After the parade: military nurses' reintegration experiences from the Iraq and Afghanistan wars.

The purpose of the current study was to describe reintegration experiences of U.S. military nurses returning from deployments in the Iraq and Afghanistan wars. A qualitative study using a phenomenological method was conducted. The population comprised nurses who served in the U.S. Army, Navy, or Air Force in Iraq or Afghanistan during 2003-2013, including Active Duty, National Guard, and Reserve nurses. Purposive sampling with Veteran and professional nursing organizations yielded a sample of 35 nurses. Nine themes emerged from analysis: (a) homecoming; (b) renegotiating roles; (c) painful memories of trauma; (d) getting help; (e) needing a clinical change of scenery; (f) petty complaints and trivial whining; (g) military unit or civilian job: support versus lack of support; (h) family and social networks: support versus lack of support; and (i) reintegration: a new normal.

Military Veteran Matriculation in US Physician Associate/Assistant Programs.

INTRODUCTION: This study aims to determine whether veterans have differential access to physician associate/assistant (PA) education by examining likelihood of matriculation relative to nonveteran peers. We explore associations between veteran status and likelihood of matriculation for change over time and whether effects differ among active duty versus non-active-duty applicants. METHODS: Multivariate logistic regression was used to investigate associations between self-identified military status and likelihood of PA program matriculation in five Centralized Applicant Services for Physician Assistants admissions cycles (2012-2013, 2014-2015, 2016-2017, 2018-2019, 2020-2021). Models controlled for age, sex, race/ethnicity, patient care experience hours, total undergraduate grade point average, and number of applications submitted and applied a Bonferroni correction for alpha inflation. RESULTS: Veteran applicant numbers were small across the study time frame but increased from 2012 (n = 708) to 2020 (n = 978), representing a 38% increase over the lookback period. Despite growth, the proportion of veterans in the matriculant pool has decreased from 4.2% in 2012 to 3.0% in 2020. In unadjusted models, military status was not strongly associated with odds of matriculation. In adjusted models, both veteran and active-duty status were associated with higher odds of matriculation, although this increase was not statistically significant at the 0.005 level for applicants on active-duty. DISCUSSION: Military veterans and active-duty military personnel have higher likelihood of matriculation into US PA programs relative to nonveteran peers. The proportion of veterans in the matriculant pool has decreased over time. This suggests that while PA programs seems to value previous military experience, further efforts to evaluate and address barriers to military veterans in applying for admissions is needed.

Full circle: a new classroom site to facilitate the veteran to physician assistant pathway.

INTRODUCTION: Former military medics and corpsmen face challenges entering a civilian health care system that underutilizes their training and experience. The MEDEX Northwest physician assistant (PA) program launched a new classroom site in Tacoma, Washington, near local military bases, to ease entry into the PA profession for those in the local military and civilian communities. METHODS: To fill the new classroom, the program conducted outreach to prospective applicants at community colleges, on-base transition and education centers, and education and career events near local installations. RESULTS: Half of the first Tacoma class members are military veterans, half are female, 71% are from disadvantaged backgrounds, and the average age is 33. The Tacoma class demographics are equivalent to the overall 2013 MEDEX entering class with the exception of a higher veteran population (p < 0.001) and a higher rate of educational or economic disadvantage (p = 0.001). DISCUSSION: The MEDEX PA program has met its mission with the new Tacoma site in terms of access for former military, disadvantaged, and local enrollees. Offering a pathway to the PA profession for those with prior military medical experience recognizes the training and skills attained while in uniform and allows entry into a meaningful civilian career.

The Texas health workforce benefit of military physician assistant program veterans.

PURPOSE: Little is known about the benefits to society of the educational development of health personnel in the military who return to civilian life and continue their careers. The U.S. Department of Defense has produced physician assistants (PAs) since the early 1970s, and PA training is now consolidated into one location in Texas as the Interservice Physician Assistant Program (IPAP). We studied redistribution of PAs upon service departure to determine if IPAP attendance had an effect on the Texas PA workforce. METHODS: The Texas Medical Board dataset of licensed PAs was examined to identify program attended, practice specialty by supervising physician designation, practice location, and primary care or specialty care practice designation. Primary care was defined as family medicine, general pediatrics, or general internal medicine. All other designations were classified as specialty practice. RESULTS: Of 6016 licensed Texas PAs, 425 (7.0%) reported attending a military PA training program. Of the 254 PAs in full-time civilian clinical practice, 148 (58.3%) reported practice in primary care settings, and 106 (41.7%) reported specialty clinical practice settings. DISCUSSION: With the average military officer retirement age of 47 years and the 2010 average U.S. retirement age of 64 years for men and 62 for women, an estimated 16 years of community workforce productivity is provided per veteran PA following completion of military service. We estimated over 47,000 outpatient visits are provided per PA following military service. The care provided can be measured as a positive return-on-investment of taxpayer-provided education.

Assessment of admissions policies for veteran corpsmen and medics applying to physician assistant educational programs.

PURPOSE: The purpose of this study was to assess the admission policies, experiences, and attitudes of physician assistant (PA) program directors with regard to recruiting, admitting, and training veteran corpsmen and medics. METHODS: A descriptive survey consisting of 18 questions was distributed to all 154 PA program directors in the United States. RESULTS: One hundred ten (71.4%) program directors participated in the survey. Veterans were admitted into 83.6% of programs in the years 2008-2010, and accounted for an average of 2.6% of all students. A minority of PA programs accepted college credits earned by veterans for their military training (45.3%) or for their off-duty education (28.4%). Few PA programs participated in the Yellow Ribbon Program (16%) or actively recruited veterans (16%). Over half of PA programs (56.7%) would be more likely to give special consideration to the admission of veteran corpsmen and medics if it was easier to equate their military education and experience to the program's admission prerequisites. The most frequently reported benefits for educating veteran corpsmen and medics in PA programs are their health care and life experiences, maturity, and motivation. Barriers for educating veterans include veterans' lack of academic preparedness for graduate education, a lack of time/access for recruiting, and the cost of PA school. CONCLUSION: Most PA program directors cited multiple benefits for educating veteran corpsmen and medics, but veterans face barriers for admission into PA programs. Approaches are discussed for facilitating the transition of corpsmen and medics from the military to careers as PAs.