NP and PA transition to practice: A scoping review of fellowships and onboarding programs.
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2023-11
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Abstract
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Newly graduated NPs and physician associates/assistants (PAs) benefit from transition to practice (TTP) support to move successfully into practice. TTP programs (such as onboarding programs, fellowships, and residencies) hold promise for improving workforce outcomes. The purpose of this scoping review was to describe the literature regarding NP/PA TTP programs.Methods
Using the Joanna Briggs Institute methodology, a specific approach for systematically conducting reviews, publications from January 1990 to May 2022 were included if they addressed fellowships, residencies, or onboarding programs for NPs or PAs. Final data extraction involved 216 articles.Results
The pace of publication increased over time, with a noticeable increase since 2015. Articles were most commonly about fellowships or residencies, NPs, and programs set in nonrural, acute care US settings and in academic health centers.Conclusions
A gap exists in our understanding of onboarding programs and programs focusing on PAs, as well as TTP support in rural and primary care settings. In addition, few articles assess TTP program outcomes such as benefits and costs. This review describes the need for more published literature in these areas.Type
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Morgan, Perri, Hilary Barnes, Heather R Batchelder, Brandi Tuttle, Asefeh Faraz Covelli, Christine Everett, George L Jackson, Lorraine Anglin, et al. (2023). NP and PA transition to practice: A scoping review of fellowships and onboarding programs. JAAPA : official journal of the American Academy of Physician Assistants, Published Ahead of Print. 10.1097/01.jaa.0000991352.36720.09 Retrieved from https://hdl.handle.net/10161/29385.
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Scholars@Duke

Perri Anne Morgan
Dr. Morgan is a health services researcher focusing on PAs and NPs in the health workforce and on outcomes associated with their use in different roles and settings. As Director of Research in the Duke PA Division, she led the development of the PA Research section, which is one of only a few such groups nationally. As a practicing PA for 25 years, Dr. Morgan has extensive knowledge of the PA profession from the perspective of a clinician. As one of a very few national experts on education, practice, and workforce issues related to the PA profession, Dr. Morgan is regularly invited to serve in national and state level policy advisory positions. Her research, linked below, addresses methodological problems of data sources for use in research on PAs and NPs, the effect of PA use on health resource utilization, and use and roles of PAs and NPs in various settings.

Brandi Tuttle
Pronouns: She/Her/Hers
Research & Education Librarian
Medical Librarian for Research & Education at the Medical Center Library & Archives
Brandi serves as liaison to the Physician Assistant Program, the Pathologists' Assistants Program, and the Master of Biomedical Sciences Program. She develops and teaches classes, conducts systematic reviews, is engaged in research support and project consultation, conducts searches for IACUC, and co-directs the Evidence-Based Practice courses for physician assistant students.
- AHIP Distinguished level (Academy of Health Information Professionals)
- MS, Library & Information Science, University of Illinois at Urbana-Champaign
- BA, Anthropology, University of Illinois at Urbana-Champaign
- AA, Sociology, Lake Land College

Christine M Everett
Dr. Everett joined the faculty of the Department of Community and Family Medicine at Duke University in August 2013 and gained a secondary appointment in the Department of Population Health in 2018. Prior to joining the faculty, she worked clinically in emergency departments in rural Wisconsin. Prior to becoming a physician assistant (PA), Dr. Everett worked in research at the National Institutes of Health and public health policy at the Food and Drug Administration.
Dr. Everett’s current research initiatives focus on healthcare team design and the impact on patient, provider, and organizational outcomes. Recent work has focused on understanding the role of primary care PAs and nurse practitioners (NPs) and how they relate to outcomes for patients with diabetes. Her work has been published in a variety of journals including Health Affairs, Journal of Rural Health , Medical Care Research and Review, and BMC Family Practice. She completed the first comparative effectiveness study of primary care PAs and NPs and has become the first PA faculty in the US to receive grant funding from the National Institutes of Health.
Nationally, Christine has served on a range of governmental and non-governmental groups, including the Healthy People 2010 Workgroup, the Agency for Healthcare Research and Quality Primary Care Team Workforce Models Workgroup, and the American Academy of Physician Assistant Research Council. She is currently a member of the advisory board for the Center for Professionalism & Value in Healthcare and the Associate Editor for Research for the Journal of the American Academy of Physician Assistants.
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