Assessment of Military Nurse Practitioner Role Transition


Name: Jacqueline Killian

Rank: Lt Col

Organization: The Geneva Foundation

Performance Site: Wilford Hall Ambulatory Surgical Center

Year Published: 2017

Abstract Status:


Newly educated and accessioned military nurse practitioners (NPs) must endure bilateral transitions, developing proficiency in two professional roles simultaneously, that of NP and military officer. A difficult transition period impacts both confidence and competence of the novice NP, affecting such areas as patient safety, NP satisfaction and retention which, in turn, may lead to a reduction in the supply of qualified military NPs in the work force. The purpose of this proposed investigation is to explore the US military active duty NPs’ transition experience in the military health care environment.The first specific aim is to collect and analyze longitudinal data to determine the transition experience of newly graduated or new to the military NP in the military health care environment. To this end the following research questions are posed: 1) How do new military NPs perceive their work/practice environment during the transition period? 2) How do new military NPs perceive the amount of supervision and coaching they receive in their work/practice environment during the transition period? 3) To what degree do new military NPs experience stress, anxiety and depression during the transition period? 4) What are the relationships between demographic characteristics, work/practice environment, supervision and coaching, and behavioral health symptoms? The second aim of the study is to establish a DoD repository for data regarding new military NP perceptions during the transition period to facilitate ongoing data collection, longitudinal analyses and informing military nurse corps leaders about trends occurring during the NP transition period that may affect policy and program revisions.A two phase cohort repeated measures design is proposed to describe the military NPs’ perception of their transition experience during the AF NP transition program in the military healthcare environment. The first phase of the design involves collection of data from AF NPs at four time points selected to capture information from NPs newly graduated in May of each year. Phase two of the study will occur in study year two, at which time the survey instrument will be deployed to Army, AF and Navy NPs to characterize their transition experience as well. Data collection will be accomplished via an e-mailed self-report survey comprised of standardized instruments that can be scored for each participant. The instruments selected for this study are based on the review of the literature regarding NP role transition and findings from preliminary data previously collected. Descriptive statistics and correlations will be used to report the basic features and distributions of the variables measured. Repeated measures ANOVA or MLM will be used to analyze the data for differences over time.Successful recruitment, training and retention of fully qualified, competent, and confident military NPs is essential for agile force projection in contingency operations and military operations other than war. NPs entering military service must navigate an interdependent and unique transition process. A wellsupported transition will improve performance in both healthcare provider and military officer roles. This study is the first to investigate this crucial period of time in the development of military advanced practice nursing personnel and will provide valuable information that may be of great utility for the MHS. The cost of NP development in terms of time and money is too great to waste and makes this investigation critical and timely. Reducing voluntary turnover is paramount to sustaining the highest quality NP officers.