Physician Assistant Education Research Articles

Perspective on the Journal of Physician Assistant Education : From Association Newsletter to Academic Peer-Reviewed Journal Celebrating 25 Years.

For 25 years, the Journal of PA Education (JPAE) and its predecessor publications have been the pre-eminent venues for disseminating and promulgating information and research on the physician assistant (PA) profession. In this article, former and current editors in chief have compiled a detailed history of the journal, its development, and its trajectory into the future, outlining the journey taken by Association of PA Programs/PA Education Association to catalog faculty scholarship through a peer-reviewed journal. Allowing for the referencing of articles and thus adding to the body of knowledge on PAs and PA education, JPAE has not only endured but thrived. This article speaks to the collective effort and excellence of staff, and the many volunteer reviewers, feature editors, and editorial board members who have nurtured JPAE along the way through numerous changes, challenges, and triumphs.

Five Evidence-Based Strategies to Foster a Culture of Well-Being in Physician Assistant Education.

The objective of this study was to discuss evidence-based strategies to promote a culture of well-being with physician assistant (PA) education. Published literature on medical student, resident, and PA student well-being was reviewed with findings subsequently categorized according to well-being strategy. Five themes were found from existing well-being research within medical student and PA student education: faculty role modeling and support, dedicated curricular time, pass/fail grading schema and de-emphasizing grades, peer support and learning communities, and evaluation importance. Physician assistant educators may be able to foster a culture of well-being for their students by making even small adjustments to the existing educational curriculum.

Physician Assistant Educators' Production Blueprint for Video Pedagogy.

This article presents a blueprint for effective video media production in physician assistant (PA) education based on validated pedagogical practices found in the literature. Using the cognitive load theory and a practical blueprint for video production designed for PA educators, this method aims to improve video production practices and better engage students within a format that improves learning outcomes for a diverse body of PA students. Students are interacting with videos, and there is an opportunity for educators to hone practices in video production to enhance student learning. A literature review of pedagogical practices in video production guides the production blueprint for video production. The practical principles of cognitive load theory improve efficiency in assimilating new information, enhance student engagement, and facilitate active and deep learning for a student learner engaging with the instructional video. Based on the literature and the author's educational video creation experience, a guide in the form of a production blueprint specific to PA education is proposed.

An Analysis of Lesbian, Gay, Bisexual, Transgender, and Queer Curricula Inclusion: A National Study of Physician Assistant Programs.

The health professions education literature shows an increased focus on inclusion of lesbian, gay, bisexual, transgender, and queer (LGBTQ) content in curricula; however, it does not address hours of content or methods for content delivery. The purpose of this study was to describe the delivery of LGBTQ content in physician assistant (PA) education through a national survey of PA programs. In 2021, a national program survey was sent to all US-accredited PA Programs (n = 284) and had a completion rate of 71.8% (n = 204). Descriptive statistics were conducted to describe trends and make comparisons in the delivery of LGBTQ content. Most PA programs are incorporating LGBTQ content into preclinical phases of PA education (81%) and describe that LGBTQ curricula align with institutional values (82%). Most report 1 to 3 hours of preclinical education for all LGBTQ population groups and cite medical interviewing courses as the most frequently used course to address LGTBQ care. Many programs (43%) do not provide instructional hours on LGBTQ content in the clinical phase, and the majority do not offer clinical rotations focused on this care. The results show variability in the level of preparedness that programs report on their students caring for LGBTQ populations. Physician assistant programs are generally integrating the content throughout their didactic curricula; however, few offer clinical experiences focused on caring for patients who are LGBTQ. Offering clinical experiences and assessing student competencies are areas of growth in health professions education as related to LGBTQ health.

Assessing Student-Reported Perceptions of Prerequisite Usefulness in Preparation for Didactic Physician Assistant Education.

To gain admittance to a physician assistant (PA) school, applicants must complete program-specific prerequisite courses and experiences. The lack of standardization contributes to complexity, expense, and limits diversity. This research assessed current didactic PA students' perceptions of prerequisite courses, course delivery methods, and direct patient care (DPC) experiences to determine which were perceived as the most useful in preparation for didactic PA education. An online cross-sectional survey was sent to eligible PA students across the United States. The survey collected opinions on the usefulness of commonly required prerequisite courses, course delivery methods, and DPC experiences. Collected data underwent statistical analysis and qualitative analysis for open-response questions. A total of 527 students completed the survey. Greater than 50% reported prerequisite courses in science and psychology as well as speech, ethics, cardiopulmonary resuscitation (CPR), medical ethics, medical terminology, and nutrition "prepared them well" or "extremely well." The most frequently recommended educational delivery method was "in person." The DPC experiences reported to best prepare students were Medical Assistant, Certified Nursing Assistant, and Scribe. The reported recommended number of DPC hours was 1000 to 1499. Chi-square tests for courses that prepared students "well" and "extremely well" revealed that in-person delivery had a statistically significant association with anatomy, physiology, ethics, CPR, medical ethics, and Spanish. These significant findings should be considered by PA programs when evaluating their requirements for admission. Furthermore, PA education associations should consider universal requirements to reduce applicant barriers, complexity, and expense, which may lead to improved diversity.

Teaching Future Physician Assistants to Provide ADEPT-CARE to Disabled Patients: A Novel Application of Disability Curriculum.

Physician assistant (PA) students will be certain to provide care to patients with disabilities in their future careers. However, there is a dearth of literature on disability-related education in PA training. This curriculum sought to fill this need. The specific aims of this study were to (1) evaluate the implementation of a 3-part disability-focused education curriculum in PA education, (2) assess changes in PA students' self-perceived confidence and attitudes toward patients with disabilities, and (3) assess students' attitudes toward ADEPT-CARE. A 3-part disability curriculum was implemented into the first-year PA curriculum at a single Mid-Atlantic institution. Students could voluntarily complete pre and post-surveys which assessed their self-perceived confidence and attitudes toward people with disabilities, perception of the curriculum, and attitudes toward ADEPT-CARE and disability health. Thirty students participated in the study, with a 100% survey response rate. Nearly all participants agreed or strongly agreed that this curriculum enhanced their medical education (n = 28, 96.6%, frequency missing n = 1). After curriculum completion, there was a statistically significant improvement in participants' confidence in their ability to assess patients with disability (46.7%-93.3%, P < 0.001), ability to provide the same quality of care to patients with disability as those without disability (80.0%-96.7%, P = 0.025), and perception of quality of life of persons with disabilities (P = 0.030). This curriculum was well received by PA students and improved their attitudes toward patients with disabilities, thereby fulfilling a critical need for PA educators.

Leadership From a Different Lens: Shaping the Future of Healthcare Education.

Physician assistant (PA) educators are responsible for preparing the next generation of PAs to be not only healthcare providers but also healthcare leaders. Regardless of whether advanced practice providers choose to pursue formal leadership roles in healthcare, they will undoubtedly be expected to possess and exhibit leadership skills. The PA profession indicates leadership as an important professional competency, yet leadership training is rare in current curricula. The PA community should consider the importance of leadership training for educators as they influence future PAs and the way PA students will affect their future patients and the healthcare systems for which they work. The aim of this article was to bring awareness to the need for leadership skill training in PA education, to review common leadership styles in healthcare, and to offer practical leadership tips to healthcare educators.

Black and Hispanic Representation Declined After Increased Degree Requirements for Physician Assistants.

The physician assistant (PA) profession is one of the least racially and ethnically diverse health professions requiring advanced education. New PA graduates are even less diverse than the current PA workforce and less diverse than professions requiring doctoral degrees. Between 1995 and 2020, the percent of all PA graduates that were Black individuals fell from 7% to 3.1%, while Hispanic representation increased from 4.5% to 7.9%. Using the federal Integrated Postsecondary Education Data System, we examine the impact of transitions to master's degrees for PAs on Black and Hispanic representation between 1995 and 2020, using individual universities as the unit of analysis. After adjusting for state and year effects, PA programs that transitioned from bachelor's to master's degrees experienced a 5.3% point decline in Black representation and a 3.8% point decline in Hispanic representation. Relative to the already low proportions of Black and Hispanic graduates in PA programs, these declines are significant. Steps should be taken to ensure that underrepresented populations have greater access to PA education.

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.

Using Reflective Practice to Enhance Student Professionalism.

Reflective practice, critically reflecting on one's actions or attitudes to engage in the process of continuous adaptation and learning, has proven to be an effective strategy for improved patient care. Additionally, literature supports applying reflective practice for professional growth in medical providers. When contemplating professionalism training in physician assistant (PA) education, it is important to consider how to obtain buy-in from students. One way to do this is to link professionalism to the students' future career as a PA. The School of Physician Assistant Studies at Pacific University (the Program) created an Online Orientation Reflective Practice Assignment that was implemented during online orientation. Students were prompted to use reflective practice to create detailed "plans for success." The goal of this assignment was to reduce common professionalism missteps students often experienced. Data regarding the number of professionalism encounters per cohort, broken down into occurrences by curricular phase (didactic vs clinical), was tracked and collated using Microsoft® Excel®. The data was analyzed to determine trends. Implementation of the Online Reflective Practice Assignment for all PA students at the beginning of their education has increased student awareness of the Program's, and the profession's, expectations regarding professionalism and accountability. Thus far, the resulting number of professionalism missteps have not decreased year-over-year. We hypothesize that this is due to the difficulty meeting increased administrative expectations and burdens put on students during the pandemic. Students' use of reflective practice to review what went wrong and to create plans to avoid missteps in the future allows them to focus on productive next steps in building their professional identity. Implementation of the Online Orientation Reflective Practice Assignment has better prepared students for the expectations of the PA profession and provided them with a solid foundation to build their professional identity throughout their education and into their careers.

Social Media in Physician Assistance and Medical Education

Objective: To assess physician assistant (PA) students’ experiences with social media (SM) as a part of their medical education. Place and duration of study: Study was conducted at Fazaia Medical College, Islamabad, Pakistan from July 2019 to July 2020 in one year duration. Methodology: This study was completed in two different phases. In phase 1 a cross sectional survey was conducted to measure student opinions and experience with social media. This survey was conducted on all 1st and 2nd year PA students. Phase 2 was a longitudinal observational survey to incorporate two 1st year PA classes regarding social media in medical education resources. First year and second year students from medical school were enrolled. Results: The mean support of social media inclusion in physician assistant, enhancing existing curriculum, and the anticipation of formal inclusion in the future was 2.42±0.58,2.53±0.98 and 2.42±1.06, respectively. While support social media inclusion in physician assistant, worthwhile addition to the lectures and Useful addition to physician assistant curriculum was 1.84±0.64, 1.77±0.72 and 2.02±0.88, respectively. Conclusion: Many physician assistants and medical students are already using social media as an informal part of their studies. Some difficulties were also identified by physician assistant students in finding a well-established educational social media. Many PA educators used our data in designing curriculum of PA students. More studies are needed to focus on social media use and its effects on examination education and learning.

PA Scholars: What Drives and Inhibits Success?

The full expression of an educator includes scholarship, yet many physician assistant (PA) educators are not published. Several barriers unique to PA education are often cited to explain this phenomenon. However, some in the PA profession have become prolific writers despite working in the same environment. In this study, authors strove to understand what motivated these productive faculty by posing 2 research questions: (1) What are the drivers of success for high-performing PA scholars and (2) how do high performing PA scholars overcome barriers? A qualitative study using a constructivist, grounded theory approach explored the experiences and motivation of PA-credentialed educators who published >5 peer-reviewed articles and whose body of work achieved an h-index of >3. High-performing scholars valued scholarship as a creative outlet and a rewarding pursuit. Scholars achieved a sense of fulfillment in their work. Research and writing were described as protective against burnout. Participants viewed barriers differently than other educators. Barriers were acknowledged, but participants developed strategies to overcome obstacles. Mentorship was seen as crucial to success. A nuanced understanding of PA research and the characteristics associated with high-performing PA scholars emerged. The study identified developmental stages associated with the formation of a scholar. Progression from prescholar to mature scholar has important implications for initiatives designed to increase scholarship and provides evidence to support the claim that scholarship positively affects job satisfaction, personal well-being, and talent retention.

Physician Assistant Gender Differences in Research, Professional Goals, and Perceptions of Support.

The majority of Physician assistant (PA) educators are women, yet men proportionately publish more and advance further in academic rank. This study examined if research interest, promotion goals, and perceptions of institutional support differed between PA educators with different gender identities. This is a subset analysis of a previously published cross-sectional study. PA programs were stratified by region and Carnegie classification and were sampled by a stratified random sampling method. PA faculty from selected programs were invited to participate in an anonymous survey. Data were analyzed to account for the stratified sample design. Means and proportions with associated 95% confidence intervals are described. There was a 51% response rate (N = 110). Sixty-three percent of respondents identified as female and 36% as male. Men had a mean of 5.67 (0.17, 11.16) career research articles and women had 1.56 (0.68, 2.44) articles. Fifteen percent (3.7%, 26.3%) of men were full professor compared to 4.3% (0, 9.1%) of women. When transitioning to a faculty role, 72.5% (58.4%, 86.6%) of men and 52.9% (41%, 64.7%) of women felt supported by their institution. Both genders valued promotion, but 80% (67.6%, 92.4%) of men reported having clear 5-year goals compared to 58.8% (46.6%, 71%) of women (P = .034). There was no statistical difference in publications between men and women in this study. Women felt less supported when transitioning to a faculty role compared to men. Both men and women valued promotion equally, but men reported working towards that goal more intentionally. This study found few consistent differences in the attitudes and behaviors towards scholarship between men and women.

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.

Implementation of an Evidence-Based Medicine Curriculum for Postgraduate Emergency Medicine Physician Assistant and Nurse Practitioner Fellows.

Within physician assistant (PA) education, the inclusion of evidence-based medicine (EBM) is mandatory. Despite existing literature on EBM training methodologies for PA students and emergency medicine (EM) physician residents, there exists a dearth of published data concerning EBM instruction within postgraduate PA EM programs. A pilot study is described providing an overview of implementation of an EBM curriculum in a single-institution postgraduate physician assistant and nurse practitioner emergency medicine fellowship. Quantitative data using pre-curriculum and post-curriculum surveys were collected. The curriculum included statistical concept screencasts, required attendance at a journal club with assigned topics for discussion, and used a critical appraisal tool designed to help fellows better analyze and understand the articles being reviewed. Upon graduation, fellows participated in structured interviews to collect qualitative data about the curriculum and application of learned concepts to the clinical setting. There was a statistically significant improvement in fellows' reported confidence in discussing the medical literature with practicing providers ( P = .02). However, there was no difference in prescores and postscores on EBM knowledge questions or on fellows' feelings of importance of EBM to clinical practice. Qualitative data revealed several themes, including helpfulness of tools provided in the curriculum, appreciation of curricular changes made secondary to fellow suggestions, and reports of improvement in reviewing medical literature and comfort in participation in local journal clubs upon graduation from the fellowship program. Limitations, including small sample size and validity concerns, are discussed. Positive changes were made to the curriculum based on qualitative data collected. The authors advocate for subsequent investigations into this subject within a multi-institutional and multispecialty context, thereby enhancing the breadth of the findings. Nevertheless, this study furnishes the initial accessible substantiation of the viability of introducing an EBM curriculum within this specific demographic.

Equipping Dutch clinical midwives: The physician assistant education program

Equipping Dutch clinical midwives: The physician assistant education program

A Tool for Physician Assistant Educators? Teaching the American Academy of Physician Assistant Ethics Guidelines With Case Examples to Physician Assistant Students.

A Tool for Physician Assistant Educators? Teaching the American Academy of Physician Assistant Ethics Guidelines With Case Examples to Physician Assistant Students.

Maximizing Clinical Skills Training in Physician Assistant Education: Integrating Simulation-Based Learning to Enhance Clinical Proficiency, Confidence, and Team-Based Care.

Maximizing Clinical Skills Training in Physician Assistant Education: Integrating Simulation-Based Learning to Enhance Clinical Proficiency, Confidence, and Team-Based Care.

Physician Assistant Faculty Perceptions Regarding Ongoing Self-assessment and Accreditation.

While the processes of ongoing self-assessment and accreditation provide significant benefits to physician assistant (PA) programs, faculty members are often challenged by the required procedures and standards set by accreditation agencies. This study explored faculty perspectives regarding the processes of ongoing self-assessment and accreditation in PA programs. A qualitative research design centered around semistructured interviews was used. A total of 26 participants were recruited, including PA program directors, associate program directors, directors of assessment and accreditation, past Accreditation Review Commission on Education for the Physician Assistant commissioners, accreditation consultants, deans, and PA Education Association leaders. Semistructured one-on-one interviews were conducted by 8 members of the research team through Zoom video conferencing. Data were collected until saturation was reached. The interview recordings were transcribed and analyzed independently by 3 researchers. The transcripts were imported into NVivo, a qualitative data analysis software, for coding and inductive thematic analysis. Six emergent themes were identified under 2 major categories: facilitators and challenges. Facilitators for conducting continuous programmatic review and analysis include it takes a village, internal and external support, and sustained faculty development, whereas challenges are lack of knowledge and time, unclear expectations, and inflexibility. The study highlights factors associated with facilitating the ongoing self-assessment process. However, a number of challenges were also identified. The study suggests opportunities for intervention at the program, institution, and profession level.