kansas board of regents program review report october 2004

H:/Program Review/Program review report 2004.doc

KANSAS BOARD OF REGENTS PROGRAM REVIEW REPORT

October 2004 Department of Physician Assistant College of Health Professions Wichita State University Primary Author: Richard Muma, PhD, MPH, Chair and Associate Professor Contributing Authors: Patricia Bunton, MS, PA-C, Instructor David Day, EdS, MPAS, PA-C, Assistant Professor Sue Enns, MHS, PA-C, Assistant Professor Audrey Griffin, MPAS, PA-C, Assistant Professor LaDonna Hale, PharmD, Assistant Professor Timothy Quigley, MPH, PA-C, Assistant Professor

TABLE OF CONTENTS PAGE Introduction 2

Institutional Data (Departmental) 2

Institutional Data (Academic) 5

Mission, Educational Philosophy & Goals 6

Objectives 6

Program Quality (Process & Faculty/Staff) 8

PA Program Assessment & Frequency Matrix 9

Student/Faculty Ratios 9

Faculty/Staff Profile 10

Program Quality (Curriculum) 12

GPA & Gender by Graduating Class 12

Schematic Representation of Curriculum 13

Student Course Evaluation Data 16

Student Attrition Data 18

Use of Assessment Data for Program Modification 19

Student Needs, Employer Demands, Student Preparation for Goals 20

Curricular Exit Survey Data 22

Service 22

Cost Effectiveness 23

Peer Comparison Costs 23

Summary & Conclusions 23

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Wichita State University Department of Physician Assistant, Program Review Report, 2004 2 INTRODUCTION The Wichita State University Department of Physician Assistant (PA), the only PA program in Kansas, was developed in 1972 and graduated its first class in 1975. Mobile Intensive Care Technician and Emergency Medical Technician programs were added in the year 2000, however, both are now suspended. This report focuses on the PA Program. All PA graduates through 2005 will receive a Bachelor of Science degree with a major in Physician Assistant studies. Due to national trends, the BS degree will be phased out by the end of 2005 and the Program will only grant an entry level Master Degree in Physician Assistant (MPA) starting in 2006. With this degree change, the professional core PA curriculum will remain unchanged, but a research component will be added. The Program is currently accredited through 2010, with its most recent review in 2004. The purpose of this report includes the following:

• Define the Program’s centrality to the mission of the college and university; • Describe the continuous evaluation process of the program; and • Analyze the current status of the program in terms of the curriculum, faculty, students,

graduates, service, and costs.

Ia. Institutional Data (Departmental)

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Wichita State University Department of Physician Assistant, Program Review Report, 2004 3


Wichita State University Department of Physician Assistant, Program Review Report, 2004 5 Ib. Institutional Data (Academic)


Wichita State University Department of Physician Assistant, Program Review Report, 2004 6 How does the Program relate to the mission and role of the College and University? II. The Mission, Educational Philosophy, and Goals of the Program Mission The mission of the Department of Physician Assistant is to be a learning community dedicated to developing generalist health care professionals by:

• Valuing students • Integrating teaching, scholarship, practice, and service • Partnering with the community

Educational Philosophy The educational philosophy of the Program centers on the premise that the education and training received will prepare and encourage students to provide primary care in areas where the need is greatest. Service and clinical education in underserved and rural areas and with minority populations is emphasized. Objectives Program Objectives The Physician Assistant Program is a multifaceted education program involving administrative, curricular, student, evaluation, and accreditation requirements. To assure these requirements are met, the Program:

• Maintains a quality accredited curriculum consistent with the program mission and educational philosophy

• Documents regular assessment and modification of the curriculum/program • Reviews and monitors assessment data with results expected to be at the program and/or

national average or above • Maintains student, faculty, and program policies as required by ARC-PA and WSU • Maintains program operations as required by ARC-PA and WSU • Assures funding for the program to be at or above the national average for U.S. PA programs • Maintains student/faculty records as required by ARC-PA and WSU • Assures continued sponsorship of the Program by WSU

Student Outcome Objectives The Physician Assistant Program provides a course of study designed to prepare an individual to practice as a physician assistant. In achieving this goal, the responsibility of the program is to provide a learning environment in which students:

• obtain the academic and clinical foundation that prepares them to assist the primary care



physician in developing and implementing a comprehensive patient-centered approach to healthcare.

• develop a medical knowledge base that provides a foundation for practicing medicine in a variety of settings.

• achieve competency in medical and technical skill that prepares them to provide healthcare to individuals of all ages.

• develop the skills that prepare them to interact as professionals within an interdisciplinary health care environment.

• develop an awareness of the ethical, social, and legal issues related to the practice of medicine.

• develop skills for continuing professional growth and lifelong learning. • are encouraged to provide healthcare services to medically underserved populations.

Program’s Centrality to the Mission of the College and University The College and University are committed to providing comprehensive educational opportunities in an urban setting. Through teaching, scholarship, and public service, the College and University seeks to equip both students and the larger community with the educational and cultural tools they need to thrive in a complex world, and to achieve both individual responsibility in their own lives and effective citizenship in the local, national, and global community. High quality teaching and learning are fundamental goals in all WSU undergraduate, graduate, and continuing education programs. The University faculty and professional staff are committed to the highest ideals of teaching, scholarship, and public service as the University strives to be a comprehensive, metropolitan university of national stature. A professional degree in physician assistant studies supports the College and University missions by:

• Providing students an opportunity to engage in a high quality program of study, which is expected of graduates on local, regional, and national levels.

• Continuing to offer the only physician assistant program in the State of Kansas which equips students with advanced PA educational tools and the larger community with health care providers.

• Furthering the maturation of the PA course of study and its associated research/scholarly areas.


Wichita State University Department of Physician Assistant, Program Review Report, 2004 8 How is the quality of the Program assessed in relation to the strengths, productivity, and qualifications of the faculty? III. Program Quality (Process and Faculty/Staff)

Process This section represents the ongoing processes of self study that have existed in the Program for years. While the focus and mission of the Program have not changed, the means to the end is constantly being re-evaluated and altered to assure continued success. Some of the elements, which play a role in our continuous evaluation process, include the following:

• Annual program retreats; • Faculty meetings; • Continual assessment of the curriculum by faculty, students, graduates, and employers; • Outcomes of WSU graduates on the NCCPA exam

Since its inception in 1972, the Wichita State University Physician Assistant Program has recognized the value of maintaining a continuous process of internal self-evaluation. In 2002, the faculty formalized the process by developing an Assessment Frequency Matrix (see page 9) used to monitor the overall status of the Program. Until this time a less formal process collected data from students, graduates, and employers on a periodic basis. In some cases, this informal process missed opportunities for evaluation. The evaluation process now in place includes both formative and summative components and involves program administrative and instructional faculty, staff, students, employing physicians, and program graduates. This process has served as a catalyst for change while providing the Program faculty the opportunity for a dynamic and effective dialogue with all of the principals involved in the education of the physician assistant at Wichita State University. This ongoing evaluation has served as a basis for identifying problems and deficiencies, studying goal achievement, implementing planning strategies, and responding to the changes occurring in both the health care field and the role of the physician assistant. The program director is responsible for the overall coordination of the process. Core faculty participate in curriculum/program planning and evaluation activities while assuming responsibility for component parts of the program administration and curriculum. With the guidance of the Program faculty, the CHP Dean, CHP Curriculum Committee, and the University Program Review Committee also assess the educational soundness of the Program. As required for continued program accreditation and self-study, all of the data collected below are reviewed during the Program's annual curriculum retreat and collectively used to make decisions on whether curricular and programmatic items should remain the same, improve, or change. Overall program image is also assessed. Additionally, the data are used to compare WSU PA Program data to national PA Program data.


Wichita State University Department of Physician Assistant, Program Review Report, 2004 9 Physician Assistant Program Assessment and Frequency Matrix

Minimum Frequencies

Each Course

Each Semester

Every Year

Every 1-5 Years

After Gradua-tion

Every 6-10 years

Ongoing

Program Objectives

Evaluation Areas/Methods

4-8 Administration X X 1 Curriculum requirements X X Evaluation – Student 2-3 -Objective tests and course evaluation X 2-3 -OSCE (formative evaluation) X 2-3 -PACKRAT (summative evaluation) X 2-3 -Professional Development Assessment X 2-3 -National certification exam scores X X 2-3 -Student failure rates in courses X 2-3 -Student attrition X 2-3 -Number of student projects published X 2-3 -Number of service hrs by fac/students X Evaluation – Program 2-3 -Faculty attrition X 2-3 -Employer survey X 2-3 -Curriculum/Graduate surveys X 2-3 -Number of research grants submitted X 2-3 -Number of research grants funded X 2-3 -Number of faculty publications X 2-3 -Number of graduates X 2-3 -Internal program review X 4-5,7 Student Guidance/Identification X X 4-5 Educational Equivalency X 4-5 Maintaining Accreditation X X

Faculty/Staff The program has continuous funding for 7 FTE core faculty, 0.1 FTE Medical Director, and 1.5 FTE staff positions. Additionally, grant funds support one 0.5 FTE staff position. All positions are currently filled. One additional faculty (non-PA) member has been added to the Program since the last review. WSU PA Program faculty positions compare similarly to national PA program data, which reports 6.1 FTE faculty per program (APAP Annual Report, 2003). Average student/faculty ratio is somewhat higher at approximately 14:1, compared to national data of 13:1 (APAP Annual Report, 2003).

Student/Faculty Ratios 1998 1999 2000 2001 2002 2003 2004Total 1st and 2nd Year Students 88 89 92 92 89 89 84 Total Faculty Positions (FTE) 6 5 6 7 7 7 7 Ratio 15:1 18:1 15:1 13:1 13:1 13:1 12:1


Wichita State University Department of Physician Assistant, Program Review Report, 2004 10 Faculty/Staff Profile*+

*Basic Science Faculty: Dr. John Carter (PT faculty) teaches anatomy, Dr. Ken Pitetti (PT faculty) teaches physiology, Dr. Cochran-Black (MT faculty) teaches clinical laboratory.

Name Highest Degree

FTE Rank Academic Specialty Research and Practice Areas

Grad. Sch. Appointment

Effort to Program %

Faculty

R. Muma, Chair

PhD

1.0

Assc. Prof.

Pathophysiology, research methods, clinical education

PA practice & employment issues, higher education, HIV

Full

100

D. Day, Assistant Director

EdS

1.0

Asst. Prof.

Pathophysiology, clinical education

Clinical medicine topics, chemical dependency, addiction medicine, educational technology

Associate

100

P. Bunton

MS, MA

1.0

Instr.

PA theory, pathophysiology, clinical education

Adult education, adolescent medicine, women’s health issues

Faculty Associate

100

S. Enns

MHS

1.0

Asst. Prof.

Research methods, pathophysiology

Practice/employment issues, emergency medicine, asthma, allergy, ophthalmology

Associate

100

T. Quigley

MPH

1.0

Asst. Prof.

PA theory, pathophysiology, clinical education

Behavioral medicine, preventive medicine, urology, nephrology

Associate

100

A. Griffin

MPAS

1.0

Instr.

Clinical education

Clinical medicine topics, emergency medicine

Associate

100

L. Hale

PharmD

1.0

Asst. Prof.

Pharmacology

Geriatrics, drug usage evaluation, prescribing patterns

Full

100

Staff

N. Chippeaux

BS

1.0

Secy.

N/A

N/A

N/A

100

M. Ellenz -- 1.0 Secy. N/A N/A N/A 100

+The Associate Dean of the College has a faculty appointment (effective January 2004) in the Department and assists in supervising student research projects and providing didactic instruction in research methodology. All faculty (with the exception of Ms. Bunton) are probationary faculty or tenured. Currently there are two tenured faculty in the Program (Dr. Muma and Ms. Enns). Faculty have been assigned to all courses in concert with their previous background, experience, and interests. At a minimum, faculty are responsible for teaching; evaluating student performance; counseling students; providing remediation; developing, implementing, and evaluating curriculum; administering and evaluating the program; engaging in scholarship; and providing service to the community and profession. Core faculty have current clinical credentials, a minimum of a bachelor degree in physician assistant education (or other related undergraduate degree), and a graduate degree in a related area, which satisfies the terminal degree criteria for the Department of Physician Assistant and PA profession. With the exception of the Department chair, all faculty practice clinically in their area of expertise, which provides opportunities for role modeling the behavior expected of PA graduates.


Wichita State University Department of Physician Assistant, Program Review Report, 2004 11 From January 1998 to present, PA faculty have published 62 peer-reviewed articles; presented on 50 topics at local, regional, and national meetings; submitted 17 grants; and received grant funding totaling $384,000. PA faculty provide ample service to the profession (e.g., AAPA Clinical and Scientific Affairs Council, PA Advisory Council for the Kansas Board of Healing Arts, NCCPA Test Writing Committee). Ninety percent of the PA curriculum is taught by full-time, tenured or probationary faculty. One faculty member is an unclassified professional (who teaches) and provides instruction for the remaining portion of the curriculum. The Program's location in a community with a medical school (University of Kansas School of Medicine-Wichita) results in a large pool of highly qualified medical school faculty who also contribute to the Program as guest instructors (in clinical medicine courses) and clinical preceptors.


Wichita State University Department of Physician Assistant, Program Review Report, 2004 12 How is the quality of the Program assessed in relation to regular offering of the curriculum and the effect of the curriculum on the students IV. Program Quality (Admissions and Curriculum) The core bachelor program is 24 months in length (12 months didactic, 12 months clinical). The master program (which began summer 2004) is 26 months in length (14 months didactic, 12 months clinical), which is equal to the national average of 26 months (APAP Annual Report, 2003). The last bachelor class began in fall 2003 and will graduate in August 2005. The Program faculty are responsible for the curriculum design and implementation. Within the constraints of the academic calendar and instructor availability, didactic coursework has been structured to build on itself and appears adequate as ascertained by student exit surveys. This structure will remain the same for the master program. Interdisciplinary learning opportunities occur with various providers including nurse practitioners (in pharmacology and clinical skills), physicians (during rotations), and other health care providers, i.e., physical/occupational therapist, social workers (during rotations). Written program objectives, learning goals, and competencies required for successful program completion are provided to the student during orientation and at the beginning of each course. All didactic and clinical courses have clearly written course syllabi, which include measurable instructional objectives and expected student competencies. The Program orients each instructional faculty and preceptor to the specific educational competencies expected of PA students. Approximately 150 individuals apply for a program position each year (42 seats are offered annually). GPA and Gender by Graduating Class (2000 class data not available) 1998 1999 2000 2001 2002 2003 2004 2005 2006GPA Qualified Applicants 3.59 3.53 * 3.57 3.53 3.52 3.52 3.46 3.35 Admitted 3.58 3.70 * 3.68 3.67 3.65 3.66 3.53 3.51 Number admitted 46 46 46 46 48 46 48 48 42 Gender (%) Female 67.3 58.6 * 67.3 66.6 71.7 75 75 73.8 Male 32.7 41.4 * 32.7 33.4 28.3 25 25 26.2 Prerequisites are required for application (BS – basic and clinical science courses; MPA – bachelor degree; basic and clinical science courses) to the program and after an initial screening process students are interviewed by one core faculty member and a practicing PA or physician. Decisions are then based on the interview scores. Once accepted, students are admitted into a lock-step curriculum. Students begin each fall (bachelor program) or summer (master program) after enrolling in a prescribed set of courses as outlined beginning on page 13.


Wichita State University Department of Physician Assistant, Program Review Report, 2004 13 Schematic Representation of Curriculum – Baccalaureate vs. Master In order to accommodate a graduate curriculum, several changes were made and include:

• Extending the program from 24 months to 26 months. • Starting the Program in the summer by offering a 5-credit hour Clinical Anatomy course. • Requiring completion of a bachelor degree and additional clinical physiology and

statistic courses as prerequisites. • Incorporating current clinical course content into three Pathophysiologic Assessment

courses, which will include additional clinical physiology/pathophysiology objectives and clinical skills as appropriate to each course.

• Combining Patient Counseling and Preventive Medicine into PA Theory II. • Combining content from Clinical Laboratory and PA Professional Issues into Seminar in

PA Practice. • Adding a research methods course. • Adding one clinical rotation elective and three courses in directed studies in research

during Year 2.

Didactic Phase – Year 1 Bachelor Curriculum Master Curriculum

Summer Semester

Course Number Course Name

PA 789 (5 cr) Clinical Anatomy (includes PA 388/389 content)

Total – 5 cr

Fall Semester - Fall Semester

Course Number Course Name Course Number Course Name

PA 300 (4 cr) Medical History & Physical Examination

PA 700 (3 cr) Physician Assistant Theory I (includes PA 300 content)

PA 302 (2 cr) Patient Counseling PA 725 (3 cr) Physician Assistant Theory II (includes PA 302/325)

PA 315 (1 cr) Physician Assistant Professional Issues

PA 726 (3 cr) PA Research Methods

PA 320 (3 cr) EENT PA 715 (3 cr) Seminar in PA Practice (includes PA 315/MT 310 content)

PA 325 (2 cr) Preventive Medicine & Community Health

HS 710 (3 cr) Applied Clinical Pharmacology

HS 710 (3 cr) Applied Clinical Pharmacology

PA 388 (3 cr) Clinical Anatomy

PA 390 (3 cr) Clinical Physiology

MT 310 (1 cr) Clinical Laboratory

Total – 22 cr Total – 15 cr


Wichita State University Department of Physician Assistant, Program Review Report, 2004 14 Didactic Phase – Year 1 (Continued) Bachelor Curriculum Master Curriculum

Spring Semester Spring Semester


PA 316 (1 cr) Dermatology PA 720 (5 cr) Pathophysiologic Assessment I (includes PA 323/330/375/390/430 content)

PA 317 (1 cr) Endocrine PA 723 (5 cr) Pathophysiologic Assessment II (includes PA 333/335/317/375/390 content)

PA 323 (4 cr) Cardiopulmonary PA 733 (5 cr) Pathophysiologic Assessment III (includes PA 320/337/316/375/390 content)

PA 330 (3 cr) GI PA 736 (3 cr) Applied Clinical Practice (includes PA 336 content)

PA 333 (3 cr) Obstetrics & Gynecology HS 711 (3 cr) Pharmacological Management of Acute and Chronic Diseases

PA 335 (3 cr) Renal & Genitourinary System

PA 336 (2 cr) Applied Clinical Practice

HS 711 (3 cr) Pharmacological Management of Acute & Chronic Diseases

PA 389 (2 cr) Clinical Anatomy


Clinical/Research Phase – Year 2 Bachelor Curriculum Master Curriculum

Summer Semester Summer Semester


PA 337 (3 cr) Neuromusculo-skeletal PA 896 (2 cr) Directed Study in Research I

PA 375 (3 cr) Clinical Skills

PA 430 (1 cr) Clinical Conference I (ACLS)



Wichita State University Department of Physician Assistant, Program Review Report, 2004 15 Clinical/Research Phase – Year 2 (Continued) Bachelor Curriculum Master Curriculum

Fall Semester Fall Semester


PA 410 (3 cr) Clinical Rotation I PA 810 (3 cr) Advanced Clinical Management Rotation I

PA 412 (3 cr) Clinical Rotation II PA 812 (3 cr) Advanced Clinical Management Rotation II

PA 414 (3 cr) Clinical Rotation III PA 814 (3 cr) Advanced Clinical Management Rotation III

PA 418 (3 cr) Clinical Rotation IV PA 818 (3 cr) Advanced Clinical Management Rotation IV

PA 897 (2 cr) Directed Study in Research II



Spring Semester Spring Semester


PA 419 (3 cr) Clinical Rotation V PA 819 (3 cr) Advanced Clinical Management Rotation V

PA 422 (3 cr) Clinical Rotation VI PA 822 (3 cr) Advanced Clinical Management Rotation VI

PA 425 (3 cr) Clinical Rotation VII PA 825 (3 cr) Advanced Clinical Management Rotation VII

PA 432 (3 cr) Clinical Conference II PA 826 (3 cr) Advanced Clinical Management Rotation Elective

PA 832 (3 cr) Clinical Assessment Seminar

PA 898 (2 cr) Directed Study in Research III



Summer Semester Summer Semester


PA 440 (6 cr) Preceptorship PA 899 (6 cr) Clinical Preceptorship


Grand Total for Program – 81 cr

Grand Total for Program – 80 cr


Wichita State University Department of Physician Assistant, Program Review Report, 2004 16 Overall, the Program has a sound and sufficient curriculum, both didactic and clinical, which is evidenced by positive course evaluations (see below), standardized test scores (see page 17), curriculum/graduate/employer surveys (see page 21), and comparison to national curricular data (APAP Annual Report, 2003). Contact hours are adequate and within the normal ranges (compared to national data), and in some cases exceed the ranges (particularly in physiology and pharmacology). Since the last review, the physiology content has improved and will be further strengthened when physiology, pathophysiology, and clinical medicine are integrated into one set of courses for the masters program. Pharmacology is the strongest it has ever been and is currently taught by a clinical pharmacologist. Student Course Evaluation Data (Didactic and Clinical Curriculum) – Fall 2003 - Summer 2004

FALL

SPRING

SUMMER

Avg For All

In-dex

PA 300

PA 302

PA 315

PA 320

PA 325

HS 710

PA 388

PA 390

MT 310

PA 316

PA 317

PA 323

PA 330

PA 333

PA 335

PA 336

PA 432

HS 711

PA 389

PA-CR

PA 337

PA 375

PA 430

1 1.40 1.14 1.37 1.29 1.38 1.17 1.21 1.23 1.10 1.29 1.62 1.28 1.27 1.44 1.23 1.59 2.15 1.17 1.31 1.93 1.18 1.19 1.19 1.35

2 1.33 1.14 1.28 1.41 1.35 1.22 1.23 1.30 1.10 1.26 1.62 1.33 1.22 1.41 1.18 1.59 2.18 1.17 1.35 2.00 1.18 1.19 1.16 1.36

3 1.40 1.22 1.29 1.24 1.38 1.24 1.20 1.20 1.10 1.29 1.98 1.44 1.18 1.42 1.18 1.61 2.18 1.12 1.45 2.00 1.18 1.19 1.19 1.38

4 1.39 1.16 1.28 1.29 1.30 1.27 1.30 1.16 1.10 1.29 1.76 1.36 1.20 1.51 1.23 1.54 2.21 1.17 1.56 1.93 1.20 1.24 1.16 1.37

5 1.40 1.14 1.26 1.27 1.35 1.22 1.50 1.16 1.12 1.29 1.48 1.31 1.17 1.41 1.18 1.63 2.10 1.12 1.37 1.93 1.20 1.24 1.28 1.35

6 2.02 1.47 2.06 1.54 2.55 1.72 1.31 1.55 1.74 1.27 2.51 1.33 1.66 1.78 1.70 1.97 2.27 1.63 1.60 1.86 1.28 1.25 1.12 1.70

7 1.71 1.11 1.23 1.49 1.40 1.17 1.27 1.23 1.10 1.31 1.71 1.33 1.30 1.71 1.20 1.80 2.13 1.15 1.55 1.92 1.25 1.19 1.38 1.42

8 1.62 1.24 1.42 1.34 1.34 1.46 1.98 1.07 1.12 1.40 1.60 1.74 1.37 2.00 1.25 1.81 2.40 1.37 1.98 2.22 1.28 1.18 1.21 1.54

9 1.69 1.45 1.53 1.41 1.41 1.44 2.21 1.16 1.17 1.38 1.71 2.08 1.44 1.95 1.33 1.90 2.48 1.49 2.35 2.04 1.43 1.19 1.27 1.63

10 1.52 1.16 1.19 1.20 1.27 1.22 1.42 1.09 1.15 1.24 1.64 1.33 1.27 1.68 1.18 2.98 2.31 1.29 1.44 2.08 1.15 1.24 1.15 1.44

11 1.71 1.41 1.45 1.41 2.05 1.37 1.88 1.22 1.17 1.50 1.95 1.62 1.47 2.00 1.29 1.87 2.36 1.37 2.13 2.16 1.20 1.17 1.29 1.61

12 1.93 1.34 1.40 1.32 1.61 1.32 1.55 1.44 1.17 1.26 1.93 1.41 1.41 1.90 1.20 2.00 2.25 1.28 1.67 2.14 1.25 1.24 1.32 1.54

13 2.16 1.13 1.33 1.29 1.54 1.34 1.22 1.13 1.13 1.38 1.79 1.38 1.49 1.73 1.18 2.13 2.28 1.25 1.51 2.09 1.40 1.14 1.26 1.49

14 1.86 1.72 1.96 1.73 N/A 1.53 1.49 1.90 1.24 1.43 2.20 1.43 1.74 2.41 1.45 1.80 2.32 1.46 1.95 2.00 1.59 1.14 1.09 1.70

15 1.86 N/A 1.75 1.48 N/A 1.48 1.30 1.30 1.20 1.33 1.80 1.74 1.29 1.97 1.22 1.89 2.24 1.42 1.28 1.95 1.30 1.14 1.12 1.53

16 1.83 1.38 1.30 1.44 1.70 1.40 1.39 1.26 1.15 1.40 1.88 1.49 1.39 2.00 1.25 1.90 2.35 1.27 1.40 2.14 1.28 1.19 1.18 1.52

17 1.76 1.44 1.68 1.58 2.15 1.45 1.51 1.70 1.22 1.46 1.83 1.49 1.56 1.95 1.38 1.86 2.33 1.47 2.10 2.04 1.70 1.19 1.18 1.65

18 1.62 1.13 1.33 1.39 1.46 1.27 1.30 1.42 1.10 1.26 1.90 1.49 1.32 2.02 1.13 2.07 2.28 1.15 1.47 1.97 1.40 1.10 1.29 1.47

19 1.93 1.16 1.30 1.50 1.41 1.29 1.27 1.37 1.07 1.33 1.81 1.49 1.32 2.00 1.13 1.92 2.28 1.15 1.40 2.04 1.50 1.10 1.21 1.48

20 1.55 1.24 1.26 1.38 1.44 1.29 1.30 1.35 1.15 1.26 1.83 1.59 1.41 1.85 1.15 1.95 2.15 1.24 1.49 2.00 1.33 1.10 1.21 1.46

Key for scores: Range 1-5; 1=Very Satisfied; 5=Very Dissatisfied. Data reported by course numbers. PA CR=Clinical Rotations Key for index: Items 1-7 (course materials/methods);1=syllabus methods; 2=syllabus topics; 3=syllabus assignments; 4=syllabus objectives; 5=syllabus evaluation; 6=syllabus textbooks; 7=handouts. Items 8-11 (Exams/assignments); 8=test items; 9=test items difficulty; 10=feedback; 11=assignment value. Items 12-17 (Course instruction); 12=audiovisual; 13=enthusiasm; 14=lab; 15=lab instructors; 16=application; 17=instructional variation. Items 18-20 (General impression); 18=course organization; 19=presentation; 20=gaining basic knowledge


Wichita State University Department of Physician Assistant, Program Review Report, 2004 17 The didactic and clinical practice curriculum has improved since the last review as also evidenced by OSCE (clinical skill formative evaluation) and PACKRAT (didactic summative evaluation) data below.

Each year the Program eagerly awaits the results of student performance on the NCCPA exam. This primary data source allows the Program to assess its overall effectiveness in terms of producing graduates capable of mastering a nationally standardized exam necessary for PA practice in every jurisdiction in the United States. The primary statistics evaluated are a comparison of WSU's pass rate to the national pass rate, comparison of WSU's student mean score to the national mean score, and a comparison of WSU's content area scores to the national content scores. The overall pass rate (first-time takers) for the Program is 90%, which is comparable to the national average. The student’s mean score was in the 70th percentile in the last two years, which represents a dramatic increase from previous years. It is important to mention that all of WSU's scores fall within one standard deviation as reported by the NCCPA. Significant efforts have been made to assure WSU scores remain at or above the national average. An improvement in the most recent NCCPA scores is reflective of these efforts. YEAR

WSU PASS RATE %

NATIONAL PASS RATE %

WSU MEAN SCORE

NATIONAL MEAN SCORE

1998 90 95 473 505 1999 85 91 483 497 2000 89 92 470 498 2001 85 91 461 489 2002 93 90 500 492 2003 95 89 485 487 On an annual basis student attrition data is collected for the APAP Annual Report to evaluate student matriculation. The average attrition rate since the last site visit was 6% (1998-2004), which is comparable to the national average of 5.1% (APAP Annual Report, 2003). Data is reviewed annually for patterns, especially increases in attrition. Gradual increases have not occurred and there is no pattern to the current attrition rates for the Program. The reasons for attrition are a mix between personal and academic issues. When academic problems arise it is usually because of poor


Wichita State University Department of Physician Assistant, Program Review Report, 2004 18 performance in the anatomy course. Personal problems center on financial issues. Even though the anatomy course is more commonly associated with student attrition, the Program faculty have not made significant changes to this course as evaluations are above average as reported by students and graduates and attrition in this area has been constant at approximately two students per class over the last 6 years. One or two students are decelerated in the program each year, which is usually due to inadequate performance on clinical rotations. Remediation is monitored through the Program's Academic warning system, which has been very effective in identifying students who have academic difficulties early on. Student Attrition Data by Graduating Class 1998 1999 2000 2001 2002 2003 2004 2005 2006 Beginning Program

46

47

47

46

48

46

46

46

42

Graduating Program

43

43

46

46

43

43

42

*

†

Attrition 3 (7%) 4 (9%) 1 (2%) 0 (0%) 5 (10%) 3 (7%) 4 (9%) 4(9%) % Grad. 93 91 98 100 90 93 91 *Graduate summer 2005 †Graduate summer 2006

At its March 2004 meeting, the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) awarded continued accreditation of WSU's PA Program through 2010. Accreditation is required as graduates cannot take the national certification examination unless they graduate from an ARC-PA accredited PA program. This formal recognition is a result of a year long process of program review (during 2003), which included the formation of self-study committees that evaluated every aspect of the Program. Continued accreditation also demonstrates commitment and dedication to quality PA education. The Program clearly has a continuing system for evaluation, which is reflected in the curriculum and every other dimension of the Program (refer to assessment matrix, page 9). Several changes have been made and are documented in this report and summarized in the table on page 19.



USE OF ASSESSMENT DATA FOR PROGRAM MODIFICATION, 1998-2004 Areas of Concern/Solutions Assessment Documents Utilized 1 Program budget stability

-reallocated college and university funds for PA program

• Program budget ledgers • ARC-PA Standards

2 Behavioral science curriculum - incorporated new required objectives into behavioral science courses offered in the didactic phase of the curriculum

• Course syllabi and objectives. • Course evaluations. • Curriculum surveys. • Graduate, employer, and preceptor surveys. • OSCE, PACKRAT and NCCPA examination

scores. • ARC-PA Standards

3 Physiology curriculum

-modified objectives -integrated content into clinical medicine courses

• Course syllabi and objectives. • Course evaluations. • Curriculum surveys. • Graduate, employer, and preceptor surveys. • OSCE, PACKRAT and NCCPA examination


4 NCCPA exam scores -Implemented examinations that follow the NCCPA blueprint and written in the style of the NCCPA exam. -Implemented end of rotation seminars that include review of clinical content, radiology workshops, and lab interpretation exercises. -Implemented summative evaluations. -Developed plan to increase number of specialties in internal medicine and prenatal care/gynecology and in clinical settings of emergency, inpatient, and long-term care.

• Senior Handbook and objectives. • Course evaluations. • Rotation tracking data. • Faculty site visit evaluations. • Faculty communication with clinical student log. • Curriculum surveys. • Graduate and employer surveys. • OSCE, PACKRAT and NCCPA examination


5 Student diversity -Modified admission process

• Class profile data

6 Laboratory space -Developed plan for new space -Remodeled AH 101 into Physical Diagnosis Lab

• ARC-PA Standards • Ahlberg Hall floor plan • Graduate surveys


Wichita State University Department of Physician Assistant, Program Review Report, 2004 20 What are the data in regard to student needs, employer demands, and preparation of students for their goals? V. Students Needs, Employer Demands, Student Preparation for Goals Student Needs As full-time students at Wichita State University, Physician Assistant Program students have access to a wide variety of excellent academic and personal counseling services. The Counseling and Testing Center provides counseling and psychotherapy to students at low cost (or free if not able to pay) for concerns such as test taking anxiety, general anxiety, depression, loneliness, academic inhibition, eating disorders and substance abuse; for concerns about relationships with peers, parents, spouses, and faculty; and to help students with basic identity development. The Physician Assistant Program also offers supportive counseling to students for professional and academic concerns through the Program Faculty Advisory Policy. If the situation warrants, students are referred to other providers as identified by the Counseling and Testing Center. Career-related counseling is available from several sources. Faculty provide ongoing professional guidance and the department helps students to identify various employment opportunities in their chosen areas (e.g., web-based job listing). Should a student decide to reconsider the choice of physician assistant, help is available through the WSU Career Center. Physician assistant faculty offer students remedial academic counseling and out-of-class help with specific skills, attitudes, and concepts. The Counseling and Testing Center is also available to help with writing, reading, and study skills. They maintain a resource library for student use and also offer some specialized services for learning-disabled students. In regard to assistance in utilizing the medical literature and engaging in research activities, several activities are in place for these purposes. Students are taught the basics of evaluating the medical literature and evidence-based medicine as several courses require literature searches for projects or presentations. In addition, last year the program developed a PA resource web page (linked to the Program Web site), which provides links to all available medical databases, electronic journals and books, a tutorial in evidence-based medicine, and other related topics. Student and Employer Demands Since its inception in 1972, the PA program has been in demand with more applicants than available student positions. In 1990, the program began experiencing 300-400 applicants per year, thus justifying the need to increase the program’s capacity by 50%. Beginning in 1998 the number of applicants declined somewhat, mostly due to an increase in the number of programs nationally from 60 to 135 and the fact that a large percentage of the programs grant master degrees. The program currently receives 130-150 applicants for approximately 42 positions annually. It is expected that applicants will remain stable, if not increase, when granting a master degree. In an effort to maintain and ultimately strengthen our applicant pool, in 2001 the program


Wichita State University Department of Physician Assistant, Program Review Report, 2004 21 began participating in a centralized application service for PA programs commonly referred to as CASPA. Only applicants applying through CASPA are considered for a position in the program. Similar to the centralized application service used by U.S. medical schools, CASPA assists programs in marketing their program to other students in the U.S. as students apply once to CASPA, but multiple programs can receive their application. One-hundred-percent of WSU’s graduates are employed within 6 months of graduation if desiring to do so. Considering all of WSU PA Program graduates to date (n=1036), 90% are certified PAs suggesting a high level of satisfaction with the PA role and current employment. Furthermore, the 2004 U.S. Bureau of Labor Statistic’s List of Fastest-Growing Occupations (2002-2012), lists the PA profession as number 3, with a projected 50% increase in jobs available over the next ten years. Preparing Students for their Goals In an effort to monitor the Program’s mission and stated education philosophy (i.e., primary care and service to underserved populations), graduate data is analyzed to determine practice settings as shown in the figure below.

WSU PA Graduate Practice Settings, 2003 (%)

0

10

20

30

40

50

60

Underserved PrimaryCare

Rural

WSU GradsNationally

Source: AAPA, 2003; n=994

Nineteen percent of WSU graduates (1998 – 2003) practice in medically underserved settings (15% for all graduates) and 38% in primary care fields (53% for all graduates), as compared to the national average of 9.3% and 43% respectively (AAPA, 2002). These data (along with the data previously presented), indicate the program is meeting its mission and educational philosophy as well as preparing students for their goals. Curricular exit, graduate, and employer surveys are conducted periodically to assess the preparation of students in relation to their goals. Curricular exit surveys indicate satisfaction in the areas of program reputation, quality of instruction, effectiveness of faculty as instructors, and the program’s ability to prepare individuals to practice as PAs.


Wichita State University Department of Physician Assistant, Program Review Report, 2004 22 Curricular Exit Survey, Graduating Classes of 2001-2004 Exit Survey Item 2001 2002 2003 2004 Av. Program reputation 1.82 1.80 1.83 2.32 1.94 Quality of instruction 2.12 1.88 1.96 2.44 2.1 Effectiveness of faculty 1.72 1.54 1.80 2.32 1.85 Program’s ability to prepare PAs for practice 1.88 1.95 1.93 2.10 1.97 Key for scores: Range 1-5; 1=Strongly agree; 5=Strongly disagree

The most recent graduate survey, which surveyed the classes of 2000-2002, collected information on their perception on the program’s ability to prepare them for their first job. Eighty-two percent of respondents were very satisfied or satisfied and 12% were neutral. Five percent were dissatisfied. Finally, the Program surveys employers of new graduates periodically (usually every three years, although the most recent surveys were done in 2003 and 1997) to ascertain whether the employer feels his/her WSU-trained PA has an adequate knowledge base, patient management ability, clinical skills, and appropriate interaction with patients and other members of the health care team. Both surveys indicate continued program satisfaction (100%) among employers of WSU graduates. What is the service the Program provides to the discipline, other programs at the University, and the metropolitan area of Kansas? VI. Service Service responsibilities include activities that benefit the department, college, the discipline, community or university. These activities include, but are not limited to: assuming leadership positions, providing expertise, serving on editorial or grant review panels, sponsoring student groups, and serving on faculty committees. These activities also include involvement in local, state, national, and international organizations, professional associations, governmental agencies, and civic groups. A summary of community service hours is provided below.


Wichita State University Department of Physician Assistant, Program Review Report, 2004 23 What is the assessment of the Program’s cost effectiveness as measured by such matters as cost per credit hour, peer comparisons, and other indicators? VII. Cost Effectiveness In an effort to assess the cost effectiveness of the Program, two main sources of data (i.e., cost per credit hour and peer comparison costs) have been evaluated since the last review. Cost Per Credit Hour The KBOR Program Review Information System five year average costs for lower and upper division credit hour in Physician Assistant is $178.51 and $169.68 respectively. A review of other undergraduate departments in the College of Health Professions reveals that the PA Department is among the lowest. As compared to lower and upper division credit hour mean costs for all WSU undergraduate programs ($126.80 and $180.26 respectively), the PA Department compares favorably, especially at the upper division level. Comparable data from other institutions are not available. Peer Comparison Costs Regular reviews of peer tuition and fee costs are evaluated to assure that the WSU PA Program remains competitive in relation to regional competitors. This was especially important when the Program decided to implement a program fee in 2003. Data from the Association of Physician Assistant Programs Directory (APAP, 2004) are listed below and demonstrate that the PA Program is very competitive in the area of tuition and fees, even after initiation of the PA Program fee.

Average - $24,000 Red Rocks College (Colorado) - $21,000 Saint Louis University - $51,000 Southwest Missouri State - $14,000 Union College (Nebraska) - $42,000 University of Colorado - $22,000 University of Iowa - $17,000 University of Nebraska - $18,000 University of Oklahoma - $15,000 Wichita State - $14,000

Summary and Conclusions As evidenced by the Program's evaluative activities, the Wichita State University Physician Assistant Program is sound in terms of its product of quality physician assistant education. Evidence shows that the Program is graduating students in adequate numbers, preparing students to practice as a PA, maintaining a qualified faculty, placing graduates in the employment setting, providing service, and offering a cost effective curriculum.
