title: Transition to a new cancer care delivery system: opportunity for empowerment of the role of the advanced practice provider.
abstract: The purpose of the study was to obtain an in-depth understanding of the perceptions of advanced practice providers (APPs) with respect to their current roles in the context of the transition to a new cancer care delivery system, as well as factors that may influence their ability to practice at their level of training and education. Five focus groups were conducted with 15 APPs (11 nurse practitioners, 4 physician assistants). Data were collected by a recorder at each focus group. Four investigators reviewed the data from each group for accuracy and to generate an initial set of codes. Codes were compared across reviewers until consensus was reached and final themes were agreed upon. The mean age of the participants was 43.5 years (range: 27 to 63 years). The APPs practiced for an average of 11 years (range: 1 to 27 years), with a mean of 6.5 years in oncology (range: 1 to 11 years). Six themes were generated from the data related to the APP role during the transition to a new oncology care system: experiencing role tension, facing communication barriers, seeking mentorship, dealing with fragmented care, recognizing the need for professional growth, and navigating a new system. Our findings may inform administrators about the role of the APP in quality care delivery. These findings may empower APPs to practice to the full scope of their training and educational preparation, thereby facilitating their goals for professional development.
authors.affiliation: Yale School of Nursing, New Haven, Connecticut; Smilow Cancer Hospital at Yale-New Haven, Connecticut; CHE Consulting Group, Inc., Mt. Kisco, New York; White River Junction Veterans Affairs Medical Center, White River Junction, Vermont; Dartmouth College, Hanover, New Hampshire.
authors.forename: Ruth
authors.initials: R
authors.lastname: McCorkle
authors.affiliation: Yale School of Nursing, New Haven, Connecticut; Smilow Cancer Hospital at Yale-New Haven, Connecticut; CHE Consulting Group, Inc., Mt. Kisco, New York; White River Junction Veterans Affairs Medical Center, White River Junction, Vermont; Dartmouth College, Hanover, New Hampshire.
authors.forename: Constance
authors.initials: C
authors.lastname: Engelking
authors.affiliation: Yale School of Nursing, New Haven, Connecticut; Smilow Cancer Hospital at Yale-New Haven, Connecticut; CHE Consulting Group, Inc., Mt. Kisco, New York; White River Junction Veterans Affairs Medical Center, White River Junction, Vermont; Dartmouth College, Hanover, New Hampshire.
authors.forename: M Tish
authors.initials: MT
authors.lastname: Knobf
authors.affiliation: Yale School of Nursing, New Haven, Connecticut; Smilow Cancer Hospital at Yale-New Haven, Connecticut; CHE Consulting Group, Inc., Mt. Kisco, New York; White River Junction Veterans Affairs Medical Center, White River Junction, Vermont; Dartmouth College, Hanover, New Hampshire.
authors.forename: Mark
authors.initials: M
authors.lastname: Lazenby
authors.affiliation: Yale School of Nursing, New Haven, Connecticut; Smilow Cancer Hospital at Yale-New Haven, Connecticut; CHE Consulting Group, Inc., Mt. Kisco, New York; White River Junction Veterans Affairs Medical Center, White River Junction, Vermont; Dartmouth College, Hanover, New Hampshire.
authors.forename: Marianne
authors.initials: M
authors.lastname: Davies
authors.affiliation: Yale School of Nursing, New Haven, Connecticut; Smilow Cancer Hospital at Yale-New Haven, Connecticut; CHE Consulting Group, Inc., Mt. Kisco, New York; White River Junction Veterans Affairs Medical Center, White River Junction, Vermont; Dartmouth College, Hanover, New Hampshire.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Sipples
authors.affiliation: Yale School of Nursing, New Haven, Connecticut; Smilow Cancer Hospital at Yale-New Haven, Connecticut; CHE Consulting Group, Inc., Mt. Kisco, New York; White River Junction Veterans Affairs Medical Center, White River Junction, Vermont; Dartmouth College, Hanover, New Hampshire.
authors.forename: Ellyn
authors.initials: E
authors.lastname: Ercolano
authors.affiliation: Yale School of Nursing, New Haven, Connecticut; Smilow Cancer Hospital at Yale-New Haven, Connecticut; CHE Consulting Group, Inc., Mt. Kisco, New York; White River Junction Veterans Affairs Medical Center, White River Junction, Vermont; Dartmouth College, Hanover, New Hampshire.
authors.forename: Catherine
authors.initials: C
authors.lastname: Lyons