Problem: This capstone project met a need for expanding clinical skills by providing a clinical skill refresher course. The course provided a review for the nurse practitioners working in employee health for a large HMO in Northern California for the evaluation and treatment of musculoskeletal injuries. This education now allows them to see injured employees and provide diagnosis and treatment on the first visit, based upon state Workers’ Compensation guidelines. Purpose and Scope: The purpose of this capstone project was to describe the level of nurse practitioners skills acquisition in musculoskeletal evaluation before and after a teaching intervention. The teaching intervention was offered to nurse practitioners working for a large HMO in employee health in Northern California. Goal: The first goal was a successful clinical refresher course for the nurse practitioners, so they would begin evaluating and treating injured employees in the employee health department. The second goal was a larger organizational goal for the Departments of Occupational Medicine and Employee Health Services for the organization, wanting nurse practitioners to see all of our own injured workers initially in employee health. Objectives: First, describe aggregate demographic characteristics of nurse practitioners working in employee health for the participating HMO. Second, to describe pre-intervention self-assessed confidence and knowledge of musculoskeletal injury evaluation and treatment by nurse practitioners working in employee health. Third, to describe post-intervention self-assessed confidence and knowledge of musculoskeletal injury evaluation and acquisition of clinical skill for physical examination techniques demonstrated in the intervention program using the OSCE. Fifth, to measure change in practice before and after the teaching intervention covering musculoskeletal injury evaluation and treatment by nurse practitioners working in employee health. Plan: Phase One: Conduct a needs assessment using a confidential online survey. Phase Two: Design a musculoskeletal teaching intervention using an Evidence Based Medicine approach. Phase Three: Implement an evidence-based teaching intervention for a projected sample. Phase Four: Evaluate the level of self-assessment of confidence and knowledge in the evaluation and management of musculoskeletal injuries before and after a family presence teaching intervention using a confidential online survey. Outcomes and Results: Using a triangulated interventional research design, results of the pre-intervention and post-intervention measures revealed a mean score increase in confidence and knowledge of evaluation and treatment of musculoskeletal injuries. Reliability estimates based on internal consistency for the pre-intervention testing achieved significance.
