Advanced practice providers (APPs), which include nurse practitioners and physician assistants, may benefit from formal postgraduate educational programs catered to developing specialty competence and facilitating the transition to clinical practice, according to research published in the Journal of Medical Education and Curricular Development. Currently, APPs are not required to participate in residency programs before practicing, but as the demand for these clinicians continues to grow, implementing standardized training in specialties that involve high-risk patient populations may expedite the acquisition of skill sets.  

The study investigators developed a training program for APPs who did not have previous experience in critical care. The program included a simulation-based boot camp that sought to train APPs in high-risk procedures commonly performed in the intensive care unit, common critical care skills, and leadership development for high-risk cases.

A total of 9 AAPs (1 with previous critical care experience) participated in the program. In a pre-boot-camp medical knowledge assessment exam, participants scored an average of 84%. In a procedural simulation-based assessment, students scored an average of 88%. In pre- and post-boot-camp self-efficacy assessments consisting of 15 items, APPs scored 50 out of 75 and 62 out of 75, respectively, which represented a mean increase of 0.8.

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The greatest improvements in average pre- and post-item responses were for feeling adequately prepared to place an intraosseous line, intubate during a code blue resuscitation, provide orders in a closed-loop fashion, and use difficult airway equipment. The researchers noted that this interactive curriculum, which contained minimal lecture time, was a valuable learning experience for both the students and their instructors.

“[I]t is our hope that this experience with the implementation, delivery, and evaluation of this simulation-based boot camp may be of value to other educational leaders seeking to provide skills training to APPs new to disciplines that involve invasive procedures and high-risk patient presentations,” the researchers concluded.


Ahmed RA, Botsch A, Derek B, et al. Advanced practice provider critical care boot camp: a simulation-based curriculum[published April 8, 2019]. J Med Educ Curric Dev. doi:10.1177/2382120519840350