Physician Assistant Programs Research Articles

Administering a Physician Assistant Program During the COVID-19 Pandemic.

Handy, Rod PhD, MBA; Spackman, Jared MPAS, PA-C; Moloney-Johns, Amanda MPAS, PA-C; Loder, Rayne MHS, PA-C; Curran, Shaun MPAS, PA-C; Valentin, Virginia DrPH, PA-C; Rolls, Joanne MPAS, MEHP, PA-C; Schaefer, Camie PhD Author Information

First Annual Conference on New Health Practitioners.

The First National Conference on New Health Practitioners was a seminal event in the development of the fledgling PA profession. Sponsored by the Association of Physician Assistant Programs and the American Academy of Physician Assistants, it was achieved by the cooperation of leaders committed to the success of the new profession. This article reveals, in a manner never before detailed, how this conference milestone was planned and what took place, and emphasizes its importance to the field. The meeting, held in April of 1973, was groundbreaking, attracting, among the 252 participants, the leadership of the American Medical Association, the National Board of Medical Examiners, the Federation of State Medical Boards, the Association of American Medical Colleges, the American Nurses Association, and federal agencies within the Department of Health, Education and Welfare, responsible for promoting and funding PA education, as well as PAs and PA educators. This remarkable participation, and conference program, have long deserved a more explicit accounting than they have had to date. Details for this article were enhanced when one of the authors (Piemme) discovered, among his archive of personal documents (from almost 50 years ago), 2 items originally generated by the US Air Force that provide more insight into details of the conference. One is a robust conference planning document outlining in detail both the organizational elements and the programmatic elements of the conference. The other is a final financial statement from the conference organizing committee.

Impact of Online Education on Anatomy Test Results

Introduction Anatomy is a fundamental science essential to the practice and understanding of medicine. As the COVID-19 pandemic has put a halt to live teaching, specifically, Anatomy classes and Lab Practical examination at Baylor College Medicine (BCM), the opportunity was presented to compare test scores of students who matriculated into the Physician Assistant (PA), Doctor of Nursing Practice-Anesthesia (DNP), and Medical School (MS) programs in 2020 with those of the same programs from previous cohorts. Students who matriculated in August of 2019 and before were able to have live Anatomy lectures, live Lab Practical examinations, and live cadaver labs. Whereas those who matriculated in the year 2020 had to watch online lectures, have online Lab Practical examinations, but still have live cadaver labs with COVID-19 rules i.e., social distancing implemented. Materials & Methods Lab Practical examination scores from classes who matriculated in the years of 2016 through 2019 were compared with those who matriculated in 2020 for the PA, DNP, and MS programs. Independent Measures Two-tailed T-test and One-Way Anova Analyses were used to determine whether there were any statistically significant differences of exam scores compared within the PA, DNP, and MS programs. The DNP and PA programs must also take a cumulative multiple-choice (MC) exam at the end of each term. These scores were also compared using the same measures. Results Independent Measures T-test revealed statistical significance (p < 0.05) when comparing the MS 2017 Lab Practical scores with the 2020 MS cohort with the 2020 cohort scoring significantly lower. For the DNP program, statistical significance was found between Lab Practical test scores from every cohort when compared to the 2020 cohort with the 2020 cohort scoring significantly higher in each comparison. Only when comparing the DNP 2016 to the 2020 cohort (MC) exam results was a statistical significance found for the MC exam with the 2020 cohort scoring significantly higher. One-Way Anova Analyses revealed there were no statistically significant findings within any of the cohorts from any of the programs other than the DNP 2016/2020 cohort comparison and 2019/2020 cohort comparison which yielded statistically significant differences with the 2020 cohort scoring significantly higher in each comparison. Conclusions While the current situation of the COVID-19 Pandemic may not be permanent, it has had a profound impact on the delivery of education in the year of 2020. As the delivery of education has shifted, one should acknowledge that test results may be impacted as well. This analysis reveals that students test scores, while varying more so than previous cohorts, were not significantly impacted in every cohort comparison with the shift to online learning. Significance Online learning in Anatomy has not been attempted before at BCM and evaluating student performance was vital this year. Anatomy at BCM continues for 2 more terms, and while the exam scores do not show significant differences for one term, the long term-term influences from COVID-19 on learning Anatomy still remains to be investigated.

Anatomy Performance and Strategic, Deep, and Surface Approaches Among Physician Assistant Students

Background Within anatomy education, relationships between learning approach and academic performance have been explored to understand programmatic curricula. Learning approaches have an impact on assessment outcomes, long-term retention of material, and overall academic success. Entwistle (2013) developed the Revised Approaches to Studying Inventory (RASI), a 52-item inventory assessing student approaches to studying in educational contexts, classifying studying preferences as strategic, deep, or surface. Objective The study aims to address whether there is a correlation between learning approach and final anatomy grade in a sample of physician assistant students. While other studies have examined the relationship between learning approach and other outcome measures, few have investigated allied health students in the United States with anatomy grade as the learning outcome. It was hypothesized that students with a dominant preference for the strategic approach would have higher anatomy grades than those who prefer deep or surface approaches. Methods First year students enrolled in a physician assistant program were invited to participate in the study two weeks following the completion of a four-credit gross anatomy course. Students were asked to complete the RASI in Qualtrics. Cronbach's alpha of the three scales were within good ranges of internal consistency: 0.81 (strategic approach), 0.82 (deep approach), and 0.83 (surface approach). Descriptive statistics characterized students’ dominant approach to learning anatomy. A one-way analysis of variance examined whether there was a difference in learning approach and anatomy grade, and whether mean anatomy grade differed by the student's dominant approach. Pearson's correlation coefficient evaluated the relationship between anatomy grade and learning approach. Analyses were performed using GraphPad Prism and significance level was set at p < 0.05. Results A total of 48 students were invited to participate and 36 completed the RASI (75% response rate). Two students exhibited an equal preference for two learning approaches and were omitted from the analysis. There were no statistical differences in mean anatomy grade and learning approach (F = 0.2756, p = 0.7609), or mean anatomy grade and learning approach by sex (F = 0.9138, p = 0.4660). Anatomy grade was not correlated with learning approach for the strategic approach (r = -0.05517, p = 0.7493), deep approach (r = 0.08033, p = 0.6414), or surface approach (r = -0.1462, p = 0.3947). Conclusion The hypothesis that dominant use of the strategic approach would positively correlate with anatomy grade was not supported. This may be due to a low variability in mean grades. A limitation of this study is the self-reported nature of the inventory, and student answers may not reflect how they truly studied. Additionally, a metacognition presentation was given following their first set of exams, which may have promoted more effective study strategies for the duration of the course. Future studies will compare the learning approaches of physician assistant and physical therapy students, and seek to identify at-risk students before culmination of the anatomy course.

Exercise is Medicine: The Prevalence of Exercise Prescription‐related Course Offerings in U.S. Physician Assistant Program Curricula

Exercise has proven to be beneficial in the prevention of chronic disease. In addition, exercise can improve the pathogenesis and symptoms associated with a variety of chronic disease states and can also attenuate drug-induced adverse effects. Hence, exercise has been described as a drug-free polypill. Exercise is Medicine®, a joint initiative between the American Medical Association and the American College of Sports Medicine, was launched in 2007 to call on all health care providers to counsel patients and prescribe exercise in the prevention and treatment of chronic disease. However, based on self-reported data, 51% of American adults still do not meet the national physical activity guidelines. Even more, the prevalence of inactivity has been reported to be much higher when the data is based off of objective measures, such as accelerometry. The high prevalence of inactivity is likely due to multiple factors, including under-education of medical professionals on how to council patients and develop exercise prescriptions. In the U.S. only 32.4% of patients seen by clinicians in 2010 received physical activity counseling that year. Therefore, the aim of the study was to determine the prevalence of required course offerings in U.S. physician assistant program curricula regarding training in exercise prescription (Rx). Program websites were accessed in 2020 for information regarding course offerings in Master of Physician Assistant Studies programs. Only those programs whose course descriptions of all the required courses were accessible online were included in the analysis. Three individuals independently analyzed course titles, course descriptions, and topics (if provided) of all programs for the search terms “exercise Rx”, “exercise”, “fitness”, and “physical activity”. After the analysis was complete, the data was combined and discrepancies were spot checked by a fourth individual. The study aimed to determine how many programs offered courses with the terms “exercise Rx”, “exercise”, “fitness”, and/or “physical activity” in the course title, course description, or course topics. Ninety one percent (165) of U.S. programs were included in the analysis. Only one program offered a required course with the term “exercise Rx” in the title, description, or course topics. This was a two credit course entitled Public Health. Five programs offered courses with the terms “exercise”, “fitness”, or “physical activity” in the title, description, or topics. These courses ranged between 1.0-2.5 credits. Three of the five courses were named Health Promotion and Disease Prevention. The data suggests that physician assistant students may be under-educated in the area of exercise Rx, which may contribute to the high prevalence of inactivity.

Improving Interprofessional Competencies and Anatomy Education of Health Profession Students in a Virtual Platform

Currently, most interprofessional education (IPE) opportunities occur in a clinical setting during professional practice despite increased efforts to include them in health profession curriculums. Students get very little exposure to IPE competencies and the curricula continues to be carried out largely in school-specific silos. Clinically relevant problems such as the detection of the Persistent Median Artery (PMA) and its possible contribution to Carpal Tunnel Syndrome (CTS) and other forearm/hand disabilities may require interprofessional collaboration from students in medical (MED), occupational therapy (OT), and physician assistant (PA) programs to improve patient outcomes in their future health profession careers. We hypothesized that basic anatomy education, exposure to IPE competencies and hand sensibility testing (HST) can be performed effectively in a virtual platform to promote IPE and increase student awareness of a vascular anomaly, PMA, that may contribute to CTS. Select cohorts of MED, OT, and PA students were recruited to form student IPE healthcare teams after receiving IRB approval for this study. Student volunteers participated in this study over Zoom sessions. All student volunteers completed pre-training and post-training assessments to measure the effectiveness of the didactic aspects of training and attainment of IPE competencies. Student IPE teams were assigned to work on a clinical scenario and were encouraged to take advantage of each team member's professional expertise, training and knowledge to determine a likely diagnosis and possible clinical treatments for the hypothetical patient. Preliminary data show an increase in student-perceptions on 16 of the 26 statements related to the IPE core competencies. 100% of students felt that participation in this project increased their knowledge of CTS. 74% of students strongly agreed that they could contribute to an informed differential diagnosis appropriate to the clinical scenario by integrating the knowledge and experience of members of their interprofessional team. 67% agreed or strongly agreed that participation in the activity increased their awareness about the importance of cultural competency in patient care. Correct student responses to the anatomy and training questions increased from the pre- to post- assessment in most of the questions asked. Student participation in IPE healthcare teams promoted and encouraged the effective practice of IPE core competencies. In addition, this IPE activity in a virtual platform also promoted an understanding of HST and awareness about the PMA and its possible role in CTS.

Student perspectives on the utility of student‐generated question writing in a physician assistant pharmacology course

Background While pharmacology does largely lend itself to merely memorizing facts for exams, understanding and retention of building block topics are critical to perform well on higher level exam questions. There is a significant body of work that indicates that generating and answering questions is beneficial to students in developing analytical skills as well as providing study resources. Students enrolled in a first-year Clinical Pharmacology course in a graduate-level Physician Assistant program were required to write forty multiple choice questions in the PeerWise platform over the course of the semester. Additionally, they were required to answer a minimum of eighty questions submitted by their peers. The purpose of this study is to get the student's perspectives on this learning activity. Methods Following the completion of the course and after grades had been turned in, students were sent a survey requesting feedback on the question-writing activity. The survey consisted of eight Likert-scaled questions about the activity as well as open response questions regarding the sources used, what they would change about the activity, and whether their skills in question-writing improved over the semester. Results All survey respondents rated the utility of question-writing in improving their depth of understanding as being useful with 90% of them rating it as being moderately to extremely useful. Eight-five percent of respondents rated studying through PeerWise (writing and answering questions) as a good idea. Most respondents indicated that they did not enjoy the process of writing questions but did enjoy the process of answering other students’ questions. Students primarily used their lecture slides and textbook to develop their questions, but some also utilized Up-to-Date and SketchyPharm. Improvements to the design of the activity included: having a certain number of questions due before each exam, more oversight of the questions by the instructors to remove incorrect questions and/or questions that violated the guidelines, and limiting the topic categories so that questions on a specific topic were easier to find. Conclusions Overall, the response to the question writing activity has been positive from the students. Students found the activity to be challenging but useful. Students’ suggestions for improvement will be incorporated into this activity for future courses.

Identification of Potentially Inhibitory Interprofessional Power Dynamics Among Healthcare Students

Introduction Conflicts related to hierarchy are a known barrier to interprofessional (IP) practice among healthcare teams. While these barriers between physicians and nurses are well established in the literature, studies on power dynamics between allied health professions and physicians are lacking. The aim of this study was to explore the prevalence of role claiming and identify negative perceptions towards occupational therapy (OT), physical therapy (PT), and physician assistant (PA) professions among first-semester OT, PT, and PA students as well as 4th-year medical (MD) students. Methods In an IRB-approved study, MD, OT, PT, and PA students were asked to complete a role knowledge survey consisting of 33 questions before and after OT, PT, and PA students completed an IP anatomy course where MD students served as near-peer mentors. The survey asked students to identify which profession (OT, PT, or PA) was best suited to aid the patient in a clinical vignette and included three open-ended questions asking for descriptions of these professions' roles. The rates at which OT, PT, and PA students claimed a role as their own professions' were assessed using Kruskal-Wallis and Wilcoxon Signed Rank tests. Perceptions of each profession were examined through thematic analysis of free responses. Results The average rate of roles students in OT, PT, and PA programs identified as their own exceeded the expected rate, 33.3%, and ranged from 38.1% (OT) to 44.2% (PT). PT students demonstrated a significant decrease, 3.9%, in role claiming following the IP course (p=.003), while OT and PA rates changed marginally. Qualitative themes included perceived limitations to each profession's scope of practice and language with belittling connotations. MD, PA, and PT students utilized verbs insinuating less power to describe OT roles (i.e. help, aid, assist) compared to verbs with authoritative connotations to describe PA and PT roles (i.e. perform, enhance, strengthen). OT and PT students emphasized an exaggerated power disparity between PAs and MDs, portraying PAs in a more subordinate light than MD students did. Inaccurate limitations to scopes of practice of OTs, PTs, and PAs were frequently found in the descriptions from students outside that profession. Preliminary comparisons of pre- and post-free responses indicate fewer inaccuracies regarding limitations to each profession's scope of practice following the IP course. Conclusions Even at the onset of their professional programs, students exhibited role claiming and negative, often inaccurate, perceptions about the roles of other health professions. The power conflict demonstrated by both quantitative and qualitative measures can impede IP collaboration. While this early IP course had a positive influence on role claiming and resolving some misconceptions about scopes of practice, several obstinate hierarchical barriers remained, particularly towards OTs and PAs. Furthermore, the inaccurate and limited views of OT, PT, and PA scopes of practice demonstrated by students outside those professions that persisted have the potential to hinder patient care. Circumventing these obstructive power dynamics is pertinent for improving IP practice between physicians and allied health professionals.

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.

New Advances in Physician Assistant Admissions: The History of Situational Judgement Tests and the Development of CASPer.

During the first 50 years of the physician assistant (PA) profession, admission to PA programs was based primarily on cognitive domains such as academic performance and standardized test scores. Many programs also considered other measurable factors, including patient care experience, community service, and extracurricular activities. While interviews were frequently conducted by the programs, it was not until the applicants had been "pre-screened" for the previously identified qualifications. As the PA profession continued to expand, PA programs began to realize that potentially strong applicants were being excluded from the admissions process because of this emphasis on mostly cognitive factors. In an attempt to reduce this disparity, PA programs have begun to expand their assessment of applicants to include assessment of noncognitive characteristics. This article outlines the history surrounding this change in the approach to admissions in medical education, reviews the development of situational judgement tests and other tools used to assess these noncognitive characteristics, and explores the relationship of these noncognitive characteristics to the development of program-defined competencies.

A National Survey of postgraduate physician assistant fellowship and residency programs

IntroductionThe development of postgraduate programs for physician assistants (PAs) began in 1973 and by 2020 there were approximately 72 programs spread across a broad range of medical and surgical disciplines. PA Post-graduate education programs are voluntary and available to American licensed PAs. Therefore, an assessment of the characteristics of PA post-graduate fellowships and residencies programs was initiated.MethodA non-experimental, descriptive research study was designed to obtain information on the characteristics of PA postgraduate education programs in the US. The source of information was from surveyed members of the Association of Postgraduate Physician Assistant Programs (APPAP). Questions were drawn from consensus discussions. Directors of postgraduate programs that were operational in 2020 were eligible to participate.ResultsSeventy-two postgraduate program directors were invited to the survey and 34 program directors replied. These programs are geographically distributed across the US in 13 states. The respondents represent a wide range of medicine: surgery, emergency medicine, critical care, orthopaedics, hospitalist, psychiatry, oncology, primary care, pediatrics, and cardiology. Most programs are associated with an academic medical center and some institutions have more than one postgraduate specialty track. The curriculum includes bedside teaching, lectures, mentorship, assigned reading, procedures, simulation, and conferences. An average program length is 12 months and awards a certificate. Stipends for PA fellows are $50,000–80,000 (2020 dollars) and benefits include paid time off, health and liability insurance. About half of the programs bill for the services rendered by the PA. Over 90% of graduates are employed within 2 months of completing a PA postgraduate training program.ConclusionA trend is underway in American medicine to include PAs in postgraduate education. PA postgraduate training occurs across a broad spectrum of medical and surgical areas, as well as diverse institutions and organizations overseeing these programs. Most PA postgraduate programs are in teaching hospitals where the PA resident or PA fellow also serves as a house officer alongside a categorical resident. This study sets the stage for more granular economic and social research on this growing phenomenon in American medicine.

Physician Assistant Roles in Prevention and Management of Anterior Cruciate Ligament Injury

With incidence of anterior cruciate ligament (ACL) injuries on the rise and a predicted impending shortage of physicians in medical fields, including orthopaedics, demand could soon outweigh supply for optimal care of these injuries. Physician assistants (PAs) are uniquely suited to care for patients in the screening, prevention, and management of ACL injuries. PAs frequently practice in primary care and in this setting can screen for at-risk patients and promote preventative techniques such as neuromuscular training. Primary care PAs can perform patient education about preventative measures and provide resources on a variety of available prevention programs that exist which aim to decrease the likelihood of ACL injury. Primary care PAs frequently use standardized scales or questionnaires in clinic to screen for health risks in their patients such as the Patient Health Questionnaire-9 (PHQ-9) for depression; the creation of a similarly standardized screening tool which assesses for ACL injury risk factors may be beneficial to aid primary care PAs in performing such screenings moving forward. Recovery from an ACL injury, regardless of operative or conservative management, can be a lengthy and complex process that is defined by months of follow-up appointments, rehabilitation exercises, and psychological management. Psychological impairment is a vital component in ACL injury recovery and has been identified as a preeminent factor in prolonging or inhibiting return to sport. By using available psychological measurement tools such as the ACL-Return to Sport after injury, as well as the patient education and counseling skills emphasized in their training, PAs can incorporate a psychologically based approach in management to promote a patient’s safe and timely return to sport. Maximizing efficiency and effectiveness of ACL rupture recovery can occur with the utilization of PAs. PAs embody the training, skills, and scope of practice to prevent and manage ACL injury; therefore, it becomes imperative to promote PA involvement in this injury. Proposed methods to achieve this objective include enhancing orthopaedic training in PA programs and integrating the work of national orthopaedic and PA organizations. More investigation is needed on this topic because having a comprehensive understanding of the potential roles of PAs in ACL care could have a profound, far-reaching impact on this increasingly prevalent injury.

Growing Neonatal Advanced Practice Providers via Mentorship Can Fill the Need: Program Description and Tool Kit.

The need for neonatal advanced practice providers (APPs) has been described. Hospital training programs for neonatal physician assistants (PAs) have been developed by physicians. No publications exist about programs administered by neonatal APPs for both new graduate neonatal nurse practitioners (NNPs) and neonatal PAs. The purpose of this work was to mentor, train, and hire neonatal APPs in a program administered by neonatal APPs. We developed a 2-pronged approach to attract PAs and new graduate NNPs. Marketing strategies included receptions, information, and mentorship. A 12-month neonatal PA fellowship program included clinical mentorship and weekly didactics. Case-based presentations were provided by neonatal APPs, neonatologists, and allied professionals. The new graduate NNP program included clinical mentorship and monthly meetings with peer support, lectures, and case presentations. Neonatal APPs were clinical mentors. Team-building activities supported mentorship and collaboration among all care providers. In less than 5 years, 10 PAs and 11 new graduate NNPs have been trained and hired, as well as experienced neonatal APPs hired for this regional neonatology program. For the first time in years, locum tenens neonatal APPs are not required. We have developed a "tool kit" of content, activities, exercises, and evaluations to support successful attainment of expected competencies. Future studies can measure retention, satisfaction, and clinical outcomes. A successful training program has been implemented to meet the growing demand. We support the values of integrity, collaboration, and equity to facilitate this successful paradigm shift among all neonatal professional team members.

Holistic Admissions and Underrepresented Minorities in Physician Assistant Programs.

The purpose of this study was to assess holistic review use in physician assistant (PA) programs and determine whether a relationship between holistic review and underrepresented minority (URM) matriculation exists. Using data from the 2016-2017 Physician Assistant Education Association annual survey of PA programs, we examined the frequency of holistic review use across PA programs. Bivariate correlation analyses and binary logistic regression were used to examine relationships between holistic review practices and program percentages of first-year underrepresented racial and ethnic minority students. Most PA programs (169/219 [77.2%]) reported using holistic review, and its use modestly correlated with percentage of students who were underrepresented racial minorities (rho = 0.16, 95% confidence interval [CI] = 0.02-0.30) or Hispanic (rho = 0.20, 95% CI = 0.06-0.33). Using several holistic review elements related to program commitment to diversity modestly correlated with percentage of students who were underrepresented racial minorities (rho = 0.25, 95% CI = 0.10-0.39) or African American (rho = 0.20, 95% CI = 0.04-0.34). Additionally, the odds of a first-year student being an underrepresented racial or ethnic minority were slightly higher in PA programs using holistic review (OR = 1.56, 95% CI = 1.23-1.99 and OR 1.33, 95% CI = 1.09-1.62, respectively). PA program use of holistic review practices was modestly associated with percentage of URM students. Further research is needed to identify elements that are most effective.

Using Data Mining for the Early Identification of Struggling Learners in Physician Assistant Education.

Despite the importance of early intervention and remediation, the relatively short duration of physician assistant education programs necessitates the importance of early identification of at-risk learners. This study sought to ascertain whether machine learning was more effective than logistic regression in predicting remediation status among students, using the limited set of data available before or immediately following the first semester of study as predictor variables and academic remediation as an outcome variable. The analysis included one institution and student data from 177 graduates between 2017 and 2019. We employed one data mining model, random forest trees, and compared it to a traditional predictive analysis method, logistic regression. Due to the small sample size, we employed leave-one-out cross-validation and bootstrap aggregation. Data provided evidence that the random forest algorithm correctly identified individuals who would later experience academic intervention with a 63.3% positive predictive value, whereas logistic regression exhibited a positive predictive value of 16.6%. This single-institution study indicates that predictive modeling, employing machine learning, may be a more effective means than traditional statistical methods of identifying and providing assistance to learners who may experience academic challenges.

Determining the Best Time to Integrate Opioid Use Disorder Training into the Curriculum Based on Student Perceptions.

The clinical phase of physician assistant (PA) education has been reported to be the best time period to deliver opioid prescribing education (OPE) and opioid addiction education (OAE); however, there are no current published studies that evaluate the timing of OPE and OAE instruction in PA curricula. This pilot study compared didactic and clinical phase cohorts' perceived confidence in their ability to evaluate patients with opioid use disorder (OUD) after receiving identical training at different time points within the curriculum. As expected, clinical phase students displayed high confidence levels in their abilities both before and after implementation of OUD-focused patient simulations. Interestingly, didactic phase students' confidence levels were comparable to clinical phase students' confidence levels after participating in the patient simulations. Our findings suggest that students can benefit from this training in both phases of the curriculum, which may encourage and help PA programs to insert this important and timely information into their curriculum.

Longitudinal Integration of Oral Health Training Into Physician Assistant Education.

The purpose of this study was to evaluate physician assistant (PA) student knowledge after integrating an oral health curriculum longitudinally into a PA program and to assess student perceptions of the oral health curriculum. This study was a 2-group longitudinal study comparing differences between the groups at 2 points in time. Cohort I (n = 60) took an oral health pretest and then, after completing oral health training, took a posttest. Cohort II (n = 49), which had not received oral health training, took identical testing on the same time interval. The students in Cohort I assessed the value of the oral health curriculum by answering a standardized perception survey. Cohort I had a statistically significant increase (p ≤ .0001) in posttest assessment scores compared to Cohort II (control group). The students who were exposed to the oral health curriculum reported a deeper understanding and appreciation of oral health disease and increased confidence in oral health clinical application. A greater awareness of the importance of oral health and chronic disease has evolved within PA education over the past 2 decades. Despite this progress, there is still a need to expand this curriculum and improve PA students' depth of knowledge in oral health. This study presents a novel and effective approach to incorporating an oral health curriculum into a PA program.

Exposure to point-of-care ultrasound in PA programs before employment.

Point-of-care ultrasound (POCUS) is integral to bedside evaluation of ED patients. This study examines POCUS exposure for physician assistants (PAs) before ED employment. A retrospective cross-sectional survey was distributed electronically to PAs employed in 13 EDs across a healthcare system. Participants were queried on POCUS education during PA training. Findings were reported as percentages of total respondents, using descriptive statistics. The response rate was 70.1%. Only 14.9% of respondents received POCUS exposure in PA school. Of those who received training, most (66.7%) received 5 or fewer hours and 94.1% strongly agree or agree that POCUS education should be integrated into PA education. In this survey, most PAs practicing in the ED did not receive POCUS education during training. Practice location and year of graduation may contribute to this finding. Healthcare systems should consider additional training for PAs working in EDs to bridge gaps in knowledge.

Interprofessional Education Activities for Students in Physician Assistant, Clinical Psychology, and Athletic Training Programs Utilizing Aspects of Team-Based and Problem-Based Learning Practices.

Interprofessional education (IPE) allows two or more professionals to learn from one another through partnership to improve patient outcomes. Implementation of IPE varies within health profession programs and universities, requiring programs to develop IPE activities that adhere to specific learning objectives or accreditation standards. These activities were a preliminary investigation on the feasibility of IPE activities at an institution with no substantial IPE infrastructure. Students integrated aspects of team-based learning (TBL), problem-based learning (PBL), and didactic components into diverse simulated patient cases with health profession students to develop skills in interdisciplinary patient-centered care. Lessons learned and future directions are discussed.

Emerging practices in onboarding programs for PAs: Strategies for onboarding.

This is the final article in a series that examines the role of onboarding programs for new physician assistants (PAs) and NPs. On-the-job learning is highly relevant for this workforce. Here we examine the strategies organizations use to impart information and skills in onboarding programs. In 2018, we interviewed 13 administrators of onboarding programs. Interviews were transcribed and analyzed for themes by a team of researchers, with feedback from interviewees. Seven strategies were identified and are described in this article: Clinical mentoring, personal and professional mentoring, meeting with/shadowing other professionals, checking in by administrators, delivering didactic content, tailoring content or ramp-up, and assessing/ensuring competency. This article describes commonly used strategies in onboarding programs for PAs and NPs and can provide guidance to those designing their own onboarding programs. The programs we examined relied heavily on mentoring and other strategies appropriate for adult learners. Future work should evaluate the effectiveness of onboarding programs.