Solutions to Prevent Delayed Graduation for PA Students

Updated: May 19, 2020

Across the nation, PA faculty are grappling with potential graduation delays for PA students. The timeline for the next few months is quite unknown, making it nearly impossible to predict when PA students will be able to resume clerkships. Fortunately, the recently updated statement from the ARC-PA provides guidance and hope for PA programs to be able to make necessary adjustments. Let's look at what the ARC-PA has provided to move PA programs forward.


PA Programs have flexibility

One of the most prominent questions being asked is whether there is any flexibility in meeting program-defined learning outcomes required for graduation. In a statement issued by the ARC-PA, they stated:


“The ARC-PA believes many programs have flexibility in how requirements for SCPEs are met (this is not new). For example, many programs do not have a behavioral medicine/psychiatry rotation, but students are getting the patient exposures in other rotations, work with appropriate preceptors, and have experiences in the appropriate settings over the course of their SCPE experiences.”


Solutions to Prevent Delayed Graduation for PA Students

What are some strategies PA programs can use to review graduation requirements for the clinical year classes of 2020? This can be a challenge for those of us who have been conditioned to look at curriculum and program requirements as linear and static.


Since elective rotations are not required in the standards, PA programs may consider the following strategies:


  • Modify SCPE requirements

  • Modify the required SCPE length

  • Temporarily adjust curricular elements not aligned with the standards

  • Change the next cohort matriculation date


Let’s look at each strategy in depth. (Please note, suggestions will not be able to apply to every PA program due to the various graduation dates.)



Modify SCPE Requirements

PA Programs across the country have varying lengths of the clinical phase. According to the 3rd clinical curriculum report (2017), the range in SCPE is between 40-70 weeks. The minimum required contact hours ranges between 1000-3000. The 3rd clinical report indicated that the mean number of weeks of student elective clerkships was 7, with a range between 4-12. Most programs have additional elective rotations that are not directly tied to meeting the core SCPE standards. Though PA programs pride themselves on these additional experiences that are invaluable for student competency. However, under the current circumstances, these may need to be modified.

Here are a few possible solutions:


  • Eliminate elective rotations

  • Transition elective rotations to nonclinical format

  • Determine if students’ completed electives can substitute for a required core rotation (For example, if a student has completed a primary care elective and achieved the learning outcomes for one of the other core standards, this can be a substitute for the yet-to-be-taken core rotation. Be sure to consult your learning outcomes to ensure alignment with Standard B3.02 and B3.03.)


If any of these changes are made and the PA program is shorter by 30 days or more in length, submit a change form (standard E1.09c).


Modify the required SCPE length

There is concern whether students will be adequately prepared upon graduation. In our recent blog, Implementing a Hybrid Clinical Year Plan, we discussed a possible solution to partially truncate the length of SCPE for the time being. Some PA programs have looked at core SCPE being reduced by 50%, with students completing part of the rotation via online instruction, then rotating into the actual SCPE.


By purposefully looking at this solution, PA programs can employ a strategic online instructional process so PA students can systematically complete the online portion of the upcoming SCPE prior to sending students back to clinical sites. Remember, our focus is on meeting the learning outcomes; the number of patients and the number of hours on site doesn’t result in guaranteed competency.



Temporarily adjust curricular elements not aligned with the standards

Your PA program might look at courses the institution requires for completion of a graduate degree that are not directly attributable to the standards. For instance, a research-based thesis isn’t necessarily required if the program has already met standard B2.01. For several PA programs, this involves a sequence of classes, along with a year-long project completion process.


At the institutional level, the program director can apply for a temporary change in curriculum to eliminate some of these requirements. This has the potential to allow the program to flex 4-6 weeks at the very end of the program. Remember, this is not an ARC-PA requirement; however, some institutions might not have the flexibility to make these changes.


Change the next cohort matriculation date

Another option PA programs are exploring involves delaying the next cohort matriculation date by one semester. This certainly has an implication for lost revenue and will likely be the least popular solution for university administration. Massey & Martin, LLC suggests exhausting clinical year modifications before resorting to changing the start date, which also require a change form.


It is understandably a daunting challenge for first semester students facing online curriculum involving basic science labs. Consider shifting one or two courses that require labs to the second semester of the program. Of course, this would require institutional approval prior to considering this.



Conclusion

If you’re a PA educator struggling to sleep at night because you’re grappling with program curriculum changes, you’re not alone. Many PA educators are concerned about their students’ welfare. Our suggestions are possible strategies your PA program can explore.


Indeed, these events are likely to change PA education in the long run due to increased innovation. At the very least, this is a time of clarifying the necessity to measure student learning outcomes based on the standards, as well as to decide if certain elements of our PA programs can be waived.


Will these changes cause our PA students to be less prepared as they enter clinical practice? We believe they will adjust and seek out learning experiences to ensure clinical competence. We have confidence in young PA students to meet the challenge.

© 2021 by Massey & Martin, LLC

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