Path to a Profession: How a Physician Assistant Becomes a Physician Assistant.

This pilot study, through the application of phenomenological methodology, considered the physician assistant (PA) profession as a "lived experience" in an attempt to understand how these medical practitioners end up on the PA path and what keeps them there. Additionally, the researchers focused on understanding why specific individuals gravitate towards the PA education option. Major themes that developed during the interviews with eight PAs included personal unfamiliarity with the PA profession during the first two decades of life, the decision to pursue PA training while in undergraduate studies, assuming roles often considered MD/DO specific and the subsequent patient confusion with the difference between a PA and an MD/DO, and significant work satisfaction resulting in the lack of desire to change profession. These themes, especially personal unfamiliarity with the PA profession and patient confusion with the difference between a PA and an MD/DO, promotes an environment that perpetuates a lack of understanding about PAs, particularly in younger (e.g., pre-collegiate) individuals. Considering the consequences of this knowledge gap along with the equivocal validity of a pilot study and the potentially subjective nature of phenomenology, the researchers recommend further investigations, both quantitative and qualitative, to either confirm or repudiate these findings.

A Method to Study the Effect of a Physician Assistant Student on Preceptor Productivity.

PURPOSE: Guided clinical experience is a critical component of a physician assistant (PA) student's education. However, clinical precepting is strongly perceived to have deleterious effects on productivity. In this study, we sought to test a method for evaluating the effect that PA students have on clinical productivity. METHODS: We recruited 14 family medicine preceptors and second-year PA students from 2 programs, the University of Washington (UW) and the University of Texas Health Science Center San Antonio (UT). We collected productivity data during 3 weeks of preceptor clinical practice-one week without a PA student present and 2 weeks with a PA student present (one week early in the student's family medicine clinical rotation and a second week late in the rotation). We collected preceptor demographic data, patient characteristics, and the primary outcome-relative value units (RVUs) per preceptor per half-day during the 3 data collection weeks. At the end of the study, we asked preceptors about the ease of data collection and any negative effects of the study itself on their clinical productivity. RESULTS: No significant differences were found in preceptor demographics or in patient characteristics, numbers of patients, or RVUs per patient seen in any of the weeks or between UW and UT. In this pilot study, no significant differences were seen in RVUs per preceptor per half-day between the 3 weeks of observation or between UW and UT. CONCLUSION: In this pilot study, the protocol was straightforward, unintrusive, and preliminarily showed no significant effects of a PA student on preceptor productivity.

Rural Versus Suburban/Urban Experiences in a Family Medicine Preceptorship.

PURPOSE: Accreditation standards require physician assistant (PA) programs to ensure students receive adequate clinical experiences. During their clinical year of training, PA students complete rotations with multiple clinical preceptors, introducing them to practice and exposing them to a variety of clinical problems. In this article, we examined Typhon Physician Assistant Student Tracking (PAST) system patient encounter logs' value for program evaluation, but also in research to address questions relevant to PA education. Specifically, we explored the MEDEX Northwest Physician Assistant Training Program student experience across rural versus suburban/urban placements in a 4-month family medicine preceptorship. METHODS: Student experience was analyzed from 2 years of collected Typhon PAST encounter data. Encounter characteristics included duration, number of clinical problems, student level of responsibility, and decision type. Patient characteristics included sex, age, race, and clinical problems recorded as ICD-9 codes. RESULTS: Individual student experience varied widely across different preceptors. However, these differences were more specific to the preceptor-student relationship than to whether the site was classified as rural or suburban/urban. Across these settings, significant differences were only noted for percentage of female and 65 or older patient encounters. The most common clinical problems reported across rural versus suburban/urban sites were highly correlated. CONCLUSIONS: Physician Assistant Student Tracking data demonstrated that individual student experience in their family medicine rotation varied widely. However, in general, rural and suburban/urban experiences were more similar than different. This study supports the value of the Typhon PAST logging system for not only tracking student activity but also addressing program evaluation and research questions.