Performance Improvement Assessment of the Interservice Physician Assistant Program (IPAP)

Abstract

Purpose. The Interservice Physician Assistant Program (IPAP) located at Fort Sam Houston, Texas, provides the education for the majority of all Army, Navy, and Air Force physician assistants. As such, ensuring that program maintains premier performance to support combat and peacetime healthcare is vital to the interests of the Department of Defense. To support this mission, an analysis of structure, process, and outcomes for the program was conducted using survey data and Physician Assistant National Certifying Examination (PANCE) scores. Methods. Methods employed included Chi Square analysis, regression, small multiple comparisons. Graphical and statistical results provided evidence of program strengths and weaknesses.Results. Analysis of survey data (33% response rate) revealed that students who had graduated four or more years ago were more likely to self-report that IPAP prepared them for clinical work (Chi-Square = 8.16, p<.006, Odds Ratio: 3.1:1). Students reported high-confidence in the disciplines of EENT, orthopedics, and dermatology as well as low-confidence in hematology and dentistry. Analysis of performance deltas provided statistically significant and practically relevant results (F(16,48) = 17.59, p < .001, adj. R^2 = .806). IPAP student first-time test-takers routinely performed above the national average; however, performance in recent years has declined. Areas of strength identified in the analysis included EENT and dermatology confirming student self-assessments. One area of weakness identified was psychiatry and behavioral health.Conclusions. Based on the analysis of structure, process, and outcome, IPAP leadership is evaluating specific performance improvement initiatives to maintain program strengths and address weaknesses.