Meeting the Accreditation Standard for Diversity.

ABSTRACT: While increasing diversity has been an ongoing concern in physician assistant (PA) education, there is now a concentrated focus on diversity, equity, inclusion, and social justice, elevating these to top priorities. To achieve the goal of diversifying the PA workforce, PA programs, with their institution's support, must systematically inculcate strategies for overcoming and dismantling barriers against students of color and students underrepresented in medicine (URiM). These strategies should disrupt the status quo and expand structural processes that ensure successful diversification of students, especially URiM students, LGBTQ students, students from medically underserved areas, and first-generation college students.

Reflections on a Physician Assistant Entrance Exam: Does the Profession Need One?

ABSTRACT: Standardized entrance exams are used in many health professions as one way to objectively measure knowledge and facilitate comparisons across student groups. The physician assistant (PA) profession has historically not employed a profession-specific entrance exam, and the idea was never seriously explored until the Physician Assistant College Admissions Test was developed recently by a commercial assessment publisher, with field testing in some volunteer programs in 2018 and the exam's first administration in May of 2020. The 2020 Physician Assistant Education Association Presidents Commission chose to investigate the issues raised by a consensus-derived, PA-specific entrance exam to stimulate more informed discussion on the efficacy of such an exam. While it may have the potential to enhance efficiency in PA admissions and reduce variability in admissions requirements, a PA entrance exam would also likely introduce new challenges, including increased costs, impact on the diversity of the applicant pool, and incongruence with an increasingly holistic admissions process. The biggest barrier would likely be the lack of current consensus on the knowledge, skills, and attributes that matriculants need to be successful in the program and in clinical practice. Development of a consensus-derived PA entrance exam would be a complex, expensive, and time-consuming endeavor, requiring considerable attention to technical issues of psychometric quality, process transparency, and legal defensibility. Changes being made to health professions admissions practices due to the COVID-19 pandemic, including the dropping of test scores as a requirement by some institutions, may make some of the issues raised in this paper more timely than ever.

Reimagining Physician Assistant Education.

The physician assistant (PA) profession has successfully flourished for over 50 years, demand for graduates remains strong, and there is a wealth of research on the quality of care that PA graduates provide. Nevertheless, health care and education are constantly changing, and we must change with them. We must continually scan the horizon and consider how best to adapt to current issues like the clinical sites crisis, as well as evolutions in technology, pedagogy, and in our students themselves. The Physician Assistant Education Association Presidents Commission, a group of past presidents, sought to stimulate a conversation on "reimagining PA education" through the lens of advances in our knowledge of the neuroscience of learning and changes in technology, including simulation, and a broader focus on innovation and "thinking outside the box." Through interviews with PA faculty and leaders, we provide some examples of areas of innovation in education, especially on the possibilities presented by a more flexible approach to innovation from the accreditation body than many PA faculty might perceive. One initial conclusion is that PA educators should focus more on helping students to "think like clinicians" from the start of their education. This paper is primarily intended to stimulate dialog, and we encourage all PA educators to form-and more importantly, share-their own thoughts and questions, through the PAEA professional learning communities and Digital Learning Hub (PAEAlearning.org/learn/digital-learning-hub/).

Using the Core Competencies for New Physician Assistant Graduates to Prioritize Admission Criteria for PA Practice in 2025.

In a fast-changing medical and educational environment, it is incumbent upon the physician assistant (PA) education community to periodically consider what the future practice environment might look like for our graduates. Changes in technology, regulation, reimbursement, health system economics, and health care delivery are among the many forces shaping the practice environment of the future. The 2018 Physician Assistant Education Association (PAEA) Presidents Commission reflected on what PA practice might look like in 2025 and used the Association's Core Competencies for New PA Graduates to consider what characteristics might therefore be required of the PA graduates who will practice in this future. We postulate that the future PA practice environment will require enhanced skills in such areas as interpreting technology-driven clinical data for patients and practices, consulting effectively with increasingly specialized members of health care teams, understanding population health and predictive analytics, and knowing how to access and critically assess new medical information. Working backward, we identify certain noncognitive attributes that will likely need to be prioritized in our admission processes and suggest some tools that can be used to assess them. These attributes include ethical responsibility, communication, critical thinking, situational judgment, and professionalism. As with all Presidents Commission articles, this piece is intended primarily to stimulate thought, dialogue, and future research. We encourage all faculty to participate in this dialogue, through the new PAEA Digital Learning Hub (https://paealearning.org/learn/digital-learning-hub/) and other channels.

Noncognitive Attributes in Physician Assistant Education.

Physician assistant (PA) admissions processes have typically given more weight to cognitive attributes than to noncognitive ones, both because a high level of cognitive ability is needed for a career in medicine and because cognitive factors are easier to measure. However, there is a growing consensus across the health professions that noncognitive attributes such as emotional intelligence, empathy, and professionalism are important for success in clinical practice and optimal care of patients. There is also some evidence that a move toward more holistic admissions practices, including evaluation of noncognitive attributes, can have a positive effect on diversity. The need for these noncognitive attributes in clinicians is being reinforced by changes in the US health care system, including shifting patient demographics and a growing emphasis on team-based care and patient satisfaction, and the need for clinicians to help patients interpret complex medical information. The 2016 Physician Assistant Education Association Stakeholder Summit revealed certain behavioral and affective qualities that employers of PAs value and sometimes find lacking in new graduates. Although there are still gaps in the evidence base, some tools and technologies currently exist to more accurately measure noncognitive variables. We propose some possible strategies and tools that PA programs can use to formalize the way they select for noncognitive attributes. Since PA programs have, on average, only 27 months to educate students, programs may need to focus more resources on selecting for these attributes than teaching them.

Reinventing the Wheel: One Program's Approach to Redesign of Didactic Courses.

Curriculum and course redesign are expected and intentional efforts in health professions education. For physician assistant (PA) education, ongoing program self-assessment is a required accreditation standard and may guide deliberate changes within curriculum. The purpose of this article is to describe one PA program's approach to the redesign of 4 courses into 3 courses that span the entire didactic phase. Significant lessons learned include the importance of planning ahead, identifying key players, documenting the process as part of ongoing self-assessment, competency mapping, and being prepared to make real-time modifications and changes based on course evaluations and faculty feedback. Our approach and guiding principles to the successful redesign of the didactic courses may provide both established and new PA educational programs with useful methods to apply in their own unique curricula.

The physician assistant teaching fellowship: A model for faculty recruitment.

PURPOSE: the rapid growth of the number of physician assistant (PA) programs in the last two decades has resulted in a heightened demand for qualified and experienced PA faculty. Barriers to recruitment and retention of faculty include the need for diverse teaching experiences and the lack of available mentors. METHODS: in order to provide a structured experience for training potential faculty for careers as PA educators and to address the barriers to recruitment and retention of new faculty, our institution has offered a PA teaching fellowship since 1998. RESULTS: the teaching fellowship has met its goal of increasing the pool of qualified PA faculty, as nine of the 11 graduates were hired full-time into PA teaching and program administration positions. Curriculum projects developed by the fellows have been incorporated into our curriculum and have been shared with other PA programs. CONCLUSIONS: the PA teaching fellowship is a valuable strategy for developing teaching skills, promoting professionalism among PA educators, increasing the pool of available and qualified PA faculty, and overcoming barriers to retention. This model may be useful to other institutions.