New NPs risk increased stress and anxiety upon entering the workforce.

Stress and anxiety result from lack of confidence and perceived preparedness.

Postgraduate training programs can help mitigate stressors felt by new graduates.

Programs may impact retention, satisfaction, confidence, and perceived competence.

Faculty and universities may benefit from partnering with postgraduate programs.

In 2011, the Institute of Medicine published a report on the future of nursing, which recommended nurse practitioner postgraduate training in the form of fellowships or residencies. Since then, the number of postgraduate programs has grown, but data is still scarce regarding their efficacy and benefits.

The goal of this integrative review is to synthesize available literature regarding the outcomes of nurse practitioner postgraduate fellowships and/or residencies on clinical competence and perceived readiness to practice.

CINAHL, PubMed, and citation searching were used to search relevant subject headings, MeSH headings, and keywords related to fellowships and residencies for nurse practitioners, resulting in 11 articles being included based on inclusion and exclusion criteria. Synthesis was completed using the Garrard Matrix method to identify common themes among the studies.

Eight quasi-experimental and three cross-sectional studies were included in this review. Programs included multiple areas of focus, including primary care, critical care, and pediatric acute care. Common themes among the studies were an increased level of preparedness, reduced turnover, and greater job satisfaction.

The major theme found among the studies was an increased confidence and preparedness to practice. Minor themes include increased job satisfaction and decreased intent to quit.

Nurse practitioner

Residency

Fellowship

Postgraduate training

Outcomes

© 2024 The Author. Published by Elsevier Inc.