The expanding role of the nurse practitioner in an academic medical center and its impact on graduate medical education.

Purpose: Academic medical centers (AMCs) have used nurse practitioners (NPs) for the provision of direct patient care for many years. However, as more NPs are hired to fill in the void created by both the 80-hour work week and the increased demands on attendings' time, their role has evolved in terms of patient care and graduate medical education. We sought to evaluate the expanded role of the NP in our large tertiary AMC to help clarify the interrelationships with the patient care delivery model and GME.

Methods: Data were collected through interviews of NPs, nurses, attendings, and residents. Data were analyzed to identify trends contributing to successful models of practice and their impact on patient care and graduate medical education (GME).

Results: Interviews were completed with 58/74 (78%) NPs employed at our medical center. Anonymous written surveys were completed by 41 (55%) providers. In terms of perceived impact on the role NPs played in GME, 77% of NPs surveyed felt that their role complimented the resident training; 9% felt that their role competed with resident training; and 14% felt that their role had no impact on resident training.

Conclusion: We believe that the presence of an experienced NP on a care deliver team can enhance the educational experience of residents as well as provide continuity of patient care in the era of the 80-hour work week.