The Contribution of Postprofessional Doctorates to the Career Development of Healthcare Workers: A Scoping Review.

INTRODUCTION: Doctorate education and implications for career trajectory for postprofessional healthcare workers like physician assistants/associates (PAs) remain under¬studied. PURPOSE: This scoping review identified findings from existing literature on the contribution of postprofessional doctorate (PPD) degrees to the career development of non-entry-level healthcare workers to inform the con¬temporary emergence of PA-specific doctorate programs in the United States. METHODS: The research followed the Joanna Briggs Institute methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews. Eligible sources examined career advancement outcomes, curriculum, and terminal projects of PPD degree programs for postprofessional healthcare workers. Empirical studies, literature reviews, and commentaries were included. Multiple relevant databases, Google, and Google Scholar were searched. Citation chaining and hand searching of relevant journals were also completed. Screening and data extraction were conducted using Covidence. RESULTS: Among 1,605 sources identified, 24 met eligibility criteria. Most sources examined the Doctor of Nursing Practice and referenced clinical acumen, professional visibility, scholarly capability, leadership readiness, teaching preparation, and self-confidence. CONCLUSION: Findings about PA PPD degrees were limited. Sources exploring other professions demonstrated career development and educational outcomes, making assessment of results challenging. Future research should delineate critical competencies required for doctor¬ate-prepared PAs.

Impact of COVID-19 on student perceived stress, life satisfaction, and psychological flexibility: examination of gender differences.

Objective: To identify stress management practices and examine the impact of the COVID-19 pandemic on well-being among male and female physician assistant (PA) students. Participants: Participants included 1,239 students from nine PA programs who matriculated pre-pandemic, acute pandemic, or post-acute pandemic. Methods: Measures included questions about stress management practices and validated instruments assessing perceived stress, life satisfaction, and psychological flexibility. Data were analyzed for differences based on year and gender. Results: Exercise (91.6%), yoga (54.6%), meditation (34.3%), and journaling (32.5%) were commonly reported stress reduction practices. Newly matriculated PA students adjusted to the COVID-19 pandemic differently based on gender. Pre-pandemic, men and women reported similar levels of perceived stress and psychological flexibility, but female students reported higher life satisfaction. Post-acute pandemic, however, female students reported higher perceived stress and lower psychological flexibility. Conclusions: Wellness resources may be strengthened by approaches that account for differences based on gender.

Foundational Skill-Building in a Novel Well-being Curriculum.

INTRODUCTION: Mental illness and decreased well-being are pervasive throughout physician assistant (PA) training, and the accreditation standards require a wellness curriculum. The purpose of this study was to determine if a mandatory, multifaceted virtual wellness curriculum can mitigate the decline in well-being experienced by first-year PA students. METHODS: First-year PA students from 5 programs (n = 259) participated in a 16-week asynchronous virtual course. The course integrated evidence-based content on vulnerability and stigma, mindfulness and decentering, and reflective writing. Total weekly content averaged 30-60 minutes and was presented in multiple formats including recorded lectures and panels, readings, and discussion forums. Students completed anonymous pre- and postsurveys, and ordinary least squares (OLS) regression with a fixed effect for each school was used for data analysis. RESULTS: In total, 157 of 259 (60.6%) students completed both surveys with matching unique identifiers. The majority of students (73.6%; 134/182) thought this course had a positive impact on their training as a PA student. Baseline scores were significantly predictive of end-point scores for the PHLMS, OMS-HC-15, SSOSH, RPQ, and UCLA-3 (see Methods section for full names of surveys). Race was significantly predictive of PHLMS and OMS-HC-15 scores; age was significantly predictive of SSOSH scores; and gender was significantly predictive of RPQ scores. DISCUSSION: For a student with low baseline well-being who is entering a PA program, dedicated curricula focusing on foundational wellness skills can be successful in improving well-being. Future work is needed to more fully characterize the scope and extent of this program's impact on PA learners. Additional efforts are also necessary to optimize the delivery and provide access to PA students nationwide.

Dental Bite-Sized Bits: A Module for Teaching Common Oral Health Conditions to Multidisciplinary Students.

The Surgeon General's report in the year 2000 highlighted the association between chronic diseases and oral health infections. Current healthcare education programs, regrettably, report only 1 to 3 h of oral health instruction within curricula. In the years 2020-2022, as part of their respective oral health curricula, 278 first-year physician assistant and 12 pre-clinical second-year pharmacy students were invited to participate in a voluntary survey examining the effectiveness of animated succinct, online video-based oral health units. Among all student responses for the post-use survey, respondents "strongly agreed" or "agreed" that learning objectives of the unit(s) were achieved after reviewing the videos. Of the participants, 97% "strongly agreed" or "agreed" that the videos helped them understand information of which they had no prior knowledge. Similarly, 98% "strongly agreed" or "agreed" the information was appropriate for their level of knowledge. Most students, 93%, "strongly agreed" or "agreed" the exercise was a valuable learning experience. Regarding the importance of future interprofessional collaboration pertaining to a mutual patient's oral health, 95% of participants "strongly agreed" or "agreed" that they would be likely to collaborate. This study demonstrates the importance of oral health as a critical area of focus in healthcare education. The study also confirms the hypothesis that Dental Bite-Sized Bits units deliver engaging, valuable oral health education for preclinical healthcare learners, incorporating interprofessional perspectives from the disciplines of dental, pharmacy, and physician assistant.

Comparing the Effectiveness of Virtual and In-Person Delivery of Mindfulness-Based Skills Within Healthcare Curriculums.

Purpose: To promote well-being, healthcare education programs have incorporated mindfulness-based skills and principles into existing curriculums. Pandemic-related restrictions have compelled programs to deliver content virtually. Study objectives were to determine (1) whether teaching mindfulness-based skills within physician assistant (PA) programs can promote well-being and (2) whether delivery type (virtual vs. in-person) can impact the effectiveness. Methods: During this 2-year study, a brief mindfulness-based curriculum was delivered to incoming first-year students at six PA programs, while students at two programs served as controls. The curriculum was delivered in-person in year one and virtually in year two. Validated pre- and post-test survey items assessed mindfulness (decentering ability, present moment attention and awareness, and psychological flexibility) and well-being (perceived stress and life satisfaction). Results: As expected, coping abilities and well-being were adversely impacted by educational demands. The mindfulness-based curriculum intervention was effective in increasing mindfulness and life satisfaction, while decreasing perceived stress when delivered in-person. Virtual curricular delivery was effective in decreasing perceived stress but not improving life satisfaction. Over half of the participants receiving the curriculum reported positive changes on mindfulness measures with approximately 14-38% reporting a change of greater than one standard deviation. Changes on mindfulness measures explained 30-38% of the reported changes in perceived stress and 22-26% of the changes in life satisfaction. Therefore, the mindfulness curriculum demonstrated statistically significant improvements in measures of mindfulness and mitigated declines in life satisfaction and perceived stress. Conclusion: Mindfulness-based skills effectively taught in-person or virtually within PA programs successfully promote well-being.

Wellness in Physician Assistant Education: Exploring Mindfulness, Well-Being, and Stress.

PURPOSE: The current study examined stress reduction activities most commonly used by matriculating physician assistant (PA) students to better understand how students are approaching self-care and management of stress. In particular, the study examined levels of mindfulness and well-being to understand how these relate to various stress reduction approaches at the time of matriculation. METHODS: Newly matriculated students at 9 PA programs located across the nation were surveyed (n = 294). Validated survey instruments assessed levels of mindfulness and general well-being. Stress reduction activities were also assessed. Univariate and multivariate analyses were used to examine levels of mindfulness and levels of well-being to see how these relate to various stress reduction approaches. RESULTS: The survey response rate was 72%. Nearly one-third of respondents (32%) identified meditation as one of their stress reduction activities, and more than half (53%) reported having participated in mindfulness practice at least once in the past year. Sixty-four percent of students reported awareness of mindfulness practices, while only 16% reported frequent practice within the year prior to matriculation. When looking at variables of interest, decentering and psychological flexibility were significant in accounting for student-reported perceived stress and life satisfaction. CONCLUSION: PA students are likely receptive to mindfulness-based interventions that have the potential to improve well-being and reduce stress. There is opportunity for programs to incorporate reliable and structured training within curricula that effectively increases levels of mindfulness and, in doing so, can lead to improvement in perceived stress and life satisfaction. Further research may assist educators in the development of strategies to promote student and clinician wellness.

The Academic Fellowship in Physician Assistant Education.

The rapid growth of the physician assistant (PA) profession has required PA programs to increase their efforts in the recruitment and retention of experienced faculty. One approach was the establishment of the academic fellowship concept in 1998. Since then, 5 PA programs have designed fellowships, 3 of which were implemented and graduated fellows. To institute and develop an academic fellowship takes time, resources, and buy-in from faculty and students. The structure of the curricula within the fellowships has been similar since 1998 and includes faculty development opportunities, lecture development and delivery, student assessment, small group facilitation, interprofessional education, and committee work. Most fellowship-trained educators have entered faculty positions after completion of their fellowship. They appear to use sound educational strategies in their teaching and are successful in their scholarly productivity. Academic fellowships are just one route in the transition to PA education, and while they may require a significant investment from the sponsoring institution and program, they can provide a unique opportunity for PAs to immerse themselves in the faculty experience before the full commitment to a career change.

Exploring the Effectiveness of Mindfulness and Decentering Training in a Physician Assistant Curriculum.

PURPOSE: Several studies have documented the effects of physician assistant (PA) training on students' perceived stress and life satisfaction. Innovative curriculum design incorporating effective stress management resources may help address this concern. METHODS: Mindfulness and decentering training was incorporated into a first-quarter course for PA students. It included lecture, in-class demonstrations and practice, and out-of-class activities. Mindfulness (Experiences Questionnaire; Acceptance and Action Questionnaire) and general well-being (Satisfaction with Life Scale; Perceived Stress Scale) were assessed precourse, postcourse, and during follow-up. RESULTS: Students reported a significant increase in levels of mindfulness postcourse, which remained stable at a 4-month follow-up. These findings were consistent regardless of prior mindfulness practice. More importantly, changes in the levels of mindfulness significantly predicted changes in life satisfaction and perceived stress. CONCLUSION: Stress management resources can be incorporated into PA courses through innovative curriculum design to help students cope with the demands of PA school.