AAACN Best Practice Guidelines - May 2022

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AAACN Best Practice Guidelines for Academic and Practice Partnerships

By Laurel More, MS, RN, NPD-BC, CPN, Children's Hospital Colorado

Elizabeth Fritz, PhD, RN, NPDA-BC, SSM Health

Over the past decade, significant changes have occurred in the United States healthcare system that have transformed how healthcare is being delivered. With the signing into law of the Patient Protection and Affordable Care Act in 2010, our country has experienced more people seeking preventive care and management of chronic conditions. This increase has driven care typically provided in acute care settings to ambulatory care settings. The Institute of Medicine’s (IOM) The Future of Nursing: Leading Change, Advancing Health (2011) report and the National Academies of Sciences, Engineering, and Medicine (NAM), The Future of Nursing 2020–2030: Charting a Path to Achieve Health Equity (2021) report necessitate nurses be prepared to practice in expanded roles to positively impact health outcomes of diverse populations. To meet the goals of these reports, nurses must be trained to incorporate equity, population health, and social determinants of health into the care they provide.   

Additionally, the publication of The Essentials: Core Competencies for Professional Nursing Education (American Association of Colleges of Nursing (AACN), 2021) addresses what the nursing workforce of the 21st century must look like to meet current patient healthcare needs, which include the integration of population health, diversity, equity, and inclusion. Academic and practice partnerships create systems that are well-positioned to support the “seamless” transition of students to professional practice, promote educational and career advancement, and improve healthcare outcomes of populations (AACN, 2012). Because nursing education has historically focused on content related to the acute care setting, there is an immediate need for academic institutions to include not only ambulatory content in the curriculum but also provide students with clinical experiences in ambulatory care settings. These educational and practice experiences allow for the transition of competent new nurses to the ambulatory care setting. Recognizing the gap, the American Academy of Ambulatory Care Nursing (AAACN) convened a taskforce of academic and practice volunteer members, including several NPD practitioners, to create ambulatory care academic-practice partnership (APP) guidelines to influence the implementation of enduring partnerships focused on providing ambulatory care experiences for students. 

The task force gathered literature from databases, online repositories, and professional organizations. Overall, the literature contained little formal research and almost no information specific to ambulatory care. Notwithstanding these limitations, four key themes were found in the literature on APPs in other settings, and many benefits were identified. These themes and benefits were explored further with a survey of nursing programs and ambulatory care organizations experienced in APPs. For more details, refer to Witwer et al. (in press).

The four themes identified in the initial literature search were Partnership Framework, Academic and Practice Preparation, Student Preparation, and Workforce Expansion. Work on the guidelines was disrupted by the 2020 pandemic. Upon resuming work, the task force added a fifth guideline category: Partnerships During Disasters and Pandemics. These five themes became the foundation for the guidelines, with subcategories and specific recommendations for both academic and practice partners in each guideline (AAACN, 2022).

  • Partnership Framework covers issues related to basic infrastructure and communication between partners.
  • Academic and Practice Preparation covers curriculum development and faculty preparation, preceptor training, and other professional development activities.
  • Student Preparation covers onboarding/orientation and evaluation processes for both academic and practice partners.
  • Workforce Expansion covers topics related to the ambulatory care nursing pipeline, including precepting, innovative student models like dedicated education units (DEUs), and nurse residencies.
  • Partnerships During Disasters and Pandemics provides guidance for both academic and practice partners on preparing for future disasters and pandemics.

Many of the pivotal recommendations in the guidelines are often carried out by NPD practitioners. These include onboarding students and faculty, training preceptors, and serving as a liaison and consultant for partnering schools of nursing. NPD practitioners are well positioned to implement the recommendations in these guidelines and advocate for improved collaborative partnerships between academia and ambulatory care.

The new guidelines for APPs in ambulatory care can be found on the AAACN website. They are free for members or available for purchase for non-members of AAACN. We hope they will be useful to our nursing professional development colleagues in ambulatory care settings.


American Academy of Ambulatory Care Nursing. (2022). Best practice guidelines for academic and practice partnerships in ambulatory and community settings.

American Association of Colleges of Nursing. (2012). Guiding principles to academic-practice partnerships  

American Association of Colleges of Nursing. (2021).  The Essentials: Core Competencies for Professional Nursing Education.

Institute of Medicine. (2011). The future of nursing: Leading change, advancing Health. The National Academies Press.

National Academies of Sciences, Engineering, and Medicine. (2021). The future of nursing 2020-2030: Charting a path to achieve health equity. The National Academies Press. https:/  

Witwer, S., Fritz, E., Antol, S, & Bilskis, S. (in press). In search of the evidence: Informing academic-practice partnerships in ambulatory care. Nursing Economic$.

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