Health Workforce Pilot Project

The Health Workforce Pilot Project is training certified nurse-midwives, nurse practitioners and physician assistants in abortion care and provision at clinics across California.

Project summary | Curriculum overview | Key researchers

Part of the Primary Care Initiative, the Health Workforce Pilot Project (HWPP) #171 is a California-based, multi-site, six-year study of advanced practice clinicians (nurse practitioners (NPs), certified nurse-midwives (CNMs), and physician assistants (PAs) as providers of early aspiration abortion care. Operating under a mechanism of the California Office of Statewide Health Planning and Development (OSHPD), HWPP #171 is a pilot project of 60 advanced practice clinicians (APCs) who are being trained in abortion care and provision at health facilities around the state, using ANSIRH’s Early Abortion Training Workbook. At the end of six years, OSHPD and ANSIRH’s HWPP Project staff will analyze and publish the training and practice evaluation data on the safety and effectiveness of NPs, CNMs, and PAs as abortion providers.

The results of this pilot project will be made available to the California legislature, health professional organizations, and state regulating bodies to promote evidenced-based legal and regulatory decision-making in regards to the provisions of abortion care by NPs, CNMs and PAs. The results will also be shared with reproductive health advocates nationwide to expand the pool of abortion providers to include all clinicians with appropriate education, training and skill.

Curriculum overview

The HWPP training plan consists of didactic education and “hands on” clinical experience, along with knowledge testing and periodic clinical assessment with the goal to train nurse practitioners, certified nurse-midwives and physician assistants to competence in all aspects of early aspiration abortion care.

The HWPP curriculum is based on the ANSIRH Workbook in Early Abortion Care (UCSF Bixby Center in Reproductive Health Research & Policy, 2007).
The HWPP training plan is based on the TEACH Project (Training in Early Abortion for Comprehensive Health Care) on early abortion that is used to train residents and primary care physicians in California and nationwide, and is accredited by the Association of Reproductive Health Professionals (ARHP) for continuing medical education credit.

Nurse practitioners, certified nurse-midwives, and physician assistants train at participating sites that have extensive experience in abortion provision and training. Each trainee completes didactic and clinical training (to competency standards) in first-trimester aspiration abortion under the supervision of a physician trainer at a designated training site.

The physician trainers are experienced providers currently offering abortion services at an institution participating in the project. In order to conduct training, all physician trainers are required to have performed at least 200 procedures and to have an excellent safety record. All trainers will have received formal “train-the-trainer” instruction prior to training NPs, CNMs and PAs at their own institution.

Amy Levi, the HWPP Clinical Education Consultant, has been a Women’s Health NP since 1981, and a Certified Nurse-Midwife since 1986. In addition to her role as the clinical instructor with HWPP, she is the Co-director of the Nurse-Midwifery/WHNP Education Program at UCSF.

Learn more about the HWPP Curriculum.

Key researchers

Diana Taylor, RN, MS, PhD, Philip Darney, MD, MSc, and Tracy Weitz, PhD, MPA are the Principal Investigators for the HWPP Project. The project is staffed by Patricia Anderson, Director of the HWPP Project, Sheila Desai, Evaluator, and Roula AbiSamra, HWPP Coordinator.

This study has been approved by the Committee for Human Research at UCSF and operates as a pilot project under the Health Workforce Pilot Program (HWPP) a mechanism of California’s Office of Statewide Health Planning and Development (OSHPD).

For more information on the project, contact Molly Battistelli. And don't miss the HWPP newsletter.

Participating clinicians: Log in to the classroom site here.

For reproductive health news, see ANSIRH’s blog.