The impact of advanced practice providers on the surgical resident experience: Agree to disagree?

B Eaton; L Hessler; L O'Meara; A Herrera; R Tesoriero; J Diaz; B Bruns

doi:10.1016/j.amjsurg.2018.10.014

The impact of advanced practice providers on the surgical resident experience: Agree to disagree?

Am J Surg. 2019 Jun;217(6):1107-1111. doi: 10.1016/j.amjsurg.2018.10.014. Epub 2018 Oct 13.

Authors

B Eaton¹, L Hessler², L O'Meara³, A Herrera⁴, R Tesoriero⁵, J Diaz⁶, B Bruns⁷

Affiliations

¹ University of Maryland, R Adams Cowley Shock Trauma Center, Division of Acute Care Surgery, 22 South Greene St, Baltimore MD 21201, USA. Electronic address: beaton@umm.edu.
² Department of Surgery, University of Maryland School of Medicine, 22 South Greene St, Baltimore MD 21201, USA. Electronic address: lhessler@som.umaryland.edu.
³ University of Maryland, R Adams Cowley Shock Trauma Center, Division of Acute Care Surgery, 22 South Greene St, Baltimore MD 21201, USA. Electronic address: lomeara@umm.edu.
⁴ Center for Shock, Trauma and Anesthesiology Research, 110 South Paca St, Room 03-002, Baltimore MD, 21201, USA. Electronic address: aherrera@som.umaryland.edu.
⁵ University of Maryland, R Adams Cowley Shock Trauma Center, Division of Acute Care Surgery, 22 South Greene St, Baltimore MD 21201, USA; Department of Surgery, University of Maryland School of Medicine, 22 South Greene St, Baltimore MD 21201, USA. Electronic address: rtesoriero@umm.edu.
⁶ University of Maryland, R Adams Cowley Shock Trauma Center, Division of Acute Care Surgery, 22 South Greene St, Baltimore MD 21201, USA; Department of Surgery, University of Maryland School of Medicine, 22 South Greene St, Baltimore MD 21201, USA. Electronic address: jdiaz@umm.edu.
⁷ University of Maryland, R Adams Cowley Shock Trauma Center, Division of Acute Care Surgery, 22 South Greene St, Baltimore MD 21201, USA; Department of Surgery, University of Maryland School of Medicine, 22 South Greene St, Baltimore MD 21201, USA. Electronic address: bbruns@umm.edu.

Abstract

Background: We examined and compared APP versus surgical resident perceptions of the role of APPs in surgical subspecialty teams.

Methods: Residents/first year surgical critical care fellows and inpatient service-specific APPs responded to a survey that examined perceptions about the APP-resident/fellow relationship. Statistical analysis compared responses using a Pearson chi-square test.

Results: Thirty-two resident/fellows (48%) and 10 APPs (42%) responded. There was consensus that having an APP on service decreases workload, contributes to continuity of care and enhances resident-patient coordination education and agreement that there was clear communication and adequate collaboration. Both groups differed with respect to APPs contribution to resident/fellow clinical education, role definition and chain of command. The majority of trainees felt that APPs function at a PGY2 level (51.7%) compared to APPs, who felt that they functioned at a PGY4/5 (22%) or Fellow (44%) level.

Conclusion: APPs and resident/fellows agree that APPs impact resident workload, continuity of care and patient-coordination education.

Keywords: Advanced practice providers; Education; Nurse practitioners; Physician assistants; Surgical residents; Workload.

MeSH terms

Attitude of Health Personnel*
Continuity of Patient Care
Fellowships and Scholarships
Female
General Surgery / education*
Humans
Internship and Residency*
Interprofessional Relations
Male
Nurse Practitioners / organization & administration*
Nurse Practitioners / psychology
Physician Assistants / organization & administration*
Physician Assistants / psychology
Professional Role / psychology
Surgeons / education*
Surgeons / organization & administration
Surgeons / psychology
Surveys and Questionnaires
United States
Workload

Grants and funding

T32 AG000262/AG/NIA NIH HHS/United States