DNP Scholarly Project
My DNP project was a program evaluation centered on the implementation of a clinical reasoning workbook within UCHealth’s APP fellowship program. My project aimed to evaluate how this clinical reasoning workbook would impact new graduate advanced practice providers (APPs) in developing their self-confidence, practice efficiency, and diagnostic competency in clinical reasoning.
Project Site Information
The organization that initiated this project is UCHealth, a top-ranking hospital system located on the Anschutz Medical Campus in Denver, Colorado.
About UCHealth's APP Fellowship Program
UCHealth’s APP fellowship program is made up of three separate tracks consisting of surgery, surgical-critical care, and medical-critical care. The program is designed to assist the transition-to-practice of new graduate APPs and supports practicing APPs seeking to change their career focus. The fellowship provides specialized clinical rotations, didactic curriculum, and hands-on patient care experiences. Their mission is to prepare, educate, and integrate APPs that will be able to operate at a high level of autonomy within their chosen specialty.
Needs Assessment & Project Development
This project addressed gaps in clinical reasoning skills that were identified among novice APPs entering UCHealth’s fellowship program. A root‑cause analysis revealed several contributing factors such as limited prior training, inconsistent teaching processes, high‑acuity clinical environments, and lack of educational resources and evaluation tools. A SWOT analysis highlighted strong preceptor support and motivated fellows, while noting challenges related to clinical workload and variable teaching styles.
Based on this needs assessment, a paper‑based clinical reasoning workbook was developed using evidence‑based strategies—using case‑based learning, reflective practice, illness scripts, and concept mapping—to build foundational clinical reasoning skills. The workbook was evaluated to determine its impact on self-confidence, practice efficiency, and diagnostic performance. Findings of this project will help to guide future improvements in APP educational support.