Introduction: The classical hematology community has increasingly turned to advanced practice providers (APPs) to fill gaps in care created by subspecialist shortages. This is especially true in sickle cell disease (SCD), a lifespan condition which receives less support and funding than other hematologic disorders. With their clinical versatility, APPs have expanded the capacity for sickle cell care in the inpatient, outpatient, and emergency settings in healthcare systems nationwide. However, primary physician associate and nurse practitioner training programs contain little, if any, content to prepare them for a career in SCD. Recognizing the need for dedicated sickle cell education, we developed a novel curriculum for post-graduate APPs to become sickle cell specialists within a pre-existing comprehensive sickle cell center or as semi-independent practitioners in a hub-spoke network. We report our four-year experience with the Sickle cell Advanced Practice Provider Opportunities and Training (SAPPORT) program.

Methods: Institutional review board approval for this program was obtained from the Johns Hopkins Hospital. The SAPPORT program is an asynchronous, year-long curriculum designed to be completed by a working professional in any location. The program is hosted on an online platform and is composed of four components: a lecture series containing 17 hours of sickle cell-specific content, a standardized observership to be completed at the learner's home institution or away at an established comprehensive sickle cell center, monthly online message board case discussions, and attendance at monthly sickle cell-specific telementoring sessions for APPs. Learners completed a 26-item sickle cell knowledge assessment at the time of enrollment and following completion of the curriculum. Additional assessments were distributed throughout the curriculum to ensure knowledge retention. Graduates of SAPPORT were surveyed one year after completion to assess the perceived value of the program and retention in sickle cell specialist positions.

Results: From 2021 to 2025, 50 APPs enrolled in SAPPORT. The number enrolled increased with each year following initiation: 4 (year 1), 11 (year 2), 14 (year 3), and 21 (current). Participants were located across the United States: Northeast (27), Midwest (10), South (8), and West (4), and one international enrollee. Sixteen participants completed the program in the first three years. The mean sickle cell knowledge assessment score rose from 68.1% (SD 21.3%) to 81.1% (SD 11.6%). One year following completion of SAPPORT, three of four graduates of the initial cohort reported continued value and relevance of curriculum content to their careers as sickle cell specialists.

Conclusions: We developed a novel SCD training program for post-graduate APPs and observed increasing enrollment with each subsequent year. Early data suggest that SAPPORT curriculum content was durable and valuable for graduates of the program, but completion rates were lower than anticipated. These findings suggest that real-world challenges such as clinical workload and personal or family obligations may impede professional development efforts for APPs. Employer commitment to providing protected time for these activities may be necessary to promote completion of the curriculum. The growing popularity and early success of the SAPPORT program demonstrates that sickle cell training programs designed for APPs are appealing, needed, and effective for retaining sickle cell specialists and ultimately will serve to increase access to quality, evidence-based care for patients with SCD.

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2025
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