Postgraduate Clinical Education of Physician Assistants

Polansky, Maura; Garver, Gloria J Hsieh; Wilson, L; Pugh, Mary; Hilton, Ginny

doi:10.1097/01367895-201223010-00008

Cited by 15 publications

(35 citation statements)

References 4 publications

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“…The survey tool was developed and validated internally in the AAMC Survey Development style 18 and was influenced by prior validated surveys of postgraduate medical fellowships. 10,[19][20][21] Each question was developed by a team that had expertise in survey design (Wright and Tackett), and two survey design team members were themselves PDs of APP fellowships in hospital medicine (Kisuule and Franco). The survey was revised iteratively by the team on the basis of meetings and pilot testing with PDs of other programs.…”

Section: Methodsmentioning

confidence: 99%

The Current State of Advanced Practice Provider Fellowships in Hospital Medicine: A Survey of Program Directors

Klimpl

Tackett

Cardin³

et al. 2019

J Hosp Med

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BACKGROUND Postgraduate training for advanced practice providers (APPs) is a growing field in hospital medicine. As hospital programs continue to benefit from highly trained physician assistants (PAs) and nurse practitioners (NPs), fellowship programs have become more prevalent. However, little is known about the number of active programs or how they prepare trainees. OBJECTIVES To describe the existing APP fellowships in hospital medicine, with a focus on program characteristics, rationale, curricula, and learner assessment. METHODS An electronic survey was distributed by e‐mail to hospital medicine program directors in May 2018. The survey consisted of 25 multiple choice and short answer questions. Descriptive statistics were calculated utilizing Stata 13 for data analysis. RESULTS Of the 11 fellowships identified, 10 (91%) of directors responded to the survey. Eighty percent of programs accept both NPs and PAs and 80% are between 12 and 13 months long. All programs cite “training and retaining” as the main driver for their creation and 90% were founded in institutions with existing physician residencies. Ninety percent of program curricula are informed by Society of Hospital Medicine resources. Despite these similarities, there was wide variation in both curricular content and APP fellow assessment. CONCLUSION APP fellowships in hospital medicine are quickly growing as a means to train and retain nonphysician hospitalists. While most programs accept similar types of applicants and share a common rationale for program development, there is little standardization in terms of curriculum or assessment. Further research may be valuable to characterize the best practices to guide the future of these fellowships.

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Section: Methodsmentioning

confidence: 99%

The Current State of Advanced Practice Provider Fellowships in Hospital Medicine: A Survey of Program Directors

Klimpl

Tackett

Cardin³

et al. 2019

J Hosp Med

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“…Although not required, these give the PAs/NPs a concentrated didactic and clinical experience that will prepare them for clinical practice. However, according to the Polansky et al study, 19 only a few postgraduate programs in trauma are available at this time. The study notes the availability of NP fellowships; however, program specialties are not specifi ed.…”

Section: Discussionmentioning

confidence: 95%

“…The study notes the availability of NP fellowships; however, program specialties are not specifi ed. 19 Although most of the PAs/NPs in the study report having mentors, 18% were unable to identify a mentor. Mentorship is an essential aspect of professional development for all health care providers.…”

Section: Discussionmentioning

confidence: 98%

Assessing the Academic and Professional Needs of Trauma Nurse Practitioners and Physician Assistants

Wilson

Wainwright

Stehly

et al. 2013

Journal of Trauma Nursing

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Because of multiple changes in the health care environment, the use of services of physician assistants (PAs) and nurse practitioners (NPs) in trauma and critical care has expanded. Appropriate training and ongoing professional development for these providers are essential to optimize clinical outcomes. This study offers a baseline assessment of the academic and professional needs of the contemporary trauma PAs/NPs in the United States. A 14-question electronic survey, using SurveyMonkey, was distributed to PAs/NPs at trauma centers identified through the American College of Surgeons Web site and other online resources. Demographic questions included trauma center level, provider type, level of education, and professional affiliations. Likert scale questions were incorporated to assess level of mentorship, comfort level with training, and individual perceived needs for academic and professional development. There were 120 survey respondents: 60 NPs and 60 PAs. Sixty-two respondents (52%) worked at level I trauma centers and 95 (79%) were hospital-employed. Nearly half (49%) reported working in trauma centers for 3 years or less. One hundred nineteen respondents (99%) acknowledged the importance of trauma-specific education; 98 (82%) were required by their institution to obtain such training. Thirty-five respondents (32%) reported receiving $1000 per year or less as a continuing medical education benefit. Insufficient mentorship, professional development, and academic development were identified by 22 (18%), 16 (13%), and 30 (25%) respondents, respectively. Opportunities to network with trauma PAs/NPs outside their home institution were identified as insufficient by 79 (66%). While PAs/NPs in trauma centers recognize the importance of continued contemporary trauma care and evidence-based practices, attending trauma-related education is not universally required by their employers. Financial restrictions may pose an additional impediment to academic development. Therefore, resource-efficient opportunities should be a prime consideration for advanced practitioners education, especially since half of the reported workforce has 3 years or less experience. The Eastern Association of Trauma and other organizations can provide an ideal venue for mentorship, academic development, and networking that is vital to PA/NP professional development and, ultimately, quality patient care.

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“…In addition, there may be a waiting list for geriatric medicine clinics, and thus the oncological team has to decide a treatment plan before the patient can be seen for a GA in a geriatric medicine clinic. In North America, the nurse practitioner may be a good person to conduct the GA because they are trained to conduct extensive health assessments as well as have the authority to prescribe medication and order diagnostic tests [141][142][143][144][145][146][147][148]. For the management of other chronic diseases, research has shown that the nurse practitioner can manage these well, and some evidence is also emerging for nurse practitioners in oncology settings [142,146,148].…”

Section: How To Organize the Assessmentmentioning

confidence: 99%

How to Implement a Geriatric Assessment in Your Clinical Practice

et al. 2014

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Cancer is a disease that mostly affects older adults. Other health conditions, changes in functional status, and use of multiple medications change the risks and benefits of cancer treatment for older adults. Several international organizations, such as the International Society of Geriatric Oncology, the European Organization for Research and Treatment of Cancer, recommend the conduct of a geriatric assessment (GA) for older adults with cancer to help select the most appropriate treatment and identify any underlying undetected medical, functional, and psychosocial issues that can interfere with treatment. The aim of this review is to describe what a GA is and how to implement it in daily clinical practice for older adults with cancer in the oncology setting. We provide an overview of commonly used tools. Key considerations in performing the GA include the resources available (staff, space, and time), patient population (who will be assessed), what GA tools to use, and clinical follow‐up (who will be responsible for using the GA results for developing care plans and who will provide follow‐up care). Important challenges in implementing GA in clinical practice include not having easy and timely access to geriatric expertise, patient burden of the additional hospital visits, and establishing collaboration between the GA team and oncologists regarding expectations of the population referred for GA and expected outcomes of the GA. Finally, we provide some possible interventions for problems identified during the GA.

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Postgraduate Clinical Education of Physician Assistants

Cited by 15 publications

References 4 publications

The Current State of Advanced Practice Provider Fellowships in Hospital Medicine: A Survey of Program Directors

The Current State of Advanced Practice Provider Fellowships in Hospital Medicine: A Survey of Program Directors

Assessing the Academic and Professional Needs of Trauma Nurse Practitioners and Physician Assistants

How to Implement a Geriatric Assessment in Your Clinical Practice

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