Physician Assistant School Research Articles

Effect of Applicant Gender on Multiple Mini-Interview Admissions Score.

Admissions criteria for physician assistant (PA) schools vary considerably, but they often involve a combination of academic measures, noncognitive "humanistic" qualities, and mission-related items. To address noncognitive attributes, some PA schools have implemented the multiple mini-interview (MMI) format developed at McMaster University in Canada. This research project looked at differences in interview scores by gender over 3 consecutive admissions cycles at one PA program. Three years of pre-existing de-identified data gathered as part of the routine admissions process were analyzed retrospectively using SPSS-v25. Data were available for all interviewees for 2015, 2016, and 2017 (N = 350 total). Between-group differences were not statistically significant by gender. Reliability (Cronbach's α) was 0.865 for academic scoring and 0.694 for MMI scoring. Analysis of 3 years of admissions data from a single program did not show evidence for gender bias in MMI scores. Although this result is reassuring, it requires continued monitoring and replication.

Opioid Prescribing Education for Physician Assistant Students: A Physician Assistant Educator Survey.

The United States is facing an opioid public health crisis. Educating providers is essential for addressing this epidemic. This study sought to understand how physician assistant (PA) programs are educating students in opioid prescribing to avoid addiction. An Internet-based survey was sent to PA educators about the current landscape of opioid prescribing education (OPE) and opioid addiction education (OAE) at their institutions. Eighty-eight completed surveys were analyzed to gauge opioid education in PA school: 49 (55.7%) educators have a mandatory OPE in their curriculum with most dedicating one hour to 3 hours (27, 55.1%) on this topic. Mandatory OAE was noted by 44 (50.0%) educators with one hour to 3 hours dedicated being the most common (24, 54.5%) amount of time. The most common method of instruction for both OPE and OAE was didactic lectures. While some programs deliver OPE and OAE to PA students, the need exists for more programs to adopt this education.

Is Student Stress Related to Personality or Learning Environment in a Physician Assistant Program?

The purpose of this research was to study the impact of students' personalities and 2 different learning environments-lecture-based learning (LBL) and problem-based learning (PBL)-on the stress perceived by 5 cohorts of physician assistant (PA) students. Students rated their stress related to family obligations, financial concerns, schoolwork, relocation, and overall stress on 6 occasions over the course of the 2-year program. Personalities of students were assessed using the California Psychological Inventory 7 months into the program. Students' expectations and observations of their learning environments were measured using the PA School Learning Environment Survey at the beginning and end of the didactic year. Personalities of LBL and PBL students were very similar, but LBL students who scored higher on the Independence concept were less stressed about their schoolwork. The LBL students, in general, were more discontented with their learning environment, but this finding was not related to higher schoolwork-related stress. In contrast, PBL students' personalities were not related to stress, and PBL students also rated some dimensions of their learning environment higher than they had expected. However, those PBL students who rated the PBL environment less favorably also reported higher schoolwork-related stress. High stress perceived by LBL students was related to some personality concepts but not to the students' learning environment, despite their overall disappointment with that environment. The PBL students were more stressed by schoolwork, although their stress was not related to personality. Problem-based learning students, except for those most highly stressed, tended to rate their learning environment more favorably.

Assessing the use of social media in physician assistant education.

ObjectivesThis study aims to assess physician assistant (PA) students’ experiences with social media (SM) as a part of their medical education. MethodsThe study is split into two phases: Phase 1- A cross-sectional survey emailed to all PA students at four PA school campuses to assess students’ prior SM experiences (226 responses, 71.1% response rate); and Phase 2- Inclusion of SM educational resources, via Twitter, within lectures performed at two PA schools. A phase-2 survey assessed students’ opinions of educational SM (50 responses, 59.5% response rate) and SM usage was tracked. ResultsThe phase-1 survey respondents indicated that 97.3% (n=220) use social media; often used as a part of their education, 65% (n=147) informally and 2.7% (n=6) formally incorporated. Students most commonly use Facebook, YouTube, and Instagram, but rarely use Twitter. Currently using SM for medical education was significantly associated with predicting that future PA education will formally include SM [rs=.341 (r2=0.12), p=<.001], as did younger age, [rs=.137 (r2=0.02), p=0.042]. Of phase-2 survey respondents, 93.1% (27/29) of SM users felt it was a useful addition to the lectures. Significantly more views were captured when messages were sent during lectures Mean (SD), 102.64(39.7) than in the peri-lecture time period [49.5(10.6), p<0.001]. Conclusions Many PA students are currently using various forms of social media to augment their education. Most PA students support formal incorporation of social media into their education. PA educators should consider using our data and methods of social media inclusion when designing curricula and while clinically precepting PA students.

2494 Selectives: Implementing self-directed collaborative selectives as part of a curriculum for pre-health care professional students

OBJECTIVES/SPECIFIC AIMS: To provide students an opportunity to select health care-oriented course work that reflects both their interests and the increasingly diverse spectrum of health professions education and health care careers. To increase the opportunity for students to enter professional schools and health care professions with enhanced engagement and experience. METHODS/STUDY POPULATION: The 4-credit elective (Selective) curriculum is a component of the 38 credit Duke School of Medicine Master of Science in Biomedical Sciences (MBS) program which is completed over 10.5 months. Students work closely with their advisors to choose activities that reflect their interests. Selectives are offered by an array of schools, institutes, and programs within Duke University, including: the School of Medicine, School of Law, Global Health Institute, Bioethics and Science Policy Master Program, Clinical Research Training Program, Center for Documentary Studies, and Medical Informatics. Students may also pursue directed studies in areas such as health policy, or an inter-professional trip to Honduras. In addition to the course-based Selectives, three research practicum options are offered: Community Engagement, Clinical Research (Duke Office of Clinical Research), and a self-selected mentored research experience. Finally, the MBS program offers 2 in-house specific Selectives: Fundamentals of Learning: Theory and Practice, and Planning for Health Professions Education. RESULTS/ANTICIPATED RESULTS: The MBS program accepted its first cohort of students in June 2015. Two cohorts have graduated and the third has begun (n=30, 2016; n=42, 2017; n=43 enrolled, 2018). Our students come from diverse background with a third from populations historically underrepresented in STEM due to race/ethnicity, and another third underrepresented due to other factors such as low socioeconomic status, first generation to college, LGBQT, and those from rural and immigrant communities. Thus far, Selective distribution has been: Clinical research practicum (7, 2016; 14, 2017; 9, 2018); Mentored research practicum (2, 2016; 1, 2017); Community engagement practicum (7, 2016; 4, 2017; 5, 2018); Planning for health professions educations (14, 2016; 32, 2017; 33, 2018), Fundamentals of learning: Theory and Practice (7, 2016; 17, 2017; 18, 2018); documentary film (1, 2016); inter-professional trip to Honduras (2, 2016, 2, 2017). Since the implementation of the curriculum, at least 53 of 70 students who have applied (76%) were admitted to health professions or other graduate schools despite having lower initial MCAT and undergraduate GPAs in aggregate than the average of students who matriculate to allopathic medical school programs: 41 to medical schools, 3 to dental school, 2 each to osteopathic and physician assistant schools and 1 each to physical therapy, business school and law school. Eighteen of the 2016 graduates, and 21 of the 2017 graduates work in research for their gap year following graduation, the majority being employed in our institution’s research programs providing a pipeline of trained research assistants and coordinators. DISCUSSION/SIGNIFICANCE OF IMPACT: Lessons learned by implementing our curriculum include the following: (1) students are eager to explore different areas of health care; (2) collaboration across schools, centers, departments, institutes, and offices increases our ability to identify common areas of interest; (3) implementing a diverse curriculum can be challenging due to the need for significant organization and planning; (4) the diversity of courses can be a source of confusion when there is a lack of standardization in learner expectations; (5) continued collaboration across, schools, centers, institutes programs, health professions and sections requires a significant amount of time and expertise. However, our programs demonstrate significant positive impacts both on students and at the institutional level. Our program shows that a diverse curriculum leads to a high number of students engaged in pursuing and successfully continuing a health profession education. Institutional benefits include a robust pipeline for a diverse research workforce.

Perceived Discrimination, Harassment, and Abuse in Physician Assistant Education: A Pilot Study.

A 2014 meta-analysis found that by graduation, 16.6% of medical students had reported abuse, harassment, or discrimination and that this hostile environment caused an increase in depression and anxiety. The purpose of this research study was to increase the understanding of discrimination and psychological/physical abuse in physician assistant (PA) education programs and the potential impact on student attrition. Information was collected using an online, anonymous survey that asked about witnessed or experienced discrimination and psychological or physical abuse during the didactic and clinical years of training in PA programs in the United States. The survey received 1159 respondents, which represents 6.1% of total PA student enrollment. Up to 30% of respondents had witnessed or experienced discrimination, and up to 2.3% had experienced psychological abuse while in PA school. The majority of witnessed or experienced discrimination during PA education was not reported (<2%). Reports were not made because students feared retribution or they simply did not know who to report to, particularly if the incident involved faculty. Reducing the prevalence of discrimination in PA education requires recognition of this issue and targeted efforts to ensure that the infrastructure of every program is inclusive and values diversity of all kinds. The authors advocate that PA programs discuss their current institutional reporting structure; develop a universal curriculum on workplace violence, discrimination, and harassment; and develop value statements that explicitly identify diversity and equity as a core value as an important first step to improving the overall "climate" and culture of the program.

Physician Assistant Applicant Pool

The physician assistant (PA) profession's first attempt to characterize the applicant pool for PA education began with publication of the first Annual Report on Physician Assistant Educational Programs in the United States in 1985. The methodology used in the report was limited, however, in identifying the number of unique applicants to PA programs. Collecting accurate and reliable data on the profession's applicant pool was the primary motivator leading to initiation of the Central Application Service for Physician Assistants (CASPA) in 2001. In the past 15 years, CASPA has provided increasingly valuable data on the profession's applicant pool, allowing for accurate tracking and analysis of trends in the growth and changing demographics of those applying to PA educational programs. This special report presents a unique analysis of CASPA data that relates the competitiveness of entry into PA programs with that experienced by our colleagues in medicine, for both Doctor of Medicine (MD) and Doctor or Osteopathic Medicine (DO) schools. We present data reflecting the most notable changing demographics of the profession's applicant and matriculant pools in sex, age, grade point average, and health care experience. We use aggregate data of self-identified race descriptors to compare the contributions of PA, medical, and osteopathic medicine schools to the improvement of diversity within the health professions. To date, the applicant pool of PA programs seems to have kept pace with the expansion of existing programs and the development of new programs. This article poses serious questions for the profession to ponder, as the demographics of those entering PA education change and the number of PA graduates continues to grow.

Abstract A19: [Advocate Abstract:] Survivors Teaching Students®: Educating Medical and other Health Professional Students about Ovarian Cancer

Abstract “The goal of Survivors Teaching Students (STS) is for future physicians, nurse practitioners, nurses and physician assistants to be able to diagnose ovarian cancer when it is in its earlier, most treatable stages. Survivors Teaching Students is offered in 96 medical schools, 103 nursing schools, 13 Nurse Practitioner schools, 26 Physician Assistant schools, and 12 allied health programs across the United States. Active programs exist in 34 states, the District of Columbia, Virgin Islands, the United Kingdom and Canada. In 2015, the program educated 10,750 students, a 10% increase over the previous year. As of June, 2016, STS volunteers have already presented to approximately 6500 students in 35 states. More than 790 specially trained ovarian cancer survivors volunteer for this program. Each presentation includes a pre- and post-test to assess the student's knowledge about ovarian cancer detection, diagnostic procedures, symptoms, and risk factors, as well as the importance of referral to a gynecologic oncologist. Medical students' and nursing students' knowledge has increased by approximately 23% and 41% respectively during the presentations. Important facts about ovarian cancer: • Ovarian cancer is the most lethal gynecologic cancer and the fifth leading cause of cancer death among women in the United States. • The majority of women are diagnosed when their ovarian cancer is in an advanced stage. • Currently, there is no reliable screening test for the early detection of ovarian cancer. • When detected in an early stage, the survival rates for ovarian cancer greatly improve. • Factors associated with an increased risk of ovarian cancer include a personal or family history of breast, colon, uterine or ovarian cancer, increasing age, never having been pregnant. • Factors associated with a decreased risk of ovarian cancer include using oral contraceptives, having and breastfeeding children, and having a tubal ligation or salpingectomy, hysterectomy or prophylactic removal of the ovaries. Ovarian cancer, even in its early stages, has symptoms: • Bloating • Pelvic or abdominal pain • Difficulty eating or feeling full quickly • Urinary symptoms (urgency or frequency) (Source: Ovarian Cancer Symptoms Consensus Statement - http://www.ocnapartners.org/wp-content/uploads/2013/01/Consensus.pdf) Women who have these symptoms more than 12 times during the course of one month should see a doctor, preferably a gynecologist-especially if the symptoms are new or unusual. Other symptoms have been commonly reported by women with ovarian cancer, including fatigue, indigestion, back pain, pain with intercourse, constipation and menstrual irregularities. However, these symptoms are not as useful in identifying ovarian cancer because they are found just as often in women who do not have the disease. If the symptoms suggest ovarian cancer, three tests should be performed: a complete pelvic exam, including a rectovaginal examination; a transvaginal ultrasound; and a CA-125 blood test. If ovarian cancer is suspected, the woman must be referred to a gynecologic oncologist. The focus of my work as an advocate and regional coordinator for STS includes survivor recruitment and training, outreach and collaboration to medical schools, and leadership of STS facilitators across the southeast United States. Locally in Charlotte, NC, I serve as facilitator and coordinator of Survivors Teaching Students through my role as Community Programs Manager for Lydia's Legacy, a 501(c)(3) non-profit whose mission is to raise awareness of gynecologic cancers through education and fund gynecologic cancer research through donation. Citation Format: Sarah Noonan. [Advocate Abstract:] Survivors Teaching Students®: Educating Medical and other Health Professional Students about Ovarian Cancer. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A19.

Commentaries on health services research

Commentaries on health services research

Attitudes Toward Academic Dishonesty in Physician Assistant Students.

The purpose of this study was to assess physician assistant (PA) students' attitudes and experiences toward academic dishonesty during training and to determine whether PA students self-report cheating during PA school. An anonymous, quantitative, exploratory, descriptive survey was sent to clinical-year PA students enrolled in PA programs accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). A sample of 493 self-selected PA students in their clinical year of training responded to the survey. Only 3% of clinical-year PA students self-reported cheating during PA school. Males self-reported significantly higher rates of cheating in PA school than females. The most common cheating behavior that clinical-year PA students reported either observing or hearing about in PA school was receiving information about an exam prior to its administration (70.9%). The attitudinal statement that respondents most strongly agreed with was that "cheaters in PA school just end up hurting themselves in the long run." The strongest predictor for cheating in PA school was a history of cheating as an undergraduate. This study confirmed previous research indicating that academic dishonesty exists in PA education. It also determined that clinical-year PA student attitudes toward and experiences with academic dishonesty vary.

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.

Cancer education in physician assistant programs.

The purpose of this study was to describe the current state of oncology education provided by physician assistant (PA) programs. This is a descriptive, cross-sectional study of PA programs using a web-based survey. The response rate was 22%. All programs reported dedicated curricular hours to address cancer: genetics, prevention/screening, diagnosis, and general treatment and counseling regarding delivering "bad news." The majority of programs provided 2 hours or less of content related to the evaluation and management of acute cancer treatment effects, oncologic emergencies, and symptoms of cancers/palliative care. Most common content areas without any dedicated time were management of patients with long-term sequelae of prior treatment or undergoing cancer surveillance and identification/management of cancer survivors. The most commonly used instructional format is lecture, interaction with preceptors, and direct patient care. Other forms of learning such as case-based learning and team-based learning are less commonly used. Most programs report the most common cancer patient encounters occur during internal medicine/primary care rotations. Although typically available, few students participate in oncology elective rotations. Data regarding faculty perception of cancer education, teaching resources, and barriers to teaching were also collected. Cancer prevention and initial diagnosis are the primary foci of instruction by PA schools. Instruction is typically by classroom lecture and clinical encounters during primary care rotations. Given the challenges faced by PA programs to provide a generalist's education for students, novel means of enhancing cancer education during PA school and continuing medical education following primary PA education will be essential to expand PAs' competencies in cancer care.

Physician shortage and the future of medicine.

Dear Sir, I’m a third year college student contemplating postgraduate work in the medical field, either entering Physician Assistant (PA) school or medical school followed possibly by pediatric surgery, but I worry about the future of medicine due to politics and the government's increasing involvement in health care. Initially I was looking into attending PA School, but the projected shortage of physicians in the U.S. may reinforce my plans instead to attend Medical School. I often pause and reflect on the laborious and arduous future that lies ahead of me. In order to learn more about medicine and how physicians function, I have spent numerous hours shadowing physicians and observing surgeons and PAs in the operating room. Not only did I gain a better understanding of how physicians and surgeons function, but I also learned about the government's involvement in the medical field. Already in my own lifetime I have observed the government's intrusion in the medical field culminating with the Affordable Care Act (better known as Obamacare) and its implementation and this worries me.[1,2] I understand physicians are now experiencing lower compensation rates, more administrative duties, and less time nurturing the patient–doctor relationship, which is so important for good health outcomes. All of this makes me nervous for the future of medicine, especially considering the predicted shortage of 90,000 doctors by 2020.[2] I believe that the predicted manpower shortage of physicians is political, in part due to the government's involvement, and the U.S. Congress’ unwillingness to increase Medicare funding and their unwillingness to promote a climate conducive to the expansion of the number of residency spaces needed to provide adequate medical care in the future. There is a growing number of injustices forced upon medicine by the government's increased control and the concomitant gradual loss of physician autonomy. I’m not the only Pre-Med student worried about the future of Medicine. Many medical students are already thinking of going into fields such as vein specialty and plastic surgery, where there is less government involvement. Medicine is a noble profession, and those who practice medicine are able to serve and provide for others. Let us not forget that medicine started as an art before it became a science. The art of medicine was to aid our fellow human beings in sickness and alleviate their suffering, while being reminded men and women are not only physical but also spiritual beings, better ministered with compassion. I hope the venerable art and science of medicine can be saved before the government and politics destroy it. The implications of Medicaid, Medicare, coupled with decreased funding, have caused an increase in the number of patients that physicians see daily in their offices and the emergency room (ER). The result is that medicine has become more and more about increasing patient volume than about individual patient care. Due to increase load and the physician manpower shortage, nurses and PAs have to step in to fill the role of physicians. I also read with great interest the editorial, “The Lost Art of Inter-Provider Communication,” written by Mona Stecker.[3] She drives home many of these issues; inter-provider communication is important to better serve patients and improve efficiency. This becomes even more important as nurses and PAs step into physicians’ shoes in the near future. Sadly, while technology has tremendously advanced and communication has become more efficient, interaction with patients has paradoxically decreased. Tape recordings, computerized notes, and technological advances have displaced face-to-face communication, and the human touch and bedside manners for which physicians have been known in former times. This is an important topic that I will continue to explore as I consider my options prior entering the medical field. It will be interesting and telling to see how the government solves the problem of the predicted shortage of physicians, as well as observing how Nurse Practitioners (NPs) and PAs step up to fill the rank vacated by physicians. Mary-Kate Hunnicutt attends the University of Georgia as a Biology major with a Pre-Med emphasis. She is involved at UGA as a member of the Pre-PA and Pre-Med Club and a member of Phi Sigma Pi, the Honors Fraternity at UGA, as well as an Athletic Relations Committee member of UGA Hero's, an organization helping provide quality life care to children affected by HIV/AIDS.

APhA’s Self-Care Institute: Preparing for the future of health care

Self-care faculty from schools and colleges of pharmacy, along with nursing and physician assistant schools, journeyed to Washington, DC, this spring for the 11th annual Self-Care Institute (SCI), a 3-day educational conference developed by APhA and supported by McNeil Consumer Healthcare. Self-care is a key component of the successful management of many medical conditions, from heart disease and diabetes to the common cold, as well as the promotion of wellness. The selfcare arena provides numerous opportunities to help patients make accurate and safe decisions regarding their use of nonprescription medications and dietary supplements in addition to prescription medications. Self-care also includes pharmacists supporting patients in managing chronic conditions and making healthful lifestyle modifi cations to optimize outcomes. SCI 2013, held June 13 to 16, was designed to help educators prepare their students for the future of health care in the United States. More than two dozen experts presented on topics such as the latest self-care therapeutic information, educational best practices, and methods of training students to promote healthy self-care behaviors. The meeting was attended by 100 pharmacy faculty as well as 11 physician assistant faculty and 7 nurse practitioner faculty.

An assessment of musculoskeletal knowledge in graduating medical and physician assistant students and implications for musculoskeletal care providers.

The purpose of the present study was to evaluate musculoskeletal knowledge among graduating medical students and physician assistant students with use of a National Board of Medical Examiners (NBME) examination. We hypothesized that there would be no difference in scores between the two groups. In addition, we looked for relationships between examination scores and both the student-reported musculoskeletal experiences and the school-reported musculoskeletal curriculum. One hundred and forty-four students from three medical schools and ninety-one students from four physician assistant schools were included in the present study; both groups were graduating students in the final semester of education. The National Board of Medical Examiners Musculoskeletal Subject Examination (NBME MSK) was utilized to assess musculoskeletal knowledge. The mean examination score (and standard deviation) was 73.8% ± 9.7% for medical students and 62.3% ± 11% for physician assistant students (95% confidence interval [CI], -13.8 to 0.00; p &lt; 0.05). Medical students with an interest in orthopaedics as a career scored significantly higher than those without an expressed orthopaedic interest, and medical students without an expressed career interest in orthopaedics scored significantly higher than physician assistant students (p &lt; 0.05). Among medical students, a longer duration of a clinical rotation in orthopaedics was associated with a higher examination score (p &lt; 0.05). The average number of hours of preclinical musculoskeletal education in the first two years of school was significantly higher for medical schools (122.1 ± 25.1 hours) than for physician assistant schools (89.8 ± 74.8 hours) (p &lt; 0.05). Graduating medical students scored significantly higher than graduating physician assistant students on the NBME MSK. This may be related to multiple factors, and further studies are necessary to evaluate the overall musculoskeletal clinical competence of both groups of students.

Physician Assistants—One Less Doctor(ate) in the House

IN RECENT YEARS, NUMEROUS ALLIED HEALTH PROFESsions have adopted or are planning to adopt clinical or practice doctorates. Although some have transitioned to an entry-level doctorate (eg, pharmacy and physical therapy) and others (eg, nursing) recognize the doctorate as an advanced practice degree, the professions’ goals are the same—to replace the master’s degree with a professionspecific doctoral degree. Allied health care clinicians with these degrees now practice, or will soon practice, as “doctors” alongside their physician colleagues. These clinicians function as competent and effective members of the health care team and had done so before obtaining doctoral degrees. So why make the move to a doctorate? Those in favor argue that a doctorate improves professional image, promotes more autonomous practice, and serves as an appropriate response to advancing technologies and the increasing complexity of health care. Others argue that doctorates may confuse patients, that they represent “degree creep,” and that doctoral degrees are sought largely for professional status rather than for issues related to clinical competence and market demand. The additional tuition costs associated with doctoral degrees and the perception that doctorates are prestigious and will attract students create incentives for universities to offer the degree. The added cost, however, has the potential to adversely affect recruitment of low-income and minority students. In addition, requirements for doctoral degrees lengthen the time in school, vary from program to program, and have not been proven to enhance students’ clinical abilities. At a time when the country is working to keep up with increasing demands of health care, do the perceived benefits of a doctorate justify the additional expense, time, and delay in getting clinicians into the workforce? The physician assistant (PA) profession has said “no.” In March 2009, PA organizations conducted a PA Clinical Doctorate Summit that involved clinically practicing PAs, PA educators, students, army PAs, representatives of other allied health professions, workforce experts, and allopathic and osteopathic physicians. Summit recommendations, which also reflect the views of a majority of surveyed PAs, express opposition to an entry-level PA clinical doctorate and officially endorse the master’s degree as the entrylevel and terminal degree for the profession. The recommendations include support for PAs who choose to pursue postgraduate training beyond the master’s degree but limit this support to non–PA-specific doctoral degrees. Discussions during the PA Clinical Doctorate Summit revolved around a number of issues, including the effects a PA doctorate could have on the profession’s relationship with physicians (eg, would physicians perceive a doctorate as a move toward independent practice?), the additional cost for students, and the potential for the degree to diminish the profession’s diversity. Final justifications for concluding that a PA-specific doctorate is unnecessary were “the length and cost of the current educational model has resulted in a responsive accessible PA workforce . . . and has adapted over 40 years to provide high quality, cost-effective, patientcentered care,” and that “both physicians and PAs practice in the domain of medicine therefore the entry-level doctorate for the practice of medicine is the MD or DO.” Despite the final recommendations, significant pressure for PAs to transition to a doctoral degree persists, especially as other clinicians work to expand their prestige and scope of practice. Some leaders in the PA profession have suggested that the decision not to endorse a clinical doctorate “ . . . may be tantamount to committing professional suicide.” They argue that physicians’ and the public’s perception that nonphysician clinicians with doctoral degrees are better educated, favors nurse practitioners, and will cause PAs to become marginalized, weakening the profession’s status within the health care community. Physicians practicing today may be unaware that physicians established the PA model of education in the 1960s to train individuals with prior health care experience to rapidly meet the needs of medically underserved areas. Currently, most applicants accepted to PA school have a bachelor’s degree, including required coursework in the basic and behavioral sciences, and 3 years of health care experience. PA education, which is modeled on medical education, averages 27 months in length and typically includes a didactic year of instruction in the sciences and clinical medi-

Things we wish we'd known before physician assistant school: a physician assistant student survival guide.

Thrasher, Ashley MMS, PA-C; Bumgarner, Sarah; Darket, Angela; VanWieren, Liz; Warner, Krista Author Information

A Novel Approach to Ranking Physician Assistant Programs

US News & World Report (US News) is the only known media publication that ranks physician assistant (PA) educational programs. In 2007 US News ranked only 73 schools based on a subjective survey of PA school faculty and administration. This study presents a new approach to the ranking of graduate PA programs. The 73 PA schools included in the 2007 US News ranking were ranked based on each school's current Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) accreditation length, student-to-faculty ratio, percentage of faculty with doctoral degrees, and the most recent 5-year average Physician Assistant National Certifying Examination (PANCE) pass rates. The top three ranked schools were, in order, University of Wisconsin-La Crosse, Oregon Health & Science University, and the University of Iowa. There was a weak-positive relationship between the standardized rankings and scores and rankings by US News (r = 0.40, r = 0.41, respectively). This novel approach to ranking of PA programs provides a basis for improving the methods of future rankings.

Physician Assistant Studentsʼ Attitudes Toward International Experiences

Purpose: This study assesses physician assistant (PA) students’ interest in international experiences. A white paper from the Physician Assistant Education Association (PAEA), formerly the Association of Physician Assistant Programs (APAP), “A Report on the Findings of the Ad Hoc Committee on International Physician Assistant Education,” recommends that the profession “explore the motivation for students’ international experiences.” In partial fulfillment of that objective, we examined the association between first-year PA students’ attitudes toward international experiences and student demographic characteristics, type of PA school attended, and prior student experiences. Methods: A convenience sample of 12 PA programs (one public and one private school in each of six US geographical regions) received surveys to distribute to their first-year students. Eleven programs returned 482 completed surveys. Results: A sizable majority of the students, 59.8%, indicated interest in international rotations. PA students with prior health care experience or prior international experience as a volunteer in missions work (faith-based or secular), or studying abroad were more likely to show interest in international rotations. Student interest in other languages and cultures, single marital status, and lack of dependents also correlates positively with increased interest in international experiences. Student self-perception of spirituality, valuing the humanitarian mission of the PA profession, and prior international military experience do not correlate with interest in international rotations. Conclusions: PA students’ interest in and participation in international rotations may affect the rapidly evolving globalization of the PA professional model.

Predictors of Academic Success for Underrepresented Minorities in Physician Assistant Programs

The physician assistant (PA) profession was developed as part of an effort to relieve a nationwide physician shortage. Rural and medically underserved areas were and in many cases continue to be especially affected by this shortage.1 The percentage of underrepresented minorities (URM)— defined here as African Americans, Latinos, and Native Americans whose representation in medical and allied health schools does not mirror their percentage of the general population—is increasing and represents 24% of the U.S. population. This number is expected to increase to 35% by 2030. Unfortunately, minority representation in medical and other allied health professional schools has not kept pace with community needs.2 The 2002 AAPA Physician Assistant Census reported that approximately 9.6% of PAs responding to the census survey were non-white.3 In the face of current challenges to traditional affirmative action programs, improvement in URM representation in medical and other allied health professions is threatened.4 It is a well-established fact that URMs completing medical or allied health education are more likely to practice in an underserved population.5 It is, therefore, imperative that URMs are recruited and achieve academic success in PA, medical, nursing, and other allied health schools. Academic success will be defined in this paper as successful completion of all academic requirements of a PA program, passing the Physician Assistant National Certifying Exam (PANCE), and timely graduation from an accredited PA program. Many URMs entering the medical and allied health professions experience more academic difficulty than their non-URM counterparts during their didactive training.6 There are many reasons for this, including inadequate academic preparation as evidenced by lower GRE, MCAT, SAT, and ACT scores and lower undergraduate GPAs. Perceived racial alienation (e.g., lack of faculty role models, tutorial support, financial support and commonalities), especially in major institutions, lack of URM faculty and mentors, perceived faculty alienation, and economic disadvantage have also been cited as barriers to academic performance.6 This article will examine obstacles to and predictors of academic success for URMs in PA school. The impetus for this paper was the perception by the author of an increased attrition rate and failure to pass the PANCE by URMs. A PA program national survey in 1986 reported a 65% dropout rate for URMs. This may suggest that this group