This document contains 19 poster abstracts selected from the American Academy of Physician Associates (AAPA) conference in Houston, Tex., from May 18-22, 2024.

The call for abstracts for the 2025 conference in Denver, Colo., opens December 2 on the AAPA conference website (www.aapaconference.org). AAPA seeks to continue its role of encouraging and supporting physician associate/assistant (PA)-related research and invites all PAs and PA students to consider submitting an abstract for this session. All topic areas are welcome, including educational topics, clinical practice topics, workforce topics, and community-based projects inclusive of quantitative and qualitative research. We hope that you and your colleagues will share your research ideas and projects and participate in the 2025 poster research session.

The selected 2024 poster session abstracts are:

Adherence to filling anticoagulant prescriptions at a university pharmacy: An analysis of outpatient data

Jasmine Archuleta; Bailee Bird; Allison Elmer; Kawika Tupola; Colgan Sloan, PharmD, BCPS, BCGP; Alden Baker, PA-C, MPAS; Jennifer Coombs, PhD, MPAS, PA-C

Selective nonresponse bias regarding questions about experienced mistreatment in PA training programs

Marcia Bouton, DMSc, MHPE, PA-C, DFAAPA; Charlotte Bolch, PhD; Nicholas Hudak, PhD, MPA, MSEd, PA-C; Dominique Frias-Sarmiento, MA; Bettie Coplan, PhD, PA-C, DFAAPA

PA program medical directors are important advocates for the PA profession: Results from a national survey

Marcia Bouton, DMSc, MHPE, PA-C, DFAAPA; Jennifer Wild, DO; Katherine Mitzel, DO; Tian Zhou, MS; Charlotte Bolch, PhD

Early psychosocial factors predict physical function and return to work status at a 2-year follow-up after a lower extremity fracture

Lucy C. Bowers, BS; William Charlton, BS; Maj. Joshua Van Wyngaarden, PT, DPT, PhD; Brian W. Noehren, PT, PhD; Paul E. Matuszewski, MD

PA use in the Veterans Health Administration

Scot Burroughs, DMSc, MPAS, PA-C

Depression rate of foster parents in Utah measured by administration of the PHQ-9

Vivian Cruz; Sabrina Higley; Damaris Huang; Kinzie Tobler; Melanie Murphy, MBA, PA-C; Jennifer Coombs, PhD, MPAS, PA-C

Primary care PA practice: Usual roles, perceived barriers, and collaborating physician opinions: a mixed-methods approach

Janet Furman, PhD, PA-C, DFAAPA; Shawna Strickland, PhD, CAE, RRT, RRT-NPS, RRT-AACS, AE-C, FAARC; Somu Chatterjee, MD, MPH; Sharon Foley, PhD, RD; Jennifer Orozco, DMSc, PA-C; Noël E. Smith, MA

Exploring compensation and autonomy among PAs in dermatology in Pennsylvania

Cynthia F. Griffith, MPAS, PA-C; Richard Froman, PhD; Hayden T. Middleton, DMSc, PA-C

Evolving PA degrees: Evaluating practicing PAs' perceived value in obtaining a clinical doctorate

Shaun Horak, DMSc, PA-C; Jannelle Reynolds, MPAS, PA-C; Shaun Grammer, DMSc, PA-C

Getting started: Applying evidence-based concepts to PA and NP orientation

Kimberlee Ketchersid, MMSc, PA-C; Kathryn Davis, MSN, CPNP-AC/PC

Evaluating the capacity for PAs' dissemination of patient-centered outcomes research

Marie-Michèle Léger, MPH, PA-C; Daniel Pace, CHCP; Eric D. Peterson, EdM, CHCP; Noël E. Smith, MA

Mentorship effect for APRNs and PAs

Victoria Louwagie, DMSc, MS, PA-C, DFAAPA; Justine S. Herndon, MS, PA-C; Brittany Strelow, DMSc, PA-C, MS, DFAAPA; Holly A. Schenzel, DNP, APRN, ACNP-BC; Elizabeth A. Cumberland, APRN, CNP; Amy Oxentenko, MD

Early development of a PA and APRN leader collaboration in an academic healthcare system

Jennifer Mahaffey, MPAS, PA-C; Rebecca Krueger, RN, ACNP; Sarah Vanderlinden, DMSc, PA-C, DFAAPA; Jamie Silkey, PA-C, MBA, MHA

Community engagement as a tool for teaching professional identity and social determinants of health

K. Alexis Moore, DMSc, MPH, PA-C; Summer Dunlap; Mary O'Connell, MPAS, PA-C

Do clinical boot camps improve PA student preparation for supervised clinical practice experiences?

Darcy Ortiz, MHA, MPAS, PA-C

Prevalence of attention-deficit hyperactivity disorder among PA students

Tia Solh, MT(ASCP), MSPAS, PA-C; Lauren A. Reid, PhD, MPH; Lucas Corbin, MHS, PA-C; Stewart Harvey, MHS, PA-C; Alexander Wood, MHS, PA-C

Cervical cancer screening implementation

Brittany Strelow, DMSc, PA-C, MS, DFAAPA; Joy Stevens, MS, PA-C; Stephanie Fink, MS, PA-C; Danielle O'Laughlin, MS, PA-C

Retention and return on investment in a PA postgraduate emergency medicine program

Lisa Swiatczak, MPAS, PA-C; Joshua Knox, MA, PA-C; Christopher Ellingsen, MPAS, PA-C; Bridget LeClair, MPAS, PA-C; Paul Coogan, MD, FACEP; Mary Jo Wiemiller, MS, PA-C; Kyle Kinderman, MPAS, PA-C

Training programs for PAs and NPs who desire hospital administrative and leadership positions: A scoping review

Stacy Laack Valentine, MS, PA-C; Michelle McMoon, PA-C, PhD

ADHERENCE TO FILLING ANTICOAGULANT PRESCRIPTIONS AT A UNIVERSITY PHARMACY: AN ANALYSIS OF OUTPATIENT DATA

Jasmine Archuleta; Bailee Bird; Allison Elmer; Kawika Tupola; Colgan Sloan, PharmD, BCPS, BCGP; Alden Baker, PA-C, MPAS; Jennifer Coombs, PhD, MPAS, PA-C

Purpose

Anticoagulant therapy commonly is prescribed for patients with atrial fibrillation or those suspected of having venous thromboembolism (deep vein thrombosis or pulmonary embolism). Nonadherence to anticoagulants can have severe consequences because these medications aim to prevent the recurrence of thrombotic events. Despite the serious consequences of nonadherence, there is a surprising lack of research on how consistently patients pick up their prescribed anticoagulant medications after being discharged from the ED. This gap in data highlights the need for further studies to understand the barriers to medication adherence and to develop strategies to improve it, ensuring better patient outcomes and reducing the risk of complications such as stroke or thromboembolism. This research aims to analyze the percentage of patients prescribed anticoagulants from the University of Utah's ED who picked up their prescriptions, with a subanalysis looking at various demographics.

Methods

The study was approved by the University of Utah institutional review board (IRB). Charts of patients prescribed anticoagulants in 2021-2022 were obtained through the University of Utah electronic medical records database. An electronic spreadsheet was used to sort and clean the data. A regression analysis was performed using RStudio. The analysis included the percentage of anticoagulants picked up and multiple variables.

Results

Two hundred twenty-five patients met the criteria for our study. Nearly 86% of patients picked up their anticoagulant prescription within 4 weeks. Of the 14.2% of patients who did not pick up their prescriptions, the variables reviewed (insurance, sex, age, weight, and location) showed no effect on whether prescriptions were picked up.

Conclusions

The prescription fill rate of anticoagulants prescribed at the pharmacy in the University of Utah ED was unaffected by any studied variables. The absence of statistically significant data might highlight a lack of bias when treating patients, easily accessible resources, and a lack of a need for intervention in the ED; a repeat of our study that addresses these limitations would be ideal.

Jasmine Archuleta, Bailee Bird, Allison Elmer, and Kawika Tupola are students in the PA program at the University of Utah in Salt Lake City. Colgan Sloan and Alden Baker practice in emergency medicine at University of Utah Health in Salt Lake City. Jennifer Coombs is director of graduate studies in the PA program at the University of Utah. The authors have disclosed no potential conflicts of interest, financial or otherwise.

SELECTIVE NONRESPONSE BIAS REGARDING QUESTIONS ABOUT EXPERIENCED MISTREATMENT IN PA TRAINING PROGRAMS

Marcia Bouton, DMSc, MHPE, PA-C, DFAAPA; Charlotte Bolch, PhD; Nicholas Hudak, PhD, MPA, MSEd, PA-C; Dominique Frias-Sarmiento, MA; Bettie Coplan, PhD, PA-C, DFAAPA

Purpose

About 38% of PA students experience mistreatment in the form of harassment, discrimination, or identity-biased evaluations, but fewer than 2% report it to their programs. Mistreatment experience can have profound psychologic effects on PA students and be disproportionately damaging to those with minoritized social identities. Female PA students are at higher risk for gender-based discrimination.

The PA Education Association (PAEA) End of Program Survey (EOPS) collects data on graduating PA students during the last month of training. The average response rate for 2017-2019 and 2021 was 40%. Some respondents opt to not answer sections of the survey, creating the potential for partial nonresponse bias. Nonresponse can result from systematic differences between those who respond and those who do not. This study compared sociodemographic data (sex, race, and ethnicity) of respondents who took the EOPS survey and completed questions related to experienced mistreatment, and respondents who did not complete any questions related to experienced mistreatment. Findings may provide insight into the interpretation of PA student mistreatment events.

Methods

The study was deemed exempt by the Midwestern University IRB. Data from four years (2017, 2018, 2019, and 2021) from the PAEA EOPS were used. Respondent data categorized as independent variables were sex, race, and ethnicity. Student response to personal experience of mistreatment was the dependent variable: those who answered any questions regarding personal experience of mistreatment were classified as responders; those who answered no questions regarding personal experience of mistreatment were classified as nonresponders. Any response (positive or negative) about experienced mistreatment resulted in the participant being classified a responder.

The data were analyzed using the statistical software R version 4.3.0 and RStudio version 2023.03.0. Descriptive analysis of the longitudinal data was performed regarding the sociodemographic variables and completion of mistreatment questions. The dependent variable (any response to mistreatment questions) was evaluated using logistic regression to assess the odds ratio (OR) of the event of responder being based on the independent sociodemographic variables. Significance level was set at alpha = 0.05.

Results

A total of 12,062 students participated in the PAEA EOPS in 2017-2019 and 2021. Most respondents were female (76%), White (84%), and non-Hispanic (92%). Of the total EOPS participants, 31% were mistreatment question nonresponders. Participants were statistically more likely to respond to mistreatment questions if they were female (OR 1.41, P < .001), Black (OR 1.38, P = .04), White (OR 1.93, P < .001), or non-Hispanic (OR 1.26, P = .005). Transgender students were less likely to complete questions about mistreatment (OR 0.11, P = .04).

Conclusions

Nonresponse bias can affect interpretation and generalizability of survey results. Participants who were Black, White, female, or non-Hispanic were more likely to complete mistreatment questions, and transgender students were less likely to complete them. Research is needed to evaluate hesitancy to respond to questions about PA student mistreatment and improve equity in data collection on this topic.

At Midwestern University in Glendale, Ariz., Marcia Bouton is an assistant professor in the PA program, Charlotte Bolch is associate director of research and sponsored programs. Nicholas Hudak is an associate professor in the PA program at Duke University in Durham, N.C. Dominique Frias-Sarmiento is a mixed-methods analyst at PAEA in Washington, D.C. Bettie Coplan is an associate professor in the PA program at Northern Arizona University in Phoenix, Ariz. The authors have disclosed no potential conflicts of interest, financial or otherwise.

PA PROGRAM MEDICAL DIRECTORS ARE IMPORTANT ADVOCATES FOR THE PA PROFESSION: RESULTS FROM A NATIONAL SURVEY

Marcia Bouton, DMSc, MHPE, PA-C, DFAAPA; Jennifer Wild, DO; Katherine Mitzel, DO; Tian Zhou, MS; Charlotte Bolch, PhD

Purpose

The Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) mandates that PA educational programs include a physician medical director. However, this requirement has softened compared with previous requirements by ARC-PA that medical directors also serve as advocates for their PA program. Advocacy and connection building is a key contribution that PA program medical directors can make to the PA profession. This study evaluated whether PA program medical directors are playing a role in PA advocacy and what factors correlate with this effort.

Methods

This study was deemed exempt by the Midwestern University IRB. The study was a mixed-methods survey using grounded theory for thematic coding. The survey was developed after a review of the literature and piloted by the research team and unaffiliated faculty to affirm content and construct validity. Two hundred sixty-two PA program medical directors from accredited programs with identified email addresses were sent an email with a link to a Research Electronic Data Capture (REDCap) survey that included demographic information and 10 Likert-scale questions. Sixty-nine directors responded, for a response rate of 26%.

Statistical analysis was performed using the R program version 4.3.0 and RStudio version 2023.03.0. Descriptive statistics, chi-square, analysis of variance, and Pearson correlation were used. A P value less than .05 indicated a significant association between responses or a significant difference in means between two groups. Qualitative thematic analysis of the question, “How have you publicly supported the PA profession,” was performed using ChatGPT. Iterative analysis of the research team was performed. Coding consensus was achieved for each response.

Results

Demographic data showed most respondents primarily had an MD degree (87%) (rather than a DO degree) and were male (66%), White (61%), practicing clinically (71%), and working as medical directors 8 to 12 hours per week (46%). Increasing diversity in this role in the future is expected as reflected in trends in medical school training demographics.

PA program medical directors in this study did not show strong support of the physician assistant to physician associate title change, with 72% of the responses being neutral, disagree, or strongly disagree. They also were not engaged in legislative efforts to support optimal team practice (84% never, very rarely, or rarely contributed to promotion of optimal team practice). However, they do have a very high level of engagement in public advocacy on behalf of the PA profession (91% frequently or occasionally). Thematic analysis showed they had public and behind-the-scenes efforts at advocacy to ease the path for PA leadership positions, PA employment, improved attitudes in healthcare organizations toward PAs, and securing clinical rotations in PA training programs. Respondents felt valued by their programs for their contribution to PA education and did not feel that their role simply fulfilled a title for accreditation. However, 36% of respondents felt that none of the professional organizations (AAPA, American Medical Association, American Osteopathic Association, state PA organization, PAEA, or PA state licensing organization) support them in their role as PA program medical director.

Conclusions

Exploring ways to support advocacy by our valued PA program medical directors in PA professional organizations would be advantageous to PA program medical directors' professional growth as well as the PA profession.

At Midwestern University in Glendale, Ariz., Marcia Bouton is an assistant professor in the PA program, Jennifer Wild is medical director and an assistant professor in the PA program, Katherine Mitzel is a clinical professor and associate dean at the university's Arizona College of Osteopathic Medicine, Tian Zhou is a statistical analyst, and Charlotte Bolch is associate director of research and sponsored programs. The authors have disclosed no potential conflicts of interest, financial or otherwise.

EARLY PSYCHOSOCIAL FACTORS PREDICT PHYSICAL FUNCTION AND RETURN TO WORK STATUS AT A 2-YEAR FOLLOW-UP AFTER A LOWER EXTREMITY FRACTURE

Lucy C. Bowers, BS; William Charlton, BS; Maj. Joshua Van Wyngaarden, PT, DPT, PhD; Brian W. Noehren, PT, PhD; Paul E. Matuszewski, MD

Purpose

This study sought to determine if early psychosocial screening and other patient factors predict return to work (RTW) and self-reported physical function 24 months after lower extremity fracture requiring surgical fixation. We hypothesized that pain self-efficacy at 6 weeks and 3 months would be associated with physical function and RTW activity.

Methods

This study was approved by the University of Kentucky IRB. The observational cohort consisted of 177 patients (average age 41.9 years ± 14.5 years) with a lower extremity fracture requiring surgical fixation at a Level I trauma center. At 6 weeks and 3 months after surgical fixation, patients completed the Pain Catastrophizing Scale, Pain Self-Efficacy Questionnaire (PSEQ), and Patient Reported Outcomes Measurement Information System (PROMIS) questionnaire. At 24 months, participants completed the PROMIS Physical Function and Cincinnati Occupational Rating Scale (CORS, a modification of the Cincinnati Knee Rating System Occupational Rating Scale), a functional assessment of ability to engage in physical labor. Linear regression analyses were completed for each outcome, including body mass index (BMI), age, sex, smoking, Injury Severity Score, depression, pain self-efficacy, and pain catastrophizing.

Results

Of the 177 patients recruited, 138 (78%) completed the study. Low PSEQ at 6 weeks (beta = 0.357, P = .001) and 3 months (beta = 0.355, P = .002) were associated with decreased CORS at 24 months. An elevated BMI at any point was associated with decreased CORS at 24 months (6 weeks: beta = -0.683, P < .001; 3 months: beta = -0.732, P < .001). Low PSEQ scores at 6 weeks and 3 months were associated with decreased physical function at 24 months (6 weeks: beta = 0.243, P < .001; 3 months: beta = 0.354, P < .001). Elevated BMI at any point was associated with decreased physical function at 24 months (6 weeks: beta = -0.336, P < .001; 3 months: beta = -0.318, P < .001). A low PSEQ (less than 40) at 3 months accounted for 16.8% worse physical function and 31.5% worse CORS at 24 months (t-value: 8.41, P < .001; t-value: 12.39, P < .001). Similarly, obesity (BMI of 30 or greater) accounted for 11.4% worse physical function and 38.5% worse CORS at 24 months (t-value: 5.64, P < .001; t-value: 16.21, P < .001). Other factors were not associated with poor physical function or RTW status.

Conclusions

Low pain self-efficacy and higher BMI identified early in the postoperative period were associated with decreased physical function and ability to return to preinjury work at 2 years. Patients exhibiting these features could potentially receive targeted interventions early in their recovery to improve outcome.

Lucy C. Bowers is a student in the PA program at the University of Kentucky in Lexington, Ky. William Charlton is an orthopedic trauma research fellow at the University of Kentucky. Maj. Josh Van Wyngaarden is an associate professor at Baylor University in Waco, Tex. Brian W. Noehren is a professor and an associate dean for research at the University of Kentucky. Paul E. Matuszewski is an associate professor of orthopedic surgery and vice chair of research at the University of Kentucky. The authors have disclosed no potential conflicts of interest, financial or otherwise.

PA USE IN THE VETERANS HEALTH ADMINISTRATION

Scot Burroughs, DMSc, MPAS, PA-C

Purpose

The Veterans Health Administration (VHA) is the largest integrated healthcare system in the United States. The VHA provides care at 172 VA medical centers and 1,138 outpatient sites of varying complexity to more than 9 million enrolled veterans. These facilities are staffed by 26,200 physicians, 2,693 PAs, 6,060 NPs, and a large cadre of additional healthcare professionals. The VA PA services chief oversees their use. We describe the growing role of PAs in the VHA.

Methods

Data were derived from the Veterans Workforce Management and Consulting Office's ongoing survey of employees in 2023. Assessing job satisfaction and employment retention in the VHA is an ongoing human resource activity to improve job satisfaction. From this survey, we partitioned the demographic and practice characteristics of PAs employed in the VHA and assessed trends.

Results

In 2023, the VHA employed 2,693 PAs. The average age was 48 years, and 61% were female. One-fifth (22%) were of minority status, and 22% were veterans. Spanning 5 years, the onboarding of PAs in the VHA increased from 2.9% to 3.7% to fill a vacancy rate of 16.6%. The PA turnover rate for the past 5 years has declined, averaging 8.6%. On a 0 to 100 job satisfaction scale, 71% of PAs rate the VHA as the Best Place to Work. Additional survey results of VHA PAs identified the workload as reasonable (3.7) and overall satisfying (4) as a career on a scale of 1 to 5.

Conclusions

PAs' characteristics and employment settings are essential factors in medical labor research. The VHA is the largest federal employer of PAs, uses them in diverse settings, and recruits at least 300 PAs annually to grow the workforce.

Scot Burroughs is the executive director of PA services in the Department of Veteran Affairs in Washington, D.C. The author has disclosed no potential conflicts of interest, financial or otherwise.

DEPRESSION RATE OF FOSTER PARENTS IN UTAH MEASURED BY ADMINISTRATION OF THE PHQ-9

Vivian Cruz; Sabrina Higley; Damaris Huang; Kinzie Tobler; Melanie Murphy, MBA, PA-C; Jennifer Coombs, PhD, MPAS, PA-C

Purpose

The mental health of foster parents is a critical factor in providing adequate care for foster children. However, data are lacking about the mental health of foster parents, particularly in relation to depression. This study aimed to quantify the rate of depression among foster parents in Utah and compare it with the rate of depression in the general adult population. In addition, the study examined the potential correlation between depression rates and factors such as regionality, age, and length of time fostering children.

Methods

One hundred fifty-five foster parents in Utah participated in the study by completing the Patient Health Questionnaire-9 (PHQ-9) survey through the Utah Foster Care Bridge app.

Results

The results indicated that 54% of foster parents had a PHQ-9 score of 5 or higher, indicating at least minimal depression, compared with 23% of the general adult population. However, no significant correlation was found between depression rates and years of fostering or the number of children being fostered.

Conclusions

The results of this study highlight the need for increased support and resources for foster parents, particularly in addressing their mental health needs. Further research with a larger sample size and more tailored survey is recommended to gain a deeper understanding of the factors that contribute to depression among foster parents, and to evaluate the effectiveness of interventions and support services.

In the PA program at the University of Utah in Salt Lake City, Vivian Cruz, Sabrina Higley, Damaris Huang, and Kinzie Tobler are students, Melanie Murphy is an assistant professor and director of clinical education, and Jennifer Coombs is a professor and director of graduate studies. The authors have disclosed no potential conflicts of interest, financial or otherwise.

PRIMARY CARE PA PRACTICE: USUAL ROLES, PERCEIVED BARRIERS, AND COLLABORATING PHYSICIAN OPINIONS: A MIXED-METHODS APPROACH

Janet Furman, PhD, PA-C, DFAAPA; Shawna Strickland, PhD, CAE, RRT, RRT-NPS, RRT-AACS, AE-C, FAARC; Somu Chatterjee, MD, MPH; Sharon Foley, PhD, RD; Jennifer Orozco, DMSc, PA-C; Noël E. Smith, MA

Purpose

PAs can help mitigate the primary care provider (PCP) shortage in the United States. To do so, PA practice must be optimized to provide efficient and effective primary care. Research is limited on the role of PAs in primary care, barriers PAs may face in primary care practice, and physician opinions of PA practice. This research identified these key concepts to gain baseline knowledge about the practice and collaboration patterns of primary care PAs.

Methods

This research was reviewed and deemed exempt by the Rush University IRB. A sequential explanatory design was used to collect quantitative and qualitative data from primary care PAs and their collaborating physicians. PAs received an invitation to participate in an online survey, and were encouraged to recruit their collaborating physician to engage in a separate similar survey. Postsurvey interviews were completed to gain a further understanding of the issues.

Results

Survey data revealed that PAs (N = 298) performed expected roles in primary care; we did not find evidence of extensive limitations to practice. PAs identified several practice barriers, including lack of involvement in decisions relating directly to their role, patient provider preference, and role misconceptions. These limits also were identified in postsurvey interviews with PAs (n = 7). Additionally, interviewees identified a lack of consistency between PA and NP practice and lack of PA leadership as practice barriers. Physician survey responses (N = 18) revealed universal agreement that PAs are competent to provide effective primary care. Physicians identified similar practice barriers, with the addition of mandated chart cosignature. No physicians were interviewed postsurvey.

Conclusions

This research is a step toward identifying barriers to primary care PA practice and can aid the profession in strategizing to overcome them. Further, opinions of physicians about PA practice can aid in optimization of the PA-physician team, resulting in further ability to provide excellent, team-based primary care to patients who need it.

Janet Furman is an assistant professor and the co-director of the PA program at Touro University in Skokie, Ill. Shawna Strickland is the associate executive director of programs at the American Epilepsy Society and adjunct faculty at Rush University in Chicago, Ill. Somu Chatterjee is an associate professor in the PA program at the University of Kentucky in Lexington, Ky. At the AAPA in Alexandria, Va., Jennifer Orozco is chief medical officer and Noël E. Smith is senior director of PA and industry research and analysis. The authors have disclosed no potential conflicts of interest, financial or otherwise.

EXPLORING COMPENSATION AND AUTONOMY AMONG PAS IN DERMATOLOGY IN PENNSYLVANIA

Cynthia F. Griffith, MPAS, PA-C; Richard Froman, PhD; Hayden T. Middleton, DMSc, PA-C

Purpose

This study investigated the compensation structures and earnings of PAs in dermatology, addressing significant disparities in compensation among various models. With a focus on productivity-based compensation, we analyzed data from a survey of 346 members of the Pennsylvania Dermatology Physician Assistants (PDPA) to understand how collections relate to salary and if there is any difference in salary based on the compensation model.

Methods

The study was approved by the University of Texas (UT) Southwestern Medical Center IRB. A postsurvey analysis was conducted of a salary survey of 84 members of the PDPA (response rate of 24%). The survey collected information on various aspects of compensation, including base salary, bonuses, and salary structure. This study explored if significant differences existed between salary types. PAs were included in the study if their primary specialty was dermatology and they had worked at least 1 full year in the field. Respondents were excluded if they had less than 1 year of clinical practice, their primary specialty was not dermatology, they practiced outside the commonwealth of Pennsylvania, or they responded that they were retired.

Results

Only one PA was hourly and full time. Among the full-time participants only, a significant difference was found in pay by compensation structure, F(2,59) = 11.98, P < .001. Production-based pay (M = $197,963.20) was significantly higher than base salary (P < .01) and base plus bonus pay (M = $156,662.60) was significantly higher than base salary (P < .05), with a mean base salary of $102,053. Although no statistically significant difference was found between production and base plus bonus pay, a mean difference of $41,300 was observed. Additionally, PAs with the highest income reported that autonomy has a top employment value.

Conclusions

Our findings reveal that PAs in dermatology who are compensated in a production-based or salary plus bonus model made significantly more than PAs who were compensated in other salary structures, specifically base salary only or hourly, and those with higher incomes chose autonomy over any other job value. However, the study has limitations, including a limited sample size from Pennsylvania and potential response bias, raising the need for additional research to generalize these findings to other PAs in dermatology across the nation and to explore missing factors such as benefits acquisition. This research contributes to a comprehensive perspective on compensation for PAs in dermatology, shedding light on a crucial aspect of the healthcare workforce.

Cynthia F. Griffith practices in dermatology at UT Southwestern Medical Center in Dallas, Tex. Richard Froman is a professor of psychology at John Brown University in Siloam Springs, Ark. At the time this abstract was written, Hayden T. Middleton practiced in family medicine at the Mayo Clinic in Rochester, Minn. He now practices in family medicine at M Health Fairview in St. Paul, Minn. The authors have disclosed no potential conflicts of interest, financial or otherwise.

EVOLVING PA DEGREES: EVALUATING PRACTICING PAS' PERCEIVED VALUE IN OBTAINING A CLINICAL DOCTORATE

Shaun Horak, DMSc, PA-C; Jannelle Reynolds, MPAS, PA-C; Shaun Grammer, DMSc, PA-C

Purpose

This study sought to determine the percentage of PAs who believe that the PA profession should be at the level of a clinical doctorate, their willingness to attend a postgraduate program, and their anticipated enrollment time frame based on years of experience in the profession.

Methods

The study was approved by the University of Nebraska Medical Center IRB. This cross-sectional study used an IRB-approved survey instrument designed by the researchers and disseminated to two accredited PA programs with a national alumni base. The survey assessed participants' agreement with the importance of a clinical doctorate for the PA profession and their likelihood to seek such a degree. Data were analyzed using descriptive statistics, analysis of variance, and logistic regression odds ratios.

Results

Career length was found to have a significant effect on respondents' perceptions, with more experienced PAs assigning higher value to advanced clinical degrees (P < .05) across the questions in the survey. Specialty focused training interest was highest for emergency medicine, critical care, orthopedics, and infectious disease if specialty pathways were offered by the doctoral program.

Conclusions

Career length appeared to have an influence on the value of a doctoral degree, with PAs who had been practicing longer being more likely than new graduates to say that a doctorate degree was important. Educational training and specialty practice settings did not appear to influence responses toward seeking and starting a doctoral degree. The findings indicate support for establishing clinical doctorate programs for PAs, with solid support from working clinicians. Additionally, there was evidence of increased interest in specialized tracks such as emergency medicine, critical care, orthopedics, and infectious disease compared with other specialties.

At the University of Nebraska Medical Center in Omaha, Neb., Shaun Horak is an assistant professor and associate program director in the Department of Medical Science, Jannelle Reynolds is an assistant professor and practices in the Department of Medical Sciences, and Shaun Grammer is an associate professor and chair of the Department of Medical Science. The authors have disclosed no potential conflicts of interest, financial or otherwise.

GETTING STARTED: APPLYING EVIDENCE-BASED CONCEPTS TO PA AND NP ORIENTATION

Kimberlee Ketchersid, MMSc, PA-C; Kathryn Davis, MSN, CPNP-AC/PC

Purpose

As the US healthcare system faces healthcare provider shortages and the resultant rapid employment growth in PAs and NPs, employers must provide resources to improve clinician satisfaction and reduce burnout. The effect of PA and NP onboarding is an emerging area of research. Literature supports that orientation and onboarding programs can improve job satisfaction and effectiveness and lower turnover rates and stress. Opportunities exist to implement evidence-based orientation and onboarding programs.

Methods

A task force, including PAs and NPs from multiple specialty areas and our academic partners, created a 4-hour advanced practice provider orientation that all PAs, NPs, and certified nurse-midwives (CNMs) at an urban academic medical center attended in their first month of hire. Orientation content was derived from structural and psychosocial themes described by Ortiz and Barnes and included orientation to organizational dynamics, electronic medical record (EMR) training, clarifying role expectations, assessing clinical competence, and creating comfort. In a 12-month period, 88 PAs, CNMs, and NPs from three hospitals and affiliated clinics attended the orientation. Fifty-three clinicians completed preassessment and 60 completed postorientation evaluation. Orientation evaluation consisted of nine questions that assessed confidence level associated with understanding organizational dynamics, clinical role, evaluation process, using the EMR, clinical documentation and billing, and quality initiatives using a Likert scale. Pre- and postassessment scores were compared using a student's t-test.

Results

In the initial survey, new hires reported the least confidence in the following areas: competency assessment, clinical documentation and billing, EMR use, and organizational dynamics. After orientation, confidence level increased in all thematic concepts implemented (P < .005). The greatest increases were noted in competency assessment (38%) and clinical documentation and billing (32%). Confidence in clinical role and quality improvement remained highest in both the pre- and post-orientation evaluations.

Conclusions

Using an evidence-based framework to structure orientation is associated with improved new hire confidence in job-required skills. Opportunities for future research include a longitudinal assessment evaluating the effect of PA, NP, and CNM orientation and continued onboarding support on clinician confidence, engagement, and retention.

Kimberlee Ketchersid is the transition to practice program manager and Kathryn Davis is interim advanced practice provider director at VCU Health in Richmond, Va. The authors have disclosed no potential conflicts of interest, financial or otherwise.

EVALUATING THE CAPACITY FOR PAS' DISSEMINATION OF PATIENT-CENTERED OUTCOMES RESEARCH

Marie-Michèle Léger, MPH, PA-C; Daniel Pace, CHCP; Eric D. Peterson, EdM, CHCP; Noël E. Smith, MA

Purpose

The Patient-Centered Outcomes Research Institute (PCORI) is the leading funder of patient-centered comparative effectiveness research (CER) in the United States. PCORI helps people make informed healthcare decisions and improves healthcare delivery and outcomes by producing and promoting high-integrity, evidence-based information that comes from research guided by patients, caregivers, and the broader healthcare community.

CER research answers patient-centered questions and helps clinicians address their public health priorities. Patients are integral in the design of PCOR and CER studies. PCOR and CER can be used to identify specific interventions and actions that have been scientifically assessed on whether they affect the desired change. PCORI implementation projects promote the use of findings from PCORI-funded studies in real-world healthcare and other settings. These projects build toward broad use of evidence to inform healthcare decisions.

The purpose of the research was to establish a baseline for the level of awareness of PCORI, PCOR, and CER.

Methods

This study used a mixed-methods cross-sectional study design. Sterling IRB, an independent IRB, reviewed the study and determined it was exempt. In February 2023, PAs were invited to participate in a survey related to the integration of evidence-based medicine in practice. Of the 3,646 PAs who saw the invitation, 760 started the survey, resulting in a 20.8% response rate. The questions for the survey were derived from a 2012 PCORI survey of PAs and NPs and included new questions on understanding and use of CER and PCOR, and identification of the topics and resources they would most be interested in. Respondents also were asked if they were interested in a follow-up focus group. Three identical virtual focus groups were held in April 2023 and consisted of 11 PAs in total. The purpose of the focus groups was to delve into the survey findings in more detail and determine tailored strategies for facilitating the use of PCOR findings in healthcare, as well as the implementation of the strategies.

Results

With respect to awareness and use of PCOR and CER, 81% of respondents were not familiar with the term comparative effectiveness research and 40% were not familiar with the term patient-centered outcomes research. However, 47% to 60% reported using CER in a variety of ways in their clinical practice in the past year. Ninety-six percent of respondents said that it is important for research to help patients make the best healthcare decisions and for research to answer the questions that concern healthcare providers. Finally, 88% agreed that clinicians and 81% agreed that patients on teams can improve healthcare. More than half (58%) were interested in joining a research team in the future.

Conclusions

PAs lack awareness of PCOR and CER terminology but are using the tenets of them in their clinical practice. PAs understand the value of CER and PCOR for patient care. PAs understand the importance of healthcare providers being part of research and are interested in joining a research team.

At the AAPA., Marie-Michèle Léger is director of clinical education, Daniel Pace is vice president of education and research and chief strategy officer, Eric D. Peterson is senior director of education and quality, and Noël E. Smith is senior director of PA and industry research and analysis. This project was funded with a PCORI Engagement Award (EADI-26764) to the AAPA. The authors have disclosed no other potential conflicts of interest, financial or otherwise.

MENTORSHIP EFFECT FOR APRNS AND PAS

Victoria Louwagie, DMSc, MS, PA-C, DFAAPA; Justine S. Herndon, MS, PA-C; Brittany Strelow, DMSc, MS, PA-C, DFAAPA; Holly A. Schenzel, DNP, APRN, ACNP-BC; Elizabeth A. Cumberland, APRN, CNP; Amy Oxentenko, MD

Purpose

Mentorship has many notable benefits, including academic advancement and career satisfaction. Limited research exists about mentorship for advanced practice RNs (APRNs) and PAs.

Methods

A survey was sent via email to all APRNs and PAs at a single multicampus academic medical center and its associated healthcare system. The univariable analysis included chi-square and Kruskal-Wallis tests to compare those with and without a mentor. The multivariable analysis determined independent predictors of factors associated with mentorship.

Results

The response rate was 32.4% (N = 934). Of those, 185 (19.8%) respondents identified having a mentor. Multivariable analysis showed that those with a mentor were statistically more likely to function as a mentor (OR 1.8 [1.2-2.7], P = .003), have an academic rank of assistant professor or higher (OR 2.9 [1.7-4.9], P = .001), be under age 45 years (OR 2.6 [1.6-4.2], P < .001), and be less than 10 years into their career (OR 1.8 [1.2-2.8], P = .006). Those with a mentor were statistically more likely to be satisfied with mentorship (84.3% versus 25.1%, P < .001) and agreed that mentorship was important for academic success (80.5% versus 7.3%, P < .001) and attaining leadership positions (69.7% versus 48.2%, P < .001).

Conclusions

This study demonstrated that mentorship for APRNs and PAs is imperative and can profoundly affect academic and career satisfaction. Future research may explore more profound organizational and professional benefits of mentorship among APRNs and PAs.

In the Mayo Clinic College of Medicine and Science in Mankato, Minn., Victoria Louwagie, Justine Herndon, Brittany Strelow, and Holly Schenzel are assistant professors of medicine, Elizabeth Cumberland is an instructor of medicine, and Amy Oxentenko is a professor of medicine. The authors have disclosed no potential conflicts of interest, financial or otherwise.

EARLY DEVELOPMENT OF A PA AND APRN LEADER COLLABORATION IN AN ACADEMIC HEALTHCARE SYSTEM

Jennifer Mahaffey, MPAS, PA-C; Rebecca Krueger, RN, ACNP; Sarah Vanderlinden, DMSc, PA-C, DFAAPA; Jamie Silkey, PA-C, MBA, MHA

Purpose

Our academic medical center has experienced significant growth of PAs and APRNs over the past decade, and now employs more than 800 of these clinicians. Since the development of the central Office of Advanced Practice in 2009, centralized leadership has been established with a chief advanced practice officer and three assistant directors. Standard titles of lead or manager were created in 2016 but adoption of these titles and expectations were inconsistent. Local leaders continued to struggle to connect to centralized leaders and to strategic initiatives. The vision for local PA and APRN leaders was to meet specific needs such as onboarding and orientation, assuring appropriate hospital privileging and credentialing, mentorship, and connecting frontline PAs and APRNs to the strategic goals. However, local leaders expressed challenges with inconsistent role expectations, confidence in core PA and APRN leader competencies, and connecting with organizational strategic plans.

Methods

All PA and APRN leaders who had an official title of lead or manager were invited to a quarterly 2-hour session series. Before the initial meeting, leaders were asked to take a demographic survey. This survey focused on length of time in their leadership position, whether they received a stipend and/or protected time, and what responsibilities they had. Time was allotted at the end of each session for small group work and networking.

Results

The initial session invited 31 leaders and was attended by 21 leaders across 11 divisions or departments, with a 67.7% attendance rate. The demographic survey was sent to all 31 leaders and had a response rate of 87% (N = 27). Fifty-five percent of the respondents were PAs and 45% were APRNs. Of those, 15 (55.6%) held the title of manager and 12 (44.4%) held the title of lead. Nearly 47% had spent less than 1 year in their leadership role, 26.7% had spent 1 to 3 years in their role, and 26.7% had spent more than 3 years in their role. About 72% said they received protected administrative time. The average amount was 0.2 full-time equivalent, with a range from 0.05 to 0.4. The mode for lead was 0.1 and the mode for manager was 0.2. About 7% reported that they received a stipend for their leadership role instead of protected administrative time. Nearly 21% reported they had the title only, with no protected time or stipend.

The initial survey queried leaders on their role descriptions and level of responsibility for specific leadership tasks, ranging from full accountability, collaboration with other department or division leaders, or no involvement at all. The most common leader responsibility was onboarding and transition to practice, with 95% reporting that they were either accountable or a collaborator. Scheduling (43.5%) and student precepting (43.4%) rounded out the top three accountable tasks for managers and leads. Responsibilities that only required collaboration without full accountability included PA and APRN recruitment (65.2%), quality improvement (60.6%), and PA and APRN practice (69.6%). Tasks that leaders were not involved in included using the data and analytic platform to follow key metrics (87%) and PA and APRN credentialing and privileging (70.9%).

Conclusions

Developing a quarterly leadership education and networking session for PA and APRN leaders created a novel collaborative network of support between local and central leaders. This initial focus to understand the state and responsibilities of leaders helped support future sessions with specific leadership development topics and guest speakers on those topics. The next phase supported targeted educational topics that aligned with top leader accountabilities. Sessions included credentialing and privileging, PA and APRN hiring process, PA and APRN student placement, and how to use data systems. Work is still needed on consistent leader titles and accountabilities. A better-defined structure and centralized support have helped the leads and manager group grow from 31 in 2022 to 42 by the end of 2023. By supporting and developing these local leaders, we will have a mechanism to influence local change, foster local PA and APRN practice expertise, and create a benchmark for future system PA and APRN leaders.

Jennifer Mahaffey, Rebecca Krueger, and Sarah Vanderlinden are assistant directors of advanced practice and Jamie Silkey is chief advanced practice officer at the Medical College of Wisconsin in Milwaukee, Wisc. The authors have disclosed no potential conflicts of interest, financial or otherwise.

COMMUNITY ENGAGEMENT AS A TOOL FOR TEACHING PROFESSIONAL IDENTITY AND SOCIAL DETERMINANTS OF HEALTH

K. Alexis Moore, DMSc, MPH, PA-C; Summer Dunlap; Mary O'Connell, MPAS, PA-C

Purpose

PA students are required to engage with social determinants of health (SDOH) during their training, but moving from theory to practical application can be challenging. Community engagement in the didactic