The Physician Assistant Profession

2020 ◽  
pp. 183-203
Author(s):  
Katherine G. Ervie ◽  
Julie Wright Banderas
Keyword(s):  
Interprofessional Education ◽  
Interprofessional Collaboration ◽  
Healthcare Delivery ◽  
Physician Assistants ◽  
The United States ◽  
Historical Background ◽  
Healthcare Team ◽  
Quality Healthcare ◽  
And Training

In the United States, quality healthcare is an expectation. The accepted healthcare delivery approach relies on interprofessional, collaborative, and person-centered teams. As a result, health professions education must implement education and training to graduate a healthcare workforce that is competent in interprofessional collaboration. Physician assistants (PA) have an important role in the healthcare team. The purpose of this chapter is to provide a historical background to the interprofessional collaborative healthcare team, the formation of interprofessional education (IPE) competencies and partnerships, and the valued role of physician assistants. The need for evidence-based results to guide IPE curricular decisions for PA programs and characteristics of published IPE activities involving PA students are summarized. Potential barriers to successful interprofessional education and resolutions to those challenges are discussed.

scholarly journals Staffing at Ambulatory Endoscopy Centers in the United States: Practice, Trends, and Rationale

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Deepak Agrawal ◽  
Rajeev Jain
Keyword(s):  
United States ◽  
Patient Care ◽  
Response Rate ◽  
The United States ◽  
Survey Study ◽  
Moderate Sedation ◽  
Endoscopic Procedures ◽  
Staffing Patterns ◽  
And Training

Background. Endoscopy nurse (RN) has a pivotal role in administration and monitoring of moderate sedation during endoscopic procedures. When sedation for the procedure is administered and monitored by an anesthesia specialist, the role of an RN is less clear. The guidelines on this issue by nursing and gastroenterology societies are contradictory. Methods. Survey study of endoscopy lab managers and directors at outpatient endoscopy units in Texas. The questions related to staffing patterns for outpatient endoscopies and responsibilities of different personnel assisting with endoscopies. Results. Responses were received from 65 endoscopy units (response rate 38%). 63/65 (97%) performed at least a few cases with an anesthesia specialist. Of these, 49/63 (78%) involved only an endoscopy technician, without an additional RN in the room. At 12/49 (25%) units, the RN performed tasks of an endoscopy technician. At 14/63 (22%), an additional RN was present during endoscopic procedures and performed tasks not directly related to patient care. Conclusions. Many ambulatory endoscopy units do not have an RN present at all times when sedation is administered by an anesthesia specialist. An RN, when present, did not perform tasks commensurate with the education and training. This has implications about optimal utilization of nurses and cost of performing endoscopies.

The History of Occupational Therapy Assistants in Canada: A Comparison with the United States

2001 ◽  
Vol 68 (4) ◽  
pp. 217-227 ◽  
Author(s):  
Penny Salvatori
Keyword(s):  
United States ◽  
Occupational Therapy ◽  
Professional Associations ◽  
Training Model ◽  
The United States ◽  
Professional Affiliation ◽  
Standards Of Practice ◽  
History Of ◽  
And Training

In the middle of the twentieth century, the role of occupational therapy assistant was introduced in North America. Although the role, utilization and training of assistant personnel have raised much controversy and debate within the profession, Canada and the United States have taken very different paths in terms of dealing with these issues. This paper focuses on the history of occupational therapy assistants in Canada, using the experience in the United States for comparison purposes. The occupational therapy literature and official documents of the professional associations are used to present a chronology of major historical events in both countries. Similarities and differences emerge in relation to historical roots; training model and standards of education; certification, regulation, and standards of practice; career laddering and career mobility; and professional affiliation. The paper concludes with a summary of issues which require further exploration, debate and resolution if the profession is to move forward in Canada.

U.S. Center for SafeSport: Preventing Abuse in Sports

2020 ◽  
Vol 28 (1) ◽  
pp. 66-71 ◽  
Author(s):  
Nicole Johnson ◽  
Katie Hanna ◽  
Julie Novak ◽  
Angelo P. Giardino
Keyword(s):  
United States ◽  
Risk Factors ◽  
Sexual Abuse ◽  
Preliminary Data ◽  
The United States ◽  
Sport Organizations ◽  
The Many ◽  
And Training ◽  
The U.S

While society at large recognizes the many benefits of sport, it is important to also recognize and prevent factors that can lead to an abusive environment. This paper seeks to combine the current research on abuse in the sport environment with the work of the U.S. Center for SafeSport. The inclusion of risk factors unique to sport and evidence-informed practices provides framing for the scope and response to sexual abuse in sport organizations in the United States. The paper then explores the creation and mission of the U.S. Center for SafeSport, including the role of education in prevention and of policy, procedures, audit, and compliance as important aspects of a comprehensive safeguarding strategy. This paper provides preliminary data on the reach of the Center, established in 2017. This data captures the scope of education and training and the increase in reports to the Center from within the U.S. Olympic and Paralympic Movement.

scholarly journals Understanding the role of nurse practitioners, physician assistants and other nursing staff in HIV pre-exposure prophylaxis care in the United States: a systematic review and meta-analysis

BMC Nursing ◽  
2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Chen Zhang ◽  
Warton Mitchell ◽  
Ying Xue ◽  
Natalie LeBlanc ◽  
Yu Liu
Keyword(s):  
United States ◽  
Study Design ◽  
Nurse Practitioners ◽  
Nursing Staff ◽  
Physician Assistants ◽  
The United States ◽  
Health Providers ◽  
Physician Health ◽  
Exposure Prophylaxis

Abstract Background Although pre-exposure prophylaxis (PrEP) was approved for primary HIV prevention by the Federal Drug Administration in 2012, PrEP utilization has been suboptimal. A body of literature and programs has emerged to examine the role of nurse practitioners (NPs), physician assistants and nursing staff in PrEP care. This review aims to understand the current status of non-physician health providers in PrEP care implementation in the United States. Methods Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance, we conducted a comprehensive literature search using multiple databases to identify peer-reviewed articles that examined the role of non-physician health providers in the implementation of PrEP. Four major databases of studies using observational study design, randomized control trials and mixed-method study design were screened from November 2019 to January 2020 were searched. Two independent reviewers examined eligibility and conducted data extraction. We employed random-effects model aims to capture variances of estimates across studies. Results A total of 26 studies with 15,789 health professionals, including NPs (18, 95% CI = 14,24%), physician assistants (6, 95% CI = 2, 10%), nursing staff (26, 95% CI = 18–34%), and physicians (62,95% CI = 45, 75%), were included in the analysis. The odds of prescribing PrEP to patients among NPs were 40% (OR = 1.40, 95% CI = 1.02,1.92) higher than that among physicians, while the likelihood of being willing to prescribe PrEP was similar. On the other hand, the odds of being aware of PrEP (OR = 0.63, 95% CI = 0.46, 0.87) was 37% less in nursing professionals than that among physicians. Conclusions Although the limited number and scope of existing studies constrained the generalizability of our findings, the pattern of PrEP care implementation among non-physician health providers was described. To achieve wider PrEP care implementation in the U.S., increasing awareness of PrEP among all health providers including both physicians and non-physicians is a key step.

scholarly journals Interprofessional collaboration and chronicity management: a systematic review of clinical trials

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Pascucci ◽  
M T Riccardi ◽  
M Sapienza ◽  
M C Nurchis ◽  
W Ricciardi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Interprofessional Education ◽  
Medical Training ◽  
Interprofessional Collaboration ◽  
Future Research ◽  
Care Practice ◽  
Chronic Patients ◽  
Health And Social Care ◽  
The Impact

Abstract The increasing prevalence of chronic disease generates significant financial, social and psychosocial burden for patients, families and healthcare system. Interprofessional collaboration (IPC) is becoming recognized as a discipline among health and social care professionals and medical training institutions worldwide. Literature research suggests that following interventions could be particularly useful in the management of chronic patients. The objective of this systematic review was to assess the impact of IPC on chronic patients compared to standard health-care practice. The PICO model was adopted and three electronic databases (Medline, EMBASE, Web of Science) were searched using appropriate keywords. Selected trials were assessed for quality and risk of bias using the National Institutes of Health Quality Assessment of Controlled Intervention Studies. Data were analyzed using descriptive statistic, and comparison of outcomes among teams with or without pharmacist was performed using t-Student test (p < 0,05). Out of 11.128, 24 studies met the inclusion criteria and 58 indicators were identified: 62% improved significantly, 38% did not show any variation, no indicator worsened after intervention. In particular, systolic blood pressure (SBP) showed a statistically significant improvement in 70.0 % of trials in which was considered while did not show any difference in the rest. The presence of a pharmacist in the team show a statistically significant improvement on SBP (p = 0,002) in patients with hypertension while no statistically significant effect is observed on glycated hemoglobin (p = 0,193) in diabetics. The results support that IPC contributes to positive patient, provider and institutional level outcomes, in particular for chronic conditions. Future research should focus on the inclusion of patient/caregivers in the collaborative team, and on the role of interprofessional education (IPE) on collaborative practice in the management of the patient with chronicity. Key messages IPC is an innovative strategy to address the complex health needs of chronic populations. Further studies are needed to evaluate the role of IPE in achieving better IPC and improving chronic patients’ outcomes.

scholarly journals The Interprofessional Showcase

2018 ◽  
Vol 1 (1) ◽  
pp. 37-54
Author(s):  
Kathleen Anne Gould ◽  
Andrea Barton ◽  
Karen Day
Keyword(s):  
Interprofessional Education ◽  
Interprofessional Collaboration ◽  
Effective Means ◽  
Academic Departments ◽  
Community Settings ◽  
Ability To Work ◽  
Group Discussions ◽  
Professional Students ◽  
Professional Disciplines

Traditional didactic instruction is not an effective means to provide the interprofessional education that health and human services professional students need. This paper describes a college event aimed at engaging undergraduate and graduate students from several academic departments in interprofessional collaboration. Participants toured and interacted in academic spaces of other professional disciplines to gain an understanding of these professional roles. Interprofessional collaboration was demonstrated and experienced in these spaces and in the group discussions that followed these activities. A series of micro-vignettes, questions, and road blocks provided problems for participants to solve in interprofessional groups. Pre-post comparison surveys indicated that participants increased in their understanding of their professional role and the role of others in health care and community settings. An improved understanding of the benefits and challenges of interprofessional teams was achieved and participants felt more confident in their ability to work in these teams at job or internship sites.

scholarly journals Experiential interprofessional education for medical students at a regional medical campus

2018 ◽  
Vol 9 (1) ◽  
pp. e59-67 ◽  
Author(s):  
Laura Walmsley ◽  
Melanie Fortune ◽  
Allison Brown
Keyword(s):  
Medical Students ◽  
Student Satisfaction ◽  
Interprofessional Education ◽  
Interprofessional Collaboration ◽  
Learning Experience ◽  
Opportunity To Learn ◽  
Healthcare Team ◽  
Positive Attitudes ◽  
Regional Medical ◽  
Regional Campus

Background: Regional medical campuses are often challenged with providing effective interprofessional education (IPE) opportunities for medical students that are comparable to those at main campuses. At distributed teaching sites, there is often less IPE infrastructure and fewer learners of other health professions. On the other hand, distributed medical education (DME) settings often have community-based clinical environments and fewer medical students, which can provide unique opportunities for IPE curriculum innovation.Methods: At the Niagara Regional Campus (NRC) of McMaster University, the Horizontal Elective for Interprofessional Growth & Healthcare Team ENhancement (HEIGHTEN) was developed to provide first-year medical students the opportunity to learn from and work alongside nurses in a community hospital. This study assesses HEIGHTEN’s impact on students’ knowledge, confidence, and attitudes towards interprofessional care, as well as student satisfaction with the learning experience using a mixed methods evaluation.Results: Findings suggest that HEIGHTEN provided an enjoyable learning experience, fostered positive interprofessional attitudes and an appreciation for the nursing role. Voluntary participation by medical students was high and increased both within the regional campus and with students from other campuses travelling to participate.Conclusion: This model for IPE can be feasibly replicated by distributed teaching sites to provide medical students with hands-on, experiential learning early in training, leading to positive attitudes and behaviours supporting interprofessional collaboration (IPC).

scholarly journals Attitudes and Behavior towards Interprofessional Collaboration among Healthcare Professionals in a Large Academic Medical Center

Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 323
Author(s):  
Benjamin E. Ansa ◽  
Sunitha Zechariah ◽  
Amy M. Gates ◽  
Stephanie W. Johnson ◽  
Vahé Heboyan ◽  
...  
Keyword(s):  
Patient Care ◽  
Interprofessional Education ◽  
Healthcare Professionals ◽  
Interprofessional Collaboration ◽  
Medical Center ◽  
Core Competencies ◽  
Academic Medical Center ◽  
Healthcare Team ◽  
Interprofessional Communication ◽  
Academic Medical

The increasing rates of comorbidities among patients and the complexity of care have warranted interprofessional collaboration (IPC) as an important component of the healthcare structure. An initial step towards assessing the effectiveness of collaboration requires the exploration of the attitudes and experience of healthcare professionals towards IPC. This online survey aimed to examine the attitudes of healthcare professionals working in a large public academic medical center toward IPC in patient care and the healthcare team, and their behavior and experience regarding IPC. The rankings, according to the perceived importance among the respondents, of the four Interprofessional Education Collaborative (IPEC) core competencies (values/ethics, roles/responsibilities, interprofessional communication, teams/teamwork) were assessed. There were strong but varying levels of consensus among healthcare professionals (N = 551) that IPC facilitates efficient patient care, improves patient problem-solving ability, and increases better clinical outcomes for patients. They acknowledged that IPC promotes mutual respect within the healthcare team and providers’ ability to make optimal patient care decisions. However, overall more than 35% of the respondents did not attend multidisciplinary education sessions (grand rounds, seminars, etc.), and about 23% did not participate in bedside patient care rounds. Interprofessional communication was ranked as the most important IPEC core competence. Although the attitude towards IPC among healthcare professionals is strongly positive, many healthcare professionals face challenges in participating in IPC. Institutional policies that facilitate interprofessional learning and interactions for this group of healthcare professionals should be formulated. Online distance learning and interactions, and simulation-enhanced interprofessional education, are options for addressing this barrier. Hospital administrators should facilitate conducive work environments that promote IPC, based on IPEC core competencies, and promote programs that address the challenges of IPC.

Interprofessional Education and Practice: A Primer for Training Future Clinicians

2014 ◽  
Vol 17 (2) ◽  
pp. 39-46 ◽  
Author(s):  
Richard I. Zraick ◽  
Ana Claudia Harten ◽  
Fran Hagstrom
Keyword(s):  
United States ◽  
Health Care ◽  
Interprofessional Education ◽  
Interprofessional Collaboration ◽  
The United States ◽  
Health And Wellness ◽  
Call To Action ◽  
Roles And Responsibilities ◽  
Challenges And Opportunities ◽  
Collaborative Learning Opportunities

Speech-language pathologists and audiologists often share roles and responsibilities with other professionals as they contribute to the health and wellness of clients/patients in educational and medical settings. Emerging changes in the educational and health care landscapes in the United States are increasing the demand for interprofessional collaboration to improve treatment outcomes. Programs in Communication Sciences and Disorders need to be responsive to health care and educational reforms and expose students to collaborative learning opportunities with those outside their professions. This introductory-level article reviews terminology and concepts related to two approaches to training tomorrow's clinicians today, Interprofessional Education (IPE) and Interprofessional Collaborative Practice (IPP). The article also discusses the challenges and opportunities related to IPE and IPP, and makes a call to action for both approaches to address educational and health care changes in the United States.

Design and Program Elements of a Clinical Leadership Program

2018 ◽  
pp. 94-114
Author(s):  
Anthony DelConte ◽  
Michael J. Gast
Keyword(s):  
Healthcare Delivery ◽  
The United States ◽  
Healthcare Decision ◽  
Ethical Considerations ◽  
Clinical Leadership ◽  
Healthcare Decision Making ◽  
Physician Leaders ◽  
Mba Curriculum ◽  
Strategic Perspective

Healthcare delivery in the United States is an ever-evolving field that is changing across multiple economic and cultural levels. Healthcare delivery systems are being affected not just by emerging technological capabilities but by ongoing changes in the structure and role of health systems themselves, as well as in the diversity of the communities they service. The older model of physician-provider is likewise evolving, and today's clinician requires the skill set necessary to navigate this new healthcare delivery environment. This chapter describes the development and implementation of a clinical leadership MBA curriculum designed to provide physician-leaders with a strategic perspective on healthcare decision making that encompasses a broad range of structural, technological, financial, cultural, and ethical considerations.

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