INTRODUCTION:Approximately 80% of physician assistant/associate (PA) new faculty come directly from clinical practice into academia, often with limited preparation for academic career advancement. Therefore, this study aimed to evaluate the perceived barriers, institutional resources, and predictors of self-efficacy navigating promotion and tenure (P&T) decisions among PA educators nationwide. METHODS:A pilot-tested, IRB-approved survey was administered via multichannel convenience sampling (n = 270). Independent variables included institutional criteria, resource utility, mentorship type, and professional barriers. Data were analyzed using descriptive statistics, nonparametric tests, and multiple linear regression to identify primary predictors of faculty self-efficacy. RESULTS:Participants reported low overall self-efficacy navigating P&T (M = 2.93, on a 5-point Likert scale). Significant barriers included high teaching/service loads (63.3%) and perceived lack of clinical valuation (52.6%). Faculty at institutions that formally valued clinical experience reported significantly higher self-efficacy (M = 3.33/5) than those at institutions without such criteria (M = 2.84/5; P = .02). The regression model (R2 = .436, P < .001) identified structured mentorship as the strongest independent predictor of self-efficacy (β = 0.36), followed by perceived clinical valuation (β = 0.28) and resource variety (β = 0.26). Gender disparities were noted, with female faculty reporting higher service loads and greater uncertainty regarding resources. DISSCUSSION:Current P&T systems do not adequately account for the clinician-educator role. To foster equity and retention, institutions must prioritize targeted support, including formalized structured mentorship, the formal acknowledgement of clinical expertise in the advancement criterion, and the provision of a diverse set of scholarly resources for P&T.
Introduction Physician assistant (PA) programs face persistent challenges in recruiting and retaining clinical preceptors due to time constraints, administrative burden, lack of compensation, and limited training. Additional pressures, such as health care consolidation, program expansion, clinician burnout, and financial implications of paid clinical sites, further strain preceptorship capacity. This study examines motivators and barriers influencing clinicians’ willingness to precept PA students. Methods This mixed-methods study used snowball sampling to recruit current, former, and nonprecepting PAs across North Carolina. Participants completed surveys with Likert-scale and open-ended items adapted from the 2011 National Survey of Physician Assistants. Four virtual focus groups, selected from survey respondents, underwent semistructured interviews informed by Self-Determination Theory (SDT). Quantitative data were analyzed using descriptive statistics and ordinal logistic regression; qualitative data underwent thematic analysis with deductive SDT coding and inductive refinement. Triangulation then integrated these findings. Results Respondents (N = 158) represented diverse clinical experience. Top motivators included student quality (66%), program support (53%), and financial compensation (51%). Key barriers were student quality (61.29%), burnout (53.23%), and lack of compensation (46.77%). From the focused group discussion, four themes emerged: Student Quality, Financial Compensation, Non-Financial Incentives, and Administrative Support. Student preparedness acted as both motivator and barrier; compensation concerns focused on fairness. Discussion Preceptorship relies on relational and professional factors, student quality, recognition, and institutional alignment, rather than financial incentives alone. System inefficiencies, inadequate preparation, and misaligned compensation hinder engagement. Improving student readiness, enhancing institutional support, and implementing transparent, layered incentives may strengthen recruitment and retention.
INTRODUCTION:Suicide is a leading cause of preventable death worldwide, with many individuals interacting with health care providers shortly before their attempt. Medical trainees often report anxiety when managing patients with suicidal ideation. Effective care requires not only clinical knowledge but also empathic understanding. Despite its importance, evidence-based strategies for teaching empathy remain limited. This study draws on Experiential Learning Theory, Transformative Learning Theory, and applies the Jefferson Scale of Empathy as a framework. METHODS:Two cohorts of 131 physician assistant students participated in a panel discussion on suicide, followed by a reflective essay writing activity. The panel consisted of patient survivors of suicide and a psychiatric clinician. Retrospective, qualitative analysis of the reflective essays was conducted to answer 2 research questions: (1) What are the overall student takeaways from the suicide panel discussion? (2) How does experiential learning about suicidality, in the form of a panel discussion, affect the student's ability to develop empathic understanding? RESULTS:Students reported increased preparedness to care for suicidal patients, recognized limitations of lecture-based empathy instruction, and expressed interest in additional training. Jefferson Scale of Empathy-guided analysis demonstrated activation of empathy across all domains, including perspective taking, compassionate care, and understanding patients' lived experiences. DISCUSSION:Experiential panel discussions appear to be an effective approach to fostering empathy in health professions education. Although this intervention enhanced multiple dimensions of empathy, some subdomains were not addressed, highlighting the need for complementary educational strategies.
ABSTRACT:Artificial intelligence (AI) is rapidly reshaping health care and higher education, yet physician associate (PA) education lacks a unified framework for its integration. This consensus statement from the PA Education Association (PAEA) AI Special Interest Group (SIG) offers guidance for PA programs navigating the challenges and opportunities presented by AI technologies.The PAEA AI SIG used a modified Delphi method following the RAND/UCLA Appropriateness Method framework. Following a twelve-month qualitative phase of iterative discussion and collaborative document development, 13 expert panelists rated 20 consensus position items on a 9-point Likert scale. Consensus was defined a priori as a median rating of 7 to 9 without disagreement (per the interpercentile range method for a 13-member panel).All 20 position items achieved consensus endorsement in round 1 (median range: 7-9; overall mean 8.3). The SIG achieved consensus across 5 domains: assessment and academic integrity, AI as a learning tool, admissions processes, faculty workflow, and AI competencies. Items with the greatest variation related to lifting AI prohibitions in application preparation (item 9, median 7) and restricting general-purpose AI in admissions review (item 10, median 8).This consensus statement provides a foundation for PA programs to transition from reactive policies toward proactive, evidence-informed AI integration strategies. The recommendations emphasize rigorous competency validation, equitable access considerations, and the primacy of human judgment in clinical education.
Introduction People with serious mental illness (SMI) are a vulnerable population with poor health outcomes who also experience challenges interacting with health providers. This study aimed to explore the perceptions and recommendations of people with SMI for the development of physician assistant (PA) curriculum using the Socio-Ecological Model of Health framework (SEM). No known previous studies have explored the attitudes of people with SMI about their mental illness care to inform curriculum. Methods People with SMI (n = 7) were recruited from a state chapter of a mental health advocacy organization to explore experiences with health care providers and recommendations for PA education. The focus group lasted 90 minutes and was facilitated by a PA and mental health provider using an interview guide. Results Four themes were identified and coded using the SEM framework. These included (1) individual attributes of health, (2) interpersonal relationships contributing to health, (3) community features contributing to health, and (4) educational aspects needed for positive health encounters. Discussion People with SMI noted difficulties in interactions with medical professionals and systems. They perceived that medical providers need more education and skills to engage with people with complex health and mental health conditions. Results of this study may suggest that PA education can be improved by considering the SEM levels of interaction and listening to patients to incorporate feedback into service provision.
INTRODUCTION:A growing number of student applications to graduate physician assistant (PA) programs has highlighted the need for effective selection of candidates. Much of the work in this area has focused on connecting student course grades and performance in the national board certification Physician Assistant National Certifying Examination (PANCE) examination; however, this is of limited value in identifying those students who struggle academically before certification. METHODS:Four cohorts of PA students (n = 176) were retrospectively analyzed to determine if differences exist in preadmission metrics and early PA course scores between those students who required academic remediation (REM, n = 57) during PA school vs. those who did not (non-remediators [NREM], n = 119). RESULTS:Students requiring remediation had significantly reduced undergraduate science (REM: 3.67 ± 0.2 vs. NREM: 3.79 ± 0.2, P ≤ .001) and organic chemistry grade point averages (REM: 3.35 ± 0.6 vs. NREM: 3.6 ± 0.5, P = .004), as well as significantly poorer scores in multiple early courses including Gross Anatomy (REM: 85.6% ± 5.4% vs. NREM: 89.9% ± 4.7%, P ≤ .0001), Pathophysiology (REM: 86.6% ± 5.2% vs. NREM: 90.9% ± 4.4%, P ≤ .0001), and Clinical Medicine (REM: 84.9% ± 4% vs. NREM: 90.2% ± 3.6%, P ≤ .0001) during their PA training. REM also had significantly reduced Physician Assistant Clinical Knowledge Rating and Assessment Tool I, Physician Assistant Clinical Knowledge Rating and Assessment Tool II, and PANCE scores compared with NREM (P ≤ .0001). DISCUSSION:Specific preadmission metrics and early academic performance indicators may identify students who require learning interventions during their graduate coursework.
INTRODUCTION:Amid a preceptor shortage, this pilot study examined the relationship between generativity, a psychosocial construct reflecting concern for guiding the next generation, and demographic characteristics among physician assistants (PAs), gaining insights for PA programs about intrinsic factors motivating preceptorship. METHODS:This descriptive correlational study analyzed survey data from 45 nationally certified PAs. Participants completed a one-time questionnaire assessing demographics, precepting status, and generativity using the validated Loyola Generativity Scale. Nonparametric analyses, correlations, and multiple regression were performed. RESULTS:Generativity scores did not differ significantly by precepting status ( P = .88). Years of practice and full-time employment were associated with higher generativity scores, though differences were not statistically significant. Correlations between generativity and age, employment status, and practice setting were weak. DISCUSSION:Although statistically nonsignificant, observed trends suggest generativity may warrant further investigation as an intrinsic factor related to precepting. Findings are hypothesis-generating and may inform future research and preceptor recruitment strategies.
ABSTRACT:The persistent underrepresentation of Black, Hispanic, and socioeconomically disadvantaged students in physician assistant (PA) education threatens the diversity of the healthcare workforce and contributes to ongoing health inequities in underserved communities. Although national commitments to inclusion have increased, representation among PA graduates has not kept pace with national demographic trends. Advancing equity in PA education requires strategies that expand access and support student success through holistic admissions practices, supportive learning environments, culturally responsive instructional approaches, and leadership approaches that promote equitable educational outcomes.
Introduction Mass casualty incidents (MCIs) are community threats prompting recommendations for formal MCI training among health care professionals, including physician assistant/associate (PA) students. In response, two accredited PA graduate programs collaborated on an immersive MCI training day aimed at improving student preparedness and confidence in responding to an MCI in the community. Methods In this prospective cohort study, didactic-year PA students (n = 45) participated in a novel MCI curriculum that involved practical skills stations and large-scale simulations. Preliminary data on program effectiveness were assessed pretraining and post-training via surveys assessing knowledge and self-reported preparedness and confidence in responding to an MCI. Paired samples t -tests were used to determine if differences were seen between pre and post assessments. Results We describe the development and implementation of MCI training in detail, including curricular design, personnel, set-up, and administration. Initial analyses showed statistically significant improvements in knowledge gained (42.4 ± 14 vs. 86 ± 12, P ≤ .0001), perceived preparedness (1.8 ± 0.8 vs. 4.3 ± 0.5, P ≤ .0001), and perceived confidence (2.9 ± 1.3 vs. 4.3 ± 0.6, P ≤ .0001) after implementation of the MCI curriculum. Conclusions The development and execution of an MCI curriculum is described and can be used as a template for PA educators wishing to incorporate this training into the curriculum. Training significantly enhanced PA students’ knowledge, preparedness, and confidence in community-based disaster response. These findings support the integration of formal MCI training in PA education to prepare future providers for real-world disaster response.
INTRODUCTION:The physician assistant/associate (PA) profession formally recognizes advanced clinical expertise through Certificates of Added Qualifications (CAQs). However, no analogous national mechanism exists to recognize advanced expertise in PA education. As PA programs expand and faculty roles grow in complexity, structured recognition of experienced PA educators warrants scholarly examination and consideration of a dedicated CAQ. METHODS:A structured conceptual analysis was conducted through review of existing National Commission on Certification of Physician Assistants (NCCPA) CAQ eligibility criteria, literature on PA faculty workforce trends, scholarly productivity, professional development outcomes, and the PA Education Association (PAEA) Educator Competencies framework. A comparative model was developed to examine distinctions between clinical specialty certification and educational expertise recognition. RESULTS:Educational expertise differs from clinical specialty practice in that competence is demonstrated longitudinally through teaching performance, curriculum design, leadership, mentorship, and scholarship rather than examination alone. It is proposed that an Education CAQ could be similarly structured with the current NCCPA CAQ framework to include documented educational practice hours, focused continuing medical education, and formal attestation aligned with established PA educator competencies. DISCUSSION:An Education CAQ may provide structured recognition of advanced educator expertise without altering entry-level educational requirements or restricting professional mobility. Development within existing certification infrastructure, in collaboration with PAEA, could align professional recognition structures with evolving workforce realities in PA education and promote advancement within higher education.
INTRODUCTION:Physician assistant (PA) programs increasingly use holistic admission strategies to evaluate noncognitive attributes not assessed by traditional academic metrics. Computer-Based Assessment for Sampling Personal Characteristics (CASPer), a situational judgment test, was developed to assess qualities such as professionalism, ethics, and decision making. Limited data exist regarding the impact of CASPer on applicant diversity in PA education. METHODS:This retrospective observational study examined applicants to a single public PA program across 5 application cycles (2021-2025). Computer-Based Assessment for Sampling Personal Characteristics scores were standardized within cohort, and a hypothetical cut score set at one standard deviation below the mean was applied. Applicants were categorized by scores greater than or less than the cut score. Gender, race/ethnicity, and underrepresented minority (URM) status were compared using chi-square tests, t tests, and logistic regression. RESULTS:Applying a CASPer cut score would have removed 16.5% of applicants. Modeling the interview pool demonstrated a 12.1% relative decrease in men and 12.5% relative decrease in URM applicants after replacement of those with less than the cut score. Computer-Based Assessment for Sampling Personal Characteristics scores did not differ significantly by race/ethnicity or gender. Logistic regression showed that male gender and lower prerequisite grade point averages were associated with higher odds of falling below the cut score. DISCUSSION:Although CASPer is intended to assess noncognitive attributes, applying a cut score was associated with reductions in male and URM applicants. These findings suggest that CASPer may influence applicant diversity through how scores are applied rather than through group differences in overall performance. Programs should consider using CASPer as one component of holistic review rather than as a rigid screening threshold.
INTRODUCTION:This study provides a 20-year analysis (2002-2021) of the Central Application Service for Physician Assistants, extending earlier reports to assess long-term trends in PA admissions. Central Application Service for Physician Assistants participation rose from 51% of programs in 2002 to nearly universal adoption by 2021. Applicant numbers increased 5-fold, reaching 28,445 in 2021, while matriculants grew from 3715 in 2007 to 11,178 in 2021. Despite growth in available seats, matriculation rates declined, fluctuating between 31% and 41%. METHODS:Central Application Service for Physician Assistants data from 2002 to 2021 were used to examine trends in applicant behavior, academic metrics, demographics, and experience. Outcomes included program participation, applicant and matriculant counts, and matriculation rates. Explanatory factors included program designations, mean overall and science grade point averages (GPAs), age, gender, race/ethnicity, first-generation and economically disadvantaged status, and shadowing and patient care experience. RESULTS:Applicant behavior and academic metrics shifted. Average program designations increased and each additional designation up to 13 improved matriculation odds. Mean overall and science GPAs rose steadily. Asian and Hispanic/Latino(a) representation increased, while proportions of Black/African American, American Indian/Alaska Native, and Native Hawaiian/Pacific Islander applicants and matriculants remained low; White applicants continued to matriculate at disproportionately higher rates. First-generation and economically disadvantaged applicants increased but were less likely to matriculate. Most applicants reported shadowing and patient care experience, associated with higher matriculation. DISCUSSION:Findings demonstrate sustained growth in PA education but slow advancement toward racial, ethnic, and economic diversity, underscoring the need for more equitable admissions strategies.
INTRODUCTION:The One Big Beautiful Bill Act eliminates the Grad PLUS program and establishes annual and aggregate federal student loan caps beginning July 1, 2026. Physician associate/assistant (PA) programs are currently classified as graduate-level for federal aid purposes, potentially subjecting PA students to lower borrowing limits than other health professions. This study examined perceptions of federal loan caps and anticipated impacts on PA education and workforce. METHODS:A cross-sectional, anonymous, web-based survey was administered in January 2026 to pre-PAs, PA students, and practicing PAs across the United States. Items assessed demographics, borrowing patterns, perceived affordability, and anticipated behavioral responses under a proposed $20,500 annual federal loan cap. Descriptive statistics, chi-square analyses, independent samples t -tests, and multivariate logistic regression were performed. RESULTS:Among 4,000+ respondents, concern regarding restrictions was high; 72% of PA students and practicing PAs reported being very or extremely concerned. Overall, 90.8% anticipated decreased applicant volume and 89.6% predicted reduced diversity under a $20,500 annual cap. Logistic regression (N = 3,106) indicated that each additional economic disadvantage factor increased odds of reporting discouragement from pursuing PA education by 20% (odds ratio = 1.20; 95% confidence interval: 1.12-1.29). Underrepresented in medicine respondents were disproportionately represented in the highest educational cost and borrowing categories ( p < 0.001). DISCUSSION:Respondents anticipate negative implications of federal borrowing caps for PA applicant volume, diversity, and service to underserved areas. Financial vulnerability appears central to perceived feasibility of PA education under proposed loan limits, raising equity and workforce sustainability concerns.
Recent federal initiatives, including the Food and Drug Omnibus Reform Act, have emphasized improving diversity in clinical trial enrollment and expanding research into community and underserved settings. However, investigator shortages and administrative burden continue to limit clinical trial capacity and site availability. Physician associates (PAs) typically serve as sub-investigators (sub-Is) with responsibilities focused on clinical care for enrolled participants. National survey data demonstrate limited advanced practice provider (APP) involvement in trial leadership: Among 271 practices surveyed, only 15% reported APP participation in trial selection, 5% had an APP serving as a primary investigator, and 3% reported APP involvement in protocol development. These findings highlight underutilization of PAs in research leadership roles. Postprofessional PA doctoral programs provide advanced training in research design, biostatistics, evidence-based practice, leadership, and scholarly communication. These competencies are directly applicable to clinical trial oversight, regulatory coordination, and site-level operations. Doctoral-educated PAs may continue serving as sub-Is while assuming expanded responsibilities in study management and protocol development within established collaborative practice frameworks. Integrating clinical trial-focused tracks into PA doctoral curricula may strengthen research workforce capacity, reduce physician administrative burden, and expand trial access in community settings. Creating structured leadership pathways for doctoral-educated PAs aligns with federal goals to improve equitable trial representation and offers a practical strategy to enhance clinical research infrastructure.
INTRODUCTION:The Accreditation Review Commission on Education for the Physician Assistant requires programs to implement ongoing self-assessment processes using numerous measures to evaluate their effectiveness, entailing data collection, critical analysis, application of results, and the formulation of conclusions. Developing, implementing, and maintaining a robust ongoing self-assessment process is challenging for physician assistant/associate educators due to competing complexities, time limitations, overwhelming amounts of data, and a lack of training and/or adequate resources, which impact program success and faculty and staff stress. Recent technological advances, such as business intelligence (BI) software, may influence faculty and staff experiences in programmatic self-assessment. METHODS:A survey was used to quantitatively and qualitatively gauge faculty and staff experiences and perceptions of using BI technology in the study program's self-assessment process. Survey items focused on data management, usability, task management, faculty and staff stress, and overall satisfaction. RESULTS:Faculty and staff reported positive perceptions overall. Favorable narratives emerged related to their experiences using BI tools for self-assessment activities within the study program. Respondents recommend these tools to other programs and offer valuable insight to ensure successful implementation. DISCUSSION:The findings of this single-program study suggest that the use of BI technology may contribute favorably to faculty and staff experiences in programmatic self-assessment. However, further studies are needed to correlate a relationship and explore generalizability.
INTRODUCTION:Physician associates (PAs) are increasingly stepping into leadership positions across all health care settings, yet formal leadership training is not consistently included in PA school curricula. We designed a leadership curriculum aimed to prepare PA students to be future health care leaders. METHODS:The curriculum was developed by an experienced PA who recognized gaps in their own leadership development. The curriculum was administered to second-year (PY-2) PA students. Group didactics were paired with facilitated small group exercises and a leadership panel discussion. Presurveys and postsurveys were collected to assess curriculum effectiveness. Data from three years of implementation were analyzed using Wilcoxon signed rank tests. RESULTS:Sixty-two presurveys and postsurveys were collected from PY-2 students from 3 cohorts. Following the curriculum, students reported a higher likelihood of taking on a leadership role (P < .01) and felt they had the tools to bring about health care change (P < .01). Their comfort with engaging in difficult conversations with a power differential and explaining how to be an effective listener to a peer significantly improved (P < .01). They found the leadership training valuable and agreed that it should be incorporated in all PA programs (P < .01). DISCUSSION:Physician associate students are highly interested in pursuing leadership roles in their careers. Our leadership curriculum led to an increased level of comfort navigating difficult conversations and provided PA students with tools for future leadership roles. The leadership curriculum was feasible, easy to adopt, and well-received. Future iterations should include long-term follow-up on roles after graduation and inclusion of a leadership mentoring component.
INTRODUCTION:Emerging research indicates that implicit biases impact clinical decision making. The aims of this mixed-methods study were to determine if implicit racial bias exists in physician assistant (PA) and physical therapy (PT) students and, if so, is interprofessional education (IPE) using a clinical simulation (CS) model with standardized patients (SPs) an effective mitigator. METHODS:Parallel cases were developed for a simulated critical-care arena. Cases were identical related to medical and social history, medications, demographics, and hospital courses. The only variable was race. Outcome measures included pre/post Harvard Implicit Test-Racism (HIAT-R), discharge location and rationale for the location, and qualitative data obtained from debriefings. RESULTS:The preintervention HIAT-R indicated that 80% of students in the PA and PT programs scored as having some level of implicit racial bias favoring people White people over Black people. The intervention appeared effective in altering student bias as measured by the postintervention HIAT-R (P < .001), discharge recommendation, and rationale for discharge recommendation. The qualitative analysis from the debriefing of the SPs revealed a greater sensitivity to perceived microaggressions in the Black SPs than White SPs. Student debriefing revealed several themes centering on guilt, lack sensitivity to persons of color, and the need to obtain additional educational content related to implicit bias. The multimodal intervention using the HIAT-R, IPE, CS, and SPs has an effect on implicit bias. DISCUSSION:Implicit racial bias is common in health care students and impacts clinical decision making associated with discharge planning. An intervention using IPE, CS, and SPs appears to mitigate the implicit bias.
ABSTRACT:Prior to PA school, my identity was closely tied to my athletic career. Throughout my time, I have gained an interest in research along with my pursuits of excelling in the classroom. As a result, this has pushed me to pursue goals that I did not think were possible. This manuscript highlights my journey from starting PA school to presenting at an international conference and beyond.
INTRODUCTION:Socioeconomic status (SES) is a complex construct that includes social factors that influence one's access to economic, environmental, and educational resources. Physician assistant/associate (PA) programs often use undergraduate grade point average (GPA), one measure of academic achievement, to assess applicants for admission, but the extent to which SES impacts undergraduate academic achievement remains unexplored. This study examines the relationship between SES and matriculation into PA programs and the extent to which undergraduate academic achievement mediates that relationship. METHODS:Using data from 3 application cycles of the Centralized Application Service for Physician Assistants, ten self-reported indicators of environmental and economic disadvantage (EED) were analyzed. Mediation analyses assessed whether and to what extent undergraduate academic achievement mediates the association between EED indicators and odds of PA program matriculation. RESULTS:In unadjusted logistic regression models, applicants who reported EED indicators had lower odds of matriculation than those who did not. In adjusted models, many EED indicators that initially appeared disadvantageous became nonsignificant or advantageous. Grade point average was a significant mediator of the relationship between SES and matriculation likelihood for most (80%) EED indicators and substantially mediated the relationship between the first-generation college student indicator and decrements in odds of matriculation. DISCUSSION:Our study is the first to examine the relationship between multiple markers of SES and PA program matriculation and, notably, identifies undergraduate GPA as a significant mediator of this relationship. Our findings highlight how childhood EED detrimentally impacts opportunity later in life and identifies intervention targets to improve equity in access to PA education.
