Advanced Diagnostic Content in Nurse Practitioner and Physician Assistant Programs

Monica Scheibmeir, PhD, APRN; Crystal Stevens, MSN, C-ANP; Mary Beth Fund, MSN, C-FNP; Kurtis Carrico, MSN, C-ANP; Jason Crenshaw, MSN, C-FNP


Journal for Nurse Practitioners. 2015;11(6):633-639. 

In This Article


The institutional review board at Washburn University approved our study in 2011. The study used a cross-sectional descriptive design. A request to participate in the online survey with a link to the survey was sent by e-mail to program directors of all PA and NP programs. A second e-mail request to complete the survey went out to all NP and PA program directors 1 week after the initial survey.


A database was developed using information from the Physician Assistant Education Association (PAEA) and the American Association of Colleges of Nursing (AACN). The database included all PA programs that belong to the PAEA as well as all schools or departments of nursing that have master's level nursing programs and had AACN membership. Each school's website was included in the original database and was used to gather further information for the study. E-mail addresses of the program directors of NP and PA programs were gathered from each program's website. If a program director was not easily identified at the school's website, the dean or the program chair was used as the default e-mail contact. There are 160 accredited PA programs listed at the PAEA website. Upon further evaluation, 35 of the 160 PA programs contained invalid e-mail addresses, leaving a total of 125 PA programs in the sample. Information from the AACN identified a total of 386 accredited master's nursing programs. However, no information was provided as to whether the program offered an NP track. Further review indicated that 68 of the master's programs did not offer an NP tract, and 2 programs were non–English-speaking. After the initial e-mail request was sent to the NP program directors, 19 nursing programs replied that they did not have an NP track within the master's curriculum, leaving a final sample of 297. Of the 125 PA programs, 47 responded (38%) and, of the NP programs, 106 of 297 responded (36%).

Instrument Development

Hart and Macnee developed a survey that addressed the perceived academic preparation of NPs for their current NP role. As important as it is to obtain postgraduate data, it is equally important to assess the educator's perspective of the adequacy of the curriculum in preparing the graduate for practice. Therefore, the research team modified the original 32-item Hart and Macnee survey by changing the focus to address the educator's perspective and not that of the graduate. The original survey included 32 items that covered areas of perceived educational adequacy as well as other demographic information related to the NP respondents. For the purposes of this project, the research team focused on item 11 of the original 32-item survey. Item 11 asked NPs to respond to their educational preparation using 25 different clinical categories (eg, differential diagnosis, pathophysiology, etc). Of the original 25 categories, the research team selected 9 of the categories that focused on procedural skills and diagnostic and laboratory tests. The 9 categories included the following topics: casting; EKG interpretation; laboratory tests; microscopy; office procedures (ie, punch biopsy); radiologic interpretations; splinting; suturing; and coding. These 9 items were selected because they are inclusive of both NP and PA practice environments and they cover those skills that require advanced education and training beyond the basic baccalaureate nursing curriculum.

The NP survey contained 7 questions, and the PA survey had 5 questions. The additional 2 questions for the NP survey asked about the types and size of NP programs offered within the institution. The surveys used identical language with the 5 questions, except that each survey was tailored to address the specific professional group (ie, PA director or NP director). NP program directors were asked to focus their answers based on the largest NP track within their school. Of the 5 questions that were identical to both groups, question 1 asked the NP and PA directors how much time was spent on each of the 9 procedural skills and diagnostic and laboratory tests within the curriculum. Program directors were provided 5 options to answer the question. The options were, "1–2 hours," "3–4 hours," "5–6 hours," "more than 6 hours," and "no time specifically devoted." Question 2 focused on the importance of teaching each of the 9 procedural skills and diagnostic and laboratory tests to prepare the NP and PA graduates, respectively. The response options were similar to question 1 in that participants were provided 5 forced choices that included "topic not needed," "minimal importance," "some importance," "substantial importance," and "utmost importance." Questions 3 and 4 inquired about teaching methodologies and the frequency of teacher-student contact. The last question asked program directors to rate the level of importance of continuing education on each of the 9 procedural skills and diagnostic and laboratory tests. The response options mirrored those options used for question 2.