Family Nurse Practitioners’ Fellowship Programs

Subject: Nursing
Pages: 6
Words: 1695
Reading time:
7 min
Study level: Master

Executive Summary

The shortage of primary healthcare providers makes the policymakers and system administrators concerned about decreasing interest and readiness of registered nurses to become Family Nurse Practitioners (FNP). One of the most significant problems facing novice FNPs is their preparedness for advanced practice and the number of responsibilities and duties. The healthcare professionals encounter such difficulties as lack of orientation, identity confusion, and emotional stress associated with independence. Current research aims to identify the role of fellowship programs in improving this process of transition to practice to determine whether it is a necessary stage for FNP’s career development.

These programs are employer-based postgraduate training techniques and assistance that allow the nurses to prepare for practical tasks and gain support from their colleagues. The study concerns such aspects as identifying challenges, observing the specifics of fellowship programs, and evaluating the role of the training in improving the transition to practice. The analysis of scholarly literature plays an essential role in identifying these aspects. The examination of sources reveals that the postgraduate training programs help FNPs develop their professional skills, become more independent, ready to become advanced nurse practitioners, and be satisfied with their work.

Consequently, the fellowship programs should become an inseparable element of the nurse practitioners’ career because they define the quality of the healthcare specialists’ experience, their healthy work-life balance, and the quality of services provided to patients.


FNPs are Advanced Practice Registered Nurses who care for patients during their lifespan. Their work includes diagnosing and treating various health issues and in different settings, which is a significant responsibility. After formal graduate education, these healthcare professionals encounter multiple problems associated with their adaptation. The fellowship programs are forms of employer-based postgraduate training, which helps them to overcome these issues. Although transitioning from FNPs to practice can be challenging, fellowship programs help them, enhancing their professional skills, self-efficacy, independence, collaboration skills, productivity, patient care outcomes, work satisfaction, and retention.

The Challenges of Novice FNPs

Transitioning novice FNPs to practice can be a significant challenge for graduates. The first issue concerns their unpreparedness to the role of advanced care practitioner, lack of orientation and support. The nurses have to learn how to understand the new settings without assistance and guidance. The next challenge of the future FNPs can be identity confusion when the students have to identify themselves as belonging to an unfamiliar environment (Owens, 2019).

This suggestion reveals that this confusion may lead to problems with the feeling of self-confidence and self-esteem. The following concern is the necessity to become independent without sufficient self-reliance. The transition to practice increases the responsibilities, which may become the source of stress and anxiety. These factors define the necessity to participate in fellowship programs to guarantee that the novice FNP is prepared for new functions.

Methods of Teaching

The postgraduate nurse programs allow the healthcare specialists to proceed to practice with the application of such teaching methods as didactic sessions and clinical supervision. Didactic sessions are the forms of education that include formal lectures, case discussions, and simulation training (Meissen, 2019). Clinical supervision is the teaching method, which comprises communication and discussions of the issues with more professional and experienced colleagues who aspire to promote the learners’ independence and autonomy. According to Kesten et al. (2021), the analysis of various fellowship programs reveals that they tend to use the mentioned approaches to educate the nurses and prepare them to practice. This finding demonstrates that these programs can be viewed as the extension of graduate nursing education.

Fellowship Programs as a Modern Trend

The postgraduate training programs become a significant element of the transition to practice, which explains their popularity in modern healthcare settings. The first program was developed in 2007 “by the Community Health Center, Inc.” as the response to the difficulties reported by the nursing students (Cappiello et al., 2019, p. 241). Mainly, their transition to providing care to patients was complicated by a lack of self-confidence and competence. By 2019, more than 500 nurses completed their fellowship programs, and even more still aspire to join this type of education and training to transit to practice smoothly (Cappiello et al., 2019, p. 242). Consequently, the challenges of the novice FNPs contribute to the popularity of these programs as a valuable source of knowledge and support.

The Specifics of Fellowship Programs

The fellowship programs are a specific type of transition from theory to practice. The peculiarity of these programs is that they do not require any licenses. Mainly, the National Organization of Nurse Practitioner Faculties explains that this form of transition to practice has no “post-licensure requirement” (Kesten and El-Banna, 2021, p. 612). This fact signifies that the fellowship programs have no specific regulations and rules, influencing their relative independence and autonomy. The analysis of 88 programs reveals that although they lack evidence-based competency evaluation, they provide sufficient support to FNPs, enhancing the development of their professional skills (Kesten and El-Banna, 2021). These particular features of postgraduate training programs define their influence on the nurses.

The Effect of Fellowship Programs on FNPs

The Development of Stress Management, Critical Thinking, and Organization Skills

The promotion of such skills as stress management, critical thinking, and organization defines the advantages of the fellowship programs. FNPs have to work in different healthcare environments and interact with other healthcare workers, patients, and their families across the lifespan. These specifics of their work determine the necessity to transit from educational settings to completing practical tasks. The fellowship programs include such aspects of adaptation of healthcare professionals as working in stressful situations, critically analyzing the symptoms and circumstances, and organizing their schedule and treatments (Walsh, 2018). Nurses’ ability to understand these aspects of their work during their transition to practice plays a critical role in their ability to cope with anxiety and challenges.

The Effect on Self-Efficacy and Readiness

The fellowship programs allow the nurses to improve their self-efficacy and readiness to become FNP. The readiness of the caregivers plays an essential role in their sense of self-confidence and self-perception, which contributes to the ability to behave and treat patients appropriately. Dumphy et al. (2019) demonstrate the results of studying the perfection of the skills of the graduate nursing students after completion of the course, revealing that the level of readiness increases. In particular, FNPs evaluate their preparedness based on skills such as managing various conditions, using evidence-based approaches, and competence. This finding demonstrates that the healthcare specialists feel more confident in their decision to become FNP when they participate in various programs to improve their transitioning period.

Enhancing Independence and Cooperation

The fellowship programs influence the FNPs, making them more independent and able to cooperate with their colleagues. According to Park et al. (2021), practice autonomy and team collaboration contribute to the nurses’ professional competence because they define whether they can demonstrate their competencies and use their knowledge acquired during education in practice.

The results of the analysis of the nurses having completed a postgraduate training program reveal that FNPs become more self-confident in independent tasks and autonomous in decision-making processes when they graduate from fellowship programs (Park et al., 2021). In addition, they can cooperate with their coworkers more effectively, understanding the relationship between colleagues and the role of interaction in finding solutions and making decisions. This example displays that such components as independence and productive communication are essential for the fellowship programs.

Improving Productivity and Patient Outcomes

The fellowship programs play a significant role in increasing productivity and enhancing patient outcomes. Advanced practice nurses experience anxiety and insecurity when they have to change their roles. According to Urbanowicz (2019), the fellowship programs include the elements that aim to cope with such emotional factors as confusion, self-doubt, and emotional turmoil. The fact that such educational programs comprise the methods to overcome these difficulties reveals that they contribute to the ability of the nurses to enhance their productivity at work. Mainly, their readiness to cope with emotional stress helps them focus on caring tasks and their responsibilities. In addition, it provides the chance to improve healthcare quality and patient outcomes.

Effect on Work Satisfaction and Retention

FNPs benefit from the fellowship programs because they may improve their work satisfaction and retention. Nursing shortages are one of the significant issues in healthcare settings. Consequently, healthcare managers identify the necessity to focus on job satisfaction to guarantee that sufficient numbers of nursing students aim to become FNPs. Halfer and Benedetto (2020) describe the study results of the transition-to-practice program explaining that nurses’ job satisfaction increases. Mainly, the involvement of such practices as discussions of the clinical dilemmas and simulations of acute medical cases provide the opportunity to master communication and decision-making skills (Halfer & Benedetto, 2020).

These methods help make the nurses satisfied with their professional skills, understand what mistakes they can make, and comprehend that they belong to a specific group of people where they can find support. These factors contribute to the retention of FNPs and their desire to work with family members of different ages and with various health issues.


Fellowship programs play an essential role in the ability of FNPs to overcome the issues of adaptation, enhancing their professional competence, self-confidence, autonomy, teamwork skills, productivity, patient care outcomes, job satisfaction, and retention. Postgraduate training programs include didactic sessions and clinical supervision, which help the nurses to overcome the issues related to adaptation and self-identification. The first program was introduced in 2007, and since that time, they became a modern trend because they helped novice FNPs to develop their professional skills.

At the same time, they helped nurses become ready to work in a healthcare environment, become independent, make decisions, cooperate with colleagues, and be effective. These factors allow FNPs to guarantee appropriate patient care outcomes, feel satisfied with their work, and continue working for their current employers. Therefore, fellowship programs are a necessary stage for the FNPs’ transition from their formal education to practice. They should be a part of their training and preparation to work with patients and their diverse health issues throughout their lifespan. As a consequence, patients might also benefit from this nurses’ participation in programs because the quality of services and competence of FNPs might increase.


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Halfer, D., & Benedetto, C. (2020). Evolution of a newly licensed RN transition-to-practice program: theory and development supporting accreditation. JONA: The Journal of Nursing Administration, 50(1), 28-33. Web.

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Park, J., Covelli, A. F., & Pittman, P. (2021). Effects of completing a postgraduate residency or fellowship program on primary care nurse practitioners’ transition to practice. Journal of the American Association of Nurse Practitioners. Web.

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