Journal of Physician Assistant Education最新文献

Introduction: Mentorship is vital for professional development in health care, but barriers limit its potential, such as time constraints, lack of training, and lack of mentors. The objective of this study was to identify and analyze the key barriers to implementing and maintaining student mentoring pathways in physician assistant/associate (PA) training programs.

Methods: Using an internet-based questionnaire, the authors surveyed 332 PA Programs from May 7 to June 10, 2024. Survey items addressed topics to implementing and maintaining formal and informal student mentoring pathways. Respondents were then asked to rank potential barriers to mentoring pathways.

Results: The response rate was 96 of 322 (29.8%). Overall, barriers to implementing formal and informal student mentoring pathways were the faculty's lack of time, securing adequate mentors, and a lack of "mentoring" being well-defined. Barriers to maintaining formal and informal student mentoring pathways were similar to barriers to pathway implementation.

Discussion: The most important barriers to implementing and maintaining PA student mentoring pathways are a lack of time and program support.

Introduction: As generative artificial intelligence (AI) tools become increasingly prevalent in higher education, their integration into physician associate (PA) education remains underexplored. The existing literature primarily focuses on short-term outcomes, with limited attention to learner engagement, critical thinking, or institutional support.

Methods: This qualitative study employed semistructured interviews with 8 self-identified AI-using didactic PA students from one private and one public institution. Interpretative phenomenological analysis and constructivist learning theory guided the analysis. Transcripts were thematically coded using an a priori codebook and refined iteratively.

Results: Three key themes emerged: (1) AI integration in learning practices: students used AI for generating practice questions, clarifying content, and rehearsing for clinical assessments; (2) student perceptions and attitudes: AI was seen as efficient and supportive, though caution was exercised due to inaccuracies and perceived limitations; (3) institutional context and support: formal guidance was minimal, with most students navigating AI use independently in permissive but understructured environments.

Discussion: Didactic PA students interviewed for this study actively incorporate generative AI into their learning through trial, reflection, and adaptation. Despite limited institutional direction, participants demonstrated emerging digital literacy and critical engagement. These findings underscore the need for AI-integrated curricular frameworks and faculty development to support the ethical and pedagogically sound use of AI by students. Programs that partner with learners in this evolving landscape may better prepare future clinicians for technology-enhanced practice.

Introduction: Delivery of physician assistant (PA) substance use disorder (SUD) curricula varies across educational programs. This study aims to examine the effectiveness of a standardized SUD curriculum and to explore PA student attitudes toward and confidence in treating patients with SUD.

Methods: PA Education Association developed and implemented an 8-hour online SUD module for PA students. Curriculum was designed by a faculty consortium and piloted by students from 20 pilot PA programs (N = 1280, across 2 cohorts). Surveys were administered to all students before starting the curriculum and after completion to collect demographic information, measure attitudes toward SUD, and assess curriculum quality.

Results: A total of 1280 PA students completed the precurriculum survey and 819 completed the postcurriculum survey. Attitudes toward diagnosis and treatment of SUD and toward patients with SUD improved after module completion on 9 of 12 Likert survey questions. Three Likert questions that infer a reluctance to treat SUD patients decreased slightly in score from precurriculum to postcurriculum surveys.

Discussion: Physician assistant student attitudes and confidence improved regarding diagnosis, treatment, and perception of those with SUD. The pilot modular curriculum was well received by students and supports distribution of curriculum to a larger population of PA students, and additional data will improve generalizability. Additional studies may include the types of SUD curricula currently offered and impact of curriculum sequencing on effectiveness and attitudinal change.

Introduction: Dermoscopy is a proven technique that improves diagnostic acumen in skin lesion evaluation. However, data are scarce on dermoscopy knowledge among physician associate or assistant (PA) students. The aim of this study was to ascertain US PA student's confidence in evaluating skin lesions, current dermoscopy knowledge, and current dermoscopy curriculum.

Methods: An anonymous, optional survey was included in the 2024 Academy of Physician Associates (AAPA) (American AAPA) student survey.

Results: A total of 613 (35.7%) PA students responded to the optional survey. Although most (78%) respondents were aware of the terms "dermatoscope" or "dermoscopy," nearly two-thirds (65%) had not yet received dermoscopy training in their PA education and 78% indicated desire to use dermoscopy in their future practice. Respondents were slightly (27%) or somewhat confident (44%) in their ability to differentiate benign and malignant skin lesions, and those with an anticipated dermatology specialty were more confident than their peers seeking other specialties. Respondents who did not recognize the term "dermoscopy" (odds ratios [ORs] = 0.2, 95% CI 0.1, 0.6) and those who did not have prior dermoscopy training (OR = 0.6, 95% CI 0.3, 1.0) were also less likely to be confident.

Discussion: Physician assistant students are interested in dermoscopy training, but training is lacking in PA programs. Physician assistant programs should incorporate dermoscopy into their curriculums to ensure trained PAs have the skill to confidently evaluate skin lesions across a range of medical specialties.

Introduction: The Accreditation Review Commission on the Education of the Physician Assistant, which accredits all US Physician Assistant (PA) programs, published standards in 2019 which specifically required programs to include instruction on medical care with respect to gender identity. The purpose of this study was to compare trends in the delivery of transgender content in US PA programs pre- and post-accreditation standard implementation.

Methods: Data were drawn from 2 separate national surveys of PA programs. The first was administered in 2018 (n = 236, response rate 100%) and the second in 2021 (n = 286, response rate 71.8%). Both included questions on hours spent and courses in which transgender health content was included. Chi-square tests were conducted to compare results between 2018 and 2021.

Results: There were statistically significant differences in PA programs reporting inclusion of transgender content between 2018 and 2021, with all courses reporting percent increases between the 2 timepoints. The largest percentage changes were in medical interviewing (43.6% in 2018, 75.5% in 2021) and infectious diseases (6.4% in 2018, 38.7% in 2021). The number of PA programs reporting <1 hour of transgender content decreased from 14.5% in 2018 to 1.6% in 2021.

Discussion: While accreditation standards are not the only contributing factor to the increases in transgender health curricular content in this study, the increases in curricula and delivery methods are pronounced. Findings suggest that accreditation standards may be a powerful strategy in ensuring health professionals receive the content necessary to care for people who are transgender.

Abstract: The physician assistant (PA) profession, historically grounded in a generalist educational model, is experiencing growing pressure to adapt to a workforce increasingly dominated by specialty practice. Questions have emerged regarding whether PA education should incorporate earlier opportunities for specialization. These questions are especially important now, given the potential transition of PA programs from master's to doctoral degrees. This article examines the historical foundations of the generalist model, current workforce and employer trends, the potential benefits and risks of early specialization, and possible middle-ground approaches to such a shift. This narrative is a call for a structured, profession-wide dialogue involving educators, policymakers, and clinicians to evaluate the implications of early specialization and guide the evolution of PA education in alignment with workforce needs and professional values.

Abstract: Professionalism is a fundamental principle of medicine affirmed as a student and applied as a health care provider. During graduate educational training, physician assistant (PA) students may fail to excel in professionalism standards, demanding an obligation for remediation. Physician assistant educators are charged with the construction and execution of effective professionalism remediation strategies for students to help ensure competent healthcare delivery upon graduation. The aim of this article is to provide clear, applicable professionalism remediation strategies to novice and experienced PA educators to be efficiently implemented with PA students through discovery of findings within published literature to be grouped into connecting themes. The article encompasses several identified themes linked to successful PA student remediation, such as remediation training for PA faculty, early remediation interventions, consideration of confounding factors upon remediation plans, PA student remediation reflections, as well as professionalism modeling within PA educators. Physician assistant faculty can impact the construction and execution of effective remediation strategies for PA students to help ensure competent health care delivery upon graduation.

Introduction: This study compares the value of web-based interactive case simulations (specifically, Aquifer) with paper-based case simulations among first-year physician assistant students working in small groups.

Methods: Forty-three first-year physician assistant (PA) students in the gastroenterology module preassigned to physical examination practice groups of 3 or 4 were randomly assigned to work through 2 cases in a crossover study. Roughly half the students were assigned to do a pancreatitis case on Aquifer while the other half worked through a pancreatitis case in a paper-based symptom-to-diagnosis simulation. The groups then switched so that each group changed to the other modality to work through a diverticulitis case. Students were surveyed at the conclusion of both exercises about the value of each modality for learning and for reinforcing learning and asked which modality they preferred.

Results: Forty completed surveys were returned. Nearly 75% of students preferred the manual symptom-to-diagnosis simulation, particularly for small group work, and the most cited reason was that it was "more realistic."

Discussion: Alhough many students found the wealth of information they could read about on Aquifer beneficial, especially when studying alone, students felt that they learned more from the group discussion during the traditional symptom-to-diagnosis case, had more fun learning, and preferred this type of exercise when working in small groups.

Introduction: This study aimed to evaluate whether physician assistant/associate (PA) students' sociodemographic factors were predictors of risk for mistreatment. A secondary analysis aimed to evaluate whether sociodemographic features were evenly distributed among respondents who answered mistreatment items.

Methods: Data originated from the PA Education Association End of Program Surveys (2018, 2019, 2021, and 2022). Independent variables were gender, race, ethnicity, and sexual orientation. Using logistic regression, odds ratios were calculated for 2 separate dependent variables: whether respondents experienced mistreatment and whether respondents completed mistreatment items.

Results: Surveys included 11,461 respondents, 3218 (28.1%) of whom experienced mistreatment; however, 3258 (28.4%) of respondents did not answer any mistreatment items. Analysis showed statistically significant sociodemographic factors for risk for mistreatment, but the model had poor fit ( P -value = 0; receiver operating characteristic [ROC] 0.553), possibly related to partial nonresponse bias. Completing mistreatment items was statistically significantly more likely for respondents who indicated they were gay or lesbian (odds ratio [OR] 1.52) or bisexual (OR 1.82) and less likely for respondents who indicated they were male (OR 0.68), sexual orientation "I don't know/prefer not to answer" (OR 0.65), Hispanic (OR 0.79), or not White (OR 0.49).

Discussion: The sociodemographic factors evaluated were inadequate to predict mistreatment of PA students, but sociodemographic factors were associated with willingness to complete mistreatment questions. Qualitative research is needed to determine why respondents who are male, Hispanic, or not White are reluctant to complete mistreatment questions. Findings could inform survey improvements to more accurately measure health professions student mistreatment.

Introduction: This paper examines student resistance to arts and humanities (A&H) educational content and whether it is durable over time among physician assistant (PA) students.

Methods: A cohort of PA students from a Midwest university medical center (N = 64) participated in ten A&H modules as part of their didactic curriculum. Focus groups assessed student responses to the modules at 2 time points: after completion of all modules and again after their clinical rotations. We coded and analyzed the data using a grounded theory approach.

Results: We found that cohort resistance to A&H changed over time. During the didactic curriculum, students attributed their struggles to an impression that they performed module tasks poorly or to a lack of interest in particular A&H activities. They reported feelings of vulnerability or anxiety, which they did not appreciate. In contrast, after clinical rotations, we heard no A&H resistance. Instead, PA students spoke of seeing greater value in A&H after its use in patient encounters, preceptor discussions/modeling, and their own increased participation in A&H due to the easing of time constraints.

Discussion: While PA students were initially resistant to the A&H activities when they were first presented during their didactic education, their perceived value of the activities became more positive over time following experience in the clinical setting during clerkships. Assessing resistance at 2 different points in the educational trajectory leads us to conclude that initial resistance to A&H education diminishes as the content connects to clinical practice through experience.