Objective: The objective of this scoping review is to map the evidence on transition-to-practice programs for newly graduated advanced practice registered nurses and physician assistants, and describe how they differ. Additional objectives include summarizing what outcomes are evaluated and what gaps remain within the literature. By consolidating this information, health care administrators may more easily reference transition-to-practice methods to enhance their own programs for advanced practice registered nurses and physician assistants.z Introduction: Transition to practice involves 2 program types: onboarding and postgraduate training. However, no existing reviews describe the state of the literature regarding these program types, and how they compare with regard to location, setting, and outcomes. Because transition-to-practice programs may improve workforce outcomes, understanding how these programs differ, and what gaps exist, is needed to help these programs grow. Inclusion criteria: This review will include articles describing transition to practice for advanced practice registered nurses and/or physician assistants, including onboarding and fellowship/residency programs. Articles will be included regardless of geographic location if they take place within a professional, clinical setting. Methods: The scoping review will follow the JBI approach. Databases to be searched include MEDLINE (PubMed), CINAHL, Cochrane Central Register of Controlled Trials, Embase, ProQuest Dissertations and Theses, Scopus, and Web of Science. All included manuscripts will be screened by two reviewers and relevant data will be extracted. These data will summarize what transition to practice programs are used, how they differ, and what gaps exist.
Background: Many new graduate primary care physician assistants (PAs) and nurse practitioners (NPs) can experience stress and difficulty as they transition to practice. Feelings of anxiety and role ambiguity are common and can lead to costly turnover, impact care continuity, and place patients at risk for poor clinical outcomes. Onboarding, the process of helping new hires adjust to social and performance aspects of their new job and has the potential to ease transition to practice for PAs and NPs. Recent research has linked PA/NP onboarding programs to increased engagement, decreased turnover, and higher clinical productivity. Purpose: To describe new graduate PA and NP perspectives of onboarding programs they completed in their first primary care position. Methodology: Thirteen semistructured interviews were conducted with new graduate PAs and NPs who participated in onboarding programs. Interviews were transcribed and then analyzed using an inductive coding methodology. Results: Analyses revealed nine thematic concepts that are described within two frameworks. Structural components include improving competence, training on the electronic health record, promoting mentorship, orienting to organizational dynamics, tailoring ramp-up of patient scheduling, clarifying expectations, and providing clear organizational support. Psychosocial factors include creating comfort and building self-confidence. Conclusion: Understanding participants' experiences with onboarding programs is essential for ensuring successful transition to practice for new graduate PAs and NPs. Implications: These findings are beneficial to the health care workforce. Administrators can incorporate these findings into existing and future programs, and new graduate PAs and NPs can negotiate for the inclusion of these components in their first position.
Objective:To describe new graduate physician associate/assistant (PA) and NP perspectives of onboarding programs in their first primary care position.Methods:Thirteen semistructured interviews were conducted with new graduate PAs and NPs who participated in onboarding programs. Interviews were transcribed and then analyzed using an inductive coding methodology.Results:Analyses revealed nine thematic concepts that are described in two frameworks. Structural components are improving competence, training on the electronic health record (EHR), promoting mentorship, orienting to organizational dynamics, tailoring ramp-up of patient scheduling, clarifying expectations, and providing clear organizational support. Psychosocial factors are creating comfort and building self-confidence.Discussion:The results describe and delineate important components for onboarding that administrators can incorporate into existing and future programs.Conclusion:Understanding participants' experiences with onboarding programs is essential for ensuring successful transition to practice for new graduate PAs and NPs.
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