Physician assistant education program director attrition and consideration to leave.

BACKGROUND: This study explores factors related to physician assistant (PA) education program directors' (PD) consideration to leave their leadership role. This is important to better understand, with the need for additional PA education PDs as the number of PA programs grows in addition to current PA program leaders considering leaving their PD role. METHODS: Data from the 2019 Physician Assistant Education Association (PAEA) Faculty and Directors Survey were used to analyze factors related to consideration for leaving the PD position. Multiple logistic regression analyses were utilized to identify predictors of PD consideration for leaving their position. Multiple regression analyses were also used to explore factors related to burnout. RESULTS: The study found burnout was a modest predictor for consideration of leaving the PD position, while underrepresented minority status was not. Additional job stress, job satisfaction, and job experience variables were found to have a modest relationship with consideration of leaving, with odds ratios between 0.28 (lack of faculty respecting each other) and 5.29 (stress from lack of personal time) for those with statistically significant relationships. CONCLUSIONS: PD consideration of leaving is a complex phenomenon with many variables and confounding factors likely at play, including, as demonstrated by this study, level of burnout. Study implications include a further understanding of how effective strategies might be designed and implemented to address the drivers of PA PD attrition. Further exploration of burnout as a possible mediating variable as well as more specific data collection directed at better understanding predictors of PD attrition would be valuable future research directions.

Implications of Entrustable Professional Activities for Motivation and Learning.

INTRODUCTION: This study sought to explore the experience of entrustable professional activity-based assessment and its effect on self-determination, a well-supported measure of motivation. The goal was to understand EPA-based assessment's implications for student motivation, learning, and wellbeing. METHODS: A qualitative case study design was utilized through a standardized simulation activity with EPA-based assessment. An analysis of interviews and reflection journals was completed by the coding of emergent themes and significant statements with a subsequent thematic analysis framed in self-determination theory (SDT). RESULTS: Entrustment was found to be an affectively and interpersonally impactful metric that provided the learner with a clear understanding of clinical performance. Quality entrustment feedback supported participants' sense of competence and increased their confidence in their ability to be autonomous as well as a valuable part of the healthcare team. DISCUSSION: EPAs appeared to support learners' sense of competence and to provide a bridge to support autonomy and the ability to relate to others. To the extent that entrustment supported learners' sense of competence, other SDT propositions could be subsequently bolstered as well. Self-determination and intrinsic motivation were uniquely supported by EPA-based assessment, if implemented effectively. Further research is needed to better define effective implementation, faculty development, and feedback strategies.

Beyond the Clinic: Physician Assistant Student Perspectives on Careers in Physician Assistant Education.

PURPOSE: Professional training programs for physician assistants (PAs) have been rapidly expanding. The profession therefore needs to develop a sufficiently robust teaching workforce. METHODS: This study surveyed current PA students from all Physician Assistant Education Association member programs to ascertain their level of interest in and understanding of careers in PA education, including faculty and precepting roles. RESULTS: The study revealed that interest was greatest in precepting roles. A higher level of education before attending a PA program correlated with a higher interest in PA education roles, although an education-related degree did not show a significant relationship with such roles. CONCLUSION: These and other study findings are important to consider as the profession continues to develop a pipeline to education careers for students and clinicians.

Accreditation and implications of clinical postgraduate PA training programs.

No consensus definition exists for postgraduate physician assistant (PA) training. This report from the AAPA Task Force on Accreditation of Postgraduate PA Training Programs describes the types of clinical training programs and their effects on hiring and compensation of PAs. Although completing a postgraduate program appears to have no effect on compensation, PAs who complete these programs may be favored in the hiring process and frequently report greater confidence in their skills. More research is needed and program accreditation is key to monitoring the effectiveness of these programs.

Postconcussive syndrome in a high school athlete.

This article describes an adolescent female who had postconcussive symptoms for more than 2 years after sustaining two concussive injuries without complete recovery between them. The case illustrates the significant effect of mild traumatic brain injury and the need for appropriate evaluation and management.

An update on primary care management of knee osteoarthritis.

Primary care providers often make the initial diagnosis and play an important role in the effective management of knee osteoarthritis. This article reviews new treatment guidelines from the American Academy of Orthopedic Surgeons and discusses when to refer patients to specialists.