Theresa E. Hegmann

Benchmarking the scholarly productivity of physician assistant educators: an update.

Purpose: Success in scholarship has long challenged physician assistant (PA) educators, most of whom enter academia with little experience in research or writing. Since most PA programs grant a professional graduate degree, and expectations for PA faculty typically focus on teaching and service rather than research, it is reasonable for promotion and tenure decisions to be based on comparisons from within the PA education realm. Providing such benchmarks is the focus of this report. Predictors of successful publication and trends over time are also explored briefly. Methods: De‐identified data from the 2010 Faculty Survey were obtained from the Physician Assistant Education Association (PAEA), including basic demographics, faculty rank and program role, degree, and number of peer‐reviewed publications. PAEA distributed the online survey in March 2010 to all faculty associated with member programs. The response rate was 35%, N = 425. SPSS version 19 was used for data analysis. Results: Respondents were 58.1% female. The mean number of publications reported by respondents over their entire career was 4.2, and over the last 3 years was 1.7. The respective median numbers of publications were one and zero. Logistic regression analysis identified three significant predictors of publication success: number of years in PA education, previous publications, and highest degree attained. Conclusions: This study seeks to provide rational benchmarks for PA program faculty seeking promotion or tenure. Previous publications and highest degree attained are key factors predicting successful publication. There is a continuing need for faculty development activities to help PA educators publish successfully.

Physician Assistant Program Director Opinions Regarding the Importance of Faculty Research and Publication

Purpose: Over the last decade, rapid growth in the number of physician assistant (PA) programs has strained our professions ability to supply sufficient numbers of well‐prepared faculty members. As the profession shifts towards an entry‐level graduate degree, PA educators—generally recruited out of clinical practice—are feeling more pressure to be involved in traditional scholarship activities. The goal of this portion of a two‐part study was to elicit opinions from PA program directors regarding the importance of, and barriers to, successful publication by their faculty members. Methods: A written survey instrument on various issues surrounding research and publication by faculty members was administered to directors of all accredited PA programs in May 2002. Results: PA program directors rated their priorities for faculty duties in the following order: (1) classroom teaching, (2) service and administrative duties, (3) clinical practice, and (4) research and academic scholarship. Program directors felt that faculty should ideally spend about 15% of their time on research activities. The factors felt to have the largest detrimental effect on publication success were: lack of time due to teaching or other responsibilities, lack of training in research design, and lack of previous experience with successful publication. Creation of set‐aside time dedicated to research and writing was considered the most important factor for promotion of faculty scholarship. Conclusions: Although program directors consider research and publication to be compatible with institutional priorities and very important to the profession as a whole, these activities are generally given a lower priority than other faculty duties.

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.

Benchmarking Scholarship Activities of Physician Assistant Faculty

Introduction: Research and publication are important components of the appointment, promotion, and tenure processes for faculty within academic institutions. Available research on scholarly productivity indicates that allied health faculty publish less frequently than academicians in other fields. Physician assistant (PA) educators have a track record of publishing even less frequently than their peers in other allied health professions. The goal of this project was to ascertain whether current core PA faculty members are successfully publishing and whether their publication rates have increased over time. Methods: A survey was mailed to all currently accredited PA programs in May 2002. Program directors distributed the survey to core faculty in their program; surveys were identified only by a code number. Faculty were asked to report the numbers of various types of scholarly activity they had undertaken in their entire careers as educators and also over the preceding 3 years, along with demographic information. Results: The response rate for individual faculty was 67%, and 72% of accredited PA programs were represented in the sample. The mean number of peer‐reviewed publications over the previous 3 years was 1.0 (median and mode were both 0); 73.3% of faculty had no peer‐reviewed publications over their entire careers as PA educators. Discussion: This study may provide more appropriate benchmarks for use in decisions regarding promotion and tenure than have been available previously for PA program faculty. The apparent lack of progress over time highlights a continuing need for faculty development activities to help PA educators publish successfully.

Reliability and Validity of PAEA End of Rotation™ Examination Scores for Predicting Performance on the Physician Assistant National Certification Examination.

Purpose In 2013, the Physician Assistant Education Association (PAEA) launched its End of Rotation™ examinations for student assessment of core clinical rotation content. Although being similar to the National Board of Medical Examiners subject examinations (“shelf exams”), these examinations have not been characterized for reliability or validated against outcomes such as the Physician Assistant National Certification Examination (PANCE). This studys objective was to determine whether a composite scale based on all 7 PAEA End of Rotation examinations can be used as an effective measure of comprehensive medical knowledge for physician assistant (PA) students in their clinical year. Methods This study was a retrospective analysis of deidentified data gathered by 3 PA programs. Scores for all 7 PAEA End of Rotation examinations and for the PANCE were available for all students in the class of 2014 for all programs, with an overall N = 134. SPSS version 21 was used for descriptive and inferential data analysis. Results The overall Cronbach alpha for the 7 End of Rotation examination scores was 0.871. Pearson correlation coefficients for the End of Rotation examinations and the PANCE ranged from 0.47 to 0.68 and were statistically significant. Simple regression of a composite 7-item End of Rotation examination average gave an R of 0.810 and an adjusted R2 = 0.654 (P < .0005), explaining 65% of the variance in PANCE scores. Conclusions This study provides solid evidence for the reliability of the composite 7-item End of Rotation score and the validity of using this composite score for the purpose of predicting whether the medical knowledge base in clinical PA students is adequate to pass the PANCE.

Snapshot of anatomy teaching in physician assistant education.

Purpose: Cadaver dissection has been a defining part of the culture of medical education for centuries. Currently there is an active debate regarding the advantages of dissection versus other forms of teaching anatomy. Methods: De‐identified data from the 2010 Curriculum Survey were obtained from the Physician Assistant Education Association, with 82 PA programs responding to anatomy curriculum questions. SPSS 21 was used for descriptive statistics, t‐tests, and Mann‐Whitney tests. Results: Programs reported a mean of 102.4 and median of 91 contact hours in anatomy (range 4‐270). The “average” PA program anatomy course used 57.4% lecture, 4.6% simulation, 25.9% dissection, and 12.1% prosection. Private programs had significantly fewer total and lab contact‐hours than public programs. Discussion: Teaching anatomy through cadaver dissection poses many challenges for health professions educators. Based on the results presented, PA programs are addressing this challenge in a variety of ways in their curricula.

Cheating by Physician Assistant Students on Patient Encounter Logs

Purpose: Medical educators commonly rely on patient encounter logs to evaluate the adequacy of students’ clinical encounters. Anecdotally, most training programs that utilize logging systems encounter problems with student falsification of entries. However, despite a large body of work on medical student cheating, falsification of log entries during clinical rotations has not been researched. This project aims to survey a national cross‐section of recent physician assistant (PA) graduates regarding cheating on patient encounter logs in order to estimate the magnitude of the problem and potentially identify factors associated with cheating. The project was supported by a PAEA research grant. Methods: After obtaining local IRB approval, an anonymous paper survey was distributed in mid‐March 2007 to a random sample of 1,800 recent PA graduates, using mailing labels obtained through the American Academy of Physician Assistants. The survey was also available in Web‐based format. Results: The response rate was 31%. The majority of respondents reported completing encounter logs during clinical rotations (94%), and of those who completed logs, 63% reported that patient encounter logs were tied to grades or some other measure of student progress. More than half (57%) self‐reported some degree of cheating behavior themselves, and 90% of respondents reported cheating behavior in their classmates. Conclusions: Cheating on patient logs during clinical training of PA students is a significant problem, but one that schools may not be aware of, since 46% of graduates reported that their program did not check the accuracy of logs. PA educators need to take proactive measures to address this issue.

Outcomes of a nationwide mentoring program for physician assistant educators.

Purpose: Physician assistant (PA) program faculty recruited from clinical practice encounter many barriers to success in academia, contributing to high attrition rates. Methods: In response, the PAEA Research Institute developed a nationwide mentoring program for junior PA educators in 2010‐2011, focused on scholarship. The program was not well‐utilized; more than half of the 33 early‐career faculty originally enrolled in the program failed to contact their volunteer mentors despite signing formal agreements. Results: Neither confidence levels nor actual scholarly productivity differed significantly between the initially matched and wait‐list groups. Time devoted to scholarship at the midpoint and end of the program correlated significantly with number of papers produced during the mentorship year (Pearson 0.830 and 0.823, respectively, P < .0001). A separate qualitative follow‐up survey identified lack of time, communication issues, and lack of structured expectations for scholarly output as significant barriers. Conclusion: These results suggest lack of time may interfere with mentoring relationships and scholarly success for early‐career PA educators.

The PDA Revolution

Authors desiring to contribute to “Technology and Education” should forward submissions to Richard Dehn, MPA, PA-C, University of Iowa, PA Program, 5167 Westlawn, Iowa City, IA 32242. E-mail: richard-dehn@uiowa.edu. Both visual and written media will be considered for publication. Visual media should be accompanied by a brief narrative. Theresa Hegmann, MPAS, PA-C University of Iowa, Iowa City, Iowa