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Two Roads Diverged in a Yellow Wood

Accreditation Provides a Quality Anchor in Disruptive Innovation

Candice Rettie, PhD 0 1131

A wonderful synchronicity occurred recently when I attended the APGAP (Association of Postgraduate APRN Programs) workshop in Phoenix.  I’d written this post the evening before the conference.  The next morning, we were greeted by the conference’s opening with exactly this picture and Robert Frost’s poem.  The idea of making choices and the impact of those choices regarding training program design, delivery, and accreditation on outcomes resonated deeply.  It was especially apt since I’d also been inspired by Robert Frost and had just finished writing this blog which focuses on choices, transitions, and creating the future.

Making choices necessitates a transition.  Staying on the same path is choosing to make a commitment to pursue familiarity and continuity; the likelihood of predictable change that occurs with a known situation – and perhaps a transition to stability.  Electing a different path is choosing a transition to new opportunities and the possibly disruptive innovation that generates new knowledge, new practice, new policies. Those choices determine how the training programs function, subsequently shaping the future of the profession.

Accreditation translates excellence in practice and awareness of emerging practice trends into salient benchmarks for quality training experiences. 

Success and Professional Identity

Understanding How Postgraduate Training Influences Novice NPs

Candice Rettie, PhD 2 1078

If you have read other blogs in this series, you know that I am frequently inspired by nature. The harvest moon was in full glory this past week, signaling farmers that it is time for harvest.  Birds and butterflies are migrating south, individually and in sky-darkening flocks. Hurricanes are rampaging through warm waters. Each day the hours of darkness increase.  All are signs of nature’s seasonal transition. 


Piaget and Kuhn each conceptualized transitions as essential steps in forward progress.  Beginning with Piaget's notion of transition -- successful transitions are characterized by 'important changes in how the [novice NP] thinks’.  Then layering on Kuhn's notion of a paradigmatic shift -- [earlier ways of practice] are 'replaced by new and different’ ways of functioning as a [confident and experienced healthcare professional.] Let’s explore how transitions occur in nurse practitioner postgraduate training programs.  These programs provide deliberate, structured opportunities for navigating the novice practitioners’ transition from newly minted to seasoned practitioner through opportunities designed to develop relevant “attitudes, beliefs and standards” that correspond with  a “clear understanding of the responsibilities of being a health care provider.” A useful nursing skill acquisition model is provided by  Patricia Benner’s stage theory of clinical competency that describes RNs' progression from novice to expert nurse. The concept of novice NPs moving through five levels of proficiency is applicable to the evolution of a novice NP’s professional identity.  Read more to learn about two recent studies that describe this developmental progression from novice NP to confident practitioner.

Nurse Practitioner’s Professional Identity

The Importance of Faculty, Mentors and Colleagues

Candice Rettie, PhD 0 2130

The process of developing a professional identity begins in undergrad, grows exponentially in graduate school, postgraduate training and professional practice, and continues throughout one’s career. It occurred to me that perhaps there is a unique aspect to the voluntary postgrad training year with its explicit focus on intensive clinical training, training to high performance models of care, and professional development in the context of a structured, transformative experience that builds on and adds to earlier experiences.  Existing relationships continue to develop while strong new bonds are formed with each cohort.   Novice NPs interact with others in a professional setting.  They embark, individually and as a cohort, on their life-long journey of re-creating and refining their professional identities – their shared, unique and individual, interpretations and expressions of their professional roles as nurse practitioners.  

Solar Eclipse and Enlightenment

Knowledge and Understanding Bridge Fear

Candice Rettie, PhD 0 783
As I think back to current events that are fueled by radically differing world views that condone intolerance, my wish is that mutual experiences of this eclipse might serve as a shared reference point that brings together unlikely conversational partners.  While we may see the same event, our perspectives differ as do our interpretations of what we witness.  Using principles of evidence-based science and decision-making as a basis for civil discourse, we can explore the reality of varying observations and analysis; contribute to a meaningful and shared understanding of events; and avoid fueling discord, superstition, and fear.

A Balanced Life

The Challenge of Modeling Wellness

Candice Rettie, PhD 0 1006

Erene Stergiopoulos is an author, an educational researcher, a decade-long cancer patient and now a third-year medical student at the University of Toronto. She recently wrote about the cloak of superhuman invulnerability that is worn by many in the helping professions.  Erene expressed eloquently how experiencing life as a patient has informed her view of healthcare and had a positive impact on her role as a future provider.  She notes that in medical education, students learn about disease, but not what it’s like to live with disease.  

Illness can serve as a crucible reminding us of the gifts of human frailty – a capacity for compassion and empathy.  

In our roles as mentors, teachers and colleagues, let’s model maintaining good health.  When we are ill, take time to heal.  When we are exhausted, make time to rest.  When we need to be replenished spiritually, seek solace. When we haven’t connected with those we care for, remember that time past is time lost. Take your vacation time and encourage your trainees to do the same.