Health Professions Education Unit, Hull York Medical School, University of York , York, UK.
Educ Prim Care. 2020 Jul;31(4):231-239. doi: 10.1080/14739879.2020.1763210. Epub 2020 May 21.
As the role of the Physician Associate (PA) establishes within the UK, there is increasing interest in the recruitment of PAs to primary care. Yet, currently 72% of all UK PAs work in secondary care. Recruitment to primary care is wanting, for reasons that remain unclear. This work sought to investigate student PA experiences in primary care and their attitudes to primary care as a career choice. A multi-site, qualitative study involving one-to-one semi-structured interviews with 19 student PAs was conducted. Data were thematically analysed, in line with an interpretivist approach and informed by communities of practice and paradigmatic trajectory theory - 'visible career paths provided by a community'. Factors were identified enabling student PA engagement with primary care paradigmatic trajectories including engaging students with a degree of responsibility in service provision. Barriers to engagement included ignorance regarding the PA role, and reverence of medical students as a 'gold standard'. A conceptual model is proposed detailing the student process of engagement with primary care trajectories, encapsulating how this process influences emerging career identity. This model could be used to optimise student PA engagement in learning about, and coming to identify with, primary care careers.
随着医师助理（PA）在英国的角色确立，人们对招聘 PA 到初级保健领域越来越感兴趣。然而，目前英国所有的 PA 中，有 72%在二级保健机构工作。由于原因尚不清楚，目前还缺乏对初级保健领域的招聘。这项工作旨在调查学生 PA 在初级保健方面的经验以及他们对初级保健作为职业选择的态度。这是一项多地点的定性研究，涉及对 19 名学生 PA 进行一对一的半结构化访谈。根据解释主义方法，数据进行了主题分析，并借鉴了实践社区和范式轨迹理论——“由社区提供的可见职业道路”。确定了使学生 PA 参与初级保健范式轨迹的因素，包括让学生在服务提供方面承担一定的责任。参与的障碍包括对 PA 角色的无知，以及对医学生作为“黄金标准”的敬畏。提出了一个概念模型，详细说明了学生参与初级保健轨迹的过程，包括这个过程如何影响新兴的职业认同。该模型可用于优化学生 PA 对初级保健职业的学习和认同。
