Physician Assistant School Applicants' Perceptions of Virtual Interviews.

PURPOSE: To evaluate the attitudes of applicants of virtual physician assistant (PA) school interviews during the 2021-2022 cycle which was impacted by the COVID-19 pandemic. METHODS: This quasi-experimental design studied applicants to PA programs in the United States. The study recruited applicants who interviewed virtually between March 2020 and January 2022 via an anonymous online survey. In addition to demographic information, the survey contained 20 questions regarding virtual PA school interviews. RESULTS: Study population n= 164. Most of the study participants were interviewed using a Zoom platform (n=147). Overall, there was an above-neutral satisfaction with virtual interviews (3.7 ±1.0, X2= 91.2, p=0.00001). The majority of participants preferred a virtual platform (56%) versus an in-person interview (44%). When stratified by race, 87% of non-White participants preferred a virtual platform for admissions. Ranked order benefits of attending virtual interviews included lower travel cost, less time away from work, ability to interview at more PA programs, and comfort interviewing at home. CONCLUSION: Virtual interviews were adopted by many medical education programs during the COVID-19 pandemic. This study provides support that PA applicants prefer a virtual platform due to lower cost and less time away from work. Further research is needed to determine preferences outside PA admissions.

Thinking Outside the Box: Advancing Clinical Education in an Era of Preceptor Shortage.

ABSTRACT: The expansion of health professions educational programs has led to an acute shortage of available clinical training sites. Rapid growth in the number of medical schools, physician assistant (PA) programs, and advanced nurse practitioner (APRN) programs, all of which share a need for similar types of clinical training experiences, has increased competition for clinical training sites and placed new challenges on educational institutions. Solutions are urgently needed to increase the quantity and quality of supervised clinical practice experiences as well as to ensure diversity among preceptors and geographical clinical sites. This article identifies key barriers to securing sufficient clinical training sites, notes emerging trends, and presents potential innovations through stakeholder collaboration for enhancing clinical training across health professions.

Substance Use Among Physician Assistant Students: A National Study on the Prevalence of Alcohol, Tobacco, Illicit Substances, and Medication Use.

INTRODUCTION: The purpose of this study was to discover the substance use prevalence among physician assistant students (PA-S) compared with the age-relevant general US population and to examine the frequency of stress, burnout, anxiety, and depression during the didactic and clinical phases, while accounting for the impact of the COVID-19 pandemic. METHODS: A 20-item survey instrument was created. Self-reported data included demographics, anxiety, burnout, tobacco, illicit substances, and prescription medication use. Outcome-based inventories included a modified Perceived Stress Scale, Patient Health Questionnaire-2 (PHQ-2), and Alcohol Use Disorder Identification Test-Concise. The survey was emailed to all US programs (∼270 programs; ∼25,000 students), with 54 programs approving dissemination to their students (n∼4,760). RESULTS: Of the 1432 responses (30% response rate, 96% completion rate), the final validated sample was 1378 students (56.1% didactic, 43.8% clinical). When compared with the national population, PA-S prevalence for tobacco (5.2%) and illicit substance use (9.9%) were notably lower; alcohol (53.5%) was comparable; and prescription medication (7.0%) is only reported for PA students due to the lack of a national comparison. A higher frequency of substance use was observed during the didactic (52.5%) vs clinical (47.5%) phases. Stress was the dominant factor in both phases (93.5% didactic, 86.1% clinical). Respondents reported that the COVID-19 pandemic had minimal impact on reported rates, other than alcohol. DISCUSSION: Although PA-S substance use prevalence is at or below the national population, PA programs are encouraged to review their policies and provide conversations and resources for students who may have one or more risk factors and experience a negative effect from current substance use.

The Relationship Between Job Satisfaction and Faculty Turnover Among Physician Assistant Educators During the COVID-19 Pandemic.

INTRODUCTION: This research explored the relationship between job satisfaction and intent to leave among physician assistant (PA) educators during the COVID-19 pandemic. Additionally, the study aimed to identify differences in PA educators' job satisfaction within gender and their intention to stay at their current employment. METHODS: A nonexperimental, cross-sectional survey was conducted with 1788 PA educators at 232 accredited programs nationally. A Web-based survey was employed to measure job satisfaction and intent to leave and to collect demographic information. Descriptive statistics were used to describe the study population, and logistic regression was used to analyze the independent variables predicting faculty turnover. RESULTS: PA educators were generally satisfied with their jobs (51.2%, n = 251), with the nature of the work, quality of supervision, and collegial relationships contributing the most to job satisfaction. Males were generally more satisfied with their jobs than females. More than half of the PA educators (52.4%, n = 257) considered leaving academia in the past year. Job satisfaction (odds ratio [OR] = .945, 95% confidence interval [CI] = .936-.956) and individual facets-including the nature of the work (OR = .806, 95% CI = .731-.888); communication (OR = .926, 95% CI = .860-.997); and quality of supervision (OR = .904, 95% CI = .850-.960)-were predictive of intent to leave. Gender was not found to significantly affect the relationship between job satisfaction and intent to leave. DISCUSSION: The findings from the study suggest the need for faculty retention to be prioritized among program and institutional leadership. PA programs need experienced leadership to develop, guide, and mentor faculty. Lastly, program and institutional leadership should create a supportive work environment that communicates clear expectations.

The New York State COVID-19 Healthcare Personnel Study: One-Year Follow-up of Physicians, Nurse Practitioners, and Physician Assistants, 2020-2021.

OBJECTIVES: The COVID-19 Healthcare Personnel Study is a longitudinal survey to assess the changing impact of the COVID-19 pandemic on the New York State health care workforce. We analyzed results from a follow-up survey of physicians, nurse practitioners, and physician assistants on the availability of equipment and personnel, work conditions, physical and mental health of participants, and impact of the pandemic on commitment to their profession. METHODS: We conducted an online survey of all licensed New York State physicians, nurse practitioners, and physician assistants in April 2020 (N = 2105) and a follow-up survey in February 2021 (N = 978). We analyzed changes in item responses from baseline to follow-up. We calculated survey-adjusted paired t tests and odds ratios (ORs) using survey-adjusted generalized linear models controlling for age, sex, region of practice, and hospital versus non-hospital-based practice. RESULTS: Twenty percent of respondents expressed continuing concern about personnel shortages at both baseline and follow-up. Respondents reported working approximately 5 more hours on average during a 2-week period at follow-up compared with baseline (78.1 vs 72.6 hours; P = .008). For 20.4% (95% CI, 17.2%-23.5%) of respondents, mental health issues had become persistent. More than one-third (35.6%; 95% CI, 31.9%-39.4%) of respondents reported that they thought about leaving their profession more often than once per month. The association between persistent mental and behavioral health issues and contemplating leaving one's profession was significant (OR = 2.7; 95% CI, 1.8-4.1; P < .001). CONCLUSIONS: Interventions such as decreasing the number of hours worked, ensuring health care professionals do not work directly with patients while ill, and addressing shortages of personal protective equipment can help address concerns of the health care workforce.

The PA profession in Liberia: A case study in pioneering innovation and resiliency.

ABSTRACT: In Liberia, the physician assistant (PA) profession began in the mid-1960s. PAs have had a major role in providing access to healthcare for patients, many of whom live in poverty and reside in remote areas where access to physicians may be severely limited. In 1964, representatives from UNICEF selected Agnes N. Dagbe, MS, RN, to be the first director of a new PA program to be developed at the Tubman National Institute of Medical Arts. Dagbe was sent to Russia to learn about their feldsher profession, which served as a significant source of inspiration for the newly emerging PA profession in Liberia. To date, Liberia has faced extreme shortages of physicians, the ravages of two brutal civil wars over a 14-year period (1989-2003), as well as outbreaks of the Ebola and COVID-19 viruses. Now, more than 54 years since the first class graduated, PAs are vital for the delivery of essential healthcare services for the citizens of Liberia.

Virtual Physician Assistant Program Interviews: Faculty and Applicant Perspectives.

INTRODUCTION: Many physician assistant (PA) programs converted from traditional in-person admission interviews to virtual interviews during the COVID-19 pandemic. The purpose of this study was to investigate the perceptions of both PA faculty and applicants to PA programs about the virtual interview process. General perceptions, advantages, and disadvantages were explored. METHODS: A mixed-method approach was implemented to collect data using 2 survey instruments: one for PA program applicants and another for PA program faculty. The surveys were created using a combination of previously used and new questions and distributed through email and social media. Descriptive statistics were used to analyze the independent and dependent variables. Chi-square, one-way ANOVA, and Spearman's rho correlation were conducted to analyze potential relationships between variables. Qualitative data were analyzed using an iterative process and inductive reasoning to identify recurring themes and code responses into common topical categories. RESULTS: Completed surveys were received from 178 applicants and 325 faculty members. If given the choice, most applicants favored virtual interviews (62.4%), while the majority of faculty preferred in-person interviews (64.0%). The majority of applicants (84.6%) and faculty (64.9%) were comfortable making a decision about the program or applicant, respectively, after the virtual interview process. The top 3 advantages of virtual interviewing for both faculty and applicants included convenience, decreased travel time, and cost savings. DISCUSSION: Both faculty and applicants perceived the virtual interview process positively, and thus, this modality may have enough advantages to support its use in the future.

Physician Assistant Program Perseveres Through COVID-19 Pandemic.

ABSTRACT: The COVID-19 pandemic has disrupted almost every aspect of life globally, with higher education one of many direct targets. Institutions and educators have been faced with urgent crises of how to conduct business as usual while maintaining expectations of high standards and uncompromised goals. As physician assistant (PA) educators at Seton Hall University, we rallied and brainstormed approaches to daily instruction to keep students on track and faculty both effective and sane. We tapped technological resources offered by our university, learned countless new skills, and adapted classroom activities to online virtual platforms. Creativity and flexibility became the norm as we modified the way we did everything while remaining laser focused on the ultimate objectives. Our intention was to provide insight, motivation, and, at a minimum, an example of how to do things differently when faced with roadblocks. We were inspired by an editorial by Mary Jo Bondy, DHEd, MHS, PA-C, former CEO of the Physician Assistant Education Association, in which she called for collective innovation, collaboration, publication, and circulation of stories. With that charge, we assembled a detailed account of how a didactic team within our faculty maneuvered the challenges created by COVID-19, in hopes of adding to the arsenal of small triumphs in this uncharted territory.

Accreditation in the Health Professions: Implications for Physician Assistant Education.

ABSTRACT: The accreditation process of health professions educational (HPE) programs is an essential ingredient in preparing a qualified healthcare workforce. Accreditation ensures that minimum standards are met by educational programs and contributes to pedagogical integrity, consistency, and academic policies and practices, leading to the desired quality of graduate outcomes. In this study, we analyzed key characteristics, policies, and practices for accreditation in 5 health professions to highlight emerging trends and discern implications for the physician assistant (PA) profession. There is growing evidence of movement toward outcome-based accreditation versus process-oriented accreditation and collaborative engagements between programs and the accreditors. Agencies are providing online discussion platforms and direct mentorship and, at the height of the coronavirus pandemic, offered virtual site visits. At an institution level, we observed a trend towards structured faculty development on accreditation, implementation of technology infrastructure for data collection, visualization and analysis, and the use of consultants for outsourcing certain elements of the accreditation process. There is a wide spectrum of approaches, from prescriptive to liberal, by the various accrediting agencies in enforcing compliance. A balance is desirable for the institutional-accreditor relationship to work effectively.

Posttraumatic Stress Disorder in a Physician Assistant After Working in an ICU During COVID-19.

INTRODUCTION: We present a case report of a physician assistant who experiences posttraumatic stress disorder (PTSD) from providing care to patients affected with COVID-19. We believe this case is important as it will reveal the unfortunate impact COVID-19 has on the mental health of health care professionals. CASE PRESENTATION: A 51-year-old White woman presented to our clinic with a 1-year history of panic attacks, mood swings, difficulty sleeping, nightmares, social withdrawal, guilt, and depression. DISCUSSION: Cross-sectional, survey-based studies have highlighted PTSD rates in health care workers during the pandemic, but these studies have not explored how exactly PTSD presents on the individual level. CONCLUSIONS: This case presents a compelling reflection on what could be a larger trend of increasing mental health issues as a direct result of the COVID-19 pandemic and emphasizes the need for better mental health support and infrastructure to be in place for the well-being of the health care workers in this country.

Assessing Harmful Bias and Celebrating Strength Through the Narratives of Black/African American Physician Assistant Students.

INTRODUCTION: Two national crises, the COVID-19 pandemic and systemic racism, have drawn nationwide attention to the disparities that exist in our society today. The American healthcare system, including physician assistant (PA) education, is not exempt from the impact of harmful bias and discrimination. The purpose of this study was to explore narratives recounting the experiences of Black/African Americans who have successfully completed their PA education in an attempt to understand how PA educators can better support students of color. METHODS: Qualitative, semi-structured interviews, guided by a critical race theory framework, were conducted with 6 Black/African American PAs who had graduated within the last 5 years. Trustworthiness was ensured through member checking, triangulation, peer debriefing during the coding and analysis process, and autoethnographic reflection. RESULTS: Themes of mentorship and cultural capital, including aspirations, family, social support, and resistance to an oppressive system, highlight the strengths present in Black/African American students. Additional themes surrounding stress related to race, including a pressure to prove, isolation and anxiety, and imposter phenomenon, all pointed toward the need for honest and safe dialogue among individuals with racial differences. DISCUSSION: This research article presents key findings and opportunities for PA educators to emphasize cultural capital to enable Black/African American PA students to thrive. Communicating across racial differences and intentional engagement are imperative for PA educators to successfully support Black/African American students.

COVID Collaborations: A Physician Assistant Program and Health Department Partnership.

ABSTRACT: The onset of the COVID-19 pandemic resulted in the displacement of clinical-phase medical learners across the country. Physician assistant (PA) and other health professions programs were challenged to innovate and offer alternate learning experiences that would meet students' needs as future health care professionals. At the same time, local and state health departments were faced with quickly increasing their capacity for contact tracing and case investigation in response to the growing number of COVID-19 infections. Through a collaborative partnership based on the needs of the local health department and clinical-phase PA students, the Duke PA program developed an elective in which students served as contact tracers and case investigators. PA students provided over 1500 hours of contact tracing and case investigation support to the local health department. Qualitative review showed students gained a greater appreciation of the impact of social determinants of health, saw first-hand how the pandemic disproportionately affected communities of color, and increased their knowledge about the role of public health. The partnership between the PA program and the health department was mutually beneficial and established a foundation for future collaborative experiences that support both the community and the needs of health professions' learners.

Assessing the Effect of the COVID-19 Outbreak on Didactic Education and Mental Health of Physician Assistant Students in the New York City Region.

INTRODUCTION: COVID-19 has profoundly affected life throughout the world, and it greatly impacted physician assistant (PA) education programs when the virus spread across the New York region 2 years ago. PA programs at Stony Brook University, Hofstra University, and the New York Institute of Technology were located in the epicenter of the pandemic and were forced to transition to online learning during the spring of 2020. The purpose of this study was to explore didactic PA students' perceptions of virtual learning, their mental health status, and the challenges and unexpected benefits they have faced during this historic time. METHODS: A consent form that linked to an 11-question electronic Qualtrics survey was emailed to all didactic students enrolled in the 3 participating PA programs. The survey data were used to conduct a descriptive analysis and a Spearman's ρ correlation analysis using SPSS 24 software. RESULTS: The survey response rate was 39% (89/229). The students perceived it to be more challenging to maintain the same level of academic achievement with virtual learning, although they felt they were able to meet learning objectives and be prepared for clinical clerkships. They reported experiencing greater stress, anxiety, and depression related to decreased socialization and isolation. However, the students said that their PA program provided enough support to assist with student needs, and they noted unexpected benefits of remote learning, including more time to spend with family members, increased schedule flexibility, and lower commuting costs. DISCUSSION: The PA students' education and mental health were negatively affected because of the abrupt transition from in-person to virtual learning. At the height of the COVID-19 pandemic, most of the students in the 3 participating PA programs in New York were affected by the change to remote learning and the subsequent lack of socialization. PA students experienced both challenges and benefits during this unscheduled virtual learning period. While students noted increases in mental health issues, they felt supported by faculty members and prepared to start clinical rotations.

The development of a visual dashboard report to assess physician assistant and nurse practitioner financial and clinical productivity.

The evolving COVID-19 pandemic has unevenly affected academic medical centers (AMCs), which are experiencing resource-constraints and liquidity challenges while at the same time facing high pressures to improve patient access and clinical outcomes. Technological advancements in the field of data analytics can enable AMCs to achieve operational efficiencies and improve bottom-line expectations. While there are vetted analytical tools available to track physician productivity, there is a significant paucity of analytical instruments described in the literature to adequately track clinical and financial productivity of physician assistants (PAs) and nurse practitioners (NPs) employed at AMCs. Moreover, there is no general guidance on the development of a dashboard to track PA/NP clinical and financial productivity at the individual, department, or enterprise level. At our institution, there was insufficient tracking of PA/NP productivity across many clinical areas within the enterprise. Thus, the aim of the project is to leverage our institution's existing visualization tools coupled with the right analytics to track PA/NP productivity trends using a dashboard report.MethodsWe created an intuitive and customizable highly visual clinical/financial analytical dashboard to track productivity of PAs/NPs employed at our AMC.ResultsThe APP financial and clinical dashboard is organized into two main components. The volume-based key performance indicators (KPIs) included work relative value units (wRVUs), gross charges, collections (payments), and payer-mix. The session utilization (KPIs) included (e.g., new versus return patient ratios, encounter type, visit volume, and visits per session by provider). After successful piloting, the dashboard was deployed across multiple specialty areas and results showed improved data transparency and reliable tracking of PAs/NPs productivity across the enterprise. The dashboard analytics were also helpful in assessing PA/NP recruitment requests, independent practice sessions, and performance expectations.ConclusionTo our knowledge, this is the first paper to highlight steps AMCs can take in developing, validating, and deploying a financial/clinical dashboard specific to PAs/NPs. However, empirical research is needed to assess the impact of qualitative and quantitative dashboards on provider engagement, revenue, and quality of care.

Initial Impact of the COVID-19 Pandemic on Physician Assistant Education.

PURPOSE: The COVID-19 pandemic significantly impacted United States (US) health professions educational programs. Physician assistant (PA) programs were forced to respond to rapidly changing circumstances early in the pandemic. This study describes the impact that the early phase of the COVID-19 pandemic had on PA programs in the United States. METHODS: This cross-sectional study is based on data from the COVID-19 Rapid Response Report 1, conducted by the Physician Assistant Education Association in April 2020. The survey sample included 254 US PA program directors with a response rate of 64.2%. Our outcome measures included temporary changes to PA program operations and clinical training, and current and upcoming budget and tuition changes, as well as the impact of the pandemic on faculty and staff employment. We used descriptive statistics to summarize these outcomes, stratified by 4 categories characterizing features of PA programs, including geographical location, academic housing, funding model, and academic health center status. RESULTS: The COVID-19 pandemic impact on programs varied geographically. A majority of programs reported making numerous temporary changes to their operations. Most programs moved both didactic and clinical education to an online format. Clinical training was temporarily suspended at almost all programs. CONCLUSIONS: PA programs continued training despite the pandemic. The long-term impact of the pandemic may be the instability of the PA education workforce.

COVID-19 and Physician Assistant Faculty Burnout: A Year into the Pandemic.

PURPOSE: The psychological effects of COVID-19 have been extensive and have affected health care workers and educators alike. The aims of this study were to evaluate how the COVID-19 pandemic has impacted PA faculty and their attitudes toward work. METHODS: Two quantitative, pre/post surveys were offered to 21 PA faculty at one institution prior to and then one year into the COVID-19 pandemic. PA faculty perceptions of workplace culture and burnout were included in the online surveys. RESULTS: Data were collected on 17 PA faculty (81% response rate). There was a statistically nonsignificant decrease in faculty disengagement (2.1 v 2.1, p = 0.87) and a statistically significant increase in faculty exhaustion (2.2 v 2.5, p = 0.005). There were statistically significant increases in communication, value, job satisfaction, and wellbeing workplace items. CONCLUSION: As many workplace protocols remain changed as a result of COVID-19, institutions should monitor and adjust processes to reduce the risk of burnout for faculty.

Opioid use disorder and COVID-19: Implications for policy and practice.

ABSTRACT: Preliminary data suggest that opioid-related overdose deaths have increased subsequent to COVID-19. Despite national support for expanding the role of physician assistants (PAs) and NPs in serving patients with opioid use disorder, these clinicians are held to complex and stringent regulatory barriers. COVID-19 triggered significant changes from regulatory and federal agencies, yet disparate policies and regulations persist between physicians and PAs and NPs. The dual epidemics of COVID-19 and opioid use disorder highlight the inadequate infrastructure required to support patients, communities, and clinicians, and may serve as the catalyst for eliminating barriers to care.

PAs and NPs provide essential care for children with COVID-19.

ABSTRACT: The rapid spread of COVID-19 brought forth a rapid increase in hospitalization rates, requiring changes in hospital use and medical personnel structure. Physician assistants (PAs) and NPs in pediatric critical care were cross-trained and redeployed to our pediatric biocontainment unit to address the clinician strain in providing high-quality patient care during these unprecedented times. This manuscript discusses the effectiveness of using these clinicians while recognizing the challenges of managing a novel virus in a new unit.