The purpose of this study was to examine PA students’ perceptions of their professional training program in relation to stressors imparted by the hidden curriculum of the community of practice during the didactic and clinical years. The cross-sectional study design involved 50 in-person, semi-structured interviews (divided evenly between students in didactic and clinical cohorts) at one Physician Assistant training program in the New York City metropolitan region. Interviews sought to improve understanding about perceptions of stressors, particularly those imparted by the hidden curriculum, and examine mitigating factors within the community of practice. Highlights of results were that daunting stresses in the didactic year were mitigated by faculty support, camaraderie among students, and, at times, students accessing important student services such as psychological counseling. The stressors were exacerbated by disorganized teaching mainly by guest lecturers, including frequent absences, which was perceived by students that their time was not a priority. The stressors of heavy course loads dwindled during the clinical year but were replaced by others related to the hidden curriculum of the medical hierarchy, including occasional depersonalization of patients, teaching by humiliation, and favoritism shown to medical students. The community of practice for Physician Assistant students is highly stressful and psychologically precarious. The culture of PA education would do well to strongly encourage self-care and a greater balance between professional preparation of mental and physical well-being in order to encourage professionalism, improve patient care, and cultivate higher levels of job satisfaction and well-being among students.

Thesis (Ed. D.)--West Virginia University, 2004. / Title from document title page. Document formatted into pages; contains xi, 236 p. : ill. Includes abstract. Includes bibliographical references (p. 196-209).

In today's society, there exists an ever-growing concern over the serious deficit in the primary physician services. With the high cost of health care consistently rising, increased demands are being made for better health care practices. The problems now facing the medical profession emphasize the lack of supply, distribution, organization, utilization, and financing of physician services.The problems of helath care are not mutually exclusive of one another; but rather, they are interrelated and dependent. The problems have manifest themselves in overburdened physicians, rapidly rising medical costs, lack of appropriate use of equipment and facilities, lack of any medical care and services in many rural areas, maldistribution of physicians in urban areas, and delays in seeking medical care by the population.During this time when medical schools are re-examining the objectives and potentialities of their programs, schools of allied health professions are developing and expanding their "non-physician" programs. One of these allied health professions receiving a great deal of attention is the physician assistant. The physician assistant, however, has not been readily accepted into established medical practice. Questions concerning minimum educational standards, licensing, legal responsibility, professional roles, and future professional goals have been raised.The present investigation was undertaken in order to determine the impressions of practicing, licensed physicians in the state of Indiana concerning the utilization, roles, and acceptance of the physician assistant concept. More specifically, this study was designed to determine what, if any, relationship between descriptive aspects of the physician and his practice and his impressions concerning the utilization of the physician assistant in medical practice. The descriptive aspects of the physician population included: medical specialty, age of physician, number of years in practice, type of practice, size of practice, the location of the practice, military experience, distance to urban areas, distance to nearest hospitals, and number of new patients seen each day.The population for this study consisted of a 10 per cent random sample of physicians practicing in Indiana during 1972. The questionnaire utilized was constructed and items selected on the basis of job descriptions, tasks, and functions presented or proposed, in some form, in clinical settings, physician assistant training programs, and to physician assistants throughout the country.The practice of quality medicine mandates that physicians be a conservative group and not take extreme positions. If confronted with a "rating-scale" type of answer, responses might tend to fall in the middle ranks. For this reason, a forced choice (yes or no) type of questionnaire was developed. Each item was designed to measure the impressions and opinions of the physician toward some aspect of the role concept for the physician assistant.A questionnaire was mailed to each of the sample members. Included with each questionnaire was: 1) an explanatory letter introducing the study, 2) an addressed, stamped envelope to be used in returning the survey form. At three week intervals, a follow-up survey form was sent to those sample members who had not returned the form. This was done for two follow-up periods to ensure maximum return.The data was handled in two ways. Initially, the data was handled in a descriptive manner; that is, a simple frequency count was done to see how physicians as a group answered each question or statement. Next, the physician population was categorized and each of the variables was measured. The statistical method used for this study was the chi square (x2) method.The mailing questionnaire was chosen as the method of data collection because it was inexpensive, successful with individuals of higher socioeconomic groups, larger sample size, and bias of the researcher minimum to results.The sample for this study consisted of a ten per cent random sample. The study was initiated in April, 1973, and terminated in September, 1973. A total of 451 questionnaires were mailed to the population sample. Of these, 225 were returned, accounting for a 51.3% questionnaire return.Of the physicians surveyed, 38.8% practiced general medicine. Genreal surgery accounted for 11.0% of the sample. The remainder was made up of various specialties. It was also observed that 32.0% of the physician sample were in the age range of 41-50 years and 28.4 were in the age range of 51-60 years. Only 2.7% of the physicians were under 30 years and 3.1% over 70 years.Of the physicians sampled, 34.4% had been practicing medicine for over 30 years and 53.9% of the physicians practiced alone. Only 1.4% of the physicians were retired.Of the physician sample, 49.8% saw from 26-50 patients each day and over 42% practiced in urban areas greater than 100,000 population. Only 8.1% of the physicians were practicing in areas of 5,000 or less population.With respect to military experience, 77.1% practiced medicine in the military.With a breakdown in regards to distance to nearest urbanarea (100,000 population), 45.4% were within 10 miles and 15.5% were located in areas greater than 50 miles from urban areas. Furthermore, 90.6% of the physicians were located within 10 miles of a hospital.It was observed that 72.1% of the physicians saw from 0-5 new patients each day; 6% saw more than 25 new patients each day.An analysis of the data revealed that physicians as a group agree with the philosophy of the physician assistant concept. The majority of physicians felt that the physician assistant should be trained through approved academic programs which were under the direction of recognized medical schools. In conjunction with this, the physicians felt that standardization in terms of quality and program content was desirable. It was interesting to note that only 79.7% of the physicians felt that standardization was necessary.Many felt they would rather train the physician assistant themselves for the specific needs of their own practice. Some physicians felt that the training programs could be offered through local hospital training schools and not only through medical schools.The next area of interest dealt with legal responsibility. Only 25% of the physicians responding felt that the physician assistant should be legally responsible for his performance.Almost 66 percent of the physicians said that the physician assistant should be permitted to write certain prescriptions. Also 41% said that the physician assistant should be able to write patient orders in the hospital.The majority of physicians felt that the physician assistant should be able to detect abnormal signs and symptoms and make preliminary diagnoses based on the results of such examinations and report these on patients' permanent records or charts. Nearly 52% of the physicians said that their patients would accept the physician assistant to take care of them when they were sick.Approximately 75% felt that the role of the physician assistant overlaps that of the registered nurse.Most of the sample did not feel that the widespread use of the physician assistant would reduce the present quality of health care. Related to this, almost 79% of the physician sample felt that present health care delivery services need to be restructured.The most quoted salary range for the physician assistant was in the 8 to 10 thousand dollar range.Most physicians stated that if they were to employ a physician assistant, they would devote more time to existing patients.Approximately 16% of the Indiana physicians, at present, employ a physician assistant and nearly 64% said they would consider employing a physician assistant in the future.On the basis of the data collected from this survey of physicians concerning the utilization of the physician assistant in Indiana, the following conclusions are made:(1) The majority of physicians feel that the physician assistant should be trained in approved programs.(2) Only 25% of the physicians feel that the physician assistant should be legally responsible for his performance.(3) The majority of physicians feel that the physician assistant should be permitted to write certain prescriptions.(4) The majority of physicians feel that the physician assistant would be accepted by their patients.(5) Nearly three-fourths of the physicians feel that the role of the physician assistant overlaps that of the registered nurse.(6) Nearly 70% of the physicians felt that health care delivery needs to be restructured in order to better meet patient needs.(7) Most physicians would utilize more time to existing patients if they were to employ a physician assistant.(8) The vast majority of physicians feel that the physician assistant is a valuable member of the health care team and will improve the quality of patient care.Ball State UniversityMuncie, IN 47306

Thesis (M.S.)--University of Wisconsin -- La Crosse, 1988. / Includes bibliographical references (leaves 52-53).

Thesis (Ph. D.)--University of North Texas, May, 2007. / Title from title page display. Includes bibliographical references.

Thesis (Ed. D.)--West Virginia University, 2010. / Title from document title page. Document formatted into pages; contains iv, 223 p. : ill. (some col.), col. map. Includes abstract. Includes bibliographical references (p. 78-80).

No description available.

Thesis (Ph.D.)--University of Nebraska-Lincoln, 2008. / Title from title screen (site viewed Sept. 18, 2008). PDF text: ix, 185 p. : ill. ; 1 Mb. UMI publication number: AAT 3304202. Includes bibliographical references. Also available in microfilm and microfiche formats.

Cultural competency training in physician assistant (PA) education may improve patient care outcomes and help reduce health disparities. Research suggests that incorporating cross-cultural communication techniques into healthcare delivery improves provider-patient relationships, patient satisfaction, adherence to treatment, and health outcomes. While PA accreditation standards include mandatory elements regarding cultural competency training of PA students, there is little research on how PA students feel about the effectiveness of this training. This study focused on determining PA students’ perceived levels of preparedness to treat patients of culturally diverse backgrounds. Specifically, the study evaluated PA students’ knowledge, skills, encounters, attitudes, awareness, and abilities regarding cultural competence, as well as students’ evaluations of these components of their education. The study utilized an online cross-sectional questionnaire with quantitative and qualitative components to 239 PA student respondents across eight American professional preparation programs in higher education institutions. The survey used a modified version of the previously validated Self-Assessment of Perceived Level of Cultural Competence Questionnaire (SAPLCC). Descriptive statistics were measured using SPSS software (v. 24). Independent sample t-tests identified significant differences in subscale scores between race and academic year. Qualitative data were hand-coded for common themes. Overall, findings showed that PA students rated their attitudes, awareness, and abilities about cultural competence as significantly greater than their knowledge, skills, and encounters. Specific areas of identified weaknesses in cultural competency education included: knowledge regarding the cultural context of care; skills associated with managing cross-cultural clinical challenges; and encounters related to coping with aggressiveness and bias. Further analysis indicated that second-year students and non-Caucasian students reported higher personal ratings for levels of cultural competence. Qualitative data provided further insight into students’ levels of preparedness, indicating that most surveyed PA students felt well prepared (39%) or moderately prepared (46%), rather than those who did not feel at all prepared (15%). Students indicated that specific classes focusing on cultural topics, discussions about cultural issues, and clinical experiences were the most useful for promoting cross-cultural education. Future investigation might explore the effectiveness of standardized approaches to training, how student perceptions align with actual care outcomes, or examine how diversity within PA programs impacts students’ preparedness to provide cross-cultural care.

This study examined if physician assistants (PAs) are cost-beneficial to employers. In an era of cost accountability, questions arise about whether a visit to a PA for an episode of care differs from a visit to a physician, and if PAs erode their cost-effectiveness by the manner in which they manage patients. Four common acute medical conditions seen by PAs and physicians within a large health maintenance organization were identified to study. An episode approach was undertaken to identify all laboratory, imaging, medication and provider costs for these diagnoses. Over 12,700 medical office visits were analyzed and assigned to each type of provider and medical department. Patient variables included age, gender, and health status. A multivariate analysis identified significant cost differences in each cohort of patients. In every condition managed by PAs, the total cost of the visit was less than that of a physician in the same department. This was significant for episodes of shoulder tendinitis, otitis media, and urinary tract infections. In no instance were PAs statistically different from physicians in use of laboratory and imaging costs. In each instance the total cost of the episode was less when treated by a PA. Sometimes PAs ordered fewer laboratory tests than physicians. There were no differences in the rate of return visits for a diagnosis between physicians and PAs. Patient differences were held constant for age, gender, and health status. This study affirms that PAs are not only cost-effective from a labor standpoint but are also cost-beneficial to those who employ them. In most cases, they order resources for diagnosis and treatment in a manner similar to physicians for an episode of care, but the cost of an episode of an illness is more economical overall when the P A delivers the care. This study validates the federal policy of support for primary care P A education and suggests that PA employment should be expanded in many sectors of the health care system. These findings and the results of this cost-benefit model are evidence of its validity in predicting health care costs.