Background: The Advanced Practice Fellowship at the University of Colorado Hospital is a 13-month post-graduate program designed to provide Nurse Practitioners and Physician Assistants with the medical knowledge and clinical skills necessary to practice hospital based medicine. As part of the program, Advanced practice fellows (APFs) have historically attended the internal medicine case conference, which is designed and led by internal medicine residents. However, APFs had low attendance and minimal participation. We hypothesized this was based on a variety of factors including: cultural barriers to participation including a sense of intimidation, topics that were not relevant to the APF’s clinical setting, and lack of peer support.
Purpose: Educational literature supports the concept of peer-to-peer learning as a superior method of clinical training and fostering a safe educational environment. There was a significant deficit in the APFs educational experience due to lack of peer-peer specific learning opportunities. In response, we created an APF specific report, mirrored upon the structure and objectives of the internal medicine case conference, with the goal of creating an environment where APFs were encouraged to attend, felt safe participating, and with a focus on learning topics designed specifically to APFs needs.
Description: We developed a monthly interactive case based series geared specifically towards APFs, in hopes of addressing clinically pertinent topics in a safe learning environment. These one-hour long sessions focused on the most common hospital presentations, pertinent differential diagnoses, and diagnostic and therapeutic plans to consider as an Advanced Practice Provider practicing in a hospital based setting. Following conference, the APFs completed an evaluation form.
Conclusions: There has been an improvement in attendance to the case conference: prior to the APF specific report, APF attendance at Resident Report was self reported at less than 25%; since starting our report we have seen increases in attendance to greater than 75%. Attendees complete evaluations following the lectures, with the following results: on a scale of 1-5 (5 being excellent, 1 being poor) 100% of participants have found these lectures to be excellent, 85% of participants have stated these lectures are excellent at eliciting curiosity and 83% of participants find APF conference is a safe place to ask clinical questions. 100% of participants believe that the APF report is a valuable learning experience and that it has improved their clinical reasoning. Advanced Practice Fellows benefit from a dedicated educational conference to meet their needs, with a focus on creating differential diagnoses, diagnostic and therapeutic plans. Development of the APF report increased both attendance and participation as compared to the resident led case conference.