Date of Award

Spring 2023

Project Type

Clinical Doctorate

College or School




Program or Major

Doctor of Nursing Practice

Degree Name


First Advisor

Dayle Sharp

Second Advisor

Paula Smith



BACKGROUND: Traditional clinical scheduling coupled with the current reimbursement system have created systematic barriers leading to decreased clinical education opportunities. Alternative scheduling models such as longitudinal integrated clerkships, one preceptor to two students and wave scheduling have the potential to eliminate these barriers and provide financial gains and increased access to care.

INTERVENTION: Interventions to meet this quality improvement project's objectives included (1) pre-intervention planning (2) focus groups, (3) video presentations and (4) a pilot program of alternative scheduling models in clinical practice.

RESULTS: A pilot program utilizing the alternative scheduling models increased the relative value units (RVU) of each participant over the month timeline. In one month of the 2:1 model the preceptors RVU data increased from 69.7 to 99.11, a 29.94 RVU increase.  Focus group data from participant A showed pre and post themes of innovation and improvement of the healthcare workforce post pilot. Participants B and C used the Longitudinal Integrated Clerkship model over the course of the month long pilot program.  Participant B’s starting RVU data was 225.06 after one month it increased to 306.68, resulting in an 81.62 RVU increase. Participant C’s starting RVU data of 325.01 increase by 76.59 to a post pilot result of 401.6. Discussion with the participants post pilot had frequent mention of the words; positive, time management partnership, flexibility, access, and patient care. These key descriptors showed the primary authors themes in innovation and improvement of the healthcare workforce.

CONCLUSION: The findings from the pilot program have the potential to increase clinical placement opportunities for advanced practice students. Integration of alternative models in practice can address workforce development, access to healthcare, and increase barriers to post-secondary education and training. (Endowment for Health, 2021). Lastly, initial pilot data utilizing the alternative models with three participants over 4 weeks resulted in an increase in revenue of $6,000. These models hold a promise to strengthen the pipeline while addressing the organizational barriers in healthcare structure and reimbursement.