PA Scholars: What Drives and Inhibits Success?

PURPOSE: The full expression of an educator includes scholarship, yet many physician assistant (PA) educators are not published. Several barriers unique to PA education are often cited to explain this phenomenon. However, some in the PA profession have become prolific writers despite working in the same environment. In this study, authors strove to understand what motivated these productive faculty by posing 2 research questions: (1) What are the drivers of success for high-performing PA scholars and (2) how do high performing PA scholars overcome barriers? METHODS: A qualitative study using a constructivist, grounded theory approach explored the experiences and motivation of PA-credentialed educators who published >5 peer-reviewed articles and whose body of work achieved an h-index of >3. RESULTS: High-performing scholars valued scholarship as a creative outlet and a rewarding pursuit. Scholars achieved a sense of fulfillment in their work. Research and writing were described as protective against burnout. Participants viewed barriers differently than other educators. Barriers were acknowledged, but participants developed strategies to overcome obstacles. Mentorship was seen as crucial to success. A nuanced understanding of PA research and the characteristics associated with high-performing PA scholars emerged. The study identified developmental stages associated with the formation of a scholar. CONCLUSION: Progression from prescholar to mature scholar has important implications for initiatives designed to increase scholarship and provides evidence to support the claim that scholarship positively affects job satisfaction, personal well-being, and talent retention.

Validation of a Novel Statistical Method to Identify Aberrant Patient Logging: A Multi-Institutional Study.

INTRODUCTION: Student patient encounter logging informs the quality of supervised clinical practice experiences (SCPEs). Yet, it is unknown whether logs accurately reflect patient encounters, and the faculty resources necessary to review for potential aberrant logging are significant. The purpose of this study was to identify a statistical method to identify aberrant logging. METHODS: A multi-institutional (n = 6) study examined a statistical method for identifying potentially aberrant logging behavior. An automated statistical Mahalanobis Distance (MD) measurement was used to categorize student logs as aberrant if they were identified as probable multivariate outliers. This approach was validated using a gold standard for aberrant logging behavior with manual review by 4 experienced faculty ("faculty consensus") and then comparing interrater agreement between faculty and MD-based categorization. In secondary analyses, we compared the relative accuracy of MD-based categorization to individual faculty categorizing data from their own program ("own program" categorization). RESULTS: 323 student logging records from 6 physician assistant (PA) programs were included. Compared to "faculty consensus" (the gold standard), MD-based categorization was highly sensitive (0.846, 95% CI: 0.650, 1.000) and specific (0.766, 95% CI: 0.645, 0.887). Additionally, there was no significant difference in sensitivity, specificity, positive predictive value, or negative predictive value between MD-based categorization and "own program" categorization. DISCUSSION: The MD-based method of identifying aberrant and nonaberrant student logging compared favorably to the more traditional, faculty-intensive approach of reviewing individual student logging records. This supports MD-based screening as a less labor-intensive alternative to individual faculty review to identify aberrant logging. Identification of aberrant logging may facilitate early intervention with students to improve clinical exposure logging during their SCPEs.

Publish or Perish: A Cross-Sectional, Bibliometric Analysis of Physician Assistant Faculty Publications.

PURPOSE: Little is known about physician assistant (PA) educators' publishing practices and the collective impact of their published works. The goal of this study was to describe the scholarly output of the PA professoriate in a way that is useful to both promotion committees and individual educators who are planning careers. METHODS: A cross-sectional study was performed to demonstrate publishing patterns. The name of each PA-credentialed educator in academic health centers was searched in Scopus. Citations of peer-reviewed articles published through 2019 were retrieved and de-duplicated. The number of publications, h-indices, journal names, and keywords were collected between May 2019 and January 2020. Differences among academic ranks were explored, and keywords were analyzed. Frequently used journals were determined and their impact factors retrieved. RESULTS: A total of 364 faculty met inclusion criteria. Between 1972 and 2019, 895 peer-reviewed articles were published; 603 were published in the last 10 years. Approximately half the study cohort (n = 172) published at least one peer-reviewed article that met inclusion criteria (range 1-89; median = 2). Overall, productivity remained steady over the last 10 years (range 0-59; median = 2). Faculty at the professor and associate level had a median h-index of 2.00 and assistants had a median h-index of 1.00. PhD-prepared faculty published more articles and had higher h-indices than faculty with other types of degrees. CONCLUSIONS: The results provide benchmarking data that can be used for promotion and professional development. More faculty must publish and increase the citation rate of their publications if we are to improve the reputation of the PA educator literature.

Credentials and Core Clerkships: Who's Training Our Physician Assistant Students (and Does It Matter)?

PURPOSE: Evaluating the effectiveness of supervised clinical practice experiences (SCPEs) is a primary responsibility of the clinical education team. Physician assistant (PA) education is unique because preceptors are not confined to one professional credential. This study evaluated the relationship between students' perceptions of rotation experiences and the professional credentials of the preceptor of record. METHODS: This retrospective data analysis evaluated data from 3 cohorts (2016-2018) across 4 PA programs. Preceptors of record were categorized as MDs/DOs or advanced practice providers (APPs). RESULTS: Analysis of 209 SCPEs found 91 APP preceptors (43%) and 119 MD/DO preceptors (57%). APP preceptors were most prevalent in family medicine/primary care (57%), internal medicine (50%), and emergency medicine (49%). Students' evaluation scores were higher for APP preceptors compared to MD/DO preceptors, but not statistically significant. CONCLUSIONS: This study showed that a considerable number of APPs are serving as preceptors and were found to have similar student evaluation scores to those of MD/DO preceptors.