Nursing education programs may face significant difficulty as they struggle to prepare sufficient numbers of advanced practice registered nurses to fulfill the vision of helping to design an improved US healthcare system as described in the Institute of Medicine's “Future of nursing” report. This paper describes specific challenges and provides strategies to improve advanced practice nursing clinical education in order to ensure that a sufficient number of APRNs are available to work in educational, practice, and research settings. Best practices are identified through a review of classic and current nursing literature. Strategies include intensive interprofessional collaborations and radical curriculum revisions such as increased use of simulation and domestic and international service work. Nurse educators must work with all stakeholders to create effective and lasting change.

Integral to the development, implementation, and sustainability of the intervention was the truly reciprocal relationship developed between community and university partners.

CBPR research partnerships are enhanced by NPs that are members of the community. CBPR partnerships present opportunities for NPs and university faculty to work on relevant community problems together.

Native American nurses experienced a great deal of stress and illness as they attempted to fulfill their mission to help their people. The three themes were: (a) paying the price to fulfill my mission, (b) being and connecting holistically, and (c) transcending the system. Recommendations include strategies for nurse educators, tracking the ethnicity of nurses in each Indian Health Service area, documenting their reasons for leaving, and conducting further research to develop community-based interventions to improve retention.

<h4>ABSTRACT</h4> <P>A pilot study was conducted to determine changes in Native American high school students’ knowledge and opinions about nursing after attending a 6-day residential summer nursing institute. To date, Native American high school students, particularly those interested in nursing, have not been well researched. Seventeen high school students affiliated with nine Northwest tribes participated in this study. A 66-item, investigator-constructed, pretest-posttest survey included 38 scaled (4-point Likert type) and 20 dichotomous items. Reliability estimates (Cronbach’s alpha) were 0.72 and 0.85 for the pretest and posttest, respectively. This pilot study showed an increase in students’ knowledge and opinions of professionalism, autonomy, and role importance in nursing after attending the summer nursing institute. A salient and culturally related reason for choosing nursing was to be important to one’s tribe. Although the sample was small, the findings provide initial evidence supporting the effectiveness of a nursing education intervention with Native American high school students and an instrument that can measure its success. </P> <h4>AUTHOR</h4> <P>Received: March 16, 2005</P> <P>Accepted: September 30, 2005</P> <P>Dr. Katz is Assistant Professor, Washington State University, Intercollegiate College of Nursing, Spokane, Washington. </P> <P>Address correspondence to Janet R. Katz, PhD, RN, Assistant Professor, Washington State University, Intercollegiate College of Nursing, 2917 West Fort George Wright Drive, Spokane, WA 99224; e-mail: <a href="mailto:jkatz@wsu.edu">jkatz@wsu.edu</a>. </P>