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Class enrollment sizes for online learning in higher education, a topic of persistent interest in the academic literature, impact student learning, pedagogical strategies, school finances, and faculty workload. Yet in the research literature, class size is addressed with insufficient specificity to provide enrollment direction. Seeking guidelines for determining online class sizes, the authors conducted a qualitative research synthesis from 43 recent higher education journals, yielding 58 evidence-based articles. It is clear that no one size fits all. Findings reflect that large classes (= 40 students) are effective for foundational and factual knowledge acquisition requiring less individualized faculty-student interaction. Small classes (= 15 students) are indicated for courses intending to develop higher order thinking, mastery of complex knowledge, and student skill development. Pedagogical intent should dictate class size. Using well-established learning theories, the authors describe current understandings of online enrollments and propose an analytical framework for pedagogically driven, numerically specific class sizes. Highlights: (1) There is academic interest in online course sizes in higher education; (2) Research indicates "no one size fits all" online classes; (3) Class sizes should be based on learning level and identified pedagogical intent; (4) Large classes are appropriate for foundation-level learning; and (5) Small classes are appropriate for learning requiring higher order thinking.

Every day the delivery of healthcare becomes more complex as new treatments are discovered and new technologies for diagnosing and treating disease are developed. Adding to this challenge, today's patients [...]

Background: Nearly 15 years after the introduction of the doctor of nursing practice (DNP) degree, stakeholders anticipate practice scholarship outcomes from graduates. Purpose: To examine the frequency of engagement in practice scholarship, the relationship between the knowledge gained in DNP programs and the frequency of engagement in practice scholarship and the relationship between engagement in practice scholarship, work role, and years since graduation with a DNP degree, as reported by practicing nurses. Methodology: This cross-sectional study recruited 306 practicing DNP graduates via a national organization and employed an electronic survey. Descriptive and inferential statistics, correlational analysis, and a one-way analysis of variance were conducted on demographics and outcome variables for 269 completed surveys. Results: The practice scholarship activity reported most frequently was evaluation of current clinical evidence and least frequently was dissemination of policy papers. Reported knowledge gained from DNP programs and frequency of engagement in practice scholarship indicate a weak positive correlation. There was a significant difference in the direct care work role and practice scholarship engagement compared with other roles, and between those practicing greater than 10 years and those with less experience. Conclusions: Results highlight the underutilization of knowledge gained in DNP programs and engagement in practice scholarship. The study emphasizes the complexity of realizing practice scholarship outcomes of DNP-prepared nurses to influence patients, populations, systems, and policy as well as the advancement of the nursing profession. Implications: This is a call to action for DNP graduates, academia, practice, and the nursing profession to support and value practice scholarship. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is Available in the Text. Nurse practitioner (NP) education has followed the pattern of other health professions in recent years to place an emphasis on competency-based education. In recent years, postgraduate NP residency/fellowship programs to achieve competence and successful transition to practice have emerged and flourished. Currently, there is no standard competency framework in use for NP residency/fellowship programs in the United States, despite numerous published frameworks available. This article aimed to provide a comprehensive analysis of competency frameworks for NP education and to summarize and compare the competency frameworks used in NP education and residency/fellowship programs. Recommendations were sought for standardization of these competencies to create consistent evaluation and outcome measurements. Seven competency frameworks used across NP education and residency/fellowship programs were reviewed and compared in table format. Commonalities, differences, and themes were extracted from this comparison. There were more similarities than differences between the competency frameworks; however, common themes emerged as the emphasis on patient-centered, evidence-based practice, systems-based and quality improvement, and interprofessional practice and teamwork. The American Association of Colleges of Nursing Common Advanced Practice Registered Nurse Doctoral-Level Competencies, published in 2017, provided the most current, inclusive, comprehensive, and complete set of competencies for NPs at the time of graduation; however, they have not defined a progression indicator for postgraduate NP competency evaluation. This review of the competencies emphasizes (a) the need for consistent and consensus-based standards and (b) areas that NP education and residency/fellowship programs can strengthen to assess their ability to describe observable, measurable competencies. Instruments to evaluate competencies are recommended. [ABSTRACT FROM AUTHOR]

Background: The American Association of Colleges of Nursing introduced the Doctor of Nursing Practice (DNP) degree in 2004. To date, few publications examine the competencies and impact of nurses with practice doctorates. Purpose: The purpose of this study was to examine reasons for seeking a DNP degree, assess knowledge and competencies acquired from DNP programs, and to inform stakeholders about the skills acquired by nurses with practice doctorates. Methods: A cross-sectional design was used to administer a self-report survey to a convenience sample of DNP-prepared nurses in practice, recruited from a national membership organization. The electronic survey was designed using constructs developed from the literature, national organization position statements, and standards of doctoral nursing education. Results: A total of 306 participants responded to the survey, 270 were used after data review. The majority of respondents did not seek a DNP degree because it was required for a job, to gain additional supervised practice, or to receive additional training with a specialty population. The majority strongly agreed that they gained competency in translating and synthesizing research evidence into practice, designing and implementing quality improvement, and identifying, measuring, and evaluating outcomes. Conclusions: Primary reasons for seeking a DNP degree were seeking knowledge, skills, competencies, confidence, and job opportunities. Implications for practice: Doctor of Nursing Practice–prepared nurses hold unique, advanced knowledge, competencies and skills to affect health care across multiple settings. Study results suggest that highly skilled DNP-prepared nurses are equipped to lead quality improvement, engage in practice scholarship, and improve clinical outcomes. [ABSTRACT FROM AUTHOR]

Background: A current trend to address the increasing numbers of new graduate nurse practitioners (NPs) and the expanding scope of practice of NPs is the emergence of employer-based postgraduate NP residency/fellowship programs. Purpose: The purpose of this study was to conduct a comprehensive examination of postgraduate NP residency/fellowship programs in the United States, to gain an understanding of the facilitators, barriers, benefits, and funding of these programs, from the perspective of the program directors. Methods: This exploratory study used a quantitative design to conduct an online survey, developed by the researchers, of program directors of postgraduate NP residency/fellowship programs. Descriptive statistics were generated for continuous variables: the mean, SD, and minimum, and maximum values, and for categorical variables, frequency and percentage were reported. Results: More than 90% of program directors indicated that NP recruitment and retention were benefits to organizations implementing NP residency/fellowship programs. Decision makers in organizations support postgraduate NP residency/fellowship programs and few barriers exist to implement programs. More than 84% indicated that physician and administrative support were facilitators to program implementation. Less than 50% of program directors identified barriers to implementation. Less than half of programs received funding sources for program implementation. Implications for practice: This study provides data and insight into the emerging industry of postgraduate NP residency/training programs and informs regulators, educators, and employers about how to maximize the facilitators, reduce and decrease barriers, identify sources of funding, and appreciate the benefits of implementing programs. [ABSTRACT FROM AUTHOR]

Background: Nurse practitioner (NP) residency/fellowship programs are an emerging industry across the country. Purpose: This study aimed to conduct an in-depth exploration about postgraduate NP residency/fellowship programs in the United States and to gain an understanding of program characteristics, educational content, and implementation methods to assist NPs to transition to practice. Methods: This exploratory study used a quantitative design to conduct an online survey of program directors of NP residency/fellowship programs to collect data about program characteristics to assist graduates to transition to practice. Descriptive statistics were calculated for continuous variables, whereas frequency and percentage were calculated for categorical variables. Results: Nurse practitioner residency/fellowship programs lack consistency in standards for educational content and delivery methods. Only 26% of the programs were accredited, and the programs were not consistently based on nationally recognized competencies. Ninety percent of the programs relied on didactic and clinical supervision delivery methods. More than 90% of the residents/fellows cared for adults older than 65 years of age and managed chronic diseases. Family Nurse Practitioner was the most commonly cited population track offered (73%). Nurse practitioner residency/fellowship programs are sparsely offered in the most rural states with underserved populations. Implications for practice: This study provides data and insight into the emerging industry of postgraduate NP residency/training programs for educators and employers. In addition, it informs regulators and decision makers about the quality and consistency of programs and the impact of programs on the care delivered by new graduate NPs. [ABSTRACT FROM AUTHOR]

To serve as leaders in health care, Doctor of Nursing Practice (DNP) graduates must implement an innovative DNP project that is relevant to practice organizations during a pandemic. This article discusses pivotal strategies to overcome barriers by implementing types of DNP projects that align with practice organizational goals and demonstrate practice outcomes to stakeholders. To serve as leaders in health care, Doctor of Nursing Practice (DNP) graduates must implement an innovative DNP project that is relevant to practice organizations during a pandemic. This article discusses pivotal strategies to overcome barriers by implementing types of DNP projects that align with practice organizational goals and demonstrate practice outcomes to stakeholders. [[J Contin Educ Nurs. 2021;52(2):61–63.] [ABSTRACT FROM AUTHOR]