PA Education Research Articles

The Self-Reported, Perceived Effect of Interactions with Pharmaceutical Industry on Physician Assistant Students and Recent Program Graduates

INTRODUCTION Physicians have long been studied in regards to their prescribing habits and interactions with the pharmaceutical industry. These studies have illuminated many problems inherent in the exchanges between doctors and pharmaceutical representatives. These have included providers making formulary requests for medications that rarely provided important advantages over existing ones, irrational prescribing behavior, increasing prescription rate, and prescribing fewer generic, and more expensive medications at no demonstrated advantage.2 One study demonstrated that roughly half of University of California Los Angeles (UCLA) medical students surveyed had been exposed to noneducational gifts, food, and published materials provided by pharmaceutical representatives by the second semester of their second year.3 The Abstracts and Brief Reports section publishes short, focused communications on a research endeavor relevant to PA education or behavior. Submissions should be limited to approximately 1,500 words and one or two exhibits (tables or illustrations). The intent of this feature is to promulgate new information and provide a platform for additional research. Authors desiring to contribute to Abstracts and Brief Reports should forward submissions (with a copy to journal staff at jpae@PAEAonline.org) to:

The Physician Assistant Clinical Doctorate: One Medical Directorʼs Opinion

4. The PA profession should explore the development of a model for advanced standing for PAs who desire to become physicians (sometimes called a “bridge program”). Since medical directors at Physician Assistant Education Association (PAEA) programs have a keen interest in the format and conduct of PA education, it seemed appropriate to me to comment in this column on this significant development. I invite comment and conversation on this issue from my medical director colleagues as well. A recent survey by Coplan et al of Midwestern University, Glendale, Arizona, summarized elsewhere in this issue,2 reveals an overall negative opinion on the part of PA program medical directors regarding the issue of any doctorate for PAs. I have to say this had reflected my own opinion as well, until recently. However, participating in the summit has given me a deeper understanding of the various facets of this issue. I would like to share here some of this different perspective the summit has afforded me with other medical directors and PA faculty who were not able to be there. Prior to attending the summit, this was a fairly black-and-white issue in my mind. I had no doubt where I stood on the issue. Since the summit, I have been persuaded that at least the postgraduate clinical doctorate for PAs has some merit — with certain caveats as described in the summit recommendations. What I have also come to appreciate is that clearly, there are good people on both sides of the issue who believe passionately in the validity of their reasons for supporting or opposing a PA clinical doctorate. I am encouraged that both groups have in common that they care deeply about the future of the PA This feature is intended to provide a forum for the sharing of ideas on the role of medical directors in PA programs. Authors desiring to contribute to Medical Director Dialogue should forward submissions to:

Physician Assistant Education: An Abbreviated History

Physician assistant educational programs began as part of a larger movement in the creation of new health professions. The educational organizations of the PA profession were fashioned by physician leaders in medical education. In developing PA programs, progressive physicians and others created innovative approaches to medical education that included decentralized education, emphasis on psychosocial components, and creative deployment approaches. The competency-based PA model employed ideas and elements that were ahead of their time in health professions education. PA education moved to a degree-based system in the 1990s. PA education was based on nontraditional models of medical education that have proved to be successful in training effective generalist clinicians.

Easing the Pain of H & P Grading: A Time Saving Method

University of Detroit Mercy, Detroit, Michigan Richard Dehn, PA-C, MPA University of Iowa Telephone: (319) 335-8925 E-mail: [email protected]

Current Status of Genetics Education And Needs Assessment of Physician Assistant Programs: A Nationwide Survey

Purpose: The explosion of genetic information resulting from the Human Genome Project and related advances has major implications for health care providers, including PAs. In order to assess the current state of genetics education in PA programs and the needs of PA program faculty related to teaching genetics and developing curricula, the authors and the Association undertook a survey of PA programs. Methods: A Web-based survey containing 18 multiple-check, Likert scale, and open-ended questions was sent to the directors of the 134 accredited PA programs in February of 2007. Results: 100 programs responded, for a 75% response rate. Eighty-one percent of responding programs expressed the need to enhance the quality and extent of genetic and molecular medicine in their curricula, and 62% planned to make changes in the near future. Genetics education is delivered with an assortment of curriculum models and taught with a rich variety of methods. It was surprising to find some salient concepts not being taught in 12-16% of programs: eg, molecular biology, Mendelian and non-Mendelian inheritance, pedigree structure, and genetic diagnostic testing. Pharmacogenomics is taught in only two thirds of programs. PA program core faculty play a major role in teaching genetics. PA program respondents indicated the following to be particularly helpful for genetics curriculum development: (1) centrally developed resources, (2) genetic case studies, and (3) up-to-date valid resources on the Web for educators and students. Conclusions: PA programs clearly see the importance of genetics in PA education, but have expressed the need for more resources to further develop their curricula. It is hoped that this survey will provide baseline data that will aid in the development of competencies and curricular components in the future.

No Longer Invisible: Challenges to PA Education

No Longer Invisible: Challenges to PA Education

Ethics Education of Physician Assistant Students: Avoiding the Procrustean Bed

When it comes to the ethics education of health professionals, one size does not fit all. The ethics education of PAs differs in two predominant ways from that of physicians. First, PAs are by definition dependent practitioners, trained to provide medical care under the direction and supervision of a physician. As dependent practitioners, PAs might be inordinately deferential to supervisory physicians in matters in which they need not or should not defer. Second, PA education is substantially shorter than that of physicians. To address these aspects of PA education, we suggest that the PA ethics curriculum include materials on (1) the nature of morality, (2) interactions between the PA and his or her supervising physician, and (3) the deleterious effect medical education can have on altruism and compassion (its tendency to negatively alter the beliefs and value systems of students or to “vanquish virtue”). We submit that PA programs should maximize, within reasonable limits, the ethics and humanities content of their curricula, and that consideration be given to some type of ethics intervention during the early postgraduate years.

Issues Regarding the Development of a Physician Assistant Program in Manitoba

University of Manitoba, Canada The Global Perspectives feature focuses on global issues relevant to PA education. Appropriate topic areas include international clinical student placements, development of PA-type programs in other countries, global or immigrant health care curriculum issues, and first person reports of international PA educational activities. Articles are typically solicited by the feature editor from individuals with direct experience in international activities. Others wishing to submit manuscripts are encouraged to obtain prior approval from the Global Perspectives feature editor. Editorials will not be accepted. Authors desiring to contribute to Global Perspectives should forward submissions to: Christine Legler PA-C, DHSc Nova Southeastern University Telephone: 503-531-0534 Email: [email protected]

Have-a-Disease Workshop: Teaching Evidence-Based Medical Interviews Using PDAs

The intent of the Technology and Education section is to provide a forum for PA educators to share their experiences and ideas with the use of technology to improve the delivery of PA education and the lives of students and faculty. Authors desiring to contribute to the Technology and Education feature should forward submissions to: Richard W. Dehn, PA-C, MPA University of Iowa Telephone: 319-335-8925 E-mail: [email protected]

Joining the Conversation

INTRODUCTION Given that this is the first installment of the Medical Director Dialogue feature under my editorship and the first in the new Journal of Physician Assistant Education (JPAE), I believe a few introductory comments are in order. So that the reader may have some context in which to place my remarks, I would like to say a little about myself. I am a family physician and assistant professor in the Department of Family and Preventive Medicine (DFPM) at the University of Utah in Salt Lake City. It is through that association that I have had the pleasure to serve as medical director of the Utah Physician Assistant Program (UPAP) for the last 3 years. Thirty percent of my professional time is spent on UPAP activities. I maintain an active clinical practice, which includes precepting family practice residents, PA students, and medical students, for 50 percent of my time. The remainder of my time is spent in assorted other academic activities. Although I have been medical director for only 3 years, my association with UPAP as lecturer and preceptor extends back to my graduation from residency 20 years ago. In fact, it was the opportunity to work with PAs that, in part, drew me to Utah for residency training in the first place. I would like to thank the current JPAE editor, Eugene Jones, for the opportunity to serve as editor for this feature, as well as my good friend Don Pedersen, founding editor and UPAP program director, for his unending provision to me of avenues through which to express my interest in PA education. An appropriate question by the reader at this point might be, “Why do we need a feature such as this in our journal?” The answer is that as JPAE serves as the “trade journal” for PA educators across the country, it is a valuable forum for the exchange of a wide variety of ideas that have the education of PA students as their common theme. As with other journals, it is unrealistic to expect that all of the articles in a given issue will be relevant to all faculty of all programs. However, it has been my experience that each issue contains one or several pieces that are relevant to our program and that stimulate conversation among our faculty at weekly meetings. It is time for medical directors as a group to contribute to those conversations, and this feature is a way for that to happen. There are a variety of issues that make their way to the list of “hot topics” at the annual meetings. I have often had my own faculty as well as those from other programs ask me, “What do you, as a medical director, think of such-and-such a topic.” The real question behind this, though, is often, “What do medical directors as a group think of this?” I have no problem answering the first version of the question, but can usually only guess at the answer to the second. I hope this feature can help do that. In addition, this should be an arena where medical directors could bring up hot topics of their own—issues that This feature is intended to provide a forum for the sharing of ideas on the role of medical directors in PA programs. Authors desiring to contribute to Medical Director Dialogue should forward submissions to:

Clinical Skills Utilized by Physician Assistants in Rural Primary Care Settings

University of Iowa, Iowa City, Iowa The Abstracts and Brief Reports section publishes short, focused communications on a research endeavor relevant to PA education or behavior. Submissions should be limited to approximately 1,500 words and one or two exhibits (tables or illustrations). The intent of this feature is to promulgate new information and provide a platform for additional research. Authors desiring to contribute to Abstracts and Brief Reports should forward submissions (with a copy to journal staff at [email protected]) to: Roderick S. Hooker, PhD, PA Department of Veterans Affairs Dallas VA Medical Center Email: [email protected]

Assessing Methods of Patient Encounter Documentation in Physician Assistant Education

Wichita State University, Wichita, Kansas The Abstracts and Brief Reports section publishes short, focused communications on a research endeavor relevant to PA education or behavior. Submissions should be limited to approximately 1,500 words and one or two exhibits (tables or illustrations). The intent of this feature is to promulgate new information and provide a platform for additional research. Authors desiring to contribute to Abstracts and Brief Reports should forward submissions (with a copy to journal staff at [email protected]) to: Roderick S. Hooker, PhD, PA Department of Veterans Affairs Dallas VA Medical Center Email: [email protected]

Development of a Cultural Competency Curriculum for Physician Assistants

Authors desiring to contribute to “Cultural Perspectives” should forward submissions to Dawn Morton-Rias, EdD, PA-C, Dean, College of Health Related Professions, SUNY Downstate Medical Center, 450 Clarkson Avenue, Box 94, Brooklyn, NY 11203. Telephone: 718-270-7709; fax: 718-270-7702; e-mail: Dawn.Morton-Rias@Downstate.edu. Feature Editor’s Note: PA educators are charged with the responsibility of ensuring that graduates possess entry-level knowledge and skills to meet the evolving needs of a dynamic patient population. Educators must not only introduce students to expanding technology, clinical innovation, and evidence-based practice, we must also ensure that they acquire basic interpersonal, clinical, and therapeutic skills: no small undertaking within the confines of a 24to 27-month PA curriculum. Shifting demographics and alarming health outcome statistics provide a clarion call for curricular revision. Wei Chao Chang, MPAS, PA-C, a surgical PA at Good Samaritan Hospital in Baltimore, Maryland, and a doctoral student at Nova Southeastern University, was inspired by his clinical experiences and consideration of the literature to explore cultural competency in PA education. This article, which is first in a three-part series on diversity in PA education, provides preliminary evidence to suggest a need for cultural competency education for physician assistants.—Dawn Morton-Rias Wei Chao Chang, MPAS, PA-C, MT (ASCP) Good Samaritan Hospital, Baltimore, Maryland

Physician Assistant Education: Will We Meet the Need?

Recent findings projecting an increased demand for PAs in the US workforce, coupled with a looming shortage of adequately prepared PA faculty and an already high faculty turnover rate, justify a discussion on how to approach these issues from the perspective of faculty preparation and development. Taking into consideration the current and projected growth rate of PA training programs, the increasing demand for PA faculty will result in an average of approximately one doctorally prepared PA faculty member per US program, at a time when most programs have either converted to or commenced with a master's degree curriculum. Until we have a better understanding of clinical PA roles and relationships, our curricular approach to educating PAs will remain based on anecdotal and empirical experiences derived from the medical school model. Doctoral programs in PA education would help define, clarify, and advance the PA profession by codifying the body of attributes, roles, and knowledge unique to the profession.

Standing at the crossroads of art & technology

article Share on Standing at the crossroads of art & technology Author: Carl J. Huhn Education Management Corporation/The Art Institute, Pittsburgh, PA Education Management Corporation/The Art Institute, Pittsburgh, PAView Profile Authors Info & Claims ACM SIGGRAPH Computer GraphicsVolume 38Issue 2May 2004 pp 20https://doi.org/10.1145/1012283.1012285Published:01 May 2004Publication History 0citation461DownloadsMetricsTotal Citations0Total Downloads461Last 12 Months3Last 6 weeks1 Get Citation AlertsNew Citation Alert added!This alert has been successfully added and will be sent to:You will be notified whenever a record that you have chosen has been cited.To manage your alert preferences, click on the button below.Manage my Alerts New Citation Alert!Please log in to your account Save to BinderSave to BinderCreate a New BinderNameCancelCreateExport CitationPublisher SiteGet Access

Setting New Standards for PA Education in Pediatrics, Beginning with Neonatology

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An Integrated Evidence-Based Medicine Curriculum in Physician Assistant Training: From Undergraduate to Postgraduate

Physician assistant educators must equip their students with the skills to competently practice medicine not only today but also in the future. Our graduates are faced with an overwhelming array of new information and it is imperative that they be competent in managing and using this evidence to improve the health of their patients. Future PAs must have the ability to construct answerable clinical questions, develop effective searches of the literature for evidence, appraise the evidence, and ultimately apply it to patients. Evidence-based medicine (EBM) provides the framework and skill set that enables PAs to efficiently become lifelong learners and critical thinkers. This article is an overview of the University of Utah Physician Assistant Program's (UPAP) EBM curriculum that is focused on clinical relevance and utility. It also outlines how programs can adapt for themselves UPAP's EBM curriculum to satisfy graduate-level educational requirements, as the master's degree becomes the standard for PA education.

A Report on the Findings of the Ad Hoc Committee on International Physician Assistant Education—October 2003

In May 2002 the APAP Ad Hoc Committee on International PA Education began its development of a white paper on international issues relating to APAP and the education of physician assistants. Specifically, the committee reviewed the results of a survey on international PA education, canvassed PA faculty to learn about their experiences with international student rotations, and identified PA educational activities outside the United States. From this preliminary research, the committee formulated the following nine objectives and corresponding goals to guide its work.

Development of a Self-Study Evaluation System

Our PA program is relatively young but has been through two accreditation cycles. In the spring of 2000 we were anticipating our third evaluation visit when we commenced our periodic self-assessment for our self-study report. It seemed to the faculty at that time that we had been gathering survey data and anecdotal data from multiple sources since program inception. But we questioned the validity of continuing to attempt program improvements based upon our impression of that feedback rather than on analysis of objective data. Although anecdotal and subjective information typically validated conclusions reached in the program’s ongoing self assessment, core faculty believed that it was also necessary to gather and analyze objective information. Therefore, we seized the opportunity of our periodic self assessment to create and develop a format of self evaluation that is now being employed for continuous self study. We presented this method to the ARC-PA evaluation team during their visit and in their closing summary they listed it as a strength of the program, stating, “The evaluation database is unique in PA education and represents a model for continuous self evaluation.” This project constituted a major objective of our HRSA grant, which has enabled us to refine the system and to bring in the appropriate consultation needed to establish and further develop it. Our consultant was Dr. David Molnar. Since this system is applicable to all PA programs, we describe it here so that other programs may make use of a similar model to facilitate and improve their own self-study activities.

Womenʼs Health Curriculum in PA Education: Results of a National Study

Womenʼs Health Curriculum in PA Education: Results of a National Study