The Perceived Intersection of Parenting and Physician Assistant Training Among Current Physician Assistant Students.

PURPOSE: Despite recent advancements in policies supporting pregnancy and parenting-related resources for physician assistant (PA) students, there remains a paucity of data on the perceptions of family planning or available resources during training. The purpose of this study was to explore the perceptions of support for, and impact on, family planning and parenting, including lactation, among PA students. METHODS: This cross-sectional study used data collected from the American Academy of Physician Associates Student Survey between January and March 2023. Descriptive and inferential statistics were performed. RESULTS: A total of 557 students (557/1353; 41.2%) completed the survey. Less than 15% of students (14.4%) believed their program provides resources to support parental leave, and many students (52.1%) remained unsure whether resources exist(ed). There was a significant difference for PA students (P = .005) by gender in whether family planning affected the decision to pursue PA training over another profession, with female students proportionately affected more than male students. Medical school was the most often considered aside from PA training. Most PA students (311/548; 56.8%) also felt pressure to wait until after training to have children. In addition, multiple students (26/554; 4.7%) admitted to being asked questions they believed were biased or inappropriate regarding pregnancy or parenting during the interview process for, or after beginning, PA school. CONCLUSION: Programs should seek opportunities to support students through all stages of family planning. Support will require both cultural and structural shifts beginning with peer stigma and extending through admissions interview question audits, faculty training, university policies, and accreditation requirements.

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.

Transparency of Parental Leave Policies to Prospective Students in US Physician Assistant Programs: A Cross-Sectional Study.

INTRODUCTION: Parental leave policies are not well established or always available for prospective graduate students. This study examined the availability and inclusivity of PA program parental leave policies to prospective students at accredited US programs. METHODS: The websites and available student handbooks of the 282 currently accredited PA programs were searched for the terms "pregnant," "pregnancy," "maternity," "parent," "family," "child," and/or "birth." Descriptive statistics and Pearson's chi-square test were used to analyze the data. RESULTS: In total, 13.5% (38/282) of PA program websites and available handbooks met search criteria. Of these 38 programs, 23 (60.5%) provide information with gendered language that discriminates based on sex, most commonly only mentioning the pregnant female. DISCUSSION: PA programs should create specific policies for pregnancy-related and parental leaves that are inclusive to heteronormative families as well as nontraditional and nonnuclear families, and these policies should be widely available to potential applicants and students.

Attitudes Towards Mental Health Among Physician Assistant Students with Shared Living Experiences Through Synchronous Videoconferencing.

PURPOSE: We tested the hypothesis that physician assistant (PA) students can benefit from exposure to senior PAs who share their living experiences with mental illness. METHODS: First-year students from 5 PA programs were asked to participate in this mixed methods study. After completing a pre-activity survey, students from 3 programs participated in an intervention consisting of senior PA faculty sharing their mental health experiences, including treatment and recovery. A facilitated discussion followed, and students not exposed to the intervention served as controls. The qualitative component of the study was based on transcripts from 3 focus groups of students in the exposed group. RESULTS: We recruited 167 students from 5 PA training programs, 112 of whom (67%) completed baseline and endpoint assessments (37 in the exposed group, 75 in the control). The intervention resulted in significant improvements on the Opening Minds to Stigma (OMS-HC, p = 0.002, Cohen's d = 0.38) and Self-Stigma of Seeking Help (SSOSH, p = 0.006, d = 0.31) scales. Change in the OMS-HC was driven by its social distance (p = 0.003) and disclosure (p = 0.02) subscales. No comparable changes were found in the control group. We identified 3 overarching themes: 1) active elements of the intervention; 2) mutuality; and 3) peer relationships. CONCLUSIONS: Senior PAs sharing their lived experiences with mental illness proved to be an effective anti-stigma intervention for PA students. A candid, intimate, and confidential virtual learning space was feasible through synchronized videoconferencing. Our findings can inform programmatic interventions to address stigma, self-stigma, help-seeking behaviors, and the overall mental health of PA students.

Assessing Trends in Physician Assistant Student Depression Risk, Suicidal Ideation, and Mental Health Help-Seeking Behavior.

PURPOSE: The purpose of this study was to assess how physician assistant (PA) student depression risk, suicidal ideation, and mental health help-seeking behaviors change during didactic training and the relationship between depression risk and demographic factors. METHODS: Data were obtained through an anonymous online survey sent to didactic students in 7 PA programs during orientation and again at midpoint of the didactic year. Descriptive statistics, independent samples t-testing, and one-way ANOVA analyses were used to assess trends in patient health questionnaire (PHQ-9) scores over the 6-month time period. The PHQ-9 is the module of the PHQ that measures severity of depression risk. RESULTS: The orientation survey response rate was 82.7% (287/347) and the midpoint survey response rate was 62% (217/350). Analysis revealed that mean PHQ-9 scores increased significantly from 2.49 to 6.42 (p < 0.001) from orientation to midpoint of the didactic year, with 18.9% of students having scores of 10 or greater at midpoint compared to 4.5% at orientation. Thoughts of self-harm and/or suicidal ideation in the past 2 weeks also increased from 3.5% to 7.4% during the same time frame. Additionally, students' likelihood of seeking mental health help decreased between orientation and midpoint despite the concurrent increases in depression risk and suicidal ideation. CONCLUSION: Rising PHQ-9 scores indicated an increased risk of major depression among didactic-year PA students. Further research on early screening methods and factors that encourage help-seeking behaviors may serve to inform programs about how to create learning environments that mitigate depression risk and promote wellbeing during professional training.