How can depth and breadth of content be balanced in physician assistant (PA) education?

Balancing Depth and Breadth of Content in Physician Assistant Education

PA education should focus on developing strong general clinical skills across the breadth of medicine while providing targeted depth in high-yield clinical conditions and healthcare systems most relevant to practice settings. 1, 2

Core Principles for Balancing Depth and Breadth

Assessment of Current Educational Needs

• PA students must develop clinical skills comparable to medical doctors across the full scope of medicine, as research shows they score similarly in history taking, physical examination, and communication skills 1
• Clinical reasoning skills require special attention, as PA students scored slightly lower (6.0 vs 6.8) compared to MDs in this area 1
• Hospitalists identify specific clinical conditions and healthcare systems knowledge as having the highest educational value for PA students 2

Curriculum Development Strategies

1. Prioritize High-Yield Clinical Content

   • Develop formal curricula for rotations based on input from practicing clinicians 2
   • Focus depth on conditions most commonly encountered in practice settings
   • Ensure breadth across the full scope of medicine to maintain general clinical competency 1

2. Implement Problem-Based Learning Approaches

   • Utilize problem-based learning (PBL) to develop clinical reasoning skills 3
   • Blend online technology with PBL curriculum to engage students using the Socratic method 3
   • This approach helps develop both depth in specific clinical scenarios and breadth across various medical conditions

3. Leverage Experienced PA Educators

   • Incorporate PA graduates as clinical instructors and role models in patient care settings 4
   • Utilize the Physician Assistant Educator Competencies framework to ensure faculty are equipped to balance depth and breadth in their teaching 5
   • Address the faculty development needs of clinicians transitioning to academic roles 5

Implementation Considerations

Inpatient Medicine Training

• Develop formal curricula for inpatient rotations that focus on the most essential clinical conditions 2
• Survey practicing clinicians to identify the most critical skills for PA students to master 2
• Ensure clinical preceptors understand the PA training pathway to optimize educational experiences (over 20% of hospitalists incorrectly answered questions about PA training) 2

Technology Integration

• Utilize online learning technologies to supplement traditional education methods 3
• Online platforms can help deliver breadth of content while preserving in-person time for depth in complex topics
• Preliminary results indicate online technology can be successfully implemented in a blended PA education curriculum 3

Faculty Development

• Invest in faculty development initiatives to help new faculty transition from clinical practice to academia 5
• Focus on improving evaluation methods and faculty development, areas identified as needing improvement 4
• Ensure faculty understand how to balance depth and breadth based on the essential knowledge, skills, attitudes, and behaviors needed for PA practice 5

Common Pitfalls to Avoid

• Overemphasis on medical education models: While PA programs were built on traditional medical education models, they must evolve to meet the specific needs of PA practice 4
• Insufficient clinical reasoning training: Special attention should be given to developing clinical reasoning skills across the breadth of medicine 1
• Lack of formal curricula: Absence of structured curricula can lead to inconsistent learning experiences; formalized approaches are preferred by both students and faculty 2
• Inadequate faculty preparation: Many PA faculty members transitioning from clinical roles need additional support to develop teaching skills 4, 5