Journal of Physician Assistant Education最新文献

Introduction: To assess the racial/ethnic diversity of graduates of US Physician Assistant/Associate (PA) programs compared with the diversity of the populations from which they draw students and to assess diversity changes over time among PA graduates.

Methods: We calculated proportion of Black or Hispanic PA graduates nationally and by school between 2010 to 2012 and 2019 to 2021 using the Integrated Postsecondary Education Data System (IPEDS) and compared it with the diversity of the 20 to 35-year-old population using the American Community Survey. We created benchmark populations for each school based on whether the school was public or private, with in-state/out-of-state proportions provided by the Physician Assistant Education Association. A diversity index (DI) was calculated for each program. A DI of 0.5 means that the representation of Black/Hispanic graduates is half their representation in the benchmark population.

Results: Although the numbers of Black/Hispanic graduates increased from 2010 to 2012 to 2019 to 2021, the percentage of Black graduates decreased. Nationally, the DI for Black graduates decreased from 0.28 to 0.23 and the Hispanic DI increased from 0.28 to 0.37 between 2010 to 2012 and 2019 to 2021. Among 213 PA programs included in the 2019 to 2021 dataset, 5 schools had a DI >1.0 for Black graduates and 7 schools had a DI >1.0 for Hispanic graduates.

Discussion: Using the IPEDS data, we found that Black and Hispanic graduates are underrepresented among PA program graduates. The PA education community needs to develop new strategies for diversifying the profession consistent with the new US Supreme Court decision banning race-conscious admissions.

Abstract: For physician associate/assistant (PA) educators, the path of least resistance often is to focus our cognitive energies on topics with which we are most comfortable and to deliver content in the style in which we are most accustomed. The consequence of this approach is that many didactic curricula are delivered in a traditional, lecture-based format, which then aligns with how the faculty were taught. Studies show that lecture-based teaching may not be the most effective and that blending teaching modalities can improve knowledge acquisition. In addition, scheduling several classroom lectures week to week can be challenging, especially in a program that uses numerous guest lecturers to deliver the curriculum. One solution to this problem may be through innovative, engaging resources that enable faculty to deliver content asynchronously. Developing and implementing such tools can be challenging to PA faculty because they are often not formally trained in education nor are they up to date on the most current innovations in educational technology. Furthermore, change can be difficult, and it could seem an insurmountable feat to step outside the comfort zone of a traditional lecture. This work describes a collaboration between PA faculty and a University Instructional Support Specialist where the Analysis, Design, Develop, Implement, Evaluate ADDIE model, a widely used system for developing training tools, was used to create an asynchronous lecture for students in the form of an interactive series of modules to replace a traditional classroom lecture.

Introduction: There are well-known strategies to increase diversity in health professions education, evidence is sparse on how such strategies are practically implemented and longitudinally sustained. This study investigated the most widely used strategies across physician assistant/associate (PA) educational programs that have consistently demonstrated the ability to graduate racial and ethnic underrepresented students.

Methods: Following a grounded theory, qualitative interviews were conducted with 41 nationally accredited PA programs identified as top performers in consistently graduating racial and ethnic underrepresented students. Semistructured interviews were conducted with a program representative focused on ascertaining the characteristics and strategies attributable to the successful recruitment and retention of underrepresented PA matriculants. The interviews comprehensively explored program resources, efforts, and practices. Transcripts were coded, and themes were identified.

Results: The study revealed 4 overarching themes: (1) Pathways from the Community to the Program and Into Healthcare; (2) Dedication to Student Retention and Support; (3) Commitment to Diverse and Inclusive Learning Environments; and (4) Alignment of Mission, Inclusive Action, and Improving Diversity Outcomes. Based on these emerging themes, we propose a new diversity framework that hinges on Retention, Outreach, Alignment, and Diversity (ROAD Framework). This framework seeks to explain the overarching goals, high-impact behaviors, and actionable steps that can be effectively implemented across PA education to facilitate further diversification.

Discussion: This study illuminated on What Works to foster diversity in PA programs. By embracing and implementing the ROAD Framework, institutions can effectively address the persistent issue of underrepresentation and contribute to cultivating a more inclusive and representative healthcare workforce.

Abstract: Collaboration is a vital skill that needs to be developed in health professions students. Developing tolerance for differing viewpoints and valuing an understanding of others' lived experiences are instrumental skills in learning to provide patient-centered care. Fostering the expression of diverse viewpoints and working through uncomfortable and distressful situations are a part of the experience in acquiring these skills. It is the educator's duty to facilitate these encounters in a way that upholds the tenants of academic freedom and civility to create optimal educational outcomes. Doing so creates opportunities for transformative learning and the facilitation of higher cognitive development when compared with the avoidance of exposing students to divergent viewpoints. It is through freedom of discussion that one must teach students that ultimately the pursuit of truth, even when it may be unwelcome, disagreeable, or deeply offensive, greatly outweighs the discomfort the process of discovering it may bring.

This article offers a unique perspective on integrating historical and contemporary issues of racism and public health within physician assistant (PA) education, specifically through the lens of personal experience as a public health data analyst during the COVID-19 pandemic. By highlighting the intersection of race, health equity, and education, this article underscores the need for PA programs to incorporate and enhance comprehensive training on the structural determinants of health and the impact of systemic racism on patient care.

Introduction: This pilot study aimed to evaluate whether and how physician associate/assistant (PA) program medical directors play a role in advocating on behalf of PAs and what factors correlate with this.

Methods: The study used a mixed-methods grounded theory approach and was deemed institutional review board exempt. After literature review, a survey was developed and piloted by study personnel and faculty to affirm validity. Recruits with known email addresses were sent a link to a survey that included demographic information and 10 Likert scale questions. There were 69 respondents, and the response rate was 26%. Fisher's exact test and analysis of variance were performed using the R program. A P-value <.05 indicated significance. Thematic analysis of qualitative data was performed using ChatGPT, followed by iterative analysis by the research team. Consensus was achieved for each response.

Results: Most of the respondents had the following characteristics: MD degree, male, White, practicing clinically, and worked as PA medical directors 8 to 12 hours per week. Participants did not support PA title change, nor had they engaged in legislative efforts to support optimal team practice. Participants were strong PA advocates by promoting PA leadership positions, PA employment, improved attitudes in health care organizations toward PAs, and securing clinical rotations. Many respondents (41%) felt that none of their professional organizations supported them in their role as PA program medical director.

Discussion: Exploring ways to support continued advocacy by our valued PA program medical directors within PA professional organizations could be advantageous to PA program medical directors' professional growth and the PA profession.

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: Inadequate clinical training site availability may inhibit physician assistant/associate (PA), advanced practice nursing (APN), and physician workforce growth. Educational institutions increasingly incentivize clinical training sites with financial compensation, with potential implications for educational costs and enrollment. This study investigated compensation trends among PA programs.

Methods: Data from the 2013 to 2019 PA Education Association Program Reports were examined. Multivariate logistic and linear regressions were estimated to identify the influence of PA program characteristics on clinical training site compensation. The effect of compensation on program enrollment was determined with a difference-in-differences estimator.

Results: Physician assistant/associate programs collectively paid nearly $19 million to clinical training sites in 2019. The percentage of programs that offer financial incentives increased from 22.2% in 2013 to 52.3% in 2019. Over this time, public institutions affiliated with academic health centers (AHCs) were least likely to offer compensation. Higher compensation rates were observed in Census divisions with greater number of programs, and programs located in New England were the most likely to offer compensation. Offering compensation did not influence growth in programs' enrollment.

Discussion: Compensation trends highlight increasing demand for PA clinical training sites, especially in areas with greater regional competition. Compensation is primarily driven by private institutions unaffiliated with AHCs. Programs likely offer compensation to maintain, rather than grow, enrollment. Additional investigation should incorporate medical school and APN program data to more fully examine the impact of these costs on learners, institutions, and the health care workforce.

Introduction: People who identify as lesbian, gay, bisexual, transgender, queer, and people who identify as something else (LGBTQ+) experience barriers to health care including a lack of health care providers adequately prepared to care for them. The literature describing LGBTQ+-focused didactic learning activities has increased in recent years, however remains limited with respect to clinical learning experiences. This publication describes the development and implementation of a clinical rotation for Physician Assistant (PA) students focused on caring for LGBTQ+ patients.

Methods: A 4-week LGBTQ+ Health clinical rotation was developed for PA students through collaboration with multiple clinical sites. Students (n = 6) were surveyed before and after completion of the clinical rotation on their knowledge, comfort, and confidence in caring for LGBTQ+ patients and to identify learning priorities. Paired t tests were used to compare quantitative pre and post data. Two reviewers independently reviewed qualitative data.

Results: Improvement in students' knowledge, comfort, and confidence were statistically significant from prerotation to postrotation surveys. Student ratings on standard course evaluations showed positive ratings for all course elements. Qualitative analysis showed that all students identified learning more about trans-related health care as a learning priority.

Discussion: Clinical rotations focused on the care of LGBTQ+ patients are valuable learning experiences which can support increased student knowledge, comfort, and confidence. Clinically based educational interventions may be one strategy in addressing the health disparities experienced by LGBTQ+ people.