Journal of Physician Assistant Education最新文献

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: Competency-based medical education has become a means in physician assistant (PA) education to ensure learner readiness for practice; align educational expectations; and assess knowledge, skills, and attitudes. Competency-based education may also serve to meet accreditation requirements. Creating program-defined competencies and associated milestones can help a PA program align with their mission and vision, developmentally guide learners through the curriculum, and ensure program assessments measure the tasks required of practice-ready graduates. This review provides an overview of a single program's process for developing program-defined competencies and associated milestones. Beginning with a literature search, the program was able to develop a working list of competencies that was then further refined into competencies with building block milestones that support the development of competency in various domains. Involving faculty in defining a program's competencies is an Accreditation Review Commission on Education for the Physician Assistant requirement that can be done from the ground up or by using previously published competencies that are refined and tailored for the program. The process of creating the competencies provides significant insight into a program's curriculum, goals and expectations for students, and assessment methods.

Introduction: The role of accreditation standards in fostering diversity and inclusion in academic programs remains poorly understood. Accreditation is one approach to increasing diversity through Standard A1.11. This study investigates the impact of the Accreditation Review Commission-Physician Assistant (ARC-PA) standards on diversity and inclusion in physician assistant (PA) programs and explores challenges faced by programs in achieving compliance.

Methods: This qualitative exploratory study first reviewed diversity standards in accreditation documents among selected health professions; second, data on the frequency of citations from ARC-PA related to diversity were gathered and analyzed; finally, opinions from 23 PA faculty and leaders were solicited through semistructured interviews. Two research team members analyzed the data to identify themes.

Results: Most institutions sponsoring PA programs had preexisting diversity policies before the inception of standard A1.11 of the ARC-PA. Between June 2020 and March 2023, seven programs received 16 citations related to Standard A1.11. Interviews with faculty revealed 4 major themes: (1) the importance of institutional support, (2) early pipeline development of applicants, (3) prioritizing faculty and/or student diversity as key program goals, and (4) local context, with institutional support and pipeline development being most prominent.

Discussion: The inclusion of Standard A1.11 in the ARC-PA Standards signifies the growing recognition of diversity, equity, and inclusion (DEI) in PA education. Institutions can advance DEI in the PA profession by leveraging accreditation-related activities through leadership, partnerships, and accountability measures consistent with the institution's mission and applicable laws. Institutional support emerged as an important factor in compliance with diversity-related accreditation standards.

Abstract: The domains of second language learning and medical learning, although different in many ways, share several commonalities. In both, there is an element of declarative learning, such as memorizing terms and rules and understanding schema. However, both domains also classically include immersive learning in authentic environments with experts (fluent speakers in language, experienced clinicians in medicine) as a means to achieve mastery. Physician assistant (PA) educators may benefit from considering these commonalities and how they may apply to their own educational practices. Several hypotheses from Stephen Krashen's monitor model of second language acquisition (acquisition-learning distinction, the monitor hypothesis, affective filter) are presented with parallels to PA education. As the study of a second language is a common experience within the United States, explicit discussion of the similarities between language and medical learning may be a tool that PA educators can use particularly to help learners as they transition from didactic to clinical learning.

Introduction: Physician assistants/associates (PAs) are expected to be competent in ordering and interpreting diagnostic imaging. However, there are no further details outlining the educational expectations of PAs as it relates to radiology upon graduation. This can result in significant variability in the radiology curricula that PA students are taught and, consequently, hinder PAs' ability to work within their full scope of practice. Therefore, the purpose of this study was to map the radiology curriculum in a Master of Physician Assistant Studies (MPAS) program to elucidate radiological educational training before graduation.

Methods: Quantitative curricular mapping was used to assess the 2021 to 2022 MPAS program for radiological involvement. Relevant course and session objectives related to radiology education were identified. In addition, educational learning material was reviewed for diagnostic imaging content.

Results: Formal radiological training was observed in 8 of 27 courses in the preclinical curriculum, with 4.35% of the total session objectives directed to radiological education. This formal exposure comprises 18.9 hours (1.71%) of curricular time. Informal diagnostic imaging exposure increased radiology education to approximately 29.5 hours (2.67%) of curricular time. One course (Diagnostic Imaging) focuses exclusively on radiology teaching and accounts for approximately 50% of the total radiologic teaching. X-ray ordering and interpretation received the greatest emphasis throughout the curriculum, while ultrasound received the least attention.

Discussion: Further integration of formal radiological education into PA programs should be considered with specific attention directed toward point-of-care ultrasound exposure and ordering/interpretation skills.

Introduction: The value of using lifestyle medicine (LM) to prevent disease is well established, yet medical education about LM is inconsistent, for both physicians and physician assistants/associates (PAs). As medical providers, PAs are uniquely positioned, with careers in a variety of disciplines from primary care to intensive care, as well as an ability to move across disciplines throughout their career lifespan. Therefore, the addition of LM principles in PA education can affect patients across the lifespan and in a wide variety of clinical settings. In addition, with burnout prevalent among PA students, the addition of LM to PA education may be able to give these future clinicians the tools they need to manage stress and improve overall wellness. The purpose of this study was to share with PA educators the valuable lessons learned when introducing LM into PA curriculum in hopes of broader adoption.

Methods: The American College of Lifestyle Medicine (ACLM) provides modules for teaching LM to medical providers which was adopted into the Northeastern University PA Program's didactic curriculum in the summer of 2023. An online survey was administered to first-year PA students in July 2023 to evaluate the PA students' perspectives on the value of adding a LM curriculum as part of their education to care for patients and the content provided through ACLM and to determine their perceived value in using the information for themselves as part of preventing future provider burnout.

Results: Most respondents (91%) indicated that they were either "likely" or "very likely" to use the information learned in the LM modules as part of their future patient care, and 86.4% indicated that they would use the information as part of their own self-care.

Discussion: Most PA student respondents (88.6%) thought that the components of LM complemented the existing PA curriculum in primary care and (86.4%) indicated that they will use the information as part of their own self-care. However, given the intense volume of information provided to PA students for their general primary care education, it was suggested to pare down the volume of materials to streamline the curriculum. Overall, these PA students believe that LM should comprise a portion of their PA medical education curricula for their patients and for themselves.