RMBI Transition to Practice
PMHNP Program
RMBI Transition-to-Practice Program
Welcome to your first year of Psychiatric Mental Health as a Nurse Practitioner.
This program is designed to support you as you move from graduate education into confident, competent practice. Over the next 12 months you will complete structured didactic coursework, virtual patient simulations, supervised clinical experiences, monthly pharmacology assessments, case presentations, and reflective assignments — all aligned with the competencies expected of an independent PMHNP.
Syllabus at a glance: onboarding and orientation; diagnostic reasoning and psychopharmacology; risk assessment and controlled-substance stewardship; care across the lifespan and in rural/underserved communities; policy, prevention, and advocacy; and progressive clinical autonomy through supervised practice.
19
course modules
310
didactic contact hours
4
program phases
Four phases, in order
Each phase maps to a window of your first year, so learning arrives when the clinical pressure does.
Phase 1 · Foundations across every domain
Weeks 1–4First pass through the whole scope of practice: how to reason to a diagnosis, the medications you will prescribe in your first week, screening and risk assessment, documentation that protects your license, and the rural and prevention lens this practice works through. Nothing is held back for later — it is taught at foundation depth.
- Course Overview: Program Introduction, Schedule & Graduation Requirements
- From Student to Prescriber: The First 90 Days
- Scope of Practice, Licensure & Collaborative Agreements
- Defensible Documentation & the Psychiatric Note
- Supervision, Consultation & Knowing When to Ask
Phase 2 · Consolidation & applied depth
Weeks 5–12The same domains again, one layer deeper: differentials that do not declare themselves, first-line failures and switching or augmenting, controlled substances, co-occurring substance use, developmental and perinatal considerations, and documentation under a growing panel.
- Diagnostic Reasoning & Differential in Psychiatry
- Applied Psychopharmacology I: Mood & Anxiety
- Applied Psychopharmacology II: Psychosis, Bipolar & Mood Stabilizers
- Suicide Risk Assessment, Safety Planning & Crisis Response
- Controlled Substances: Stimulants, Benzodiazepines & the PDMP
- Therapeutic Alliance & Brief Psychotherapy in the Med Visit
Phase 3 · Complexity & vulnerable populations
Weeks 13–24Serious mental illness, dual diagnosis, medically complex and polypharmacy patients, child and family systems work, perinatal and geriatric prescribing, trauma-responsive and culturally responsive care, and rural access barriers — all revisited at the depth independent practice demands.
- Child & Adolescent Psychiatric Care
- Older Adults, Cognition & Deprescribing
- Perinatal & Reproductive Mental Health
- Co-Occurring Substance Use & Trauma-Informed Care
Phase 4 · Autonomy, mastery & leadership
Weeks 25–52Every domain once more at practice level: panel and population management, defensible clinical decisions without prompting, supervision and consultation as a peer, telepsychiatry, billing and quality, and leading prevention, screening, and early-intervention reform across schools, pediatrics, and families.
- Panel Management, Telepsychiatry & Clinic Efficiency
- Billing, Coding & Compliance for the New Prescriber
- Burnout, Moral Distress & Sustainable Practice
- Capstone: Independent Practice Readiness Review
Program learning outcomes
What you will be able to do by the end of year one, and the evidence kept in your record for each outcome.
Assessment & diagnostic reasoning
Conduct a complete psychiatric evaluation across the lifespan — history, mental status, developmental and trauma history, substance use, and medical review — and produce a prioritized differential with documented medical rule-outs.
Evidence: Virtual patient simulations, monthly note reviews, case presentations, module knowledge checks.
Psychopharmacology & monitoring
Select, initiate, titrate, combine, and de-prescribe psychotropic medications safely — accounting for age and weight, pregnancy and lactation, comorbid medical illness, interactions with medications and supplements, and required laboratory and metabolic monitoring.
Evidence: Twelve monthly pharmacology examinations (≥85%), pharmacology case studies, prescribing audits.
Risk assessment & crisis response
Stratify suicide, self-harm, and violence risk; co-create safety plans including means restriction; manage acute agitation and involuntary pathways; and document a defensible disposition rationale.
Evidence: Risk-focused simulations, crisis case studies, note-review rubric risk domain.
Therapeutic alliance & psychotherapeutic skill
Integrate brief psychotherapeutic and motivational interventions, psychoeducation, and shared decision-making into medication visits, and repair alliance ruptures.
Evidence: Therapy-encounter simulations, peer discussion assignments, supervision observation.
Documentation, coding & throughput
Produce accurate, individualized, audit-ready documentation that supports the level of service billed, closed within 24 hours, while managing a full panel.
Evidence: Daily clinical log, timeliness and chart-edit metrics, physician note reviews.
Special & vulnerable populations
Adapt assessment, treatment, and access planning for children and adolescents, older adults, perinatal patients, co-occurring substance use, serious mental illness, LGBTQIA+ patients, and rural and high-barrier communities.
Evidence: Population modules, rural mental health case studies, complex-population simulations.
Prevention, systems & advocacy
Build screening and prevention into routine care; collaborate with pediatrics, schools, and families; and articulate an evidence-based case for lifespan mental health screening and prevention policy.
Evidence: Prevention and policy advocacy assignments, integration project, capstone presentation.
Professional identity & sustainability
Practice within licensed scope, escalate appropriately, use supervision deliberately, and sustain a workload with documented burnout-prevention and reflective practice habits.
Evidence: Supervision documentation, reflective practice entries, month-12 competency review.
Your year-one timeline
Didactic hours taper as clinical autonomy grows — from half-time classroom in week one to fully clinical practice with twice-monthly supervision by month eight.
Week 1 · Onboarding
~90% didactic / ~10% observationSupervision: Direct and continuous · Volume: No independent panel
- Module 1 course overview completed and attested
- Credentialing, EHR, e-prescribing, and PDMP access verified
- Scope-of-practice and supervision agreement signed
Weeks 2–3 · Simulation & shadowing
50% didactic / 50% clinicalSupervision: Side-by-side with a skilled PMHNP · Volume: Observation and co-interviewing
- 3 virtual patient encounters at ≥90% in week 2
- 3 more virtual patient encounters at ≥90% in week 3
- First full case study and treatment-plan assignment submitted
Week 4 · Supervised independent start
~35% didactic / ~65% clinicalSupervision: Same-day precepting, 100% note review · Volume: 2–4 patients/day, extended visits
- First independent visits with filtered complexity
- Daily clinical log established
- Documentation closed same day
Months 2–4 · Graduated autonomy I
~25% didactic / ~75% clinicalSupervision: Weekly 60-minute supervision meeting — team supervision (weeks 1 & 3), collaborative physician meeting (weeks 2 & 4) · Volume: 7 → 9 patients/day, 20–25% new evaluations
- 3 physician note reviews + 3 case presentations each month
- Monthly pharmacology examination passed at ≥85%
- Rural access and diagnostic reasoning case studies completed
Months 5–8 · Graduated autonomy II
~25% didactic / ~75% clinicalSupervision: Weekly alternating supervision (team weeks 1 & 3 · physician weeks 2 & 4), complexity expanded · Volume: 10 → 14 patients/day, 30–35% new evaluations
- Complex-population and co-occurring-use modules completed
- Prevention, integration, and policy advocacy project submitted
- Competency ratings at Competent in most domains
Months 9–11 · Independent practice readiness
Effectively 100% clinicalSupervision: Twice-monthly supervision meetings · Volume: Full panel
- Documentation timeliness sustained at ≥95%
- Note-review scores sustained at ≥90%
- Panel-management, billing, and sustainability modules completed
Month 12 · Graduation review
100% clinical + reviewSupervision: Final competency review with physicians and leadership · Volume: Full panel, independent
- Capstone independent-practice readiness review
- All seven competency domains rated Competent or Independent
- Written approval → TTP Program certificate issued
Graduation checklist
Completion is criterion-based. Every item below is signed off by the program director or a supervising physician before you practice independently.
Didactic curriculum
All modules completed, including Module 1 course overview
Every knowledge check ≥80%, every attestation signed · verified by Portal completion record
All weekly assignments: case studies, treatment plans, clinical decision-making, peer discussion
All graded and passing; peer replies substantive · verified by Reviewer grading in the gradebook
Rural mental health case series completed
Passing grade on each · verified by Program director
Prevention, integration, and policy advocacy project submitted
Passing grade with reviewer feedback addressed · verified by Program director
Simulation & examinations
Three virtual patient encounters in week 2
≥90% each, before independent practice · verified by Simulation scoring record
Three virtual patient encounters in week 3
≥90% each, before independent practice · verified by Simulation scoring record
Complex-population simulations assigned later in the year
≥90% each · verified by Simulation scoring record
Twelve monthly pharmacology examinations
≥85% each; retake after remediation if missed · verified by Examination record
Clinical performance
36 physician note reviews (3 per month × 12)
Rubric ≥90%, with documented improvement where early scores fall short · verified by Supervising physician
36 case presentations to a supervising physician (3 per month × 12)
Passing on the shared presentation rubric · verified by Supervising physician
Documentation timeliness and accuracy
≥95% of notes closed within 24 hours; chart edits trending down; no unsigned orders at month close · verified by Clinical log metrics
Volume ramp met through each stage to a full panel
Stage targets met with acceptable accuracy · verified by Clinical log + clinical lead
Daily clinical log maintained across all 52 weeks
Contemporaneous, not reconstructed · verified by Program director
Competency & final approval
All seven competency domains rated Competent or Independent
Final competency review at month 12 · verified by Supervising physicians + reviewers
Capstone independent-practice readiness review
Passing · verified by Program director + physicians
Written graduation approval
Signed by supervising physicians and RMBI leadership · verified by Program director
Program certificate issued with documented contact hours and verification code
Issued on approval · verified by Portal certificate record
Program FAQ
Knowledge checks with rationales
Every module ends in a scored check at an 80% threshold, with a rationale for each answer.
Signed attestations
Learners sign a timestamped attestation per module — retained for supervision and credentialing files.
Certificates on completion
Each completion issues a certificate with contact hours and a verification code.
This portal is invitation only. Enrollment accounts are issued by the program administrator to @rmbigroup.org addresses, and every account requires two-step verification with an authenticator app at each sign-in.