Journal of Physician Assistant Education最新文献

Purpose: Physician assistant (PA) program matriculants are consistently less diverse than the US population. This study evaluates whether administration of an Implicit Association Test (IAT) to PA program admission committees is associated with changes in the likelihood of (1) receiving an admission interview, (2) receiving an offer of admission, and (3) matriculation of individuals underrepresented in medicine (URiM).

Methods: Admission committees from 4 PA programs participated in an IAT before the 2019/2020 admissions cycle. Applicant outcome data (n = 5796) were compared with 2018/2019 cycle (n = 6346). Likelihood of URiM students receiving offers to interview, offers of admission, and matriculation were evaluated using random effects multiple logistic regression models. Fully adjusted random effects models included URiM status, year (control vs. intervention), multiplicative interaction terms between URiM and year, applicant age, and undergraduate grade point average (GPA) Secondary analyses examined associations of each race/ethnicity individually.

Results: Underrepresented in medicine status, age, and GPA were significantly associated with all admission outcomes ( P < .05). The intervention effect was not statistically significant. In sensitivity analyses examining each individual race rather than URiM status, our results did not importantly differ.

Conclusion: Findings suggest admission committee member participation in IAT before admissions had no significant impact on the likelihood of admission of URiM students. This may suggest that making individuals aware of their implicit biases is not, in and of itself, sufficient to meaningfully affect the diversity of PA program admission metrics.

Purpose: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Purpose: The aim of this prospective, perception scale study was to evaluate pharmacy student expectations and perceptions of student medical providers before and after interprofessional education (IPE).

Methods: Using pre- and postactivity surveys, the expectations and perceptions of 2 cohorts of third-year pharmacy students who worked with first-year physician assistant (PA) students and second-year medical (MD) students in an evidence-based, case-based IPE session were compared.

Results: Before engaging in the interprofessional activities, the pharmacy students' (N = 131) expectations were either similar for both student provider groups or greater for MD students. However, these expectations differed significantly from postactivity perceptions. After completion of the IPE experiences, when compared with MD students, PA students were perceived as having equal or greater knowledge of patient care (60.2 vs. 12%, P < .001), demonstrating equal or superior application of evidence-based practice (46.6 vs. 5.3%, P < .001), being equally or more collaborative (54.1 vs. 10.5%, P < .001), and being equally easy or easier to work with (69.9 vs. 10.5%, P < .001).

Conclusion: The magnitude of shift in expectations and perceptions demonstrates the value of IPE and underscores the high caliber of PA educational standards.

Purpose: The purpose of this novel study was to determine whether any association exists between student well-being and physician assistant (PA) program approaches to teaching provider health and well-being (provider wellness).

Methods: Data were sourced from 3 PA Education Association surveys. Data from the 2019 Matriculating Student and End of Program Surveys (EOPS) were analyzed to compare student-reported well-being across 6 measures. Next, data from the 2019 Didactic Curriculum Survey were assessed and matched to the 2019 EOPS data. Finally, generalized estimating equation models were used to assess the independent effects of course structure, mode of instruction, and contact hours on well-being scores among end-of-program students (within one month of graduation).

Results: While levels of well-being were generally favorable, except for "level of social activity" ( P = .20), across measures, graduating student levels of well-being ( P < .05) were statistically significantly lower than matriculating student levels of well-being. No associations were found between levels of student well-being and whether programs reported teaching or not teaching provider wellness. Some aspects of instruction (eg, contact hours) were inconsistently associated with various well-being measures.

Conclusion: In this study, no consistent associations between approaches to teaching provider wellness and various measures of student well-being were identified. Further research is needed to determine what approaches to promoting wellness are effective.

Purpose: The purpose of this study was to examine relationships between physician assistant (PA) educators' perspectives on students' self-assessment (SA) accuracy and students' use of SA education practices and types of abilities assessed.

Methods: Using correlation analysis and a novel, online survey, PA educators were asked about their perceptions of students' SA accuracy in relation to SA educational activities and assessed abilities.

Results: A total of 308 educators responded. Most respondents used at least one type of SA activity, with feedback and practice being the most common types and comparative assessment, the least common type. Most respondents indicated that students self-assess noncognitive abilities more than cognitive abilities, with SA of communication skills occurring most. Spearman's correlation coefficient was used for correlation analysis with a significant, small correlation noted between the frequency of activities and educators' overall perceptions of students' SA accuracy (r = 0.15, P = .02) and SA accuracy of cognitive abilities (r = 0.17, P = .02). Educators' perceptions of students' SA accuracy were positively skewed, regardless of student training level (ie, didactic and clinical training phases). A mild predictive relationship exists between overall perception of students' SA accuracy and how frequently educators use SA activities (r = 0.29, P = .05).

Conclusion: Although respondents indicated they used practice and feedback activities, providing instruction on how to self-assess and using comparative evaluations to calibrate SAs will improve accuracy. Further research is needed to understand why educators perceive PA students' SA abilities as more accurate, regardless of training level.

Purpose: Evidence exists that physicians in training and practice often do not understand advanced practice providers (APPs) and their roles in professional practice. This study asked the question: What are the messages and messengers during the anticipatory professional socialization period that potentially influence how residents perceive APPs?

Methods: Semistructured interviews were conducted with 15 residents in one academic setting. Transcripts were analyzed using an inductive approach to coding to identify the messages and sources of those messages (messengers) that had influenced how residents perceived APPs.

Results: Participants reported limited exposure to APPs before medical school, although most had heard of APPs from family, friends, or advisors or through their own experience in a clinical setting. The messages that participants received were related to how physicians and APPs compare in their training and clinical roles, and how APPs and physicians (and the people who pursue these professions) differ based on their presumed personal attributes. Some messages appeared to support biases against APPs.

Conclusion: While interprofessional education in medical school aims to prepare physicians to collaborate across professions, attention to anticipatory professional socialization occurring before medical school may also be important to mitigate professional biases that interfere with effective teamwork.

Purpose: This case study emerged from the necessity to reschedule an in-person long case examination to an online platform for physician assistant students' final clinical examination during COVID-19 restrictions. The aim of this study was to evaluate the experiences of students and examiners for a high stakes' clinical examination online.

Methods: This was an evaluation research study using the Context, Input, Process, Product model, which provided a framework to establish the effectiveness and/or success of an online format for a high stakes' clinical examination. All students and examiners were invited to take part in virtual interviews.

Results: The results suggest that both students (n = 5) and examiners (n = 7) agree that, although the stress of a face-to-face examination was lessened for the student, this was balanced by a new stressor of potential Internet problems. All agreed that a virtual setting for a high stakes' assessment is not transferable, with both groups citing the lack of opportunities to "read the patient" and "showcase their physical examination skills" as challenging.

Conclusion: Our study suggests that, in the context of balancing the risks of the pandemic with graduating health care professionals, the online clinical examination format met the required assessment criteria. Recommendations suggest that the long case could be planned so that students and patients are in the same setting to perform a physical examination, confirming the finding that questions on "how to" examine a patient are no substitute for "doing."