Setting Up for Success: Best Practices for Oncology APP Onboarding

In today’s evolving oncology landscape, advanced practice providers (APPs) are playing an increasingly vital role in delivering high-quality, team-based cancer care. That being said, even the most skilled clinicians need the right support and structure when stepping into the complex world of oncology; that’s where thoughtful, well-designed onboarding programs come in.  

The state oncology societies recently hosted a 3-part webinar series to explore proven onboarding and retention models for oncology APPs across different practice settings. These 60-minute webinars highlighted structural tools, mentorship strategies, and team-based approaches that help reduce burnout and help APPs build confidence and deliver high-quality cancer care. 

The first webinar, Setting up for Success: Best Practices in Oncology APP Onboarding, was hosted virtually on May 28. 

A Model From Academia: University of Colorado Cancer Center  

The webinar kicked off with Glen Peterson, DNP, ACNP, RN, APP education and quality director and hematology quality director at the University of Colorado Cancer Center in Aurora, Colorado, who reviewed APP onboarding perspectives from an academic cancer center.  

Dr. Peterson emphasized that onboarding isn’t just about checking boxes—it’s about building confidence, fostering community, and laying a solid clinical foundation. “Everyone has a different pace of learning,” he said. “So we focus on what is important for the APP going through orientation, making sure we support them for every phase and every need.” 

At the core of their approach is fostering a team culture rooted in support and shared success. “We always say: We’re going to make sure that you’re successful,” Dr. Peterson shared. “If they want to be part of the team, care about their colleagues, and care about patients, they will succeed.”  

Every APP at the University of Colorado Cancer Center undergoes a structured 14-week onboarding program regardless of previous experience. This consistency, Peterson explained, ensures that all new hires develop a shared foundation in the program’s culture, expectations, and clinical excellence.   

Key components of their onboarding program include:  

• Multiple preceptors for diverse perspectives and scheduling flexibility 
• Standard inpatient training for all APPs—even those headed to outpatient roles—to build clinical confidence and team familiarity  
• Procedural training through workshops and hands-on experience in the sedation suite, covering bone marrow biopsies, lumbar punctures, and more  
• Robust educational resources, including a SharePoint site for internal guidelines, recorded lectures, disease-specific modules, and hospital medicine training in partnership with a fellowship program.  

Each APP also receives a personalized orientation notebook with weekly goals, tasks, and educational content tailored to areas like CAR-T therapy. Preceptors and preceptees regularly review this notebook to align expectations, track progress, and provide feedback.   

The final key aspect of their APP support includes a “slow roll-off” approach, where they gradually transition to independent practice. The patient load is capped, their case complexity is managed, and weekly check-ins continue. “Post-orientation support is probably as important or sometimes more important than the orientation process,” Dr. Peterson noted. “The most important thing for us is to make sure APPs feel supported.”  

Bridging the Gap From Orientation to Independence: A Comprehensive Cancer Center Perspective  

Similar to academic medical centers, comprehensive cancer centers are equally innovative with onboarding models tailored to their unique practice environments. Jennifer Gray, DNP, ACNP-BC, AOCNP, assistant director of advanced practice at Atrium Health Levine Cancer Institute in Charlotte, North Carolina, offered a compelling look into how her institution creates a thoughtful and efficient onboarding experience for APPs entering high-volume, community-based oncology care.   

Atrium Health adapts its onboarding timeline to match each APP’s clinical background:   

• New graduates and specialty changers receive a 3-month onboarding experience.   
• Experienced APPs are typically onboarded over 6-8 weeks, though Dr. Gray emphasized that this process is “very much personalized to the APP and their previous experience.”  

Like many programs, Atrium Health doesn’t rely on just 1 preceptor. Instead, each new hire is assigned 2 to afford more schedule flexibility while maintaining some consistency, according to Dr. Gray.  

To ease the often-tricky transition from onboarding to full practice, Atrium Health has implemented a mentorship program for all new APPs. This program includes regular check-ins with a dedicated APP mentor, scheduled meetings with the supervising physician, and ongoing conversations with APP leadership. 

Key components of their onboarding model include: 

• A billing and regulatory course, including state board and APP-specific policies  
• Research compliance training, including CITI and GCP  
• A patient experience course, which Dr. Gray noted is “extremely detailed and central to” Atrium’s culture  
• Enrollment in the Advanced Practitioner Society for Hematology and Oncology’s Cancer Therapy Prescribing Course, which Dr. Gray called their “foundational course for new oncology hires.”  

For APPs assigned to specialty clinics, additional fellowship-level classes are included, along with shadowing opportunities designed to build institutional awareness and cross-team collaboration. Dr. Gray concluded, “[We want our APPs] to understand how to refer patients for different services and to start building relationships with those departments across the institution.”  

Scaling Support Across a Large Community Practice  

From New York Cancer and Blood Specialists (NYCBS), Jonathan Catrona, MS, PA-C, advanced practice clinical education specialist, explained that onboarding APPs means more than welcoming a few new faces—it’s about building a foundation for clinical excellence across dozens of sites and hundreds of providers. “We’re a very large community oncology practice in Long Island, New York,” said Catrona. “From Suffolk County to the Hudson Valley, we have over 30 locations and have about 10 to 20 hospitals that we cover.” 

NYCBS by the numbers encompasses:   

• 110 APPs in both inpatient and outpatient roles  
• Up to 15 new APP hires per year  
• Services across Long Island, New York City, and Westchester.  

Despite its size, NYCBS offers a highly structured and intentional onboarding process, shaped by the fast-paced realities of community oncology. Every APP candidate follows a 3-tiered vetting process: initial review by APP directors, a shadowing session with a seasoned APP, and input from their paired attending physician. This approach ensures that both parties feel confident in the match, especially given the system’s high-volume expectations. “Our APPs are expected to see around 12 to 20 patients per day. That’s 2 to 3 patients per hour,” Catrona explained.

NYCBS recently adopted a centralized 6-month onboarding program developed in collaboration with OneOncology, a national network of community cancer practices. Each new hire is paired with a dedicated APP preceptor and their partner physician. With the goal of full independence by the end of 3 months, the pace is individualized depending on experience:   

• 6-8 weeks for experienced APPs  
• A full 3 months for those newer to oncology  
• Highly experienced APPs are sometimes fast-tracked. 

To support experiential learning, NYCBS provides a custom training manual, guidance on oncology workups, treatment adverse effects, and diagnostic plans. The training manual also reiterates the importance of using up-to-date and peer-reviewed literature and encourages its use. 

“We’re looking for not mastery of content, but willingness to learn, to make sure they’re getting the foundations done,” Catrona said. 

Final Thoughts: Building a Smarter, Stronger Oncology APP Workforce  

Across 3 different institutions, one message came through loud and clear: deliberate, structured APP onboarding isn’t a luxury—it’s a necessity. Whether it’s a small cancer center onboarding a single APP per year, or a large multisite practice hiring 15, each presenter underscored the same foundational principles: 

• Pair new hires with committed preceptors. 
• Create protected time and space for learning.  
• Structure education around real-world clinical workflows. 
• Instill confidence through repetition, not pressure. 

When the attendees were polled, the results reflected what is seen across the country: wide variability in supervision models, onboarding plans, and team sizes. Despite these differences, 1 theme resonated throughout the discussion: successful onboarding is not a one-size-fits-all process. It must be adaptable, intentional, and, above all, supportive.