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This study evaluates whether academic performance differs when physician assistant (PA) students learn gross anatomy using a mixed-reality (MR) program versus cadaveric dissection. First-year PA student volunteers at Case Western Reserve University enrolled in an anatomy course were divided into two cohorts. During a given unit, each cohort spent laboratory sessions learning through either dissection or MR.At the end of each unit, participants were given a laboratory practical exam on each modality. Differences in exam scores were compared between modalities within the same cohort and between cohorts on the same modality. While students who performed cadaveric dissection within a given unit had less difference between lab exam scores, positive Pearson’s correlation coefficients (r>0.80) and Spearman’s rho (rs=0.78) indicate that individual students perform equivalently across both exams. Additionally, no difference was found between cohorts on lecture exams (p>0.05), suggesting that MR holds value in a PA gross anatomy curriculum.

The purpose of this study was to assess the degree to which servant leadership characteristics are exhibited in medical group practices, and the degree to which servant leadership characteristics correlated with measures of empathic care. This study featured an explanatory mixed methods research design embedded in appreciative inquiry. A total of 189 mid-level practitioners consisting of nurse practitioners, physician assistants, and practice mangers responded to a 32-item scale survey that featured a six-point Likert scale to measure servant leadership items and a 10-point continuous scale to assess measures of empathic care. The servant leadership items were based on the seven pillars of servant leadership. Data analyses included assessing means, standard deviations, and percentage distributions for servant leadership statements and empathic care statements. Additionally, bivariate correlation analysis and standard multiple regression analysis were conducted to assess the degree of influence of servant leadership characteristics on measures of empathic care. Findings from this study identified Pillar 1 (Persons of Character) as the servant leadership pillar most strongly exhibited in the medical group practices. Furthermore, Pillar 5 (Has Foresight) was the strongest correlate of reported empathic care within medical group practices as well as team members’ proclivity to practice servant leadership behaviors with patients more than with each other. The study also found that clinicians and non-clinicians significantly differed in their endorsement of all of the servant leadership pillars except Pillar 1 (Persons of Character). The findings of this dissertation point to strategies for promoting an environment of empathic care, and team building and organizational development and training in the medical group practices. This dissertation is available in open access at AURA: Antioch University Repository and Archive, http://aura.antioch.edu/ and OhioLINK ETD Center, https://etd.ohiolink.edu/

The Physician Assistant and Nurse Practitioner professions initially began in response to healthcare shortages after the Vietnam War in the 1960s. Highly trained combat medical personnel developed into highly skilled PAs, while during this same time nurses began advanced practices that ultimately evolved into the position of NPs. Since this time, the roles and responsibilities delegated to each of these fields have drastically evolved, and are expected to continue to do so in the face of current health care reform under President Obama's Patient Protection and Affordable Care Act initiated in 2010. Originally perceived as "understudies" to physicians, PAs and NPs have become much more trained in their expertise, respected in their roles, and autonomous in their practice. Due to this, it has been predicted that PAs and NPs will become the major primary care providers in the face of increasing demands in this area of medicine. Large numbers of aging populations and up to 32 million newly insured patients seeking healthcare, coupled with physician shortages, have increased demands on PAs and NPs to fill these employment gaps. As there has been an increased demand on the PA and NP profession, there has been a paralleled increase in the number of educational programs producing graduates, larger class sizes, and larger numbers of PAs and NPs entering the workforce. The problem is posed when PAs and NPs, who desire to pay off student loans quickly and, understandably, seek high wages and professional advancement, pursue specialty and subspecialty employment versus filling in primary care gaps as anticipated. As the roles of PAs and NPs change, and more is expected of them in terms of practice and reliability, there are barriers to their growth. Professional tensions between these providers and physicians, poor understanding of what roles PAs and NPs hold by the public, unequal reimbursement for comparable services, and strict state legislation that limits the scope of practice of both PAs and NPs all inhibit these healthcare professionals from practicing to their fullest potential. This, in turn, may hinder persons becoming PAs and NPs from funneling into the ever increasingly demanding primary care field of medicine, and may pose future problems as patient populations increase under the Affordable Care Act. This paper assesses the current roles and responsibilities of PAs and NPs, how each profession is expected to grow, and the evolution of these healthcare providers as the potential "solution" to primary care needs. Statistics regarding current distributions of PAs and NPs in practice, educational expansion, obstacles that these professions must overcome, and the capabilities of PAs and NPs alike are analyzed, and conclusions drawn on what the contributions of these healthcare professionals may be in the future. Overall, it is expected that PA and NP presence in the medical field will undoubtedly increase. Whether these professionals will serve as an adequate source of primary care providers in the face of increasing demands imposed by the Affordable Care Act is yet to be seen, however. Barriers including professional tensions, reimbursement policies, wages, and strict state restrictions on the scope of practice of these individuals will need to be addressed. While it is projected that PAs and NPs will "solve" the current and future primary care physician shortage, this fact truly remains to be seen.

Health disparities in minorities and those of low socioeconomic status persist despite efforts to eliminate potential causes. Differences in the delivery of services can result in different healthcare outcomes and therefore, a health disparity. Some of this difference in care may attribute to discrimination resulting from clinical biases and stereotyping which may provide a possible source for the persistence of health disparities. Health disparities may occur because the delivery of services at some level is inadequate. Disparities resulting from the quality and quantity of care delivered by a practitioner result in differentiated delivery of healthcare, thus unequal health outcomes. The purpose of this study is to evaluate and identify potential disparities in routine screening practices of physician assistants.A randomized sample of practicing physician assistants in Kentucky were analyzed (N= 112) to determine if the race or socioeconomic status of a patient influenced their likelihood of offering different routine screening recommendations and screening test recommendations. Clinical vignettes were created with only the race and socioeconomic status of the patient modified, resulting in four separate vignettes. Through the use of a survey instrument, participants were randomly assigned to one of four written clinical vignettes. Statistical analysis using a MANOVA revealed that the race of a patient had a statistically significant multivariate effect on differences in screening recommendations and race and socioeconomic status had significant multivariate effects on screening test recommendations.Study results suggest that race and socioeconomic status continues to be a significant factor in the prevalence of healthcare disparities. More importantly, this study reveals that Physician Assistants may provide differentiated care based on a patient’s race. Limitations and future directions for this study may be used to examine PA educational curriculums for the inclusion of health disparities and possible continuing medical education opportunities for practicing PAs.

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The 2000s was mostly a lost decade for reform of the health care delivery system. Among the few significant innovations was the retail medical clinic, where individuals could receive basic health care at posted prices without appointments, typically from nurse practitioners or physician assistants. Most retail clinics were associated with chain drugstores, supermarkets, or other "big box" retailers. This short article describes the implications of the retail clinic model for US health policy and health care reform. It is no longer available from the online journal in which it originally appeared.