Physician Assistants Research Articles

Building Interprofessional Competency Through A Virtual Cardiopulmonary Case Collaboration

Introduction Interprofessional education (IPE) experiences are prioritized as a key component of physician assistant (PA) and Doctor of Physical Therapy (DPT) education programs’ curricula to reflect contemporary practice. Virtual IPE is reported to facilitate clinical decision making and teamwork in students. However, limited studies exist on its effectiveness to promote the IPE Collaborative's (IPEC) core competencies. As we aim to increase IPE in our curriculum, virtual IPE offers several advantages. The purpose of this study was to evaluate whether a case-based, virtual IPE improved students' knowledge and attitudes of collaborative team skills using the Interprofessional Collaborative Competencies Attainment Scale (ICCAS). Methods This study used a retrospective pretest-posttest design. Students in first-year PA and DPT programs (n = 130, PA = 48, DPT = 82) completed the ICCAS survey before and after attendance of a mandatory virtual IPE event. The virtual IPE session centered on designing a collaborative plan of care for an individual with congestive heart failure in an outpatient setting. To assess skill attainment, students completed the ICCAS survey. t Tests with Bonferroni's correction (P < .01) were conducted for analyses. Results One hundred twenty-two students (PA = 46, DPT = 76) provided complete survey data. Statistically significant improvement was noted for all 20 questions (P < .001). Large pre/post-IPE event effect sizes were observed for all 20 statements in the ICCAS. No statistically significant differences between the 2 disciplines were noted. Discussion Our findings suggest that a virtual case-based IPE experience may offer benefits to improve the student's attitude and knowledge related to IPEC during the initial year of PA and DPT programs. These data are encouraging as integration of virtual IPE experiences may affect teamwork competencies in healthcare programs.

Assessing Student-Reported Perceptions of Prerequisite Usefulness in Preparation for Didactic Physician Assistant Education.

To gain admittance to a physician assistant (PA) school, applicants must complete program-specific prerequisite courses and experiences. The lack of standardization contributes to complexity, expense, and limits diversity. This research assessed current didactic PA students' perceptions of prerequisite courses, course delivery methods, and direct patient care (DPC) experiences to determine which were perceived as the most useful in preparation for didactic PA education. An online cross-sectional survey was sent to eligible PA students across the United States. The survey collected opinions on the usefulness of commonly required prerequisite courses, course delivery methods, and DPC experiences. Collected data underwent statistical analysis and qualitative analysis for open-response questions. A total of 527 students completed the survey. Greater than 50% reported prerequisite courses in science and psychology as well as speech, ethics, cardiopulmonary resuscitation (CPR), medical ethics, medical terminology, and nutrition "prepared them well" or "extremely well." The most frequently recommended educational delivery method was "in person." The DPC experiences reported to best prepare students were Medical Assistant, Certified Nursing Assistant, and Scribe. The reported recommended number of DPC hours was 1000 to 1499. Chi-square tests for courses that prepared students "well" and "extremely well" revealed that in-person delivery had a statistically significant association with anatomy, physiology, ethics, CPR, medical ethics, and Spanish. These significant findings should be considered by PA programs when evaluating their requirements for admission. Furthermore, PA education associations should consider universal requirements to reduce applicant barriers, complexity, and expense, which may lead to improved diversity.

An Analysis of Lesbian, Gay, Bisexual, Transgender, and Queer Curricula Inclusion: A National Study of Physician Assistant Programs.

The health professions education literature shows an increased focus on inclusion of lesbian, gay, bisexual, transgender, and queer (LGBTQ) content in curricula; however, it does not address hours of content or methods for content delivery. The purpose of this study was to describe the delivery of LGBTQ content in physician assistant (PA) education through a national survey of PA programs. In 2021, a national program survey was sent to all US-accredited PA Programs (n = 284) and had a completion rate of 71.8% (n = 204). Descriptive statistics were conducted to describe trends and make comparisons in the delivery of LGBTQ content. Most PA programs are incorporating LGBTQ content into preclinical phases of PA education (81%) and describe that LGBTQ curricula align with institutional values (82%). Most report 1 to 3 hours of preclinical education for all LGBTQ population groups and cite medical interviewing courses as the most frequently used course to address LGTBQ care. Many programs (43%) do not provide instructional hours on LGBTQ content in the clinical phase, and the majority do not offer clinical rotations focused on this care. The results show variability in the level of preparedness that programs report on their students caring for LGBTQ populations. Physician assistant programs are generally integrating the content throughout their didactic curricula; however, few offer clinical experiences focused on caring for patients who are LGBTQ. Offering clinical experiences and assessing student competencies are areas of growth in health professions education as related to LGBTQ health.

Physician Assistant Educators' Production Blueprint for Video Pedagogy.

This article presents a blueprint for effective video media production in physician assistant (PA) education based on validated pedagogical practices found in the literature. Using the cognitive load theory and a practical blueprint for video production designed for PA educators, this method aims to improve video production practices and better engage students within a format that improves learning outcomes for a diverse body of PA students. Students are interacting with videos, and there is an opportunity for educators to hone practices in video production to enhance student learning. A literature review of pedagogical practices in video production guides the production blueprint for video production. The practical principles of cognitive load theory improve efficiency in assimilating new information, enhance student engagement, and facilitate active and deep learning for a student learner engaging with the instructional video. Based on the literature and the author's educational video creation experience, a guide in the form of a production blueprint specific to PA education is proposed.

Development of a Novel, Reusable Task Trainer for Foreign Body Removal and Abscess Incision and Drainage.

Cutaneous abscess incision and drainage and foreign body removal are 2 common procedures in a variety of outpatient settings. The goal of this project was to create a novel, clean, reusable task trainer that could more accurately reproduce all the steps necessary to perform cutaneous abscess drainage or foreign body removal including ultrasound to identify the abscess cavity or foreign body. The novel task trainer was constructed using silicone for both the base and the top skin. Toothpaste mixed with saline was used for the abscess material as this produced an ultrasound image that mimicked purulent material. A piece of a metal paper clip was imbedded in the top skin to mimic a cutaneous foreign body. Physician assistant (PA) students given a didactic lecture then used the novel task trainer as part of a clinical skills course. After the activity, the PA students were asked to voluntarily complete a brief preretrospective/postretrospective survey comprised 8 questions that addressed their self-perceived knowledge and skills using a 5-point Likert scale. Survey data from an initial cohort of PA students at one university show effectiveness of the models when used with the associated curriculum. This study demonstrates the feasibility of constructing a practical, low-cost, non-animal-based task trainer for the purpose of training incision and drainage of cutaneous abscesses and removal of cutaneous foreign bodies. This novel task trainer allows for ultrasound skill development and provides realistic imaging experience.

PULMONARY REHABILITATION IN ROMANIA: FROM THE BEGINNINGS TO THE PRESENT

Pulmonary rehabilitation is the standard of care for patients with chronic lung disease. Material and method: Starting from the systematic review of specialized literature and practical expertise obtained both internationally and nationally, the exposition emphasizes the aspects related to pulmonary rehabilitation in patients with chronic lung diseases. Results: The cornerstone of pulmonary rehabilitation is the American Thoracic Society (ATS)/European Respiratory Society (ERS) Statement on Pulmonary Rehabilitation published in 2006 and developed based on the documents of the American College of Chest Physicians (ACCP) and American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) published in 1997 and 2004. The document was subsequently updated in 2007, 2013, 2015, 2021 and 2023, with the concept of pulmonary rehabilitation constantly evolving over the years. In Romania, pulmonary rehabilitation is carried out according to these guidelines and international standards, Iasi being a reference center in this field. Conclusions: Pulmonary rehabilitation is one of the most powerful evidence-based therapies for patients with chronic lung disease. Keywords: COPD, exercise capacity, training, quality of life.

Knowledge, Attitudes, and Behaviors of Medical Residents towards Traditional and Complementary Medicine: A Cross-sectional Study

Objective: This study aimed to evaluate the knowledge, attitudes, and behaviors of medical residents working at a faculty of medicine hospital about Traditional and Complementary Medicine (TCM). Material-Method: This is a cross-sectional study. The study was conducted with clinical science assistants working at the faculty of medicine between 15 July and 15 December 2021. A survey containing questions to determine the clinical and demographic characteristics of the participants and their knowledge, behavior, and attitudes toward TCM applications was applied to the participants. Results: A total of 261 medical residents participated. The average age was 29.4±2.6 years and 51.7% (n=135) were male. 82% of the participants were studying internal medicine sciences. The average length of time as a physician was found to be 4.4 years, and the average length of time as a physician in the total branch was 2.6 years. Cupping therapy was the most known method with 55.6%. The most frequently used method (19.2%) was phytotherapy; the most frequently recommended (16.5%) was phytotherapy; the most formally trained (4.2%), was cupping therapy; the most desired formal training (41%) was acupuncture; the most frequently declared method (11.9%) as another TCM method was diet. 36.4% of the participants found TCM useful. 82% thought that these methods should only be applied by trained physicians. Conclusion: It was determined that the level of TCM knowledge among assistant physicians was low. Although the majority of participants had a positive attitude towards TCM, they had low rates of application, implementation, and recommendation.

Perceived utility of the inclusion of physician assistants in the surgical process quality and continuing education in Germany : Results of an interprofessional online survey

Compared to Anglo-American countries, physician assistants (PA) remain an underrepresented professional group within the German healthcare system. In the surgical disciplines, PAs may relieve the administrative burden of doctors by taking on delegable routine tasks, thus creating time and resources for advanced surgical training. According to interprofessional experts, can the use of PA lead to an optimization of surgical training and again in time for surgical qualification in Germany? After searching for systematic reviews of the current state of knowledge, an online survey was initiated among surgeons and PAs via social networks to determine current and desired clinical areas of activity for PAs in surgery and their future influence on specialist training in Germany. A total of nine systematic reviews were identified, suggesting abeneficial impact of PAs on length of stay, direct costs, and treatment outcomes in surgical scenarios. The online survey included 234 surgeons and 114 PAs. Hospitals with ≥ 90 surgical beds employed PAs far more frequently (65%) than smaller institutions (40%). Although both professional groups are generally highly satisfied with the integration of PAs into clinical workflows, there are gradually different opinions about the preferred spectrum of tasks and duties. PAs would like to have greater responsibility in ordering and interpreting diagnostic tests, communicating with patients, and working in the operating theater. Surgeons are concerned that PAs could replace surgical interns and residents. PAs may enrich healthcare in Germany on various levels and can also improve surgical training. The voice and needs of all professional groups must be considered and respected during the upcoming health system reform.

Contextual barriers and enablers to establishing an addiction-focused consultation team for hospitalized adults with opioid use disorder

BackgroundHospitalization presents an opportunity to begin people with opioid use disorder (OUD) on medications for opioid use disorder (MOUD) and link them to care after discharge; regrettably, people admitted to the hospital with an underlying OUD typically do not receive MOUD and are not connected with subsequent treatment for their condition. To address this gap, we launched a multi-site randomized controlled trial to test the effectiveness of a hospital-based addiction consultation team (the Substance Use Treatment and Recovery Team (START)) consisting of an addiction medicine specialist and care manager team that provide collaborative care and a specified intervention to people with OUD during the inpatient stay. Successful implementation of new practices can be impacted by organizational context, though no previous studies have examined context prior to implementation of addiction consultation services (ACS). This study assessed pre-implementation context for implementing a specialized ACS and tailoring it accordingly.MethodsWe conducted semi-structured interviews with hospital administrators, physicians, physician assistants, nurses, and social workers at the three study sites between April and August 2021 before the launch of the pragmatic trial. Using an analytical framework based on the Consolidated Framework for Implementation Research, we completed a thematic analysis of interview data to understand potential barriers or enablers and perceptions about acceptability and feasibility.ResultsWe interviewed 28 participants across three sites. The following themes emerged across sites: (1) START is an urgently needed model for people with OUD; (2) Intervention adaptations are recommended to meet local and cultural needs; (3) Linking people with OUD to community clinicians is a highly needed component of START; (4) It is important to engage stakeholders across departments and roles throughout implementation. Across sites, participants generally saw a need for change from usual care to support people with OUD, and thought the START was acceptable and feasible to implement. Differences among sites included tailoring the START to support the needs of varying patient populations and different perceptions of the prevalence of OUD.ConclusionsHospitals planning to implement an ACS in the inpatient setting may wish to engage in a systematic pre-implementation contextual assessment using a similar framework to understand and address potential barriers and contextual factors that may impact implementation. Pre-implementation work can help ensure the ACS and other new practices fit within each unique hospital context.

Patient activation and health literacy in Dutch patients with multiple involved specialties

Abstract Aim To examine the association between having a higher number of involved specialties, patient activation (PA), and health literacy (HL) in patients visiting a general hospital. Subject and methods Patients ≥ 18 years of age who had an appointment with the medical specialist or physician assistant were asked to participate in this study. Patients completed the Patient Activation Measure-13 (PAM) questionnaire and the European Health Literacy Survey Questionnaire (HLS-EU-Q). They were stratified into having < 3 or ≥ 3 involved medical specialties in the past 12 months. Two association models were built to examine the association. Results This study included 200 patients with 52% males (n = 104), a median age of 65 years, and low levels of education (67%). Patients with ≥ 3 involved medical specialties (58%) had lower total PAM scores (p = 0.03) and had lower HLS-EU-Q index scores (p = 0.23). The multivariable regression analysis showed that having ≥ 3 involved medical specialties was not associated with low PAM scores (OR = 1.59, p = 0.13) when adjusted for low education, low HLS-EU-Q scores, and higher age (> 65 years). In addition, having ≥ 3 involved medical specialties was not associated with low HLS-EU-Q scores (OR = 1.10, p = 0.76) when adjusted for low PAM scores and low education. Conclusion Patients with ≥ 3 involved medical specialties visiting the internal medicine department of a general (non-academic) hospital had variable levels of PA and HL. Moreover, having ≥ 3 involved medical specialties was not significantly associated with lower PA and HL. Importantly, the number of involved specialties may not be a proxy for recognizing low PA and HL. Organizations aiming to improve PA and HL could measure these constructs directly.

Teaching Future Physician Assistants to Provide ADEPT-CARE to Disabled Patients: A Novel Application of Disability Curriculum.

Physician assistant (PA) students will be certain to provide care to patients with disabilities in their future careers. However, there is a dearth of literature on disability-related education in PA training. This curriculum sought to fill this need. The specific aims of this study were to (1) evaluate the implementation of a 3-part disability-focused education curriculum in PA education, (2) assess changes in PA students' self-perceived confidence and attitudes toward patients with disabilities, and (3) assess students' attitudes toward ADEPT-CARE. A 3-part disability curriculum was implemented into the first-year PA curriculum at a single Mid-Atlantic institution. Students could voluntarily complete pre and post-surveys which assessed their self-perceived confidence and attitudes toward people with disabilities, perception of the curriculum, and attitudes toward ADEPT-CARE and disability health. Thirty students participated in the study, with a 100% survey response rate. Nearly all participants agreed or strongly agreed that this curriculum enhanced their medical education (n = 28, 96.6%, frequency missing n = 1). After curriculum completion, there was a statistically significant improvement in participants' confidence in their ability to assess patients with disability (46.7%-93.3%, P < 0.001), ability to provide the same quality of care to patients with disability as those without disability (80.0%-96.7%, P = 0.025), and perception of quality of life of persons with disabilities ( P = 0.030). This curriculum was well received by PA students and improved their attitudes toward patients with disabilities, thereby fulfilling a critical need for PA educators.

Expressing the Complexities of the Student-Cadaver Relationship Through Visual Artwork.

Many physician assistant (PA) students first encounter death in the earliest days of their training when working with cadavers in the gross anatomy laboratory. Developing a deep knowledge of human anatomy is fundamental to health profession training programs and modern medical practice. Despite decreased laboratory hours and integration of technology and diagnostic imaging into modern anatomy courses, there remains value in the cadaver dissection experience. Medical learners experience diverse and complex feelings toward cadavers; learning to regulate one's personal responses within the anatomy laboratory is a skill that can be extrapolated to clinical practice. Art is one way for students to process their experiences with cadavers, and creating art for cadaver memorial ceremonies is an opportunity for student emotional processing while honoring the lives of their cadaveric teachers. A PA program in New England incorporated student art into a cadaver memorial ceremony, with 4 pieces of artwork and corresponding artist statements from that ceremony included in this piece. The works of art are visually diverse, but there is a shared sentiment in the artist statements of reflection, awe, appreciation, and humanity. Encouraging students to process complex experiences artistically may provide an enduring practice throughout a career in medicine.

764 Burn Advanced Practice Provider Fluorescein Dye Staining Reduces Ophthalmology Consults

Abstract Introduction Facial burn injury patients typically receive ophthalmology consultations irrespective of the severity of their peri-ocular or ocular involvement. Minor facial burns without significant eye involvement or ocular complaints often do not require in-patient ophthalmologist assessment. We sought to assess ocular fluorescein dye staining by burn unit Advanced Practice Providers (APP; Physician Assistants and Nurse Practitioners) to decrease unnecessary ophthalmology consults. Methods A prospective evaluation was performed at our ABA-verified burn center for all facial burn injury patients admitted between January 1 through August 31, 2023. Patients who presented with full-thickness injuries to their eyelids or peri-ocular area, those exhibiting tense eyelids raising concern for ocular compartment syndrome, those with severe eye pain and anyone with acute vision loss were excluded from staining and received an immediate ophthalmology consult. For patients with facial burns who did not meet the aforementioned criteria, fluorescein dye stains were administered upon admission by APPs, if available. Ophthalmology consults were only ordered for patients with positive stains. Results 83 patients were admitted with facial burns between January 1 and August 31, 2023. Of these, 42 patients received fluorescein dye stains by APPs. Among those stained, 79% were male and 21% female. The average age was 49 years old (range 19 to 82). The average TBSA affected was 8.46% (range 0.1% to 38.5%). The majority of patients (83%) had flame/flash burns, 7% had scald burns, 2% had chemical burns, 2% had sun burns and the remainder had unclear etiology. 34 patient dye stains (80%) yielded negative results, obviating the need for an ophthalmology consult. The remaining 8 had positive results, necessitating a consult. Among these, 4 were false positives with no ocular injury found by ophthalmology. The remaining 4 exhibited ocular chemosis, trace punctate epithelial erosions, thermal keratopathy and chronic central epithelial defects from prior Lasik surgery. Ophthalmology was consulted in 37 out of 83 patients, with only 8 consults resulting from APP staining. This signifies a 48% overall reduction in consults placed during this 8-month time frame, and an 80% reduction of consults in whom qualified for the pathway. Conclusions Fluorescein dye staining by burn unit APPs minimizes unnecessary ophthalmology consults, likely reducing healthcare costs for patients and healthcare facilities. Applicability of Research to Practice Burn centers should consider fluorescein dye stain screening as part of routine practice for burn patients.

Physician assistants in the German inpatient care: barriers and enablers of integration

PurposeVarious health systems are challenged by a multifaceted crisis of increased service demand and workforce shortages. The effects are devastating and may end up in decreased access to care, poor quality of patient care and extreme demands on the workforce. The introduction of the physician assistant (PA) profession provided an avenue to address such challenges in several countries. In Germany, the integration of PAs has been proceeding slowly.Design/methodology/approachTo understand the integration of the profession in Germany, we conducted 15 expert interviews to reveal how the PA profession is perceived among healthcare experts as well as the barriers and facilitators of integration in inpatient care.FindingsOur results highlight a generally positive perception of PAs, particularly in terms of workload relief and bridging the gap between healthcare professionals. Nonetheless, barriers include resistance from healthcare workers unfamiliar with the PA role, while workforce shortages and collaborative teamwork facilitate integration.Originality/valueThese findings lay the groundwork for potential integration-enhancing strategies in Germany.

Office procedures for older adults by physician associates and nurse practitioners.

We hypothesized that physician associate (PA) and nurse practitioner (NP) procedural roles are expanding. We sought to describe ambulatory procedures these professionals performed in 2021 for older adults. Retrospective observational cohort study of Medicare Part B data. US Bureau of Labor Statistics data were used to provide overall PA and NP employment context. Medicare Part B databases were probed for outpatient events by PAs and NPs using a modified list of the Council of Academic Family Medicine's recommended clinical procedures that focused on 29 procedures organized into 9 categories called procedure clusters. These procedures were linked to Current Procedural Terminology codes and PA and NP National Provider Identifier codes in Medicare Part B and then tabulated and analyzed for 2021. The Bureau of Labor Statistics provided NP and PA employment trends for context. The trend of the procedures and providers spanning 2014-2021 was analyzed. In 2021, 23,581 NPs and PAs filed 9.6 million Medicare Part B enrollee procedure claims. Most procedures (96%) involved skin or the musculoskeletal system. PAs filed more than twice as many claims for skin and musculoskeletal procedures as NPs, and NPs filed 1.25 times as many as PAs for the eye, ear, nose, and throat; pulmonary; genitourinary; gastrointestinal-colorectal; and women's health categories. From 2014 through 2021, the number of PAs and NPs in clinical practice increased by 72%, and the number of those who filed procedure claims increased by 74%. Overall, PAs performed more skin and musculoskeletal procedures than NPs, and NPs performed more procedures in the other 7 procedure clusters than PAs. PA and NP employment growth does not fully explain these observations. We suggest that outpatient procedural task-shifting activity presents an area for further research.

Leadership From a Different Lens: Shaping the Future of Healthcare Education.

Physician assistant (PA) educators are responsible for preparing the next generation of PAs to be not only healthcare providers but also healthcare leaders. Regardless of whether advanced practice providers choose to pursue formal leadership roles in healthcare, they will undoubtedly be expected to possess and exhibit leadership skills. The PA profession indicates leadership as an important professional competency, yet leadership training is rare in current curricula. The PA community should consider the importance of leadership training for educators as they influence future PAs and the way PA students will affect their future patients and the healthcare systems for which they work. The aim of this article was to bring awareness to the need for leadership skill training in PA education, to review common leadership styles in healthcare, and to offer practical leadership tips to healthcare educators.

Burnout, Personal, and Occupational Factors as Predictors of Physician Assistant Faculty Intent to Leave After the COVID-19 Pandemic.

This study addressed whether burnout, personal, or occupational factors predicted physician assistant (PA) faculty intent to leave and established a new postpandemic national benchmark for PA faculty burnout and intent to leave. In spring 2023, a nonexperimental, cross-sectional survey was emailed to 2031 PA faculty drawn from program faculty listings and the PA Education Association member database. Descriptive statistics were used to describe the sample, and a multiple regression analysis was conducted to analyze the predictive ability of the independent variables on intent to leave. The response rate was 30% (609 of 2031), with 496 responses (24.4%) included in the analysis. The sample reflected the population of PA faculty. The regression model significantly predicted intent leave ( P < .001). The adjusted R2 was 0.46, indicating the combination of independent variables predicted 46% of the variance in PA faculty intent to leave. Significant predictors included emotional exhaustion and identifying as multiracial ( P < .001), control and values ( P < .01), and depersonalization, fairness, rewards, and clinical year faculty role ( P < .05). The sample had moderate levels of burnout and experienced burnout at higher rates than in prepandemic studies. Physician assistant faculty in administrative leadership roles had the highest levels of burnout and intent to leave. Despite this, PA faculty intent to leave measures were similar to prepandemic levels. Several of the predictive variables were related to well-being and social-emotional aspects of the workplace. These findings have implications for institutional policies and practices that support faculty well-being and workplace culture to enhance retention.

Helping Babies Breathe-A Comparative Analysis of Virtual and Traditional Mentored Train-the-Trainer Courses: A Pilot Program for Physician Assistants in Liberia

Helping Babies Breathe-A Comparative Analysis of Virtual and Traditional Mentored Train-the-Trainer Courses: A Pilot Program for Physician Assistants in Liberia

Credentialing and training advanced practice providers for advanced tertiary care pediatric otolaryngology: A curriculum for hospital and ambulatory practice

ObjectivesInclusion of advanced practice providers (APPs) in hospital-based pediatric otolaryngology has been growing rapidly, aligning with a 70% increase in physician assistants in all surgical subspecialties in recent years. A post-graduate training program is developed to reflect these growing and changing responsibilities. MethodsCurriculum development took place at one institution over eight years for 16 APPs following a standard Six Step Approach to medical curriculum: 1) Problem Identification and General Needs Assessment, 2) Targeted Needs Assessment, 3) Goals & Objectives, 4) Education Strategies, 5) Implementation, and 6) Evaluation and Feedback. This was integrated into an onboarding process for new hires and a continuing education plan for established providers. Gaps were identified throughout the process to improve education, skills required for competency, and readiness for independent practice. ResultsThe curriculum incorporated a subset of goals and objectives from the familiar resident curriculum with significant differences in orientation and onboarding. A Clinical Competency Checklist was used initially for feedback and later to support credentialing after completion of the curriculum. A Procedure Rating Form was used for feedback and documentation of the number of performances required for credentialing. Self-Assessment was utilized to further identify readiness for independence and tailor additional education to meet practice needs. ConclusionThe curriculum and onboarding process presented can be used for any advanced practice provider joining an individual or team of pediatric otolaryngology providers. A standardized curriculum is helpful to the supervisors and trainees. Further collaboration between institutions and development of benchmarks will help ensure excellence in education and in care of pediatric otolaryngology patients.

Clinical Physician Assistant Students’ Perceptions of Evidence-Based Medicine Resources: A Cross-Sectional Examination

Evidence-based medicine (EBM) instruction is required for physician assistant (PA) students. As a follow-up to an initial didactic year survey, this study seeks to understand which attributes of EBM resources clinical PA students find most and least useful, their self-efficacy utilizing medical literature, and their usage of EBM tools in the clinic. Results indicate that students preferred UpToDate and PubMed. PA students valued ease of use, which can inform instructors and librarians. Respondents utilized EBM tools daily or a few days a week, underscoring the importance of EBM tools in real-world scenarios. After their clinical year, students felt moderately confident utilizing the medical literature, emphasizing EBM training.