Physician Assistant Education Association Research Articles

Assessing the Racial and Ethnic Diversity of Physician Assistant/Associate Program Graduates from 2010 to 2012 and 2019 to 2021.

To assess the racial/ethnic diversity of graduates of US Physician Assistant/Associate (PA) programs compared with the diversity of the populations from which they draw students and to assess diversity changes over time among PA graduates. We calculated proportion of Black or Hispanic PA graduates nationally and by school between 2010 to 2012 and 2019 to 2021 using the Integrated Postsecondary Education Data System (IPEDS) and compared it with the diversity of the 20 to 35-year-old population using the American Community Survey. We created benchmark populations for each school based on whether the school was public or private, with in-state/out-of-state proportions provided by the Physician Assistant Education Association. A diversity index (DI) was calculated for each program. A DI of 0.5 means that the representation of Black/Hispanic graduates is half their representation in the benchmark population. Although the numbers of Black/Hispanic graduates increased from 2010 to 2012 to 2019 to 2021, the percentage of Black graduates decreased. Nationally, the DI for Black graduates decreased from 0.28 to 0.23 and the Hispanic DI increased from 0.28 to 0.37 between 2010 to 2012 and 2019 to 2021. Among 213 PA programs included in the 2019 to 2021 dataset, 5 schools had a DI >1.0 for Black graduates and 7 schools had a DI >1.0 for Hispanic graduates. Using the IPEDS data, we found that Black and Hispanic graduates are underrepresented among PA program graduates. The PA education community needs to develop new strategies for diversifying the profession consistent with the new US Supreme Court decision banning race-conscious admissions.

Diversity of PA cohorts during the evolution to an entry-level master's degree.

This study evaluated the racial and ethnic diversity of physician associate/assistant (PA) graduating cohorts during the profession's transition from a standard undergraduate degree to an entry-level master's degree. Using all existing program reports from the Physician Assistant Education Association (1985-2019), we explored potential associations between changes in tuition, degree types offered, and racial/ethnic makeup of graduating cohorts. We observed a strong negative association between Black students and graduates versus increasing tuition and the rise of master's level programs. More equitable opportunities for joining the PA profession may be needed.

Time to Pivot: A Guide to Holistic Admissions.

As an ever-increasing number of physician assistant (PA) programs moves toward holistic admissions, a better understanding of how to achieve their stated admission goals becomes more important. With the June 2023 US Supreme Court decision effectively ending affirmative action in higher education, navigating holistic admissions is now an even greater challenge. In this article, the PA Education Association's Presidents Commission offers a guide for programs to use in implementing holistic admissions at their institutions and key considerations. Is the process mission-driven? Does it follow principles of quality improvement and incorporate ongoing assessment of that process? Using data can be a constructive and insightful way to inform the process. The authors hope that tools, resources, and recommendations offered in this article will serve as valuable resources for any program attempting to institute or improve its holistic admissions process.

Academic Rank Disparities in Minoritized and Racialized Physician Assistant Educators.

The aim of this study was to investigate the disparities in career progression and the need for inclusive mentorship in the physician assistant (PA) profession, specifically focusing on racial/ethnic minority faculty. Pooled data from the Physician Assistant Education Association Program Survey in 2015, 2017, and 2019 were analyzed to examine the effect of PA faculty race/ethnicity on academic rank promotion. Logistic regression models were used to assess the association between faculty race/ethnicity and the likelihood of being in a middle/late-career (associate/professor) or early-career status (instructor/assistant), adjusting for confounding factors. The analysis revealed significant disparities in career progression, particularly for Black/African American and Hispanic faculty members, who were 44% less likely to be in late-career positions compared with White faculty. These disparities persisted even after accounting for gender, highest degree, region, and years in rank. The slower career progression experienced by minoritized faculty can have negative impacts, such as lower salaries, impostorism, reduced social capital, isolation, marginalization, burnout, and attrition. The findings highlight the urgent need for increased efforts to promote diversity and inclusion in the PA profession. Creating a more equitable academic environment requires addressing systemic biases, implementing inclusive mentorship initiatives, and promoting diversity in hiring and promotion decisions. By prioritizing equity, diversity, and inclusion, the PA profession can foster a more diverse, innovative, and satisfied workforce while reducing turnover. Continued research and evidence-based strategies are essential to effectively address these disparities and create a more inclusive and equitable environment in the PA profession.

Physician assistant education program director attrition and consideration to leave

BackgroundThis study explores factors related to physician assistant (PA) education program directors’ (PD) consideration to leave their leadership role. This is important to better understand, with the need for additional PA education PDs as the number of PA programs grows in addition to current PA program leaders considering leaving their PD role.MethodsData from the 2019 Physician Assistant Education Association (PAEA) Faculty and Directors Survey were used to analyze factors related to consideration for leaving the PD position. Multiple logistic regression analyses were utilized to identify predictors of PD consideration for leaving their position. Multiple regression analyses were also used to explore factors related to burnout.ResultsThe study found burnout was a modest predictor for consideration of leaving the PD position, while underrepresented minority status was not. Additional job stress, job satisfaction, and job experience variables were found to have a modest relationship with consideration of leaving, with odds ratios between 0.28 (lack of faculty respecting each other) and 5.29 (stress from lack of personal time) for those with statistically significant relationships.ConclusionsPD consideration of leaving is a complex phenomenon with many variables and confounding factors likely at play, including, as demonstrated by this study, level of burnout. Study implications include a further understanding of how effective strategies might be designed and implemented to address the drivers of PA PD attrition. Further exploration of burnout as a possible mediating variable as well as more specific data collection directed at better understanding predictors of PD attrition would be valuable future research directions.

Enhancing Physician Assistant Psychiatry Interviewing Skills Using Standardized Patients.

The aim of this pilot study was to assess whether supplemental psychiatry training in the didactic year increases the scores on the Physician Assistant Education Association (PAEA) Psychiatry and Behavioral Health End of Rotation examination and psychiatry preceptor evaluation. Data were obtained from the physician assistant (PA) students on PAEA Psychiatry and Behavioral Health End of Rotation examination and psychiatry preceptor evaluation for a single institution. Then, a comparison was performed for PA students who did not participate in supplemental psychiatry/behavioral health training (Cohort 1/historical control group; n = 62) and PA students who participated in supplemental psychiatric and behavioral health training (Cohort 2/experimental group; n = 63) to determine the effects of the groups. An independent t test demonstrated that the experimental group performed significantly better than the control group on both the Psychiatry and Behavioral Health PAEA End of Rotation examination and preceptor evaluation {control group (M = 83.4) and experimental group (M = 86.3; t [117] = 2.8; P < .05)} and the preceptor evaluation {control group (M = 90) and experimental group (M = 92.6; t [112] = 2.1; P < .05)}. In addition, both analyses demonstrated a moderate effect size (End of Rotation examination, d = 0.51; preceptor, d = 0.62). A multiple regression analysis was used to control for age, sex, grade point average (GPA), and training intervention. Age, sex, and GPA were found not to affect the results. However, treatment intervention was statistically significant for both the End of Rotation examination and preceptor evaluation scores. Supplemental training in behavioral health and psychiatry, which included a standardized patient encounter and an interactive session dedicated to psychiatry interviewing techniques, resulted in students performing better on the Psychiatry and Behavioral Health PAEA End of Rotation examination and preceptor evaluation.

Reasons clinical education directors intend to leave their jobs

ObjectivesThe goals of this study were to characterize clinical coordinators compared to other Physician Assistant (PA) faculty, and investigate factors associated with intent to leave their position, institution, and academia in the U.S.MethodsThis was a secondary analysis of data obtained from the 2019 Physician Assistant Education Association (PAEA) Faculty and Directors Survey. We examined bivariate associations with faculty role and conducted multiple logistic regression to identify predictors of intent to leave among clinical directors.ResultsClinical directors indicated an intention to leave their position more often than other faculty. Factors influencing intent to leave were a lack of satisfaction with professional development and moderate to high levels of burnout. Clinical directors with severe burnout had 27x the odds of intending to leave academia.ConclusionsOur results suggest why clinical directors intend to leave and underscore the need for professional development opportunities and faculty mentoring. Faculty-centered work arrangements are needed to reduce burnout among clinical directors.

Whither the PA doctorate?

New perspectives have been brought to bear in the discussion of the topic of the physician associate/assistant (PA) doctoral degree in general and the entry-level PA doctorate in particular. Both the Physician Assistant Education Association (PAEA) and the American Academy of Physician Associates (AAPA) have sought and supported formal research investigations into the question. Evidence from studies shows that perceived benefits and risks are strongly influenced by the lens of the various stakeholders; that most PAs believe that the master's degree is enough for clinical practice; and that most clinical PAs and PA students are not in favor of an entry-level doctorate. Lessons learned from other healthcare professions that have transitioned to a clinical doctorate only marginally serve as a model for the PA profession. PA organizations need to fully own and embrace the task of leading the discussion and reaching a definitive conclusion in the determination of PA doctoral education. Failure of the PA profession to act decisively on the doctoral degree question would essentially default this decision to colleges and universities, which tend to have a vested economic interest in new types of degrees.

Physician Assistant Program Perseveres Through COVID-19 Pandemic.

The COVID-19 pandemic has disrupted almost every aspect of life globally, with higher education one of many direct targets. Institutions and educators have been faced with urgent crises of how to conduct business as usual while maintaining expectations of high standards and uncompromised goals. As physician assistant (PA) educators at Seton Hall University, we rallied and brainstormed approaches to daily instruction to keep students on track and faculty both effective and sane. We tapped technological resources offered by our university, learned countless new skills, and adapted classroom activities to online virtual platforms. Creativity and flexibility became the norm as we modified the way we did everything while remaining laser focused on the ultimate objectives. Our intention was to provide insight, motivation, and, at a minimum, an example of how to do things differently when faced with roadblocks. We were inspired by an editorial by Mary Jo Bondy, DHEd, MHS, PA-C, former CEO of the Physician Assistant Education Association, in which she called for collective innovation, collaboration, publication, and circulation of stories. With that charge, we assembled a detailed account of how a didactic team within our faculty maneuvered the challenges created by COVID-19, in hopes of adding to the arsenal of small triumphs in this uncharted territory.

Academic leadership in physician assistant/associate medical education: a cross-sectional analysis of the association with doctoral degree, gender, and minority status

BackgroundThere is a critical need for a diverse pool of academic leaders to increase the number and diversity of the medical workforce. Physician Assistant/Associate (PA) is a growing medical profession. Although the master’s degree is the terminal degree for PAs, a growing number of PAs obtain a variety of doctoral degrees. However, there is no standardized training for academic PA leaders. The purpose of this study was to identify factors associated with PA academic leadership. Specifically, this study explored the following factors: doctoral degree credentials, gender and underrepresented minority status.MethodsUsing the 2019 Physician Assistant Education Association Faculty and Directors survey, we assessed the relationship between academic leadership groups [Program Director (PD), Academic Director (AD), and Clinical Director (CD)] doctoral degree, gender, and underrepresented minority in medicine (URIM) status. Multivariable logistic regression models were used to determine the predictors of being in a leadership role. Results with p < 0.05 were considered statistically significant.ResultsOf the 956 participants, 71% were female, 4% Hispanic, 86% White, 4% Black, 2% Asian, and 1% Native Hawaiian/Pacific Islander/American Indian/Alaska Native. Overall, 9% were URIM. Mean age was 45.6 (SD = 10.2) years. Average time in PA education was 2.9 years (SD = 1.4). Approximately 50% (n = 472) had a leadership role (PD-24%, AD-10%, CD-16%). Of all leaders, 68% were female, 9% were URIM, and 19% had a doctoral degree. Having a doctoral degree increased the odds of being a PD [AOR 2.38, CI [1.57–3.59], p = < 0.0001, AD and CD = non-significant]. More time in PA education increased the odds of being a PD [AOR 1.10, CI [1.07–1.12, p = < 0.0001] and AD [AOR 1.06, CI [1.03–1.09], p = < 0.0001], but not a CD. Gender and URIM status were not significantly associated with leadership roles. URIMs had doctorate degrees at higher rates than non-URIMs.ConclusionPA academic leaders differ by doctoral degree attainment but not by gender and URIM status. URIM faculty are grossly underrepresented in the PA professorate, but disproportionately have doctoral degrees. Academic training opportunities for all PA academic leaders and strategies to increase URIM faculty are needed.

Physician Assistant Program Policies to Assess and Address Student Reports of Mistreatment During Clinical Training.

Many physician assistant (PA) students experience mistreatment in clinical learning environments, and accredited PA programs are required to define, publish, and make readily available policies and procedures for student reports of mistreatment. The purpose of this study is to describe the prevalence, content, and dissemination of program policies to address students' reports of mistreatment involving preceptors during supervised clinical experiences. To conduct a national policy analysis, the investigators included 10 new survey items in the 2019 Physician Assistant Education Association annual program survey. Deidentified data were analyzed by using descriptive statistics. The program response rate to the survey items was 99% (232). Approximately 76% of PA programs reported having a learner mistreatment policy. Policy content across programs varied widely, and several student reporting mechanisms were available. Program directors, clinical faculty, and institutional leadership were most likely to be involved in the management of reports. A majority programs actively assessed for mistreatment and most did so through clinical course evaluations and at the end of each clinical phase course. Most programs disseminated information about policy to faculty, students, and preceptors at least once a year. The descriptions of policy content, procedures, and dissemination increase educators' understanding of current policies across PA programs in the context of renewed efforts to write or revise policy that is specific to mistreatment. The authors discuss key policy priorities to define mistreatment, offer a range of confidential reporting mechanisms, review the management of reports, and consider how to optimize dissemination strategies.

Initial Impact of the COVID-19 Pandemic on Physician Assistant Education.

The COVID-19 pandemic significantly impacted United States (US) health professions educational programs. Physician assistant (PA) programs were forced to respond to rapidly changing circumstances early in the pandemic. This study describes the impact that the early phase of the COVID-19 pandemic had on PA programs in the United States. This cross-sectional study is based on data from the COVID-19 Rapid Response Report 1, conducted by the Physician Assistant Education Association in April 2020. The survey sample included 254 US PA program directors with a response rate of 64.2%. Our outcome measures included temporary changes to PA program operations and clinical training, and current and upcoming budget and tuition changes, as well as the impact of the pandemic on faculty and staff employment. We used descriptive statistics to summarize these outcomes, stratified by 4 categories characterizing features of PA programs, including geographical location, academic housing, funding model, and academic health center status. The COVID-19 pandemic impact on programs varied geographically. A majority of programs reported making numerous temporary changes to their operations. Most programs moved both didactic and clinical education to an online format. Clinical training was temporarily suspended at almost all programs. PA programs continued training despite the pandemic. The long-term impact of the pandemic may be the instability of the PA education workforce.

Assessing demand for doctoral-prepared PA faculty: a five-year longitudinal study

PurposeMany health profession programs have transitioned to doctoral credentials. While a master’s degree is the terminal degree for the physician assistant (PA) profession, there is increasing discussion regarding the doctoral degree as the PA terminal credential in US higher education.This study examines trends, demand and economic opportunities for doctoral prepared PA faculty; specifically, assessing to what extent PA faculty employers prefer doctoral credentials.MethodologyThis longitudinal retrospective observational study assessed commonly required/preferred academic credentials in PA faculty job postings. Data from 2014 to 2020 was obtained from the labor analytics firm Burning Glass Technologies (BGT) and other academic job search engines. Data on current PA faculty and program directors were obtained from Physician Assistant Education Association (PAEA) survey reports. Wage gap analysis was performed to gain additional insight for the supply and demand of PA educators with a doctoral degree.ResultsOf the 612 unique job ads posted from 232 PA programs between 2014 and 2020, approximately 38.9% (238) stated a preference or requirement for a doctoral degree. Nearly half of the postings for program directors and leadership positions preferred candidates with doctorates. There was a correlation between tenure eligibility positions (20.1%) and preference/requirement for doctoral credentials. PAEA survey data (2014–2019) revealed approximately 24% PA faculty and 45–48% of program directors held a doctoral degree with Doctor of Philosophy (PhD) as the most frequently held doctorate. No significant difference existed in wages for faculty with or without doctoral degree.ConclusionsBased on a national sample of PA program job ads, there is a preference for doctoral-prepared PA educators and the demand for these candidates is greater than market supply. Our analysis has implications for individual faculty career planning, employers and the PA profession as it debates transition to a terminal doctoral credential. Further studies should assess the impact of doctoral credentials on PA education by examining measurable outcomes.

Association of Preadmission Factors With Physician Assistant Student Diversity.

A new physician assistant (PA) program accreditation standard requires institutional support for PA student diversity. Therefore, preadmission factors associated with diversity should be identified to inform decision-making. The purpose of this study was to explore associations between preadmission factors of interest and percentages of underrepresented minority (URM) students in PA programs. Physician Assistant Education Association (PAEA) survey responses from 169 PA programs were analyzed by using simultaneous multiple regression. The variables included the standardized testing requirement of the Graduate Record Examinations (GRE), undergraduate preprofessional phase, public or private institution, writing sample requirement, mission statement inclusive of care for underserved populations, and local racial or ethnic demographics. GRE score requirements were found to be negatively associated with percentages of African American and total non-White, non-Asian students (p < .05). Local URM racial and ethnic population demographics were shown to be positively associated with African American, Hispanic, and total non-White, non-Asian students (p < .05). Undergraduate preprofessional phase, type of institution, writing sample requirement, and mission statement supportive of underserved populations did not show significant associations with URM diversity. Faculty and administration members who are involved in decision-making in PA admissions processes should consider the potentially negative impact of a GRE requirement as it relates to the percentages of African American and total non-White, non-Asian matriculants. Educational institutions might also consider exploring new PA program development in geographic areas with supportive local demographics as an approach to achieving more student diversity.

Evaluation of Disability Education and Emergency Preparedness Curricula of Physician Assistant Programs.

The purpose of this pilot study was to evaluate whether physician assistant (PA) programs in the Midwest integrate both disabilities and emergency preparedness education into 1 curriculum. A convenience sample was utilized to survey program directors and deans of PA programs. Emails were obtained from the Physician Assistant Education Association. A 26, closed-ended question Qualtrics survey was based on an original study by Tanenhaus et al.1. Out of 43 accredited physician assistant programs surveyed, 9 programs replied (21%), and 1 program did not complete the survey. Six of the 10 programs (66%) responded that their program provided lectures specific to emergency preparedness. All 9 programs responded they do not offer a graduate-level track or concentration in emergency/disaster preparedness, and they do not offer a dual degree or a multidisciplinary program that highlights emergency/disaster preparedness. This study was conducted to bring awareness to physician assistant students' education regarding disabilities and emergency preparedness. As public health crises continue to arise, such as coronavirus disease (COVID-19), it is critical to have appropriately trained health care professionals. The study revealed that most programs lack a graduate-level track or concentrations, dual degrees, or extracurricular opportunities related to disabilities and emergency and disaster preparedness.

The Predictive Strength of the End of Curriculum Exam.

To assess the value of the Physician Assistant Education Association's End of Curriculum examTM and formative and summative exams during the physician assistant program in predicting Physician Assistant National Certifying Exam (PANCE) scores. Value of the End of Curriculum exam, Physician Assistant Clinical Knowledge Rating and Assessment Tool (PACKRAT I, PACKRAT II), PANCE simulation (SUMM I), and Objective Structured Clinical Examination in predicting future PANCE scores was assessed using correlation and regression analysis of data for 27 PA students from one cohort. The End of Curriculum exam, PACKRAT I, PACKRAT II, and SUMM I are statistically significant predictors of PANCE score (p < 0.01). A combination of PACKRAT I and PACKRAT II was the best predictor of PANCE score and explained a large amount of variance (77.0%) in PANCE scores. PAEA's End of Curriculum exam is one of the strongest predictors of PANCE score (r = 0.78). It offers an additional opportunity for programs to provide PA students with another layer of academic advising and to guide their preparation for PANCE.

Building an Advising Model for Physician Assistant Education.

Physician assistant education is balancing an explosion of new programs, an increase in novice faculty, and expectations from accreditation standards to track student progress longitudinally. The traditional "one-size fits all" model of advising will not meet the demands of this changing educational environment. This article introduces a longitudinal advising model that integrates various strategies from existing models such as proactive, appreciative advising, and the GROW (Goal, Reality, Options, Will) coaching model with a focus on the goal of achieving the new Physician Assistant Education Association (PAEA) Competencies for the New Graduate.

Development of the Proposed 13 Entrustable Professional Activities for Physician Assistant Graduates.

Competency-based training has not consistently produced medical professionals who are ready to practice. To address this situation, entrustable professional activities (EPAs) have been introduced as a means to assess medical trainee readiness for their next phase of training or practice. Thirteen EPAs were developed by the Physician Assistant Education Association (PAEA) Presidents Commission in 2016 to indicate what activities they thought future physician assistant (PA) students should be expected to perform at the completion of their PA education. The 13 EPAs as proposed by the PAEA Presidents Commission were adopted by the Mayo Clinic PA program and further developed through multiple steps, including (1) Discovery and Alignment; (2) EPA Development; (3) Curriculum Development; (4) Assessment and Rubric Development, and (5) Implementation.

Onward and Upward: Introducing the Healthcare Simulation Standards of Best PracticeTM

Onward and Upward: Introducing the Healthcare Simulation Standards of Best PracticeTM

Comparing the Physician Assistant National Certifying Examination Pass Rate of Graduates From Programs Utilizing Distance Education to the National Average.

The goal of this study was to compare the Physician Assistant National Certifying Examination (PANCE) pass rate of graduates from physician assistant (PA) programs utilizing distance education to the national average of PANCE pass rates. The Physician Assistant Education Association online PA program directory was used to obtain the name and number of physician assistant (PA) programs that offered distance education in their curriculum. The National Commission on Certification of Physician Assistants PANCE Exam Performance Summary Report was reviewed for each PA program that offered distance education. The 5-year first-time taker mean pass rate for all PA programs offering distance education was calculated and compared to the 5-year national first-time taker average for all PA programs in the United States over the same 5-year period. The mean 5-year first-time taker pass rate for PA programs offering distance education was 96.9%. The 5-year national first-time taker average pass rate for all PA programs was 96.0%. The results of this study show that graduates from PA programs utilizing distance education are effectively prepared to pass the PANCE and do so at a rate that is higher than the national mean for all PA programs.