Physician Assistant Profession Research Articles

Challenges of Clinical Education.

As we celebrate the 50th anniversary of the physician assistant (PA) profession and specifically PA education, think of the tens of thousands of clinical preceptors who were or currently still are involved in the education of PA students. The clinical phase of PA programs has become the rate-limiting issue in PA education. For decades, developing clinical education sites was relatively easy. Over the last decade, rapid expansion in medical, nurse practitioner, and PA education programs has resulted in greater challenges in obtaining necessary clinical training sites. This article attempts to address several of the current challenges in PA clinical education.

Founding of the Association of Physician Assistant Programs and the Organization's Central Role in the Development of the Physician Assistant Profession.

The Physician Assistant Education Association (PAEA) (formerly Association of Physician Assistant Programs [APAP]) was founded in 1972 by early PA program leaders to encourage collaboration and discussion among program leaders and faculty on a wide range of issues of mutual concern. This article addresses the founding of the organization, which continues to represent PA programs today. It addresses the important accomplishments of APAP during the 1972-1974 period and describes in detail the essential contributions of APAP and its leaders in developing the PA profession. Included are discussions of "the Role of the Registry of Physicians' Associates," which was incorporated into APAP; the sponsorship of "the First National Conference on New Health Practitioners" in collaboration with AAPA; the "Launching a Joint National Office" for APAP and AAPA in Washington, DC, in 1973; and "Places at the Table," which reviews the successful efforts of APAP leaders to gain inclusion of AAPA and APAP in the Joint Review Committee on Educational Programs for Assistants to the Primary Physician (JRC-PA) for accrediting qualified programs, the contribution of APAP leaders to the development of the first Certification Examination for the Assistant to the Primary Care Physician by the National Board of Medical Examiners (NBME) in 1973, leadership in the founding of the National Commission on the Certification of Physician Assistants (NCCPA) in 1974, and collaboration with the Association of American Medical Colleges (AAMC) in developing interdisciplinary education and training. It concludes with a summation of the legacy of APAP (PAEA's) formative years.

Physician Assistant Education Association: Past, Present, and Future.

The Physician Assistant Education Association (PAEA), known as the Association of Physician Assistant Programs (APAP) until 2006, is the professional organization that represents physician assistant (PA) programs in the United States. Its mission is to "pursue excellence, foster faculty development, advance the body of knowledge that defines quality education and patient-centered care, and promote diversity in all aspects of PA education." PAEA has played an important role in promoting and shaping the educational mission of the PA profession. PAEA experienced a modest beginning, but it has evolved quickly as it increased its governance structure, staff, budget, and member services to support a rapidly growing profession over the last couple of decades. PAEA's current progress has positioned the profession well to increase our national visibility and our ability to affect the future of health care delivery. The future of PA education and PAEA will certainly be impacted by our continuing ability to adapt to change and to be visionary in our approach to the significant challenges we will face. Collectively, the Association staff, volunteers, and members will strive to fulfill its mission.

Returning the Physician Assistant Profession to its Roots Could Ease the Tension; Reduce Animosity between Physician Assistants and Others. Meanwhile, a Third World Country Needs Physician Assistants

Returning the Physician Assistant Profession to its Roots Could Ease the Tension; Reduce Animosity between Physician Assistants and Others. Meanwhile, a Third World Country Needs Physician Assistants

Female PAs-Where are we today?

As the physician assistant (PA) profession celebrates its 50th birthday, we can be proud of the gains our profession has accomplished. However, despite the positive reports of job satisfaction, a marked increase in female PA leaders, and overall gains in PA compensation, a significant wage gap remains between male and female PAs. The PA profession is flourishing but it is time female PAs are paid equitably.

Are Physician Assistants Needed in Guatemala? A Survey of Potential Urban and Rural Users.

The shortage of trained health care personnel has been increasing worldwide. With the physician assistant (PA) profession, created in the United States in the 1960s, expanding globally, this study sought to ascertain whether PAs can be an innovative solution to this crisis. We conducted a convenience sample survey to assess the need for and acceptability of future PA professionals in Guatemala. Eighty-nine doctors, nurses, and community members from rural and urban areas of Guatemala participated in the survey. More urban (70%) than rural (58%) respondents found it difficult to access a doctor, with cost being the major reason (34%). Access in rural areas was reportedly limited by lack of doctors and inaccessible office hours. Most survey respondents considered PAs to be suitable and potentially helpful providers for Guatemala, with a preference for competencies in the diagnosis of serious illnesses, drug prescription, labor and delivery attendance, and care for injuries and fractures, especially in rural locations. Belonging to the community was deemed very important for a PA who would practice in the country.

From feldschers to physician assistants in Bulgaria.

The physician assistant (PA) profession was established in Bulgaria in 2014 in response to a growing shortage of medical staff and was modeled on the United States experience. Feldschers provided a similar role in Bulgaria from 1878 to 1999 but feldscher training was discontinued in 1999 because of a physician surplus. However, healthcare in Bulgaria changed after the country joined the European Union, and some physicians left for better opportunities elsewhere. The loss of physicians and an aging population meant that PAs were seen as a strategy to offset Bulgaria's growing healthcare demand.

PAs

From the very beginning, popular media has played an essential role in driving public awareness and recognition of physician assistants (PAs) as major contributors to healthcare. But for PAs, popular media can be a double-edged sword. Over time, the roles of PAs have evolved from bit players to leading characters on television medical dramas. Even so, on some occasions, the roles of PAs have been marginalized and misrepresented. In the future, the PA profession will need to remain vigilant about how PAs are portrayed in the popular media and must learn how to use the full benefit of the media to promote the profession's diversity, flexibility, collegiality, and civic-mindedness.

Examining the Gap: Compensation Disparities between Male and Female Physician Assistants

BackgroundCompensation disparities between men and women have been problematic for decades, and there is considerable evidence that the gap cannot be entirely explained by nongender factors. The current study examined the compensation gap in the physician assistant (PA) profession. MethodsCompensation data from 2014 was collected by the American Academy of PAs in 2015. Practice variables, including experience, specialty, and hours worked, were controlled for in an ordinary least-squares sequential regression model to examine whether there remained a disparity in total compensation. In addition, the absolute disparity in compensation was compared with historical data collected by American Academy of PAs over the previous 1.5 decades. ResultsWithout controlling for practice variables, a total compensation disparity of $16,052 existed between men and women in the PA profession. Even after PA practice variables were controlled for, a total compensation disparity of $9,695 remained between men and women (95% confidence interval, $8,438–$10,952). A 17-year trend indicates the absolute disparity between men and women has not lessened, although the disparity as a percent of male compensation has decreased in recent years. ConclusionsThere remain challenges to ensuring pay equality in the PA profession. Even when compensation-relevant factors such as experience, hours worked, specialty, postgraduate training, region, and call are controlled for, there is still a substantial gender disparity in PA compensation. Remedies that may address this pay inequality include raising awareness of compensation disparities, teaching effective negotiation skills, assisting employers as they develop equitable compensation plans, having less reliance on past salary in position negotiation, and professional associations advocating for policies that support equal wages and opportunities, regardless of personal characteristics.

Diffusion of PA innovation: Risk-taking vs. safe bet.

The physician assistant (PA) profession is a health workforce innovation. This article discusses whether, after 50 years, the PA profession is still an innovation.

Research on the PA profession: The medical model shifts.

Physician assistant (PA)-focused research arose in response to the idea that an assistant to the busy physician could improve healthcare delivery. The process of answering questions about the profession has involved multiple approaches and various scholarly disciplines. In the course of this undertaking, what emerged were three stages of examination of PA behavior. The bibliographic span from this period contains about 2,400 studies that advance some notion of PA benefit to society. On the 50th anniversary of the PA profession, a question arises as to what research has shown. The answer is that PAs are providing care at significant levels of quality and quantity and their presence is enriching many challenges in healthcare delivery. In an era where demand for medical services is outstripping supply, the good idea born in the 1960s is emerging as a medical innovation domestically and globally.

Returning the Physician Assistant Profession to its Roots, Could Ease the Tension and Reduce Animosity

Returning the Physician Assistant Profession to its Roots, Could Ease the Tension and Reduce Animosity

Integrating interprofessional experience throughout a first-year physician assistant curriculum improves perceptions of health care providers

Abstract Purpose Interprofessional collaboration is essential in Physician Assistant (PA) practice. Therefore, a three-semester sequence of Hospital Community Experience (HCE) was implemented during the didactic phase of the PA program providing students with weekly opportunities to shadow/observe health care professions. Methods This longitudinal, cohort study evaluated the effect of the HCE on PA students' perceptions of other health care professions prior to HCE, immediately after HCE, and one year later, after the clinical clerkships. The Interprofessional Perception Scale (IPS) survey was used to assess perceptions. Results Comparison of the IPS between the Pre-HCE and subsequent time points revealed statistically significant positive change in perception of other health care professions while also identified some areas for future research and curricular intervention. The greatest number of statistically significant changes occurred in statements which related to how other professions viewed the PA profession and how other professions worked with PAs. Conclusion The interprofessional HCEs emerged to be important in shaping the desired interprofessional professional identity of PA students.

Self-Directed Learning in Physician Assistant Education: Learning Portfolios in Physician Assistant Programs.

Self-directed learning (SDL) portfolios are underused in the educational process and should be considered by physician assistant (PA) programs. Clinicians such as PAs are responsible for self-identifying their learning needs, competencies, and ongoing educational requirements. This article introduces an outline for SDL in the PA profession, for direct use by learners and indirect use by educators. Without a plan, many professionals may lack the insight, motivation, and knowledge needed to improve their skill set and establish goals for individual lifelong learning. This study conducted a review of the literature. Then, by incorporating SDL portfolios into PA educational methodologies, it constructed a concept map for individuals to monitor, self-direct, and actively participate in their own learning in academic settings and throughout their career.

An update on the expansion of the physician assistant profession in Europe

An update on the expansion of the physician assistant profession in Europe

Insights into the physician assistant profession in Canada

Physician assistants (PAs) have been used for decades in the Canadian military. Now, PAs are being introduced in various clinical settings to provide patient care for the general population. This article reviews major developments in the PA profession across Canada over the last decade. Nearly 541 PAs are employed in Canada or work for a Canadian agency. Growing evidence demonstrates the positive effect of PAs; however, key issues challenge the extent to which the PA movement will continue to build momentum.

Nurse practitioners and physician assistants in primary care: An update of changes since 2008

This article is an update to a 2008 article “Nurse Practitioners and Physician Assistants in Primary Care” which will provide not only a basic understanding of the Nurse Practitioner and Physician Assistant profession, but also developments in the professions over the last 8 years. Issues pertaining to healthcare quality, access to care, reimbursement, and increasing healthcare costs are influencing the United States healthcare system. The roles of the nurse practitioner (NP) and physician assistant (PA) in health care are crucial today in providing access to care and ensuring efficiency of care, while maintaining the quality of care given to the public. Since NPs and PAs have come into existence, they have helped with holding down healthcare costs, providing care to underserved populations, and enabling physician practices to serve their patients better. Availability of care and physician shortage became growing issues in health care. Increasing demands on physicians in terms of “intensity and complexity” of the care required began to exist. This increasing demand led to the development of these disciplines as a way to combat the challenges of health care. There are approximately 175,000 NPs and 90,000 PAs practicing in the U.S. today an increase from 100,000 and 60,000 8 years ago. Those numbers have more than doubled since 1990. In fact, according to Roblin, NP/PAs are capable of potentially seeing 50%–75% of all primary care visits. Given their track record, employing NPs and PAs in primary care settings seems like a logical choice. In all, 40% of NPs are trained as family NPs and 10% are trained in pediatrics. Other NPs are trained to specialize, unlike PAs who are always trained as generalists with half in medical offices and the other half in hospitals, public health, nursing homes, and other settings. NPs and PAs are used by approximately one-quarter of primary care physicians, seeing nearly the same types of patients as the physician. Family physicians are using NPs and PAs more than any other medical specialty. More than 60% of physician group practices are now employing NPs and

Is Professionalism Important in Physician Assistant Education?

Purpose: This study was designed to demonstrate the importance of a formal professionalism curriculum in physician assistant (PA) education. The PA concept arose from the medical profession, and PA education was designed to follow the medical model of education. Courses have been mandated by the Accreditation Council for Graduate Medical Education (ACGME) to include professionalism. Just as in the curriculum in medical schools, PA educators have been allowed to create their own professionalism curricula. The American Academy of Physician Assistants (AAPA) and the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) have mandated that professionalism and ethics must be included in PA education. To address this need, a professionalism curriculum for first year PA students was created that combined standards of professionalism that are taught in medical school with those from the PA profession. Method: Sixty-four students enrolled in their first year of a master’s degree PA program were asked to voluntarily participate in a two-part survey to assess their knowledge of professionalism. The initial survey was administered prior to any formal education in professionalism. The same survey was repeated following the completion of the professionalism curriculum. The design of the survey was cross sectional and consisted of close ended questions. A Likert scale was utilized for responses, allowing for statistical analysis and comparison. Results: Sixty-three of 64 students completed both surveys. Results did not demonstrate a statistically significant improvement in knowledge of professionalism. Student evaluations were overwhelmingly positive, as was their participation in group discussions. Conclusions: Professionalism did not significantly improve. The lack of statistical significance may have referred to the lack of reliability in the findings but did not indicate the curriculum was effective or ineffective. It may have been wiser to continue professionalism education throughout the didactic year, incorporating case studies and simulation exercises.

Twenty Years of Growth and Innovation: A Reflection on PACKRAT's Impact on Physician Assistant Education.

In its 20th year, the Physician Assistant Clinical Knowledge Rating and Assessment Tool (PACKRAT) is a student self-assessment that can assist physician assistant (PA) students and PA program faculty in identifying strengths and areas in need of improvement in the didactic and clinical phases of PA education. In this reflection, we provide an overview of the history of PACKRAT and outline some of its benefits for students and PA programs, as well as its generative role in assessment within PA studies. Taking a broader view of PACKRAT's impact on assessment for the PA profession, we outline the research on its benefits and its use to maximize student performance, as well as how it has promoted the development of additional assessment tools.

Veterans as physician assistants.

The physician assistant (PA) profession emerged nearly 50 years ago to leverage the healthcare experience of Vietnam-era military trained medics and corpsmen to fill workforce shortages in medical care. In 2009, the American Recovery and Reinvestment Act Primary Care Training and Enhancement program was established to improve access to primary care. Training military veterans as PAs was again identified as a strategy to meet provider access shortages. However, fewer than 4% of veterans with military healthcare training are likely to apply to PA school and little is known regarding the factors that predict acceptance to training. In 2012, we surveyed all veteran applicants and a stratified random sample of nonveterans applying to PA training. We compare the similarities and differences between veteran and nonveteran applicants, application barriers, and the factors predicting acceptance. We conclude with a discussion of the link between modern veterans and the PA profession.