Georgetown University Family Nurse Practitioner Program Trains Hundreds of Students Using AHRQ App to Improve Primary Care

Approximately 600 students who have completed a Georgetown University masters’ level course for family nurse practitioners use an electronic app from AHRQ that provides evidence-based recommendations for preventive services, thus improving the care they can provide to patients.

AHRQ’s Electronic Preventive Services Sector, or ePSS, educates graduate students at Georgetown, in Washington, D.C., about recommendations on appropriate screening, counseling, and preventive care  from the U.S. Preventive Services Task Force (USPSTF).

Some 150 students each year have been trained using the ePSS app since 2015. The students access the app on their smart phones or tablets and learn more about the strength of evidence behind the recommendations, helping them to provide more comprehensive care, according to Amy Culbertson, D.N.P., assistant professor of nursing at Georgetown University’s School of Nursing and Health Studies.

She teaches a required course on primary healthcare for families, which introduces students to the family nurse practitioner’s role in promoting wellness and managing primary healthcare for individuals and families across the life span. Many students were already aware of the ePSS app when Dr. Culbertson began teaching the class in 2015, but it has since become a required course resource.  

USPSTF grade letters (A, B, C, D, and I) reflect the Task Force’s recommendation to clinicians about whether to offer or provide the service as part of their practice, based on the balance of benefits versus  harms of providing the service. An “I” grade indicates that evidence is insufficient to make this determination.

“With the plethora of guidelines out there, it is beneficial for students to have a consistent resource for evidence-based guidelines,” Dr. Culbertson said. The ePSS app is “very user-friendly for them,” and the levels of certainty that accompany USPSTF recommendations “help them understand the idea of level of evidence to support—or not to support—a recommendation,” she said.  

When students meet with patients in the clinical setting for a wellness visit, students consult the ePSS to find out which preventive services are recommended, Dr. Culbertson explained. The ability to reference the app helps students to understand the recommendations for each patient individually, allowing for a better understanding of which preventive services or screening tests their patients may need.

“Students will tell us they are more comprehensive with their wellness exams using the app,” Dr. Culbertson said. “They pay closer attention to how a patient’s age, gender, tobacco use, and sexual activity, along with other behaviors, impact the types of preventive care recommended. This information better informs students about a patient’s health needs and determines proper timing for particular screening tests or recommendations.”

Students also learn the most current guidelines about how often various screening tests should be performed. Scientific evidence has evolved about recommendations on the frequency of Pap tests, breast cancer screening, and other services based on a patient’s age and health history, and the ePSS app puts the latest information at family nurse practitioners’ fingertips. 

Students also use the USPSTF website as one reference to evaluate a particular patient encounter. As part of the class, students are asked to analyze a plan of care for a clinical patient. The goal of the assignment is to determine whether their plan of care for the patient is fully evidence-based. Students then write a paper comparing what tests they ordered during the wellness encounter with what the evidence-based resources recommend.

Dr. Culbertson is confident that ePSS and the USPSTF recommendations will help her students continue to build their clinical skills over a lifetime, as these resources help students to stay current on the evidence that informs care decisions. “They are able to use the recommendations for comparison with other sources and decide for themselves the best plan of care for their patient.”