The Effects of a Pass-Fail Curriculum on a Physician Assistant Program.

Abstract

The grading scale for students in a physician assistant program of study is not standardized. Students may be evaluated on a traditional 5-tiered A to F scale or a pass-fail system. The decision to change from ordered grading to pass-fail at an established program in the southeast was done following a change in the affiliated School of Medicine. The purpose of this study was to review effects on student scores following such a change. The Physician Assistant National Certifying Exam (PANCE) and PACKRAT 2 exam scores for the last 2 cohorts of students scored in the 5-tiered system (2016, N = 60 and 2017, N = 59) were compared against the same for the first 2 cohorts (2018, N = 59 and 2019, N = 58) of the pass-fail system. Nonrandom sampling of all students in each cohort year was evaluated using 2-tailed t-testing. A total of 236 student scores were evaluated using a 95% confidence interval. The traditionally scored classes outperformed all pass-fail cohorts (means 460.67/491.86 versus 503.34/493.92). P values were found to be significant at all values between the 5-tier scored classes and the pass-fail cohorts in PANCE scoring, resulting in failure to reject the null hypothesis. This was also true for the PACKRAT 2 with the exception of the 2019 cohort, which was significant only for outperformance of the other pass-fail cohort. For the purpose of this study, the only analysis performed was scoring. For cohorts undergoing curricular change, unforeseen impacts on initial standardized exam scores may occur. In this study, PANCE scores for the first year of the 2 pass-fail cohorts decreased while the overall program scores remained at or above the national average. The pass-fail cohort did show an upward trend in the second year of the curriculum, suggesting that as programs become more familiar with the pass-fail system, steady improvements occur. This suggests that while an anticipated drop in initial scores may be expected, further studies are needed to evaluate the impact on stress reduction, long retention, and intraclass competition.