Bridget Colleen Calhoun

The Use of Standardized Patients in the Training and Evaluation of Physician Assistant Students

Purpose: Standardized patients (SPs) are used extensively in physician and nursing education, where they have proven to be valuable educational tools. Practice with SPs may provide durable benefits regarding communication skills. However, the extent to which SPs are used in physician assistant (PA) training is unknown. The primary aim of this study was to determine the extent to which programs use SPs and whether SP utilization varied by the programs affiliation with an academic center or medical school. Methods: Self‐administered surveys were sent to one academic coordinator at each of the then 134 accredited PA programs. Results: Ninety‐six programs returned surveys. At programs represented by survey participants, SPs play various roles, including providing medical histories and participating in complaint‐specific and organ‐specific “sensitive” examinations (rectal, pelvic, etc). Programs housed in medical schools were more likely to use professional patients. Respondents from programs not using SPs provided reasons why they were not used. Most common among these were issues related to cost, access, training, and recruitment. To a lesser extent, liability issues were also cited, as was a perceived lack of evidence that SPs add value to PA education. Details about SP compensation were provided by only 48 (50%) respondents, but reflected a broad range of remuneration. Conclusions: The majority of accredited PA training programs use SPs. Although they play a range of educational roles, they are most commonly used for the most sensitive components of physical examination. Use of SP patients was particularly common in programs affiliated with medical schools and community colleges.

Incidence and progression of coronary artery calcium in HIV-infected and HIV-uninfected men.

Objective:The aim of this article is to determine whether HIV-infected (HIV+) men have either higher incidence or more rapid progression of coronary artery calcium (CAC) compared with HIV-uninfected (HIV−) controls. Design:Prospective observational study. Setting:Multicenter study in four US academic research centers: University of Pittsburgh, Johns Hopkins University, University of California Los Angeles, and Northwestern University. Participants:Eight hundred and twenty-five men (541 HIV+ and 284 HIV−) enrolled in the cardiovascular substudy of the Multicenter AIDS Cohort Study who underwent serial cardiac computed tomography (CT) imaging during a mean follow-up of 5 years (range, 2–8 years). Main outcome measures:Incidence and progression of CAC assessed by cardiac CT. Results:During follow-up, 21% of HIV+ men developed incident CAC compared with 16% of HIV− men. This association persisted after adjustment for traditional and HIV-associated risk factors: hazard ratio 1.64 (1.13–3.14). However, there was no association between HIV serostatus and CAC progression among men with CAC present at baseline. Current smoking and increased insulin resistance, both modifiable risk factors, were independently associated with increased incidence of CAC. No evidence supporting an elevated risk for either CAC progression or incidence was found for either dyslipidemia or long-term usage of antiretroviral therapy. Conclusion:In this large study of HIV+ and HIV− men who underwent serial cardiac CT scan imaging, HIV+ men were at significantly higher risk for development of CAC: hazard ratio 1.64 (1.13–3.14). In addition, two important and modifiable risk factors were identified for increased incidence of CAC. Taken together, these findings underscore the potential importance for smoking cessation and interventions to improve insulin resistance among HIV+ men.

The Professional Development Needs of Faculty of Physician Assistant Programs

INTRODUCTION The physician assistant (PA) educational community has exploded over the past decade. Since 1998, the number of accredited programs has grown from 110 to 148. In addition to these new programs, many established programs have increased class enrollment; the national median second-year class enrollment increased from 32 students in 2000-2001 to 38 students in 2007-2008.1,2 In order to satisfy the need for faculty, many PA programs have hired instructors directly from clinical practice who have little, if any, experience in teaching, curriculum design, and student assessment. This is not a new problem. In 1998, Glicken and Blessing coauthored a report, published in the predecessor to this journal, summarizing the results of a faculty needs assessment conducted by the Association of Physician Assistant Programs (APAP), now known as the Physician Assistant Education Association (PAEA).2 They cited the same challenge in recruiting faculty “directly from clinical medicine.”1 At the time of the original survey, the number of PA programs was also rapidly expanding and little was known about self-identified needs of PA faculty. The results of the Glicken and Blessing survey reinforced the value of in-person workshops covering such topics as classroom teaching, instructional design, assessment and evaluation, and communication skills1 and provided the framework for the eventual establishment of the PAEA Faculty Development Institute (FDI). The FDI is still in existence and is charged with promoting the professional development of PA program faculty and staff through enrichment, knowledge, and skills in the areas of education, scholarship, management, and leadership. Since its inception, the FDI has offered workshops geared towards PA educators at all levels of experience. Over the years, PAEA and the FDI have evolved to meet the changing needs of PA educators. With the Glicken and Blessing data now 10 years old, FDI decided to conduct a revised survey to identify current needs of PA faculty and to establish future directions.

An International Public Health Course For Health Science Students

INTRODUCTION Modern students want to be global citizens. You only need to browse university brochures and Web sites to appreciate the popularity of undergraduate study-abroad and semesterat-sea programs. This popularity extends into professional training programs as well. The number of physician assistant (PA) programs offering international clinical rotations is increasing, with 77 programs reporting active or inactive international rotation sites in 2007.1 The Physician Assistant Education Association (PAEA) International Affairs Committee recently administered a survey regarding student participation in international rotations and reported that 233 students completed an international rotation in 2006.1 Such activity may be reflective of the overall globalization of the PA profession, with at least seven nations (Australia, Canada, South Africa, England, Scotland, Taiwan, and the Netherlands) now exploring the development of health professions with clinical roles similar to those of PAs.2 The Duquesne University John G. Rangos School of Health Sciences offers educational programs in athletic training (AT), health management systems (HMS), occupational therapy (OT), physical therapy (PT), physician assistant, speech language pathology (SLP), and a doctoral program in rehabilitation sciences (DRS). The Duquesne University PA program is a 5-year, entry-level master’s degree program that enrolls college freshmen, most of whom have no medical experience. The program has established international rotations for PA students in Haiti and Africa, for which feedback has been overwhelmingly positive. In 2005, we decided to expand our international repertoire and develop an overseas experience appropriate for PA students, as well as students from other departments in the School of Health Sciences, prior to matriculation into the clinical phase of training.