Andrea Bequest, PA-C; Pinky Jha, MD, MPH; Paige Gioia, PA-C
WMJ. 2024;123(5):331,338.
With an increase in physician assistant (PA) programs, demand for clinical rotations is increasing.1 Clinicians are hesitant to precept students due to perceptions of decreased productivity and financial burden.2 A study of PA program probation revealed 4 of the 7 most common violations were related to supervised clinical practice experience.3 With expanding PA involvement in the growing hospitalist specialty, our goal is to prepare students for clinical work and for the Physician Assistant National Certifying Examination (PANCE).4 To achieve an innovative, structured clinical rotation in the Section of Hospital Medicine at the Medical College of Wisconsin, each of our advanced practice providers implemented a daily lecture on various medicine topics. The PA students were provided a list of expectations, a “how-to guide,” and a documentation cheat sheet. Students are actively involved in seeing patients, writing notes, calling consults, and communicating with members of the health care team.
From June 2023 through May 2024, we surveyed 19 PA students before and after their internal medicine rotation using a Qualtrics survey. We received 19 pre-rotation and 17 post-rotation surveys. Per the pre-rotation survey, 74% had not participated in daily lectures at their clinical rotations, and 89% responded that they had received a document with rotation expectations. The post-rotation survey indicated that 1 student attended 0 to 5 lectures, 3 students attended 5 to 10 lectures, 7 students attended 10 to 15 lectures, and 6 students attended over 15 lectures. Of the respondents, 88% strongly agreed the lecture series prepared them for their end-of-rotation exam, and 100% said they felt prepared to apply the knowledge they learned from the lectures clinically. When asked to rate the lectures on a scale of 1 to 5, with 5 being the greatest, 76% rated the lectures a 5, and 24% rated them a 4. When asked if the rotation met expectations, 88% of respondents replied “strongly agree,” 12% replied “agree,” and 100% said they would recommend this rotation to others.
The survey results indicate PA students perceive benefits of a structured rotation. The daily lecture series helped prepare them for end-of-rotation exams and apply knowledge clinically. Passing the internal medicine exam is a strong indicator that the student will pass the PANCE.5 As PA training programs expand, there is a need for similar initiatives and to retain students for clinical work within the organization. We can decrease the gap between increasing students and demand for preceptors by leveraging our existing PAs and developing and implementing structured clinical rotations to prepare our future workforce.
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- Gietzen L, Roman C, Hegmann T. Reliability and validity of national end of rotation examinations: an update. J Physician Assist Educ. 2018;29(2):86-88. doi:10.1097/JPA.0000000000000191