Confidence in the Patient Evaluation by Junior Residents and Physician Assistant

Abstract

APGO Advisor: Lee A. Learman, MD, PhD PURPOSE: To describe and compare faculty and senior resident confidence in junior resident (JRES) and physician assistant (PA) evaluation of patients with nonemergent compared with emergent gynecologic problems. BACKGROUND: Duty hour restrictions have necessitated the increasing use of PAs at the University of Chicago Department of obstetrics and gynecology. Some faculty have expressed concern about this change. METHODS: Using information from focus groups and interviews with residents, PAs, and faculty, we created three emergent and three nonemergent patient scenarios. Each scenario was used to create two subtly different cases (12 total) involving a JRES or a PA. These were sent by email to 29 faculty and 28 residents in an anonymous, voluntary survey. Respondents indicated their perceived confidence. Survey responses were summarized with counts and proportions. We adjusted for multiple testing using the Benjamini-Hochberg method. RESULTS: The 35 surveys received included 21 which were complete and 17 from faculty. Too few senior residents surveys (4) were available for analysis. In the 3 comparable sets of emergent case scenarios, faculty respondents tended to be more confident in the JRES (76.5%, 100%, 100%) than the PA (82.4%, 76.5%, 94.1%). In the 3 comparable sets of nonemergent case scenarios, faculty respondents tended to have less confidence in the JRES (76.5%, 64.7%, 100%) than the PA (88.2%, 94.1%, 100%). DISCUSSION: No large differences were identified in faculty confidence in JRES and PA management of common gynecology patient problems. Senior resident confidence in JRES and PA management could not be assessed due a low response rate.