When your PA Program achieves provisional accreditation, it’s a time for celebration and relief—you’ve worked hard to face this monumental challenge. Yet it is not a time to relax nor become complacent. As your program launches the inaugural class, issues may arise that can derail progress and even prevent the survival of your new provisional PA program. Through Massey & Martin’s extensive work with numerous PA programs and with my own experience as an inaugural PA program director, we’ve identified five major issues many new PA programs struggle with. Fortunately, we also know several strategies to address them!
1. The Programmatic Assessment
The Commission website provides ample evidence of an alarming number of provisional PA programs being placed on probation. The accreditation actions site also testifies to the citations related to inadequate assessment C1.01, C1.02.
Strategy for Compliance: Ensure the launch of your programmatic assessment
The provisional application should chronicle the implementation of the data collection phase beginning immediately upon matriculation of the first class. The program’s committee structure must be functional and actively participate during the critical first year. Because many faculty members lack experience, this can become complicated; it is crucial to provide faculty development for assessment to ensure active participation among the entire team. The provisional monitoring visit occurs before the first-class graduates. The program must implement the entire assessment system to provide evidence that all data collection has occurred, and that appropriate analysis, modifications, and actions plans have been data-driven. (Read about receiving institutional support below if you need additional resources to ensure you achieve the required programmatic assessment as defined by the 5th Edition Standards, Appendix 14B.)
2. Support for Faculty Members
New provisional PA programs often employ several faculty members coming directly from clinical practice. Understandably, the first year of your PA program launch can feel a bit chaotic—especially so for faculty new to teaching.
Strategy for Compliance: Ensure faculty members receive adequate support
Faculty need and should receive support in order to prevent burnout and added stress during the first year. Consider establishing a mentoring program for all faculty (even those who are not new to teaching). Experienced faculty members can provide ongoing support and mentorship to newer faculty; this may include peer reviews and an examination of course syllabi, exams, and materials. Provide access to all possible external faculty development sources, such as PAEA new faculty skills.
3. Student Professionalism
There hasn’t been anything written, as far as I know, about the behaviors and demeanor of inaugural PA classes. Over the years, though, I have observed an increased sense of entitlement and discord among classes in newly launched PA programs. This can be avoided by enacting consistent policies regarding student professionalism.
Strategy for Compliance: Establish a student affairs committee
Consider establishing a student affairs committee to avoid student professionalism issues. This elicits an opportunity to meet with students displaying professionalism issues early in the year. Faculty can emphasize when a student is not meeting the program’s behavioral expectations. Students who meet with faculty privately, have their behavior documented, and sign an acknowledgement for improvement plans are likely to improve. This is not intended to be a punitive process; it’s a chance for struggling students to learn the difference between a professional program’s expectations and an undergraduate program’s expectations.
4. Program Director Burnout
Program directors working in a newly provisionally accredited PA program must be able to multitask like never before. In most new PA programs, the program director has the most experience in education—while, as mentioned earlier, many faculty members have little to no experience. Because of the major imbalance, faculty members are inclined to turn to the program director for support. Senior administration also may add stress when expressing confusion about the program’s fiscal needs. This easily causes PA program directors to carry an overwhelming load—which can quickly lead to burnout.
Strategy for Compliance: Ensure adequate support
In order to avoid burnout, the program director needs to receive robust support for faculty development. This is especially crucial within the first couple years of the program launch. Consider attending seminars for program directors, such as those sponsored for PAEA. Leadership development seminars offered by the institution can also prove to be effective. Finally, consider employing an experienced director who can act as a mentor.
5. Institutional Support
New provisional PA programs are particularly vulnerable when their institution isn’t familiar with the unique challenges of a graduate health science program. By the time the PA program launches, the original pro forma the administrator developed may be obsolete. Unexpected costs—such as academic resources, clinical site development, and additional faculty and staff—often arise.
Strategy for Compliance: Schedule regular budget talks
Keep your institution informed by scheduling regular budget conversations with your immediate report. When unanticipated costs arise based on your self-assessment process, prepare a data-driven proposal for additional fiscal report. For example, the original projected number of faculty members may be inadequate after launch and the workload is greater than expected. Senior administrators may not anticipate the PA program faculty having additional workload considerations, like accreditation-related committees necessary for the robust assessment process. Programs may lack internal resources for data analysis. To avoid using the accreditation issue too frequently, plan requests for new staff and faculty hires carefully by using national benchmarks and the institution’s own workload policies as a tool. Remember to note the 5th Edition Standards, particularly Standard E1.11:
“The program must immediately inform the ARC-PA in writing, using forms and processes developed by the ARC-PA when: a) enrollment exceeds its maximum approved class size, or b) it encounters a substantive decrease in fiscal support of: i. 20% or more decrease in overall budget or for program expenditures, or ii. 5% or more decrease in its operating budget. This provides valid information to if there is an unexpected reduction in budgetary support.”
While this list is nowhere near exhaustive, we believe these five issues are among the most common inaugural PA programs struggle to overcome. Anticipating these challenges is an important part of program planning and strategizing. Take time to celebrate your initial provisional status, then take a proactive approach to prepare for the trials ahead.