title: Improvement of resident perceptions of nurse practitioners after the introduction of a collaborative care model: a benefit of work hour reform?
abstract: BACKGROUND
  Nurse practitioners (NPs) are assuming larger roles in many residency programs as a result of work hour reform, which is creating the potential for collaboration with interns and residents.
  
  
  OBJECTIVE
  To assess housestaff perceptions of NPs.
  
  
  METHODS
  We used a 17-item survey before and after the implementation of a collaborative care model in a university-based medicine residency.
  
  
  RESULTS
  The majority of residents held favorable attitudes about NPs before the introduction of the collaborative care model. After 1 year, more interns and residents appreciated NPs' clinical judgment (effect size [ES] = .26, p =.02), thought they should be able to order laboratory tests (ES = .23, p = .05) and perform basic procedures (ES = .67, p < .0001), and viewed them as colleagues (ES = .25, p = .04). Only a minority felt NPs contributed to their education.
  
  
  CONCLUSIONS
  The promotion of collaborative care can be an unintended consequence of work hour reform. Educators are encouraged to think about how changes in the curriculum structure can provide opportunities for positive collaborative care experiences.
authors.affiliation: Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA. bellini@mail.med.upenn.edu
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Bellini
authors.forename: Judy A
authors.initials: JA
authors.lastname: Shea
mesh_terms: D003299:Cooperative Behavior; D019538:Health Care Surveys; D006785:Hospitals, University; D006787:Hospitals, Veterans; D006801:Humans; D007396:Internship and Residency; D007400:Interprofessional Relations; D009722:Nurse Practitioners; D010348:Patient Care Team; D012938:Social Perception; D016526:Workload / Q000592:standards