title: The expanding role of the nurse practitioner in an academic medical center and its impact on graduate medical education.
abstract: OBJECTIVE
  Academic medical centers (AMCs) have used nurse practitioners (NPs) for the provision of direct patient care for many years. However, as more NPs are hired to fill in the void created by both the 80-hour work week and the increased demands on attendings' time, their role has evolved in terms of patient care and graduate medical education. We sought to evaluate the expanded role of the NP in our large tertiary AMC to help clarify the interrelationships with the patient care delivery model and GME.
  
  
  METHODS
  Data were collected through interviews of NPs, nurses, attendings, and residents. Data were analyzed to identify trends contributing to successful models of practice and their impact on patient care and graduate medical education (GME).
  
  
  RESULTS
  Interviews were completed with 58/74 (78%) NPs employed at our medical center. Anonymous written surveys were completed by 41 (55%) providers. In terms of perceived impact on the role NPs played in GME, 77% of NPs surveyed felt that their role complimented the resident training; 9% felt that their role competed with resident training; and 14% felt that their role had no impact on resident training.
  
  
  CONCLUSIONS
  We believe that the presence of an experienced NP on a care deliver team can enhance the educational experience of residents as well as provide continuity of patient care in the era of the 80-hour work week.
authors.affiliation: University of Maryland Medical Center, Baltimore, Maryland 21201, USA.
authors.forename: Mona
authors.initials: M
authors.lastname: Bahouth
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Esposito-Herr
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Babineau
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration; D015142:Baltimore; D003695:Delivery of Health Care / Q000458:organization & administration*; D006784:Hospitals, Teaching; D006801:Humans; D007396:Internship and Residency; D007407:Interviews as Topic; D009722:Nurse Practitioners / Q000458:organization & administration; D024802:Nurse's Role; D015397:Program Evaluation; D000078329:Workforce