Physician Assistant Programs Research Articles

Does Remote and/or Virtual Learning Prepare First-Year Physician Assistant Students for Clinical Rotations as Effectively as In-Person Learning?

The coronavirus disease 2019 pandemic has profoundly affected many lives, and the aftermath is still uncertain. Many aspects of life have been affected, including physician assistant (PA) education. The collective efforts of students and faculty, perseverance, and optimism have allowed the uninterrupted preparation of the next generation of PAs. The objective of this study was to understand PA students' perceptions of the effectiveness of remote and/or virtual learning in preparing PA students for clinical rotations. This pilot study was a mixed-methods survey with quantitative and qualitative data involving 3 accredited PA programs in the United States. Statistics were analyzed using SAS 9.4. Ninety-four individuals responded to the survey with a response rate of 46.8%. Response distributions, standard deviations, and means were calculated. Likert scale response means for each survey item were used to estimate the overall perspective of the participants. Most participants highlighted the advantages of flexibility and an opportunity to balance school and family life, but the participants did not favor remote and/or virtual learning platforms for effectively preparing students for their clinical phase. More research on a larger scale is warranted. Including students' hands-on skills performance measures in addition to perceptions could provide objective evidence for the efficacy of remote and/or virtual learning in preparing students for clinical rotations.

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

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

Predictors of applicant pool racial and ethnic diversity among physician assistant education programs: a national cross-sectional cohort study

BackgroundNumerous studies have demonstrated that the increasing racial and ethnic diversity of the US population benefits from access to healthcare providers from similarly diverse backgrounds. Physician assistant (PA) education programs have striven to increase the diversity of the profession, which is predominantly non-Hispanic white, by focusing on admitting students from historically excluded populations. However, strategies such as holistic admissions are predicated on the existence of racially and ethnically diverse applicant pools. While studies have examined correlates of matriculation into a medical education program, this study looks earlier in the pipeline and investigates whether applicant – not matriculant – pool diversity varies among PA programs with different characteristics.MethodsData were drawn from the 2017–2018 Central Application Service for PAs admissions cycle. Applications to programs with pre-professional tracks and applicants missing race/ethnicity data were excluded, resulting in data from 26,600 individuals who applied to 189 PA programs. We summarized the racial and ethnic diversity of each program’s applicant pools using: [1]the proportion of underrepresented minority (URM) students, [2]the proportion of students with backgrounds underrepresented in medicine (URiM), and [3]Simpson’s diversity index of a 7-category race/ethnicity combination. We used multiple regressions to model each diversity metric as a function of program characteristics including class size, accreditation status, type of institution, and other important features.ResultsRegardless of the demographic diversity metric examined, we found that applicant diversity was higher among provisionally accredited programs and those receiving more applications. We also identified trends suggesting that programs in more metropolitan areas were able to attract more diverse applicants. Programs that did not require the GRE were also able to attract more diverse applicants when considering the URM and SDI metrics, though results for URiM were not statistically significant.ConclusionsOur findings provide insights into modifiable (e.g., GRE requirement) and non-modifiable (e.g., provisionally accredited) program characteristics that are associated with more demographically diverse applicant pools.

Describing the landscape of integrated clinical educational programs for PAs and NPs.

Postgraduate clinical training (PCT) has been available to PAs since the 1970s and to NPs since at least 2007. Some programs now enroll PAs and NPs. Although this new training model appears to be expanding, little data about integrated PA/NP programs are available. This study examined the PA/NP PCT landscape in the United States. Programs were identified from membership rosters of the Association of Postgraduate Physician Assistant Programs and the Association of Post Graduate APRN Programs. Data (program name, sponsoring institution, location, specialty, accreditation status) were identified from programs' websites. We identified 106 programs at 42 sponsoring institutions. Various specialties, most commonly in emergency medicine, critical care, and surgery, were represented. Few were accredited. PA/NP PCT is now common, with about half of the programs accepting PAs and NPs. These programs represent a unique form of interprofessional education involving full integration of two professions in the same program and are worthy of further investigation.

Foundational Skill-Building in a Novel Well-being Curriculum.

Mental illness and decreased well-being are pervasive throughout physician assistant (PA) training, and the accreditation standards require a wellness curriculum. The purpose of this study was to determine if a mandatory, multifaceted virtual wellness curriculum can mitigate the decline in well-being experienced by first-year PA students. First-year PA students from 5 programs (n = 259) participated in a 16-week asynchronous virtual course. The course integrated evidence-based content on vulnerability and stigma, mindfulness and decentering, and reflective writing. Total weekly content averaged 30-60 minutes and was presented in multiple formats including recorded lectures and panels, readings, and discussion forums. Students completed anonymous pre- and postsurveys, and ordinary least squares (OLS) regression with a fixed effect for each school was used for data analysis. In total, 157 of 259 (60.6%) students completed both surveys with matching unique identifiers. The majority of students (73.6%; 134/182) thought this course had a positive impact on their training as a PA student. Baseline scores were significantly predictive of end-point scores for the PHLMS, OMS-HC-15, SSOSH, RPQ, and UCLA-3 (see Methods section for full names of surveys). Race was significantly predictive of PHLMS and OMS-HC-15 scores; age was significantly predictive of SSOSH scores; and gender was significantly predictive of RPQ scores. For a student with low baseline well-being who is entering a PA program, dedicated curricula focusing on foundational wellness skills can be successful in improving well-being. Future work is needed to more fully characterize the scope and extent of this program's impact on PA learners. Additional efforts are also necessary to optimize the delivery and provide access to PA students nationwide.

Did court dismiss student's due process claim?

A graduate student in the Slippery Rock University physician assistant program was placed at the Wellington Retreat in Florida for her first clinical rotation. The student handbook for the program outlined the university's policies and procedures, including the grounds for dismissal. It stated a student could be dismissed from the program based upon inappropriate behavior or unprofessional conduct at a clinical site.

Evaluation of the Efficacy of an Online Learning Module to Increase Wound Care Theoretical Knowledge Amongst Medical Students

We developed and evaluated an online learning module for teaching wound care basics to junior medical learners, which was assessed for its ability to increase theoretical knowledge of wound care, and medical learners' perceptions on the use of an online module to teach wound care practices. Between February 2022 to November 2022, participants were enrolled into our unblinded, matched-pair single-arm study. Participants completed a pre- and postquiz prior to and after completing the online module, respectively. Scores on the pre- and postquiz were matched by participant and evaluated for improvement. The online module was composed of free text, animated videos with voiceovers, pictorial examples, and tables, as well as unscored knowledge checks, covering the categories of i) normal wound healing physiology, ii) describing wounds/assessment of wounds, iii) choosing dressings for wounds, and iv) addressing and understanding wound aetiologies, including diabetic, arterial, and venous ulcers. Participants were enrolled at the University of Toronto in Toronto, Canada. Participants were recruited from the undergraduate medicine and physician assistant programs at the University of Toronto. Students were provided with information on how to participate in the study through email and in-person recruitment. Thirty-three participants entered the study, and 23 participants completed the study. Across all participants, the prequiz to postquiz score increase averaged 13.29%, representing a statistically significant increase (p = 0.0000013). Ten of the 20 questions and all question categories had a statistically significant increase in the postquiz scores. All respondents found the module very useful (67%) or extremely useful (33%) for learning wound care, and 67% were very satisfied overall with the quality of the module, with the remainder (33%) of respondents somewhat satisfied. Online learning modules are effective at increasing wound care knowledge in junior medical learners, with high satisfaction amongst learners.

FLAT-Reclaiming My Body From Breast Cancer.

Emily Thimling, MPAS, PA-C, is a clinical assistant professor for the Physician Assistant Program at the University of Evansville, Evansville, Indiana. Correspondence should be addressed to: Emily Thimling, MPAS, PA-C, Physician Assistant Program, University of Evansville Stone Family Center for Health Sciences, 515 Bob Jones Way, Evansville, IN 47708. Email: [email protected] The author declares no conflict of interest.

The Relationship Between Job Satisfaction and Faculty Turnover Among Physician Assistant Educators During the COVID-19 Pandemic.

This research explored the relationship between job satisfaction and intent to leave among physician assistant (PA) educators during the COVID-19 pandemic. Additionally, the study aimed to identify differences in PA educators' job satisfaction within gender and their intention to stay at their current employment. A nonexperimental, cross-sectional survey was conducted with 1788 PA educators at 232 accredited programs nationally. A Web-based survey was employed to measure job satisfaction and intent to leave and to collect demographic information. Descriptive statistics were used to describe the study population, and logistic regression was used to analyze the independent variables predicting faculty turnover. PA educators were generally satisfied with their jobs (51.2%, n = 251), with the nature of the work, quality of supervision, and collegial relationships contributing the most to job satisfaction. Males were generally more satisfied with their jobs than females. More than half of the PA educators (52.4%, n = 257) considered leaving academia in the past year. Job satisfaction (odds ratio [OR] = .945, 95% confidence interval [CI] = .936-.956) and individual facets-including the nature of the work (OR = .806, 95% CI = .731-.888); communication (OR = .926, 95% CI = .860-.997); and quality of supervision (OR = .904, 95% CI = .850-.960)-were predictive of intent to leave. Gender was not found to significantly affect the relationship between job satisfaction and intent to leave. The findings from the study suggest the need for faculty retention to be prioritized among program and institutional leadership. PA programs need experienced leadership to develop, guide, and mentor faculty. Lastly, program and institutional leadership should create a supportive work environment that communicates clear expectations.

Thinking Outside the Box: Advancing Clinical Education in an Era of Preceptor Shortage.

The expansion of health professions educational programs has led to an acute shortage of available clinical training sites. Rapid growth in the number of medical schools, physician assistant (PA) programs, and advanced nurse practitioner (APRN) programs, all of which share a need for similar types of clinical training experiences, has increased competition for clinical training sites and placed new challenges on educational institutions. Solutions are urgently needed to increase the quantity and quality of supervised clinical practice experiences as well as to ensure diversity among preceptors and geographical clinical sites. This article identifies key barriers to securing sufficient clinical training sites, notes emerging trends, and presents potential innovations through stakeholder collaboration for enhancing clinical training across health professions.

Haunted hospital: An innovative and engaging approach to interprofessional education simulation

The purpose of this article is to describe the design and implementation a novel simulation interprofessional educational (Sim-IPE) activity. Healthcare students from medicine, nursing, physician assistant, physical therapy, occupational therapy, biomedical science, and divinity programs were invited to participate in a Sim-IPE event. The students (n = 57) participated in a Halloween-themed event to learn more about one another's’ healthcare professions, develop an appreciation for the roles, responsibilities and similarities and differences in practice. Students reported the simulations were an effective and engaging methodology to learn about IPE. This innovative approach was well received by all students and lends itself to larger multi-institutional Sim-IPE activity or additional IPE events during their educational programs.

Comparison of personality styles between students enrolled in osteopathic medical, pharmacy, physical therapy, physician assistant, and occupational therapy programs.

Comparison of personality styles between students enrolled in osteopathic medical, pharmacy, physical therapy, physician assistant, and occupational therapy programs.

Exploring Motivations and Barriers To Accreditation Adoption Among Physician Assistant and Nurse Practitioner Emergency Medicine and Orthopedic Surgery Residency and Fellowship Programs.

Althoughthere has beenarapidincrease in thenumber of physician assistant(PA) and nurse practitioner postgraduate residency/fellowship specialty training programs in the United States, voluntary accreditation of these programs is a relativelynew phenomenon. There is little research examiningwhich factors may be predictorsof accreditation adoption among PA and nurse practitioner (NP) postgraduate programs. Therefore, the primary aim of this study was to investigatewhich motivating factors influencepostgraduate programs choiceon whether to pursue accreditation. Methodology A descriptive cross-sectional survey consisting of 10 questions was distributed to 56 postgraduate emergency medicine and orthopedic surgery PA, NP, and joint PA/NP residency/fellowship programs via email between November2022and February2023. Descriptive statistics were performed. Results Nineteen postgraduate programs responded to the survey. Two programs submitted incomplete surveys where less than 50% of the total items were completed. The partially completed surveys were omitted from the data analysis. The final response rate was 30% (17/56). Among the responded programs, 47% (8/17) offer dual PA and NP training, and 53% (9/17) are PA only. Although 88% (15/17) of postgraduate programs have discussed accreditation funding with their sponsoring institution only 76% are planning to do so or are in the process of pursuing accreditation. The two most commonreasons for pursuing accreditation are program validation and assessment of educational quality 59% (10/17) and competition for applicants 24% (4/17). However, Magnet hospital designation, requirement of the sponsoring institution, or demand from employers were notdeterminingfactors of whether to pursue accreditation or not. Reasons for not pursuing accreditation includedhigh costs of accreditation 18% (3/17), lack of perceived value of accreditation 6% (1/17), and lack of protected time to pursue accreditation 6% (1/17). Conclusion Although literature is still lacking on the effectiveness and impact of PA and NP postgraduate program accreditation, the findings of this rare study indicate that postgraduate programs are motivated to pursue accreditation. It is important for accreditors to communicate the utility of program-level accreditation and other value-added benefits to programs and their sponsoring institutions. Further work is necessary to better understand the value of external validation, specific drivers for validation, and barriers that influence accreditation adoption among these postgraduate programs.

The feasibility of self-directed POCUS training in Physician Assistant education

The increasing use of Point of Care Ultrasonography (POCUS) in medicine and healthcare prompted this pilot study, which aims to gain insight into the feasibility of online, self-directed POCUS training in the Physician Assistant (PA) curriculum. A mixed-method approach was used, gathering and analyzing data obtained from two cohorts of students in their didactic phase of training. Students completed a baseline survey, followed by the completion of several self-directed POCUS training modules, after which a post-survey was obtained. Seventy-six percent of the students had never used POCUS before. At the completion of the training, students demonstrated an increased level of confidence and comfort level using POCUS. The self-directed, self-paced, online format was not very favorable among the students. The recommendations for modifications, to incorporate live hands-on instruction were well received. It is important for PA programs to evaluate all aspects of a proposed POCUS training, including students’ perception, for a more meaningful learning experience.

The effects of the SNAPPS model on clinical learning experiences for Physician Assistant students

The current study was created to pilot an approach to clinical experiential learning for Physician Assistant (PA) students by teaching students the six-step clinical teaching model: (1) Summarize the case, (2) Narrow the differential diagnosis, (3) Analyze the differential diagnosis (what key patient findings support or lack support for each), (4) Probe the preceptor (ask for clarification of topics about which the learner feels unsure), (5) Plan management (with preceptor input) and (6) Select a care-related issue for self-directed learning; abbreviated to SNAPPS. SNAPPS is known to be learner-led and has been shown in research to be effective in increasing insights into clinical reasoning and encouraging timely feedback to medical students. The research question asked what effect SNAPPS training may have on PA student ratings of (1) learning climate, (2) control of session, (3) communication of goals, (4) promotion of understanding and retention, (5) evaluation, (6) feedback and (7) global assessment on a survey instrument following clinical learning experience. In a Solomon-four group design, PA students from an Atlanta-based PA program completed the validated PA Clinical Rotation Evaluation (PACRE) instrument before and/or after a SNAPPS training or case-based education module. An analysis of variance showed the effects of group designation on the domains of Control of Session (F(3, 9) = 9.084, p= .004), Communication (F(3, 9) = 7.527, p=.008) and Evaluation (F(3, 9) = 5.626, p= .019) was statistically significant for differences in PACRE scores. It was noted that the case-based groups scored clinical rotation higher on the instrument than the SNAPPS groups, highlighting the potential effect that SNAPPS groups may have reflected more critically on their learning experience.

Virtual Physician Assistant Program Interviews: Faculty and Applicant Perspectives.

Many physician assistant (PA) programs converted from traditional in-person admission interviews to virtual interviews during the COVID-19 pandemic. The purpose of this study was to investigate the perceptions of both PA faculty and applicants to PA programs about the virtual interview process. General perceptions, advantages, and disadvantages were explored. A mixed-method approach was implemented to collect data using 2 survey instruments: one for PA program applicants and another for PA program faculty. The surveys were created using a combination of previously used and new questions and distributed through email and social media. Descriptive statistics were used to analyze the independent and dependent variables. Chi-square, one-way ANOVA, and Spearman's rho correlation were conducted to analyze potential relationships between variables. Qualitative data were analyzed using an iterative process and inductive reasoning to identify recurring themes and code responses into common topical categories. Completed surveys were received from 178 applicants and 325 faculty members. If given the choice, most applicants favored virtual interviews (62.4%), while the majority of faculty preferred in-person interviews (64.0%). The majority of applicants (84.6%) and faculty (64.9%) were comfortable making a decision about the program or applicant, respectively, after the virtual interview process. The top 3 advantages of virtual interviewing for both faculty and applicants included convenience, decreased travel time, and cost savings. Both faculty and applicants perceived the virtual interview process positively, and thus, this modality may have enough advantages to support its use in the future.

Education Research: Neurologic Education in Physician Assistant Programs

Background and Objectives A growing number of advanced practice providers (APPs) are entering neurologic practice, and educational initiatives focused on postgraduate training in neurology for these providers are growing in turn. Neurologic education in APP degree programs is not well defined, which limits the ability to tailor these initiatives to the specific needs of APPs. We aim to describe neurologic education in physician assistant (PA) degree programs to better inform these efforts. Methods The 2018 American Academy of Neurology clerkship director survey was adapted for directors of PA programs via an iterative approach. The survey was distributed to program directors (PDs) of accredited programs in Fall 2021 and again in Spring 2022 for nonresponders. Simultaneously, websites of accredited programs were systematically reviewed for content related to neurologic education. Results Sixty of 255 contacted PDs completed the survey (23.5%). All PDs reported education in selected neuroscience topics. Neuroradiology instruction was included less frequently (66.7%) than neuroanatomy (91.7%) or neurologic examination techniques (95.0%). Twenty-six PDs (43.3%) reported a dedicated neuroscience course; 53 of 260 websites reviewed identified dedicated neuroscience courses (20.8%, k = 0.41). Directors of 10 (38.5%) reported neuroscience courses were neuroscience trained. Only 1 program required a neurology clinical rotation in both the website review (0.4%) and the PD survey (1.7%, k = 1.00). Elective neurology rotations were offered by 51 programs (85.0%) and used by less than 20% of students in 46 programs (92.0%). More programs with dedicated neuroscience didactics (80.0% vs 74.2%) and offerings in clinical neurology (78.7% vs 66.7%) reported graduates pursuing careers in neurology, but these differences were not statistically significant. Discussion Survey respondents reported the inclusion of most of the queried preclinical neuroscience topics, typically distributed throughout the curriculum. Dedicated neuroscience courses were less common and most commonly not taught by a neurologist or neurology APP. Clinical neurology rotations are almost never required, but most programs offer an elective. These results suggest opportunities for augmenting neurologic education in APP degree programs, including encouraging students to take clinical neurology rotations and increasing exposure to APPs practicing neurology. These findings additionally inform key targets for postgraduate educational initiatives.

Everybody Copes: An Interprofessional Workshop on Stress, Coping, and Helping Primary Care Patients Manage Medical Stressors.

The value of psychological principles has become apparent in medical settings, especially with the rise of patient-centered care. We aimed to provide a curriculum informing medical providers about the theoretical basis and clinical utility of the social-cognitive model of stress and coping. This workshop was delivered to an interprofessional team of faculty and trainees. Our initial pedagogical approach was to relate the concepts of cognitive appraisals and coping strategies to participants' own stress responses. We then used didactic presentation and small-group activities to explore ways to promote adaptive coping with patients to improve health outcomes. Learners participated in a mindfulness exercise, conceptualized coping strategies given a hypothetical case scenario, and, in small groups, role-played a patient encounter to construct an effective coping repertoire for the patient. Participants completed a prework self-assessment and workshop evaluation form. The 2.5-hour workshop had 48 participants from five professions (medicine, education, physician assistant, pharmacology, psychology). We received 35 evaluations (73% response rate). Learners reported increased real-world skills (M = 8.0 out of 10) and feeling better prepared for working in interprofessional settings (M = 7.6 out of 10). Qualitative feedback suggested that participants recognized the importance of individual differences in coping with stress and felt they could categorize strategies into emotion- or problem-focused coping. This workshop provided participants with basic knowledge about the social-cognitive model of stress and coping and allowed them to practice newly learned skills in a role-play as an interprofessional medical care team.

Addressing Critical Pandemic Psychiatric Staffing Shortages Through Advanced Practice Provider Training and Resources.

Back to table of contents Previous article Next article Controversies in Psychiatric ServicesNo AccessAddressing Critical Pandemic Psychiatric Staffing Shortages Through Advanced Practice Provider Training and ResourcesLuming Li, M.D., M.H.S., Janet Gates, P.A.Luming LiSearch for more papers by this author, M.D., M.H.S., Janet GatesSearch for more papers by this author, P.A.Published Online:7 Feb 2023https://doi.org/10.1176/appi.ps.20220390AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail View article Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - Psychiatric Services $35.00 Add to cart PPV Articles - Psychiatric Services Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited byNone Metrics KeywordsAdministration and managementCommunity psychiatryEducationCareer DevelopmentPublic psychiatryThe authors thank Sylvia Muzquiz-Drummond, M.D., and J. Michael Smith, D.H.Sc., P.A.-C., for their work initiating and supporting the physician assistant fellowship program and reviewing the manuscript. These views represent the opinions of the authors and not necessarily those of the Harris Center for Mental Health and IDD or Baylor School of Medicine.PDF download History Published online 7 February 2023

Developing a Genital Training Associate Program.

Genitourinary training associates (GTAs) are individuals educated to teach medical learners invasive exams and procedures using their own body. Through specified protocols, the GTA teaches exam techniques to students in a supportive environment while giving feedback to the learner to optimize skill acquisition. Additionally, this experience can teach best practices for future provider-patient communication. To help ensure access to GTAs for medical learners, physician assistant (PA) programs should consider developing a GTA training program at their institution. The purpose of this article is to outline the necessary steps to educate GTAs and develop a GTA training program.