MSN6400: Advanced Practice in Primary Care Detailed Weekly Schedule
This core graduate course for Family Nurse Practitioner (FNP) students focuses on the provision of comprehensive, evidence-based primary care across the entire lifespan (infants through older adults). The course emphasizes health promotion, disease prevention, acute illness management, and chronic disease care in outpatient and community settings. Students will refine advanced clinical reasoning, diagnostic skills, pharmacologic and non-pharmacologic management, and patient-centered care while integrating cultural competence, social determinants of health, and interprofessional collaboration.
Credit Hours: 4 credits (3 didactic + 1 clinical seminar)
Prerequisites: Advanced Pathophysiology, Advanced Pharmacology, Advanced Health Assessment
Co-requisite: Minimum 200 clinical hours in a primary care/family practice setting
Course Learning Outcomes
Upon successful completion of this course, students will be able to:
Conduct thorough, age-appropriate history taking and physical examinations across the lifespan.
Synthesize assessment data to formulate differential diagnoses and evidence-based management plans for common acute and chronic conditions.
Develop individualized health promotion and preventive care strategies tailored to patients’ developmental stage, lifestyle, and cultural context.
Apply legal, ethical, and regulatory principles in primary care decision-making.
Critically appraise current clinical guidelines and research to improve patient outcomes in primary care.
Detailed Weekly Schedule
Week 1: Foundations of Advanced Primary Care Practice
Weekly Notes: Role and scope of the FNP, patient-centered medical home model, health equity, social determinants of health, and billing/coding basics. Introduction to clinical guidelines (USPSTF, AAFP, AAP).
Discussion Questions:
How do social determinants of health influence health outcomes in underserved populations?
Discuss the advantages and challenges of full practice authority for FNPs.
Assignment: Write a 2-page professional philosophy statement describing your vision as a future FNP.
Week 2: Health Promotion & Preventive Care Across the Lifespan
Weekly Notes: Wellness visits, immunization updates, cancer screening, cardiovascular risk assessment, and lifestyle counseling. Use of tools such as ASCVD calculator and USPSTF recommendations.
Discussion Questions:
How would you address vaccine hesitancy in a family with children and elderly members?
Compare preventive care priorities for a 25-year-old versus a 65-year-old patient.
Assignment: Create a preventive care checklist for three different age groups (pediatric, adult, geriatric).
Week 3: Care of Infants, Children & Adolescents
Weekly Notes: Well-child care, developmental milestones, common pediatric conditions (otitis media, asthma, ADHD), and adolescent health (HEADSS assessment, contraception).
Discussion Questions:
How do you manage parental concerns about screen time and behavioral issues in toddlers?
Discuss confidentiality and consent when providing reproductive care to adolescents.
Assignment: Develop an anticipatory guidance handout for a 6-month or 15-year-old well visit.
Week 4: Adult Health Promotion & Acute Care I (Respiratory & Infectious Disease)
Weekly Notes: Upper and lower respiratory infections, pneumonia, bronchitis, sinusitis, and antimicrobial stewardship. Influenza, COVID, and emerging infections.
Discussion Questions:
When is imaging or antibiotics warranted for acute sinusitis or bronchitis?
How has antimicrobial resistance changed primary care prescribing practices?
Assignment: SOAP note for a 32-year-old with acute cough and fever.
Week 5: Cardiovascular & Metabolic Conditions
Weekly Notes: Hypertension, hyperlipidemia, coronary artery disease, heart failure, and metabolic syndrome. Lifestyle modification and pharmacologic management.
Discussion Questions:
Compare JNC 8 and ACC/AHA hypertension guidelines.
How do you approach a patient with resistant hypertension?
Assignment: Develop a comprehensive management plan (including education and follow-up) for a newly diagnosed hypertensive patient.
Week 6: Endocrine Disorders
Weekly Notes: Diabetes mellitus (Type 1 & 2), thyroid disorders, osteoporosis, and obesity management. Use of ADA and AACE guidelines.
Discussion Questions:
Discuss the role of GLP-1 agonists versus SGLT2 inhibitors in Type 2 diabetes.
How would you manage subclinical hypothyroidism in a 45-year-old woman?
Assignment: Create a diabetes self-management education (DSME) plan for a newly diagnosed patient.
Week 7: Gastrointestinal & Genitourinary Disorders
Weekly Notes: GERD, IBS, constipation, hepatitis, UTI, BPH, and kidney disease screening.
Discussion Questions:
Differentiate between IBS and inflammatory bowel disease in primary care.
When should you refer a patient with GERD for endoscopy?
Assignment: Patient education brochure on lifestyle management of GERD or IBS.
Week 8: Midterm Week
Midterm Exam (Weeks 1–7) + Clinical Reflection Paper (3 pages) analyzing two diverse patient cases from clinical.
Week 9: Women’s Health in Primary Care
Weekly Notes: Menstrual disorders, contraception, menopause, cervical and breast cancer screening, and pregnancy confirmation/initial care.
Discussion Questions:
Compare the risks and benefits of different contraceptive methods for a 28-year-old woman.
How do you address sexual health concerns in perimenopausal patients?
Assignment: Develop a contraceptive counseling script using shared decision-making.
Week 10: Men’s Health & Musculoskeletal Conditions
Weekly Notes: Prostate health, erectile dysfunction, testosterone therapy, low back pain, osteoarthritis, and sports injuries.
Discussion Questions:
Discuss current USPSTF guidelines on PSA screening.
Outline a stepwise approach to managing chronic low back pain in primary care.
Assignment: SOAP note and management plan for a 55-year-old man with knee pain.
Week 11: Neurologic & Dermatologic Conditions
Weekly Notes: Headaches, seizures, dementia screening, skin cancer detection, eczema, psoriasis, and acne.
Discussion Questions:
Differentiate tension, migraine, and cluster headaches and their management.
When should a suspicious skin lesion be referred to dermatology?
Assignment: Create a skin lesion identification and patient education resource.
Week 12: Mental Health in Primary Care
Weekly Notes: Depression, anxiety, bipolar disorder, PTSD, ADHD in adults, and suicide risk assessment. PHQ-9, GAD-7, and integration with behavioral health.
Discussion Questions:
How can FNPs improve access to mental health services in primary care?
Discuss pharmacologic vs. non-pharmacologic approaches to mild-moderate depression.
Assignment: Develop a depression or anxiety screening and initial management protocol.
Week 13: Geriatric & Palliative Care
Weekly Notes: Frailty assessment, polypharmacy, falls prevention, cognitive impairment, advance care planning, and end-of-life discussions.
Discussion Questions:
How do you balance quality of life with chronic disease management in frail elderly patients?
Discuss the role of the FNP in advance directive conversations.
Assignment: Medication reconciliation and deprescribing plan for an 82-year-old with polypharmacy.
Week 14: Chronic Disease Management, Care Transitions & Emergencies in Primary Care
Weekly Notes: Asthma/COPD, heart failure management, care coordination, hospital follow-up, and recognition of conditions requiring urgent referral.
Discussion Questions:
What systems can improve care transitions after hospital discharge?
How do you manage a patient with multiple chronic conditions (multimorbidity)?
Assignment: Final Project – Comprehensive Case Study: Develop a full care plan for a complex patient with at least three chronic conditions.
Week 15: Course Synthesis & Professional Development
Weekly Notes: Quality improvement in primary care, malpractice considerations, leadership, and career planning.
Discussion Questions:
How will you stay current with evolving primary care guidelines?
Reflect on your growth throughout this course.
Assignment: Portfolio submission (including two best SOAP notes and a professional development plan).
This course combines didactic learning with clinical application to prepare students for independent and collaborative primary care practice as competent Family Nurse Practitioners.
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