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Updated: Jan 16, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Patient perception of nurse practitioner care, nurse practitioner scope of practice, and how that influences provider
Naomi Hemp1, Lisa Walker-Vischer1, Jordan Rose2
1The Valley Foundation School of Nursing, San José State University, San José, California.
Background:
California is experiencing a shortage of primary care providers, contributing to delayed access and inappropriate emergency department utilization. Although recent legislation is moving nurse practitioners (NPs) toward full practice authority, public misconceptions about their scope may hinder their effective integration into the primary care workforce.
Purpose:
This study aims to assess patient perception of NP care versus physician care, patient understanding of NP scope of practice, and how those perceptions influence provider choice. Findings can help inform legislative and clinical decisions regarding NP autonomy in California.
Methodology:
A cross-sectional design gathering quantitative data by a one-time anonymous Qualtrics survey was disseminated.
Results:
The sample (N = 24) was predominantly female (75%), aged 30-49 years (50%), White (75%), and non-Hispanic/Latino (66.67%), with 45.83% holding a master's degree or higher. A paired samples t -test showed significantly more favorable perceptions of care by NPs (M = 4.76, SD = 0.33) than MDs (M = 4.42, SD = 0.67), t (22) = -2.85, p = .009, d = 0.59. Regression analyses showed no significant demographic predictors. Substantial gaps in knowledge of NP scope and legislation were identified.
Conclusion:
Findings suggest NPs are perceived favorably relative to physicians; however, limited public understanding of NP scope of practice underscores the need for targeted educational initiatives. Although demographic variables were not significant predictors, future longitudinal research with larger, more diverse samples is essential to substantiate these findings and inform evidence-based policy development.
Implication:
Expanding public understanding of NP roles is essential to support policy changes and optimize primary care access and delivery.
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