Nurse‐practitioners (NPs) play an increasing role in the delivery of inpatient care, often within hospitalist programs. Work evaluating this collaborative relationship is limited. In other settings, qualitative studies have suggested there are role confusion and knowledge deficits that may impair physician/NP collaboration. However, no validated tool exists to effectively measure physician attitude toward and knowledge about NPs in acute care. We developed a simple survey to measure knowledge and attitudes in the domains that previous qualitative studies found to be critical.
A 30‐item survey with 20 Likert‐scale items was designed to address the key issues of scope of practice, collaboration, supervision, and NP patient outcomes; 6 questions pertained to NP scope‐of‐practice regulations, and 4 were demographic questions. Face validity was assessed by 2 NP faculty. Discriminate validity was assessed in 2 ways: by comparing the responses of NPs and physicians and by comparing physicians' responses according to comfort level. Survey responsiveness was determined by physicians' responses before and after an educational intervention.
To establish face validity, 2 NP experts agree that this 30‐question survey addresses key domains of a successful NP/physician collaborative relationship. Discriminate validity was reflected by significant differences (P < .05) between NPs and physicians in 22 of the 23 relevant items. Responses to 5 items had significant differences (P < .05), and responses to 7 items (P < .1) differed between physicians who are comfortable/very comfortable and those not comfortable and somewhat comfortable working with NPs. Responsiveness of the survey was demonstrated by a significant change (P < .05) in responses to 9 of the 23 items before and after an educational intervention.
This simple tool assesses major themes affecting physician/NP collaboration. Items within this tool adequately discriminate between NPs and physicians and among physicians with varying comfort levels working with NPs. The NP‐validated knowledge and attitude survey can be used to assess future educational interventions aimed at various providers to improve understanding of NP roles and responsibilities. Future work with this tool will include further refinement and testing in additional physician groups.
M. M. Forbes, None; T. E. Cardin, None; C. T. Whelan, Pfizer, research grants; TAP, research grants; SHM, research grants.
To cite this abstract:Forbes M, Cardin T, Whelan C. Validation of a Tool Measuring Physician Attitudes and Knowledge of Nurse‐Practitioners. Abstract published at Hospital Medicine 2007, May 23-25, Dallas, Texas Abstract 23. Journal of Hospital Medicine. 2007; 2 (suppl 2). https://www.shmabstracts.com/abstract/validation-of-a-tool-measuring-physician-attitudes-and-knowledge-of-nursepractitioners/. Accessed April 6, 2020.