Preparing Nurse Practitioners and Physician Assistants for Effective Roles in Graduate Medical Education: A Framework for Onboarding, Role Clarity, and Patient Safety

Health care delivery models have increasingly integrated nurse practitioners (NPs) and physician assistants (PAs) as essential members of interprofessional teams within graduate medical education (GME). While initially utilized to support clinical coverage and duty-hour compliance, NP and PA roles have expanded to include meaningful contributions to trainee education, healthcare team function, and continuity of patient care. This article proposes a structured framework for NP and PA onboarding and professional development across five key domains: accreditation requirements, role clarification and supervision, interprofessional teamwork and communication, patient safety and handoffs, and ongoing educational development. Enhancing NP and PA understanding of GME expectations and regulatory standards, particularly those outlined by the ACGME, may optimize their impact on both trainee learning and patient outcomes. Strengthening NP and PA integration through targeted education and development opportunities may improve team-based care, promote patient safety, and enrich the clinical learning environment.