SESSION T136 FRIENDS WITH BENEFITS: COLLABORATION OPPORTUNITIES IN PHYSICIAN ASSISTANT CLINICAL EDUCATION
April Stouder, MHS, PA-C
Laura Gerstner, MHA, MSHS, PA-C
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 � 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
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 � [email protected]
� 919-681-3165
� Laura Gerstner, Campbell PA Program, Director of Clinical Education � [email protected]
� 910-893-1252