Join us as we discuss the drivers and processes of implementing a postgraduate nurse practitioner residency program at your health center, the benefits of implementing a postgraduate residency program, and the residency tracks for Family, Psychiatric/Mental Health, Pediatric, and Adult-Gerontology Nurse Practitioners. We will be joined by Charise Corsino, Program Director of the Nurse Practitioner Residency Program, and Nicole Seagriff, Clinical Program Director of the Primary Care Nurse Practitioner Residency Program, from the Community Health Center Inc.

1. Building the Case for Implementing Postgraduate
NP Residency and NP/PA Training Programs
Webinar
Thursday December 9th, 2021
1:00-2:00pm Eastern / 10:00-11:00am Pacific

2. Continuing Education Credits
In support of improving patient care,
Community Health Center, Inc. / Weitzman
Institute is jointly accredited by the
Accreditation Council for Continuing Medical
Education (ACCME), the Accreditation Council
for Pharmacy Education (ACPE), and the
American Nurses Credentialing Center
(ANCC), to provide continuing education for
the healthcare team.
A comprehensive certificate will be sent after
the end of the series, Summer 2022.
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3. Disclosure
• With respect to the following presentation, there has been no relevant (direct or indirect) financial relationship
between the party listed above (or spouse/partner) and any for-profit company in the past 12 months which
would be considered a conflict of interest.
• The views expressed in this presentation are those of the presenters and may not reflect official policy of
Community Health Center, Inc. and its Weitzman Institute.
• We are obligated to disclose any products which are off-label, unlabeled, experimental, and/or under
investigation (not FDA approved) and any limitations on the information hat we present, such as data that are
preliminary or that represent ongoing research, interim analyses, and/or unsupported opinion.
• This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of
Health and Human Services (HHS) as part of an award totaling $137,500 with 0% financed with non-governmental
sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an
endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.
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4. At the Weitzman Institute, we value a
culture of equity, inclusiveness,
diversity, and mutually respectful
dialogue. We want to ensure that all
feel welcome. If there is anything said
in our program that makes you feel
uncomfortable, please let us know via
email at nca@chc1.com
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5. National Training and Technical Assistance Partnership
Clinical Workforce Development
Provides free training and technical assistance to health centers across the
nation through national webinars, learning collaboratives, activity sessions,
trainings, research, publications, etc.
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6. Objectives
• Identify the drivers of implementing postgraduate nurse
practitioner program at your health center
• Describe the process of implementing postgraduate
residency programs
• Recognize the benefits of implementing postgraduate
residency programs
• Highlight the training specialties for Family, Psychiatric
Mental Health, Pediatric and Adult-Gerontology Nurse
Practitioners
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7. Growth and Development of CHCI
Postgraduate Residency Training Programs
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8. Primary Care, Psychiatric/MH and Specialty Postgraduate Training Programs –
Total 253 Programs Nationally
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9. CHCI Residency Program Today
• Started 1st program in 2007 – have been
operating for 15 years
• CHC has graduated over 125 alumni
• 0 % drop-out rate
• NP Residency Specialty Tracks:
– Family NPs (est. 2007)
– Psych MH NPs (est. 2015)
– Pediatric NPs (est. 2019)
– Adult Gero NPs (est. 2019)
• 1 year Post-Residency - Center for Key
Populations Fellowship (est. 2017)
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10. The
Residency
Experience

11. Polling Question
What is your primary goal for attending this webinar?
Already involved in a residency program
Starting a residency program
Thinking about starting a residency program
Just wanted to learn more
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12. Drivers of Implementing a
Postgraduate Residency Program
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13. Why Start a Postgraduate Residency Program?
Solve a Problem
• Address the shortage of expert clinicians, particularly for
vulnerable populations
• Give new primary care medical and behavioral health
providers the opportunity for postgraduate residency
training in fully integrated primary care settings
• Support the development of confidence, competence and
mastery in the FQHC setting
• Reduce attrition due to burnout and distress during the
initial postgraduate year
• Provide the depth, breadth, volume, and intensity of
clinical training to a model of care consistent with PCMH,
IOM/FON, and FQHC principles and services
• Prepare the next generation of leadership for FQHCs
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For the
common
good
For the
good of
clinicians
For the
good of
your
organization

14. A Growing Need for Expert NPs in our
Primary Care Workforce
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Rural and Nonrural Primary Care
Physician Practices Increasingly Rely
on Nurse Practitioners
Hilary Barnes, Michael R. Richards, Matthew D.
McHugh, and Grant Martsolf
“By 2016, NPs constituted 25.2 percent of providers in
rural and 23 percent in nonrural practices.”
Health Affairs,
June 2018
Growing Ranks of Advanced
Practice Clinicians- Implications
for the Physician Workforce
David Auerbach, Douglas Staiger, and Peter
Buerhaus
“Two thirds of the health care providers joining the
US workforce by 2030 will be nurse practitioners
(NPs) or physician assistants (PAs). The large influx
will have it greatest effect in primary care where
fewer physicians are choosing primary care”
The New England Journal of Medicine,
June 2018

15. The Road to Developing a
Postgraduate Residency Program
• Answer the question: What are your drivers for starting a postgraduate program?
• Learn the essential elements of a postgraduate program
– Accrediting standards
– State licensing requirements
• Assess your own resources (physical, human, financial)
• Consider creating an academic partnerships
• Secure board, leadership, and clinical buy-in
• Develop financial and strategic plan including potential partners
• Costs and benefits:
– Direct and indirect costs
– Return on Investment: immediate and longer term
– Benefits beyond the financial return
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16. Framework for Postgraduate
Residency Programs
• 12 months, Full-Time Employment
• Full Integration into Home Site and
Organization
• Continuous training to clinical complexity
and a high performance model of care
– Team-Based Care
– Inter-professional collaboration
– Integrated care
– Data driven quality improvement
– Expert use of technology
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Clinical-based
practice
experiences
Regularly
scheduled
education
session
System based
learning and
Quality
Improvement
Population
health focus
Leadership and
professional
development

17. 1) Precepted Continuity Clinics (40%); Residents develop and manage a panel of patients with the exclusive attention
of an expert preceptor (NP, PA or Physician)
2) Specialty Rotations (20%); Experience in primary care specialty areas to expand and enhance resident practice
knowledge and skills
3) Mentored Clinics (20%); Work within a primary care team focusing on diversity of chief complaints, efficiency,
episodic and acute care
4) Didactic Sessions (15%); Topics that are high volume, complexity and/or burden topics in primary care. Includes
participation in Project ECHO sessions for managing chronic pain, treating HIV/Hep C, opioid addiction, complex
pediatrics
5) Quality Improvement Training (5%); Training to a high performance QI model, including front line QI improvement,
data driven QI, and leadership development.
Core Element of a Postgraduate NP Residency
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12 Months
Full-time Employment
Training to Clinical Complexity and
High Performance Model of Care
team-based care, inter-professional collaboration, integrated care,
data driven QI ,expert use of technology
Full Integration into Home
Site and Organization

18. Key Program Staff and Responsibilities
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ROLE RESPONSIBILITES SKILLS TIME COMMITMENT
Administrative –
Program
Coordinator/
Manager
Responsible for the oversight of the
administration of the program.
Manage day to day implementation
and logistics of the program, as well
as troubleshoot issues.
• Organized and detail
oriented
• Knows organization
• Experience and/or
training in program
management
Dependent on size of the
program – could be
combined with other job
role
Starting out - 2 to 3
member residency - .4 to .5
FTE
Clinical – Clinical
Program Director
or NP Lead
Responsible for the clinical
oversight of the program including
curriculum development and
delivery
• Trained in clinical
discipline of the program
• Commitment to training
• Understanding of clinical
delivery of care in area of
training
Dependent on size of the
program
2 to 3 member residency -
.2 to .4 FTE
Clinical –
Preceptor and
Supervisors
Responsible for direct supervision
and training of residents
• Expert provider in their
discipline
• Commitment to training
NP Residency – 4 to 8 hours
per week

19. Program Drivers
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Your organization should ask:
Why do we want to start a
postgraduate residency
training program?
What are
your
drivers?
Recruitment
Training
Retention
Clinical
Workforce

20. Polling Question
What is your primary reason for starting a postgraduate training
program?
Recruitment and Retention
Committed to Training
Staff Development
Staff Satisfaction
Patient Access
Unsure
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21. Process of Implementing a
Postgraduate Residency Program
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22. Top to Bottom Support
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Flinter, M., & Bamrick, K. (2017). Training the next generation: Residency and fellowship programs for nurse practitioners in Community
Health Centers. Retrieved from https://www.weitzmaninstitute.org/sites/default/files/NPResidencyBook/NPResidencyBook.pdf

23. Leadership and Board of Directors
• CEO, leadership team and BOD must be fully committed to the
training program and allocating the necessary resources
• What do they need to know:
– Mission Statement & Program Drivers
– National Landscape
– Outcomes
– Program Structure
– Resource Assessment
– Finances
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24. Cost Considerations and Sustainability
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Program investment must be viewed as a multi-year life cycle project
Year 1 –
Investment
Year 2 – ROI
Retention of residents
Additional benefits
• Smooth transition to full time practice
already trained to your organization’s system
• Increased productivity post residency
• Reduce recruitment costs for external
candidates
• Increased provider satisfaction for staff
involved in the program
• Creates a network of alumni which can
support future recruitment

25. Guiding Principles For Communication
25
Flinter, M., & Bamrick, K. (2017). Training the next generation: Residency and fellowship programs for nurse practitioners in Community Health Centers.
Retrieved from https://www.weitzmaninstitute.org/sites/default/files/NPResidencyBook/NPResidencyBook.pdf

26. Key Organizational Departments:
Finance, Human Resources, IT, Operations, Clinical and Support Staff
• Understanding the role and support
each department will need to provide
• Structure for communicating and
completing required tasks
• Identifying leads in each department
that your team can work with to
implement key program components
• Developing policies and procedures
that all parties agree to follow for key
program tasks
26
Flinter, M., & Bamrick, K. (2017). Training the next generation: Residency and fellowship programs
for nurse practitioners in Community Health Centers. Retrieved from
https://www.weitzmaninstitute.org/sites/default/files/NPResidencyBook/NPResidencyBook.pdf

27. Overall Organization Communication and Education
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Communicate
organization’s plan to
launch a postgraduate
residency program

28. Review of Program Structure
and Design
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29. Program Accreditation
• There are currently two pathways for accreditation: NNPRFTC and ANCC
• Accreditation provides external validation of rigor, quality, and high standards.
• Where to go for additional resources in the development of a program (Accreditation
standards and self study guide)
• Website: www.nppostgradtraining.com
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30. A Month in the Life of an NP Resident
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• Precepted Clinic – generally 4 different
preceptors each for one half day
• Mentored Clinic – can be done at
residents home site, or other locations.
May be preceptors but can also include
other non-preceptor providers.
• Rotation – generally 1 day per week, for
4 weeks
• Each month rotation may be on a
Monday or Tuesday – alternating with
mentored clinic
• Education Day – includes alternating
educational components – Project
ECHO, QI Seminar, Cohort Meeting,
Office hours

31. Evaluations and Assessment of
Resident Performance
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COMPETENCY DOMAINS
1. Patient Care
2. Knowledge for Practice
3. Practice-based Learning and
Improvement
4. Interpersonal and Communication
Skills
5. Professionalism
6. Systems-based Practice
7. Inter-professional Collaboration
8. Personal and Professional
Development

32. Questions?
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33. Wrap-Up
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34. To download the digital version of "Training
the Next Generation: Residency and
Fellowship Programs for Nurse Practitioners
in Community Health Centers"
https://www.weitzmaninstitute.org/
NPResidencyBook
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35. Weitzman COVID-19 Resources
CHCI has curated a series of
resources, including webinars to
support your health center
through education, assistance and
training.
https://www.weitzmanlearning.org
/coronavirus
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36. Contact Information
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For information on future webinars, activity
sessions, and learning collaboratives:
please reach out to nca@chc1.com or visit
https://www.chc1.com/nca