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Development and Implementation of a Clinical Competency Career Ladder for Advanced Practice Providers
Basia Adams1, Amirul Anuar, Garry Lapidus
1Author Affiliations: Co-Director (Dr Adams), Office of Advanced Practice Providers, Connecticut Children's, Hartford, CT; Biostatistician (Anuar), Research Operations and Development, Connecticut Children's, Hartford, CT; Co-Director (Lapidus), Office of Advanced Practice Providers, Connecticut Children's, Hartford, CT.
Objectives:
Evaluate the understanding of an Advanced Practice Provider (APP) career ladder designed to promote growth and address salary compression.
Background:
APPs are essential to academic medical centers. Targeted ladders may support recruitment, engagement, and retention.
Methods:
In 2023, a 4-level APP career ladder was launched at the Northeast Pediatric Health System for nurse practitioners and physician assistants. Pre-post surveys assessed implementation and compensation understanding. A 2-way ANOVA tested pre-postsurvey effects.
Results:
Most APPs agreed or strongly agreed that a career ladder clarifies clinical competencies (54% pre vs. 72% post) and provides a development pathway (69% pre vs. 77% post). Knowledge differed by practice location, with outpatient APPs reporting lower knowledge than inpatient peers ( P =0.016). Understanding of salary compensation was stable with a small, nonsignificant post increase.
Conclusions:
The ladder clarified competencies, supported growth, and recognized APP contributions. Nurse executives should consider implementing competency-based ladders to strengthen this workforce.
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