Currently submitted to: JMIR Research Protocols
Date Submitted: May 21, 2026
Open Peer Review Period: May 21, 2026 - Jul 16, 2026
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Evaluation of evidence quality of nurse practitioner and physician assistant postgraduate training programs for program-level outcomes: A systematic review protocol
ABSTRACT
Background:
Transition to practice can be challenging for new-to-practice nurse practitioners (NPs) and physician assistants/associates (PAs). Internationally, there has been an increase in the number of postgraduate training programs across health care settings. A scoping review found that outcomes were reported in 60% of 216 articles. However, there is no evaluation and synthesis of associated program outcomes.
Objective:
By building upon earlier work, the purpose of this systematic review is to assess the evidence quality of the literature specifically reporting on program-level outcomes for NP and PA postgraduate training programs. We will appraise the rigor of outcomes measurement, analysis, and reporting.
Methods:
This review will follow the JBI approach for systematic reviews. MEDLINE (PubMed), CINAHL (EBSCOhost), Cochrane Library (Wiley) Cochrane Central Register of Controlled Trials, Social Science Database (ProQuest), and Health Source: Nursing/Academic Edition will be searched for articles published in peer-reviewed journals since 1990 and in English. Studies on NP and PA postgraduate training programs (residencies, fellowships, onboarding) reporting program-level outcomes (job placement, turnover and retention, productivity, and costs of programs) will be included. Studies using quantitative and mixed-methods study designs will be included. Conference abstracts, editorials/opinions, dissertations/theses, reviews, and qualitative studies will be excluded. Screening, data extraction, and critical appraisal will be conducted by 2 independent reviewers. Relevant data will be extracted, and the level of rigor of each study will be established using standardized critical appraisal tools.
Results:
This review began in June 2025, and searches of databases were completed in October 2025. The title and abstract screening stage was completed December 2025. As of May 2026, we have started full text screening.
Conclusions:
Understanding the quality of outcomes reporting of post-graduate training programs for NPs and PAs will be valuable to researchers, administrators, and clinicians, as findings can inform future program development, implementation, and evaluation. Clinical Trial: PROSPERO 2025 CRD420251091013
Citation
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