Bridging the Gap: A Descriptive Study of Knowledge and Skill Needs in the First Year of Oncology Nurse Practitioner Practice

Margaret Rosenzweig

Joan Giblin

Marsha Mickle

Allison B. Morse

Patricia Sheehy

Valerie Sommer

Bridging the Gap Working Group

ONF 2012, 39(2), 195-201. DOI: 10.1188/12.ONF.195-201

Purpose/Objectives: To identify the knowledge and skill needs of oncology nurse practitioners (ONPs) as they enter cancer care practice, and to identify necessary educational resources.

Design: Cross-sectional, descriptive.

Setting: A national e-mail survey.

Sample: 610 self-described ONPs from the Oncology Nursing Society's database.

Methods: The project team developed a 28-item electronic survey. The survey was randomly distributed via e-mail.

Main Research Variables: ONPs' feelings of preparedness in the first year of ONP practice.

Findings: In the first year of practice, 90% of ONPs rated themselves as prepared or very prepared in obtaining patient history, performing physical examination, and documenting findings. ONPs rated themselves as not at all or somewhat prepared in clinical issues of chemotherapy/biotherapy competency (n = 81, 78%), recognizing and managing oncologic emergencies, (n = 77, 70%), and recognizing and managing drug toxicities (n = 63, 61%). The primary source of oncology education for ONPs new to practice was almost exclusively the collaborating or supervising physician (n = 84, 81%).

Conclusions: Specific knowledge and skills, such as information about chemotherapy, oncologic emergencies, and side effects of therapy, are needed before an ONP enters a cancer care practice.

Implications for Nursing: Cancer-specific education should be made available to new ONPs as they begin independent practice.

Jump to a section


    Akscin, J., Barr, T., & Towle, E. (2007). Benchmarking practice operations: Results from a survey of office-based oncology practices. Journal of Oncology Practice, 3, 9-12. doi:10.1200/JOP.0712504
    American Academy of Nurse Practitioners. (2007). Quality and cost-effectiveness of NP care. Retrieved from
    American Nurses Association. (2008). APRN Consensus Work Group and the National Council of State Boards of Nursing APRN Advisory Committee. Retrieved from
    American Society of Clinical Oncology. (2007). 2008-2013 workforce strategic plan to ensure continuing access to quality cancer care. Retrieved from
    Bahouth, M. N., & Esposito-Herr, M. B. (2009). Orientation program for hospital-based nurse practitioners. AACN Advanced Critical Care, 20, 82-90. doi:10.1097/NCI.0b013e3181945422
    Bishop, C. S. (2009). The critical role of oncology nurse practitioners in cancer care: Future implications. Oncology Nursing Forum, 36, 267-269. doi:10.1188/09.ONF.267-269
    Bryant-Lukosius, D., & Dicenso, A. (2004). A framework for the introduction and evaluation of advanced practice nursing roles. Journal of Advanced Nursing, 48, 530-540. doi:10.1111/j.1365-2648.2004 .03235.x
    Cunningham, R. (2004). Advanced practice nursing outcomes: A review of selected empirical literature. Oncology Nursing Forum, 31, 219-232. doi:10.1188/04.ONF.219-232
    Erikson, C., Salsberg, E., Forte, G., Bruinooge, S., & Goldstein, M. (2007). Future supply and demand for oncologists: Challenges to assuring access to oncology services. Journal of Oncology Practice, 2, 79-86. doi:10.1200/JOP.0723601
    Focus on Staff. (2007). Oncology education for nurse practitioners and physician assistants. Journal of Oncology Practice, 3, 269-270.
    Hayes, E. (2007). Nurse practitioners and managed care: Patient satisfaction and intention to adhere to nurse practitioner plan of care. Journal of the American Academy of Nurse Practitioners, 19, 418-426. doi:10.1111/j.1745-7599.2007.00245.x
    Hoffman, L. A., Tasota, F. J., Zullo, T. G., Scharfenberg, C., & Donahue, M. P. (2005). Outcomes of care managed by an acute care nurse practitioner/attending physician team in a subacute medical intensive care unit. American Journal of Critical Care, 14, 121-132.
    Kinney, A. Y., Hawkins, R., & Hudmon, K. S. (1997). A descriptive study of the role of the oncology nurse practitioner. Oncology Nursing Forum, 24, 811-820.
    McMillan, S. C., Heusinkveld, K. B., & Spray, J. (1995). Advanced practice in oncology nursing: A role delineation study. Oncology Nursing Forum, 22, 41-50.
    Murphy-Ende, K. (2002). Advanced practice nursing: Reflections on the past, issues for the future. Oncology Nursing Forum, 29, 106-111. doi:10.1188/02.ONF.106-112
    Nevidjon, B., Rieger, P., Miller Murphy, C., Rosenzweig, M. Q., McCorkle, M. R., & Baileys, K. (2010). Filling the gap: Development of the oncology nurse practitioner workforce. Journal of Oncology Practice, 6(1), 2-6. doi:10.1200/JOP.091072
    Oncology Nursing Society. (2007). Oncology nurse practitioner competencies. Retrieved from
    Patlak, M., & Levit, L. (2009). Ensuring quality cancer care through the oncology workforce: Sustaining care in the 21st Century: Workshop summary. Retrieved from
    Rosenzweig, M. Q., & Roth, E. (2010). Ensuring safety and quality in cancer care: An educational template for the oncology nurse practitioner. Retrieved from
    Rudy, E. B., Davidson, L. J., Daly, B. J., Clochesy, J. M., Sereika, S., Baldisseri, M., … Ryan, C. (1998). Care activities and outcomes of patients cared for by acute care nurse practitioners, physician assistants: A comparison. American Journal of Critical Care, 7, 267-281.
    Skalla, K. A., & Caron, P. A. (2008). Building a collaborative hematology/oncology advanced nursing practice. Oncology Nursing Forum, 35, 29-32. doi:10.1188/08.ONF.29-32
    Towle, E. L., Barr, T. R., Hanlet, A., Kosty, M.,Williams, S., & Goldstein, M. A. (2011). Results of the ASCO study of collaborative practice arrangements. Journal of Oncology Practice, 7, 278-282. doi:10.1200/JOP.2011000385
    U. S. Census Bureau. (n.d.). Census regions of the United States. Retrieved from
    Warren, J. L., Mariotto, A. B., Meekins, A., Topor, M., & Brown, M. L. (2008). Current and future utilization of services from medical oncologists. Journal of Clinical Oncology, 26, 3242-3247. doi:10.1200/JCO.2007.14.6357
    Young, T. (2005). Utilizing oncology nurse practitioners: A model strategy. Community Oncology, 2, 218-224.