Experience of Physician Assistants and Nurse Practitioners in Onboarding Programs

Investigators: Nathalie Ortiz Pate, MPH, MHS, Hilary Barnes, PhD, Lorraine Anglin, MHS, Mara Sanchez, MMS, Heather Batchelder, MA, LPA, Christine Everett, Ph.D., Perri Morgan, Ph.D.

Objective: Newly graduated nurse practitioners (NPs) and physician assistants (PAs) face challenges in adapting to their first jobs. Because of this, some organizations are instituting formal onboarding programs to support PAs and NPs as they transition from students to practicing clinicians. Yet, more research is needed to identify which components of NP and PA onboarding programs are successful and why. This study seeks to address that gap.

Methods: Between 2020-2021, the study conducted thirteen primary care NPs and PAs semi-structured interviews. Respondents answered questions about their onboarding programs, noting strengths and weaknesses of the programs and whether they felt their transition to clinical practice was successful after the program.

Findings: Findings were coded into six structural components and two psychosocial components of training programs. Structural components included: 1) Improving competencies, 2) Providing mentorship, 3) Orientating to organizational dynamics, 4) Tailoring ramp up of patient scheduling, 5) Clarifying expectations, and 6) Providing clear organizational support.

Psychosocial components of training programs were described as:

  1. Creating a feeling of comfort
  2. Building professional self-confidence.

Policy Implications: Employers and organizational managers can use onboarding programs to increase retention and decrease employee turnover, which is expensive and disruptive to patient care. This study highlights six structural components and two psychosocial components that employers and managers could strive to incorporate into their onboarding programs.

 

Project Products: 

Manuscript
  • Pate NO, Barnes H, Batchelder HR, Anglin L, Sanchez M, Everett C, Morgan P. PA and NP onboarding in primary care: The participant perspective. JAAPA. 2023 Feb 1;36(2):1-9.
View the manuscript

 

Research brief
  • Oritiz Pate, N, Barnes, H, Anglin, L, Sanches, M, Batchelder, H, Everett, C, Morgan, P. Identifying Successful Strategies for New Nurse Practitioner (NP) and Physician Assistant (PA) Onboarding Programs. Carolina Health Workforce Research Center, Cecil G. Sheps Center for Health Services Research, UNC-CH. February 2022.
View the brief

 

Presentations, webinars, and refereed conference papers and posters
  • Ortiz, N. Barnes, H. 2023 October 26. “October 2023.” JAAPA Podcast.
  • Barnes, H. 2022 August. Novice nurse practitioner role transition and strategies for supporting new clinicians. Nursing Grand Rounds, Nicklaus Children’s Hospital.
  • Ortiz Pate, N., Barnes, H., Anglin, L., Sanchez, M., Batchelder, H., Everett, C.M., Morgan, P. “Identifying Successful Strategies for New Nurse Practitioner (NP) and Physician Assistant (PA) Onboarding Programs”. Poster presented at the 2022 Annual Conference of the American Association of Physician Associates, Indianapolis, Indiana, May 2022
  • Ortiz Pate, N. (2022). The Participant Perspective: Onboarding for the Physician Assistant and Nurse Practitioner. Poster Presentation AAMC. May 2022. (virtual)