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Abstract
Background and Objectives Integrating advanced practice providers (APPs) into neurologic practice can improve access, promote patient education, and reduce health care costs. APPs receive limited formal education in neurology, so on-the-job training is essential. We set out to identify common challenges and best practices for onboarding, training, and integrating APPs into neurologic practice.
Methods We conducted a survey and focus group with 8 APPs currently practicing within an academic neurology department as part of a clinical quality improvement initiative. We explored their roles in multidisciplinary teams, challenges faced during onboarding and training, and strategies for success. Qualitative thematic analysis was performed.
Results Neurology APPs serve diverse roles including caring for hospitalized and ambulatory patients, performing procedures, assisting trainees, and performing research. Participants reported limited formal neurologic education before their job and a need for educational sessions and resources tailored to APPs. Neuroanatomy, neuroimaging, and generating a neurologic differential diagnosis were key knowledge gaps identified. We identified 7 informal strategies for on-the-job training, 7 challenges to on-the-job training, and factors promoting or threatening job satisfaction. Graded responsibility and clinical mentorship were essential for successful onboarding. APPs desired peer-to-peer mentorship and structured educational opportunities.
Discussion Common challenges and success strategies identified can inform the design of a formal curriculum for onboarding neurology APPs. Our findings suggest that an optimal APP training process involves graded responsibility and support for self-directed learning, employs peer mentors, and targets education of the multidisciplinary team including physicians and patients. Our results may inform other institutions recruiting, hiring, and training APPs.
Footnotes
Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.
Previous Presentations: Galina Gheihman, Angeliki Vgontzas, Jordan Paulson, David Pilgrim, Tracy Batchelor, Mary A. O'Neal, Christopher T. Doughty. Integrating Advanced Practice Providers (APPs) in an academic Department of Neurology: perspectives and experiences of current APPs (Abstract 4443). American Association of Neurology Annual Meeting 2020. Neurology Apr 2020, 94 (15 Supplement). Galina Gheihman, Angeliki Vgontzas, Jordan Paulson, David Pilgrim, Tracy Batchelor, Mary A. O'Neal, Christopher T. Doughty. Integrating Advanced Practice Providers (APPs) in an academic Department of Neurology: perspectives and experiences of current APPs. Abstract at the Women in Medicine and Science Symposium, Brigham & Women's Hospital, Sept 2020.
- Received November 23, 2020.
- Accepted March 5, 2021.
- © 2021 American Academy of Neurology
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