 1 semester.…”