Posted: May 14, 2015

Building the Workforce of the Future: Physicians, Advanced Practice Nurses, and Collaborative Training in a Public and Community Psychiatry Fellowship


Starting in the 2011-2012 academic year, the Public and Community Psychiatry Fellowship at Case Western Reserve University began accepting and training psychiatric advanced practice nurses (APNs: nurse practitioners, clinical nurse specialists) alongside psychiatrists, which we have labeled "collaborative training". The fellowship is a one-year fellowship that focuses not directly on clinical skill development, but instead on team-based interactions, systems-based care delivery, and leadership development, particularly as pertains to public systems of mental health care. Fellows spend time in clinical field placements, didactics, individual supervision, and make several presentations that highlight systems-based issues and seek to develop administrative skills.

APNs participate in the fellowship exactly as physician fellows do. We added lectures to help elucidate APN practice, culture and training for physicians. Additionally, we facilitate discussions to help understand the value and positive experiences of working collaboratively, as well as the concerns and pitfalls of collaborative practice, highlighting how physician hierarchy can negatively impact APNs as well as how the expanding role of APNs is forcing physician roles and training to evolve for physicians and nurses alike. Finally, fellowship is structured so that fellows experience individual supervision from both APNs and physicians, hear didactics from both disciplines and seek out collaborative practice opportunities when available at their field placements.


Population Health, Public Health Sciences, Psychiatry Fellowship, Psychiatric Advanced Practice Nurses, Collaborative Training, Systems-Based Care


Patrick Runnels, MD, Case Western Reserve University School of Medicine

Rosa Ruggiero, CNP, Case Western Reserve University School of Medicine

Farah Munir, DO, Case Western Reserve University School of Medicine