Role preparation for advanced practice nursing: practicing consultation and collaboration skills.

Role Preparation for Advanced Practice Nursing: Practicing Consultation and Collaboration Skills Nurse educators are charged with ensuring that graduates are well prepared to function in the context of an ever-evolving and increasingly complex health care environment. Professional consultation and collaboration skills have been identifi ed as necessary for the advanced practice nurse, yet teaching such skills can be a challenge. In 1995, the American Association of Colleges of Nursing (AACN) fi rst identifi ed communication, collaboration, and consultation as essential content in the advanced practice nursing curriculum. The new Essentials of Master’s Education in Nursing (AACN, 2011) has similarly identifi ed Interprofessional Collaboration for Improving Patient and Population Health Outcomes as one of the nine essentials stressing collaboration, consultation, and communication skills in interprofessional teams. Core competencies outlined by the National Organization of Nurse Practitioner Faculties (2011) also include the nurse practitioner’s ability to make appropriate and timely referrals and consultations and to effectively collaborate in providing care. Competencies specifi c to psychiatric and mental health nurse practitioners include building collaborative, interdisciplinary relationships to provide optimal care to the patient, collaborating as a member of the interdisciplinary mental health and other health care teams, and providing consultation to health care providers and others to enhance quality and cost-effective care (National Panel for Psychiatric Mental Health NP Competencies, 2003). Finally, the landmark Future of Nursing report (Institute of Medicine, 2011) likewise underscores the importance of preparing nurses for team-based and interprofessional patient care as a vital nursing education transformation needed to meet current practice challenges and goals. Given these educational and practice mandates, a team of adult and family primary care nurse practitioner faculty and psychiatric and mental health advanced practice nurse faculty at MGH Institute of Health Professions School of Nursing developed an innovative learning experience for students to practice consultation and collaboration skills in a safe, supportive environment. We focused specifi cally on consultation and collaboration between primary care and psychiatric and mental health advanced practice nursing students because approximately 70% of all primary care visits have a psychosocial basis (Fries, Koop, & Beadle, 1993) and because the majority of Americans receive treatment for behavioral health conditions from a primary care provider (Kessler & Stafford, 2008; Quirk et al., 2000). Collaborating to address behavioral health issues in the context of primary health care can substantially reduce the health care burden, while also improving care and quality of life for affected patients at the same time. Models of integrated primary and behavioral health care include onsite mental health and primary care clinicians working in the same offi ce, collaborative coordination of care with community-based mental health clinicians, and collaborative care such as proposed in medical home models.