Faculty Practice for the Sake of Practice

Ann Marie Hart, PhD, APRN-BC, FNP

Disclosures

April 18, 2007

The Value of Clinical Practice

For a variety of personal and professional reasons, nurse practitioner (NP) faculty value clinical practice -- so much so, that more three fourths of NP faculty engage in it.[1] Despite this, many academic institutions do not recognize practice activities in faculty workloads or consider them in tenure and promotion decisions. Efforts to recognize practice as legitimate (and worthy of tenure consideration) of the NP faculty member's role in academia are ongoing. The National Organization of Nurse Practitioner Faculties (NONPF)[2] requires that NP program directors and other faculty members who teach clinical components maintain current certification, which requires a minimum of 1000 hours of nursing practice every 5 years.[3,4] In addition, NONPF maintains a Faculty Practice Resource Center,[5] which describes a variety of practice definitions and models to assist new faculty members who are in the midst of negotiating for practice time.

A variety of publications emphasize the value of NP faculty practice to academic institutions.[6,7,8] Central to these manuscripts is the argument that faculty practice contributes to the teaching, research, and service missions of the institution. In addition, Boyer's[9] thoughts about the scholarship of application and engagement are frequently referenced to legitimize the role of practice in academia, and NP faculty who engage in practice are encouraged to demonstrate evidence of their clinical scholarship through research and peer-reviewed publications.

There is no question that faculty practice is associated with a multitude of research and teaching opportunities. Reflective clinical practice often results in a host of researchable questions, and the clinical setting is a natural environment for scientific investigation. Furthermore, NP students benefit enormously when they learn alongside faculty in their clinical practice settings and actively participate in the integration of research-based evidence into practice.

However, in our efforts to legitimize faculty practice, we must be cautious not to overlook the most fundamental justification for this practice -- clinical competency. At the most basic level, NP faculty need to practice to remain competent clinicians and teachers. To do this, faculty need to be involved in some direct patient care, aside from the care that they provide with NP students. In her now classic article regarding the leadership challenges associated with NP education, Booth[10] stated: "The (NP) program must have a sufficient number of well prepared nurse practitioner faculty who remain active in practice themselves: this practice must be time without students in order to allow total immersion in the caregiver role" (p. 58). Similarly, the argument could be made for the need for faculty to have practice time without the added pressure to perform research or write for publication.

The bottom line is that there is nothing inherently wrong with NP faculty engaging in practice solely for the sake of remaining competent. While faculty practice readily lends itself to teaching and research, mandating that all institutionally endorsed faculty practice is associated with student teaching or result in funded grants, research projects, and/or publications, devalues the very essence of practice. Evidence-based clinical practice is a valuable scholarly activity in and of itself and is associated with its own set of evaluation criteria -- clinical outcomes.

These clinical outcomes, not the number of publications or funded research projects, represent the most important criteria for evaluating faculty practice and are best measured through rigorous self-, peer, and patient review. While it is vital for NP students to be exposed to practicing faculty and for faculty to disseminate research, teaching, and other scholarly ideas that result from practice, it is not essential that all faculty practice activities be directly associated with teaching, research, or writing for publication. In NP education, the most essential resource is clinically competent faculty members.

While teaching and research are absolutely critical to quality NP education, these activities are best carried out by clinically competent NP faculty who are allowed to fully immerse themselves in practice. Faculty practice must be recognized as the core of NP education.

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