Journal of Physician Assistant Education最新文献

Introduction: Research on note-taking strategies in the higher education setting has been in existence since the 1920s. While both pros and cons exist for handwritten and digital note-taking techniques, recent research has focused on novel ways to optimize digital note-taking. With more students using laptops or tablets with a stylus, educators need to be equipped to coach students on evidenced-based ways to improve their digital note-taking.

Methods: PubMed, ERIC, and CINAHL databases were searched on January 6, 2025, using combinations of the following key words: digital, technology, analogue, note-taking, cognition, memory, laptop, stylus, and tablet. Studies were included if they were performed with adult learners in the higher education setting with a primary focus on note-taking.

Results: Three hundred thirty records were screened with 25 included in final review. Thematic analysis identified three emerging themes: (1) collaborative/group note-taking, (2) outlines, and (3) mind mapping, concept maps, or matrixes.

Discussion: Physician assistant/associate faculty can educate students on ways to conduct collaborative or group note-taking, create outlines, and generate mind maps, concept maps, or matrixes. These evidence-based digital note-taking strategies can be conducted independently or as a group. By supplementing these strategies with basic retrieval practices outside of the classroom, students will increase their likelihood of academic success.

Introduction: Traditionally, if ultrasound needle-guidance training is included in physician assistant (PA) education it occurs during the clinical year and uses live patients at the bedside. This practice requires learning a highly tactile skill in a high-stress learning environment where mistakes during the learning process will likely result directly in patient discomfort or complication-related injury. Simulation training with formalin-embalmed cadavers can provide realistic training opportunities with no risk to patients. This study examines the effectiveness of integrating simulation training in ultrasound-guided percutaneous cyst drainage into PA education.

Methods: Thirty-seven PA student participants engaged in training activities to learn to use ultrasound to access and drain synthetic cysts embedded within cadaver tissue. Participants were assessed using pre-training and post-training self-confidence questionnaires and objective skills examinations administered by an instructor.

Results: Participant self-confidence related to all assessed aspects of performing the procedure significantly increased after training ( P < 0.0001). Only 2 participants were unable to successfully pass the skills assessment. Participants required 1.9 needle sticks on average to complete the procedure successfully in an average time of 143 seconds.

Discussion: Simulation training using synthetic cysts and formalin-embalmed cadavers provides PA students with a realistic and low-stress learning environment in which to develop the complex tactile skills needed to successfully guide a needle with ultrasound while performing a clinical procedure. Training sessions like this should be integrated into PA education to allow students to safely develop the skills and confidence they need to perform ultrasound-guided procedures on live patients and minimize risk of adverse outcomes.

Introduction: This study examined how social media content from physician assistant (PA) programs influences students' attitudes and decisions regarding matriculation.

Methods: A 16-question anonymous survey was distributed via email to PA programs across the United States. Contact information from PA program Web sites was used to email faculty, encouraging distribution to PA students and recent graduates who matriculated between January 2021 and January 2024. The survey aimed to understand PA student demographics, social media usage patterns, and their influence on program matriculation decisions.

Results: A total of 374 PA students from 28 programs (11% of all programs) completed the survey, with an average age of 25.7 years. Social media played a minor role in students' enrollment decisions. Top factors were accreditation status, location and cost of living, and first-time Physician Assistant National Certifying Examination pass rate. While 51% were aware of their program's social media presence, over 75% reported it was "not at all important" in their decision. However, 366 students used social media at least 3 times a week, with Instagram, Facebook, and TikTok being the most visited platforms. The most impactful posts were "Day in the Life of a PA student" videos, clinical year curriculum, and classroom technology, while posts about preceptors and faculty were least impactful.

Discussion: Despite frequent social media use, 78% of respondents indicated social media presence had little to no impact on their program choice. However, targeted social media posts, such as "A Day in the Life of a PA Student" could impact their decision-making process.

Introduction: Many institutions are facing financial challenges that may adversely affect physician assistant (PA) programs. This study examines the relationship between the financial stability of private, nonprofit institutions offering entry-level PA programs and accreditation outcomes.

Methods: This cross-sectional study explored a possible association between Composite Financial Index of sponsoring institutions for 3 years preceding the most recent ARC-PA review and the program's accreditation outcome for reviews between 2017 and 2023. Institutional characteristics were summarized for programs experiencing positive compared with adverse accreditation outcomes. Logistic regression was used to examine the association between Composite Financial Index and accreditation outcome while controlling for the effects of institutional characteristics and program's time since initial accreditation.

Results: The study included 144 PA programs (119 with positive accreditation outcomes, 25 with adverse outcomes). Almost all PA programs studied are financially stable. Institutional characteristics were unrelated to specialized accreditation status. "Insufficient human resources" was the most cited issue (17 instances), affecting 3.4% of programs with positive outcomes and 52% with adverse outcomes ( P < .001). The average time between initial accreditation and the most recent review was significantly longer for programs with adverse outcomes ( P = .02). Each additional year between the initial accreditation and most recent review increased the odds of an adverse accreditation outcome by 4%.

Discussion: While new insights about accreditation success were found, questions remain about which financial measures predict an institution's ability to support PA programs. Future research should investigate why longer running programs face more adverse outcomes.

Introduction: Physician assistant (PA) programs have seen unprecedented growth in the past 10 years with over 300 accredited PA programs currently. With this growth comes the need for qualified faculty.

Methods: This retrospective quantitative data analysis examined the relationship between participation in the PA Education Association (PAEA) workshops and retention in PA education and/or career advancement post workshop attendance. All PA faculty attendees of PAEA workshops using existing data from the workshop rosters and membership profiles from 2017 to 2021 (n = 1600) were analyzed. The 2019 workshop participants (n = 274) served as a subset of the workshop attendees to compare to nonworkshop attendee PA faculty employed in PA education in 2019 (n= 2857). There were 1320 individuals who attended at least one of the PAEA workshops and met inclusion requirements.

Results: Analysis revealed a significant relationship between attending a workshop and remaining in PA education. An odds ratio of 2.2 indicated that individuals who attended a workshop were more than twice as likely currently to be in PA education than those who did not. For the PA faculty who attended a workshop, the number of workshops attended was not found to be a significant predictor ( P -value > .05) of attaining a promotion in the time frame observed. For workshop attendees, the number of workshops attended was found to be a significant predictor of staying in PA education ( P -value < .05).

Discussion: This study has provided information about the value of professional development programming in helping to retain PA educators in their faculty roles.

Introduction: The Physician Assistant National Certification Exam (PANCE) is the standard for assessing the medical knowledge of the Physician Assistant graduate. Performance on this high-stakes examination is often the culmination of countless hours of preparation. A tool to predict PANCE scores empowers faculty to identify and prepare students who may be at risk.

Methods: This retrospective, single-institution study examined scores from 10 standardized PA Education Association examinations for their combined accuracy in predicting student first-time numeric PANCE scores. Individual scores from 4 consecutive Physician Assistant program cohorts (n = 91) were analyzed using a multiple regression model to obtain a coefficient of multiple correlation (R) with ANOVA (analysis of variance) statistical testing for significance. A predictive equation was then developed to predict first-time PANCE scores of the fifth cohort (n = 31). A simple linear regression was used to correlate the predicted PANCE score from the model with the actual PANCE score.

Results: The multiple regression model was statistically significant, evidenced by the ANOVA results (F = 22.53, P < 0.0005). The multiple regression model shows a strong multiple correlation (R = 0.86), demonstrating the effectiveness of this combination of standardized exams in predicting PANCE results.

Discussion: The multiple regression model reliably predicts first-time PANCE scores, thus providing validity evidence for the use of these standardized PA Education Association examinations in assessing content/task areas. Applying this model can identify students in our program at risk for PANCE failure and improve success as evidenced by a first-time pass rate in the most recent graduating cohort of 100%.

Introduction: There has long been a shortage of health care providers in rural areas. Interventions that have been shown to increase rural recruitment have yet to be explored in physician associates (PAs). This study seeks to identify the association between PA training site and first job location.

Methods: We conducted a repeated cross-sectional analysis of recent PA graduates' data at one institution. The institution consists of 2 campuses, an urban and rural campus. We analyzed the data using multivariable logistic regression.

Results: We analyzed 7 cohorts (n = 601) of students, of whom 26.29% (n = 158) trained at the rural campus. There were no significant differences between campus locations on any sociodemographic characteristics, except race (White, rural = 78.48% vs. urban = 68.85%, P = .02). Students were more likely to choose a job in a rural area when they completed more rural rotations (odds ratio (OR) = 1.47, 95% confidence interval (CI) = 1.22-1.70), controlling for primary care specialty, gender identity, attending a rural campus, and being raised in an economically disadvantaged area. In a sensitivity analysis of more recent cohorts, we found similar results. Training at a rural campus or completing rural rotations were not associated with obtaining jobs in primary care health professional shortage areas or medically underserved areas.

Discussion: Similar to research in medical students, PAs who complete clinical training in rural areas may be more likely to choose their first job in a rural area, independent of where they were raised. This has policy and institutional implications to address access to care disparities for rural populations.

Introduction: The purpose of this study was to measure benchmarks for the competency "generating a prioritized differential diagnosis" in physician assistant/associate (PA) students as they progress through training and compare these benchmarks to experienced clinicians.

Methods: This cross-sectional study used a survey with 3 clinical vignettes of 50 words or less. Each participant was instructed to provide a prioritized list of up to 10 diagnoses for each vignette. The study group included 3 cohorts of PA students-first-year (PAS-1), second-year (PAS-2), and third-year (PAS-3)-and a reference group of experienced clinicians. Outcomes included top slot diagnosis, differential concordance index, emergent diagnoses, organ systems, list length, and time to completion.

Results: Fifty-five students and 9 clinicians participated. PAS-2 and PAS-3 had a greater number of concordant responses and higher accuracy in top slot diagnosis based on agreement with the reference group. With experience, student lists included more emergent diagnoses and more organ system considerations. Clinicians and PAS-1 took significantly less time (340 seconds [SD 141.5, interquartile range (IQR) 226.7-445.8]) to complete all vignettes compared with PAS-2 and PAS-3 (663 seconds [402.5, 310.6-850.1]). Mean list length was progressively greater from PAS-1 (2.9 [1.8, 2-4]) to PAS-3 (6.4 [2.6, 4-8]) with clinicians having the greatest mean list length (6.8 [2.7, 5-9.5]).

Discussion: Differential diagnosis ability among PA students appears to develop in both breadth and concordance with experienced clinicians. Targeted feedback to students might include increasing list length and considering more organ systems and emergent though less prevalent diagnoses.

Introduction: Gender disparities in academic publishing hinder career advancement and limit diverse contributions in the physician assistant (PA) profession. Although many female PA educators publish successfully, the barriers they face remain underexplored. This study examined the challenges and facilitators of female authorship to inform strategies that promote equity in scholarly productivity.

Methods: First and last PA authors of Journal of Physician Assistant Education (JPAE) research articles (2014-2022) were identified. Identified authors were invited to participate in a survey, which was adapted, piloted among 8 faculty members, and distributed through Qualtrics. Descriptive statistics and inferential tests were applied.

Results: Among 177 unique PA authors, 69% identified as female. The response rate was 47%. Women had a median age of 49 years (IQR 44-60), compared with 55 years (IQR 41-64) for men. More men (40%) held full professor rank than women (20%). Women reported fewer first-author or last-author publications, lower levels of institutional support, and more frequent authorship conflicts (37% vs. 7.7%, P < .001), with 24% of women experiencing repeated disputes.

Discussion: Despite similar educational backgrounds, men held higher academic ranks and published more frequently. Women reported lower institutional support, which may contribute to disparities in research productivity. Authorship conflicts may further hinder female publication success and affect future collaborations. Addressing biases, improving collaboration, and ensuring equitable institutional support are essential for fostering gender equity in PA faculty advancement.