Abstract
Purpose: An advanced practice provider (APP) career advancement pathway was developed to promote clinical excellence, enhance job satisfaction, reduce turnover, and improve retention at a major metropolitan National Cancer Institute–designated comprehensive cancer center. Data Sources: A comprehensive literature search was conducted using the PubMed electronic database. Conclusions: The Memorial Sloan Kettering Cancer Center (MSKCC) Advance Model, MSK’s APP Career Advancement Pathway of Excellence Theoretical Model, was established by integrating principles and tenants from the Strong Model of Advanced Practice Nursing and Benner’s Novice to Expert model. It comprises seven domains of scholarly engagement: direct comprehensive care, research, drivers of change, education, publications and professional leadership, technology and innovation, and mentorship. The model serves as the foundation for the formal career pathway program known as the MSK Ascend Program. The MSK Ascend Program recognizes and honors APP engagement in professional development, establishes a structured pathway for recognition and promotion, and provides a foundation for the continuous development and advancement of APP practice at MSK. Implications: Leadership support and commitment are critical to the successful implementation and sustainability of the Ascend Program. This commitment continues to drive professional growth and satisfaction among APPs. The development and iterative refinement of the program exemplify adaptability and an enduring dedication to advancing the MSK APP community.
References
Ackerman, M. H., Norsen, L., Martin, B., Wiedrich, J., & Kitzman, H. J. (1996). Development of a model of advanced practice. American Journal of Critical Care, 5(1), 68–73.
Ahn, Y. S., & Choi, J. S. (2023). Nurses’ perceptions of career ladder systems, job satisfaction and turnover intention: A cross-sectional study. Nursing Open, 10(1), 195–201. https://doi.org/10.1002/nop2.1294
Arthur, E., Brom, H., Browning, J., Bell, S., Schueler, A., & Rosselet, R. (2020). Supporting advanced practice providers’ professional advancement: The implementation of a professional advancement model at an academic medical center. The Journal for Nurse Practitioners, 16(7), 504–508. https://doi.org/10.1016/j.nurpra.2020.04.012
Benner, P. (1982). From novice to expert. The American Journal of Nursing, 82(3), 402–407. https://doi.org/10.2307/3462928
Chamblee, T. B., Dale, J. C., Drews, B., Spahis, J., & Hardin, T. (2015). Implementation of a professional portfolio: A tool to demonstrate professional development for advanced practice. Journal of Pediatric Health Care, 29(1), 113–117. https://doi.org/10.1016/j.pedhc.2014.06.003
Coleman, Y. A., & Desai, R. (2019). The effects of a clinical ladder program on professional development and job satisfaction of acute care nurses. Clinical Journal of Nursing Care and Practice, 3, 44–48. https://doi.org/10.29328/journal.cjncp.1001016
Dreyfus, S. E. (2004). The five-stage model of adult skill acquisition. Bulletin of Science, Technology & Society, 24(3), 177–181. https://doi.org/10.1177/0270467604264992
Essary, A. C., Bernard, K. S., Coplan, B., Dehn, R., Forister, J. G., Smith, N. E., & Valentin, V. L. (2018). Burnout and job and career satisfaction in the physician assistant profession. A review of the literature. National Academy of Medicine. https://doi.org/10.31478/201812b
Evans, A., Loera, K., Harris, D., Carson, S., Boutros, L., & Okuhara, C. (2019). Development, implementation, and satisfaction with a nurse practitioner professional ladder: A children’s hospital experience. Journal of Pediatric Health Care, 33(1), 111–116. https://doi.org/10.1016/j.pedhc.2018.06.008
Faris, J. A., Douglas, M. K., Maples, D. C., Berg, L. R., & Thrailkill, A. (2010). Job satisfaction of advanced practice nurses in the Veterans Health Administration. Journal of the American Academy of Nurse Practitioners, 22(1), 35–44. https://doi.org/10.1111/j.1745-7599.2009.00468.x
Han, R. M., Carter, P., & Champion, J. D. (2018). Relationships among factors affecting advanced practice registered nurses’ job satisfaction and intent to leave: A systematic review. Journal of the American Association of Nurse Practitioners, 30(2), 101–113. https://doi.org/10.1097/JXX.0000000000000006
Hansen, B. S., & Dysvik, E. (2022). Expanding the theoretical understanding in advanced practice nursing: Framing the future. Nursing Forum, 57(6), 1593–1598. https://doi.org/10.1111/nuf.12827
Harris, P. A., Taylor, R., Minor, B. L., Elliott, V., Fernandez, M., O’Neal, L., McLeod, L., Delacqua, G., Delacqua, F., Kirby, J., Duda, S. N., & REDCap Consortium (2019). The REDCap consortium: Building an international community of software platform partners. Journal of Biomedical Informatics, 95, Article 103208. https://doi.org/10.1016/j.jbi.2019.103208
Kaplow, R., & Reed, K. D. (2008). The AACN synergy model for patient care: A nursing model as a force of magnetism. Nursing Economic$, 26(1), 17–25.
Kauffman, K. R., Cline, G. J., & Hays, S. M. (2021). A ladder that matters: Conceptual development of a clinical ladder program for nurse practitioners and physician assistants. Journal of the American Association of Nurse Practitioners, 34(2), 230–237. https://doi.org/10.1097/JXX.0000000000000662
Kidd, V. D., Amin, A., Bhatia, N., Healey, D., Fisher, C., Rafiq, M., E Gallegos, M. J. A., & Munoz, K. (2023). Optimal use of advanced practice providers at an academic medical center: A first-year retrospective review. Cureus, 15(1), Article e34475. https://doi.org/10.7759/cureus.34475
Linzer, M., Jin, J. O., Shah, P., Stillman, M., Brown, R., Poplau, S., Nankivil, N., Cappelucci, K., & Sinsky, C. A. (2022). Trends in clinician burnout with associated mitigating and aggravating factors during the COVID-19 Pandemic. JAMA Health Forum, 3(11), Article e224163. https://doi.org/10.1001/jamahealthforum.2022.4163
McComiskey, C., Simone, S., Schofield, D., McQuillan, K., Andersen, B., Johannes, S., & Weichold, A. (2018). Professional advancement for advanced practice clinicians. The Journal for Nurse Practitioners, 14(1), 12–17. https://doi.org/10.1016/j.nurpra.2017.09.018
McGrath, B. A., Jacobs, M. L., Watts, R. M., & Callender, B. C. (2022). Developing and sustaining advanced practice provider services: A decade of lessons learned. Journal of Hospital Medicine, 17(12), 1014–1020. https://doi.org/10.1002/jhm.12932
Paplanus, L. M., Bartley-Daniele, P., & Mitra, K. S. (2014). Knowledge translation: A nurse practitioner clinical ladder advancement program in a university-affiliated, integrated medical center. Journal of the American Association of Nurse Practitioners, 26(8), 424–437. https://doi.org/10.1002/2327-6924.12082
Schlak, A. E., Poghosyan, L., Liu, J., Kueakomoldej, S., Bilazarian, A., Rosa, W. E., & Martsolf, G. (2022). The association between health professional shortage area (HPSA) status, work environment, and nurse practitioner burnout and job dissatisfaction. Journal of Health Care for the Poor and Underserved, 33(2), 998–1016. https://doi.org/10.1353/hpu.2022.0077
Scholtz, A. K., Ogle, S., Berry, A., Picard, B., Keashen, R., Felix, A., Bailer, A., & Hobbie, W. (2022). Supporting advanced practice providers through the development and implementation of an advanced practice provider professional advancement program. Journal of Pediatric Health Care, 36(2), 174–180. https://doi.org/10.1016/j.pedhc.2021.02.003
Slagle, A., Wakim, N., & Gray, S. E. (2023). A global examination of clinical ladder programs – A synthesis of commonalities and opportunities for standardization. Worldviews on Evidence-Based Nursing, 20(1), 56–63. https://doi.org/10.1111/wvn.12622