Assessing the Racial and Ethnic Diversity of Physician Assistant/Associate Program Graduates from 2010 to 2012 and 2019 to 2021.

INTRODUCTION: To assess the racial/ethnic diversity of graduates of US Physician Assistant/Associate (PA) programs compared with the diversity of the populations from which they draw students and to assess diversity changes over time among PA graduates. METHODS: We calculated proportion of Black or Hispanic PA graduates nationally and by school between 2010 to 2012 and 2019 to 2021 using the Integrated Postsecondary Education Data System (IPEDS) and compared it with the diversity of the 20 to 35-year-old population using the American Community Survey. We created benchmark populations for each school based on whether the school was public or private, with in-state/out-of-state proportions provided by the Physician Assistant Education Association. A diversity index (DI) was calculated for each program. A DI of 0.5 means that the representation of Black/Hispanic graduates is half their representation in the benchmark population. RESULTS: Although the numbers of Black/Hispanic graduates increased from 2010 to 2012 to 2019 to 2021, the percentage of Black graduates decreased. Nationally, the DI for Black graduates decreased from 0.28 to 0.23 and the Hispanic DI increased from 0.28 to 0.37 between 2010 to 2012 and 2019 to 2021. Among 213 PA programs included in the 2019 to 2021 dataset, 5 schools had a DI >1.0 for Black graduates and 7 schools had a DI >1.0 for Hispanic graduates. DISCUSSION: Using the IPEDS data, we found that Black and Hispanic graduates are underrepresented among PA program graduates. The PA education community needs to develop new strategies for diversifying the profession consistent with the new US Supreme Court decision banning race-conscious admissions.

Black and Hispanic Representation Declined After Increased Degree Requirements for Physician Assistants.

PURPOSE: The physician assistant (PA) profession is one of the least racially and ethnically diverse health professions requiring advanced education. New PA graduates are even less diverse than the current PA workforce and less diverse than professions requiring doctoral degrees. Between 1995 and 2020, the percent of all PA graduates that were Black individuals fell from 7% to 3.1%, while Hispanic representation increased from 4.5% to 7.9%. METHODS: Using the federal Integrated Postsecondary Education Data System, we examine the impact of transitions to master's degrees for PAs on Black and Hispanic representation between 1995 and 2020, using individual universities as the unit of analysis. RESULTS: After adjusting for state and year effects, PA programs that transitioned from bachelor's to master's degrees experienced a 5.3% point decline in Black representation and a 3.8% point decline in Hispanic representation. Relative to the already low proportions of Black and Hispanic graduates in PA programs, these declines are significant. CONCLUSION: Steps should be taken to ensure that underrepresented populations have greater access to PA education.

Time to Pivot: A Guide to Holistic Admissions.

ABSTRACT: As an ever-increasing number of physician assistant (PA) programs moves toward holistic admissions, a better understanding of how to achieve their stated admission goals becomes more important. With the June 2023 US Supreme Court decision effectively ending affirmative action in higher education, navigating holistic admissions is now an even greater challenge. In this article, the PA Education Association's Presidents Commission offers a guide for programs to use in implementing holistic admissions at their institutions and key considerations. Is the process mission-driven? Does it follow principles of quality improvement and incorporate ongoing assessment of that process? Using data can be a constructive and insightful way to inform the process. The authors hope that tools, resources, and recommendations offered in this article will serve as valuable resources for any program attempting to institute or improve its holistic admissions process.

Meeting the Accreditation Standard for Diversity.

ABSTRACT: While increasing diversity has been an ongoing concern in physician assistant (PA) education, there is now a concentrated focus on diversity, equity, inclusion, and social justice, elevating these to top priorities. To achieve the goal of diversifying the PA workforce, PA programs, with their institution's support, must systematically inculcate strategies for overcoming and dismantling barriers against students of color and students underrepresented in medicine (URiM). These strategies should disrupt the status quo and expand structural processes that ensure successful diversification of students, especially URiM students, LGBTQ students, students from medically underserved areas, and first-generation college students.

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.

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.

Pipeline to the Physician Assistant Profession: A Look to the Future.

ABSTRACT: The current pipeline of physician assistant (PA) school applicants reflects the future workforce of the profession, which is why the admissions process with all its components and variables is so important. Many studies have shown that a workforce that represents the patients it cares for leads to improved health outcomes, especially among underrepresented minority populations. Yet, PA programs have made little progress over the past 2 decades in increasing the diversity of matriculants and graduates. As a profession, it is our collective responsibility to intentionally advance diversity, equity, and inclusion, and examining the admissions process would be the most logical place to start.

C4Tech: Virtual connections between the classrooms, clinicians, and community clinics to bridge the gap between research and practice.

AIM: E-learning technologies are becoming vital components of medical and health professions education, as highlighted during the current coronavirus disease (COVID-19) pandemic. The National Academy of Medicine (NAM) considers education technologies essential to forming connections between education and healthcare delivery systems, which promote evidence-based practice and continuous learning and quality improvement in healthcare. There is a lack of evidence-based models to guide the integration of technology in medical and health profession education, in particular models that form synergistic linkages between healthcare education and delivery systems. This paper presents the evaluation of an innovative blended learning model, which leverages virtual technology to connect students in the classroom with clinicians in community clinics (C4Tech) for authentic learning related to quality improvement (QI) and social determinants of health (SDH). METHOD: This study applied a case study approach to evaluate the efficacy of the C4Tech model in supporting learning outcomes and assessed how virtual collaboration influenced the process of learning. RESULTS: This study contributes to a more comprehensive understanding of how to design effective blended courses that connect the healthcare education and delivery systems through virtual technology. It also demonstrates how to connect students and practicing clinicians virtually to design evidence-based quality improvement projects.

Connecting Classrooms, Clinicians, and Community Clinics Through Technology (C4Tech) for Active and Collaborative Learning.

PURPOSE: This pilot study investigated the level of cognition that physician assistant (PA) students achieved through adoption of an innovative blended learning model that connects the classroom, clinicians, and community clinics through electronic-learning (e-learning) technologies (C4Tech) used in a PA course. This education intervention aimed to facilitate authentic learning collaborations between PA students and practicing clinicians that would result in higher-order cognition related to the manifestations of social determinants of health and health disparities. METHODS: A case study approach was adopted to assess levels of cognition and changes in those levels resulting from application of an innovative blended learning model. Content analysis using Bloom's taxonomy of cognitive domains facilitated determination levels of cognition and changes in those levels. The sample of 8 groups comprised 70 PA students and 8 clinical instructors from community clinics with underrepresented patient populations. RESULTS: Analysis of 2 course assignments revealed that application of the C4Tech model yields high levels of cognition. By the course's end, all 8 groups achieved at least the "evaluate" level of cognition and half of the groups achieved the highest level of cognition, the "create" level. A wide variation in the level of cognition was demonstrated between the first and second assignments in each group and among groups. CONCLUSION: Our findings suggest that e-learning technologies can be effective in blending classrooms and work environments for authentic and collaborative learning. Adoption of the C4Tech model yielded higher-order cognition related to course content.

Improving health disparities in PA practices: A quality improvement initiative.

OBJECTIVE: To assess a quality improvement initiative designed to highlight awareness of health disparities and improve healthcare practices among participants. METHODS: Data were collected from 102 clinically practicing PAs over a 2-year timespan via the quality improvement initiative Outside the Box: Reducing Health Disparities. As part of the program, participants reviewed 10 random charts in their practice, documenting how they identified and/or managed common health disparities. Then, participants reviewed the educational materials provided and implemented practice-specific interventions. Thirty days after the initial review, a second random review of charts was executed. RESULTS: Postintervention results showed statistically significant moderate- to large-sized quality improvement across most categories. CONCLUSIONS: This study demonstrates that Outside the Box participation was associated with practice quality improvements among participants in several domains that are known to experience health disparities. Results suggest that increasing awareness of ideal professional behaviors can result in quality improvements in practices.

Race, ethnicity, and the physician assistant profession.

The physician assistant (PA) profession has long had a focus on providing primary healthcare to all. In order to best serve an increasingly diverse population, we examine the racial and ethnic diversity trends experienced in PA education and the PA profession, in the context of national demographics, and the racial and ethnic diversity of other health professions. We also offer recommendations to improve the racial and ethnic diversity of the PA profession.