{"pk":17418,"title":"Effects of Non-physician Practitioners on Emergency Medicine Physician Resident Education","subtitle":null,"abstract":"Introduction: The effects of non-physician practitioners (NPP) such as physician assistants and nurse practitioners on the education of emergency medicine (EM) residents have not previously been specifically evaluated. Emergency medicine societies have made policy statements regarding NPP presence in EM residencies without the benefit of empiric studies.\nMethods: A cross-sectional, mixed methods questionnaire with strong validity evidence was distributed to current EM residents who were members of a large national society, the American Academy of Emergency Medicine Resident and Student Association (AAEM/RSA), between June 4–July 5, 2021.\nResults: We received 393 partial and complete responses, representing a 34% response rate. A majority of respondents (66.9%) reported that NPPs have a detracting or greatly detracting impact on their education overall. The workload in the emergency department was reported generally as lighter (45.2%) to no impact (40.1%), which was cited in narrative responses as an aspect of both enhancing and detracting from resident physician education. Non-physician practitioner postgraduate programs in EM were associated with a 14x increase in the median number of procedures forfeited over the course of the prior year (median = 7.0 vs 0.5, P<.001). Among respondents, 33.5% reported feeling “not confident at all” in their ability to report concerns about NPPs to local leadership without retribution, and 65.2% reported feeling “not confident at all” regarding confidence in the Accreditation Council for Graduate Medical Education to satisfactorily address concerns about NPPs raised in the end-of-year survey.\nConclusion: Resident members of the AAEM/RSA reported having concerns about the effects of NPPs on their education and their confidence in being able to address the concerns.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"midlevel practitioners"},{"word":"Nurse practitioner"},{"word":"physician assistant"},{"word":"Resident Education"},{"word":"Graduate Medical Education"}],"section":"Emergency Medicine Workforce","is_remote":true,"remote_url":"https://escholarship.org/uc/item/9g14r2jx","frozenauthors":[{"first_name":"Andrew","middle_name":"W","last_name":"Phillips","name_suffix":"","institution":"DHR Health Research Institute, Edinburg, Texas","department":"None"},{"first_name":"Jeremy","middle_name":"P","last_name":"Sites","name_suffix":"","institution":"University of Kentucky, Department of Pediatrics, Pediatric Critical Care, Lexington, Kentucky","department":"None"},{"first_name":"Faith","middle_name":"C","last_name":"Quenzer","name_suffix":"","institution":"San Diego State University, School of Public Health, Division of Epidemiology and Biostatistics, San Diego, California","department":"None"},{"first_name":"Daniel","middle_name":"M","last_name":"Lercher","name_suffix":"","institution":"University of North Carolina at Chapel Hill, Division of Pediatric Critical Care Medicine, Chapel Hill, North Carolina","department":"None"}],"date_submitted":"2022-09-04T10:56:16-04:00","date_accepted":"2022-09-04T10:56:16-04:00","date_published":"2023-04-28T14:46:57-04:00","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/17418/galley/8862/download/"}]}