Abstract: Neurodiversity, encompassing conditions such as autism spectrum disorder, attention-deficit/hyperactivity disorder, and dyslexia, represents a significant and often under-recognized segment of the population, including within science, technology, engineering, mathematics, and medicine fields like medicine. Neurodiverse individuals possess unique skills, including enhanced creativity, analytical thinking, and meticulous attention to detail, which are valuable in health care professions. However, failure to recognize and support these individuals can result in missed opportunities, social isolation, and mental health challenges. Despite a growing emphasis on diversity, equity, inclusion, and belonging in higher education, neurodiversity is frequently overlooked, particularly in physician assistant (PA) education. This article examines the unique challenges faced by neurodiverse PA student learners and the existing literature gap regarding neurodiversity in PA education. It underscores the need for greater awareness, reduced stigma, and improved support systems. Recommendations include integrating neurodiversity into the PA curriculum, providing faculty training on inclusive teaching practices, and establishing tailored accommodations to foster a sense of belonging. PA programs can foster a more equitable health care system by creating inclusive learning environments that acknowledge and cater to the unique needs of neurodiverse student learners, thereby enhancing student-faculty interactions and promoting academic success. The aim of this article was to facilitate the reimagining of PA education to champion cognitive diversity. By promoting a more inclusive learning environment, PA programs can cultivate future clinicians who are better equipped to serve diverse patient populations.
Introduction: Creating a successful remediation plan for physician assistant/associate students comes with its challenges, particularly because of the limited time available for both faculty and students. In an accelerated 24-month program, the pace of the curriculum leaves little time to fall behind in mastering knowledge and skills. One possible solution is appointing an adjunct faculty member to serve as a dedicated Remediation Specialist (RS) to focus solely on student remediation.
Methods: The RS reviews assessments of failing students and develops a review session based on shared areas of weakness among them. This session is promptly offered postassessment to ensure timely review. While required for failing students, the session is open to all didactic students. In addition, students complete a remediation assignment of their choice.
Results: Implementation of a RS demonstrated positive program outcomes. Students requiring remediation receive re-education in areas of deficiency within the curriculum. Furthermore, the time burden is shifted away from the core faculty. Students are remediated in targeted areas.
Discussion: Dedicated remediation specialists are commonly used in health profession education programs. The utilization of these specialists often results in higher examination pass rates, licensure pass rates, and improved clinical skills. While some programs select a candidate training in education and pedagogy, our program's RS is a trained physician assistant/associate and able to provide discipline-specific support.
Introduction: As the world becomes more technology focused, emerging technologies such as extended reality (XR) have been incorporated into medical education over the past few decades. Now that XR is more accessible to physician assistant (PA) education, educators must determine the extent to which XR can improve knowledge retention over current modalities. The purpose of this article was to perform a review of what XR pedagogical approaches are being used in PA education and what value they provide to learning.
Methods: A thorough literature database search conducted by a research librarian identified 228 unique articles published between 2012 and August 2023. These articles were further categorized by date, language, study method, and population sample and further screened for relevance and eligibility. Of the 228 unique articles identified, 8 met the eligibility criteria for this review.
Results: The focus of research ranged from XR integration to proof of concept of XR in educational environments. Selected studies used both qualitative and quantitative data. General impressions of XR in PA education reflect its potential to supplement current methods; however, the authors also admit the need for additional critical analysis.
Discussion: While there is a paucity of research into this specific topic, multiple studies showed that using XR principles in medical education led to better confidence among students and improved their perception of learning. While there currently is no direct statistically significant evidence to show a superiority of XR over traditional didactic learning, it is important to consider that not all educational tools need to improve outcomes; rather, they can improve student perception, which opens the door to further learning. Future studies should continue to longitudinally evaluate integrating XR into PA programs with a specific focus on knowledge retention.
Introduction: Gender minorities are undermeasured among physician assistant/associate programs and across the profession. This study describes the 2020 to 2021 Centralized Application Service for Physician Assistants self-identified gender minority applicant pool, examining whether gender minority status is associated with matriculation.
Methods: A retrospective cohort of 2020 to 2021 admission cycle participants (n = 30,123) was described and evaluated for associations between self-identified gender minority status and likelihood of program matriculation using logistic regression. Models were controlled for important potential confounders, including total undergraduate grade point average, race/ethnicity, hours of patient experience, and age.
Results: Of the 30,123 total applicants, 0.21% (n = 63) self-identified as a gender minority. Total matriculation was 27.64% (n = 8325) compared with gender minority matriculation of 20.63% (n = 13). Gender minority status was associated with a nonsignificant lower likelihood of matriculation (odds ratio [OR] = 0.68; 95% confidence interval [CI]: 0.37-1.25). Fully adjusted models were unchanged controlling for academic achievement, patient care experience, age, and race/ethnicity (OR = 0.83; 95% CI: 0.51-1.35).
Discussion: These findings suggest that gender minority applicants have a similar likelihood of matriculation in physician assistant/associate programs as compared with non-gender minority applicants. Low prevalence of self-identified gender minority status could indicate reluctance to self-identify and is concerningly lower than population prevalence.
Abstract: Knowledge is power, and with that power comes the responsibility to share it. As physician assistant (PA) students, we have seen how life-saving skills like cardiopulmonary resusictation (CPR) can bridge gaps in equity and access. Yet, research reveals that minority communities are less likely to perform CPR during an out-of-hospital cardiac arrest (OHCA). For many, this hesitation stems from fear or lack of knowledge, and it is a critical problem. Each year, over 350,000 Americans experience OHCA, but only 40% receive timely bystander CPR, with significant disparities for women and minority communities. To address these disparities, we joined Coronary By-Physician Assistant Students (Coronary By-PASs), an initiative to teach hands-only CPR in Durham, NC. Founded by Duke PA Program alumna during her training, Coronary By-PASs focuses on overcoming barriers to CPR training, such as financial constraints and geographical inaccessibility. During our involvement, the program grew into a sustainable, student-led project, with a lasting impact on future cohorts. We taught CPR to diverse communities, many of whom had never received training before and built trust through meaningful engagement. One memorable moment came when a participant expressed feeling included for the first time because of diverse training manikins. This experience taught us not only how to teach CPR but also how to foster trust and hope within communities. Beyond CPR instruction, we gained invaluable skills in community planning, advocacy, and communication. Coronary By-PASs is not just a program; it is a model for bridging health care gaps and creating lasting change. We are committed to continuing this work, empowering communities and advancing health care equity.
Introduction: Burnout is prevalent among both physician assistant (PA) students and faculty in the United States. Theories concerning the root cause of this burnout include a breakdown of community, which, in this context, serves as a framework comprising membership, influence, integration and fulfilment of needs, and shared emotional connection. A community framework has yet to be formally applied to the PA learning environment. The objective of this study was to explore the ways in which PA students experience community with faculty and how this perceived sense of community affects those students' perceived well-being.
Methods: This was a qualitative study completed using semistructured, one-on-one virtual interviews with PA students of the graduating class of 2024 at one institution devised by using an interview guide created by the investigators based on a community framework. Interviews were recorded and transcribed by Microsoft Teams and analyzed using thematic analysis.
Results: Three major themes were produced from four participant interviews: (1) Students felt interactions with faculty were uniquely positioned to affect their well-being as influenced by their level of vulnerability as a student in a rigorous program; (2) students observed a wide range of faculty actions, values, and personality qualities that promoted a sense of community with faculty; and (3) students perceived a fragmentation between faculty members and the class itself, as well as between the two entities, which impaired their sense of community.
Discussion: PA students are vulnerable community members with a wide range of needs. Faculty interactions are crucial to meeting those needs. Future research can involve the recruitment of additional students, cohorts, or programs for diversified perspectives.
Introduction: Physician assistants (PAs) should understand the implications and risks involved with airway management. Our study aimed to facilitate PA students' familiarity with airway management with instruction from anesthesiology residents. We assessed the students' knowledge of airway management both before and after a seminar to see if knowledge was retained.
Methods: Physician assistant students participated in a seminar (didactic lecture and a hands-on workshop) on airway management led by anesthesiology residents. The students took a true-false pretest and repeated the test following the seminar. After four months, the students repeated the same true-false test to assess retention. We used Friedman test to analyze differences between the pretest, posttest, and retention tests, as well as performed an itemized analysis on the questions.
Results: The students showed a significant difference between the pretest and posttest ( P < 0.001) and between the pretest and retention test ( P = 0.006). Students performed better per question on the retention test compared with the pretest, except for a question related to an indication for intubation (Z score = -2.757; P = 0.006).
Discussion: Our results demonstrated that educating PA students in airway management with anesthesia resident direction resulted in a statistically significant increase in their knowledge on the topic four months after the training. Interactive learning seems beneficial for gaining knowledge on the basic principles of airway management.
Introduction: As new equity, diversity, and inclusion programs emerge in physician assistant/associate (PA) education, there is a need to assess baseline levels of implicit and explicit biases among PA preceptors' and trainees. The objectives of this study were (1) to measure implicit and explicit race (Black/White) and weight (fat/thin) biases among PA preceptors and trainees and (2) to identify potential gaps in PA preceptor and trainee education.
Methods: This is a cross-sectional study of PA preceptors and trainees from one program operating in several US states; implicit and explicit race and antifat biases and receipt of prior education were measured.
Results: Preceptor response rate was 6.4% (N = 78) from an eligible population of 1222, and trainee response rate was 25.7% (n = 43) from an eligible population of 167. Sixty-eight preceptor participants (87.2%) and 23 trainees (53.5%) identified as White. Preceptors held strong (Cohen d = 0.81), and trainees held moderate (Cohen d = 0.43) pro-White implicit bias. Overall, preceptors and trainees held little and no explicit race bias (Cohen d = 0.18 and d = 0.0, respectively). Preceptors and trainees held strong implicit antifat bias (Cohen d = 1.24 and Cohen d = 0.76). Preceptors held moderate explicit antifat bias (Cohen d = 0.65); trainees held strong explicit antifat bias (Cohen d = 0.95). Trainees received significantly more education on working with diverse populations compared with preceptors (100% vs. 57.7%, P < 0.001) and working with patients who are overweight (74.4% vs. 41.0%, P < 0.001).
Discussion: Implicit race and antifat bias exists among our sample of PA preceptors and trainees. A gap in education for preceptors on working with diverse populations and patients who are overweight was identified. Future research should address both.
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.
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