Sandra Sanchez

AltaMed Health Services
USA

Abstract Title: Nurse Practitioner Fellowship’s Increased Competencies in Patient Care Practice Knowledge, Medical Conditions, and Clinical Procedures at a Federally Qualified Health Center

Biography:

Sandra Sanchez has 10+ years of experience in pipeline and workforce development programs. The manager of AltaMed’s Nurse Practitioner Fellowship program, she oversees day-to-day operations and continued growth, and secured its accreditation. She earned her master’s degree in Higher Education Learning from California State University, Northridge.

Research Interest:

Research Objective – To measure improvements in self-reported competencies that Nurse Practitioners (NP) report before and after their fellowship program. Study Design – Fellows completed pre- and post-fellowship surveys rating competency levels in three categories: Patient care and knowledge for practice; Assess, diagnose, treat, and mange over time medical conditions experienced in primary care; and Perform clinical procedures commonly seen in primary care. For the 2023-2024 cohort, the survey questions had a scale from 1– 5, where 1=Novice and 5=Superior. The 2024-2025 cohort had the same competency questions on a scale from 1 – 4, where 1=Novice and 4=Expert. Additional competency levels that they rated themselves on at the midpoint and postfellowship: Interpersonal and communication skills; Professionalism; and Innovation and Systems Thinking. Population Studied – NP fellows from the most recent two years of the fellowship program: 7 fellows (2023-2024 cohort) and 6 fellows (2024-2025 cohort). Principal Findings – The average change at baseline (before the fellowship) and postfellowship was a self-reported increase by both cohorts for each competency. In the 2023- 2024 cohort, fellows reported an increase in competencies for “Patient care and knowledge for practice” by 1.6, “Assess for, diagnose, treat and manage over time common medical conditions” by 1.8, and “Performing clinical procedures” by 1.1. In the 2024-2025 cohort, the increases were 1.3, 1.4, and 0.7 for the respective categories. A number of competencies were statistically significant increases, but they differed between the two cohorts. Conclusions – Differences in the competencies that fellows reported feeling more competent in by the end of the fellowship can be areas for the program team to focus on for future cohorts. A fellowship provided at a federally qualified health center focused on primary care can improve NPs’ perceived competency which can further increase their confidence in their skills in practice to deliver quality care for patients. Key words: NP fellowship, increasing competencies, federally qualified health center, primary care for underserved patients