How can physician assistant (PA) learning outcomes be improved?

From the Guidelines

Physician assistant learning outcomes can be improved through a comprehensive approach that integrates clinical experience with didactic education, focusing on practice-based learning and improvement, as outlined in the 2023 ACC/AHA/SCAI advanced training statement on interventional cardiology 1.

Key Components of Improved Learning Outcomes

• Implementing structured clinical rotations across diverse specialties with graduated responsibility, allowing PAs to manage increasingly complex cases under appropriate supervision.
• Utilizing simulation-based training, evidence-based teaching methodologies, and incorporating regular formative assessments with detailed feedback to identify knowledge gaps early.
• Implementing competency-based education to ensure PAs master essential skills rather than simply completing time requirements.
• Providing interprofessional education experiences and mentorship programs to prepare PAs for collaborative practice and professional development.
• Integrating technology, such as electronic health record training, telehealth experience, and point-of-care tools, to prepare PAs for modern healthcare delivery.

Practice-Based Learning and Improvement

As emphasized in the 2023 ACC/AHA/SCAI statement 1, practice-based learning and improvement are crucial for PA learning outcomes. This includes:

• Identifying personal knowledge gaps and seeking educational and training opportunities to improve knowledge, skills, and performance.
• Utilizing clinical practice guidelines and other information tools at the point of care to improve clinical decision-making.
• Maintaining current standards of care by performing literature searches, interpreting data, and applying results to clinical care.
• Soliciting and incorporating feedback from patients, colleagues, and other healthcare team members to improve clinical performance.

Evaluation and Lifelong Learning

Evaluation tools such as case logs, chart review, and multisource evaluation can assess PA competency 1. Additionally, developing the practice of lifelong learning, including regular review of journals and practice guidelines, and attendance at scientific and continuing medical education meetings, is essential for ongoing professional development, as highlighted in the 2020 ACC clinical competencies for nurse practitioners and physician assistants in adult cardiovascular medicine 1.

From the Research

Improving Physician Assistant Learning Outcomes

To improve physician assistant (PA) learning outcomes, several strategies can be employed:

• Competency-based medical education: Implementing a competency-based medical education model, where abilities necessary for the practice of medicine are defined as learning outcomes, can help PAs achieve mastery in their field 2.
• Effective assessment and feedback: Using assessments that measure the performance of skills, such as direct observation or patient registries, and providing routine, timely, and nonthreatening feedback can assist PAs in their professional development 2.
• Entrustable professional activities: Building a competency-based workplace curriculum around entrustable professional activities (EPAs) can provide a practical model for PA training, allowing for individualized approach and flexibility 3.
• Workplace learning strategies: PAs can use various methods for workplace learning, such as assessing educational needs, instruction, and assessment of learning, with a focus on real patient problems and active forms of learning 4.
• Comprehensive physician assessment: Implementing a multifaceted physician-level performance assessment system can help align continuing medical education with quality improvement and provide meaningful feedback to PAs 5.
• Service-learning: Incorporating service-learning activities into PA education can help develop students who are better prepared to address social determinants of health and provide compassionate care to diverse populations 6.

Key Considerations

When implementing these strategies, it is essential to consider the following:

• Alignment with learning objectives: Ensuring that learning activities, including service-learning, are aligned with specific course learning objectives is crucial for effective learning outcomes 6.
• Structured critical reflection: Using structured critical reflection can help PAs realize and demonstrate desired learning outcomes, making the learning experience more impactful and authentic 6.
• Faculty training: Training faculty in the implementation of service-learning and effective use of structured critical reflection can create a more supportive environment for PA education 6.