Date of Award

January 2026

Document Type

Open Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)

Department

Yale University School of Nursing

First Advisor

Joan Kearney

Abstract

AbstractGERD Mastery for the Advanced Practice Provider: A Train-The Trainer Program

Background: This Doctor of Nursing Practice (DNP) project addressed a specialty-care gap in gastroenterology driven by the projected U.S. shortage of ~1,630 gastroenterology physicians. Gastroesophageal reflux disease (GERD) has a high prevalence and cost burden as is, but delayed treatment can further increase costs (Barrett’s esophagus ~$8,755/year; esophageal adenocarcinoma ~$146,391/year) and patient morbidity.

Purpose: To develop and implement “GERD Mastery for the Advanced Practice Provider,” an evidence-based train-the-trainer (TTT) program to increase guideline-concordant GERD knowledge and train others. Methods: In partnership with a national organization, a Plan–Do–Study–Act framework guided expert panel review and delivery of a 3-hour synchronous Zoom training. Knowledge was measured with a 10-item multiple-choice pre/post test; perceptions were collected via Likert items and open-ended feedback (Qualtrics).

Results: Seventeen APPs completed the program. Pre-test scores ranged 4–10 (mean 6.5) and post-test scores ranged 6–10 (mean 8.0); 12 improved and none declined. A paired t-test showed a significant knowledge increase (mean difference 1.47, SE 0.31; t(16)=4.74, p=0.0002). Participants reported high value, increased confidence, and willingness to recommend, with suggestions to slow pacing and add more case-based interactivity. Conclusions: The program was low cost to develop and deliver (estimated direct cost $719) and supports TTT-based standardized specialty education as a scalable strategy to strengthen APP readiness, expand access to evidence-based GERD care, and reduce downstream costs from delayed diagnosis and disease progression due to physician shortage.

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This is an Open Access Thesis.

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