Background:

The number of physician assistants (PA) practicing hospital medicine is increasing.1 The number of PA schools in the US has also increased from 54 in 1992 to 218 in 2015.2While there is an increasing need for robust PA student inpatient medicine education, little educational research has been done to determine the impact of a hospital medicine curriculum for PA students.

Methods:

Based on a prior needs assessment3, we developed a curriculum for PA students rotating on a hospital medicine rotation to ensure that PA students were routinely exposed to diagnoses from the SHM Core Competencies.  The curriculum was implemented at Duke Regional Hospital, a site with hospitalist preceptors, a well-established PA student presence, and no prior formal curriculum. Nine months after implementation, we sent an email survey to hospitalist preceptors. Hospitalists used Likert scales to rate the impact of the curriculum on their ability to teach, on the learning experience for PA students, and the ability of the rotation to address selected core competencies. This data was compared to data obtained prior to curriculum implementation. The surveys were anonymous and voluntary.

Results:

20 (50%) of 40 invited hospitalists responded to the emailed survey.

Hospitalists rated the impact of the curriculum on their ability to teach positively (mean response 3.06, Likert scale 1-very negative impact, 4- very positive impact) and also rated the impact on the PA student educational experience positively (mean response 3.32, Likert scale 1-very negative impact on education, 4-very positive impact on education).

The post-implementation survey of faculty found no significant impact for each of the target diagnoses.  However, several healthcare systems topics from the core competencies improved significantly: care of the un- or under-insured (p=0.03), communication with patients and families (<p=0.01), team approach and multi-disciplinary care (p=0.02), patient education (p=0.03), drug safety/drug interactions (p=0.01), and patient safety and quality improvement processes (p=0.03).

Conclusions:

Implementation of a hospital medicine curriculum for PA students was well received by hospitalists.  Curriculum implementation may have also positively impacted learning about healthcare systems. Given the growth of hospital medicine PAs, more educational research is needed in this area.

1)      National Commission on Certification of Physician Assistants, Inc. 2015 Statistical Profile of Certified Physician Assistants: An Annual Report of the National Commission on the Certification of Physician Assistants. Available at http://www.nccpa.net/research.

2)      Program data from Accreditation Review Commission on Education for the Physician Assistant. Available at http://www.arc-pa.org/accreditation/resources/program-data/.

3)      Sharma P, Brooks M, Roomiany P, Verma L, Criscione-Schreiber L, Training PA students in inpatient medicine: the nuts and bolts of curriculum development and attending engagement. Poster at SHM Annual Meeting, 2016.