Interservice Physician Assistant Program Research Articles

Prerequisite Delivery Method and Academic Outcomes in a Physician Assistant Education Program.

The Interservice Physician Assistant Program (IPAP) educates up to 169 matriculants per year. Each service branch sets the admission criteria, including all prerequisites, for their applicants. We hypothesized that prerequisites obtained online/virtual are less rigorous than coursework completed in-person. The purpose of this investigation was to evaluate whether online/virtual prerequisite courses were associated with academic deceleration or attrition at any point. Student self-reported data were retrospectively analyzed to evaluate program scores of students who took prerequisites online/virtual or in-person. There were no statistically significant differences in foundational course performance between online/virtual and in-person coursework. In addition, students who took anatomy online performed better than students who completed the coursework in-person (140.6 ± 15.6 vs. 145.6 ± 14.7, P = .05). This analysis indicates that using the prerequisite source to predict academic difficulty may not be possible in IPAP students. Faculty will need to continue to search for other predictors of academic difficulty.

Review of an Initial Physician Assistant Training Program Orthopaedics Course Curriculum Using Kern's 6-Step Process

Graduating an average of 169 graduates per year, the Interservice Physician Assistant Program (IPAP) is the largest physician assistant training program in the world. The IPAP orthopedics course is a 4-credit hour course that started as approximately 60 hours of lecture, 9 hours of laboratory practice to prepare for an Objective Structured Clinical Examination, and 4 hours of splinting laboratory. After several cohorts performed poorly on the second block exam and student critiques voiced the need for course revision, the curriculum committee formed a sub-committee to review the course content and structure. The primary course instructor was familiar with Kern's 6-step approach to curriculum development and proposed using the Kern’s approach for the curriculum review and revision. This article aims to demonstrate the use of Kern's 6-step approach for review and revision of an introductory orthopedic course curriculum. This article shows how an IPAP curriculum sub-committee executed the 6 steps of the Kern’s process: (1) problem identification and general needs assessment, (2) targeted needs assessment, (3) development of goals and objectives, (4) development of educational strategies, (5) implementation, and (6) evaluation and feedback. To our knowledge, this is the first example of a physician assistant program using Kern's 6-step process to revise a curriculum. Thus far, the revisions show a positive change, indicating that other physician assistant programs could conduct similar reviews using the Kern’s 6-step approach.

A Prospective Assessment of a Novel, Disposable Video Laryngoscope With Physician Assistant Trainees Using a Synthetic Cadaver Model.

Airway obstruction is the second leading cause of preventable death on the battlefield. Video laryngoscopy has improved airway management in the emergency setting for several decades, and technology continues to improve. Current technology in the supply chain is cost-prohibitive to incorporate at Role 1 facilities, which is where many intubations occur by novice intubators. The i-view is a novel video laryngoscopy device that is handheld, inexpensive, and disposable. The aim of this study was to determine if the i-view is suitable based on performance assessments by physician assistant trainees and survey feedback. We prospectively enrolled physician assistant students at the Interservice Physician Assistant Program at Joint Base San Antonio-Fort Sam Houston. We provided them structured training on how to use the device, and then, a board-certified emergency medicine physician or certified registered nurse anesthetist assessed their intubations performed on a SynDaver mannequin model. We surveyed the participants afterward. We enrolled 60 Interservice Physician Assistant Program students. Most participants were male (75%) with a median age of 32 years. Service affiliations included Army (50%), Navy (23%), Air Force (18%), and Coast Guard (8%). Most (70%) had previous deployment experience. All the participants successfully cannulated the mannequins and 98% achieved first-attempt success. Most participants (78%) reported a grade 1 view. On postprocedure survey, 91% strongly agreed with using this device in the deployed setting and 89% strongly agreed with finding it easy to use. All physician assistant trainees successfully and rapidly performed endotracheal intubation using the disposable i-view video laryngoscope. Study participants rated the device as easy to use and desirable for deployment. Further research is necessary to validate this novel device in the clinical setting before recommending dissemination to the deployed military medical force sets, kits, and outfits.

The history and role of PAs in the US Coast Guard.

The US Coast Guard is a military service in the Department of Homeland Security charged with broad domestic and international missions. In 1971, the Coast Guard began recruiting physician assistants (PAs) in an effort to supplement physician staffing support. When first introduced, PAs were in the enlisted ranks. However, consistent with the other armed services, their entry ranks changed from enlisted to commissioned warrant officer and later to a commissioned officer status. As their numbers grew, PAs began augmenting and later replacing general medical officers assigned to treatment facilities and aboard ships. Their role is to keep the 43,000 men and women of the Coast Guard and their dependents healthy by providing medical care at 40 bases and stations. As of 2020, the Coast Guard has 47 commissioned PAs who work on shore postings, on polar-bound ice breakers, training ships, as faculty in the Interservice Physician Assistant Program, or as senior administrative officers. About one-third are female.

Interservice Physician Assistant Program: Educators for an Expanding Profession.

The number of physician assistant (PA) programs has increased exponentially across the past decade, and the demand for PAs will likely remain strong through 2025. Because of this rapid growth, both new and established PA programs face significant challenges in recruiting experienced educators. We describe the value of using PAs trained through the Interservice Physician Assistant Program (IPAP) as civilian PA educators. The literature on IPAP and its graduates proved too limited to conduct a formal systematic review. We searched the PubMed and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases for works speaking to the value that IPAP-trained PAs may bring to civilian PA training. Those findings were supplemented with informal conversations with IPAP-trained PAs currently employed in the military and those working in civilian PA education. Themes were identified supporting the potential value of IPAP-trained PAs in civilian training. Military PAs work within hierarchical organizations and may transition easily to academic settings. They leave military service not only as highly trained and proficient primary care providers but also as experienced educators. Military PAs must demonstrate professionalism across their entire military careers. They serve as leaders and work in teams, but they are also experienced in negotiating up chains of command. They are trained in and apply the latest innovations in health care delivery and have provided care with a degree of autonomy uncommon in civilian PA practice. The PAs trained through IPAP leave the service with skills and experiences valuable to civilian PA training. Employing these PAs in civilian education honors their service contributions while addressing emerging PA educator workforce demands.

The Interservice Physician Assistant Program: Education quantity and quality.

The Interservice Physician Assistant Program (IPAP) was formed in 1996 by the assimilation of three service programs (Army, Air Force, and Navy). Applicants are selected from each service and upon successful completion of the program become commissioned officers within their respective medical corps. Clinical training takes place within military treatment facilities across the United States. Located in San Antonio, Texas, the program graduates about 169 PAs a year. Graduates are deployed to attend to service personnel, refugees, civilians, and victims of epidemics. The IPAP is unique in that it is the largest PA program in the world and its applicant pool is restricted to military personnel.

The Interservice Physician Assistant Program: The veterans' solution.

The Interservice Physician Assistant Program: The veterans' solution.

The Texas Health Workforce Benefit of Military Physician Assistant Program Veterans

Little is known about the benefits to society of the educational development of health personnel in the military who return to civilian life and continue their careers. The U.S. Department of Defense has produced physician assistants (PAs) since the early 1970s, and PA training is now consolidated into one location in Texas as the Interservice Physician Assistant Program (IPAP). We studied redistribution of PAs upon service departure to determine if IPAP attendance had an effect on the Texas PA workforce. The Texas Medical Board dataset of licensed PAs was examined to identify program attended, practice specialty by supervising physician designation, practice location, and primary care or specialty care practice designation. Primary care was defined as family medicine, general pediatrics, or general internal medicine. All other designations were classified as specialty practice. Of 6016 licensed Texas PAs, 425 (7.0%) reported attending a military PA training program. Of the 254 PAs in full-time civilian clinical practice, 148 (58.3%) reported practice in primary care settings, and 106 (41.7%) reported specialty clinical practice settings. With the average military officer retirement age of 47 years and the 2010 average U.S. retirement age of 64 years for men and 62 for women, an estimated 16 years of community workforce productivity is provided per veteran PA following completion of military service. We estimated over 47,000 outpatient visits are provided per PA following military service. The care provided can be measured as a positive return-on-investment of taxpayer-provided education.

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

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.

Military Physician Assistants: Their Background And Education

The US military and the physician assistant (PA) profession have long been intertwined. The first few classes at the Duke University PA Program consisted largely of ex-military corpsmen and medics. Facing a shortage of providers in the early 1970s, the three service branches developed programs to train their own PAs; these programs were merged into the Interservice PA Program in 1996. Discrepancies in rank among the three service branches were finally resolved when Army PAs were commissioned in 1992. Today, retired military PAs bring invaluable experience to the civilian workforce and help meet the health care needs of society. The contributions of military and ex-military women and men have been instrumental in building and shaping the PA profession.

Evaluation of the Relationship between Student Performance on the PACKRAT And PANCE Examinations

Purpose: The purpose of this study is to determine the relationship between student scores on the Physician Assistant Clinical Knowledge Rating and Assessment Tool (PACKRAT) and performance on the Physician Assistant National Certifying Examination (PANCE). Methods: PACKRAT scores from students enrolled in the Interservice Physician Assistant Program (IPAP) following their didactic year of training were compared to the PANCE scores by the same students. The PACKRAT examination was administered to students within the last few weeks of their first year of training, just prior to beginning their clinical rotations. The PANCE scores represent the first attempt by IPAP graduates to attain certification shortly following completion of their second phase of training (clinical rotations). The study included those students that began their training in May of 1999 through May 2001. The first didactic year is divided into three separate trimesters and a new class of students begins each four months. This represents students included in seven different classes (n = 375). The relationship between the scores was evaluated by determination of the correlation coefficient. Analysis of the predictive value of PACKRAT results with respect to passing the PANCE was accomplished using logistic regression. Results: Correlation between PACKRAT and PANCE scores showed a correlation coefficient of 0.668 (P<0.001). Logistic regression showed a significant relationship between PACKRAT scores and PANCE performance (P<0.001). A PACKRAT score of < 55% (raw score = 124) had a sensitivity of 77.2% and specificity of 83.3%. Conclusions: The scores obtained by the students on the PACKRAT examination correlated well with those obtained on the first administration of the PANCE. In addition, PACKRAT scores proved to have a strong predictive value of student pass/fail performance on the PANCE.

Predicting Success on the Physician Assistant National Certifying Examination

Researchers have studied predictors of success in education programs to validate and improve admission requirements and course curricula. Programs that are in high demand such as the Interservice Physician Assistant Program (IPAP) conducted at Fort Sam Houston, Texas, must make wise use of the limited resource of education to ensure that those accepted complete the program. Purpose: This study was conducted to determine the predictors of the level of success on the Physician Assistant National Certifying Examination (PANCE). Method: The study examined independent variables categorized as demographics, academic performance, and clinical performance as predictors of the level of success on the PANCE. Data were analyzed using stepwise and multiple linear regression. Results: Four demographic variables were found to be significantly correlated with PANCE scores. All academic performance variables were also significant with correlation coefficients p < .01 with the PANCE score. The clinical performance variable also emerged as moderately significant in predicting PANCE scores. Stepwise regression analysis indicated that first and third trimester scores and gender were the best predictors of the level of success on PANCE scores. Full multiple regression of PANCE scores on trimesters predictors resulted in R = .79, accounting for 62% of the variance in PANCE scores. Conclusions: Final results indicated that higher scores in the first and third trimesters predict higher PANCE scores. Knowledge of predictors of success can be used to modify the program curriculum and admission prerequisites to maximize academic performance and in turn achieve higher scores on the PANCE.