Journal of Physician Assistant Education最新文献

Introduction: The number of negative life events experienced during medical training correlates with student burnout, suggesting both curricular and extracurricular factors affect student well-being. This study explores physician assistant (PA) student definitions and experiences with burnout and well-being, burnout prevention strategies, and suggested resources.

Methods: This qualitative, phenomenological study used structured, focus group interviews of a total of 7 first-year PA students at 2 time points. Thematic analysis used a literature-derived codebook and emergent codes were identified empirically. Codes that were found across interview groups with a frequency of ≥3 unique responses were considered significant.

Results: Prior conceptual models of burnout provided analytical domains and categories for burnout and well-being: outcome, negative source, positive effect, definitions, experiences, contributions, and prevention strategies. Nineteen significant codes (13 a priori and 6 emergent codes) were identified empirically. Participants described prior definitions of burnout, factors contributing to burnout, and prevention strategies. Emergent codes specifically described the impact of burnout outside the classroom. Experiences of well-being focused on balance and holistic support including the importance of diverse resources and faculty/staff support.

Discussion: A comparison of participant responses with prior literature suggests PA students experience an alternative understanding of burnout and well-being. Looking through the lens of different conceptual models, tensions in professional identity formation may contribute to student burnout. Incorporating and revisiting curricular activities to promote self-assessment and self-reflection can aid well-being, emphasize faculty/staff support, and allow for individual modifications throughout the professional journey.

Introduction: Many college students in the United States use disability accommodations, and their use has been shown to increase retention and college success. However, even with disability accommodations, these students have lower Grade Point Averages (GPAs) than their nonaccommodated peers and score lower on standardized tests. What has not been reported is the use of disability accommodations by physician assistant (PA) students, their GPAs, and Physician Assistant National Certifying Examination (PANCE) performance compared with their nonaccommodated peers.

Methods: Data were collected from five cohorts of PA students from four institutions for the years 2019 to 2023 (N = 1128). Deidentified data included GPA at the time of graduation, first-time PANCE score, and whether an academic accommodation was used during PA education (yes/no). Descriptive statistics, Pearson correlation, and hierarchical regression models were analyzed with statistical significance set at P < .05.

Results: Physician assistant students with disability accommodations had statistically significant lower GPAs at time of graduation and had lower first-time PANCE scores than those without. Physician Assistant National Certifying Examination failure rates among those with accommodations was 25.58% (22/86) and among those without accommodations was 6.37% (66/1036).

Discussion: These results echo national data from undergraduate students, and medical students, namely that PA students with disability accommodations have lower GPAs and lower scores on the PANCE compared with their nonaccommodated peers. Recognizing this trend is an essential step in identifying areas for improvement as the academic community strives to support the success of diverse students, while ensuring excellent training and preparation for the workforce.

Introduction: Diversity within the health professions workforce can improve patient satisfaction and enhance team productivity. As the physician assistant (PA) profession grows, PA educational programs have struggled to achieve greater diversity. Recent literature identified top performing PA programs in achieving diverse student cohorts. This study examined the associations between PA program characteristics and successful recruitment and graduation of students from underrepresented minority (URM) groups.

Methods: Program characteristics from the 2019 PA Education Association Program Survey and Faculty Survey were obtained (n = 141 programs). Programs were categorized as exemplary or nonexemplary in recruiting and graduating diverse student cohorts according to prior literature. Univariate and multivariate logit regression specifications identified program characteristics associated with exemplary status.

Results: Programs of longer duration and those with a greater percentage of URM faculty were more likely to be exemplary (2.2 and 2.5 percentage point increase in likelihood, respectively). Positive but not statistically significant associations were also observed between exemplary status and programs that did not require an admissions test and those with greater percentages of the faculty who identified as Asian, Hispanic, or underrepresented in medicine.

Discussion: Having faculty from URM backgrounds may influence PA programs' success in improving student cohort diversity. Other program characteristics, including absence of admissions testing requirements, may also shape student diversity. These findings can inform PA and other health professions programs as they develop approaches to increase racial and ethnic diversity among their students.

Abstract: The rapid evolution of technology offers the health industry advancement of organizational operations that directly impact clinical practice. Physician assistant (PA) educational settings have an added responsibility to set a foundation for students where they can develop comprehensive digital skills necessary for professional growth in the workforce. The challenges for PA educators of behavioral medicine fundamentals include personalizing pedagogy to all learners to equip students with the soft skills they will need in clinical practice. It is far too often that patients are unwilling to communicate their concerns or collaborate in their care plans when rapport is not well established between health care providers and their patients. Artificial intelligence applications broaden the opportunities for PA educators to create learning environments that are conducive for students with various learning styles. Physician assistant leaders in education and clinical practice have the opportunity to influence the inclusiveness of digital tools in their clinical settings and communities to better meet the needs of their patients and enhance patient outcomes. The skills developed as a result of digital integration among PA education prepares learners for all medical disciplines where adaptability is valued. Digital leadership begins in PA education and enhances the clinical practice of PAs.

Abstract: This paper focuses on the impact of artificial intelligence (AI) in physician assistant/associate (PA) education based upon results from a national survey of PA faculty conducted by the PA Education Association in early 2024. This is the first survey of its kind to assess PA faculty perspectives on the topic. It adds to the growing body of knowledge related to AI across all contemporary business, social, and educational activities. A survey containing Likert ranking questions and open-ended comments was sent to all faculty listed in the PA Education Association database (n = 4338). A response rate of 14.8% was established after removing incomplete survey responses from the data set. The knowledge, attitudes, and confidence among faculty were analyzed, along with open-ended comments that explored concerns and current utilization of digital technology among participating respondents. While knowledge of AI technology was measured as average to good by 60.9% of faculty, confidence in using it was low. Group differences in self-reported knowledge of AI was only significant by participants' primary role in in their institution (χ 2 (10) = 53.6, P ≤ 0.001). Participation in formal or informal continuing education programs focused on AI appears to increase confidence levels among participants, although only 35% of respondents indicated participating in these activities. Most respondents (64.9%) expressed a positive view of AI technology in PA education, but did express concerns, particularly on student's development of critical thinking skills and academic integrity. The paper concludes by recommending training and support for faculty to harness AI's potential and enhance PA education, ensuring that AI complements rather than replaces the critical human elements in teaching and learning.

Introduction: Individuals with higher social and economic needs are less likely to complete higher education, including medical and graduate nursing training. The purpose of this study was to explore the relationship between social determinants of health (SDOH) and perceptions of flourishing among medical (MD), physician assistant/associate (PA), and nurse practitioner (NP) students.

Methods: This study consisted of a single online survey using a cross-sectional design. Current MD, PA, and NP students from 2 academic medical centers in the United States were recruited between August 6 and October 9, 2023. Survey questions included demographics and multiple validated instruments including the Secure Flourish Index (SFI; flourishing) and WellRx (SDOH). Students were categorized into 3 groups based on SDOH needs determined by the WellRx score. Descriptive statistics, chi-square, and ANOVA testing were performed (alpha = 0.05).

Results: A total of 301 of 1820 (16.5%) eligible students participated. Students had an average of at least 1 unmet SDOH need (M 1.1, standard deviation [SD] 1.2). Over 35% of students (n = 111/301, 36.9%) needed to work, 14.0% (n = 42/301) reported difficulty paying for utilities, and 9.3% (n = 28/301) reported food insecurity. Some students (15.3%, n = 45/294) had seriously considered leaving training in the prior 6 months, citing personal mental health (66.7%, n = 30/45) and financial stress (55.6%, n = 25/45) as contributing factors. Total SFI scores were almost 16 points higher among low SDOH risk group students (M 88.2, SD 14.0) than high-risk group students (M 72.7, SD 13.5; P < .001).

Discussion: Students' social and economic needs are intertwined with their ability to flourish and their considerations for leaving training.

Introduction: The use of educational technology has changed the landscape of higher education. Lecture capture, a method of recording in-person lectures for viewing outside of class, has been used extensively in health professions education. However, little is known about how lecture capture is used in physician assistant/associate (PA) education or to what degree, if any, does offering recorded lectures affect attendance policies.

Methods: A link to a four-question online survey was emailed to all PA program directors listed on the PA Education Association online member directory, and the survey response rate was 41%.

Results: There is an even distribution of programs that provide recorded lectures (49.6%) vs. those that do not (50.4%). The most common rationale for providing recordings was to offer an additional resource, while the highest ranked reason for not offering recordings was the concern for passive learning. Most PA programs (93.4%) require attendance for in-person didactic lectures. The primary reason for doing so is out of concern for academic performance. Of those programs that provide recorded lectures, 90.2% require attendance (55/61). Of those programs that do not provide recordings, 96.8% also mandate didactic lecture attendance (61/63).

Discussion: These results suggest (1) only half of the PA programs offer recorded in-person didactic lectures, (2) most PA programs require attendance at in-person didactic lectures, and (3) providing students with lecture recordings does not increase the likelihood of mandatory attendance.

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.