Readiness for Practice - How to Assess an APP for Successful Onboarding and Clinical Proficiency-Slides

Slides

Pdf Summary

The presentation "Readiness for Practice: How to Assess an APP for Successful Onboarding and Clinical Proficiency" by Amteshwar Singh, MD, David Klimpl, MD, and Bethany Zablotsky, PA-C, addresses integrating Advanced Practice Providers (APPs) into hospital medicine teams. Given that 83% of hospitalist programs employ APPs, with significant proportions of Nurse Practitioners (NPs) and Physician Assistants (PAs) practicing in hospitals, optimizing onboarding and assessment processes is crucial.<br /><br />Key objectives include recognizing challenges and opportunities in APP onboarding, understanding valid APP performance assessment instruments, utilizing assessment results for professional growth, and leveraging Society of Hospital Medicine (SHM) resources.<br /><br />The presenters emphasize the importance of setting clear expectations, defining role division, providing frequent feedback, and fostering open communication. They caution against assuming homogeneity among APPs and discourage underutilizing them in clerical roles. Many physicians lack formal training on collaborating with APPs, contributing to misunderstandings regarding APP scopes of practice.<br /><br />Successful onboarding depends on coordinated communication among APPs, institutions, and attending physicians, recognizing individual backgrounds, strengths, and preferred feedback styles.<br /><br />Rounding models vary in supervision and support: from high-support "buddy systems" where APPs and physicians round together, to low-supervision independent APP teams often handling low-acuity cases.<br /><br />Assessment tools should be valid, reliable, and fair, supporting feedback and professional development. The CHAPP-RA instrument, a milestone-based APP assessment, shows promise but faces challenges like rater engagement, survey fatigue, and effectively using data without creating a punitive environment.<br /><br />Entrustable Professional Activities (EPAs) adapted for APPs help measure readiness through graded supervision levels, guiding entrustment decisions. The presentation also encourages practical group exercises to draft EPAs tailored to specific clinical needs.<br /><br />Onboarding toolkits and standardized checklists from institutions like UT Health San Antonio and University of Chicago serve as models for systematic transition programs. Supplementary hospitalist fellowships for APPs provide additional training and retention benefits.<br /><br />Overall, the talk underscores a collaborative, structured approach to APP onboarding and assessment, aiming to enhance clinical proficiency and integration within hospital medicine teams.

Keywords

Advanced Practice Providers

APP onboarding

hospital medicine

clinical proficiency

APP assessment tools

CHAPP-RA

Entrustable Professional Activities

physician-APP collaboration

onboarding toolkits

hospitalist programs