Reflections on a Physician Assistant Entrance Exam: Does the Profession Need One?

ABSTRACT: Standardized entrance exams are used in many health professions as one way to objectively measure knowledge and facilitate comparisons across student groups. The physician assistant (PA) profession has historically not employed a profession-specific entrance exam, and the idea was never seriously explored until the Physician Assistant College Admissions Test was developed recently by a commercial assessment publisher, with field testing in some volunteer programs in 2018 and the exam's first administration in May of 2020. The 2020 Physician Assistant Education Association Presidents Commission chose to investigate the issues raised by a consensus-derived, PA-specific entrance exam to stimulate more informed discussion on the efficacy of such an exam. While it may have the potential to enhance efficiency in PA admissions and reduce variability in admissions requirements, a PA entrance exam would also likely introduce new challenges, including increased costs, impact on the diversity of the applicant pool, and incongruence with an increasingly holistic admissions process. The biggest barrier would likely be the lack of current consensus on the knowledge, skills, and attributes that matriculants need to be successful in the program and in clinical practice. Development of a consensus-derived PA entrance exam would be a complex, expensive, and time-consuming endeavor, requiring considerable attention to technical issues of psychometric quality, process transparency, and legal defensibility. Changes being made to health professions admissions practices due to the COVID-19 pandemic, including the dropping of test scores as a requirement by some institutions, may make some of the issues raised in this paper more timely than ever.

Gestión de la ciencia, tecnología e innovación / Management of science, technology and innovation

La Universidad de Ciencias Médicas de las Fuerzas Armadas Revolucionarias (FAR) de Cuba, es una institución docente de nivel superior, fundada hace más de 36 años, con el propósito de formar profesionales de alta competencia en diferentes áreas del conocimiento y ciudadanos/as integrales dispuestos hacia la investigación, el servicio a la sociedad y sus fuerzas armadas.1 En el contexto económico actual y sus tendencias, el conocimiento es un recurso básico y el aprendizaje permanente un proceso fundamental para alcanzar niveles de desarrollo crecientes. Esta premisa ha sido ampliamente reconocida y aparece enunciada en diversos documentos de política y en las normas que conforman el marco jurídico del Sistema Nacional de Ciencia, Tecnología e Innovación.2 La gestión de ciencia, tecnología e innovación está ineludiblemente orientada a la formación del talento humano con las competencias y el liderazgo necesarios, para articular actores, procesos y entidades que consolidan necesaria alianza entre la universidad, el Estado, el sector productivo y la sociedad, en la búsqueda del conocimiento, la innovación y la competitividad. Estos vínculos contribuyen a la solución de los problemas locales, regionales, nacionales e internacionales.3,4 Esta actividad persigue garantizar la mejora continua en la universidad, a través de los procesos y del seguimiento de una matriz de riesgos y oportunidades. Su objetivo es generar e implementar investigaciones aplicadas, sistémicas y de impacto que generen conocimiento científico relevante para los servicios médicos, esencialmente a través de tareas temáticas y proyectos de investigación y desarrollo, enmarcados en las prioridades del sistema de ciencia e innovación tecnológica de las FAR.5 El conocimiento emerge de una imperativa necesidad: es promovido y gerenciado por la institución, e integra los valores y la cultura del medio en la que se desarrolla su obtención y socialización. En la gestión del proceso de toma de decisiones científico tecnológicas de la universidad, se observan: a) Las políticas de ciencia y tecnología, toman como base el análisis de experiencias nacionales e internacionales, nuevos desafíos, instrumentos gubernamentales de planificación / gestión, cambios organizacionales, y la interrelación de los actores, sus planes y programas de investigación, la cooperación con otras entidades o centros tecnológicos afines, el rediseño de las políticas y el replanteo institucional si procede. b) La planificación e inteligencia estratégica, contienen la prospectiva como instrumento de planificación, gestión, el pensamiento y diagnóstico estratégico. c) La economía de la innovación, descansa en la revisión de los enfoques teóricos, dinámicas y modelos de análisis del proceso innovativo y los patrones de especialización internacional. d) La teoría organizacional, se crea sobre la base de objetivos, herramientas de gestión, presupuestos, gestión del capital humano, enfoques institucionales, sistemas de incentivos, grupos de intereses, la evolución de otras instituciones y el análisis de los procesos de cambio. e) Los indicadores de ciencia, tecnología e innovación están contenidos en fuentes de datos, manuales y otros indicadores (bibliométricos, de evaluación de la investigación, de impacto social de la ciencia y la tecnología, etc.).6 f) La transferencia tecnológica, explora los modelos, canales y actores del proceso de transferencia de tecnología, las fuentes oficiales, comerciales y académicas de información, el sistema de patentes, la infraestructura informativa en ciencia y tecnología, el acceso a información, el proteccionismo científico-tecnológico, el impacto de las tecnologías de la información sobre la gestión, la producción y la capacidad de absorción, como elemento determinante para la obtención de resultados en el proceso de transferencia tecnológica.7,8 La necesidad de fortalecer políticas orientadas a explotar las capacidades y competencias del sector científico, tecnológico y productivo en la institución docente, para contar con equipos, directivos/as, profesionales y técnicos dotados de herramientas conceptuales y metodológicas para tales fines, ha de seguir presumiblemente la ruta crítica antes señalada(AU)

The Future of Clinical Education: Opportunities and Challenges from Allied Health Deans' Perspective.

ISSUE: There is limited information and consensus on the future of clinical education and the key factors impacting allied health (AH) clinical training. AH deans identified both opportunities and challenges impacting clinical education based on a proposed educational model. METHODS: From July 2013 to March 2014, 61 deans whose institutions were 2013 members of the Association of Schools of Allied Health Professions (ASAHP) participated in a three-round Delphi survey. Agreement on the relative importance of and the ability to impact the key factors was analyzed. Impact was evaluated for three groups: individual, collective, and both individual and collective deans. AH deans' responses were summarized and refined; individual items were accepted or rerated until agreement was achieved or study conclusion. RESULTS: Based on the deans' ratings of importance and impact, 159 key factors within 13 clinical education categories emerged as important for the future of clinical education. Agreement was achieved on 107 opportunities and 52 challenges. CONCLUSIONS: The Delphi technique generated new information where little existed specific to AH deans' perspectives on AH clinical education. This research supports the Key Factors Impacting Allied Health Clinical Education conceptual model proposed earlier and provides a foundation for AH deans to evaluate opportunities and challenges impacting AH clinical education and to design action plans based on this research.

Academia Nacional Joven: ¿vamos a dejar pasar el tren para España? / No disponible

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Doctoral programs in health professions education.

The interest to pursue doctoral degrees in the health professions is increasing exponentially. Some reasons for this increase include innovations in curriculum and instructional strategies, competency-based assessment, particularly at the postgraduate level, and accreditation requirements. Through various electronic search methods, interviews, review of documents and site visits, 24 structured doctoral programs were identified worldwide that offer a PhD in health professions education (HPE) or medical education. A number of other programs were also identified that do not follow a structured curriculum; however, through supervision and guidance, candidates could complete a number of publishable projects thus meeting the requirements for a doctorate degree. Also, some institutions train fellows for doctoral degrees in HPE without necessarily advertising or labeling the programs as a PhD in medical or HPE. There are also discipline-specific PhDs, such as medicine and dentistry, which focus on education. For example, a student interested in studying surgical technical skills could be directed to take a PhD in kinesiology. It is time for institutions and individuals to start thinking about disciplinary diversity and not focus exclusively on studies of medical education.

A matter of degrees: the introduction of clinical doctorates to the Saudi higher education system and a comparative prospective from the American model.

Recent unprecedented growth in Saudi population challenged its infrastructure and intensified demand for higher education and healthcare. In response, both the government and the private sector founded numerous colleges and universities, increasing the overall number from 8 to 49 institutions of higher education. A significant portion of the expansion has been in the health professions higher education, which also included the establishment of new teaching hospitals and other medical training facilities. As part of this growth, practice (clinical) doctorates have conspicuously made their presence felt in Saudi Arabia. The doctor of pharmacy is the first clinical doctorate that has been formally adopted as the terminal professional degree in the field. Others are in the works. Results are presented using descriptive methods. Data were collected from reviews of the literature and individual institutional websites of Saudi colleges, universities and salient governmental regulatory and national accrediting agencies. This article will introduce clinical doctorates, their status and state of implementation in the American health professions higher education system as a possible model. The article will review the current status of clinical doctorates' implementation in Saudi Arabia. It will conclude with a recommendation for concerned stake holders, including policy makers, educators, and practitioners.

[Current states and future aspects of graduate schools for adult graduate students: experiences of the master's course as a medical technologist].

The educational system for medical technologists (MTs) has gradually shifted from a three-year technical school system to a four-year university system. It is worthwhile for MTs to advance to a graduate school, in order to improve their routine-work skills, performances, and also to advance their own research as well as to learn how to direct younger MTs. Recently, MTs who advance to the graduate school as adult graduate students are increasing. In this article, the current states and future aspects of the graduate school of Iwate Medical University are reported. In our Department of Central Clinical Laboratory in Iwate Medical University Hospital, three of my colleagues have completed the master's course of the graduate school as adult graduate students, and three are currently attending the school. Nevertheless, none of them has advanced to the doctor's course yet. The primary reason why they do not advance is the heavy burden on any adult graduate students physically, mentally, and financially to study in the graduate school and carry out routine duties at the same time. Thus, in order to encourage MTs to go or to graduate school education, it is important to arrange systems which will enable MTs to advance to the graduate school as adult graduate students. I believe there are three key elements to make this possible. Firstly, prepare easier access to curriculums for MTs to study special fields and learn special skills. Secondly, arrange an increase in the salary scheme depending on the degree attained from the graduate school. Thirdly, provide financial support for graduate school expenses. In conclusion, it is expected that a large number of MTs will advance to the graduate school if these changes for a better educational environment are made.

Landscaping biostatistics education in India.

Biostatistics plays an important role in measuring, understanding, and describing the overall health and well-being of a population. Biostatistics as a subject evolved from the application of statistics in various research aspects of biology, biomedical care, and public health. However, with a recent increase in number of health and pharmacy related research, the demand for trained biostatisticians is also increasing. The present paper is an attempt to undertake a situational analysis of biostatistics education in India. A systematic, predefined approach, with three parallel strategies was used to collect and assemble the data regarding training in biostatistics in India. Our study results show that there is paucity of programs providing specialized training in biostatistics in India. Only about 19 institutions in India are offering various courses in biostatistics/medical statistics/health statistics/biometry. It is important to look into the current capacity building initiatives in this domain. Some other means for giving importance to biostatistics could be by making it a separate branch/specialization in a majority of the institutions, particularly in medical colleges.

Using health promotion competencies for curriculum development in higher education.

Health promotion core competencies are used for a variety of reasons. Recently there have been moves to gain international consensus regarding core competencies within health promotion. One of the main reasons put forward for having core competencies is to guide curriculum development within higher education institutions. This article outlines the endeavours of one institution to develop undergraduate and postgraduate curricula around the Australian core competencies for health promotion practitioners. It argues that until core competencies have been agreed upon internationally, basing curricula on these carries a risk associated with change. However, delaying curricula until such risks are ameliorated decreases opportunities to deliver dynamic and current health promotion education within higher institutions.

Las transformaciones del Sistema Nacional de Salud y los escenarios del cambio en la formación profesional / The transformations of the Nacional Health System and the scenaries of the change in the professional formation

Se fundamentan los cambios que implica la universalización de la educación médica superior como aspectos estratégicos del perfeccionamiento del sector de la Salud Pública y su incidencia en los procesos universitarios para la formación de profesionales.(AU)

There are explained the changes that the universalization of medical education means as strategic aspects for the improvement of the Public Health Sector and its incidence in the university processes for the formation of professionals.(EU)

Kathleen Mears Memorial Lecture: The magic of becoming an END technologist. Education: past, present, future.

We have all traveled various roads to becoming electroneurodiagnostic (END) technologists. END (formerly known as EEG) technology education began with informal mentorship such as on-the-job training. Later it progressed into formal educational training programs under the Commission on Accreditation of Allied Health Education Programs (CAAHEP). The American Society of Electroneurodiagnostic Technologists (ASET) has been actively pursuing the formulation of a standardized END curriculum and educational resources that should make the process of starting a training program easier. ASET has already produced online courses that have become a valuable resource for educating END technologists. What's next? Could it possibly be a combination of the old and the new? Perhaps taking advantage of the strengths of both the mentorship and formal educational techniques could be an answer to meeting the ever-increasing demand for END technologists. Let's imagine!

La coordinación de los recursos humanos 'un fantasma atraviesa España' / Coordination of Human Resources: 'A ghost lies across Spain'

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Competência: distintas abordagens e implicações na formação de profissionais de saúde / Competence: different approaches and implications in the training of healthcare professionals

Este texto apresenta algumas das principais concepções sobre currículos orientados por competência, analisando essas distintas abordagens em função do referencial teórico que as fundamenta, de suas dimensões constituintes e das conseqüentes implicações na organização curricular. Aponta, no novo significado trazido pela abordagem dialógica de competência, um caminho para a integração da teoria e da prática na formação de profissionais de saúde

A historical overview of interdisciplinary family health: a community-based interprofessional health professions course.

The Interdisciplinary Family Health course at the University of Florida Health Science Center is a course for beginning health profession students designed to teach core values, such as community-based family health, health promotion and disease prevention, and teamwork in the context of home visits. In addition, the course provides a valuable service to volunteer families by helping them identify useful community resources, and by formulating wellness care plans for prevention of illness and stabilization of chronic illness. In this article, the authors describe the historical development of the course, which began as a grant-supported pilot course for 20 medical students in 1996. After several additional grants helped fund an expansion involving other colleges, the course was given institutional support in 2001 and currently includes over 400 students and 70 faculty from four colleges working to improve the health status of over 150 local volunteer families. The theoretical constructs and objectives of the course were developed collaboratively by dedicated faculty from five Health Science Center colleges over seven years. In addition to benefiting the community and students, the course has encouraged an atmosphere of collaboration among faculty and colleges that has been a tangible benefit to the academic health center. The development and continuing support of this course demonstrates that barriers to such efforts can be overcome by dedicated faculty and administration.