Postgraduate APRN Fellowships have been recommended by the Future of Nursing Report (2010) as a method to seamlessly transition recently graduated APRNs into the clinical setting. Peak Vista offers an accredited outpatient Primary Care APRN Fellowship as part of an effort to improve health care access for people facing access barriers to care.

The Fellowship is philosophically oriented around Benner’s Novice to Expert Model, Bandura’s Theory of Self-Efficacy and vicarious learning, and general adult learning theory. Self-evaluated and preceptor-evaluated competencies are derived from modified ACGME Milestones (2019) which support the continuous progression of knowledge, skills, attitudes, and professional goals.

The five core competencies identified by the IOM Committee (2003) as crucial to health professionals' education include the following:

• The ability to deliver patient-centered care, considering an increasingly diverse US population with varying cultural backgrounds, expectations and values.
• The ability to work in interdisciplinary teams and practice team-based skills, especially for patients with chronic conditions.
• The training and ability to search and evaluate the scientific evidence base upon which health care decisions should be made in practice.
• The knowledge and ability to analyze the root causes of medical errors and quality problems and fix them through system-wide approaches.
• A solid foundation and skills in using cutting-edge information technology to deliver high-quality medical care, such as being able to search the medical literature online or being able to use computerized order entry systems that automatically flag pharmaceutical contraindications and errors.

Fellows complete a QI project focused on an aggregate population or clinical practice problem. They are also required to attend CME's and work on projects and assignments that may occur outside of working hours. Additionally, Fellows are required to attend provider meetings over the course of the year.

The Fellowship combines precepted interdisciplinary clinical immersion, relevant post-graduate didactic, and self-directed population management QI activities.

The goals of the Fellowship are:

• Increase access to quality health care for communities by assisting recently graduated APRNs to transition seamlessly to the practice setting.
• Nurture the confidence and competence of transitioning APRNs in the primary care setting, thereby improving APRN and employer satisfaction.
• Improve APRN retention in the primary care setting.
• Immerse APRNs in a collaborative and interdisciplinary model of primary care and vulnerable populations care consistent with the recommendations of the Institute of Medicine.
• Facilitate professional development and life-long learning through continued population-focused interdisciplinary education and quality assessment/improvement appropriate to the primary care setting.
• Provide mandated hours of precepted prescriptive practice experience as required by the Colorado Board of Nursing and Department of Regulatory Agencies.  

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