Primary Care Nurse Practitioners and Family Physicians Responsibilities in Primary Care Teams: A Scoping Review

Context: Working in primary care teams involves sharing responsibilities in order to make the most of each professional’s specific scope of practice. While this necessity is global, it is particularly salient in Quebec, where family physicians and primary care nurse practitioners (PCNPs) have strongly overlapping scopes of practice. Despite increasing implementation of team-based care, little is known about how these professionals share responsibilities in practice. Objective: To map and synthesize existing knowledge, and identify gaps, regarding responsibility-sharing between PCNPs and family physicians in primary care teams. Study Design and Analysis: Scoping review design conducted based on Arksey and O’Malley’s framework (2005), completed by Levac et al. (2010). Study selection and data extraction will be conducted by two separate investigators, with disagreements resolved by consensus or intervention of a third investigator. Data extraction and analysis will be informed by the Nurse Practitioner-Physician Comanagement Model by Norful et al. (2018). Setting: Medline, CINAHL and Healthcare Administration Database will be searched from January 2002 to August 2026. Search strategy concepts are primary care, family doctor, PCNPs, responsibility sharing and synonymous terms. Reference lists of included articles will be scanned for additional articles. Studies included: Primary research studies (qualitative, quantitative, or mixed methods) in English or French examining any aspect of responsibility sharing between PCNPs and family physicians in primary care teams. Instrument: A data extraction table was created and iteratively modified using the first relevant articles found. Outcomes: Contextual factors; PCNP and family physician responsibilities; role formalization and autonomy, decision-making and conflict resolution processes; patient, team and system outcomes Expected Outcomes: This review will inform clinicians, researchers, and policymakers by clarifying how responsibility-sharing between family physicians and PCNPs is operationalized and by identifying gaps to guide future research.