Hulse Betty, Schweinle William E, Kassin Katie, Trimble Nancy D
Betty Hulse, MSPAS, PA-C, is an associate professor/clinical education coordinator, University of South Dakota, Physician Assistant Studies Program, Vermillion, South Dakota.
William E. Schweinle, PhD, is a professor of Biostatistics, University of South Dakota, Physician Assistant Studies Program, Vermillion, South Dakota.
J Physician Assist Educ. 2025 Mar 1;36(1):e25-e33. doi: 10.1097/JPA.0000000000000628. Epub 2024 Oct 25.
This study examines training, experience, and collaborative practices of physician assistants (PAs) with employment experience and their perspectives on practice act legislation.
Mixed method study with quantitative and qualitative data.
One hundred eighty participants completed the survey. During clinical employment, 81.05% of respondents reported physicians participated in training. However, supervising physicians trained only 43.46%; 56.54% reported being trained by nurse practitioners (NPs), PAs, and/or other physicians. Onsite collaboration with physicians was reported by 87.2%. Supervising physician involvement was reported by 67.3%, and of these, 59% collaborated with PAs, NPs, and/or other physicians as well. One-third collaborated only with NPs, PAs, and/or other physicians. Daily/weekly collaboration with a supervising physician was reported by 78.89% in their first position and 54.87% in their current/most recent position; 77.22% collaborated with NPs, PAs, and/or other physicians in their first position and 71.68% in their current/most recent position. Most (64.44%) felt PAs should not be legally required to have physician supervision. Most (76.12%) felt care quality would not decrease if supervision were lifted. Most (74.44%) agreed that PAs are hired less frequently than NPs in states where physician supervision is required for PA but not NPs.
Findings suggest that team-based practice is already the current structure of PA clinical training and collaboration with PAs receiving significant support from physicians who are not supervising physicians and other nonphysician practitioners. Establishing oversight at the practice level is supported by this practice structure. Determining effects of practice act legislation on employment training, collaboration, and hiring practices warrants further research.
本研究考察了有工作经验的医师助理（PA）的培训、经验及协作实践，以及他们对执业法案立法的看法。
采用包含定量和定性数据的混合方法研究。
180名参与者完成了调查。在临床工作期间，81.05%的受访者表示医师参与了培训。然而，指导医师仅培训了43.46%；56.54%的受访者称接受过执业护士（NP）、医师助理及/或其他医师的培训。87.2%的受访者表示与医师进行现场协作。67.3%的受访者称有指导医师参与，其中59%的指导医师还与医师助理、执业护士及/或其他医师协作。三分之一的指导医师仅与执业护士、医师助理及/或其他医师协作。78.89%的受访者表示在其第一个职位时每日/每周与指导医师协作，在其当前/最近一个职位时这一比例为54.87%；77.22%的受访者表示在其第一个职位时与执业护士、医师助理及/或其他医师协作，在其当前/最近一个职位时这一比例为71.68%。大多数（64.44%）人认为从法律上不应要求医师助理接受医师监督。大多数（76.12%）人认为取消监督护理质量不会下降。大多数（74.44%）人同意，在要求医师助理而非执业护士接受医师监督的州，医师助理的受聘频率低于执业护士。
研究结果表明，基于团队的实践已经是医师助理临床培训的当前模式，且医师助理在临床培训和协作中得到了非指导医师和其他非医师从业者的大力支持。这种实践模式支持在实践层面建立监督机制。确定执业法案立法对就业培训、协作及招聘实践的影响值得进一步研究。
