Journal of Physician Assistant Education最新文献

Introduction: Artificial intelligence (AI) tools, such as customized chatbots, present an opportunity to enhance active learning in physician assistant (PA) education. This study evaluated student perceptions and outcomes associated with incorporating an AI chatbot designed to promote self-directed learning, retrieval practice, and individualized feedback within a didactic clinical medicine course.

Methods: Faculty developed a course-specific chatbot (GPT-4o, OpenAI) integrated with lecture materials, open-access medical texts, and sample PANCE-style questions. The chatbot generated customized multiple-choice questions and provided tutoring functions for targeted remediation. Utilization data ("impressions") were collected across modules, and students completed an anonymous Qualtrics survey assessing perceptions of usefulness and engagement. Quantitative data were analyzed descriptively, and qualitative responses underwent thematic analysis.

Results: Sixty-three of 70 eligible students (90%) completed at least one survey item. Nearly all respondents (95%) used the chatbot, and 95% agreed or strongly agreed that it improved examination preparation and information retention. Most students identified practice questions and individualized feedback as the most beneficial features of the chatbot. Student use of AI increased significantly over the course, and qualitative analysis revealed themes of enhanced active recall, self-assessment, and confidence. Faculty noted reduced time demands for tutoring and quiz creation following initial tool development.

Discussion: Integration of a customized AI chatbot within PA education promoted active learning, self-efficacy, and AI literacy while ultimately reducing faculty workload. Early exposure to AI-based tools may not only enhance student readiness for didactic and summative assessments but also cultivate the skills necessary to use similar technologies effectively and responsibly in clinical practice.

Introduction: With the rapid increase in the number of Physician Assistant/Associate (PA) programs, more clinically trained PAs are entering into the world of academia as PA educators. These individuals may not have received formal education on research and scholarship. Given that scholarly activities have both written and unwritten rules, understanding these nuances before embarking on scholarly pursuits is incredibly important for early career or novice researchers.

Methods: This article aimed to identify the top considerations for PAs engaging in scholarly activities. These considerations were identified through a literature review and from the collective lived experience of former/current PA faculty.

Results: Five considerations were identified for PAs who wish to engage in scholarly pursuits. The first consideration is mentor identification. The second is collaboration and the formation of a study team. The third is establishing authorship and the order of authors. The fourth is clear communication and reasonable deadlines. Finally, the fifth is identifying a target journal and determining a plan for payment of journal publication fees.

Discussion: Early career faculty or novice researchers must navigate the nuances of not only academia, but pursuit and participation in scholarly activities. For many, this is an entirely new world, and mistakes are made along the way. This article aims to equip the reader with a thorough understanding of the top considerations for engaging in scholarly activity in the hopes that this knowledge will smooth the transition for those who wish to embark upon the journey of scholarship.

Introduction: Entrustable Professional Activities (EPAs) operationalize Competency-Based Medical Education (CBME) by defining observable clinical tasks that learners should be trusted to perform. Although EPA frameworks have been developed for physician training, a validated EPA framework tailored to newly graduated physician associates (PAs) has not been established.

Methods: A modified Delphi study was conducted with 35 experts from PA education and clinical practice. An initial list of 21 EPAs was created through adaptation of existing EPA frameworks and original development aligned with the 2020 PA Competencies. Each EPA was evaluated using the Queen's EPA Quality rubric. Three iterative survey rounds were conducted using Qualtrics. EPAs reaching ≥75% expert consensus were retained. Qualitative feedback was used to refine EPA language between rounds.

Results: Twelve EPAs met the consensus threshold, with all ultimately reaching "Strongly Agree" levels. These were categorized into 5 domains: Establishing Core Clinical Skills, Developing Critical Thinking with Reflective Practice, Developing Interconnected Clinical Skills, Proactive Patient Care Skills, and Enhancing Communication and Cultural Awareness. Participants represented a diverse range of roles, specialties, and geographic regions.

Discussion: This study provides a validated, profession-specific EPA framework for PA graduates. The 12 EPAs align with CBME principles, accreditation standards, and national PA competencies. They offer a structured approach to readiness-to-practice assessment, curriculum development, and faculty training. Future research should evaluate implementation, impact on clinical outcomes, and implications for certification and licensure.

Abstract: Newly matriculated physician assistant students may demonstrate difficulty with adjusting to the rigorous demands of a condensed medical education program. Traditional resources such as academic support, faculty mentorship, and student mental health can be used as part of a comprehensive support system. However, some students continue to struggle despite engaging in these options. Downward trends in student success can have ripple effects on program accreditation, recruitment, and student wellness. Building an internal Student Success Coaching Program is a feasible way to provide a targeted, supplemental layer of support to positively impact students' overall progress.

Introduction: The impact of unprofessional behavior in medical training has been well-documented, with studies linking it to increased professional misconduct later in clinical practice, including breaches of ethical standards and license revocations. Notably, students with documented professionalism violations during physician assistant (PA) training face a 5-fold increase in the likelihood of postgraduate disciplinary actions. The condensed nature of PA education, averaging 27 months, compared with 4 years of medical school, reduces opportunities for identifying and remediating such behaviors. A review of the literature highlighted best practices in evaluating professionalism and informed the design of a program-level intervention.

Methods: The program implemented a multilayered professionalism assessment strategy based on insights from the literature. Core components included peer evaluation, faculty advising and documentation, mentorship, preceptor feedback, and structured self-reflection. Effectiveness was assessed by comparing professional remediation rates before and after implementation and by surveying students on the perceived value of the peer professionalism tool.

Results: Following implementation, a measurable reduction in professionalism remediation was observed. Survey data also indicated that students valued peer evaluation as a meaningful component of their professional development.

Discussion: The multilayered approach frames professionalism as a developmental process rather than a fixed marker of competence. Early, repeated interventions across multiple advisory meetings created opportunities for professional development and guided targeted remediation strategies. Embedding this model within PA education encourages sustained professional growth and better prepares students for the responsibilities of clinical practice.

Introduction: This study describes the rationale, implementation, and outcomes of defining a program-specific end of curriculum (EOC) exam passing score to support fairness and transparency in student graduation and remediation decisions.

Methods: Using 6 years of data from Stanford University's Master of Science in Physician Assistant Studies program (graduating cohorts 2020-2025), predictive models of Physician Assistant National Certifying Examination (PANCE) performance were examined to explore the impact of iterative adjustments to EOC cut scores. Data from the first 4 cohorts (n = 110) were used to train predictive models, while 2 subsequent cohorts (n = 53) served as validation data. Generalized linear models using EOC scores alone (model I) and EOC plus selected end of rotation exam scores (model II) predicted PANCE performance.

Results: Applying model I to test cohorts established empirical support for setting and adjusting EOC passing thresholds over time. Model II offered only marginal improvement over model I, suggesting that EOC performance alone sufficiently predicts PANCE outcomes.

Discussion: While the program's mandated EOC remediation plan in 2024 and 2025 resulted in extended matriculation and postponed PANCE dates for 5 students, all students passed their EOC retake and subsequent PANCE. Results support using EOC scores as a reliable predictor of PANCE performance, provided appropriate remediation can be provided. Importantly, by viewing program extension decisions like mandated remediation in a consequential validity framework, the study underscores the need for PA programs to develop local, evidence-based, and equitable policies for decision-making.

Introduction: Mentorship is vital for professional development in health care, but barriers limit its potential, such as time constraints, lack of training, and lack of mentors. The objective of this study was to identify and analyze the key barriers to implementing and maintaining student mentoring pathways in physician assistant/associate (PA) training programs.

Methods: Using an internet-based questionnaire, the authors surveyed 332 PA Programs from May 7 to June 10, 2024. Survey items addressed topics to implementing and maintaining formal and informal student mentoring pathways. Respondents were then asked to rank potential barriers to mentoring pathways.

Results: The response rate was 96 of 322 (29.8%). Overall, barriers to implementing formal and informal student mentoring pathways were the faculty's lack of time, securing adequate mentors, and a lack of "mentoring" being well-defined. Barriers to maintaining formal and informal student mentoring pathways were similar to barriers to pathway implementation.

Discussion: The most important barriers to implementing and maintaining PA student mentoring pathways are a lack of time and program support.

Introduction: As generative artificial intelligence (AI) tools become increasingly prevalent in higher education, their integration into physician associate (PA) education remains underexplored. The existing literature primarily focuses on short-term outcomes, with limited attention to learner engagement, critical thinking, or institutional support.

Methods: This qualitative study employed semistructured interviews with 8 self-identified AI-using didactic PA students from one private and one public institution. Interpretative phenomenological analysis and constructivist learning theory guided the analysis. Transcripts were thematically coded using an a priori codebook and refined iteratively.

Results: Three key themes emerged: (1) AI integration in learning practices: students used AI for generating practice questions, clarifying content, and rehearsing for clinical assessments; (2) student perceptions and attitudes: AI was seen as efficient and supportive, though caution was exercised due to inaccuracies and perceived limitations; (3) institutional context and support: formal guidance was minimal, with most students navigating AI use independently in permissive but understructured environments.

Discussion: Didactic PA students interviewed for this study actively incorporate generative AI into their learning through trial, reflection, and adaptation. Despite limited institutional direction, participants demonstrated emerging digital literacy and critical engagement. These findings underscore the need for AI-integrated curricular frameworks and faculty development to support the ethical and pedagogically sound use of AI by students. Programs that partner with learners in this evolving landscape may better prepare future clinicians for technology-enhanced practice.

Introduction: Delivery of physician assistant (PA) substance use disorder (SUD) curricula varies across educational programs. This study aims to examine the effectiveness of a standardized SUD curriculum and to explore PA student attitudes toward and confidence in treating patients with SUD.

Methods: PA Education Association developed and implemented an 8-hour online SUD module for PA students. Curriculum was designed by a faculty consortium and piloted by students from 20 pilot PA programs (N = 1280, across 2 cohorts). Surveys were administered to all students before starting the curriculum and after completion to collect demographic information, measure attitudes toward SUD, and assess curriculum quality.

Results: A total of 1280 PA students completed the precurriculum survey and 819 completed the postcurriculum survey. Attitudes toward diagnosis and treatment of SUD and toward patients with SUD improved after module completion on 9 of 12 Likert survey questions. Three Likert questions that infer a reluctance to treat SUD patients decreased slightly in score from precurriculum to postcurriculum surveys.

Discussion: Physician assistant student attitudes and confidence improved regarding diagnosis, treatment, and perception of those with SUD. The pilot modular curriculum was well received by students and supports distribution of curriculum to a larger population of PA students, and additional data will improve generalizability. Additional studies may include the types of SUD curricula currently offered and impact of curriculum sequencing on effectiveness and attitudinal change.

Introduction: Dermoscopy is a proven technique that improves diagnostic acumen in skin lesion evaluation. However, data are scarce on dermoscopy knowledge among physician associate or assistant (PA) students. The aim of this study was to ascertain US PA student's confidence in evaluating skin lesions, current dermoscopy knowledge, and current dermoscopy curriculum.

Methods: An anonymous, optional survey was included in the 2024 Academy of Physician Associates (AAPA) (American AAPA) student survey.

Results: A total of 613 (35.7%) PA students responded to the optional survey. Although most (78%) respondents were aware of the terms "dermatoscope" or "dermoscopy," nearly two-thirds (65%) had not yet received dermoscopy training in their PA education and 78% indicated desire to use dermoscopy in their future practice. Respondents were slightly (27%) or somewhat confident (44%) in their ability to differentiate benign and malignant skin lesions, and those with an anticipated dermatology specialty were more confident than their peers seeking other specialties. Respondents who did not recognize the term "dermoscopy" (odds ratios [ORs] = 0.2, 95% CI 0.1, 0.6) and those who did not have prior dermoscopy training (OR = 0.6, 95% CI 0.3, 1.0) were also less likely to be confident.

Discussion: Physician assistant students are interested in dermoscopy training, but training is lacking in PA programs. Physician assistant programs should incorporate dermoscopy into their curriculums to ensure trained PAs have the skill to confidently evaluate skin lesions across a range of medical specialties.