What are two psychiatric end-of-rotation questions for Physician Assistant (PA) students?

From the Guidelines

Here are two psychiatric end-of-rotation questions for Physician Assistant (PA) students, focusing on the assessment and treatment of patients with schizophrenia and other psychiatric conditions, as outlined in the American Psychiatric Association practice guidelines 1.

Question 1: Assessment of a Patient with Schizophrenia

A 25-year-old male presents with disorganized thinking, hallucinations, and delusions. What are the essential components of the initial psychiatric evaluation for this patient?

• The initial assessment should include the reason for presentation, patient goals and preferences, psychiatric symptoms, trauma history, substance use, psychiatric treatment history, physical health assessment, and psychosocial and cultural factors, as recommended by the American Psychiatric Association 1.
• A mental status examination, including cognitive assessment, and an assessment of risk for suicide and aggressive behaviors should also be performed 1.
• Quantitative measures to identify and determine the severity of symptoms and impairments in functioning should be used to guide treatment planning 1.

Question 2: Treatment of a Patient with Schizophrenia

A 30-year-old female with schizophrenia presents with persistent psychotic symptoms despite treatment with an antipsychotic medication. What are the recommended treatment options for this patient?

• The patient should be treated with clozapine, as recommended by the American Psychiatric Association for patients with treatment-resistant schizophrenia 1.
• The treatment plan should be comprehensive, person-centered, and include evidence-based nonpharmacological and pharmacological treatments, such as cognitive-behavioral therapy for psychosis (CBTp) and supported employment services 1.
• Regular monitoring for effectiveness and side effects of antipsychotic medication is essential, and consideration of long-acting injectable antipsychotic medication may be necessary for patients with a history of poor adherence 1.

From the Research

Psychiatric End-of-Rotation Questions for PA Students

• Two potential psychiatric end-of-rotation questions for Physician Assistant (PA) students are not explicitly provided in the given studies 2, 3, 4, 5, 6.

Assessment of PA Students' Knowledge

• The PAEA End of Rotation exams, including the Psychiatry and Behavioral Health exam, are used to assess medical knowledge of PA students 2.
• These exams are developed by experienced PA educators and national exam experts, and are statistically validated for accuracy and consistency 2.

Relationship Between End of Rotation Exams and PANCE Performance

• Studies have shown a statistically significant correlation between scores on the PAEA End of Rotation examinations and subsequent PANCE performance 3, 4, 6.
• The End of Rotation exam scores are predictive of PANCE performance, with higher exam scores associated with better PANCE performance 3, 4, 6.