Physician assistant self-assessment of entry-level competency: A comparison with observations of supervising physicians.

PURPOSE

The present study was conducted to gain comparative knowledge of physician assistants' and supervising physicians' perceptions of adequacy of physician assistant (PA) preparation at entry-level for effective practice in the primary care setting.

METHODS

The sample included 1,000 PAs working in their first professional employment and their supervising physicians. Each PA/physician pair independently completed a survey to evaluate knowledge, skills, and patient care as well as diagnosis, management, and treatment of common conditions encountered in primary care. A 3-point scale for Entry-Level and Required Knowledge and Skills was used to assess proficiency: (1) exposed to subject area, but lack confidence in knowledge and/or practice skills; (2) have general knowledge and understanding of subject area and believe prepared for entry-level practice; and (3) have thorough knowledge of subject matter and expertise in practice. Competence was defined at 2.0.

RESULTS

Ten percent (n = 98) of PAs and 5% (n = 46) of physicians responded to the survey. PA means were below 2.0 in 13 of 31 medical knowledge and patient care competencies and four of five medical/surgical procedures evaluated. With regard to diagnosis, management, and treatment of common medical conditions, the PA ranking was > 2.0 in 17 of 18 competencies. Overall, physicians' ranking of PA preparations were higher than PA self-assessments, reaching significance in 13 of the 54 competencies.

CONCLUSIONS

While PAs were less confident and competent regarding entry-level medical knowledge and patient care, self-reported ability to diagnose, manage, and treat common conditions was ranked as competent for their current practice setting and met expectations of supervising physicians.