Journal of Physician Assistant Education最新文献

Introduction: Artificial intelligence tools show promise in supplementing traditional physician assistant education, particularly in developing clinical reasoning skills. However, limited research exists on custom Generative Pretrained Transformer (GPT) applications in physician assistant (PA) education. This study evaluated student experiences and perceptions of a custom GPT-based clinical reasoning tool.

Methods: A mixed-methods study was conducted with first-year PA students (n = 72) at Butler University in April 2025. Students engaged in a custom GPT-4-Turbo Butler University PA Clinical Case Companion, designed to deliver interactive clinical cases using Socratic dialogue across hematology and nephrology specialties. Postengagement surveys assessed students' perceptions of the tool's helpfulness, cognitive challenge, and clinical skill development across 7 clinical domains. Surveys used Likert scales and open-ended questions. Researchers applied descriptive analysis on quantitative data and thematic analysis to qualitative responses.

Results: Fifty-nine students completed surveys (81.9% response rate). Ninety percent of respondents rated the tool moderately to extremely helpful. Students reported significant improvement in developing differential diagnoses (79.7%), ordering diagnostic studies (81.4%), and interpreting tests (78.0%). Qualitative analysis revealed 3 primary themes: appreciation for immediate feedback (36%), detailed real-time explanations (36%), and receiving GPT-initiated student prompting (12%). Students suggested earlier curriculum integration and expressed concerns about the accuracy of case content.

Discussion: Custom GPT-based clinical reasoning tools can serve as an adjunct to traditional PA educational methods by offering personalized, on-demand learning experiences. Students perceived substantial benefits in developing clinical reasoning skills, but noted limitations in history-taking skills. Implementation should include faculty oversight and artificial intelligence literacy training to address accuracy concerns while maximizing educational benefits.

Abstract: Over the past decade, there has been a robust increase in the number of Physician Assistant/Associate (PA) Programs operating in the United States. Curriculum design and construction remains a major activity and strategic priority for our profession as PA education faculty. However, our curriculum design, redesign, and renewal initiatives are often focused on unique and idiosyncratic changes or "tinkering" that can lead to curriculum dilution and drift. An alternative approach to curriculum design is to view the curriculum as a culture. Through this lens, curriculum design becomes a reculturing that provides programs with opportunities to embed curricular values into the learning environment, curricular decision making, and learner-centered educational experiences. This article reflects on a decade of curricular reculturing in our program including how we designed and built the Colorado Curriculum using a curricular culture approach, the pressures it encountered, and the intersections at which we find ourselves as we identify current opportunities for re-engagement. Most importantly we identify and share our major lessons learned including the profound cultural shift activated by such a cultural approach; the substantial time investment required; and the critical commitments to conscious and consistent communication and onboarding needed to hold the program and change initiative together.

Introduction: Physical activity positively affects physical, mental, and emotional health and enhances academic performance. However, many students fail to meet recommended activity levels. Research indicates that graduate students' physical inactivity rates align with national averages, with sedentary behavior increasing due to academic demands. Similarly, physician assistant (PA) programs, characterized by intense didactic and clinical phases, often leave little time for physical activity, potentially affecting health and academic outcomes. The purpose of this study was to examine the relationship between physical activity, academic performance, and overall health in PA students.

Methods: A 26-item survey collected self-reported data on demographics, physical activity habits, academic achievements, and perceptions of well-being. Outcome measures included a modified PA Education Association survey and World Health Organization (WHO) global physical activity questionnaire. The survey was distributed to 309 PA programs and social media platforms, reaching 5510 students.

Results: Of 870 responses (16% response rate), 794 PA students (54.85% didactic, 45.15% clinical) were included. Moderate-intensity physical activity correlated with a higher grade point average (GPA), having associations with frequency (P < .001) and duration (P = .034). Vigorous activity had no significant relationship with GPA but was associated with body mass index (P = .006). Physical activity also correlated with reduced stress (P = .002) and increased social engagement (P = .001).

Discussion: Moderate-intensity activity correlated with better academic performance, physical and mental well-being, stress reduction, and social engagement. However, PA students' activity levels fall below WHO recommendations, mirroring broader trends in the United States and globally.

Introduction: In response to an Accreditation Review Commission on Education for the Physician Assistant Standards, 5th edition requirement for instruction on provider personal wellness, evidence-based multicomponent wellness programming was integrated into didactic and clinical phases of a physician assistant (PA) education program. This study aimed to examine whether PA students' perceived stress declined from before to after their participation in each semester's wellness programming and to gauge students' perceptions of programming acceptability and success.

Methods: Three cohorts of students enrolled in mandatory wellness programming were invited to complete pre- and post-programming assessments over 4 semesters. Linear mixed models were used to examine change in perceived stress from pre- to post-phase programming over time. Mean satisfaction ratings and thematic analysis of qualitative data were used to examine acceptability, success, and students' program improvement recommendations.

Results: There were 121 pre- and 87 post-assessments completed with 110 (95%) of students completing at least one assessment; 43 students from 2 cohorts rated program satisfaction and 34 provided open-ended feedback. On average, perceived stress declined by about 5.7% from before to after programming. Decline in perceived stress did not differ based on gender, program phase, or cohort. Female students had higher perceived stress compared with male students on average over time. Students' average program satisfaction was "neutral." They recommended more autonomy and personalized wellness programming.

Discussion: This research suggests that multicomponent wellness programming is associated with a small decline in students' perceived stress. Increasing students' autonomy to select and engage in personally relevant programming may improve outcomes.

Introduction: The current study examined the correlation between physician assistant/associate (PA) learner intersectional identities, stress, well-being, and PA program application data. We investigated how multiple marginalized identities (MIs) affect PA students' experiences, including their decision timing to enter the profession, stress levels, and overall well-being.

Methods: Using data from the PA Education Association 2019 Matriculating Student Survey, multivariate logistic regression was used to examine the relationship between MIs, stage of life one decides to become a PA, age at graduation, and stress and well-being among PA students. The odds of increased stress and well-being among those with single or multiple marginalized identities were also assessed.

Results: On average, nonmarginalized students were more likely to decide to become a PA at an earlier age (P < 0.001). Marginalized students submitted fewer PA school applications and were less likely to receive acceptance letters (P = 0.001). Compared with their nonmarginalized counterparts, both single and multiple MIs had increased stress levels. In addition, the prevalence of financial concerns was significantly higher among marginalized populations (P < 0.001).

Discussion: This study highlighted the significant impact of intersectionality and having multiple MIs on the health and well-being of PA students. Individuals who identify with multiple MIs, experience increased stress levels, increased financial concerns, and diminished overall well-being.

Introduction: This study examined demographic characteristics among physician assistant/associate (PA) program applicants who were offered admission and among matriculants at 5 PA programs that eliminated the Graduate Record Examination (GRE) admissions requirement.

Methods: Collated admissions data for 4 cycles were categorized into 2 periods, one representing 2 cycles before GRE removal (GRE period) and one representing 2 cycles after GRE removal (no-GRE period). Chi-square analyses were used to compare percentages of applicants offered admission and percentages of matriculants who were from backgrounds underrepresented in medicine (URiM), were first-generation college students, and who reported economic disadvantage (ED) across the 2 periods.

Results: Individual program outcomes varied. Some experienced statistically significant increases in various measures; others experienced increases or decreases that were insignificant. Collectively, compared with the GRE period, the proportion of applicants offered admission during the no-GRE period who were URiM was 6.2% higher (P = .002, 95% confidence interval [CI] [2.3%, 10.1]); the proportion who were first-generation was 11.2% higher (P < .001, 95% CI [7.3%, 15.0%]); and the proportion with ED was 9.4% higher (P < 0.001, 95% CI [5.8%, 13.0%]). Among matriculants, the proportion who were URiM was 8.7% higher (P = 0.001, 95% CI [3.7%, 13.6%]), the proportion who were first-generation was 8.6% higher (P = 0.001, 95% CI [3.8%, 13.5%]); and the proportion with ED was 8.8% higher (P < 0.001, 95% CI [4.2%, 13.3%]).

Discussion: Study results suggest that for some PA programs, eliminating the GRE admissions requirement may positively contribute to various approaches to admitting more students from diverse backgrounds.

Abstract: According to the National Commission on Certifications of Physician Assistants, approximately 1.8% of physician assistants (PAs) work in general pediatrics. In addition, PAs work in varying pediatric subspecialties, such as cardiology, neonatology, and emergency medicine. Each of these subspecialties accounts for less than 0.1% to 0.4% of practicing PAs. Currently, 0.3% of PAs work in pediatric emergency medicine (PEM). Given the specialization of PEM, as well as other pediatric subspecialities, additional postgraduate education is essential to support PA competency and self-efficacy. Educational approaches may range from self-directed learning, case-based discussions, lectures, workshops, and other strategies. At Children's National Hospital in Washington, DC, our Advanced Practice Provider education team implemented discussion-based sessions tailored to the interests and needs of recently hired and newly certified PAs.

Abstract: Artificial intelligence (AI) is increasingly being used across a broad spectrum of careers and institutions, with its adoption in the setting of higher education expected to exponentially increase in the coming years. As its relevance and use increases, the incorporation of AI must be done responsibly and ethically, upholding the laws and regulations under which educational institutions operate to protect student privacy and nondiscrimination rights. Ensuring responsible use requires collaboration among various institutional departments and educators. By fostering such relationships and understanding ethical considerations regarding the use of AI, higher education institutions can make use of the advantages of AI while protecting students' rights.

Introduction: There are two aims to this study: does ageism exist in health care students and if so, is a clinical simulation featuring interprofessional education with standardized patients an effective mitigator?

Methods: This was a nonequivalent, mixed methods, multiple group pretest-post-test, one site design. Ninety-one subjects were included. The outcome measures included 3 ageism instruments, discharge recommendations and rationale, and debriefing assessment.

Results: Data indicate ageism is common among health care students. Nearly 80% of students tested pre-intervention were found to favor younger over older people. Pre and post results found a difference ( P < .001) indicated the effectiveness of the mitigating intervention. Before the intervention, age was the primary factor for discharge decisions. For postintervention, the rationale changed to clinical and patient variables. Discharge locations similarly changed. The debriefing analysis revealed 5 student themes: lack of awareness, mitigation need, guilt, building interprofessional connections, and the beneficial nature of the experience.

Discussion: Our results indicate a prevalence of implicit ageism in entry-level physician assistant and PT students which impacted clinical decision-making related to discharge plans. An interprofessional education with clinical simulation and standardized patients proved to be an effective bias mitigator within this group.

Abstract: Artificial intelligence (AI) is rapidly transforming various areas, including health care and education. This article explores the role of AI in physician assistant (PA) education, examining its current uses, potential benefits, and ethical considerations. Artificial intelligence, particularly through tools like ChatGPT and other large language models, offers significant promise in PA education. These models can understand, summarize, translate, predict, and generate text, providing clear and simple responses to complex questions. The potential for AI to enhance PA education is immeasurable, ranging from administrative assistance to clinical decision support and personalized learning experiences.