Journal of Physician Assistant Education最新文献

Introduction: Creating a successful remediation plan for physician assistant/associate students comes with its challenges, particularly because of the limited time available for both faculty and students. In an accelerated 24-month program, the pace of the curriculum leaves little time to fall behind in mastering knowledge and skills. One possible solution is appointing an adjunct faculty member to serve as a dedicated Remediation Specialist (RS) to focus solely on student remediation.

Methods: The RS reviews assessments of failing students and develops a review session based on shared areas of weakness among them. This session is promptly offered postassessment to ensure timely review. While required for failing students, the session is open to all didactic students. In addition, students complete a remediation assignment of their choice.

Results: Implementation of a RS demonstrated positive program outcomes. Students requiring remediation receive re-education in areas of deficiency within the curriculum. Furthermore, the time burden is shifted away from the core faculty. Students are remediated in targeted areas.

Discussion: Dedicated remediation specialists are commonly used in health profession education programs. The utilization of these specialists often results in higher examination pass rates, licensure pass rates, and improved clinical skills. While some programs select a candidate training in education and pedagogy, our program's RS is a trained physician assistant/associate and able to provide discipline-specific support.

Abstract: Neurodiversity, encompassing conditions such as autism spectrum disorder, attention-deficit/hyperactivity disorder, and dyslexia, represents a significant and often under-recognized segment of the population, including within science, technology, engineering, mathematics, and medicine fields like medicine. Neurodiverse individuals possess unique skills, including enhanced creativity, analytical thinking, and meticulous attention to detail, which are valuable in health care professions. However, failure to recognize and support these individuals can result in missed opportunities, social isolation, and mental health challenges. Despite a growing emphasis on diversity, equity, inclusion, and belonging in higher education, neurodiversity is frequently overlooked, particularly in physician assistant (PA) education. This article examines the unique challenges faced by neurodiverse PA student learners and the existing literature gap regarding neurodiversity in PA education. It underscores the need for greater awareness, reduced stigma, and improved support systems. Recommendations include integrating neurodiversity into the PA curriculum, providing faculty training on inclusive teaching practices, and establishing tailored accommodations to foster a sense of belonging. PA programs can foster a more equitable health care system by creating inclusive learning environments that acknowledge and cater to the unique needs of neurodiverse student learners, thereby enhancing student-faculty interactions and promoting academic success. The aim of this article was to facilitate the reimagining of PA education to champion cognitive diversity. By promoting a more inclusive learning environment, PA programs can cultivate future clinicians who are better equipped to serve diverse patient populations.

Introduction: Burnout is prevalent among both physician assistant (PA) students and faculty in the United States. Theories concerning the root cause of this burnout include a breakdown of community, which, in this context, serves as a framework comprising membership, influence, integration and fulfilment of needs, and shared emotional connection. A community framework has yet to be formally applied to the PA learning environment. The objective of this study was to explore the ways in which PA students experience community with faculty and how this perceived sense of community affects those students' perceived well-being.

Methods: This was a qualitative study completed using semistructured, one-on-one virtual interviews with PA students of the graduating class of 2024 at one institution devised by using an interview guide created by the investigators based on a community framework. Interviews were recorded and transcribed by Microsoft Teams and analyzed using thematic analysis.

Results: Three major themes were produced from four participant interviews: (1) Students felt interactions with faculty were uniquely positioned to affect their well-being as influenced by their level of vulnerability as a student in a rigorous program; (2) students observed a wide range of faculty actions, values, and personality qualities that promoted a sense of community with faculty; and (3) students perceived a fragmentation between faculty members and the class itself, as well as between the two entities, which impaired their sense of community.

Discussion: PA students are vulnerable community members with a wide range of needs. Faculty interactions are crucial to meeting those needs. Future research can involve the recruitment of additional students, cohorts, or programs for diversified perspectives.

Introduction: As new equity, diversity, and inclusion programs emerge in physician assistant/associate (PA) education, there is a need to assess baseline levels of implicit and explicit biases among PA preceptors' and trainees. The objectives of this study were (1) to measure implicit and explicit race (Black/White) and weight (fat/thin) biases among PA preceptors and trainees and (2) to identify potential gaps in PA preceptor and trainee education.

Methods: This is a cross-sectional study of PA preceptors and trainees from one program operating in several US states; implicit and explicit race and antifat biases and receipt of prior education were measured.

Results: Preceptor response rate was 6.4% (N = 78) from an eligible population of 1222, and trainee response rate was 25.7% (n = 43) from an eligible population of 167. Sixty-eight preceptor participants (87.2%) and 23 trainees (53.5%) identified as White. Preceptors held strong (Cohen d = 0.81), and trainees held moderate (Cohen d = 0.43) pro-White implicit bias. Overall, preceptors and trainees held little and no explicit race bias (Cohen d = 0.18 and d = 0.0, respectively). Preceptors and trainees held strong implicit antifat bias (Cohen d = 1.24 and Cohen d = 0.76). Preceptors held moderate explicit antifat bias (Cohen d = 0.65); trainees held strong explicit antifat bias (Cohen d = 0.95). Trainees received significantly more education on working with diverse populations compared with preceptors (100% vs. 57.7%, P < 0.001) and working with patients who are overweight (74.4% vs. 41.0%, P < 0.001).

Discussion: Implicit race and antifat bias exists among our sample of PA preceptors and trainees. A gap in education for preceptors on working with diverse populations and patients who are overweight was identified. Future research should address both.

Introduction: Interpersonal theory can be used to better understand the personal and social manifestations of individual difference variables in physician assistant (PA) students. Emotional intelligence (EI) is characterized by self and social awareness that facilitates effective communication. While EI has been examined in PA students, a theoretical framework for describing why and how EI has beneficial effects has not been articulated. Interpersonal theory can be used to generate hypotheses about EI and expected correlates.

Methods: One hundred nine PA students completed questionnaires assessing EI, social behavior (ie, dominance and affiliation), interpersonal efficacy, social support, loneliness, and negative social experiences. Regression analysis was used to determine interpersonal style and efficacy associated with EI. Correlation analyses were used to determine bivariate associations.

Results: Emotional intelligence was associated with a friendly interpersonal style and confidence in one's ability to establish relationships. As expected, EI was positively correlated with social support and negatively correlated with loneliness. While in the expected direction, EI was not associated with fewer negative social experiences.

Discussion: Emotional intelligence is a potentially valuable personal resource in the lives of PA students, and there may be implications related to EI and its impact on the medical encounter. Results are discussed in terms of curriculum in PA programs and how cultivating EI could be of benefit for students. Additional research is proposed to determine which aspects of EI facilitate an effective medical encounter.

Introduction: There is a keen interest regarding burnout in academic medicine with an existing need for more studies. The priority population were underrepresented physician assistant/associate (PA) educators in the United States. The purpose was to determine external/internal contributors leading to perceived burnout; investigate whether primary/secondary appraisal inform coping strategies; and determine whether there was an existing relationship between demographic factors and emotional exhaustion (EE).

Methods: This study used a mixed-methods design using a convenience sample representative (n = 101). For the quantitative portion, the participants completed a demographics survey and the Maslach Burnout Inventory-Educators Survey from which their average EE score was calculated. For the qualitative portion, 11 participants were interviewed identifying burnout perception, contributors, and coping strategies. Statistical analyses (analysis of variance, Pearson r, t-test, multiple linear regression) were used to determine the relationship between demographic variables and EE. Qualitative data were analyzed and presented categorically.

Results: There was a statistically significant relationship between sex and EE (t(100) = -2.42, P < 0.05, d = -0.54), demonstrating that women underrepresented minority (URM) PA educators experience burnout at increased rates compared with their men counterparts. There were no statistically significant relationships between age (r = 0.015, R2 = 0.000225, P = 0.883), race (F(1, 98) = 0.108, P = 0.744, η2 = 0.001), faculty role (F(1, 97) = 3.09, P = 0.082, η2 = 0.031), and "years in faculty position" and EE (F(1, 99) = 0.271, P = 0.604, η2 = 0.003). The overall predictive model was not statistically significant (F(5, 92) = 1.859, P = 0.109, R2 = 0.092, adjusted R2 = 0.042). The qualitative data offered insight into burnout perception, contributors, coping strategies, current institutional/programmatic burnout strategies, suggested institutional/programmatic burnout strategies, common occupational stressors, initial responses to occupational stressors, and overall experiences of URM PA educators.

Discussion: The quantitative data demonstrated a significant difference between EE score and gender; no correlation between EE and age; and nonsignificant differences between EE and race, EE, "years in faculty position," and faculty role and demographics as a predictor for EE. These findings are supplemented by the qualitative data with the interviewees relating social isolation secondary to gender and lack of diversity as burnout contributors. Regarding URM PA educator experiences, the participants related their minority status, URM faculty allyship, and being a Black woman in academia as important topics for consideration. These triangulated data can be used to inform future burnout health interventions and research.

Abstract: Intellectual property laws were not originally designed to address digital classrooms and shared online learning environments, but these concerns are now relevant to many educational institutions. The recent expansion of technology utilization in health professions education presents educators with the challenges to accurately interpret copyright law and implement best practices under the tenets of fair use. Discerning legal and ethical parameters relevant to copyright law will encourage the implementation of best practices in disseminating information and creating appropriate learning activities in the age of digital education.

Introduction: Physician assistants (PAs) should understand the implications and risks involved with airway management. Our study aimed to facilitate PA students' familiarity with airway management with instruction from anesthesiology residents. We assessed the students' knowledge of airway management both before and after a seminar to see if knowledge was retained.

Methods: Physician assistant students participated in a seminar (didactic lecture and a hands-on workshop) on airway management led by anesthesiology residents. The students took a true-false pretest and repeated the test following the seminar. After four months, the students repeated the same true-false test to assess retention. We used Friedman test to analyze differences between the pretest, posttest, and retention tests, as well as performed an itemized analysis on the questions.

Results: The students showed a significant difference between the pretest and posttest (P < 0.001) and between the pretest and retention test (P = 0.006). Students performed better per question on the retention test compared with the pretest, except for a question related to an indication for intubation (Z score = -2.757; P = 0.006).

Discussion: Our results demonstrated that educating PA students in airway management with anesthesia resident direction resulted in a statistically significant increase in their knowledge on the topic four months after the training. Interactive learning seems beneficial for gaining knowledge on the basic principles of airway management.

Introduction: Team-based learning (TBL) is a type of active learning. While TBL was first used in medical instruction at the start of the 2000s, its efficacy within the physician assistant (PA) education has yet to be demonstrated. The objective of this study was to determine existing information about TBL in PA education and to demonstrate the need for further study.

Methods: A mixed scoping review was undertaken. Articles were identified across the search engines CINAHL Complete, Embase, ERIC, and PubMed. Findings were then evaluated using Rayyan and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Forty-nine articles were identified across all databases, with 2 independent reviewers screening records. Ultimately, 6 studies were included. Four studies were original articles, and the other 2 were conference abstracts.

Results: Based on the limited data available, TBL was generally beneficial in all available studies; however, results should be interpreted with caution given the paucity of available data. Studies included both hybrid curriculum and TBL alone. Studies demonstrated significant findings when evaluating TBL course outcomes, examination grades, and student confidence. All articles evaluated different outcomes, so comparison between results is challenging. The strength of research from conference abstracts was limited. Further study is necessary to determine if TBL is effective in other programs.

Discussion: If demonstrated to be effective in PA education, TBL may be used to improve outcomes such as examination performance, course grades, long-term retention of knowledge, or student confidence.

Introduction: To determine the drivers and barriers to flourishing for clinical health professions students through a review of peer-reviewed literature.

Methods: Articles were analyzed in Scopus, PubMed, and EBSCOHost and hand-searched education journals through May 2024 describing flourishing among clinical health professions students. Whittemore and Knafl's integrative approach was used, and quality was assessed by the Mixed Methods Appraisal Tool.

Results: The 26 articles included medical (14/26, 53.8%), pharmacy (8/26, 30.8%), physician assistant (3/26, 11.5%), and nurse anesthetist (1/26%, 3.8%) students. Results were framed by the Social Ecological Model. Individual drivers included meaningful work, feeling valued, and pride in overcoming challenges, while barriers included feelings of self-sacrifice to achieve success. Intrinsic factors were both drivers and barriers (eg, positive affect was positively correlated with flourishing). Interpersonal drivers included feelings of belonging, social relationships, and mentorship, while scheduling conflicts was a barrier. Organizational drivers included integrated wellness efforts and faculty buy-in, while barriers included inadequate recovery time between demanding tasks, required participation in activities perceived to have individual low-value, and resource inaccessibility/insufficiency. There was a deficit in the exploration of the impact of communities, public policy, and race and/or ethnicity on flourishing.

Discussion: Limitations include possible exclusion of relevant articles due to search term and database selection. Students, faculty, and programs are cocreators of environments that promote or thwart flourishing. Educators can intentionally create learning environments that promote flourishing through increasing student autonomy, implementing community-building activities, and developing individual values in the context of training.