Supporting Advanced Practice Provider Transition to Practice

Transition from formal education to professional practice is known to be a tumultuous time for both the new graduate and their employer. This transition can be especially difficult for new graduate healthcare providers. Significant research efforts have focused on the experience of transition to practice for registered nurses, but very little has focused on their advanced practice colleagues. Nurse practitioners and physician assistants are known to have turnover rates greater than twice that of their physician colleagues within the first two years of practice following graduation (Anderson, 2012). The evidence shows common themes of psychological stress, a lack of support and guidance, role uncertainty and feelings of isolation during transition to practice (Barnes, 2015; Fenwick, et. al., 2012; Hart & Macnee, 2007; Sullivan & Bentz, 2010). While widely studied in registered nurses, interventions to improve transition to practice for advanced practice providers (APPs) are minimal. The Institutes of Medicine (2010) has suggested an increase in post-graduate residency programs to improve transition. Such residencies are not an accessible option for many organizations as they carry a significant cost burden (Wiltse Nicely & Fairman, 2015). However, the organizational benefits of promoting successful transition to practice are numerous and include decreased turnover and associated recruitment costs, improved employee effectiveness and commitment and higher job satisfaction (Strauss et al, 2016; Friedman, Cooper, Click & Fitzpatrick, 2011; Ashforth, Sluss & Saks, 2007; Allen, 2006). Using Van Maanen & Schein’s (1979) Theory of Organizational Socialization, an orientation program to support the transition to practice of advanced practice providers was developed. Included in the presentation will be a discussion of the various components of the orientation program as well as the process of operationalization into the larger health system. The impact of the program on perceived peer and organizational support, role clarity, organizational commitment, perceived competence and turnover intention on new graduate advanced practice providers will also be discussed.