Background:
The number of physician assistants (PAs) who are hospitalists has rapidly expanded. Little educational research has been done to understand what knowledge and skills PA students need in preparation for a career in hospital medicine. We sought to identify which topics and experiences practicing hospitalists felt were most critical for PA students. A second research goal was to better describe hospitalists’ understanding of PA training.
Methods:
We emailed an anonymous, voluntary survey to 85 hospitalists from Duke University Hospital, Duke Regional Hospital and Duke Raleigh Hospital. The survey was designed to 1) elicit hospitalists’ opinions about which clinical conditions, types of learning experiences, and areas of systems-based practice are most essential for PA student learners and 2) assess respondents’ knowledge regarding the educational structure and duration of PA school. Questions about potential curriculum content were derived from the core competencies for learners identified by the Society of Hospital Medicine. To our knowledge, application of this set of competencies to PA student learners has not been previously studied. We obtained study exemption from the Duke IRB. Responses were analyzed using descriptive statistics.
Results:
Of the 85 survey invitations sent, we received 57 responses. 85% of respondents reported working with PA students in their current role. The top 3 clinical conditions identified as priorities for PA student education were acute coronary syndrome, congestive heart failure, and community acquired pneumonia. The top 3 educational experiences identified were working with physician clinical preceptors, working with midlevel provider role models and rounding on patients throughout their hospital course. The top 3 areas of systems based practice were diagnostic decision making, care of the elderly patients, and communication with patients and families.
While the majority of participants correctly identified the length of preclinical and clinical training as one year each, 22% of respondents gave an incorrect answer for preclinical training (ranging from 0 to 36 months) and 23% gave an incorrect answer regarding the duration of clinical training. While PAs are able to enter fully licensed practice after the completion of PA school, 17% of respondents said this was not the case. Expectations for the amount of time a newly graduated PA would take to become an independent practitioner varied from 1 to 48 months.
Conclusions: Through this faculty survey, we identified the most high-yield clinical content and types of educational experiences for PA students on an inpatient medicine rotation. To our knowledge, this is the first attempt to define the learning objectives for PA students on a hospital medicine rotation through formally surveying practicing hospitalists. The results of our survey are guiding curriculum development for our PA students to enable optimal education of this important group of future hospitalists.