Journal of Physician Assistant Education最新文献

Introduction: Primary care providers need to be able to effectively recognize and treat common mental health concerns. Foundational mental health training is typically embedded into physician assistant (PA) didactic training; while essential, students in didactic training may not yet recognize the relevance and clinical nuances of these presentations. To better prepare university-based PA students to address mental health in primary care, a 4-session interdisciplinary psychosocial skills enhancement group was developed for second-year students and conducted over 3 years. This weekly virtual group was facilitated by a doctoral-level student in clinical psychology and attended by PA students in their family medicine rotation (n = 204). Students presented patient cases, provided feedback to fellow students, developed case conceptualizations, and engaged in didactics.

Methods: After completing the group, participants received a survey assessing their satisfaction, perceived improvements in behavioral health knowledge and comfort, and suggestions for refining the group. Descriptive analyses and qualitative content analyses were conducted.

Results: Survey results were overall positive, indicating that students felt more prepared to treat behavioral health conditions and enjoyed having a group facilitator from outside their program with expertise in psychology. Qualitative results suggested the benefits of increased reflective practice, improved peer support, and appreciation for didactic psychosocial content.

Discussion: Given the prevalence of behavioral health concerns in primary care, incorporating an interdisciplinary training and supervision component may be an effective way of increasing clinical competencies, enhancing professional well-being, and better meeting future patient needs.

Introduction: Point-of-care ultrasound (POCUS) integration into physician assistant (PA) program curricula continues to increase; however, guidance on specific curricular components is lacking. This study aims to establish expert consensus on essential POCUS curriculum components for PA programs.

Methods: A validated survey was administered to an expert panel of 100 PAs. Respondents rated the appropriateness of various curriculum components on a 9-point Likert scale. Data analysis included descriptive statistics and measures of consensus. Recommendations were categorized as strongly recommended , recommended , conditional recommended , and not recommended based on appropriateness and consensus levels.

Results: The survey had a 63% response rate (n = 63). Strongly recommended and recommended determinations were made for PA curricula to include foundational POCUS concepts, obtaining specific views for most body system areas, identification of specific anatomical structures and findings, and procedural guidance.

Discussion: Integrating POCUS into PA education is essential for enhancing diagnostic and clinical skills. Foundational concepts received strong support, while advanced applications had varied consensus, suggesting tailored curricula based on program-specific goals. These recommendations provide a structured framework for comprehensive POCUS training, aligning with broader trends in medical education and equipping PAs with essential ultrasound skills for diverse clinical settings.

Introduction: The state of substance use disorder (SUD) training among US physician assistant/associate (PA) programs was last published in 2001. The purpose of this study was to provide an updated evaluation of the SUD training curriculum among Accreditation Review Commission on Education for the Physician Assistant (ARC-PA)-accredited PA programs. In addition, we will identify any potential barriers to implementing SUD education in either the didactic or clerkship curriculum.

Methods: From April to October 2023, an 18-item Web-based survey was administered via Qualtrics to 208 ARC-PA-accredited PA programs. Questions queried delivery of SUD education during the 2021 to 2022 academic year.

Results: A total of 33 PA programs completed the survey. Most (93.9%) but not all the surveyed PA programs required SUD education in the didactic curriculum. Programs varied widely in the hours dedicated to SUD (mean 10.5 ± 11.7 hours, range 1-36 hours) and the delivery format. Relatively few programs (39.4%) provided dedicated SUD training in the clinical clerkship curriculum due to a lack of available clinical sites and qualified preceptors, coupled with SUD not being prioritized within the program.

Discussion: While most surveyed PA programs provide SUD education in the didactic curriculum, there is a large variance in the amount of time spent and the topics covered. Relatively few programs provide SUD training in the clerkship curriculum, primarily due to insufficient clinical sites, qualified preceptors, and program priorities.

Abstract: This article serves as a practical guide for physician assistant/physician associate (PA) educators regarding gender bias. Beginning with common language regarding bias, discrimination, and microaggressions, the work also illuminates the far-reaching consequences of pervasive gender bias in medicine and health science training. PA education is not immune to this problem, making mitigation critical. Next, the work integrates the concept of reflective practice and the use of a systematic approach to both assess bias in an individual work, class, course, curriculum, and program. Finally, the work provides strategies for mitigating bias through inclusive language and images via the use of an inclusive checklist, creating a positive quality improvement process for use by PA educators.

Introduction: Prior research has suggested that physician assistant/associate (PA) educators often cannot dedicate sufficient time to research since most of their time is committed to teaching, service, and practicing clinically. Because of the time constraints and lack of scholarship training, PA faculty are not motivated to participate in scholarly activities, resulting in burnout and low productivity.

Methods: This study examined the 2019 PA Education Association Faculty and Directors data set, focusing on descriptive and bivariate analysis of demographic characteristics, highest degree completed, academic rank, years in PA education, primary position within the PA program, and various aspects of scholarship activities such as the number and types of publications.

Results: Nearly half (50.3%) of PA faculty reported publishing during their academic career, with a median of 3 publications in total since the start of their PA education career (interquartile range [IQR], 1-7). The data revealed that the mean number of peer-reviewed articles is 2 (IQR, 1-5), with no books and chapters published. Compared with PAs who did not publish, PA faculty who published were more likely to be male (35.4% vs. 29.1%; P = .035), to hold a doctorate (41.3% vs. 20.3%; P < .001), and to indicate their academic role as a professor (12.4% vs. 4.4%) and associate professor (33.8% vs. 12.3%; P < .001).

Discussion: Although there has been some improvement regarding the number of publications, growth has been significantly slow. Although the reason for this slow growth is multifaceted, gender disparities and time and lack of funding appear to be some of the major reasons.

Introduction: Professionalism in physician assistant (PA) students is an essential behavior to assess during formative medical education. Objective structured clinical examinations (OSCEs) provide an opportunity to evaluate PA students performing professional behaviors within simulated clinical settings. This scoping review aims to explore insights the existing literature offers regarding evaluating the professional behaviors of PA students using an OSCE. A secondary objective is to identify gaps in the literature to clarify future research.

Methods: This scoping review was conducted in March 2024. From January 2018 until March 2024, CINAHL, MEDLINE Ultimate, Health Source-Nursing/Education, and PubMed online databases were searched for publications in English. Records included research studying PA or medical students evaluated on professional behaviors using an OSCE or performance-based assessment instrument. Allied health profession students were excluded from the primary search because of their heterogeneous curriculum models outside the population of interest.

Results: This review includes 5 papers. All papers reported communication as a professional behavior measured in an OSCE or performance-based assessment. A consensus or formal definition of professional behavior is a notable absence in this scoping review.

Discussion: More definitive homogenous evidence is needed to assess the professional behaviors of PA students using an OSCE. This limits the guidance and educational standards for future health profession educators. Comprehensive research into professional behaviors among PA students is essential. Scholars must publish their findings on professionalism curriculum design and outcomes to facilitate a broader understanding and improvement in educating future PA professionals.

Introduction: To present a physician assistant (PA) program's experience and lessons learned by requiring a new standardized test as an admissions requirement. A state academic PA program changed an admission requirement by requiring the Physician Assistant College Admissions Test (PA-CAT) instead of the Graduate Record Examination. The admissions requirement change correlated with a 72% drop in the applicant pool.

Methods: Data from previous literature present background information on standardized testing and predictors of student success. The program-specific data retrospectively evaluate changes in application numbers.

Results: Several studies have evaluated various preadmission metrics and their correlation to student success. However, the PA-CAT and its predictor of student success in the program and passing the Physician Assistant National Certifying Exam still need to be evaluated.

Discussion: Requiring standardized testing increases the barrier to applicant PA school admissions. Despite its potential, the PA-CAT has yet to be extensively studied to predict success in matriculated PA students and should be used cautiously. The implications of using the PA-CAT as an admissions requirement are a potential decrease in the strength of applicants, the number of total applicants, and the overall decline in the quality of graduating PAs. This cautionary note is crucial for maintaining the quality and integrity of our PA programs.

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.

Introduction: This study examines training, experience, and collaborative practices of physician assistants (PAs) with employment experience and their perspectives on practice act legislation.

Methods: Mixed method study with quantitative and qualitative data.

Results: One hundred eighty participants completed the survey. During clinical employment, 81.05% of respondents reported physicians participated in training. However, supervising physicians trained only 43.46%; 56.54% reported being trained by nurse practitioners (NPs), PAs, and/or other physicians. Onsite collaboration with physicians was reported by 87.2%. Supervising physician involvement was reported by 67.3%, and of these, 59% collaborated with PAs, NPs, and/or other physicians as well. One-third collaborated only with NPs, PAs, and/or other physicians. Daily/weekly collaboration with a supervising physician was reported by 78.89% in their first position and 54.87% in their current/most recent position; 77.22% collaborated with NPs, PAs, and/or other physicians in their first position and 71.68% in their current/most recent position. Most (64.44%) felt PAs should not be legally required to have physician supervision. Most (76.12%) felt care quality would not decrease if supervision were lifted. Most (74.44%) agreed that PAs are hired less frequently than NPs in states where physician supervision is required for PA but not NPs.

Discussion: Findings suggest that team-based practice is already the current structure of PA clinical training and collaboration with PAs receiving significant support from physicians who are not supervising physicians and other nonphysician practitioners. Establishing oversight at the practice level is supported by this practice structure. Determining effects of practice act legislation on employment training, collaboration, and hiring practices warrants further 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.