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Purpose To examine access to care in the Medicare population based on state nurse practitioner (NP) practice regulation. Data sources Secondary data analysis of the Medicare Current Beneficiary Survey Access to Care 2011 dataset. Items used to measure access to care were usual source of care, appointment waiting times, and difficulties encountered. States were designated as full, reduced, or restricted NP practice based on data from the American Association of Nurse Practitioners State Regulatory Map. Conclusions Self‐reported usual source of care (N = 1,496,251) was not significantly affected by state regulation (p > .05); however, these results were based on only 3% of the sample answering the question. Significant differences were seen in sites for care across state groups (N = 41,650,566, p ≤ .01). Participants in reduced (B = −1.86) and restricted (B = −2.82) states reported lower waiting times than those in full practice states (N = 371,166, p < .01). Participants in reduced practice states had 67% lower odds of having trouble accessing care than participants in full practice states (N = 5,568,495, p = .01). More participants in restricted and reduced states reported cost as a difficulty (N = 1180, p = .03). Implications for practice Access to care based on state NP practice regulation is an important area of study because of the changing nature of health care and the growing support for full practice. This study examined access to care in states with different levels of NP practice regulation, but did not directly measure outcomes in individuals based on NP care. Additional research is needed to examine the impact of state regulation in different patient populations (self‐insured, Medicaid, uninsured), and changes in access to care over time as state regulations change.

Peer-teaching is an educational strategy that has recently been incorporated into a School of Nursing curriculum. This change was analyzed to determine the effectiveness of peer-teaching from the nursing student perspective. The Adult Health II nursing students taught basic nursing skills to Nursing Assessment students, and a survey was anonymously completed by both the Adult Health II and Nursing Assessment students who voluntarily participated in the survey. The survey results were then used to analyze the successes and shortcomings of peer-teaching through comparison to findings from similar research projects. The aim of this research is to use the knowledge gained to influence future teaching strategies and classroom structure within Schools of Nursing. This research, therefore, illustrates the results of peer teachings and how those results will be used in the future nursing curriculum.

Objective: The American Association of Colleges of Nursing has identified competency-based education (CBE) as a priority in nursing education. The Objective Structured Clinical Examination (OSCE) has been used across health professions as a tool to incorporate competency-based education. However, the OSCE has been correlated with intensive faculty resources and high costs. The objective of this study was to discuss the evaluation of a low cost OSCE and its ability to incorporate the role of self-assessment in competency-based education within a nurse practitioner program.Methods: Faculty at a public university developed and evaluated an OSCE, exploring its implementation as a component of CBE while minimizing costs using a quasi-experimental design. Nine nurse practitioner students in their third year of a BSN-DNP program completed a pre- and post- assessment of their perceived ability in three OSCEs. Undergraduate nursing students were recruited for the standardized patient role. The OSCEs were recorded for evaluation by faculty and for self-evaluation by the students.Results: There was no significant difference noted in student self-evaluations pre- and post-assessment. There was a statistical difference in the faculty ratings of the student in the otitis media OSCE, with the student rating their performance higher than faculty. There was no statistical difference noted in either the women’s health or hypertension assessments.Conclusions: Recordings of the OSCEs allowed students to identify strengths and weaknesses, cultivating the practice of self-assessment. Integration of minimal cost OSCEs provides opportunities for programs with varying budgets to incorporate it as a component of CBE.