1021 - Characterizing the Clinical Role of Radiation Oncology Advanced Practice Providers Using Clinical Entrustable Professional Activities
Presenter(s)
B. S. Wagner1, L. Martinka1, D. Gordon1, S. Anderson2, K. Bukolt3, K. Martin4, and D. W. Golden5; 1Rush University Medical Center, Chicago, IL, 2Rush University Medical Center, Chicago, IL, United States, 3Texas Oncology, Dallas, TX, 4Brigham and Women's Hospital and Dana-Farber Cancer Institute/ Harvard, Boston, MA, Boston, MA, 5Department of Radiation Oncology, RUSH University Medical Center, Chicago, IL
Purpose/Objective(s): Advanced Practice Providers (APPs), including Physician Associates/Assistants (PAs) and Nurse Practitioners (NPs), are being increasingly utilized in radiation oncology. However, radiation oncology-specific training for APPs is not standardized. This study aims to elucidate the current role of United States radiation oncology APPs, assess clinical responsibilities, and identify areas where formalized training can ensure APPs are practicing at their full scope of practice.
Materials/Methods: A survey was distributed to radiation oncology APPs in North America collecting data on demographics, practice structure, training, and clinical tasks using the framework of the 52 Entrustable Professional Activities (EPAs) developed by the Radiation Oncology Education Collaborative Study Group (ROECSG). Participants rated their level of independence for each EPA and provided free-text responses on additional responsibilities not covered by the EPAs.
Results: The response rate was 121/204 (59%). 37 PAs and 84 NPs participated. 53.7% practiced a different specialty before working in radiation oncology. 63.6% had three or more APPs in the department and 71.9% covered multiple physicians. 65.3% worked in a practice that utilized radiation oncology residents and 79.7% of these APPs reported working directly with the residents. 74.4% do not perform any procedures. 115/121 (95%) complete follow-up and survivorship visits, 86/121 (71%) complete unscheduled acute symptom visits, 79/121 (65%) complete out-patient consults, 55/121 (45%) complete in-patient consults, and 46/121 (38%) complete weekly on-treatment visits. 21.5% specialized in one disease site, 40.0% covered more than one disease site, and 38.8% covered all disease sites. >90% perform 37/52 ROECSG EPAs in some capacity. >90% complete EPAs 2, 4, 7, 18, and 19 independently. >90% do not complete EPAs 15, 32, 33, 38, and 40. Only 2.5% of APPs received formal radiation oncology training during their APP education. Significant differences were not observed between PA and NP responsibilities.
Conclusion: APPs are performing many of the ROECSG EPAs, primarily during follow-up and survivorship visits. However, job responsibilities vary widely across radiation oncology clinics nationwide, underscoring the need for formalized education. Bridging these educational gaps is essential to empower APPs to meet the growing demands of cancer care, support the evolving field of radiation oncology, and enhance the overall quality of patient care.