This program, to be held at VAMHCS, is supported by the Office of Academic Affiliations who oversees the PC NP residency in collaboration with the VA’s Office of Nursing Services.

The program is designed to provide a supportive learning environment and a path to success for new nurse practitioners interested in geriatric primary care careers with the Department of Veterans Affairs and working with rural and underserved Veterans. It employs an interprofessional “clinician-leader-improver” model comprised of three major components: (1) clinical practice; (2) quality improvement science; and (3) leadership. Learning activities include clinical training, mentorship, didactic seminars, applied individual and/or team projects, and online learning activities.

Mission Statement

Through comprehensive education in primary geriatrics, the VAMHCS PC-NPR seeks to increase Nurse Practitioners’ clinical skills and improve health-related outcomes for older Veterans.

About the Medical Center

The VA Maryland Health Care System (VAMHCS) includes the Baltimore, Perry Point and Loch Raven VA Medical Centers, and six Community-Based Outpatient Clinics (CBOCs) located in counties surrounding Baltimore City and extending to Maryland’s Eastern Shore. During fiscal year 2018, the VAMHCS had over 140,000 Veterans eligible for primary care services and completed 231,354 cumulative visits. At the VAMHCS, approximately 56 % of the Veterans are over the age of 65 and 21% of those are African American. The need for primary care for aging Veterans living in Maryland is considerable, and expansion of these services through a nurse practitioner residency program designed to meet the needs of this population group is an excellent solution.

Services offered within the VAMHCS system include primary care, rehabilitative care, long-term care, hospice care, and inpatient/outpatient mental health care, all of which will be accessible as training sites to the nurse practitioner residency program. VAMHCS is also home to a highly funded research and development programs within the VA including the Baltimore Geriatric Research, Education and Clinical Center (GRECC), the Multiple Sclerosis Center of Excellence (MSCoE), the Epilepsy Center of Excellence (ECoE) and the VISN5 Mental Illness Research, Education and Clinical Center (MIRECC). In addition to these research centers the VAMHCS has a mature educational portfolio receiving over 130 position stipends from the Office of Academic Affairs annually. The Baltimore VA Medical Center is situated adjacent to the University of Maryland, Baltimore campus which is home to the University of Maryland Schools of Nursing (UMSON) and Medicine (UMSOM); furthermore, the VAMHCS maintains a strong collegial partnership with the UMSON as well as The George Washington Nursing School.

Program Goals

1. To develop competent Nurse Practitioners with the clinical skills necessary to improve health-related outcomes for older patients, especially older Veterans.
2. To provide interdisciplinary observational and practice experiences in geriatric care with Veterans with complex health care problems.
3. To develop leadership skills and commitment to advancing Nurse Practitioner roles within an interdisciplinary health care system.
4. To expand the VAMHCS workforce in primary care geriatrics by improving the confidence, productivity, and job satisfaction of new nurse practitioners who choose to work in a veteran centric setting.
5. To integrate principles of research and quality improvement into practice.

Program Structure

1. Preceptor Clinics: These are the cornerstone of the residency program. The NP resident will engage in 3 sessions per week. In precepted sessions, the NP residents develop their own patient panel while having an expert primary care provider (MD, APRN or PA) exclusively assigned to them.
2. Specialty Rotations: The NP resident will engage in 2 specialty rotations per week in areas of high-volume/high-burden/high-risk situations most commonly encountered in the Veteran population. Planned rotations include: Cardiology, Diabetes, Endocrine, GI, Mental Health, and Orthopedics.
3. Didactic: Formal learning sessions on a variety of complex clinical challenges most commonly encountered in VAMC will be conducted each week. The content of the presentations is planned to correspond to the residents’ current clinical experiences.
4. Interprofessional Education (IPE): Monthly Interprofessional education and clinical practice is essential when dealing with the complex needs of the Veteran. Monthly IPE training will allow the NP resident to develop an understanding of the roles and responsibilities of other members of the health care team, establish and build rapport, develop communication skills and build strategies to manage conflict.
5. Project: Each resident is required to complete a Quality Improvement and/or research project related to an identified care problem. The Nurse Practitioner resident will be afforded dedicated time each week to assess their selected topical area/problem, review pertinent literature, implement project to address problem, collect data, analyze, and interpret that data related to improving outcomes. The project, once completed, will be presented to members of the clinical staff, program leadership, and the Quality, Safety, and Improvement Council.

For questions, please contact:

Laura Mastella, DNP, ANP-BC, WHNP
PC-NPR Program Director

410-605-7000 Ext. 54349

Laura.Mastella@va.gov

 Residency Program Application