Implementing a needs assessment for new oncology advanced practice providers
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Implementing a Needs Assessment for New Oncology Advanced Practice Providers:. A Tailored Approach to Onboarding. Heather Brom, MS, RN, NP-C & Sharon Steingass, MSN, RN, AOCN ®

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Implementing a Needs Assessment for New Oncology Advanced Practice Providers:

  • A Tailored Approach to Onboarding.

  • Heather Brom, MS, RN, NP-C & Sharon Steingass, MSN, RN, AOCN®

  • The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute

Needs Assessment

Goal Setting


  • A modified needs assessment tool was created using the 2009 ONS Bridging the Gap Working Group Survey to tailor the clinical orientation processstarting Fall 2014 (n=20)

  • As part of the onboarding process, the advanced practice educator sends each new APP a link to an electronic survey.

  • Results are reviewed by the advanced practice educator with the new APP and preceptor to make them both aware of the new APP’s educational needs. Together goals are created and integrated into their unique onboarding experience. Examples include:

    • Within the first two weeks of onboarding, develop a standard approach to patient presentation.

    • Review and become familiar with disease specific NCCN guidelines within the first six months  to improve knowledge and management of patient treatment plans.

    • Complete prescribing formulary quiz to increase understanding of prescriptive authority within the first month.

    • Within the first three months, meet with clinical trials specialist to increase understanding of current trials and process of patient recruitment and enrollment.

  • In just the short time, we have found our new APPs eager to complete the survey. Both the orientee and the preceptor appreciate having more specific goals to attain during the orientation process and an advanced practice educator as a resource to them both.

Individualizing the clinical onboarding process for advanced practice providers using a needs assessment tool.


  • Predicted shortage of oncologists is 2,000 to 4,000 by 2020

    • Advanced practice providers (APPs) – clinical nurse specialists, nurse practitioners, and physician assistants will fill this gap

  • The challenge:

    • Lack of formal oncology training

    • Reports of 60-81% of oncology APPs receiving on the job training from collaborating/supervising physicians.

    • The majority of new oncology NPs (61-78%) feel not at all or somewhat prepared to deal with many common oncology issues such as chemotherapy, oncologic emergencies, and drug toxicities.

  • With the oncology APP workforce growing and its known educational deficits, it is incumbent on employers to find novel solutions to this challenge.

Next Steps

Our Experience – Describing our APP Staff

  • The graph below provides a snapshot of our participant group – looking at their experience in oncology as well as within the role of the APP. The past 12 months we have onboarded 42 APPs to our organization, representing 23% of our APP workforce.

  • We are considering repeating the needs assessment at three, six, and twelve month intervals to track the new APP’s progress over time.

  • Other outcomes of interest include retention, physician satisfaction, and new employee engagement.

  • Further analysis will include comparing our role and oncology experience and needs assessment findings to national averages.


Bajorin, D. F. & Hanley, A. (2011). The study of collaborative practice arrangements: Where

do we go from here? Journal of Clinical Oncology, 29(27), 278-282.

Rosenzweig, M., Giblin, J., Mickle, M., Morse, A., Sheehy, P., Sommer, V., & The Bridging the Gap Working Group. (2012). Bridging the gap: A descriptive study of knowledge and skill needs in the first year of oncology nursing practice. Oncology Nursing Forum, 39(2), 195-201.

*indicates average score of less than limited experience

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