Academic journal article Journal of Allied Health

Evaluation of Physician Assistant Student Knowledge and Perception of Competence in Palliative Symptom Management

Academic journal article Journal of Allied Health

Evaluation of Physician Assistant Student Knowledge and Perception of Competence in Palliative Symptom Management

Article excerpt

PURPOSE: To assess the impact of the current curriculum for physician assistant (PA) students in palliative medicine and end-of-life care. METHODS: PA students were invited to participate in an anonymous online survey evaluating seven domains of knowledge in palliative medicine coupled with a self-assessment in competence. Participants were also asked to identify current and desired educational formats in palliative medicine education. There were 1,313 emailed surveys with 139 total responses. RESULTS: Our results demonstrate that a year of clinical training only resulted in minimal improvement in factual knowledge. This suggests that there is insufficient exposure to palliative medicine education during their clinical training. CONCLUSION: PA students recognize their knowledge gaps and lack of exposure in palliative medicine. A more focused curriculum is needed in training experiences for PA students. J Allied Health 2014; 43(4):e69-e74.

PALLIATIVE MEDICINE has been increasingly recognized within the Physician Assistant (PA) community over the past few years as a vital part of patient care for seriously ill patients with life-limiting illnesses. An article published in the Journal of Physician Assistant Education in 2010 noted that pain management and treatment of common end-of-life symptoms should be emphasized when incorporating palliative care and end-of-life instruction into existing curricula.1 The Accreditation Review Commission on Education for the Physician Assistant Accreditation Standards for Physician Assistant Education, 4th edition 2010, requires that all programs must include instruction in the provision of clinical medical care across the lifespan.2 There is increasing recognition that clinicians should be capable of providing basic palliative interventions and identify patients who would benefit from specialized palliative consultative services.

The number of PAs providing care in the inpatient hospital setting is expected to continue to grow. A recent cross-sectional survey of PAs working in the Linked States was conducted to assess their current state of knowledge in Core Competencies for Hospital Medicine. One of the top three content areas PA hospitalists believed would have helped to better prepare them to care for inpatients was palliative medicine (85%).3 Although PA training "should include competency in palliative care," no study published to date has assessed the impact of current didactic and clinical training on knowledge about palliative medicine.

Our study aims to assess knowledge and self- perceived skills for PAs after didactic training and clinical training exposure in current routine education. Our study was adapted, with permission, from a recent study published in the Journal of Palliative Medicine which evaluated resident physicians and fellows on seven domains of knowledge of palliative care and pain management with a self-assessment of competence in these areas.4 Since PAs often function in a similar capacity within the hospital setting, results of this study can help identify areas of improvement within the curriculum to better meet the requirements for palliative medicine education. It is vital that training provides a strong educational foundation that will enable PAs to meet the needs of a very sick hospitalized patient population.

Methods

Subjects

A sample of PA students currently enrolled in PA school were invited to participate in our survey. There were 1,313 e-mailed survey invitations with 139 total responses. All sites were represented in the responses. Since PA schools have varied start and end dates, students were defined based on extent of education at time of participation: partial didactics, completed didactics, or completed didactics and clinical. Comparisons were made between the cohorts of students to assess whether palliative education was gained or lost during clerkship experiences. PA students who had completed their education more than three months prior to participating in the survey were excluded from the study because their clinical work experiences can bias the impact of their clinical rotation education. …

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