Journal of Physician Assistant Education最新文献

Introduction: This article describes an innovative approach to accreditation compliance and to bridging the gap between didactic education and clinical practice through competency-based assessment (CBA) implemented during the final semester of the didactic phase in a physician assistant program. While CBA is more commonly used in the clinical phase, its application in the didactic curriculum represents a novel strategy for ensuring clinical rotation readiness while demonstrating compliance with Accreditation Review Commission on Education for the Physician Assistant standards.

Methods: This program developed 22 didactic competencies that aligned with programmatic competencies, providing students with multiple opportunities to demonstrate rotation-ready proficiency. Implementation included restructuring classroom time around focused clinical reasoning practice, problem-based learning, and objective structured clinical examinations with comprehensive feedback mechanisms. Assessment of effectiveness triangulated course outcomes, student perceptions, and preceptor evaluations.

Results: The assessment demonstrates strong alignment between CBA experiences and clinical performance expectations. Student feedback highlighted the value of individualized guidance, practical preparation, and enhanced clinical reasoning skills. The approach successfully addressed key accreditation standards: curriculum competency design (B1.01), alignment of outcomes with competencies (B1.03e), and support of demonstrating effectiveness of didactic curriculum (C1.01b). Despite challenges, including resistance to change and assessment complexity, the CBA system improved student self-regulation through deliberate practice and reflection.

Discussion: This compliance strategy offers physician associate/assistant programs an effective framework for developing confident, capable students truly prepared for clinical rotations while providing robust documentation of didactic design, alignment, and curriculum effectiveness for accreditation purposes.

Introduction: Medical learners face challenges affecting educational success. Unsuccessful application of didactic content can result in poor performance in the clinical phase of learning. Efforts which target standardized remediation and application of adult learning theory are effective.

Methods: In 2020, a physician assistant remediation curriculum was designed to improve clinical knowledge and performance on standardized examinations using evidence-based techniques. The program developed practical and professional skills reinforcing a core set of national examination topics. We surveyed participants to assess program acceptability. To demonstrate efficacy, we determined the pass rate of the Physician Assistant National Certifying Examination (PANCE).

Results: The 12 learners participating in the program passed the PANCE. Participants agreed the program was well organized and well paced and provided high-quality content, the faculty were organized and demonstrated solid medical knowledge, and their advice was helpful.

Discussion: Providing an evidence-based remediation program embracing adult learning methods is imperative to address the complexity of today's learners.

Introduction: Postbaccalaureate (postbac) programs have been widely studied in medical education but remain understudied in physician assistant (PA) education. Given the accelerated nature of PA education, postbac programs may provide valuable academic preparation. This study examines the association between postbac attendance and PA program matriculation.

Methods: A retrospective analysis was conducted using deidentified data from 12,075 applicants to 8 geographically diverse PA programs during the 2021 to 2022 Centralized Application Service for Physician Assistants cycle. Formal postbac participation was defined as the completion of 30 to 60 credits through a structured postbac program. Descriptive statistics, t -tests, chi-square tests, and logistic regression were used to assess factors associated with matriculation.

Results: Only 1.48% of applicants completed a formal postbac program. These applicants had significantly lower cumulative undergraduate grade point averages (GPAs) (3.275 vs. 3.425, P < .001) but comparable science GPAs (3.187 vs. 3.247, P = .0745) compared with nonpostbac applicants. Matriculation rates were similar between groups (48.6% vs. 46.5%). Among matriculants, postbac students had lower cumulative GPAs but similar biology, chemistry, and physics (BCP) GPAs. Logistic regression showed that cumulative GPA, BCP GPA, underrepresented minority status, and number of applications were positively associated with matriculation. Postbac credit hours and patient care experience had minimal predictive value.

Discussion: Although postbac attendance did not significantly increase matriculation rates, comparable BCP GPAs despite lower cumulative GPAs suggest academic benefit. These findings support further exploration of postbac pathways as tools for strengthening science readiness among diverse applicants.

Introduction: The traditional use of cadaveric dissection in Human Anatomy education for Physician Assistant students has been increasingly challenged by the need for greater clinical relevance, flexibility, and cost efficiency. In response, our program transitioned to a modernized anatomy curriculum incorporating virtual anatomy tools and point-of-care ultrasound (POCUS) to enhance learning and better prepare students for clinical practice.

Methods: We replaced cadaveric dissection with a combination of the Virtual Human Dissector, Sectra Anatomy Table, and POCUS. Implementation strategies included structured faculty development workshops, hands-on training sessions, and early communication with incoming students. Anatomy instruction was redesigned to integrate clinical imaging and real-time ultrasound scanning to promote active learning and application of anatomical knowledge.

Results: Initial feedback from students indicated high levels of engagement, satisfaction, and perceived relevance to clinical practice. Challenges included faculty adaptation to new technologies and student expectations regarding traditional anatomy instruction. These were mitigated through deliberate onboarding processes and early exposure to the new curriculum model. A longitudinal evaluation is currently underway to assess knowledge retention and clinical application outcomes over time.

Discussion: Transitioning to virtual anatomy and POCUS-based instruction offers a clinically meaningful, flexible, and sustainable alternative to cadaveric dissection. Our experience demonstrates that such curricular innovations can enhance, rather than diminish, basic science education, better aligning anatomy instruction with the competencies required in modern clinical settings.

Introduction: Student evaluations of teaching (SETs) are often biased, particularly with regard to differences in race, ethnicity, and accent. This study examines how unconscious biases in SETs impact teaching evaluations.

Methods: This study employed a mixed-methods approach, combining qualitative thematic and critical discourse analysis with quantitative statistical analysis. Student evaluations of teaching from medical learners were analyzed for biases related to race/ethnicity and accent. Iterative coding was used to identify themes, ensuring inter-rater reliability. Quantitative data were analyzed with chi-squared and t-tests to assess differences in instructor ratings based on faculty characteristics.

Results: An analysis of 26,659 student comments from 852 health professions courses revealed that faculty with racial, ethnic, and accent differences received more critical feedback compared with their White, General American accented counterparts. While positive attributes like enthusiasm and clear communication were noted for both groups, faculty with accents or non-White were less likely to receive praise and more likely to face negative feedback. No grossly discriminatory comments were found in the dataset.

Discussion: This study highlights the pervasive bias in SETs, where faculty with accents or who are non-White receive more negative feedback and fewer positive comments than their White, native-accented counterparts. Disparities in qualitative evaluations contribute to additional stress and inequity for marginalized faculty. Given the emotional toll and potential impact on career advancement, SETs should be critically reconsidered, with feedback triangulated alongside other objective measures to ensure fairer evaluations of teaching effectiveness.

Introduction: This study investigates the relationship between Accreditation Review Commission on Education for the Physician Assistant Standard A (Administration) citations and the attributes of sponsoring institutions for physician assistant (PA) programs. It also explores the association between initial program accreditation date and Standard A citations. The hypothesis suggests that resource levels, infrastructure, and clinical enterprise relationships of different institution types influence compliance with Standard A requirements.

Methods: Data on accreditation citations were obtained from publicly available sources on arc-pa.org, while sponsoring institution attributes were retrieved from Physician Assistant Education Association Data on Demand. The study included 309 PA programs with citations recorded from September 2020 through September 2023. Descriptive statistics summarized key characteristics, and chi-square tests examined relationships between categorical variables and Standard A citations. Analysis of variance assessed associations between initial accreditation year and Standard A citations, with significant results analyzed using the Tukey Honest Significant Difference test (P < .05).

Results: Of the 309 programs analyzed, 63 received Standard A citations, primarily for "Fair Practices and Admissions" (31), "Institution Responsibilities" (27), and "Program Director" (30). Programs housed in nonacademic health centers were more likely to receive citations (23.1%) compared with those in Academic Health Centers (AHCs) (7.4%). Significant associations were found between AHC status and both Institution Responsibilities (Χ2(4) = 4.098, P = .043) and overall A Standard citations (Χ2(4) = 8.167, P = .004).

Discussion: Findings suggest that PA programs in nonacademic health centers are over 3 times as likely to receive Standard A citations. Although causation cannot be inferred, AHCs may inherently provide greater resources that enhance compliance with Administrative Standards.

Introduction: Tools for assessing noncognitive attributes like professionalism have been added into physician assistant/associate (PA) programs admission practices. Situational judgment tests (SJTs) like Casper are gradually being adopted into holistic processes to meet this need. The study explores whether a relationship exists between a student's Casper z score and receipt of a professionalism infraction during PA school.

Methods: This quantitative study used a cross-sectional, nonexperimental design. Purposive sampling of 3 cohorts of PA students (N = 131) who completed the curriculum were included. The Pearson chi-square and Fisher exact test were used for assessing aggregate data. Statistical significance was predetermined at P < .05.

Results: Chi-square testing showed a statistically significant difference between the observed and expected variables (Χ2(1, N = 131) = 7.230, P = .007). The Fisher exact test showed a statistically significant association between the variables P = .016 with the results unlikely because of chance. Thus, there is a statistically significant relationship between a negative Casper z score and receipt of a professionalism infraction and a positive Casper z score and not receiving a professionalism infraction.

Discussion: Situational judgment tests like Casper can serve as a data point in holistic admission processes to prepare faculty for students who may need additional support in meeting professionalism competence. Personal biases and program expectations around professionalism standards must be acknowledged when assessing prospective and current students. Additional research is needed on SJTs and admission processes, student promotion practices, and implications for future clinical practice.

Introduction: The shift toward virtual interviews in physician assistant/associate (PA) admissions accelerated during the COVID-19 pandemic, yet little is known about applicants' modality preferences. This study aimed to determine whether personal characteristics were associated with applicants' choice of interview format and to assess whether interview type was associated with admission outcomes and first-semester academic performance.

Methods: This multicenter retrospective study included 405 interviewees to 3 private PA programs during the 2023 to 2024 admission cycle. Applicants chose either in-person or virtual interviews. Data were extracted from Centralized Application Service for Physician Assistants and institutional records and included demographics, academic metrics, and interview outcomes. Bivariable analyses and logistic regression were used to explore associations between interview type, admission status, matriculation, and grade point average (GPA).

Results: Of 405 interviewees, 270 chose in-person and 135 virtually. Those who chose virtual interviews were older, more likely to be male, lived farther from campus, had more patient care experience, and were more likely to identify as underrepresented in medicine (URiM). Among matriculants, those who interviewed virtually were more likely to report economic and environmental disadvantage. The proportion of interviewees offered admission and the proportion that matriculated were higher for those who chose in-person interviews than for those who chose to interview virtually. Interview type was not associated with first-semester GPA. Logistic regression identified URiM status and geographic distance as significant predictors of virtual interview choice.

Discussion: Offering virtual interviews may promote greater access and diversity without compromising academic outcomes. Applicants with URiM backgrounds or greater geographic/economic constraints were more likely to choose virtual formats. These findings support continued offering of virtual interviews as a strategy to reduce barriers in PA admissions.

Introduction: Advancing to an entry-level doctoral degree in physician assistant/associate (PA) education has raised concerns about potential faculty shortages. This cross-sectional, descriptive study examined hiring practices for PA faculty in PA programs and faculty qualifications required by the sponsoring institutions. The purpose of this study was to examine whether faculty qualification requirements differ between PA programs and institutions.

Methods: Two separately distributed surveys assessed faculty hiring policies across 310 accredited PA programs and 273 sponsoring institutions. Piloted for content validity, surveys were distributed via email from March-May 2025 to PA program directors and chief academic officers. Respondents reported on policies for hiring principal (ie, full-time), didactic instructional (ie, part time), and preceptor faculty, including degree requirements, relevant qualifications, and minimum experience expectations. Data were summarized descriptively.

Results: Among responding PA program directors, 78% required full time principal faculty to hold a master's degree. For preceptor roles, programs required an average of 1.8 years of professional experience, with only 19% mandating a master's degree. Regarding sponsoring institutions, 73% of those responding indicated that full-time faculty hiring decisions were based on either an earned terminal degree or consideration of additional expertise or qualifications.

Discussion: Although neither institutional nor accreditation standards universally mandate policies that exclusively consider academic credentials, 78% of responding PA programs appear to apply degree expectations for full-time principal faculty. Experience remains a primary qualification for preceptors, with formal degree requirements less common. These findings offer insight into current hiring practices and faculty qualification requirements amid ongoing discussions about doctoral-level entry into the profession.

Introduction: The purpose of this study was to identify physician assistant (PA) program characteristics that predict interprofessional education (IPE) practice and contribute to the development of synergistic relationships across different health care education programs.

Methods: This concurrent explanatory mixed methods study was designed to elucidate relationships between IPE and PA program characteristics. Quantitative data provided by the PA Education Association from the 2019 Didactic Survey were explored for correlations between program characteristics and IPE. Concurrently, a purposeful sample of 7 PA educators contributed qualitative data via semistructured interviews, which were analyzed from a phenomenological perspective.

Results: Although no statistically significant predictive relationships were found among IPE ratio of the curriculum and program characteristics, qualitative data revealed themes of logistics, motivation, and collaboration.

Discussion: Study findings illuminate strategies for creating synergies that support successful IPE. Programs and institutions may increase IPE practice experiences for their students through the motivation of educators and leaders. Considering the diversity of PA programs, sharing ways to facilitate more collaboration among health care educators can increase IPE practice in PA education.