SESSION T136 FRIENDS WITH BENEFITS: COLLABORATION OPPORTUNITIES IN PHYSICIAN ASSISTANT CLINICAL EDUCATION

April Stouder, MHS, PA-C

Laura Gerstner, MHA, MSHS, PA-C

DISCLOSURES

�  None

LEARNING OBJECTIVES

�  Describe innovative, and increasingly necessary, clinical education collaborative opportunities for PA Programs.

�  Outline the benefits of relationship building and developing communication channels between regional clinical educators.

�  Identify opportunities and initial steps for engaging regional educational programs, clinical training sites, and health systems in cooperative efforts to benefit all involved.

TAKE A MOMENT

�  Consider the daily responsibilities of a clinical coordinator

TAKE A MOMENT

�  Consider the daily responsibilities of a clinical coordinator �  Student assessment – exams, logging data, assignments, OSCEs

�  Credentialing or onboarding procedures

�  Schedule snafu’s…putting fires out!

�  Remediation

�  Site evaluation and development

�  Preceptor relations & appreciation

�  Policy creation/revision

�  Research/scholarship

GROWTH IN PA LEARNER VOLUME

�  Rapid Expansion of PA Programs, ARC-PA data �  187 accredited programs

�  64 applicant programs

�  Expansion of PA class sizes �  Affordable Care Act

�  Institutional pressure

�  Demand > Supply

�  Highest # of PA Programs by state: �  NY: 21/1 (accredited/developing)

�  PA: 20/1

�  CA: 10/1

�  OH: 10/0

�  FL: 9/3

�  NC: 8/3

�  TX: 8/0

�  MA: 7/1

OTHER MEDICAL LEARNERS

�  MD, AAMC data �  5000+ additional MD students since

2009 �  139 MD programs in US

�  Offshore programs, not included

�  DO, AACOM data �  30 programs, 40 locations in US

�  3 new programs in 2013

�  Nursing, CCNC Data �  74 applicant programs

�  Physical therapy, CAPTE Data �  218 accredited, 14 developing

programs

�  Occupational Therapy, AOTA Data �  22 developing programs

�  Pharmacy, ACPE Data �  35 developing programs

OTHER PRESSURES

�  Aging population & newly insured à provider & practice

�  Electronic health records

�  Aging of experienced preceptors �  Attrition

�  Consolidation of large health systems

�  State authorization compliance

�  Preceptor payment/incentives

A SAMPLING OF CURRENT PA CLINICAL COLLABORATION �  Philadelphia area

�  7 programs

�  Occasional help with placements between 2 programs

�  Some research collaboration

�  Boston area �  Soon to be 4 programs

�  No current collaboration

�  Texas �  8 programs

�  No current collaboration

�  Florida �  9 programs/3 developing

�  No current collaboration

TIME IS RIGHT

�  Regional collaboration, rather than competition �  Training programs, healthcare systems, professions

�  State vs regional

�  Goals are similar à train quality providers

�  Silo Approach �  Not sustainable in this dynamic environment!

EXISTING GUIDELINES (APAP)

�  Voluntary, only published example for clinical education

�  Specific to use of clinical training sites

�  Published in 1998 �  4 points of inter-program collaboration

�  APAP members agree to a spirit of cooperation and collaboration in the use of clinical training sites

�  Need for CC to CC communication; asking preceptors if they work with other programs and if so, notifying the program of interest

�  Follow up with program that previously used a site to verify quality of experiences

�  Programs/CCs sensitive to preceptor burnout and student quality when sharing training sites

COLLABORATION EFFORTS – ONE EXAMPLE

�  NC Clinical Coordinators, Spring 2013 �  Accredited and developing programs (once CC hired)

�  Range of programs – academic medical centers, private, public

�  Neutral meeting place

�  Discussed common issues �  Structure of CY at each program, support/team

�  Listserv & contact info

�  Policies – visiting students & out-of-state rotations

�  Preceptor development & support

�  EOR rollout strategies

FOLLOW UP

�  Decided upon annual Spring meetings �  Rotating hosts/locations

�  Phone calls, emails as needed

�  Informal dinner/gathering at PAEA Forum in Memphis

BENEFITS OF COLLABORATION

�  Anticipated �  Sharing resources – policies, procedures, common issues

�  Gaining information about programs

�  Relationship building with colleagues in similar faculty roles

�  Research opportunities?

BENEFITS

�  Unanticipated �  Assistance with “pinch” student placement needs

�  Sharing info about problematic sites in overlapping regions

�  Sense of comradery – very comfortable calling on colleagues

�  Connecting at regional & national conferences

�  Mentoring new faculty

�  Sounding board for new ideas – assessment, policies

�  Several PAEA proposal collaborations

WHAT CAN WE LEARN FROM OUR MEDICAL COLLEAGUES?

EXAMPLES FROM THE LITERATURE

NURSING

�  Nursing Literature �  Clinical academic practice partnership

�  Dedicated education unit concept

�  Schools & health centers, hospitals or clinics partnering

�  Recruitment, capacity, continuity

NURSING & PA

� MN: The Clinical Coordination Partnership (TCCP) Project �  Independent organization

�  State grant funded

�  Piloted with pre-licensure nursing students

�  Education & clinical partners

�  Identify barriers, assess capacity & placement needs

�  Centralized student scheduling & standardized orientation

�  Reduced workload time by 70% over 3 years for partners

�  Next step: rolling out for advanced practice nurse & PA students �  Financial support by members

�  3 PA programs, 6 APN programs, 6 major health systems/hospitals

PHARMACY

�  Pharmacy consortium (multistate or regional) �  Alignment of expectations & administrative tasks to streamline process for

preceptors & sites �  Syllabi, manuals, student orientations

�  Evaluation tools

�  Online system for student profiles, immunizations

�  Preceptor development

�  Cooperative approach to scheduling

MEDICINE

�  Medical Education Literature �  “Teaching practice” concept

�  Longitudinal placements

�  Higher volumes

THINKING OUTSIDE OF THE BOX

�  Partnering with Health Systems/Shared faculty positions �  Clinical placements for learners, instructors, recruitment tool

�  Educational “pods” �  regional faculty – oversees all students/orientation at given site

�  clinical placements at regional hospitals

�  Paired interprofessional clinical placements

THE CHALLENGE

�  Refer back to your list…how can you collaborate? �  Other regional PA clinical coordinators

�  Health systems �  Network with leadership

�  Band together with other programs who send students to the site to lobby for change

�  Central student scheduling system

�  Uniform credentialing procedures

�  Other medical institutions or programs �  Consider educational partnerships

�  Interprofessional learning opportunities

INITIAL STEPS

�  Reach out to other Clinical Coordinators in your state/region �  Build relationships!

�  Utilize program or institutional leadership �  Facilitate introductions, network, advocate

�  Be brave & think big!!

REFERENCES

�  Nicholson J. Voluntary guidelines for program collaboration on clinical training sites.  Perspective on Physician Assistant Education 2001; 12(2):110-111.2. 

�  Kalet AL, et al.  Medical training in school-based health centers:  a collaboration among five medical schools.  Acad Med. 2007 May;82(5):458-464.3. 

�  Duke LJ, et al.  Establishment of a multi-state experiential pharmacy program consortium.  Am JPharm Educ. 2008 Jun 15; 72(3):62.

�  Stouder A, Talarico B. Playing Nicely in the Sandbox: Exploring Clinical Education Collaboration Opportunities. PAEA Forum 2013.

�  Applicant Programs. Accreditation Review Commission on Education of the Physician Assistant Web site. http://arc-pa.org/provisional_acc/applicant_programs.html Accessed September 17, 2014.

�  Total enrollment in US medical schools. Association of American Medical Colleges website. https://www.aamc.org/download/321526/data/2013factstable26-2.pdf Accessed September 17, 2014.

�  TCCP Expands to Serve Advanced Practice Nursing and Physician Assistants http://www.healthforceminnesota.org/News-and-Events/Impact-2013-04.html#article5 Accessed September 17, 2014.

�  US Colleges of Osteopathic Medicine. http://www.aacom.org/about/colleges/Pages/default.aspx Accessed September 17, 2014.

QUESTIONS?

�  April Stouder, Duke PA Program, Director of Clinical Education �  april.stouder@duke.edu

�  919-681-3165

�  Laura Gerstner, Campbell PA Program, Director of Clinical Education �  gerstnerl@campbell.edu

�  910-893-1252