Kidd Vasco Deon
Orthopedic Surgery, School of Medicine, University of California, Irvine, USA.
Cureus. 2023 Mar 21;15(3):e36490. doi: 10.7759/cureus.36490. eCollection 2023 Mar.
Although there has been a rapid increase in the number of physician assistant (PA) and nurse practitioner postgraduate residency/fellowship specialty training programs in the United States, voluntary accreditation of these programs is a relatively new phenomenon. There is little research examining which factors may be predictors of accreditation adoption among PA and nurse practitioner (NP) postgraduate programs. Therefore, the primary aim of this study was to investigate which motivating factors influence postgraduate programs choice on whether to pursue accreditation. Methodology A descriptive cross-sectional survey consisting of 10 questions was distributed to 56 postgraduate emergency medicine and orthopedic surgery PA, NP, and joint PA/NP residency/fellowship programs via email between November 2022 and February 2023. Descriptive statistics were performed. Results Nineteen postgraduate programs responded to the survey. Two programs submitted incomplete surveys where less than 50% of the total items were completed. The partially completed surveys were omitted from the data analysis. The final response rate was 30% (17/56). Among the responded programs, 47% (8/17) offer dual PA and NP training, and 53% (9/17) are PA only. Although 88% (15/17) of postgraduate programs have discussed accreditation funding with their sponsoring institution only 76% are planning to do so or are in the process of pursuing accreditation. The two most common reasons for pursuing accreditation are program validation and assessment of educational quality 59% (10/17) and competition for applicants 24% (4/17). However, Magnet hospital designation, requirement of the sponsoring institution, or demand from employers were not determining factors of whether to pursue accreditation or not. Reasons for not pursuing accreditation included high costs of accreditation 18% (3/17), lack of perceived value of accreditation 6% (1/17), and lack of protected time to pursue accreditation 6% (1/17). Conclusion Although literature is still lacking on the effectiveness and impact of PA and NP postgraduate program accreditation, the findings of this rare study indicate that postgraduate programs are motivated to pursue accreditation. It is important for accreditors to communicate the utility of program-level accreditation and other value-added benefits to programs and their sponsoring institutions. Further work is necessary to better understand the value of external validation, specific drivers for validation, and barriers that influence accreditation adoption among these postgraduate programs.
尽管美国医师助理（PA）和执业护士（NP）研究生住院医师/专科培训项目的数量迅速增加，但这些项目的自愿认证却是一个相对较新的现象。很少有研究探讨哪些因素可能是PA和NP研究生项目采用认证的预测因素。因此，本研究的主要目的是调查哪些激励因素会影响研究生项目在是否寻求认证方面的选择。方法 在2022年11月至2023年2月期间，通过电子邮件向56个研究生急诊医学和骨科手术PA、NP以及联合PA/NP住院医师/专科培训项目发放了一份包含10个问题的描述性横断面调查问卷。进行了描述性统计分析。结果 19个研究生项目回复了调查。有2个项目提交的调查问卷不完整，完成的项目总数不到50%。在数据分析中省略了部分完成的调查问卷。最终回复率为30%（17/56）。在回复的项目中，47%（8/17）提供PA和NP双重培训，53%（9/17）仅提供PA培训。尽管88%（15/17）的研究生项目已与其主办机构讨论过认证资金问题，但只有76%的项目计划这样做或正在寻求认证。寻求认证的两个最常见原因是项目验证和教育质量评估59%（10/17）以及吸引申请人竞争24%（4/17）。然而，磁铁医院指定、主办机构的要求或雇主的需求并非是否寻求认证的决定因素。不寻求认证的原因包括认证成本高18%（3/17）、认为认证缺乏价值6%（1/17）以及缺乏用于寻求认证的受保护时间6%（1/17）。结论 尽管关于PA和NP研究生项目认证的有效性和影响的文献仍然不足，但这项罕见研究的结果表明，研究生项目有动力寻求认证。对于认证机构来说，向项目及其主办机构传达项目层面认证的效用和其他增值效益非常重要。有必要进一步开展工作，以更好地理解外部验证的价值、验证的具体驱动因素以及影响这些研究生项目采用认证的障碍。
