A Qualitative Evaluation of Medical Students' Perspectives Regarding Collaboration with Physician Assistants.

INTRODUCTION: Physician assistant (PA) is a burgeoning profession in Canada, with several accredited training programs. Because the scope of practice for PAs in Ontario, as delineated by the province, stipulates that all tasks they perform must be delegated by a supervising physician, it is expected that medical students will increasingly encounter and work alongside PAs in clinical environments. There has been a paucity of research to date investigating how medical students experience this professional relationship. This current study aimed to investigate the attitudes and perspectives that medical students have about working with PAs. METHODS: Medical students from the University of Toronto (n = 11) in various stages of training participated in 3 focus groups. The focus groups used a semi-structured interview guide to explore medical students' general opinions of the profession, their understanding of the interprofessional relationship, and their experiences working with PAs. Qualitative methods with a phenomenological underpinning were used to analyze the focus groups. RESULTS: The findings show that medical students have observed or collaborated with PAs in clinical environments but are generally unaware of the profession's scope of practice and responsibilities. Medical students also viewed PAs as beneficial to patient care and expressed a desire to discover more about the profession through formal education. DISCUSSION: This call for interprofessional education should be heeded by medical faculty to better prepare medical students for future collaboration with PAs.

Impact of 18F-fluorodeoxyglucose PET/CT in the management of patients with plasma cell disorders.

OBJECTIVES: To evaluate the impact of F-fluorodeoxyglucose PET/CT examinations on the management of patients with plasma cell disorders. METHODS: This is a retrospective review of patients in a provincial database with PET/CT performed for plasma cell disorders between 2011 and 2018. The impact of PET/CT on actual patient management and outcome was assessed by two independent readers who compared planned pre-PET/CT management, documented at time of PET/CT requisition, to actual management received through linkages to administrative databases. PET/CT was considered of high impact if it altered the provision of active treatment, changed the modality of treatment or chemotherapy regimen. Change in management and the proportion of patients with high impact PET/CT were assessed. RESULTS: There were 44 patients with plasma cell disorders, including multiple myeloma, solitary plasmacytoma, Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal protein, Skin changes syndrome, or monoclonal gammopathy of undetermined significance or biclonal gammopathy of undetermined significance. Management was altered after 38/56 (67.9%) PET/CT scans. Considering just the initial PET/CT scan in patients who underwent multiple scans, 31/44 (70.5%) patients had their management altered subsequent to PET/CT. CONCLUSION: PET/CT resulted in a change in planned management in more than two-thirds of patients with plasma cell disorders in the current selected patient cohort. These results should be validated in a larger prospective trial.