Ready or Not: A Crossover Study of (Un)graded Individual Readiness Assurance Tests in Team-Based Learning.

OBJECTIVE: This study aimed to measure the effects of graded vs ungraded individual readiness assurance tests (iRATs) on the students' test scores and achievement goals in a team-based learning classroom. METHODS: A 2 × 2 crossover study was conducted in a required second-year pharmacotherapy course. Teams 1 to 8 were assigned to a UG iRAT during the first half of the course, followed by a G iRAT the second half of the course (G/UG group). Teams 9 to 16 were assigned to the opposite grading sequence (ie, UG/G). A multivariate analysis of variance was used to analyze the differences in test scores, as measured using iRAT and examination scores. A separate multivariate analysis of variance was used to examine the differences in achievement goals. RESULTS: There was a significant difference in test scores based on the iRAT grading condition. Individual readiness assurance tests were higher in the G condition (72.51% vs 67.99%); however, the examination scores were similar in the G and UG conditions (81.07% vs 80.32%). There was no statistically significant difference in the achievement goals based on the iRAT grading condition. CONCLUSION: In a required second-year pharmacotherapy course that uses team-based learning, student performance on the iRAT was modestly lower in the UG iRAT condition; however, the students' examination scores were unchanged. Achievement goals were unchanged based on the iRAT grading condition.

Physician Assistant Faculty Perceptions Regarding Ongoing Self-assessment and Accreditation.

PURPOSE: While the processes of ongoing self-assessment and accreditation provide significant benefits to physician assistant (PA) programs, faculty members are often challenged by the required procedures and standards set by accreditation agencies. This study explored faculty perspectives regarding the processes of ongoing self-assessment and accreditation in PA programs. METHODS: A qualitative research design centered around semistructured interviews was used. A total of 26 participants were recruited, including PA program directors, associate program directors, directors of assessment and accreditation, past Accreditation Review Commission on Education for the Physician Assistant commissioners, accreditation consultants, deans, and PA Education Association leaders. DATA COLLECTION: Semistructured one-on-one interviews were conducted by 8 members of the research team through Zoom video conferencing. Data were collected until saturation was reached. DATA ANALYSIS: The interview recordings were transcribed and analyzed independently by 3 researchers. The transcripts were imported into NVivo, a qualitative data analysis software, for coding and inductive thematic analysis. RESULTS: Six emergent themes were identified under 2 major categories: facilitators and challenges. Facilitators for conducting continuous programmatic review and analysis include it takes a village, internal and external support, and sustained faculty development, whereas challenges are lack of knowledge and time, unclear expectations, and inflexibility. CONCLUSION: The study highlights factors associated with facilitating the ongoing self-assessment process. However, a number of challenges were also identified. The study suggests opportunities for intervention at the program, institution, and profession level.

Characteristics of Hybrid Learning Among Health Professions Programs: A Mixed-Methods Study.

PURPOSE: To characterize current trends in hybrid education within the physician assistant (PA) profession, specifically program design, drivers, and outcomes in comparison with physical therapy hybrid education. METHODS: This was a mixed-methods study involving secondary data analysis and focused interviews with stakeholders to triangulate the data. RESULTS: Compared with traditional PA programs, hybrid programs have similar admission requirements, higher cost of tuition, larger class size, and higher attrition rate than national mean. Physician Assistant National Certifying Exam outcome data are in line or slightly lower than national scores. Technological advancements and need for faculty/learner flexibility by time and location are frequently cited driving forces. CONCLUSIONS: There is a growing trend toward hybrid education among health professions. Other than cost, attrition rate, and immersion experiences, characteristics of hybrids are similar to traditional programs. It is relevant for PA educators to understand how this educational design may shape the future of PA graduates. Long-term impact should be evaluated with future studies.

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.

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.

Developing and evaluating an instrument to assess perceptions of an entry-level physician associate doctoral degree.

BACKGROUND: Most health professions in the United States have adopted clinical or practice doctorates, sparking an ongoing debate on whether physician assistants/associates (PAs) should transition from a master's to a doctorate as the terminal degree for the profession. Although more studies are anticipated, there is no validated instrument assessing perceptions of various stakeholders regarding an entry-level PA doctoral degree. The objective of this study was to develop and evaluate a novel self-report measure to assess perceptions of an entry-level PA doctoral degree. METHODS: A multifaceted, mixed-methods approach was adopted. Based on a comprehensive literature review of the doctoral transition experiences in other health professions, an initial version of perceptions of an entry-level terminal PA doctoral degree scale (PEDDS) was generated. This scale was pilot tested with a group of PA faculty, students, and clinicians. Then, a cross-sectional survey consisting of 67 items was conducted with a national random sample of practicing PAs and PA students. Additionally, semi-structured interviews were conducted to ensure the validity of PEDDS. A principal component analysis (PCA) was conducted to reduce the number of items and reveal the underlying structure of PEDDS. RESULTS: The PCA confirmed 10 factors of PEDDS consisting of 53 items as the best-fit factor structure with adequate internal consistency of subscales. Those factors include a) expected positive impact on the PA profession, b) expected impact on prerequisites, (c) expected impact on the student preparedness as PA faculty and educators, (d) expected impact on the student preparedness as clinicians, (e) expected impact on accreditation and certification, (f) expected impact on curriculum, (g) expected impact on PA educators, (h) expected positive impact on diversity, (i) expected negative impact on the PA profession, and (j) expected impact on the student competency. CONCLUSIONS: The present study highlights the need to develop valid and reliable measurements to assess perceptions regarding the transition to the entry-level doctorate across health professions. This study could be used to guide further discussion of the entry-level doctorates for PAs and other health professions by bridging the gap of existing literature related to valid, reliable, and standardized measures on this topic.

Assessing demand for doctoral-prepared PA faculty: a five-year longitudinal study.

PURPOSE: Many health profession programs have transitioned to doctoral credentials. While a master's degree is the terminal degree for the physician assistant (PA) profession, there is increasing discussion regarding the doctoral degree as the PA terminal credential in US higher education.This study examines trends, demand and economic opportunities for doctoral prepared PA faculty; specifically, assessing to what extent PA faculty employers prefer doctoral credentials. METHODOLOGY: This longitudinal retrospective observational study assessed commonly required/preferred academic credentials in PA faculty job postings. Data from 2014 to 2020 was obtained from the labor analytics firm Burning Glass Technologies (BGT) and other academic job search engines. Data on current PA faculty and program directors were obtained from Physician Assistant Education Association (PAEA) survey reports. Wage gap analysis was performed to gain additional insight for the supply and demand of PA educators with a doctoral degree. RESULTS: Of the 612 unique job ads posted from 232 PA programs between 2014 and 2020, approximately 38.9% (238) stated a preference or requirement for a doctoral degree. Nearly half of the postings for program directors and leadership positions preferred candidates with doctorates. There was a correlation between tenure eligibility positions (20.1%) and preference/requirement for doctoral credentials. PAEA survey data (2014-2019) revealed approximately 24% PA faculty and 45-48% of program directors held a doctoral degree with Doctor of Philosophy (PhD) as the most frequently held doctorate. No significant difference existed in wages for faculty with or without doctoral degree. CONCLUSIONS: Based on a national sample of PA program job ads, there is a preference for doctoral-prepared PA educators and the demand for these candidates is greater than market supply. Our analysis has implications for individual faculty career planning, employers and the PA profession as it debates transition to a terminal doctoral credential. Further studies should assess the impact of doctoral credentials on PA education by examining measurable outcomes.

An Exploration into the Physician Assistant Entry-Level Doctoral Degree: Lessons Learned From Across Health Professions.

ABSTRACT: This article explores current trends in the ongoing debate about transitioning to an entry-level doctoral degree for the physician assistant (PA) profession and identifies lessons learned from the disciplines of nursing, pharmacy, and physical therapy, which have already transitioned to an entry-level doctoral credential. We conducted a mixed-method study that involved an interprofessional systematic literature review and an examination of publicly available databases. Based on lessons learned from other health professions, a model for implementation of an entry-level doctoral degree for the PA profession is presented here. Recommendations for the profession include establishing a clear objective for doctoral degree transition, providing flexibility for options in program delivery, and transitioning through a phased approach. Further studies are warranted to explore risks and benefits in detail and to establish PA doctorate essentials, competencies, and an accreditation plan before the profession transitions to an entry-level doctoral credential.

Building an Advising Model for Physician Assistant Education.

ABSTRACT: Physician assistant education is balancing an explosion of new programs, an increase in novice faculty, and expectations from accreditation standards to track student progress longitudinally. The traditional "one-size fits all" model of advising will not meet the demands of this changing educational environment. This article introduces a longitudinal advising model that integrates various strategies from existing models such as proactive, appreciative advising, and the GROW (Goal, Reality, Options, Will) coaching model with a focus on the goal of achieving the new Physician Assistant Education Association (PAEA) Competencies for the New Graduate.

Curriculum essentials of an entry-level PA doctoral degree.

OBJECTIVES: With increasing discussion of physician assistant (PA) doctoral education, investigation of curriculum essentials and competencies has become relevant. METHODS: We conducted a national mixed-methods study comprising a survey and semistructured interviews to capture stakeholders' views on essential curricular elements for PA doctoral education. RESULTS: If the PA profession decides to transition to a terminal doctoral degree, 75% of respondents indicated this would require new content, with half indicating it would require significant change to the curriculum, enhance PA educational rigor, and change the competencies of the new graduate. The majority of respondents favored a bridge program model and the Doctor of Medical Science (DMSc) as the degree title. CONCLUSIONS: Overall, respondents agreed that transition to an entry-level PA doctoral degree would affect various aspects of the curriculum. As the prospect of an entry-level PA doctoral degree gains further attention, additional debate on curriculum essentials and competencies is warranted.

Advancing Physician Assistant Faculty Development: A New Model.

PURPOSE: The purpose of this article is to describe the development, implementation, and evaluation of an innovative physician assistant (PA) faculty development model. METHODS: The Maryland Physician Assistant Leadership and Learning Academy's (PALLA's) executive team developed a 10-month fellowship designed to build a skilled faculty pipeline. The fellowship framework was grounded in the PA educator competencies, the 3 pillars of academia, and the 5th edition Accreditation Standards for Physician Assistant Education. The self-perceived impact of the fellowship was evaluated through multiple surveys. RESULTS: Survey results show that all of the learning activities met fellows' expectations, and fellows indicated strong agreement in self-perceived achievement in meeting the fellowship outcome goals. CONCLUSION: Study results provide evidence that formal training increases self-perceived competence in clinicians transitioning to academia. PALLA can serve as a model for other states to ensure faculty capacity within PA education.

A physician assistant entry-level doctoral degree: more harm than good?

BACKGROUND: As most health professions in the United States have adopted clinical or practice doctorates, there has been an ongoing debate on whether physician assistants (PAs) should transition from a master's to a doctorate as the terminal degree. The authors examined perceived risks, benefits and impact of transitioning to an entry-level PA doctoral degree. METHODS: A multi-prong, mixed-methods approach was used that included a literature review and collecting quantitative and qualitative data using a survey and interviews. Bivariate analysis and binomial logistic regression were performed to evaluate relationships between perceptions/perspectives on an entry-level PA doctoral degree and the anticipated impact of it causing more harm than good to the PA profession. Deductive content analysis was used to analyze the qualitative data. RESULTS: Of 636 PA clinicians and students (46% response rate), 457 (72%) disagreed that an entry-level PA doctoral degree should be required. More than half of the respondents (54%) agreed that it should be offered but not required and 380 respondents (60%) agreed that an entry-level doctoral degree would cause more harm than good. Race, educational attainment, occupation, and length of practice as a PA were significantly associated with having a perception of causing more harm. There was strong positive association between the perception of a doctoral degree causing more harm with expectations of having a negative impact on the availability of clinical training sites (OR = 4.39, p < .05). The most commonly cited benefits were parity with other professions and competitive advantage, whereas the perceived risks were increased cost for education, decreased diversity in the profession, and negative impact on the PA/physician relationship. CONCLUSIONS: The major takeaway of our study was that perceived benefits and risks are strongly influenced by the lens of the stakeholder. While the majority of PAs and students appear to be not in favor mainly due to the potential harm, the proportion of those in favor is not insignificant and their views should not be ignored. Addressing concerns with key stakeholders could help the PA profession to transition to a doctoral degree with minimal adverse impact.

Creating disseminator champions for evidence-based practice in health professions education: an educational case report.

INTRODUCTION: In today's healthcare environment, it is a necessity to prepare nurses and other health professionals to provide and disseminate evidence-based practices (EBP) throughout their careers. PURPOSE: This educational case report describes a health professional education program's successful endeavor to educate and create evidence-based champions. CASE DESCRIPTION: The presented model for developing evidence-based practitioners is based on two distinct phases. Phase one is for EBP skill development and includes preparing students how to read, analyze and discuss levels of evidence within the didactic and clinical curriculum. Phase two is focused on developing dissemination skills by requiring students to complete a clinical case report project with the assistance of academic and clinical faculty mentors. Phase three reviews outcomes of the project and phase four provides the mechanism for future plans. Based on quality, student and faculty interest, a select number of case reports are chosen for presentation at a university Research Day as well as submitted for state and national conferences to further disseminate findings. OUTCOMES: This educational activity had positive outcomes including: increased student participation, Clinical Instructors and faculty scholarship, and dissemination of EBP. Data demonstrates student interest in presenting at Research Day to have steadily increased during the 3-year period of this endeavor. Dissemination occurred at university (n = 22), state (n = 13) and national (n = 9) levels. Additional educational benefits derived from this project included, 1) broader participation of clinical settings, 2) requests by additional clinics to participate for purposes of developing EBP and scholarly presentation skills of clinicians, and 3) increased opportunity for academic faculty to continue engagement in contemporary clinical practice. CONCLUSION: The evolution of this case report project has allowed an academic requirement to become a marker of distinguished commitment to professional advancement.