B59-03 Knowledge Assessment of Advanced Practice Providers on the Management of Incidental Pulmonary Nodules

Rationale The prevalence of incidentally identified lung nodules will continue to increase due to growing use of computed tomography (CT) for clinical purposes. Up to 60% of these pulmonary nodules are not followed as recommended, with 5% resulting in a lung cancer diagnosis. The aim of this study was to assess the knowledge of Advanced Practice Providers (APPs) regarding the management of incidental pulmonary nodules (IPN). Methods This study was deemed “Not human subject research” by the IRB committee. An electronic survey regarding lung nodules was completed by APPs within a health system across inpatient and outpatient academic and community practice sites from April 2025 to May 2025. The survey covered the following domains: 1) Participant characteristics (6 questions), 2) Knowledge assessment (10 questions), and 3) Resource utilization (1 question). Results The 84 participants included 49 (58.3%) Certified Registered Nurse Practitioners and 35 (41.7%) Physician Assistants. 69 (80.2%) surveys were completed; 17 (19.8%) were partially completed. 45 (53.6%) practiced within the Academic Practice Group and 39 (46.4%) at a Community Medical Group location. 15 (17.9%) of the Advanced Practice Providers worked inpatient, 61 (72.6%) worked outpatient, 7 (8.3%) had both inpatient and outpatient roles, and 1 (1.2%) worked in the Emergency Department. Participant APP experience: 22 (26.2%) with 1-3 years, 19 (22.6%) with 4-6 years, 21 (25.0%) with 7-10 years, 15 (17.9%) with 11-20 years, and 7 (8.3%) with 21+ years. Confidence levels were variable with 11 (13.1%) reporting not confident at all, 17 (20.2%) as slightly confident, 25 (29.8%) as somewhat confident, 25 (29.8%) as fairly confident, and 6 (7.1%) as completely confident. Ten multiple choice questions regarding lung nodule management demonstrated an overall correct score of 42.5%. Spearman correlation testing demonstrated a weak positive association between years of APP experience and confidence level, which was statistically significant, rs[84] =0.349, p 0.001. A one-way ANOVA revealed a statistically significant difference in average score related to confidence level, F-value 4.75, p = 0.002. No associations were identified when comparing average score to APP type or number of years as an APP. Multiple linear regression analysis identified no relationship between the average score and lung nodule resources utilized. Conclusions Research questions were grouped into four primary question management areas: low-risk, single nodule; high-risk, single nodule; high-risk, multiple nodule; subsolid nodule. The study revealed a knowledge gap in overall incidental pulmonary nodule management in all question areas. This abstract is funded by: None