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.

Enhancement of anatomical learning and developing clinical competence of first-year medical and allied health profession students.

Hands-on educational experiences can stimulate student interest, increase knowledge retention, and enhance development of clinical skills. The Lachman test, used to assess the integrity of the anterior cruciate ligament (ACL), is commonly performed by health care professionals and is relatively easy to teach to first-year health profession students. This study integrated teaching the Lachman test into a first-year anatomy laboratory and examined if students receiving the training would be more confident, competent, and if the training would enhance anatomical learning. First-year medical, physician assistant and physical therapy students were randomly assigned into either the intervention (Group A) or control group (Group B). Both groups received the course lecture on knee anatomy and training on how to perform the Lachman test during a surface anatomy class. Group A received an additional 15 minutes hands-on training for the Lachman test utilizing a lightly embalmed cadaver as a simulated patient. One week later, both groups performed the Lachman test on a lightly embalmed cadaver and later completed a post-test and survey. Students with hands-on training performed significantly better than students with lecture-only training in completing the checklist, a post-test, and correctly diagnosing an ACL tear. Students in Group A also reported being more confident after hands-on training compared to students receiving lecture-only training. Both groups reported that incorporating clinical skill activities facilitated learning and created excitement for learning. Hands-on training using lightly embalmed cadavers as patient simulators increased confidence and competence in performing the Lachman test and aided in learning anatomy.