Journal of Physician Assistant Education最新文献

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: Physician Assistant/Associate (PA) clinicians face a major learning curve when transitioning from patient provider to PA educator. Furthermore, PA educators juggle multiple responsibilities including teaching, grading, advising, mentoring, interviewing, researching, writing, and more. Recently published research has indicated that 52.4% of PA educators thought about leaving their faculty roles within the past year. To assist in the effort to prioritize faculty retention, a personal story of faculty burnout and lessons learned is shared.

Methods: Burnout and its three associated subscales are defined, while symptoms of burnout are outlined in a manner specific to the role of a PA faculty member.

Results: Drawing from the existing evidence base, suggestions are made to improve the well-being of PA educators and prevent faculty burnout or turnover.

Discussion: While being a PA faculty member is extremely rewarding, it can also be challenging, particularly for early-career PAs or those transitioning from clinical practice with no prior work experience as an educator. Strategic implementation of good habits may aid faculty members in preventing burnout and improving work-life balance.

Introduction: Preceptors are crucial in the education of physician assistant (PA) students, yet many lack formal preceptor training. The aim of this scoping review was to describe the curriculum and design of existing preceptor training programs for physician assistants, nurse practitioners, and physicians.

Methods: This scoping review was developed following the methodologic framework provided by the Joanna Briggs Institute. The literature search included a review of the electronic databases CINAHL and MEDLINE, a Web search, and an examination of article references. The search encompassed empirical, peer-reviewed studies written in English and published between January 1, 2019, and May 1, 2024.

Results: Out of 1106 sources identified, 32 met the eligibility criteria, representing 31 preceptor training programs. Eighty-four percent of these programs were based in the United States. Fifty curricular topics were identified and organized into 10 domains. Feedback and teaching were addressed in 97% of the programs. Sixteen programs used an online format, which increased each year compared with other formats. Lectures were the most common teaching method. Program length varied. The majority of participants and article authors were physicians, with only 5 programs including PA participants.

Discussion: The curricula and design of preceptor training programs varied but were generally well received by participants. There was limited involvement of PAs in both participation and authorship of preceptor training research. This review underscores the benefits of preceptor training while highlighting the need for increased PA engagement in both training and program development.

Introduction: There are several ramifications of a potential degree transition to an entry-level doctoral degree for Physician Assistant (PA) programs. The purpose of this article is to investigate the impact on institutional accreditation and transitioning to an entry level doctoral degree. To understand the potential impact on racial diversity, a subset of programs was further reviewed.

Methods: The Standards from the Accreditation Review Commission for PA Education (ARC-PA) and the six Institutional Accreditation commissions that recognize institutions were reviewed. The accreditation outcomes from all ARC-PA accredited programs' institutions were reviewed.

Results: The majority of PA programs, including those that graduate the highest diverse populations of PAs, are already recognized as comprehensive or doctoral degree granting institutions. This means they would likely not encounter significant accreditation challenges in an application to transition. Most PA programs meet the requirements for credit hour, length of program, and expectations of 'substantial mastery' of the content in the curriculum to satisfy institutional accreditation requirements at the professional doctoral degree level. The faculty qualifications and level of scholarship required would need to be in compliance with the institutional accreditor's expectations.

Discussion: This paper highlighted the general institutional accreditation requirements that would need to be met in order to establish a PA doctoral program. Fortunately, the standards tend to be broad and if the PA program can meet ARC-PA Standards, it is likely the institutional accreditor standards would be satisfied.

Introduction: Gender minorities are undermeasured among physician assistant/associate programs and across the profession. This study describes the 2020 to 2021 Centralized Application Service for Physician Assistants self-identified gender minority applicant pool, examining whether gender minority status is associated with matriculation.

Methods: A retrospective cohort of 2020 to 2021 admission cycle participants (n = 30,123) was described and evaluated for associations between self-identified gender minority status and likelihood of program matriculation using logistic regression. Models were controlled for important potential confounders, including total undergraduate grade point average, race/ethnicity, hours of patient experience, and age.

Results: Of the 30,123 total applicants, 0.21% (n = 63) self-identified as a gender minority. Total matriculation was 27.64% (n = 8325) compared with gender minority matriculation of 20.63% (n = 13). Gender minority status was associated with a nonsignificant lower likelihood of matriculation (odds ratio [OR] = 0.68; 95% confidence interval [CI]: 0.37-1.25). Fully adjusted models were unchanged controlling for academic achievement, patient care experience, age, and race/ethnicity (OR = 0.83; 95% CI: 0.51-1.35).

Discussion: These findings suggest that gender minority applicants have a similar likelihood of matriculation in physician assistant/associate programs as compared with non-gender minority applicants. Low prevalence of self-identified gender minority status could indicate reluctance to self-identify and is concerningly lower than population prevalence.

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: In the United Kingdom there are 37 physician associate (PA) training programs with limited knowledge of the educators involved, their training, and specific needs.

Method: An online questionnaire was sent to PA educators in all UK training programs requesting information on academic title and responsibilities, clinical and nonclinical background, education and qualifications before becoming a PA educator, formal and informal training received in the role, and insights into career progression.

Discussion: The questionnaire highlighted 5 specific areas that should be specific recommendations for UK training programs to support PA educators, alongside existing guidance. These centered on academic and leadership development, clinical engagement, student support, and pedagogical research.

Conclusion: We believe that implementing these recommendations across training programs will improve the opportunities for all those delivering PA education and consequently improve the offering to the students undertaking PA studies programmes.

Introduction: Physician assistant/associate (PA) courses rely heavily on hands-on experience during clinical placement, and higher education institutes aim to provide students with an equitable experience. This article aims to understand how student gender and supervisor gender affect student experience on clinical placement at 2 PA courses in the United Kingdom, where PAs are known as physician associates. We found no evidence of pedagogical literature that focused on the gender differences in PA experience, so we aim to be the first to provide this research.

Methods: To assess student experience, student feedback was collected through online qualitative surveys and stratified by student and supervisor gender. 95% confidence intervals were calculated for scaled questions.

Results: Qualitative feedback from students shows a clear difference in their clinical placement experiences. Male students report fewer opportunities to observe and assess female patients, while female students report fewer opportunities observe and assess male patients. The most significant difference is seen when male students are seeing female patients. The discrepancy becomes more pronounced when male students are supervised by male supervisors and when female students are supervised by female supervisors.

Discussion: In planning clinical placements for students, programs must understand and recognize the potential for differences in experience based on student and supervisor gender and should take action to ensure a more equitable experience for all students.

Introduction: Service learning is a commonly used teaching modality in physician assistant (PA) programs; however, the literature analyzing the written reflections of PA students who participate in these experiences is limited. The purpose of this study was to describe the experiences of PA students who participated in a service-learning clinic through analysis of their written reflections.

Methods: An exploratory qualitative research design, using conventional content analysis, was used to examine the reflections of both didactic and clinical-phase PA students who participated in a service-learning clinic between 2016 and 2020.

Results: The results demonstrate that these experiences contribute to the professional identity formation (PIF) of PA students, with faculty role modeling being an important facilitator in the process. Our analysis shows that students, regardless of their role in the clinic, reported a positive experience, and the reflections showed elements of PIF.

Discussion: Service-learning clinics play an important role in the PIF for PA students, with role modeling by faculty clinicians being an important facilitator in this process.

Introduction: Many physician assistant/associate (PA) programs lack point-of-care ultrasound (POCUS) education in the PA curricula and a standardized approach to ultrasound training. The four-component instructional design (4C/ID) model merges 4 concepts for developing effective instructional design content for complex content delivery, such as ultrasound. This research study created an interactive, 2-part ultrasound curriculum with an instructional designer for PA students using the 4C/ID model.

Methods: Two interactive ultrasound curriculum models were created from the 4C/ID model using a knowledge-based precurriculum quiz, learning tasks with online modules and recordings, part-task practice with ultrasound experts, skills checkoffs, and a postcurriculum quiz including questions on students' perspectives of ultrasound. Two-tailed paired t-test analysis assessed the effectiveness of training.

Results: Evaluation of prelearning and postlearning quizzes demonstrated multiple statistically significant assessments supporting the use of instructional design technology for a PA program's ultrasound curriculum.

Discussion: This small study demonstrated that the 4C/ID model may be beneficial for PA POCUS training. The 2-part interactive curriculum improved PA student competency of ultrasound principles and applications and increased confidence for future clinical use of ultrasound.