Physician Assistants as Tomorrow’s Surgeons. Utilising a Clinical Role as a Training and Selection Tool for Medical Students
2The Faculty of Medicine, The Hebrew University of Jerusalem, Israel
3Chemistry and Biotechnology, Harel High School, Israel
Background:
Medical students are employed as physician assistants (PA) in emergency departments (ED) throughout Israel. In our orthopedic ED, PAs provide clinical support, including patient assessment and minor procedures. No formal instruction or assessment currently exist, showing a need to improve the training process.
Aims:
1.To improve the quality of PA training in the orthopedic ED.
2.To encourage interest in orthopedic surgery and identify students suitable for residency.
Methods:
1.A training program based on CBME (competency based medical education) was designed and delivered in early 2021 to new PAs. All appointees undertook a mandatory shadowing shift after completing a one-day pre-employment course based on four elements: focused history-taking; physical examination; commonly missed injuries; practical skills. PAs were directly overseen by orthopedic residents. They were required to complete a set number of procedures and demonstrate competence in practical areas (physical examination, casting and suturing) within 60 days of commencing work. A practical exam was administered, alongside ongoing evaluation by the supervising resident.
2.Selection of PAs was preferential to students demonstrating an interest in a future orthopedic career. This was seen as an opportunity to identify potential residents and, likewise, provide meaningful clinical exposure to aid selection of future specialty.
Results:
1.All candidates successfully fulfilled the course requirements and passed the practical exam. Very positive feedback was received, with students stating that they felt confident in assessing orthopedic injuries. All supervising residents expressed confidence in the PAs’ ability to competently assess patients.
2.Seven students (87.5%) reiterated their desire to undertake orthopedic training, and all agreed that the program had been beneficial in clarifying their choice of specialty.
Conclusion:
1.CBME principles can be used to improve PA training in the orthopedic ED.
2.Where medical students are employed as PAs, this facilitates training for potential residents and helps students choose a specialty.