Tobias Tamara, Callahan Nicole, Augustine Laura, Tanaka Barbara
Seattle Reproductive Medicine, Bellevue, Washington.
Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota.
F S Rep. 2024 Sep 21;5(4):363-368. doi: 10.1016/j.xfre.2024.09.002. eCollection 2024 Dec.
To evaluate the current utilization of advanced practice providers (APPs) within the field of reproductive endocrinology and infertility.
Cross-sectional.
Web-based.
A total of 201 APPs surveyed through the American Society of Reproductive Medicine APP Professional Group.
Anonymized online survey.
Demographics, scope of practice and responsibilities, and training and onboarding.
Respondents were primarily Family Nurse Practitioners (26.4%), Women's Health Nurse Practitioners (33.3%), or Physician Associates (29.8%). Two-thirds (67.4%) reported that their scope of practice is limited by their employer or practice, 43.5% by state restrictions, and 25.2% by insurance. Survey respondents reported that 44.4% of their time at work is dedicated to performing procedures and scans and 30.6% to conducting consults and follow-ups. The most commonly reported duties were physical examinations (88.6%), intrauterine inseminations (86.6%), saline sonohysterograms (79.6%), endometrial biopsies (76.6%), ultrasounds (74.6%), and problem visits such as for pain, cysts, and bleeding (73.1%). Most survey respondents (61.7%) reported having autonomy in deciding protocols and treatment options for patients in their practice. Respondents described their onboarding training as including observation/on-the-job training (94.0%), independent reading of texts and journals (66.7%), American Society of Reproductive Medicine online courses (45.3%), formal orientation (34.8%), and practice-organized training programs (29.4%).
Advanced practice providers are highly trained members of the care team, but continue to be underused within the field of reproductive endocrinology and infertility. Improvements in educational resources and/or use of a formalized program to train APPs to their full scope of practice may help increase clinic efficiency and improve patient access to care.
评估生殖内分泌与不孕症领域高级执业提供者（APP）的当前使用情况。
横断面研究。
基于网络。
通过美国生殖医学学会APP专业组对201名APP进行了调查。
匿名在线调查。
人口统计学、执业范围与职责、培训与入职情况。
受访者主要为家庭护士执业者（26.4%）、女性健康护士执业者（33.3%）或医师助理（29.8%）。三分之二（67.4%）的人报告称其执业范围受到雇主或执业机构的限制，43.5%受到州法规限制，25.2%受到保险限制。调查受访者表示，他们工作时间的44.4%用于执行操作和扫描，30.6%用于进行咨询和随访。最常报告的职责包括体格检查（88.6%）、宫腔内人工授精（86.6%）、盐水超声子宫造影（79.6%）、子宫内膜活检（76.6%）、超声检查（74.6%）以及针对疼痛、囊肿和出血等问题的就诊（73.1%）。大多数调查受访者（61.7%）报告在决定其执业中患者的治疗方案和治疗选择方面拥有自主权。受访者将他们的入职培训描述为包括观察/在职培训（94.0%）、独立阅读文本和期刊（66.7%）、美国生殖医学学会在线课程（45.3%）、正式入职培训（34.8%）以及执业机构组织的培训项目（29.4%）。
高级执业提供者是护理团队中受过高度培训的成员，但在生殖内分泌与不孕症领域仍未得到充分利用。改善教育资源和/或采用正规项目培训APP使其充分发挥执业范围的作用，可能有助于提高诊所效率并改善患者获得医疗服务的机会。
