Advanced Practice Provider Skills Course

Abstract: Advance practice providers (APPs) constitute much of the consultation liaison (C-L) workforce. According to a 2022 survey of C-L service directors by the ACLP Interdisciplinary Education Subcommittee, 42% of inpatient C-L teams included APPs. C-L service directors indicated an intention to expand C-L services, including a significant proportion of APPs.

APP certification programs, including nurse practitioner (NP) and physician assistant (PA) programs, have broad curricular requirements but vary in the quality of clinical experiences. Commonly, newly graduated NPs and PAs must rapidly acquire clinical knowledge in their specialty area, leading to a stressful transition to practice¹ and a tendency toward underconfidence.² Outside of the Psychiatric Mental Health Nurse Practitioner certification and PA psychiatry fellowships,³ APP certification programs do not include a standardized psychiatry curriculum. Further, there is no standardized consultation-liaison (C-L) curriculum, despite the complexity and urgency of problems that arise in C-L settings. Studies have identified the need for ongoing education and professional development to improve APPs competence and confidence.^3,4

The authors aim to address APP training gaps by offering a half-day skills course covering C-L essentials. We are building on the inaugural APP skills course which was offered at the ACLP in 2023. Based on this experience and feedback received in real-time and with a post-course survey, we plan to offer a continuation of the half-day skills course with increased time dedicated to interactive case discussions. Our target audience is early career C-L APPs, though through nuanced case discussions, we hope that seasoned APPs can also share their experiences. We plan to offer structured didactics on medication safety, psycho-oncology, and challenging interpersonal dynamics. Psychiatrists will lead the didactic portions, while psychiatrists and psychiatric APPs will co-facilitate the case discussions. Longitudinal themes will be incorporated in case discussions and include psychopharmacology, medication monitoring, liaising and relationship building skills, identifying one’s scope, and utilizing team resources.

References:

1. Hoffmann RL, Klein SJ, Rosenzweig MQ. Creating quality online materials for specialty nurse content: Filling a need for the graduate nurse practitioner. J Cancer Educ. 2017 Sept;32(3):522-27.

2. MacLellan L, Levett-Jones T, Higgins I. Nurse practitioner role transition: A concept analysis. J Am Assoc Nurse Pract. 2015 Jul;27(7):389-397.

3. Morreale Mk, Balon R, Coverdale J, Louie AK, Beresin E, Guerrero APS, Aggarwal R, Brenner A. Supporting the education of nurse practitioners and physician assistants in meeting shortages in mental health care. Acad Psychiatry. 2020 Aug; 44(4):377-79.

4. Latter S, Maben J, Myall M, Young A. Evaluating nurse prescribers’ education and continuing professional development for independent prescribing practice: findings from a national survey in England. Nurse Educ Today. 2007 Oct;27(7): 685-96.

Agenda Overview: Agenda Overview
10 minute Introduction, audience polling
30 minute didactic: Medication Safety: Antipsychotics
45 minute Interactive Medication Safety Cases: Small Group Breakouts
30 minute didactic: Psycho-Oncology
45 minute: Interactive Psycho-Oncology Cases: Small Group Breakouts
30 minute didactic: Challenging Interpersonal Dynamics
45 minute Interactive Challenging Dynamics Cases: Small Group Breakouts

Diversity, Equity, and Inclusion: Our submission targets APPs, a workforce that can reduce health disparities by increasing access to medical and psychiatric care. APPs have not traditionally been a prominent focus of ACLP meetings, and we hope this course will promote inclusion and participation of APPs within the academy. We will include principles of Diversity, Equity, and Inclusion (DEI) throughout the event such as how bias can impact countertransference in challenging interpersonal situations.