Building Relationships: Advanced Practice Providers and Fellows in Neonatal-Perinatal Medicine

Katie Forman; Christie J. Bruno; Susan Izatt; Mamta Fuloria; Aaron Adams; Mimi Kim; Jennifer Zuber; Nefertiti Cano; Mariam S. LaTuga

doi:10.1055/s-0043-1771503

American Journal of Perinatology, Table of Contents

Am J Perinatol 2024; 41(S 01): e2514-e2520
DOI: 10.1055/s-0043-1771503

Original Article

Building Relationships: Advanced Practice Providers and Fellows in Neonatal-Perinatal Medicine

Katie Forman

¹Division of Neonatology, Department of Pediatrics, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York

,

Christie J. Bruno

²Division of Neonatology, Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut

,

Susan Izatt

³Division of Neonatology, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina

,

Mamta Fuloria

¹Division of Neonatology, Department of Pediatrics, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York

,

Aaron Adams

³Division of Neonatology, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina

,

Mimi Kim

⁴Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York

,

Jennifer Zuber

¹Division of Neonatology, Department of Pediatrics, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York

,

Nefertiti Cano

¹Division of Neonatology, Department of Pediatrics, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York

,

Mariam S. LaTuga

¹Division of Neonatology, Department of Pediatrics, Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York

› Author Affiliations

Abstract

Objective Advanced practice providers (APPs) are a critical component of health care teams, especially in the neonatal intensive care unit. At times, APPs and neonatal-perinatal medicine (NPM) fellows may experience tension in their professional relationship. They may perceive the other's performance and abilities differently. We hypothesized that satisfaction with the APP–NPM fellow interprofessional relationship would be associated with higher perception of APP competence by NPM fellows.

Study Design We surveyed 274 medical providers: NPM fellows (24.8%), NPM program directors (24.5%), and APPs (50.7%). APPs were defined as neonatal nurse practitioners, pediatric nurse practitioners, physician assistants, or neonatal hospitalists. We obtained demographic data, information about sources of conflict in the APP–NPM fellow relationship, level of satisfaction with the relationship, and targeted interventions for improvement. NPM fellow perception of APP competence as well as APP self-assessed competence were elicited. Statistical analyses were performed with chi-square tests and Fisher's exact tests.

Results Overall, APPs and NPM fellows were generally satisfied with their relationship. All groups reported APP competence as equivalent to a third-year NPM fellow. NPM fellow perception of APP competence increased with year of fellow training. Higher perceived APP competence by NPM fellows correlated with higher relationship satisfaction scores. Difficulties with teamwork, communication and respect were associated with lower satisfaction within the APP–NPM fellow relationship.

Conclusion The professional working dynamic between these two groups is viewed positively by all. Satisfaction with the APP–NPM fellow relationship correlated with higher perception of APP competence by NPM fellows. Targeted interventions that increase NPM fellow perception of APP competence and ameliorate the difficulties encountered in the APP–NPM fellow relationship may improve this interprofessional relationship.

Key Points

Advanced practice providers and NPM fellows may have similar responsibilities leading to challenges.
NPM fellows with higher perceived competence of APPs had higher satisfaction with their relationship.
Training APPs to teach, creating interprofessional education, and routine debrief sessions may help.

Keywords

medical education - workforce - nurse practitioner - physician assistant - clinical learning environment - academic healthcare

Full Text

References

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Supplementary Material

Supplementary Material