Understanding Nurse Practitioner and Physician Assistant Scope and Education Team-based Care

Overview of NP and PA education and assessment

Before adding a non-physician clinician (NPC) to your team, carefully evaluate each candidate’s education, training and experience.

For NPs and PAs, education and training requirements are standardized, with established competencies for licensing and/or board certification.
Privileging allows NPCs to practice to their desired scope based on state regulations and their license and credentials.
NPCs’ previous clinical experience can vary greatly. For NPs, it's important to know about their education and training program to understand how much in-person experience they have gained. Including shadowing time as part of the interview experience can help you gauge an NPC’s expertise and comfort with a practice’s patient population to help identify onboarding and orientation needs.
All states have statutes and regulations governing scope of practice. Health systems and employers may have additional guidelines, policies, or procedures related to how NPCs practice within your environment.

NP vs. PA training comparison chart

Comparison area	Nurse Practitioners	Physician Assistants
Basics	Licensed clinicians who are trained in the advanced practice of nursing with a chosen population focus May practice independently in more than 30 states	Licensed clinicians who can practice medicine in every specialty and setting Nearly always work under supervision or collaboration with a physician
Education	Master’s or doctoral degree Virtual programs available Trained in advanced practice of nursing Must be a registered nurse (RN) with a nursing license At least 500 clinical hours Trained in chosen population focus area (family, adult/ gerontology, neonatal, pediatrics, women’s health, or psychiatric/mental health)	Master’s degree In-person education Curriculum modeled on medical school curriculum 2,000 hours of clinical rotations in family medicine, internal medicine, general surgery, pediatrics, obstetrics and gynecology, emergency medicine, and psychiatry Trained as a medical generalist Increasing number of residency opportunities available for specialization
Regulations	Regulated by state nursing boards In a handful of states, the medical board has some role in regulation	Regulated by state medical board (or separate PA board if the state has one)
Certification maintenance	100 hours of continuing education and 1,000 clinical hours every five years May take an exam as an alternative to 1,000 hours of clinical practice every five years Six certifying bodies (one for each population focus area)	100 hours of continuing medical education every two years Recertification every 10 years through an exam that evaluates general medical knowledge One certifying body

Training and experience interview questions

Asking the right questions can help you understanding each NPC’s education, training and experience. This can help you assess how an NPC will best fit into your practice and determine how to structure your onboarding and training plans.

When interviewing an NP or PA to hire, ask:

Are you board-certified and licensed to practice in this state?
What privileges have you obtained from former employers?
What can you tell us about your family medicine clinical rotations and care experiences?
What patient ages are you comfortable seeing?
Are you comfortable with medically complex patients?
(If an NP) Are you specifically trained in family medicine?
What level of experience do you have with the procedures that are common in our practice area?