Assessing the academic and professional needs of trauma nurse practitioners and physician assistants.

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.

Postgraduate clinical education of physician assistants.

PURPOSE: Physician assistant (PA) postgraduate clinical training programs have existed since 1971. There are anecdotal reports of increasing numbers of programs available in the United States, although a reliable means of identifying and tracking such programs has not been available. The purpose of this study was to describe the current state of postgraduate, clinical educational programs for PAs based on defined criteria for study inclusion and to propose the use of these criteria for use by future investigators to determine trends in program development. METHODS: All programs potentially meeting the study criteria for postgraduate PA clinical programs, including programs actively enrolling PAs and that provide didactic and clinical instruction of 6 or more months duration, were contacted to participate in an online survey. RESULTS: A total of 49 programs (42 nonmilitary) programs were included with 22 nonmilitary programs opening for enrollment in or after 2008. Most programs enrolled one or two PAs annually. All respondents of nonmilitary programs indicated that a certificate of completion was provided and no academic credit or degree was offered. A variety of didactic and clinical instructional methods were used. Most sites also provided clinical rotations for PA students, and many required PA residents to participate in student teaching. Although few programs have been accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA), most programs are pursuing, or plan to apply for, accreditation. CONCLUSIONS: The results of this survey provide an up-to-date report on the status of PA postgraduate clinical training programs. The investigators recommend future studies use the same criteria for inclusion to establish future trends in program development.