Journal of Physician Assistant Education最新文献

Abstract: Although there has been a surge in physician assistant (PA) programs in the United States, PA programs have concurrently experienced challenges with partnering with a sufficient pool of clinical training sites. During the long-lived fee-for-service era, many programs have relied on transactional relationships with individual clinicians, hospitals, community health centers, private practices, and other entities to provide the required clinical experiences for PA learners. These arrangements often involved bargaining a supervised clinical experience in exchange for continuing medical education credit or other incentives included in a clinician's benefits package. However, with the recent transformation of the US health care delivery system into a value-based care model, academic service partnerships have emerged as valuable solutions. Academic service partnerships uniquely integrate health professions learners into health systems by providing more sustainable, results-driven clinical experiences that benefit the program, the clinical training site, and the patients.

Introduction: Many physician assistant (PA) students experience mistreatment by preceptors in clinical settings though most do not report it to their institution. Nonreporting limits an institution's ability to address mistreatment and provide student support. Several reasons for nonreporting have been described in national surveys. The purpose of this study was to identify factors predictive of student reporting behavior.

Methods: This study used a nonexperimental, cross-sectional, predictive research design with quantitative analytic methods. Data were from 2 national surveys administered to PA students and programs in 2019. The sample was PA students who experienced mistreatment performed by preceptors. Logistic regression was used to identify which independent variables were predictors of student mistreatment reporting to their institution.

Results: Students were twice as likely to report mistreatment involving physical or sexual behavior compared with other types. Older students were more likely to report mistreatment than younger students. Policy factors were not significant predictors of student reporting behavior.

Discussion: Student likelihood to reporting severe forms of mistreatment indicate they recognize those behaviors as mistreatment and believe they are important enough to report. Greater likelihood of reporting by older students indicates the influence of student demographics and life experience. Policy factors and institution characteristics were not significant predictors of student reporting behavior, which suggest the limits of policy as a facilitator of mistreatment reporting. These findings have implications for educational program policy design, implementation, and evaluation, as well as underscore the need for further research to understand factors influencing students' decision to report mistreatment.

Introduction: International exchange programs between physician assistants (PAs) and other advanced practice providers (APPs) from different countries can facilitate opportunities for global health training and experiences. This article examines a survey of 5 PAs, 4 nurse practitioners, and 1 certified nursing specialist working in the United States (US) about their experience collaborating in an international exchange program with APPs in the Netherlands.

Methods: Ten APPs in the United States anonymously answered an 8-item survey on their experience in an international exchange program with APPs in the Netherlands with a 100% response rate. The survey contained questions regarding the impact of the program on cultural competence, professional development, and perception of health care systems.

Results: All respondents agree or strongly agree that the program contributed to APP growth in cultural competence and professional development. Eighty percent of respondents found APP practices in the United States compared with the Netherlands to be somewhat or extremely similar, with differences noted in training and education, patterns of utilization, and roles in procedures. Free responses indicate APPs are used similarly in the Netherlands and the United States, while APP training models and health care infrastructure in the 2 countries have notable differences.

Discussion: Survey results examined in this article underscore how an international exchange program can not only enrich individual professional paths but also positively contribute to the broader global health care landscape. The lessons learned, shared experiences, and insights gained have the potential to shape health care practices on an international scale, fostering a collaborative and interconnected future for health care providers worldwide.

Abstract: There are many variations of anatomy courses taught in accredited physician assistant (PA) programs in the United States. Course directors and program leadership must choose how to effectively deliver content within their program constraints. Our anatomy course has faced challenges related to instructional time for didactic and laboratory sessions, course length, curricular placement and alignment, assessments, and faculty availability. These challenges are not specific to anatomy courses in PA curricula but exist in anatomy courses in various health care programs. In this article, we present major solutions to challenges in didactic delivery, laboratory sessions, course content, and assessments over a 5-year period. Through modifications and problem-solving, we identified the following 4 lessons learned during this process: course alignment to clinical relevance, intentional content delivery for different pedagogical approaches, structured laboratory sessions with appropriate staffing, and an appropriate weighting for assessments. These lessons and solutions will be useful to other anatomy and disciplines-based course directors facing similar challenges.

Abstract: This article presents a blueprint for effective video media production in physician assistant (PA) education based on validated pedagogical practices found in the literature. Using the cognitive load theory and a practical blueprint for video production designed for PA educators, this method aims to improve video production practices and better engage students within a format that improves learning outcomes for a diverse body of PA students. Students are interacting with videos, and there is an opportunity for educators to hone practices in video production to enhance student learning. A literature review of pedagogical practices in video production guides the production blueprint for video production. The practical principles of cognitive load theory improve efficiency in assimilating new information, enhance student engagement, and facilitate active and deep learning for a student learner engaging with the instructional video. Based on the literature and the author's educational video creation experience, a guide in the form of a production blueprint specific to PA education is proposed.

Introduction: To better understand factors contributing to low matriculation rates for health professions students from backgrounds underrepresented in medicine (URiM), this study examined the influence of healthcare-releated preadmission experiences on physician assistant/associate (PA) program matriculation.

Methods: We analyzed data from the Centralized Application Service for PAs 2018 to 2019 admissions cycle to compare characteristics of non-URiM and URiM PA program applicants and matriculants. The primary focus was on preadmission healthcare-releated experiences. To control for the strong influence of grade point average (GPA) on the likelihood of matriculation, we divided applicants into 2 groups: those with GPA < 3.6 (the median GPA for matriculants) and those with GPA ≥ 3.6. Analyses consisted of descriptive statistics and logistic regressions.

Results: Our sample consisted of 25,880 PA program applicants. Higher proportions of URiM compared with non-URiM applicants identified as first-generation college students (39.3% vs. 19.9%) or indicated economic disadvantage (32.3% vs. 12.5%). Overall, higher proportions of URiM compared with non-URiM applicants reported no patient care experience (24.3% vs. 17.9%), no shadowing (31.7% vs. 21.7%), or no volunteering (32.2% vs. 26.9%). Among all applicants with GPA < 3.6, reporting any type of experience was associated with increased odds of matriculation. Among URiM applicants with GPA ≥ 3.6, patient care experience did not influence odds of matriculation (odds ratio [OR] = 1.22, P = .23), whereas shadowing was associated with twice the odds (OR = 2.01, P < .001).

Discussion: Although academic metrics are known to predict PA program matriculation, we found that preadmission experiences also play a role. The study findings suggest that lack of experience hours may hinder URiM student access to PA education.

Introduction: This study explored the attitudes of physician assistant (PA) students toward the future care of individuals with serious mental illness (SMI). Physician assistant student education offers a unique opportunity to confront and reduce bias toward individuals with SMI. However, no previous literature has documented PA student attitudes toward SMI.

Methods: Preclinical students (n = 7) from a single PA program were invited to participate in 2 focus groups exploring attitudes toward the future care of patients with SMI. The focus groups lasted approximately 60 minutes and were conducted by non-PA faculty using a question guide.

Results: Four themes emerged from interviews: perceptions about the population, knowledge of mental health conditions, approach to care, and program curriculum input.

Discussion: Several themes aligned with the participant's level of training. Participants demonstrated didactic knowledge yet lacked clinical exposure to provide context. Future studies should focus on developing interactive learning techniques to prepare students for patients with SMI.

Abstract: Blue sky thinking references the opportunity to brainstorm about a topic without limits… to consider what things might be like if creative thoughts were unconstrained by current philosophies or other boundaries. This article is a call to our fellow educators to consider how blue sky thinking applied to physician assistant (PA) program accreditation might further advance programs, faculty, and the profession. To develop and maintain a PA program, institutions must voluntarily undergo evaluation by the Accreditation Review Commission on Education for the Physician Assistant. Compliance with accreditation encourages sound educational practices, promotes program self-study, stimulates innovation, maintains confidence with the public, and focuses on continuous quality improvement. In addition, accreditation "can hold institutions accountable for desired outcomes and professional standards." Indeed, while the PA profession has promulgated across the globe, the 50+ years of graduating PAs educated with the highest quality education assures that the United States remains a gold standard. As the 5th edition of the standards are implemented and planning for the 6th edition is underway, in the spirit of continuous quality improvement, we encourage stakeholders of the PA profession to contemplate ways in which accreditation might continue to purposefully advance a desired future state for the profession. In this article, we draw on examples from other health professions which might inform a discussion around the future of PA accreditation. Specifically, the topics of a unified profession title and degree, a specific title and position for program leadership, a modification to how PA programs receive medical direction, and efforts to advance scholarship are addressed.