Mentorship Impact for Advanced Practice Registered Nurses and Physician Assistants/Physician Associates

doi:10.21203/rs.3.rs-3340710/v1

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Research Article

Mentorship Impact for Advanced Practice Registered Nurses and Physician Assistants/Physician Associates

https://doi.org/10.21203/rs.3.rs-3340710/v1

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Objective

Mentorship has many notable benefits, including academic advancement and career satisfaction. Limited research regarding mentorship for Advanced Practice Registered Nurses (APRNs) and Physician Assistants/Physician Associates (PAs) exists.

Methods

A survey was sent via email to all APRNs and PAs at a single academic medical center. The univariable analysis included Chi-square and Kruskal-Wallis tests to compare those with and without a mentor. The multivariable analysis determined independent predictors of factors associated with mentorship.

Results

The response rate was 32.4% (n = 934). 185 (19.8%) identify having a mentor. Multivariable analysis shows those with a mentor are statistically more likely to function as a mentor (OR 1.8 [1.2–2.7], p = .003), have an academic rank of assistant professor or higher (OR 2.9 [1.7–4.9], p = .001), be < 45 years old (OR 2.6 [1.6–4.2], p < .001), and be < 10 years into their career (OR 1.8 [1.2–2.8], p = .006). Those with a mentor are statistically more likely to be satisfied with mentorship (84.3% vs. 25.1%, p < .001) and agree mentorship was important for academic success (80.5% vs. 7.3%, p < .001) and attaining leadership positions (69.7% vs 48.2%, p < .001).

Conclusion

This study demonstrates that mentorship for APRNs and PAs is imperative and can profoundly affect academic and career satisfaction. Future research may explore more profound organizational and professional benefits of mentorship among APRNs and PAs.

Mentor

Academic Rank

Nurse Practitioner

Physician Associate

Physician Assistant

Advanced Practice Registered Nurses (APRNs) and Physician Assistants/Physician Associates (PAs) are integral professions within healthcare. APRNs and PAs are versatile and have many career roles, which may include clinician, educator, researcher, and administrator. These roles require experience, time, guidance, and skills to be successful. Mentorship has been identified as a critical component of success in business, education, and medicine.^1–4 A mentor and mentee relationship may be established in different ways. This may include an informal, organic natural relationship based on mutual interest and goals, or through formal, structured, preassigned mentoring programs.^5–7 These relationships may be within the peer-to-peer, apprenticeship, reverse, functional, mosaic, succession, and/or nurturing models of mentorship.^8–12 What remains unknown are the current professional mentoring habits of APRNs and PAs, particularly the gaps in mentorship and differences in mentoring.

The primary aim of this study was to determine if APRNs and PAs employed at an academic medical center and its associated health system identify a mentor within their professional life and determine satisfaction and importance in their mentor-mentee relationship. The secondary aims were:

To determine if age, gender, full-time equivalency (FTE), primary employment, medical specialties/subspecialties, years of practice, location of practice, additional formal training beyond APRN/PA degree, or presence of a mentorship program are factors that predict the presence, or lack thereof, of a mentor in academic medicine.
To determine if having a mentor is more likely to lead to the APRN and PA having a leadership role or academic rank.
To determine if any leave of absence from practice amongst APRNs and PAs negatively impacts career trajectory.

Study Design

This study was approved by the Mayo Clinic Institutional Review Board (IRB) as a descriptive, correlational, cross-sectional study using a 23–40 question electronic survey tool¹³ modified specifically for APRNs and PAs (Supplemental Fig. 1). APRNs and PAs were identified by the Human Resources department by job code and degree. APRNs included certified nurse practitioners (CNP), certified nurse midwives (CNM), certified registered nurse anesthetists (CRNA), and certified nurse specialists (CNS). To ensure a shared understanding of the term mentor, we used a definition that included components of sponsorship. Regardless of the presence or absence of a mentor, respondents were asked to report the level of agreement or satisfaction with elements and characteristics of mentorship on a 5-point Likert scale.

The survey was conducted from June 20, 2022 to October 17, 2022. The survey was sent via email, and reminders were sent in 2-week intervals. No incentive or compensation was offered to complete the survey. All received written information about the purpose of the study, and informed consent was obtained. No personal identifiers were collected. Data was collected and managed using REDCap (Research Electronic Data Capture), a secure electronic data capture tool.¹⁴

Statistical Analysis

Survey answers were described using frequency counts and percentages for categorical variables and median and interquartile range [IQR] for continuous variables. Chi-square and Kruskal-Wallis tests were used to compare categorical and continuous variables between participants with and without mentors and between APRNs and PAs. Multivariate analysis was conducted to determine independent predictors of factors associated with mentors, presented as odds ratios [OR] and 95% confidence intervals (CI). Likert scale responses were grouped for analysis. Agree and strongly agree were defined as “agree,” and neutral, disagree, and strongly disagree were defined as “not agree”. Satisfied and very satisfied were defined as “satisfied,” and neutral, unsatisfied, and very unsatisfied were defined as “not satisfied”. SAS statistical software was used for the analyses (SAS Institute Inc., version 9.4). Statistical significance was p < 0.05.

Respondents

The survey was sent to 2,882 APRNs and PAs, with 934 completing the survey (response rate 32.4%). Respondents include 632 (67.7%) APRNs and 295 (31.6%) PAs. Respondents are distributed across the academic medical center and health system. Respondent demographics are summarized in Supplemental Table 1.

Mentorship

185 (19.8%) identify having a mentor,198 (21.2%) identify their department/division as having a formal mentorship program, and 235 respondents (25.2%) function as a mentor to another colleague. Mentor demographics are summarized in Supplemental Table 2.

Through univariable analysis, itis statistically significant to more likely have a mentor when a division/department has a formal mentorship program (p < 0.001), be younger (p < 0.001), have fewer years of work experience (p < 0.001), holding academic rank, (p = 0.004) and functioning as a mentor to another (p < 0.001), Table 1. The location of the primary worksite is also statistically significant (p = 0.03), as some sites are more likely to have a mentor than others, Table 1. Gender identity, FTE, the primary role of employment, the primary area of clinical practice, having a leadership position, and additional formal training beyond the initial degree were not statistically significant. Factors associated with having a mentor are further summarized in Table 1.

The multivariate logistical analysis demonstrates that respondents who have a mentor are more likely to have a formal mentorship program (OR 3.6 [95% CI 2.5-5.3], p < 0.001), be a mentor to others (OR 1.8, [95% CI 1.2-2.7], p = 0.003), be 44 years old or younger (OR 2.6 [95% CI 1.6-4.2], p < 0.001), have < 10 years of work experience (OR 1.8 [95% CI 1.2-2.8], p < 0.001), and have academic rank of assistant professor or above (OR 2.9 [95% CI 1.7-4.9], p < 0.001), Table 2. Primary worksite and license/certification were not statistically significant, Table 2.

Absences

312 respondents (33.4%) noted a prolonged absence during their careers. This is equitable amongst APRNs (208, 32.9%) and PAs (99, 33.6%). When assessed by gender, absences are more common in women (37.5%). The most identified absence was parental leave (191, 61.2%). Most did not report a negative impact on career trajectory (266, 85.2%), but if reported, the most commented effect was missed clinical expertise (24, 60.0%), followed by missed leadership position (16, 40.0%), other negative impacts (9, 22.5%), or missed academic promotion (7, 17.5%).

Attitudes and Beliefs About Mentoring

Those with a mentor are statistically more likely than those without to agree that a mentor relationship helped network within the medical specialty (80.5% vs. 33.5%, p < 0.001), a mentor is important to attain a leadership position at the institution (69.7% vs. 48.2%, p < 0.001), a mentor is important to achieve academic success (80.5% vs. 57.3%, p < 0.001), and that it is important for their mentor to have the same gender/gender identity (11.9% vs. 6.2%, p = 0.01), Figure 1. Those with a mentor are also statistically more likely to be satisfied with the mentor-mentee relationship (84.3% vs. 25.1%, p < 0.001), Figure 1. There was no significant difference between groups in feeling that it is important for the mentor to be of the same race/ethnicity or that career trajectory would be better with a mentor, Figure 1.

Comparison of APRNs and PAs

The comparison of APRNs vs PAs is summarized in Table 3 and Figure 2. APRNs are statistically more likely to be women (p < 0.001), older (p < 0.001), have lower FTE (p < 0.001), work in a medical specialty (p < 0.001), have additional formal training (p = 0.02), and work in the main Minnesota campus (p < 0.001). There was no statistical difference between having a leadership position, academic rank, primary employment, or career stage, Table 3.

121 (19.1%) APRNs and 63 (21.6%) PAs identify having a mentor, which was not significantly different between groups (p = 0.55). APRNs are statistically more likely to have an APRN mentor (67, 55.4%) whereas PAs are more likely to have an MD/DO/MBBS mentor (28, 44.4%), p < 0.001. APRNs statistically had more female mentors (median 1 mentor, [IQR 1-2]) compared to PAs (median 1 mentor, [IQR 0-1]), p = 0.003, but fewer male mentors (median 0 mentors [IQR 0-1] vs. 1 mentor, [IQR 0-2]), p = 0.005. There was no statistical difference between the groups regarding having a mentorship program, mentor gender, mentor working within the academic institution, location of mentor within the academic institution, being of the same race/ethnicity as the mentor, or the overall number of mentors, Table 3. While there is no statistically significant difference between groups in terms of being a mentor to others, APRNs are statistically more likely to have a female mentee (p = 0.02), Table 3.

PAs are statistically more likely than APRNs to agree that a mentor is important to achieve academic success (68.5% vs. 58.7%, p = 0.009) and career trajectory would have been better having a mentor (65.1% vs. 54.1%, p = 0.002), Figure 2. There was no statistically significant difference in agreeing that their mentor should have the same gender/gender identity, be of the same race/ethnicity, help network within medical specialty, that mentors help attain leadership, or satisfaction with mentorship, Figure 2.

To date, this study is the most robust survey of APRN and PA mentorship, encompassing a variety of clinicians through multiple states, practices, and licensures. The benefits of mentorship have been well established, including helping improve clinical knowledge¹⁵ and improve career outcomes such as job satisfaction and perception of promotion or career advancement.^6,16 Although most APRNs and PAs did not identify as having a mentor (185, 19.8%), up to 85% of respondents agreed that mentorship is important for career success, which is like other health professionals.¹⁷

As seen in other studies, our study supports a disconnect between the understanding of mentorship importance and the finding and keeping of a mentor.¹³ Within this organization, there is no formal mentorship program for APRNs or PAs, although if a mentorship program is available, there is a 3.6 times higher likelihood to have a mentor and nearly 2 times as likely to function as a mentor to another. Informal mentoring relationships have been found to produce more extensive and significant improvements in career outcomes.⁶ This does not negate the benefits of additional formal professional mentorship programs and relationships.

More than 90% identify their mentor as an employee of the academic medical center and its affiliated health system. Additionally, the respondents are primarily employed in clinical practice (97.9% APRNs and 98.6% PAs). The three largest areas of clinical practice are medical specialties, surgery and internal medicine. Although APRNs and PAs primarily work in clinical practice, their contributions also include quality improvement, research, and education. Despite this, 49.8% did not hold an academic rank, which evaluates contributions through practice, education and research. Mentorship has been shown to be vital to health professionals as they navigate their profession and organization.^{4, 18} Without a mentor, individuals may not know how to improve their practice or expand into education and research.

Those with a mentor are 2.7 times more likely to be under the age of 45 and almost twice as likely to be less than ten years into their career which matches a previous study.¹³ As of 2018, half of the APRN workforce is under the age of 45,¹⁹ and preliminary findings of the 2022 American Academy of Nurse Practitioners (AANP) report an average time in the practice of 9 years.²⁰ As of 2022, almost one-third of board-certified PAs have been practicing for five years or less, and nearly sixty percent are under the age of 40.²¹ Our participant demographics are like the demographics of the APRN/PA workforce. Nevertheless, it is likely that those earlier on in their career, who are generally younger, have sought out mentorship or have been part of a mentorship program (e.g., during the onboarding process) to help develop their skills. APRNs and PAs should proactively seek out mentors through their practice, state, or national societies early in their career to foster career growth, understanding that mentoring evolves with time as their career progresses.

Academic Rank

At our institution, 50% of APRNs and PAs hold an academic rank ranging from instructor to professor. Most hold the rank of instructor (37.8%), with fewer progressing to higher ranks. This aligns with studies demonstrating difficulty in the progression of academic rank in medicine, especially in women.^{18, 22–24} Those with a mentor are statistically more likely to achieve academic rank and are almost three times as likely to have progressed to the academic rank of assistant professor or higher. Our sample is mostly women, and women are less likely to have mentors.¹⁸ Identifying opportunities and lowering/eliminating barriers for women to obtain a mentor can help create decrease disparities.

Leadership

Approximately half of APRNs and PAs hold a leadership position, either internally or externally. Respondents are statistically more likely to believe that a mentor will help in obtaining a leadership position. Mentorship has been shown to help advance careers and develop leaders.²⁵ It is possible that those in leadership roles can benefit from mentorship to improve their leadership skills and their work unit. Leadership within healthcare can lead to better health outcomes, cost efficiency, and retention.^{26, 27} Obtaining an advanced degree was not associated with having a mentor, however, those with an additional degree are statistically more likely to hold a leadership position. We believe a mentor can assist in helping a mentee navigate pursuing an additional degree, thereby increasing the probability of leadership advancement.

Absences

Most APRNs and PAs did not perceive their career trajectory was impacted by a leave of absence. However, leaves of absence, particularly in women, have been associated with slower progression in academic rank and fewer leadership positions held.^{23, 28} Most of the respondents were women, and the most common reason for an absence was parental leave. Those that perceive a negative impact from an absence believe they missed out on leadership positions and academic promotion. This is important for fellow leaders to be aware of and to consider connecting more often to review goals with those who have had an absence.

Primary Worksite

Surprisingly, there is a statistically significant difference in the primary worksite of respondents; those with a mentor were more likely to work at the main academic medical center campuses as opposed to the associated health system. This was not corroborated by multivariate logistical regression; therefore, the relationship may not be impactful. To our knowledge, there is no literature regarding APRN and PA mentorship at smaller medical institutions. It could be said that within a smaller health system, there may be fewer staff with experience with being a mentor, leading to fewer mentors available to provide mentorship.

Differences Between APRNs and PAs

There were multiple statistically significant differences between APRNs and PAs. APRNs are more likely to be women, older, work in medical subspecialties and primary care, and have lower FTE. This matches the APRN workforce data showing predominantly women (90%), older (54% over age 45), and general or specialty inpatient or ambulatory care.¹⁹ Most PAs are women, but there are more men practicing as PAs. PAs are also younger, work in a surgical subspecialty, and have higher FTE. This matches the PA workforce data showing surgical subspecialties as the top practice area, predominately women, and younger age.²¹ While these differences are worth reporting, we do not feel that these differences alter the message regarding mentorship. The primary worksite was statistically different, which could be representative of sample bias. APRNs were more likely to have additional formal training, which is represented by the inclusion of clinical doctoral degrees in the survey, as the American Association of Colleges of Nursing endorsed the transition to clinical doctorate degrees for APRNs in 2004.²⁹

Our work revealed no statistical difference between APRNs and PAs having a mentor. However, mentors were statistically different; PAs were more likely to have a physician mentor, whereas APRNs were more likely to have an APRN mentor. This is important to consider when creating targeted interventions, as both professions show a similar prevalence of mentoring relationships yet differences in the mentor profession. APRNs and PAs are also statistically more likely to have a mentor when a division/department has a formal mentorship program. Organizations that promote APRN and PA academic rank and clinical expertise should consider offering mentorship and advisement with these goals in mind.

Targeted Interventions

We highlight the unique need for targeted mentorship of APRNs and PAs. We show mentorship gaps within the APRN and PA professions that serve as a framework for other organizations to assess mentorship in their department and institution. Increased socialization of known mentorship programs such as those with the American Academy of Physician Associates (AAPA) or the AANP should be partnered with.

We encourage APRNs and PAs to seek mentorship interprofessional and across disciplines. A prior study revealed PA leaders overwhelmingly could identify an influential physician mentor and were satisfied or very satisfied with their physician mentoring relationship.³⁰ Cross-disciplinary and interprofessional mentoring has many benefits.³¹ APRNs and PAs would most likely see fruitful outcomes from mentorship beyond their professions.

Finally, we encourage APRN and PA educators to have formal mentorship programs, separate from faculty advising. This early mentoring in the training phase can be in a vertical peer, horizontal peer or in an apprenticeship model.^{9, 32–34}

Limitations

Our study has several strengths, including the largest study of its kind, multisite involvement, and participant demographics like the APRN/PA workforce, which can increase external validity. However, there are some limitations. First, this is a single organizational study; therefore, results may be isolated to our institution. Mentorship is an element of organizational culture, and we included a multi-campus U.S. academic medical center and associated community health system. We acknowledge that mentorship, career advancement, and scholarly activities may not be as heavily encouraged or supported in non-academic medical centers. The response rate was 32.4% and ideally would have been higher, which may have been impacted by this study conducted during the COVID-19 pandemic. The participant’s responses perceptions of mentorship may have also been influenced by the pandemic. We acknowledge that respondents are mostly APRNs, which may result in differences and generalizability. While respondents were mostly women, this is consistent with the national workforce of APRNs¹⁹ and PAs.²¹ We did not track mentor/mentee dyads; for example, it is possible that persons identify themselves as a mentor, but their assumed mentee did not acknowledge the effort; thus, this mentorship may have been under-reported. Lastly, mentors may under-report their impact on mentees and may not consider the true number of people they are mentoring.

Further Research

Additional research is recommended to understand the significance and characteristics of APRN and PA mentorship. We would wish to explore APRN and PA mentorship independently and their unique characteristics. Further studies may identify opportunities and barriers for APRN and PA mentorship and development, including patterns in women and men. Innovative models for improving academic mentorship continue to be studied.³⁵ Finally, lack of mentorship versus lack of engagement and engagement with mentors is an important distinction for future research efforts.³⁶

The presence of formal mentorship programs and professional development regarding mentorship could increase the percentage of those who identify a mentor, thereby positively affecting the career outcomes and trajectory of mentor and mentee APRNs and PAs. The presence of formal APRN and PA educational training mentorship programs may also impact attitudes, beliefs, and participation in mentoring relationships. Mentorship has been shown to be impactful.² More research is needed to assess APRN and PA mentoring relationships, identify gaps and formulate informal and formal mentoring to optimize career progression and satisfaction.

Advanced Practice Registered Nurse (APRN), Physician Assistant/Associate (PA), full-time equivalent (FTE), certified nurse practitioners (CNP), certified nurse midwives (CNM), certified registered nurse anesthetist (CRNA), certified nurse specialists (CNS), REDCap (Research Electronic Data Capture), confidence interval (CI), American Academy of Physician Associates (AAPA), American Association of Nurse Practitioners (AANP)

Financial Support: Small grant funding supplied by the Office of Mayo Clinic Health System Research

Disclosures: The authors report no relevant disclosures related to this work.

Ethics approval and consent to participate

Informed consent was obtained from all the participants. This study was approved by the Mayo Clinic Institutional Review Board.

Consent for publication

Not applicable.

Availability of data and materials

All data generated or analyzed during this study is included in this published article and its supplementary information files.

Funding

Small grant funding supplied by the Office of Mayo Clinic Health System Research

Competing Interests

The authors declare no disclosures or competing interests.

Authors’ contributions

V.L., and J.H. contributed to the design and implementation of the research, to the analysis of the results and to the writing of the manuscript. B.S., H.S., E.C., contributed to project development and manuscript review. A.O. contributed to mentorship, project management and manuscript review.

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Table 1. Factors Associated with Having a Mentor

Variable (n, %)

With Mentor

N = 185

Without Mentor

N = 726

P value

Identified Having a Formal Mentorship Program

Yes

Did not respond

80 (43.2)

105 (56.8)

0 (0)

113 (15.5)

611 (84.2)

2 (0.3)

< 0.001

Function as a Mentor to Another Colleague

Yes

Did not respond

71 (38.4)

113 (61.1)

1 (0.5)

161 (22.2)

559 (77.0)

6 (0.8)

< 0.001

Gender/Gender Identity

Man

Woman

Other/Choose Not to Disclose

27 (14.6)

155 (83.8)

3 (1.6)

119 (16.4)

581 (80.0)

26 (3.6)

0.27

Age

18-24 years old

25-34 years old

35-44 years old

45-54 years old

55-64 years old

65+ years old

Did not respond

0 (0)

67 (36.2)

83 (44.9)

22 (11.9)

13 (7.0)

0 (0)

146 (20.1)

289 (39.8)

189 (26.0)

99 (13.7)

3 (0.4)

< 0.001

Stage in Career

0-3 years since training

4-6 years since training

7-9 years since training

10+ years since training

Did not respond

66 (35.7)

28 (15.1)

35 (18.9)

56 (30.3)

0 (0)

116 (16.0)

130 (17.9)

116 (16.0)

360 (49.5)

4 (0.6)

< 0.001

Primary Role of Employment

Clinical

Education/Research

Did not respond

181 (97.9)

3 (1.6)

1 (0.5)

708 (97.5)

14 (1.9)

4 (0.6)

0.84

Primary Area of Clinical Practice

Family Medicine

Internal Medicine

Surgical Specialty

Medical Specialty

Emergency Medicine

Did not respond

24 (13.0)

26 (14.1)

52 (28.1)

72 (38.9)

4 (2.1)

7 (3.8)

74 (10.2)

101 (13.9)

251 (34.6)

235 (32.4)

32 (4.4)

33 (4.5)

0.12

Academic Rank

Instructor

Assistant Professor/Associate Professor/Professor

Does not hold Academic Rank

Did not respond

65 (35.1)

36 (19.5)

83 (44.9)

1 (0.5)

279 (38.4)

76 (10.5)

370 (51.0)

1 (0.1)

0.004

Current Full-Time Equivalency

1.0

0.8-0.99

0.55-0.79

Less than 0.55

Did not respond

133 (71.9)

34 (18.4)

13 (7.0)

3 (1.6)

2 (1.1)

470 (64.7)

179 (24.7)

45 (6.2)

27 (3.7)

5 (0.7)

0.13

Leadership Position Held (Current or Previous)

Yes

96 (51.9)

89 (48.1)

369 (50.8)

357 (49.2)

0.90

Additional Formal Training Beyond APRN/PA Degree

Yes

Did not respond

47 (25.4)

138 (74.6)

0 (0)

172 (23.7)

545 (75.1)

9 (1.2)

0.66

Primary Worksite

Arizona Campus

Florida Campus

Main Minnesota Campus

Southeast Minnesota Region

Southwest Minnesota Region

Northwest Wisconsin Region

Southwest Wisconsin Region

Did not respond

29 (15.7)

36 (19.4)

87 (47.2)

9 (4.9)

12 (6.5)

8 (4.2)

3 (1.6)

1 (0.5)

94 (12.9)

132 (18.2)

312 (42.9)

38 (5.2)

65 (9.0)

39 (5.4)

42 (5.8)

4 (0.6)

0.03

Abbreviations: APRN – Advanced Practice Registered Nurse; PA – Physician Assistant/Associate

Table 2. Multivariate Logistical Regression: With or Without Mentor

Variable	Odds Ratio (95% CI)	P value
Identified Having a Formal Mentorship Program Yes vs No	3.6 [2.5-5.3]	< 0.001
License/certification APRN vs PA	1.0 [0.68-1.46]	0.99
Function as a Mentor to Another Colleague Yes vs No	1.8 [1.2-2.7]	0.003
Academic Rank Assistant Professor or Higher vs Instructor or None	2.9 [1.7-4.9]	< 0.001
Age 44 or Less Years vs 45+ Years	2.6 [1.6-4.2]	< 0.001
Stage in Career < 10 years vs10+ years	1.8 [1.2-2.8]	0.006
Primary Worksite Main AZ, FL, or MN Campus vs Regional Health System	1.2 [0.8-1.8]	0.49

Abbreviations: APRN – Advanced Practice Registered Nurse; AZ – Arizona; FL – Florida; MN – Minnesota; PA – Physician Assistant/Associate

Table 3. Comparison of Advanced Practice Registered Nurses (APRNs) vs Physician Assistants/Associates (PAs)

Variable (n, %)

APRN

P value

Demographics

N = 632

N = 295

Gender/Gender Identity

Man

Woman

Other/Choose Not to Disclose

81 (12.8)

529 (83.7)

22 (3.5)

73 (24.7)

216 (73.2)

6 (2.1)

< 0.001

Age

18-24 years old

25-34 years old

35-44 years old

45-54 years old

55+ years old

Did not respond

0 (0)

104 (16.5)

270 (42.7)

165 (26.1)

91 (14.4)

2 (0.3)

0 (0)

113 (38.3)

109 (36.9)

50 (17.0)

22 (7.5)

1 (0.3)

< 0.001

Stage in Career

0-3 years since training

4-6 years since training

7-9 years since training

10+ years since training

Did not respond

138 (21.8)

117 (18.6)

103 (16.3)

272 (43.0)

2 (0.3)

49 (16.7)

47 (15.9)

52 (17.6)

145 (49.2)

2 (0.6)

0.16

Primary Role of Employment

Clinical

Education/Research

Did not respond

614 (97.1)

15 (2.4)

3 (0.5)

289 (98.0)

4 (1.4)

2 (0.6)

0.42

Primary Area of Clinical Practice

Family Medicine

Internal Medicine

Surgical Specialty

Medical Specialty

Emergency Medicine

Did not respond

79 (12.5)

73 (11.6)

204 (32.3)

233 (36.9)

10 (1.6)

33 (5.1)

23 (7.8)

54 (18.3)

101 (34.2)

82 (27.8)

26 (8.8)

9 (3.1)

< 0.001

Academic Rank

Instructor

Assistant Professor/Associate Professor/Professor

Does not hold Academic Rank

Did not respond

231 (36.6)

73 (11.6)

328 (51.9)

0 (0)

122 (41.4)

39 (13.2)

133 (45.1)

1 (0.3)

0.17

Current Full-Time Equivalency

1.0

0.8-0.99

0.55-0.79

Less than 0.55

Did not respond

385 (60.9)

172 (27.3)

47 (7.4)

24 (3.8)

4 (0.6)

224 (75.9)

45 (15.3)

15 (5.1)

8 (2.7)

3 (1.0)

< 0.001

Leadership Position Held (Current or Previous)

Yes

317 (50.2)

315 (49.8)

153 (51.9)

142 (48.1)

0.63

Additional Formal Training Beyond APRN/PA Degree

Yes

Did not respond

167 (26.5)

461 (72.9)

4 (0.6)

56 (19.0)

234 (79.3)

5 (1.7)

0.02

Primary Worksite

Arizona Campus

Florida Campus

Main Minnesota Campus

Southeast Minnesota Region

Southwest Minnesota Region

Northwest Wisconsin Region

Southwest Wisconsin Region

Did not respond

94 (14.9)

82 (13.0)

311 (49.2)

28 (4.4)

35 (5.5)

49 (7.8)

29 (4.6)

4 (0.6)

70 (23.7)

48 (16.4)

97 (32.9)

21 (7.1)

23 (7.8)

14 (4.7)

1 (0.3)

< 0.001

Mentorship

Variable

Respondents

P value

Identified Having a Mentor (n, %)

Yes

Did not respond

632

121 (19.1)

492 (77.9)

19 (3.0)

295

63 (21.4)

231 (78.3)

1 (0.3)

0.55

Identified Having a Formal Mentorship Program (n, %)

Yes

Did not respond

632

489 (77.3)

140 (22.2)

3 (0.5)

295

238 (80.7)

57 (19.3)

0 (0)

0.31

Number of Mentors (n, %)

1 Mentor

2-3 Mentors

4-5 Mentors

6 or more Mentors

Did not respond

121

67 (55.4)

44 (36.4)

5 (4.1)

0 (0)

30 (47.6)

2 (3.2)

1 (1.6)

0 (0)

0.44

Gender Identity of Mentor (n, %)

Man

Woman

Other/Choose Not to Disclose

No mentor/did not respond

121

31 (25.6)

87 (71.9)

2 (1.7)

1 (0.8)

26 (41.3)

36 (57.1)

0 (0)

1 (1.6)

0.12

Number of Mentors by Gender Identity (median [IQR])

Man

Woman

Other/Choose Not to Disclose

0 [0-1]

1 [1-2]

0 [0-0]

1 [0-2]

1 [0-1]

0.003

0.005

Profession of Primary Mentor (n, %)

APRN

PA-C

MD/DO/MBBS

PhD

Other

No mentor/did not respond

121

67 (55.4)

15 (12.4)

35 (28.9)

1 (0.8)

3 (2.5)

0 (0)

15 (23.8)

19 (30.2)

28 (44.4)

0 (0)

1 (1.6)

0 (0)

< 0.001

Mentor works at our Academic Center/Associated Health System Sites (n, %)

Yes

No mentor/did not respond

121

108 (89.3)

12 (9.9)

1 (0.8)

58 (92.1)

3 (4.8)

2 (3.2)

0.24

Worksite of Primary Mentor

Arizona Campus

Florida Campus

Main Minnesota Campus

Southeast Minnesota Region

Southwest Minnesota Region

Northwest Wisconsin Region

Southwest Wisconsin Region

No mentor/did not respond

121

15 (12.4)

24 (19.8)

54 (44.7)

4 (3.3)

3 (2.5)

7 (5.8)

1 (0.8)

13 (10.7)

13 (20.6)

10 (15.9)

21 (33.4)

4 (6.3)

7 (11.1)

2 (3.2)

1 (1.6)

5 (7.9)

0.10

Same Race/Ethnicity as Mentor (n, %)

Yes

Choose not to disclose/did not respond

121

91 (75.2)

27 (22.3)

3 (2.5)

43 (68.3)

18 (28.5)

2 (3.2)

0.63

Function as a Mentor to Another Colleague (n, %)

Yes

Did not respond

632

149 (23.6)

477 (75.5)

6 (0.9)

295

84 (28.5)

210 (71.2)

1 (0.3)

0.12

Gender Identity of Primary Mentee (n, %)

Man

Woman

Other/Choose Not to Disclose

Did not respond

149

11 (7.4)

118 (79.2)

20 (13.4)

0 (0)

15 (17.9)

55 (65.4)

12 (14.3)

2 (2.4)

0.04

No competing interests reported.

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Mentorship Impact for Advanced Practice Registered Nurses and Physician Assistants/Physician Associates

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Introduction

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Study Design

Statistical Analysis

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Discussion

Academic Rank

Leadership

Absences

Primary Worksite

Differences Between APRNs and PAs

Targeted Interventions

Limitations

Further Research

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