Recent increases in the numbers of new NP programs have generated concern regarding quality and effectiveness of NP preparation. For instance in 1994, The Texas Higher Education Coordinating Board and the Board of Nurse Examiners for the State of Texas studied the standard curriculum requirements for advanced practice designation. In addition to research and theory courses, the curriculum for APNs typically include advanced physiology, pharmacology, and clinical practice emphasizing a selected role. Preceptorships in an appropriate clinical area are a vital part of the educational process. The changes made in Texas strengthened the content requirements for advanced courses in health assessment, pathophysiology, pharmaco-therapeutics, practice role, and preceptorship. Additionally, to address quality issues and strengthen the practice role, educators are standardizing nurse practitioner curricula across the state and are working collaboratively with new initiatives to meet the increasing need for NPs. Clearly, excellence in educational standards is a key to public acceptance and professional effectiveness