How to Help Students at Risk: Preparing for PANCE

Updated: Sep 1, 2020

Dr. Donald Becker* at the Woodcreek University* PA program was nervous as he opened the NCCPA portal to review his students’ PANCE scores. He knew there were a higher number of students than usual whom he was worried about. As he reviewed the report, his anxiety was justified: six students in his class of thirty failed the PANCE on their first attempt. Dr. Becker knew the PA program had a proud tradition of very high first-time test taker pass rates on the PANCE; these lacking results meant the PA program needed to take action—but how?

Identifying students at risk

If your PA program has seen first-time test taker PANCE scores drop, or if failure rates have been high for some time, it is imperative that you take action immediately. The success of the PA program relies on the first-time test taker pass rate.

Learn about our NEW workshop: Raising Your PANCE Pass Rate!

The first step is identifying struggling students, known as Students at Risk (STAR), early on. This means making time in the schedule to identify such students, then providing the necessary support they need.

Categorizing to predict success on the PANCE

The best way to predict student success on the PANCE is by identifying your STAR students. Some PA programs choose to categorize students into four risk categories: Low risk, Moderate risk, High risk, Critical risk.

The following didactic level courses are used to identify STAR students:

  • Pharmacology

  • Clinical Medicine

  • Pathophysiology

  • Surgery

  • Emergency Medicine

In addition, End of Rotation exams are utilized to determine a predicted level of risk. The PACKRAT is used as a supplemental tool in determining the level of risk as well.

Using a regression curve, the following scale was developed to assess the students’ level of risk.

Providing support to students at risk

Identifying STAR students early on provides adequate time for remediation. This begins with faculty meeting with their students regularly, monitoring those at risk to create and ensure a successful remediation plan is put in place. Such remediation allows students to progress at a normal rate, remediating in areas of weakness.

Supporting critical and high level of risk STAR students

Students identified as in the critical and high level of risk categories need to be contacted by their PA faculty advisor. All other students are continually monitored each semester to ensure they stay within the low to moderate risk category.

On a case-by-case basis, devise an initial assessment and remediation plan. The initial assessment should review current cumulative GPA, End of Rotation exam scores, PACKRAT scores, and predicted level of risk scores. The student’s PA faculty advisor should then review the student’s study skills, learning style, and high impact sheets.

The primary focus of the initial meeting is not only to review areas of weakness but also to develop a remediation contract. This contract should involve designing a four-month study plan, including reviewing all areas of weakness, completing extra examination questions, and meeting with the student’s PA faculty advisor.

ARC-PA guidelines

The ARC-PA provides guidelines for PA programs to implement an in-depth assessment process and a required report:

“The ARC-PA reviews the PANCE first time pass rate percentages by student cohort. Any program with a PANCE pass rate percentage of 85% or less for its 2019 cohort, must submit an analysis of its PANCE performance to the ARC-PA by July 1, 2020. In any year that the PANCE pass rate for first time takers by cohort for that year has a pass rate percentage of 85% or less, the program must submit an analysis of PANCE performance by July 1 of the following year. The NCCPA will provide programs their previous year’s data in February of each year. The focus for the report will be the ARC-PA’s Four Key Elements of Analysis included in the Data Analysis Resource. Data related to PANCE outcomes should include but is not limited to correlation of PANCE outcomes and:

  • Admissions criteria as predictors of success

  • Individual course performance

  • Course and instructor evaluations

  • Program instructional objectives, learning outcomes, and breadth and depth of the curriculum

  • Student summative evaluation results

  • Remediation practices and results

  • Attrition criteria and data for cohort being reviewed

  • Feedback from students who were unsuccessful on PANCE, if available

  • Preceptor and graduate feedback (employer feedback is not required but may be helpful if available to the program)”

To learn about other strategies, see Bringing Clarity to the SSR Part 1, Part 2, and Part 3.

Checklist: Taking action to ensure success

Use the following checklist to track the actions your PA program is taking, or has taken, to further ensure the success of students at risk:

  • PA students are completing high impact notes

  • PA faculty are utilizing “Classroom to Clinic” by Dr. Scott Massey and Dr. Mona Sedak

  • PA faculty are meeting with students at risk regularly

  • PA faculty are holding open discussions about at-risk students’ progress

  • PA faculty are reviewing PACKRAT scores to determine areas of weakness

  • PA faculty has the ability to monitor test question analysis by Rosh Review, Q Bank, and/or other test banks

  • PA faculty are providing motivation, support, and guidance to PA students

Remember, the last four months of the PA program include the critical final steps in preparing PA students for the PANCE. With this in mind, Massey & Martin, LLC recommends three more action steps:

  • Develop a grade watch excel sheet

  • Monitor each semester grades

  • Identify students who consistently score less than a 3.0 average

Student Responsibility

PA students must understand the investment of time, energy, and money needs to begin for they take the PANCE, not after. Nobody wants to invest in a review course after they weren’t successful on the PANCE. Thus, guidance, motivation, and support are critical.

Student Obstacles

Keep the following obstacles in mind as you work with PA students in your program:

  • PA students get in their own way: Many PA students feel the competition in PA school should end once they’ve been accepted and thus roll back their efforts. It is important to push back on this and encourage them to continue using all their effort to success

  • PA students don’t want to be labeled as at-risk: PA students understandably do not want to be known as the student who is at-risk. Therefore, keep PA students’ grades private from other students.

  • PA students feel singled out: To ensure no one PA student feels singled out, help students understand, to some degree, everyone is at-risk until they have passed the PANCE

Be wary about giving out total class numbers of students who are in each risk category. Students may try to figure out who is in each category, which can be intimidating for critical and high-risk students.


The PA faculty at Woodcreek University chose to embrace the challenge that occurred with the class of 2019 PANCE results. They reached out to students who failed on their first attempt and provided them with guidance to prepare for their second attempt. It was a delight when all six students passed the exam on the second attempt.

This process was formative for the classes of 2020 and 2021. They took responsibility for the initial pass rates for the class of 2019.

The system for identifying STAR students was embedded into the University’s assessment process. The PA students embraced it as a mentoring system, not a punitive system. Now Woodcreek University’s PA program is ready and adequately prepared to support, motivate, and guide their future classes.

If your PA program is seeing less than desirable PANCE scores, it's time to take action. Massey & Martin, LLC is excited to introduce our newest workshop: Raising Your PANCE Pass Rate! This individualized workshop will show you how to raise the pass rates for the class of 2020. This 1-1.5 day workshop provides a comprehensive overview of how to identify students at risk for underperforming on the PANCE.

*Names of individuals and institutions have been changed to ensure privacy

© 2021 by Massey & Martin, LLC

  • LinkedIn - White Circle

Tel: 954-551-0087

|           United States