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The Design and Implementation of a Professional Development Program for Physician Assistants in an Academic Emergency Department.

ABSTRACT: Physician assistants (PAs) are expanding their role in academic emergency departments (EDs). There are no published models for how to integrate PAs into departmental educational activities, scholarship, and operations outside of a PA residency approach. We created a professional development program for PAs that would provide them with opportunities to integrate into all aspects of our department mission and provide them with a forum for personal growth and ongoing education. The program provides PAs with resources including protected time and mentorship to become a content expert in an academic area of interest. We review our 5-year experience creating and implementing this program, which has grown from six PAs in 2013 to 24 PAs in 2018. These PAs now have formal roles in five of our eight divisions, participating in education, administrative, and research activities. The retention rate for PAs in this program is 90.2% versus 85.7% for PAs at our department who are not in the program. Our experience and results demonstrate the value of investing in the professional development and continued education of PAs at an academic ED versus the traditional model of service and the potential for integration into all aspects of an academic ED's mission.

SUBMITTER: Monette DL

PROVIDER: S-EPMC7163200 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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The Design and Implementation of a Professional Development Program for Physician Assistants in an Academic Emergency Department.

Monette Derek L DL Baccari Brian B Paskind Laura L Reisman David D Temin Elizabeth S ES

AEM education and training 20190912 2

Physician assistants (PAs) are expanding their role in academic emergency departments (EDs). There are no published models for how to integrate PAs into departmental educational activities, scholarship, and operations outside of a PA residency approach. We created a professional development program for PAs that would provide them with opportunities to integrate into all aspects of our department mission and provide them with a forum for personal growth and ongoing education. The program provides ...[more]

PMID: 32313862

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Project description:The laryngeal mask airway (LMA) is used to facilitate adequate ventilation in the majority of procedures requiring general anaesthesia in the UK. Excessive LMA cuff pressure and/or volume, generated by injection of air to form an adequate seal within the upper airway, has been associated with pharyngolaryngeal morbidity, an indicator of quality in anaesthetic practice. However, measurement of LMA cuff pressure to limit excessive cuff pressure is not routine practice, despite trial data showing this reduces adverse outcomes. Our aim was to reduce morbidity from the LMA through the implementation of an educational and interventional program targeted at anaesthetic nurses and operating department assistants (ODA), to alter their physician colleagues' practice. LMA cuff pressure measurements were made, and postoperative outcomes recorded, in an observational cohort of surgical patients over an initial 2-month period. These results, including patient morbidity and the evidence for LMA cuff pressure measurement, were presented to anaesthesia providers and their assistants. An implementation plan to adjust pressures within recommended levels was then undertaken by anaesthesia assistants. In 90 patients, >95% of LMA pressures were beyond the recommended level; higher volumes of injected air correlated with excess pressure (r=0.58; p<0.0001) and were associated with pharyngolaryngeal morbidity in 28% patients (P=0.04). There was no association with difficulty in LMA insertion, duration or type of surgical procedure. In the implementation cohort (102 patients), pharyngolaryngeal morbidity was reduced to 11% (P=0.001) in the 45 patients where LMA cuff pressure was reduced to within normal limits (absolute risk reduction: 38% (95% CI: 22-54%). LMA manometry in three patients (95% CI: 2-5) was required to prevent an episode of postoperative pharyngolaryngeal morbidity. A systematic educational and interventional program targeted at the entire perioperative anaesthesia team, but implemented by anaesthesia assistants, can improve perioperative safety and quality.

Project description:BackgroundTo design and implement an emergency medicine (EM) postgraduate training curriculum to support the establishment of the first EM residency program at Addis Ababa University (AAU).MethodsIn response to the Ethiopian Federal Ministry of Health mandate to develop EM services in Ethiopia, University of Toronto EM faculty were invited to develop and deliver EM content and expertise for the first EM postgraduate residency training program at AAU. The Toronto Addis Ababa Academic Collaboration-EM (TAAAC-EM) used five steps of a six-step approach to guide curriculum development and implementation: 1. Problem identification and general needs assessment, 2. Targeted needs assessment using indirect methods (interviews and site visits of the learners and learning environment), 3. Defining goals and objectives, 4. Choosing educational strategies and curriculum map development and 5.ImplementationResultsThe needs assessment identified a learning environment with appropriate, though limited, resources for the implementation of an EM residency program. A lack of educational activities geared towards EM practice was identified, specifically of active learning techniques (ALTs) such as bedside teaching, simulation and procedural teaching. A curriculum map was devised to supplement the AAU EM residency program curriculum. The TAAAC-EM curriculum was divided into three distinct streams: clinical, clinical epidemiology and EM administration. The clinical sessions were divided into didactic and ALTs including practical/procedural and simulation sessions, and bedside teaching was given a strong emphasis. Implementation is currently in its seventh year, with continuous monitoring and revisions of the curriculum to meet evolving needs.ConclusionWe have outlined the design and implementation of the TAAAC-EM curriculum; an evaluation of this curriculum is currently underway. As EM spreads as a specialty throughout Africa and other resource-limited regions, this model can serve as a working guide for similar bi-institutional educational partnerships seeking to develop novel EM postgraduate training programs.

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The Design and Implementation of a Professional Development Program for Physician Assistants in an Academic Emergency Department.

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The Design and Implementation of a Professional Development Program for Physician Assistants in an Academic Emergency Department.

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