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Advanced practice providers (APPs) in radiation oncology perform many clinical tasks, especially follow-up visits. However, their roles and training vary significantly, highlighting a need for standardized responsibilities to improve cancer care.

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Area of Science:

  • Oncology
  • Medical Education
  • Healthcare Administration

Background:

  • Advanced practice providers (APPs), including physician associates (PAs) and nurse practitioners (NPs), are increasingly integral to radiation oncology practice.
  • Standardized, radiation oncology-specific training for APPs is currently lacking.
  • This study aims to clarify the diverse clinical roles of APPs within US radiation oncology settings.

Purpose of the Study:

  • To elucidate the current clinical responsibilities of APPs in US radiation oncology.
  • To assess how APP roles align with established professional activities (EPAs) in radiation oncology.
  • To identify gaps in training and practice standardization for APPs in this specialty.

Main Methods:

  • A survey was distributed to radiation oncology APPs across the US.
  • The survey collected data on demographics, training, practice structure, and clinical tasks.
  • Clinical tasks were evaluated using the 52 entrustable professional activities (EPAs) framework from the Radiation Oncology Education Collaborative Study Group (ROECSG).

Main Results:

  • A total of 121 APPs (37 PAs, 84 NPs) participated; many transitioned from other specialties.
  • APPs predominantly performed follow-up/survivorship visits (95%) and acute symptom visits (71%).
  • While 22 EPAs were performed by over 90% of APPs, significant variation existed, and many EPAs were rarely performed; only 2.5% received formal radiation oncology training during APP education.

Conclusions:

  • APPs in radiation oncology engage in a broad range of clinical activities, particularly in patient follow-up and survivorship care.
  • Significant variability exists in APP responsibilities and EPA performance across different practice settings.
  • Standardizing APP roles and enhancing specialized training are crucial for meeting cancer care demands and improving patient outcomes.