Physician Assistant Students Research Articles

Early Neurosurgical Education in the Era of Distant Learning: Incorporating Virtual Reality and Cadaveric Specimen Demonstrations

BackgroundVirtual reality (VR) has emerged as a powerful tool for neuroanatomy education of post-graduated medical trainees. However, its use in early training, such as of undergraduate, medical and physician assistant students, in neurosurgery has not been evaluated. We also have limited insight into how VR may be integrated with traditional teaching methods. MethodsWe created the first of its kind elective course on neuroanatomy for medical students incorporating lecture-style didactics, case-based VR activities and cadaveric dissections. The course ran entirely remotely with each student tuning into class with their own VR headset. We asked the students to self-report their level of confidence with the material and complete knowledge quizzes, which were compared in aggregate between pre- vs post-course, and pre- vs post- each session. Results66.6% of students rated teaching quality of the course as excellent, and 33.3% as satisfactory. Most students (77.7-88.8%) also described the course as having a positive impact on their training. On aggregate analysis, the cohort reported increased levels of confidence in their understanding of neuroanatomy (mean 2.75 vs 5.4, p=0.02), neurosurgical approaches (mean 1.25 vs 5.7, p<0.0001) and the use of VR in neurosurgery (mean 1.5 vs 6.1, p<0.0001). Objectively, the cohort also performed better on post-session assessments, a difference which was statistically significant at p<0.05, in all but the first assessment. ConclusionsIntegration of VR with traditional pedagogical tactics is well received by the learners and contributes to measurable learning outcomes. Our experience informs the future use of VR tools in medical education.

Aintree Catheter Versus Gum Elastic Bougie for Airway Exchange Using the i-Gel Supraglottic Device: A Cadaver Study.

Airway compromise is the third leading cause of preventable death on the battlefield. Most combat medics carry supraglottic airway (SGA) devices for airway management. However, exchanging an SGA device for a definitive airway can be challenging, especially in austere environments. This study aims to compare the Aintree intubation catheter (AIC) to the gum elastic bougie (GEB) as adjuncts for performing airway device exchange with the i-gel SGA device in place. This randomized crossover cadaver study of 48 participants examined the success rate of two endotracheal introducers (AIC and GEB) when performing a blind airway exchange with an i-gel in place. Study participants were combat medics (MOS 68W), physician assistant students, physician assistant staff, emergency medicine (EM) physician residents, and emergency medicine attending physicians attending classes at the installation Medical Simulations Training Center. Each participant performed up to three attempts using both endotracheal tube introducers on the same cadaver. The primary outcome was successful airway exchange rate with each device, and the secondary outcome was time to successful airway exchange. Although the AIC had a slightly higher success rate of 33% compared to the GEB success rate of 30%, this result was not statistically significant, P = .56. Similarly, participants completed successful airway exchanges with the AIC faster, with a mean time of 86.5 seconds (95% CI: 71.2 to 101.9) versus 101.2 seconds (95% CI: 85.5 to 116.9) with the GEB. However, this result was also not statistically significant, P = 0.18. This study demonstrates no significant difference in success rate and time to completion of successful iterations of airway exchanges between the two devices. Although the AIC performed slightly better overall, these results are not statistically significant. Additionally, blind exchange intubations appear to be of high risk with minimal success, so we recommend against this technique in routine practice.

Mindfulness, Self-Compassion, and Perfectionism in Physician Assistant Students: Implications for Wellness Curricula

Mindfulness, Self-Compassion, and Perfectionism in Physician Assistant Students: Implications for Wellness Curricula

Clinical Laboratory Science and Physician Assistant Students Interprofessional Education Event; Learning From Each Other

Clinical Laboratory Science and Physician Assistant Students Interprofessional Education Event; Learning From Each Other

Evaluation of Skin of Color Curricular Content for Physician Assistant Education.

Physician assistants (PAs) are often members of dermatologic care teams. Adequate knowledge of dermatologic conditions in skin of color (SOC) is crucial to proper diagnosis, treatment, and patient satisfaction. The objective of this study was to increase PA students' objective knowledge of and comfort level with evaluating dermatologic conditions in SOC. Eligible participants included 36 PA students at a major metropolitan medical center during the 2022 to 2023 academic year. A preintervention survey, immediate postintervention survey, and 7-month follow-up postintervention survey were administered before and after a SOC lecture. The surveys concluded with a 10-question, image-based, multiple-choice examination. There was a significant increase in accurate diagnoses of acne scarring, eczema, psoriasis, rosacea, and seborrheic dermatitis in SOC (59.4% preintervention to 76.9% postintervention, P = .029). Student confidence, as rated on a scale of 1 (minimally confident) to 5 (extremely confident), in diagnosing these conditions increased from 2.97 to 3.52 (P = .036). Implementation of a SOC-specific dermatology lecture significantly increased the accuracy and confidence with which PA students diagnosed dermatologic conditions.

Broadening the View of Holistic Care: Integrating Arts and Humanities Into Physician Assistant Education.

The integration of arts and humanities (A&H) into physician assistant (PA) preclinical curriculum may enhance student performance and improve their patient rapport. Arts and humanities content could promote the personal and professional qualities we desire in clinicians including competence, compassion, and empathy. The aim of this research was to determine what PA students report learning from A&H modules designed to foster personal insight and perspective-taking. The "Introduction of Humanities & Arts into Physician Assistant Education" (IHAPAE) project is an intercampus collaboration between 2 Midwest Universities. The IHAPAE faculty collaboratively created and delivered A&H-based modules within first-year communication courses. Two cohorts of PA students (N = 130) participated in modules and subsequently attended exploratory focus groups to elicit their perceptions of the A&H curriculum. Using a constructivist grounded theory approach for data analysis, we found that PA students perceived multiple benefits. Specifically, module content promoted reflection and stress reduction, improved their continuity of care notes, provided utility in cultivating empathy in patient communication, and introduced students to A&H approaches they could recommend to patients. The process model that emerged from student perceptions fits well with existing emotional regulation theory and provides empirical evidence for cultivation of empathy and patient-centeredness. Given the positive outcomes of our project, PA programs should consider the value of incorporating the A&H activities into their curriculum to enhance the student experience and develop essential provider attributes and skills.

A pragmatic approach to teaching physician assistant students basic pain management.

Chronic pain is increasing in prevalence, with new cases now outnumbering those of diabetes, depression, or hypertension. Advanced practice providers have reported that their training in pain management inadequately prepared them to care for patients suffering from painful conditions. In response, the authors of this work developed a basic pain management conceptual framework to provide physician assistant (PA) students with the foundational knowledge necessary to manage and treat patients suffering from a wide variety of painful conditions. The devised framework activity includes categories of pain management such as conservative therapies, medications, injections, minimally invasive procedures, and moderately to highly invasive procedures. This framework can be incorporated into the existing PA educational curriculum and presented alongside a realistic pain patient case study. Furthermore, other health science educational programs, such as nurse practitioner or pharmacy programs, could adopt this framework to increase student knowledge in pain management.

Teaching and Evaluating the Virtual Physical Exam in Telemedicine.

With the rapid adoption of telemedicine since the COVID-19 pandemic, it has become imperative to teach and evaluate health professional trainees on skills important to conducting effective virtual visits. We developed a simulation-based workshop with (1) readings, (2) a lecture covering online communication and the virtual head and neck exam, (3) a telemedicine simulation with a standardized patient observed by faculty, (4) personalized feedback from faculty, and (5) a group debrief session. We created an evaluation rubric based on three of 20 Association of American Medical Colleges (AAMC) telemedicine competencies to assess learner performance during the simulations. Students (medical and physician assistant students; n = 50), and internal medicine residents (n = 20) completed this workshop in 2023. At least 90% of trainees across the two groups were rated as approaching entrustment or entrustable in each competency. This workshop is an example of a scalable telemedicine curriculum that can be used to teach and evaluate learners in the virtual physical exam across the training continuum.

A Pilot Interprofessional Education Curriculum for Optimizing Mental Health in Chronic Pain Treatment and Understanding Interprofessional Practice.

With the urgent need for clinicians capable of responding to the opioid crisis, an interprofessional education (IPE) pilot curriculum was launched to assess trainee self-efficacy in managing chronic pain and mental health conditions, and attitudes toward interprofessional practice among resident physicians, family nurse practitioners (FNP), and physician assistant (PA) students. This study involved the implementation of a pilot curriculum consisting of five interactive IPE sessions. All invited trainees across two academic institutions were asked to complete the assessments. Self-efficacy in managing chronic pain and mental health was measured at baseline and following IPE training using a researcher-developed tool, while attitudes toward interprofessional practice were measured with the Attitudes Toward Health Care Teams scale. Resident physicians were compared to FNP/PA students to examine differences between groups and within groups over time. The final analysis involved 25 trainees who attended at least one IPE training session and completed pre-session and post-session surveys. The total pre-session survey and post-session survey response rate was 37.5% (n=36). Self-efficacy in chronic pain management improved among the resident physician (mean=3.85 ±0.40) and FNP/PA groups (mean=3.84±0.46) (p=0.05 and p=0.001), respectively. Self-efficacy in mental health management was not significantly improved among resident physicians (mean=3.41±0.49, p=0.48), but improved among FNP/PA students (mean=3.46±0.31, p<0.001). There was no difference in attitudes toward interprofessional practice. While IPE training did not result in attitudinal changes toward interprofessional practice, it shows potential for improving self-efficacy in managing chronic pain and mental health, particularly among FNP/PA trainees. This study was limited by a small sample size of trainees included in the finalanalysis.

Implications of Requiring the Physician Assistant College Admissions Test on Physician Assistant Program Applicant Pool: Lessons Learned.

To present a physician assistant (PA) program's experience and lessons learned by requiring a new standardized test as an admissions requirement. A state academic PA program changed an admission requirement by requiring the Physician Assistant College Admissions Test (PA-CAT) instead of the Graduate Record Examination. The admissions requirement change correlated with a 72% drop in the applicant pool. Data from previous literature present background information on standardized testing and predictors of student success. The program-specific data retrospectively evaluate changes in application numbers. Several studies have evaluated various preadmission metrics and their correlation to student success. However, the PA-CAT and its predictor of student success in the program and passing the Physician Assistant National Certifying Exam still need to be evaluated. Requiring standardized testing increases the barrier to applicant PA school admissions. Despite its potential, the PA-CAT has yet to be extensively studied to predict success in matriculated PA students and should be used cautiously. The implications of using the PA-CAT as an admissions requirement are a potential decrease in the strength of applicants, the number of total applicants, and the overall decline in the quality of graduating PAs. This cautionary note is crucial for maintaining the quality and integrity of our PA programs.

Impact of Biopsychosocial Pain Education on Physician Assistant Students' Pain Knowledge, Pain Attitudes, and Recommendations for Lower Back Pain

Impact of Biopsychosocial Pain Education on Physician Assistant Students' Pain Knowledge, Pain Attitudes, and Recommendations for Lower Back Pain

Clinical Learning and LGBTQ+ Health: Summary of a LGBTQ+ Health Clinical Rotation.

People who identify as lesbian, gay, bisexual, transgender, queer, and people who identify as something else (LGBTQ+) experience barriers to health care including a lack of health care providers adequately prepared to care for them. The literature describing LGBTQ+-focused didactic learning activities has increased in recent years, however remains limited with respect to clinical learning experiences. This publication describes the development and implementation of a clinical rotation for Physician Assistant (PA) students focused on caring for LGBTQ+ patients. A 4-week LGBTQ+ Health clinical rotation was developed for PA students through collaboration with multiple clinical sites. Students (n = 6) were surveyed before and after completion of the clinical rotation on their knowledge, comfort, and confidence in caring for LGBTQ+ patients and to identify learning priorities. Paired t tests were used to compare quantitative pre and post data. Two reviewers independently reviewed qualitative data. Improvement in students' knowledge, comfort, and confidence were statistically significant from prerotation to postrotation surveys. Student ratings on standard course evaluations showed positive ratings for all course elements. Qualitative analysis showed that all students identified learning more about trans-related health care as a learning priority. Clinical rotations focused on the care of LGBTQ+ patients are valuable learning experiences which can support increased student knowledge, comfort, and confidence. Clinically based educational interventions may be one strategy in addressing the health disparities experienced by LGBTQ+ people.

Mock Board Exam Writing Groups in Physician Assistant Education: A Method to Enhance Curriculum and Mentor Junior Faculty.

Ensuring students are prepared for the Physician Assistant National Certification Exam (PANCE) is an institutional priority for all physician assistant programs. While many factors predicting PANCE performance have been investigated, exploration and discussions of interventions to improve PANCE performance are limited. Repeated exposure to board-style questions has been shown to improve board scores in similar populations. Currently, existing question banks cannot be used to generate secure summative examinations, and commercial question banks may perpetuate inequitable access among physician assistant (PA) students. To address this issue, the University of Oklahoma Physician Assistant program used a community of practice model to create a mock board exam writing group. The group was created to facilitate the development of 9 PANCE-style exams to bolster students' clinical preparedness and PANCE performance. These writing groups also provided a platform for junior faculty to receive feedback and guidance from senior colleagues, thus facilitating and promoting mentorship. This article highlights the potential benefits of mock board exam writing groups in PA education and provides insight into their development and implementation.

Autism Identification and Referral: How Best to Equip Physician Assistant Students for Successful Practice

Autism Identification and Referral: How Best to Equip Physician Assistant Students for Successful Practice

Development, Implementation, and Assessment of an Online Modular Telehealth Curriculum for Health Professions Students.

Several national health profession organizations endorse or have developed competencies for telehealth, yet there is no standardized curriculum for teaching telehealth to health professions students. Additionally, implementing telehealth curricula is challenging due to limited curricular space and differing needs of various health profession programs. We describe the development, implementation, and pilot assessment of an online, modular telehealth curriculum for health professions students. An online, modular telehealth curriculum for health professions students was developed in 2021-2022. Nine modules were created, focusing on the logistics of performing a telehealth visit and system-based virtual assessments. In academic year 2022-2023, course directors from the Duke doctor of medicine (MD), physician assistant (PA), and nurse practitioner (NP) programs utilized modules in their courses. For modules taken, students were surveyed and self-assessed their confidence, knowledge gained, and likelihood of utilizing the telehealth skills taught in the module(s). During the 2022-2023 academic year, MD, NP, and PA students at Duke participated in one or more of the telehealth modules in an existing course. The median responses to self-assessed confidence questions for all health profession students to be in the "moderately" or "very confident" range. Similarly, students reported a median response of "moderate knowledge gained" for each module taken. NP students reported slightly lower levels of confidence and likelihood of utilizing telehealth skills than other professions. No other significant differences in the remainder of responses were observed between health professions. Exposure of health professions students to telehealth through utilization of online, interactive modules may result in increased telehealth skill confidence and knowledge, and furthermore, a belief that they will utilize these skills in future practice. Larger scale implementation of the telehealth curriculum and development of outcome measures which assess clinical application of skills conveyed will provide more information about the efficacy of the curriculum.

Impact of a Novel Asynchronous Nutrition Course on Knowledge, Attitudes, and Self-Efficacy of Physician Assistant Students

Impact of a Novel Asynchronous Nutrition Course on Knowledge, Attitudes, and Self-Efficacy of Physician Assistant Students

From the “backburner” to the forefront: Qualitative analysis of medical and physician assistant students’ reflections on Crip Camp

BackgroundDisability-focused health professions education must evolve to portray the lives of disabled patients, lived experiences of ableism, and disability history more accurately and authentically. Methods of education that utilize first-person perspectives of disabled people to deliver authentic representations are limited in the current literature. ObjectiveTo explore first-year medical and physician assistant students' reflections on healthcare access, healthcare providers’ roles, and barriers to health equity for patients with disabilities after watching an exemplar, first-person perspective documentary titled Crip Camp: A Disability Revolution. MethodsA three-part, student-created disability curriculum “Introduction to Disability and Anti-Ableist Healthcare” was offered as an elective for first-year medical students during the 2021–2022 and 2022–2023 academic years. The disability curriculum was required for first-year physician assistant students during the 2023–2024 academic year. One curricular component was watching Crip Camp: A Disability Revolution and completing a 500-750-word reflective essay. Qualitative thematic analysis was used to organize essay responses. ResultsSeven major themes emerged in the students’ essays highlighting the importance of disability-focused education, the necessity of understanding the historical context and mistreatment of people with disabilities, limitations of health policies and health systems, the role of trainees and providers, and intersectionality. Themes were aligned with the socioecological model and disability consciousness to reflect healthcare delivery and education benefit, respectively. ConclusionCrip Camp: A Disability Revolution was an effective educational intervention to provide and apply knowledge in reflecting on healthcare experiences of people with disabilities. The themes have implications for health professions education and health care delivery.

Stressed and Depressed: Prevalence of Anxiety and/or Depression in Physician Assistant Students: Corrigendum.

Stressed and Depressed: Prevalence of Anxiety and/or Depression in Physician Assistant Students: Corrigendum.

Impact of Pre-Admission Grade Point Averages on Anesthesiologist Assistant Student Performance at Emory University School of Medicine.

The Anesthesiologist Assistant career is gaining significant popularity in the health professions in the United States. Given that this medical occupation is relatively young, there is limited information regarding student success in this demanding graduate-level program. Assessing if pre-admission metrics influence how students perform during the curriculum is essential to recruiting the appropriate candidates. Grade point averages have been shown to correlate with student success in medical education programs for both medical students and physician assistant students, but there is currently no information regarding anesthesiologist assistant students. Pre-matriculation science and cumulative grade point averages were accessed in a deidentified manner for Emory University Anesthesiologist Assistant Students, and 2-tailed Pearson coefficients were calculated to see if there was a correlation with performance during the science/didactic curriculum of our program and with the clinical curriculum of the program. The 2-tailed Pearson coefficients showed a moderately strong positive correlation between pre-admission science and cumulative grade point averages and performance during the science curriculum of the Emory program (r=0.522). Data also suggested a moderate correlation with grade point averages at graduation from our program (r=0.484). Similar results were found with cumulative grade point averages as well. Given the limited information, we have regarding pre-admission metrics and performance in an Anesthesiologist Assistant program, our study shows that pre-admission science scores and grades in general in undergraduate studies does in fact mimic the information found from studies of other health profession students. Further studies are needed to elucidate how to choose the most appropriate candidates for admission to anesthesiologist assistant programs.

Building Interprofessional Competencies Through a Collaborative Prescribing Activity With Osteopathic, Pharmacy, and Physician Assistant Students.

Medication errors can lead to significant adverse events. Nearly 50% of medication errors occur during the prescription-writing stage of the medication use process, and effective interprofessional collaboration and communication are key to reducing error in this process. We developed a three-part, 60-minute, interprofessional education activity providing medical, physician assistant, and pharmacy students the opportunity to practice collegial interprofessional communication surrounding prescribing practices. Learners met virtually initially as a large group and divided into small groups facilitated by a health professional. Part 1 involved reviewing two prescriptions prepared by learners; part 2 was a discussion about the education, roles, and responsibilities of each profession; and part 3 focused on identifying prescription errors in examples provided by faculty. Students completed a post-pre survey measuring their perception of learning the Interprofessional Collaborative Competency Attainment Survey (ICCAS) areas. Of 317 participants (151 doctor of osteopathy, 68 master of physician assistant studies, and 98 doctor of pharmacy students), 286 completed the post-pre survey, for a 90% response rate. Students reported statistically significant (p < .001) increases in all 20 questions spanning the six ICCAS areas. The virtual format allowed multiple institutions to participate from various locations. It broadened the learners' experience by fostering interaction among those with varied perspectives and allowed collaboration between locations and programs that otherwise could not have participated. The activity introduced students to virtual collaboration and key telehealth skills, enhancing their confidence and familiarity with virtual interactions in a professional setting.