Patient-centered medical homes and physician assistant education: preparing the PA student for the practice of the future.

PURPOSE

The patient-centered medical home (PCMH) holds promise for improving primary health care delivery, but little is known about its impact on medical education. The purpose of this study was to examine the extent to which physician assistant (PA) students are exposed to elements of the PCMH during the didactic and clinical phases of their education.

METHODS

A survey was distributed to clinical coordinators at all accredited PA programs in the United States that met the study inclusion criteria. The survey inquired about curricula central to practice in the PCMH: team-based care, electronic medical record utilization, and principles of care coordination.

RESULTS

Of the 211 clinical coordinators that were surveyed, we received responses from 87 (41%), of which 94% stated that they teach principles of interprofessional team-based practice during the didactic phase. Sixty percent or more teach concepts related to physician-directed teams, quality improvement, care coordination, and electronic medical records. Only 25% of respondents provide instruction in payment structures that reward care coordination and high quality care, and 22% stated that their students do not have exposure to the PCMH. Most importantly, less than 25% of respondents utilize designated PCMH clinical sites, and those that do have been doing so for less than two years.

CONCLUSION

Many PA programs teach some of the core concepts of PCMH during the didactic phase, but exposure to PCMH during clinical clerkships remains limited. Concerted effort is needed to better prepare PA students to function in these emerging team-based practices.