David P. Asprey

The Impact of Age and Gender on the Physician Assistant National Certifying Examination Scores and Pass Rates

Purpose: Demographic characteristics may influence individual performance on the entry‐level Physician Assistant National Certifying Examination (PANCE). The purpose of this study was to investigate the influence of age and gender on PANCE performance. Methods: PANCE scores were obtained from the National Commission on Certification of Physician Assistants (NCCPA) for three cohorts: all first‐time PANCE takers from the years 1990, 1995, and 2000. The total study population equaled 9,247. Results: In each of the 3 years studied, there was a statistically significant (P<.0001) negative correlation between age and PANCE score, indicating that lower scores were obtained by older examinees. Failure rates of the examinees reveal a statistically significant (P<.0001) and moderately positive relationship (r=.21) between age and likelihood of failure. In each of the 3 years examined, female examinees significantly outperformed males (P<.0001). The correlation between the PANCE score and age within the female examinee population was r=‐.10 (P<.0001), and for the males r=‐.23 (P<.0001), yielding a weighted average correlation of r=‐.16 (P<.0001 ‐ r2 = .03). The relationship between age and score was significantly more pronounced in the male examinees (P<.0001).

The Impact of Program Characteristics on the Physician Assistant National Certifying Examination Scores

Purpose: The purpose of the study was to determine what influence program characteristics have on performance on the PANCE and to determine the stability of this influence longitudinally over three cohorts sampled at 5‐year intervals. The demographic factors considered for the population studied were those of degree granted, class size, and total program length. Methods: PANCE scores were obtained from the NCCPA for three cohorts: first‐time PANCE takers from 1990, 1995, and 2000. The individual scores received were also accompanied by a program code and the year of testing. The final study population was 6,109, with 1,303 from 1990 (21%), 2,184 (36%) from 1995, and 2,622 (43%) from 2000. Copies of the APAP Physician Assistant Programs Directory from 1988, 1993, and 1998 were used to further build the database by adding program length, class size, and degree conferred. Results: Program characteristics related to degree granted were associated with higher test scores; however, class size and program length did not demonstrate a clear relationship with PANCE scores. Students from masters degree‐granting programs significantly outperformed students graduating from schools awarding non‐masters degrees during each of the 3 years included in this study. In examining the influence of program length, the relationship was in opposite directions and significant for the 1995 and 2000 cohorts only. When examining the characteristic of class size, the correlation between class size and PANCE scores for 1990 was r=0.05; for 1995, r=‐0.02; and for 2000, r=0.09. The relationship was statistically significant for the 2000 cohort. Conclusion: This study identified a relationship between the degree granted and PANCE scores. It also demonstrated that changing from a non‐masters to a masters degree program was associated with higher performance on the PANCE.

Comparison of Medical Student and Physician Assistant Student Performance on Standardized-Patient Assessments

Purpose: Standardized patients (SPs) are widely used in medical education for teaching and evaluating clinical skills. SP exams allow assessment of clinical skills that are difficult to measure through more traditional testing methods. However, this form of evaluation presents distinct challenges, including establishing credible passing scores; high costs to the program; and difficulty of demonstrating accuracy, reliability, and validity. There is little research available on physician assistant (PA) student performance on SP exams. This study compares performance of third‐year medical students (M3s) and PA students in a well‐established SP testing program over a 3‐year period at the University of Iowa Carver College of Medicine. Methods: Both groups of students had completed an average of 36 weeks of clinical rotations prior to the SP exams. In 2004, 39 M3s and 25 PA students participated in three of the same SP cases; in 2005, 32 M3s and 23 PA students participated in four of the same cases, and in 2006, 30 M3s and 23 PA students participated in two of the same cases. Specific cases varied from year to year. Scoring was accomplished through checklists completed by SPs. The overall mean scores of PA and M3 students were compared for each year, using SAS to run t‐tests. Results: No significant differences were found between the two types of students. Conclusions: This result would be expected if SP testing truly functions as a measure of clinical experience, since these groups of students had comparable time in clinical rotation settings, though greatly differing amounts of didactic training.

Clinical Skills Utilized by Physician Assistants in Rural Primary Care Settings

Feature Editor’s Note: Procedural skill and prescribing have been identified as two of the most important defining roles for PAs. Asprey’s survey sharpens the focus on the skills needed for PAs to manage in rural health practices and what programs may want to emphasize.

Reaching a New Milestone

The attainment of milestones is a common method of tracking the expected maturation and growth of an individual or an organization. Merriam-Webster’s Online Dictionary defines milestone as “an important point in the progress or development of something: a very important event or advance.” As the editor in chief of the Journal of Physician Assistant Education (JPAE), I consider the fact that, beginning with this volume, JPAE’s production and editorial management has now been transitioned to a professionally published journal as the attainment of a monumental new milestone in the Physician Assistant Education Association’s (PAEA’s) growth. Although JPAE is relatively young in comparison to many of the journals associated with health care and the practice of medicine or even that ofmedical education, this milestone and JPAE’s quarter century of existence is a substantial accomplishment.During thepast 26 years, theAssociationofPhysician Assistant Programs (APAP), now PAEA, has published a scholarly journal that reflects the work of faculty members from various physician assistant (PA) programs related to topics of interest to our community of educators. While our organization continues tomakeprogress in advancing itself inmanydifferent venues, with this edition of the journal, JPAE has reached apivotal turningpoint in its natural progression andmaturation. The journal started from rather humble beginnings. Those of uswhohavebeenassociatedwith PAeducation for a couple decades or more may recall that the JPAE started as a newsletter known as Perspectives on PA Education. It was published initially as a paper version of the newsletter, stapled in the corner, and circulated withmodest support by PAEA (then APAP). The journal has been built upon the great work of its founding editor Dr Donald Pedersen, who conceived and carried it through the critical gestational period. The newsletter that was initially produced at the University of Utah’s PA program was a labor of love. It was known by program faculty as “Perspectives,” and it was enthusiastically enjoyed by PA faculty across the country as a means of sharing ideas with colleagues involved in the business of educating PAs. In 2005, another important milestone was reached when PAEAassumed the responsibility of producing the journal with staff members serving as its editorial and production staff. Dr Gene Jones was appointed editor in chief, and it transitioned into a full-fledged journal known as the Journal of Physician Assistant Education. Drs Pedersen and Jones, along with associated staff at the University of Utah and PAEA, nurtured the journal through those early formative stages, achieving the critical milestones that have positioned it as a scholarly journal that we all can take great pride in today. This important milestone for the journal and PAEA offers the perfect opportunity for us not only to reflect on how far we have come but also to look forward. With the rapid increase in the number of PA programs and the transition to programs granting the master’s degree, we have many more faculty members who are involved in scholarly activities, thus emphasizing the critically important need for a venue to publish and disseminate their work. Our partnership with publishing experts at Wolters Kluwer provides us with a new set of capabilities that includes a truly professional looking journal, the potential for greater distribution, a much expanded online presence, and an assembly of professional staff dedicated to the journal’s production. This transition appears well aligned with the recent growth and maturation we have seen in our membership and our professional organization. As we mark this newmilestone, we also look forward to the next milestone on the horizon. Our current quarterly production is being challenged by the increasing number of quality submissions and is begging the question of when will PAeducation bebetter servedby amore frequently published journal. JPAE remains dedicated to advancing PA education by publishing ethically produced scholarly manuscripts germane toPAeducators andbyprovidinga forum for the sharing of ideas and innovations that will enhance the education of PA students. To that end, we celebrate thismilestone and eagerly anticipate the next one. As always, I welcome your thoughts, suggestions, and ideas for making our journal the best that it can be.