Community-Based Nurse Practitioner Fellowship

Fellowship Program

Vanderbilt University School of Nursing (VUSN) is pleased to implement a HRSA-funded Primary Care Nurse Practitioner Residency (NPR) program. The purpose of the project is to prepare APRNs to work in rural and underserved communities.

Mission, Goals, and Outcomes

The mission of the Vanderbilt University School of Nursing (VUSN) Community-Based APRN Fellowship Program is to expand Tennessee’s primary care and behavioral health workforce by increasing the number of nurse practitioners serving in rural and medically underserved communities. Supported by the Health Resources and Services Administration (HRSA), the fellowship prepares nurse practitioners for autonomous, human-centered practice through evidence-based education, compassionate clinical care, and reflective professional development. The program supports the transition of advanced practice registered nurses (APRNs) into underserved practice settings through a structured, evidence-based fellowship model that promotes quality, safety, and professional growth while addressing the social determinants of health and advancing equitable, high-quality, person-centered care.

Goal I. Increase the APRN workforce in rural and medically underserved areas. 

Expected Outcomes: 

• Recruit, train, and retain 5 APRNs in rural and medically underserved settings annually. 
• 100% of fellows complete the 12-month fellowship program.
• All fellows are employed or receive employment offers in rural, underserved, or primary care settings by end of the program completion.

Goal II. Increase the competence and confidence of new APRNs to practice in rural and medically underserved areas. 

Expected Outcomes: 

• Fellows engage in all required learning activities supporting attainment of competencies.
• Fellows achieve proficiency across core domains (patient-centered care, clinical judgment/clinical reasoning, systems-based, patient safety & quality, professionalism, & leadership), demonstrating readiness for autonomous practice in rural and underserved settings.
• Fellows self-report high levels of job satisfaction.
• Fellows complete and disseminate an EBP or QI project addressing a clinical or systems-level issue relevant to underserved populations.

Goal III. The fellowship program engages fellows, mentors, and stakeholders in ongoing evaluation processes to ensure stakeholder satisfaction and to drive continuous quality improvement through systematic analysis of outcomes, feedback, and data-informed program enhancements. 

Expected Outcomes: 

• Mentors and clinical partners report satisfaction with the fellowship’s communication, collaboration, and overall program support.
• The fellowship program demonstrates ongoing quality improvement through systematic evaluation of outcomes, stakeholder feedback, and implementation of data-driven enhancements.

Our NPR program will increase the APRN primary care workforce in rural and underserved communities through collaboration with partner community-based health clinics (CBHCs). The program funding supports 5 fellows during each cohort year who meet the following eligibility criterion:

• Demonstrate a strong desire to work with rural or urban underserved populations.
• Within 18 months of graduation from an accredited FNP, PMHNP, or WHNP program with applicable specialty certification completed by program start date
• Availability to work as a full-time employee of the CBHC for the duration of the 12-month program

Benefits

The fellowship includes specialty-specific learning pathways for Family Nurse Practitioners (FNP), Psychiatric Mental Health Nurse Practitioners (PMHNP), and Women’s Health Nurse Practitioners (WHNP), with shared core content and specialty-aligned clinical immersion.

Fellows participate in additional focused learning modules and experiences involving social determinants of health, psychopharmacology, telehealth, and other educational topics designed to build post-graduate NP proficiency in caring for rural or medically underserved patients.

The program uses a structured patient volume progression with guidance from a clinical mentor at the CBHC throughout the 12-month program., monthly group debrief conferences, and ongoing coaching and support from VUSN faculty.

Clinical mentorship is supplemented through regular, one-on-one reflective supervision meetings with non-clinical mentors and members of the fellowship program leadership team.

Fellow progress is evaluated through structured competency assessments, reflective supervision, and mentor feedback. Program outcomes and stakeholder input are reviewed annually to guide continuous quality improvement.