Physician Assistant National Certifying Exam Research Articles

Physician Assistant Program Accreditation Analysis and Survey of Program Directors.

To inform physician assistant program directors through citation analysis after implementation of the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) Accreditation Standards, 5th edition. This research used descriptive statistics, Pearson correlation, and the coefficient of determination to analyze the citations reported by ARC-PA during January 2021 to February 2023. Concurrent first-time taker Physician Assistant National Certifying Exam (PANCE) results were used to determine whether a correlation exists between pass rates and citations. In addition, a survey was sent to each institution's current program director to investigate leadership concerns and differences between programs placed on a provisional, continued, or probation status by ARC-PA. Of the 98 program submissions for accreditation, 13 submissions resulted in a probation status outcome. For these 13 programs placed on probation, 46.2% and 30.8% were cited for being noncompliant with leadership Standards A2.09 and A1.02, respectively. Pearson correlation analysis indicates a significant negative correlation between ARC-PA citations and first-time taker PANCE pass rates ( P = .023, 95% confidence interval [CI] = [-0.49 to -0.04]). This is particularly true for programs with continued accreditation ( P = .007, 95% CI = [-0.67 to -0.13]) and programs that performed below the 85% benchmark ( P = .013, 95% CI = [-0.94 to -0.22]) for first-time taker PANCE pass rates. Although a negative correlation is observed between the number of levied citations and PANCE pass rates, the coefficient of determination does not indicate that the number of citations can predict PANCE pass rates ( R2 = 0.0368). Regarding survey data, 42.86% of programs placed on probation cited institutional support as their biggest program weakness or threat. Conversely, 22.22% of programs with provisional status and 12.5% of programs with continued status reported institutional support as their biggest weakness or threat. This research identifies leadership as a deficit of concern associated with programs placed on probation. In addition, a significant negative correlation exists between the number of citations and first-time taker PANCE pass rates-especially for programs with first-time taker PANCE pass rates below 85% or for programs with continued accreditation status.

Impact of Integrated Pharmacology Instruction by Principal Faculty Pharmacists in Two Physician Assistant Programs: A Retrospective Study.

In recent years, there has been a growing trend toward integrating pharmacology instruction into physician assistant (PA) programs by dedicated PA faculty pharmacists. Pharmacists train to become medication experts. Incorporating pharmacist instruction in a PA program during the didactic year provides PA students with an early opportunity to experience interprofessional education and interdisciplinary synergy through clinical application. This article presents a retrospective study that aims to evaluate the impact of integrated pharmacology instruction by principal PA faculty pharmacists on student satisfaction and standardized assessment metrics. Student satisfaction was measured by course evaluations and exit/alumni surveys. Standardized metrics included Physician Assistant Clinical Knowledge Rating and Assessment Tool and Physician Assistant National Certifying Exam assessments. The findings indicate that having a principal faculty member with specialized expertise in pharmacology has improved the overall course satisfaction, knowledge, and competence of PA students and perceptions of the relevance and effectiveness of pharmacology instruction in their clinical practice. The results of this study support the value of using pharmacist faculty members in PA programs to enhance the quality of pharmacology instruction and ultimately contribute to the success of PA students in their professional careers.

The Application of Adaptive Minimum Match k-Nearest Neighbors to Identify At-Risk Students in Health Professions Education.

When learners fail to reach milestones, educators often wonder if any warning signs could have allowed them to intervene sooner. Machine learning can predict which students are at risk for failing a high-stakes certification examination. If predictions can be made well before the examination, educators can meaningfully intervene before students take the examination to reduce their chances of failing. The authors used already-collected, first-year student assessment data from 5 cohorts in a single Master of Physician Assistant Studies program to implement an "adaptive minimum match" version of the k-nearest neighbors algorithm using changing numbers of neighbors to predict each student's future examination scores on the Physician Assistant National Certifying Exam (PANCE). Validation occurred in 2 ways by using leave-one-out cross-validation (LOOCV) and by evaluating predictions in a new cohort. "Adaptive minimum match" version of the k-nearest neighbors algorithm achieved an accuracy of 93% in LOOCV. "Adaptive minimum match" version of the k-nearest neighbors algorithm generates a predicted PANCE score for each student one year before they take the examination. Students are classified into extra support, optional extra support, or no extra support categories. Then, one year remains to provide appropriate support to each category of student. Predictive analytics can identify at-risk students who might need additional support or remediation before high-stakes certification examinations. Educators can use the included methods and code to generate predicted test outcomes for students. The authors recommend that educators use predictive modeling responsibly and transparently, as one of many tools used to support students. More research is needed to test alternative machine learning methods across a variety of educational programs.

Characteristics of Hybrid Learning Among Health Professions Programs: A Mixed-Methods Study.

To characterize current trends in hybrid education within the physician assistant (PA) profession, specifically program design, drivers, and outcomes in comparison with physical therapy hybrid education. This was a mixed-methods study involving secondary data analysis and focused interviews with stakeholders to triangulate the data. Compared with traditional PA programs, hybrid programs have similar admission requirements, higher cost of tuition, larger class size, and higher attrition rate than national mean. Physician Assistant National Certifying Exam outcome data are in line or slightly lower than national scores. Technological advancements and need for faculty/learner flexibility by time and location are frequently cited driving forces. There is a growing trend toward hybrid education among health professions. Other than cost, attrition rate, and immersion experiences, characteristics of hybrids are similar to traditional programs. It is relevant for PA educators to understand how this educational design may shape the future of PA graduates. Long-term impact should be evaluated with future studies.

Professionalism in Physician Assistant Education as a Predictor of Future Licensing Board Disciplinary Actions.

The purpose of this study was to evaluate associations between postgraduate disciplinary actions (PGDA) by state licensing boards and physician assistant (PA) school documented professionalism violations (DPV) and academic probation. This was a retrospective cohort study comprising PA graduates from 2001 to 2011 at 3 institutions (n = 1364) who were evaluated for the main outcome of PGDA and independent variable of DPV and academic probation. Random-effects multiple logistic regression and accelerated failure time parametric survival analysis were used to investigate the association of PGDA with DPV and academic probation. Postgraduate disciplinary action was statistically significant and positively associated with DPV when unadjusted (odds ratio [OR] = 5.15; 95% CI: 1.62-16.31; P = .01) and when adjusting for age, sex, overall PA program GPA (GPA), and Physician Assistant National Certifying Exam Score (OR = 5.39; 95% CI: 1.54-18.85; P = .01) (fully adjusted). Academic probation increased odds to 8.43 times (95% CI: 2.85-24.92; P < .001) and 9.52 times (95% CI: 2.38-38.01; P < .001) when fully adjusted. Students with professionalism violation or academic probation while in the PA school had significant higher odds of receiving licensing board disciplinary action compared with those who did not. Academic probation had a greater magnitude of effect and could represent an intersection of professionalism and academic performance.

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.

Examination of Similarities and Quantitative Analysis of Trends Between Admissions Variables and Academic Outcomes.

The purpose of this study was to analyze similarities and trends between admissions variables and academic outcomes of physician assistant (PA) graduate programs to better understand the correlations between them. First, multiple admissions variables were examined individually to determine whether and, if so, why they were similar to each of the following 3 academic outcomes: students' first-time Physician Assistant National Certifying Exam scores and overall and first-term graduate school grade point averages (GPAs). Afterward, trends between those individual academic outcome variables and the independent variables associated with any admissions criteria found to share similarities with individual academic outcomes were analyzed using simultaneous multiple linear regression models. Each model used at least 562 students from a sample set of 566 across 3 different PA graduate school programs. Undergraduate GPAs and Graduate Record Examination (GRE) Verbal Reasoning and Quantitative Reasoning scores shared similarities with each academic outcome, and those similarities were included in each regression model. In each model, the undergraduate GPA beta coefficient was greater than the value of the GRE beta coefficients. Based on the beta coefficient values, the undergraduate GPA variable appeared to be the nonbinary and non-age-independent variable that trended upward the strongest alongside increases in each academic outcome when other variables were controlled for.

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

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

Correlation between physician assistant students' performance score of history taking and physical exam documentation and scores of Graduate Record Examination, clinical year grade point average, and score of Physician Assistant National Certifying Exam in the United States.

PurposeLearning to perform and document patient history taking and physical exam (H&P) entails a major component of the first year academic education of physician assistant (PA) students at Wayne State University, USA. The H&P is summative of multiple aspects of PA education, and students must master communication with patients and other health care providers. The objectives of this study were first, to determine if there was a correlation between scores on the Graduate Record Examination (GRE) component testing and scores on graded H&Ps. The second objective was to identify a correlation between proficiency with H&P documentation and academic and clinical year grade point average (GPA) and Physician Assistant National Certifying Exam (PANCE) score.MethodsSubjects included 147 PA students from Wayne State University from 2014–2016. PA students visited local hospitals or outpatient clinics during the academic year to perform and document patient H&Ps. Correlation between the H&P mean scores and GRE component scores, GPAs, and PANCE scores were analyzed.ResultsThe subjects were 26.5 years-old (+6.5) and 111 females (75.5%). There was no correlation between the GRE component score and the H&P mean score. The H&P score was positively correlated with GPA 1 (r=0.512, P<0.001), with GPA 2 (r=0.425, P<0.001) and with PANCE score (r=0.448, P<0.001).ConclusionPA student skill with H&P documentation was positively related to academic performance score during PA school and achievement score on the PANCE at Wayne State University, USA.

Predicting PANCE Outcomes from First Year Evaluative Measures in a PBL Curriculum

Purpose: Previous research has explored various Physician Assistant (PA) student evaluative measures to see if they have predictive validity with regard to Physician Assistant National Certifying Exam (PANCE) scores. Recent literature has begun to evaluate how measures from the first year of didactic education might be helpful in identifying at-risk individuals early in the program. The purpose of this paper was to extend work in that area within a problem-based learning (PBL) curriculum. Method: Participants included 140 students from two consecutive PA classes. Data were imported regarding each student’s evaluative measures of multiple choice question (MCQ) examinations, patient management assessments (PMA), a form of modified essay question (MEQ) examination, and facilitator evaluation ratings (FERs) from the end of each of six curricular units that comprise the didactic year. Results: Correlational analyses revealed all MCQ and MEQ (PMA) scores correlated significantly with PANCE scores. Regression analyses revealed that scores from two specific MCQ unit exams and one specific MEQ unit exam produced a three-factor model that accounted for 57% of variance in PANCE scores. FERs, though significantly correlated with PANCE scores, did not add to the predictive power. Conclusions: Use of MCQ and MEQ scores from the first year of didactic training in PA programs can successfully predict PANCE scores and may therefore be helpful in identifying students who are at risk for poor PANCE performance on their first attempt. Having such information available can direct faculty to students who need extra help early in their educational programs to increase likelihood of their success. With the significant correlations between FERs and PANCE scores, it is clear that faculty who facilitate PBL are also able to identify students who might be at risk based on their interactions during PBL sessions and can also utilize this information to assist student

The Relationship Between Physician Assistant School Admissions Exam (PA-CAT) and Undergraduate Performance Measured by Science GPA and Cumulative GPA"

Purpose: Physician Assistant (PA) programs often set minimum GPA and graduate record examination (GRE) requirements for admission, citing that candidates with higher admission scores will perform better in the PA program. However, to date, there are limited published studies with inconsistent results that have investigated the validity of using these preadmission characteristics to predict performance in PA programs or on the Physician Assistant National Certifying Exam (PANCE). The development of a physician assistant college admission test (PA-CAT) that has predictive validity to determine PANCE success would give PA admissions committees an additional resource to make decisions. This study was conducted to determine the strength of the relationship between PA-CAT and undergraduate cumulative and science GPA. Methods: The PA-CAT is comprised of 180 questions covering 12 subject areas based on research identifying the relative importance of that subject to success in the PA curriculum. The exam was administered through a secured computer-based testing to 479 newly admitted PA students across the United States. Regression analysis was conducted with Rasch scale scores as the dependent variable and two independent variables (undergraduate GPA and undergraduate science GPA). Results: The PA-CAT Rasch scale scores are positively correlated with undergraduate GPA (r=0.16) and undergraduate science GPA (r=0.22). Although these correlation coefficients are statistically significant (pConclusion:Early results from this research study demonstrates there is a statistically significant relationship between the PA-CAT and undergraduate science GPA in newly admitted PA students. Limitations of the study include the fact that students voluntarily took this exam without consequence. Further study is needed to determine if the exam can be generalized to the entire PA applicant pool thereby providing a valid instrument for admissions decisions.

PAEA End of Rotation™ Exams Accurately Identify Students at Risk of Physician Assistant National Certifying Exam Failure.

Physician Assistant Education Association (PAEA) End of Rotation™ exams are used by programs across the country. However, little information exists on the predictive ability of the exams' scale scores and Physician Assistant National Certifying Exam (PANCE) performance. The purpose of this study was to evaluate End of Rotation exam scores and their relationship with poor PANCE performance (PPP). In an IRB-approved, multi-center, multi-year study, associations between PAEA End of Rotation exam scale scores and PANCE scores were explored. A taxonomy of nested linear regression models with random intercepts was fit at the program level. Fully adjusted models controlled for year, timing of the exam, student age, and gender. Fully adjusted linear models found that 10-point increases in End of Rotation exam scores were associated with a 16.8-point (95% confidence interval [CI]: 14.1-19.6) to 23.5-point (95% CI: 20.6-26.5) increase in PANCE score for Women's Health and Emergency Medicine, respectively. Associations between exams did not significantly vary (P = .768). Logistic models found End of Rotation exam scores were strongly and consistently associated with lower odds of PPP, with higher exam scores (10-point increase) associated with decrements in odds of PPP, ranging between 37% and 48% across exams. The effect estimate for the Emergency Medicine exam was consistently stronger in all models. PAEA End of Rotation exam scores were consistently predictive of PPP. While each End of Rotation exam measures a specialty content area, the association with the overall PANCE score varied only by a change in odds of low performance or failure by a small percentage. Low End of Rotation exam scores appear to be consistent predictors of PPP in our multi-center cohort of physician assistant students.

Considerations Around Predicting Physician Assistant National Certifying Exam Scores From PACKRAT®: A Multiprogram Study.

The Physician Assistant Clinical Knowledge Rating and Assessment Tool (PACKRAT®) is a known predictor of performance on the Physician Assistant National Certifying Exam (PANCE). It is unknown, however, whether these associations (1) vary across programs; (2) differ by PACKRAT metrics (first-year [PACKRAT 1], second-year [PACKRAT 2], and composite score [arithmetic mean of PACKRAT 1 and PACKRAT 2]); or (3) are modified by demographic or socioeconomic variables. Linear and logistic hierarchical regression models (HRMs) were used to evaluate associations between PACKRAT metrics and (1) continuous PANCE scores and (2) odds of low PANCE performance (LPP), respectively. Likelihood ratio tests were used to evaluate differences in associations between programs and effect modification by demographic and socioeconomic variables. Receiver operating characteristic (ROC) curves were used to examine the sensitivity, specificity, positive predictive values, and negative predictive values for various PACKRAT metrics/cut points. Models were adjusted for demographic and socioeconomic variables. The PACKRAT scores were standardized for each year to the national mean and SD. Adjusted HRMs across 5 programs (n = 1014) found the composite score to have the strongest association, with a 10-percentile-point increase associated with a 22-point (95% confidence interval [CI]: 19-26) increase in PANCE score. The composite score also strongly predicted decrements in odds of LPP (odds ratio: 0.46; 95% CI: 0.38-0.55). Hierarchical regression models and ROC curves identified significant variability in associations among programs. Effect modification was not observed by any investigated variable. The composite score had the largest magnitudes of association with PANCE scores and odds of LPP. The significant difference in association identified between programs suggests that the predictive ability of the exam is not uniform. The lack of effect modification by demographic and socioeconomic variables suggests that associations do not significantly differ by these metrics.

Reliability and Validity of National End of Rotation Examinations: An Update.

This study sought to evaluate the reliability of the PAEA End of Rotation™ exam scores used as a combined scale. The study also investigated how closely the individual exam scores and the combined scale correlate with Physician Assistant National Certifying Exam (PANCE) performance to validate their use as tools for assessing physician assistant (PA) students during their clinical training. Deidentified PAEA End of Rotation examination and PANCE scores were used to calculate Pearson correlations, Cronbach's alpha, and value of Cronbach's alpha if individual exams were removed from the analysis. A linear regression model was generated to predict certification exam scores. End of Rotation examinations are a reliable predictor of certification examination performance independent of PA program or test version, with Cronbach's alpha at 0.847. The mean of all 7 examinations may be used, but the mean of just 4 examinations (Emergency Medicine, Family Medicine, General Surgery, and Internal Medicine) is also a valid predictor of certification examination performance.

Enhancing Physician Assistant Student Clinical Rotation Evaluations With the RIME Scoring Format: A Retrospective 3-Year Analysis.

This article describes a 3-year retrospective analysis of student clinical rotation evaluations using the Reporter-Interpreter-Manager-Educator (RIME) scoring format. The intent of the analysis was to assess scoring trends to determine whether students with high scores on the Physician Assistant National Certifying Exam (PANCE) also achieved high RIME scores on clinical rotations. The top and bottom quartiles of PANCE scores were identified for the University of Texas (UT) Southwestern Medical Center's physician assistant (PA) classes of 2010-2012 (n = 106). RIME scores for the top and bottom quartiles of students (n = 54) also were identified. RIME scores for the same cohort of students were analyzed using the top and bottom quartiles of students' PANCE scores. The Wilcoxon matched-pairs signed rank test revealed that students with top quartile PANCE scores received a higher aggregate RIME score of 557 compared with the lower quartile of PANCE performers' score of 520 (P < .03). Results for RIME scoring trends, PANCE scores, and end-of-rotation examination scores are presented. Students from the UT Southwestern Medical Center's PA classes of 2010-2012 obtained a Manager classification most often (52%), and students with higher PANCE scores also received higher RIME scores on clinical rotations.

Correlation of the Physician Assistant Education Association End of Rotation Examinations with the Physician Assistant National Certifying Exam.

The purpose of this study was to determine whether student scores on the Physician Assistant Education Association (PAEA) End of Rotation™ subject examinations had a statistically significant relationship with subsequent performance on the Physician Assistant National Certifying Exam (PANCE). The raw scores achieved by students from 3 participating programs were correlated with scores on the PANCE. Seven 120-question End of Rotation examinations, developed by the PAEA, were administered to students from 3 PA programs (n=72). The examinations measured knowledge in the following disciplines: family medicine, internal medicine, behavioral medicine, emergency medicine, surgery, OB/GYN, and pediatrics. The mean PANCE score for all programs was 426 (SD=90) and mean End of Rotation examinations score was 68% (SD=8.3). The Pearson coefficient between the PANCE and End of Rotation examinations scores was 0.856 (P<.05). The results of this pilot study suggest that there is a statistically significant correlation between scores on the PAEA End of Rotation examinations and subsequent PANCE performance.

The Relationship Between Formative and Summative Examination and PANCE Results: A Multi-Program Study

This correlational research study was conducted to validate externally a previous pilot study that examined the relationship between formative and summative examinations and PANCE scores at one physician assistant (PA) program. The study was expanded to five PA programs to test the hypothesis that PA programs throughout the country could use comprehensive examinations that mirrored the Physician Assistant National Certifying Exam (PANCE) along with the Physician Assistant Clinical Knowledge Rating and Assessment Tool (PACKRAT) scores to predict future PANCE performance successfully. The six participating PA programs administered the SUMM I, which is a 360-question PANCE simulation exam based upon the National Commission on Certification of Physician Assistants (NCCPA) blueprint, the SUMM II, a 700-question examination based upon the NCCPA blueprint, and the PACKRAT examination to all second-year students. Participating programs were provided cut scores for each of the test instruments that identified students at critical risk for failing the PANCE. The scores of the study participants from the originating institution were gathered between 2007 and 2010 and from five additional programs in 2011-2012 to determine correlational strength between the instruments and the PANCE. The SUMM I, SUMM II, and PACKRAT scores (N = 421) were combined in a regression model to generate a predicted PANCE score. The strength of correlation between the predicted PANCE score and actual PANCE score demonstrated an Rvalue of 0.79 and an R2 Of 0.62. This correlational study suggests that summative examination instruments can be developed and triangulated with PACKRAT scores to predict future performance on the PANCE and determine thresholds of risk for failing the PANCE based upon stratified levels of past performance.

Correlations Between PANCE Performance, Physician Assistant Program Grade Point Average, and Selection Criteria

The purpose of this study was to examine correlations between first-time Physician Assistant National Certifying Exam (PANCE) scores and pass/fail status, physician assistant (PA) program didactic grade point average (GPA), and specific selection criteria. This retrospective study evaluated graduating classes from 2007, 2008, and 2009 at a single program (N = 119). There was no correlation between PANCE performance and undergraduate grade point average (GPA), science prerequisite GPA, or health care experience. There was a moderate correlation between PANCE pass/fail and where students took science prerequisites (r = 0.27, P = .003) but not with the PANCE score. PANCE scores were correlated with overall PA program GPA (r = 0.67), PA pharmacology grade (r = 0.68), and PA anatomy grade (r = 0.41) but not with PANCE pass/fail. Correlations between selection criteria and PANCE performance were limited, but further research regarding the influence of prerequisite institution type may be warranted and may improve admission decisions. PANCE scores and PA program GPA correlations may guide academic advising and remediation decisions for current students.

The Use of Noncognitive Factors in Physician Assistant Admissions

To identify the most influential noncognitive factors valued in admissions processes by physician assistant (PA) programs throughout the United States, as well as the motivators for and barriers to using these factors. A literature search was performed using PubMed and the Journal of Physician Assistant Education to identify noncognitive factors that were reported to have an effect on admissions in various health professions. A survey was developed incorporating the most frequently identified factors and was electronically distributed to all program directors of the Physician Assistant Education Association (PAEA). Respondents were asked to rank the noncognitive factors that were most valued by their program's admissions process as well as to rate motivators and barriers for the use of these noncognitive factors in admissions. Survey responses were anonymous but respondents reported program location by geographic region as defined by PAEA. There were 94 respondents from 154 programs surveyed (61% response rate). The five most influential noncognitive factors were faculty/staff/interviewer interactions, career motivation, knowledge of profession, maturity, and professionalism. The most important motivators for using noncognitive factors were identified as academic success and career success. All aforementioned factors and motivators did not vary based on PA program region (P > .05). The factors identified with the highest level of regional variance were leadership experience (P = .014), self-awareness (P = .034), cultural sensitivity (P = .022), undergraduate institution (P = .010), and peer interaction (P = .035). These study results will assist PA applicants in becoming more competitive and provide programs with additional factors for consideration in current admissions practices. Further considerations for research include correlating results to academic success as well as success on the Physician Assistant National Certifying Exam (PANCE).

A Comparison of Student Knowledge Acquisition by Organ System and Skills in Parallel Problem-Based and Lecture-Based Curricula

A 5-year longitudinal study was conducted of students' acquisition of knowledge by organ system and skill development between two curricular tracks: problem-based learning (PBL) and lecture-based learning (LBL). Analysis of these data is reported. A comprehensive examination was administered to all students enrolled in the LBL and PBL curricular tracks on five occasions: 0, 4, 8, 12, and 24 months. The organ-system and skills subtest scores from these comprehensive examinations and the Physician Assistant National Certifying Exam were compared. Organ-system subtests: Of the 12 organ-system subtests measured, there was a statistically significant difference between the LBL and PBL curricula in the mean test scores for one subtest (psychiatric). In addition, there were significant differences in all organ-system subtests by time, and finally there was a curriculum by time interaction in 10 of 12 subtests. Skills subtests: There were statistically significant differences in the mean test scores for one of seven subtests (applying scientific concepts), as well as significant differences in all skills subtests by time and a curriculum by time interaction in six of seven subtests. Statistical differences observed could mostly be explained by differences in knowledge on program entry or in time of exposure to curricular content. The importance of clinical training was evidenced in some organ systems, particularly reproductive and psychiatric. More uniform learning appears to occur in skills education, and there is evidence that the PBL model provides a sound grounding in the application of basic science.