The promise and problems of non-physician practitioners in general surgery education: Results of a multi-center, mixed-methods study of faculty

James E. Coverdill, Jeff Scott Shelton, Adnan Alseidi, David C. Borgstrom, Daniel L. Dent, Russell Dumire, Jonathan Fryer, Thomas H. Hartranft, Steven B Holsten, M. Timothy Nelson, Mohsen M. Shabahang, Stanley R. Sherman, Paula M. Termuhlen, Randy J. Woods, John D. Mellinger

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Background: Nurse Practitioners and Physician Assistants – called non-physician practitioners or NPPs – are common, but little is known about their educational promise and problems. Methods: General surgery faculty in 13 residency programs were surveyed (N = 279 with a 71% response rate) and interviewed (N = 43) about experiences with NPPs. The survey documents overall patterns and differences by program type and primary service; interviews point to deeper rationales and concerns. Results: NPPs reduce faculty and resident workloads and teach residents. NPPs also reduce resident exposure to educationally valuable activities, and faculty sometimes round, make decisions, and operate with NPPs instead of residents. Interviews indicate that NPPs can overly reduce resident involvement in patient care, diminish resident responsibility and decision making, disrupt team dynamics, and compete for procedures. Conclusions: NPPs both enhance and hinder surgical education and highlight the need to more clearly articulate learning outcomes for residents and activities necessary to achieve those outcomes.

Original languageEnglish (US)
Pages (from-to)222-226
Number of pages5
JournalAmerican Journal of Surgery
Volume215
Issue number2
DOIs
StatePublished - Feb 2018

Keywords

  • Duty hour restrictions
  • Non-physician practitioners
  • Nurse practitioners
  • Physician assistants
  • Surgical education

ASJC Scopus subject areas

  • Surgery

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    Coverdill, J. E., Shelton, J. S., Alseidi, A., Borgstrom, D. C., Dent, D. L., Dumire, R., Fryer, J., Hartranft, T. H., Holsten, S. B., Nelson, M. T., Shabahang, M. M., Sherman, S. R., Termuhlen, P. M., Woods, R. J., & Mellinger, J. D. (2018). The promise and problems of non-physician practitioners in general surgery education: Results of a multi-center, mixed-methods study of faculty. American Journal of Surgery, 215(2), 222-226. https://doi.org/10.1016/j.amjsurg.2017.10.040