History of the Profession (H&R)w

What originally developed the idea of PAs

inadequate healthcare

Feldshers

Russian field surgeons that were introduced to the army in the 1650s (Similar to PA)

feldsherism

policy of using non-physician providers for primary care in developing countries

Barefoot Doctors

Non-physician providers that worked on farming fields in China in the 1960s

Practicante

Non-physician providers in Puerto Rico in the early 1900s to provide rural care

What other countries had precursors to the PA

Russia (Feldshers)

China (Barefoot Doctors)

Puerto Rico (PRacticante)

Loblolly boys

Naval crewmember who assisted ship’s surgeon and carried gruel to sick shipmembers in the 1810s

What were the predecssors to the PA profession in the US

Loblolly boys

Surgeon’s Steward

Cleveland Clinic Urology

Vivian Thomas at John Hopkins

Surgeon’s Steward

served on large ships, trained in basic medicine in the 1840s

Vivian Thomas

A surgical technican trained at John Hopkins that perfected CT surgeyr

Where was the model for urologic PAs found

Cleveland Clinic

The Soviet Feldsher as a Physician Assistant

An article published by the NIH in 1972 that first coined the term PA

Where are places the PAs work overseas

Missionary, relief, and other non-governmental organizations (NGO)

Corporations (oil companies in the far north or in Saudi Arabia)

US Armed Forces

Other governmental positions (Peace Corps, CIA)

What shifted healthcare in the US to need more providers

Amazing breakthroughs in sciences. Development of new specialties and subspecialties

Hospitals shifting toward services

Young physicians moving into specialties

Small towns were losing primary care physicians

When did the Surgeon General identify the shortage of medical professinal

1959

Charles Hudson

Wrote a 1961 editorial in JAMA calling for mid-level provider from fomer military corpsman

What are the periods in the PA profession time line

Precedent Events and Prototype Period (1650-1960)

Ideological Period (1960-1965)

Implementation Period (1966-1972)

Evaluation and Standardization (1973-1980)

Incorporation Period (1981-1990)

Maturation and Consolidation (1991-2000)

Expansion and Integration Period (2001-present)

What were the prototype PA programs

Duke: 1965

University of Colorado- Child Health Associate Program 1966

University of Washington- MEDEX program 1969

Eugene Stead

Developed the first PA program at Duke University in 1965

Thelma Ingles

Assisted Eugene Stead in forming the first PA program

When did the first PA program begin

October 1965

What was the modal of the 1965 Duke PA progam

Duration (2 years)

Role of employing physician (new relationship)

Followed “medical model”

Intention to train a generalist assistant

Dr. Harvey Estes

Expanded the Duke PA Program in 1967 by designing the PA curriculum and getting governement fudns

When did the Duke PA program expand to the modern PA curriculum

1967

Child Health Associate Program

A PA progam formed by Univeristy of Colorado in 1968

Henry Silver

Founded the Child Health Associate Program with Loretta Ford

Loretta Ford

Founded the Child Health Associate Program with Henry Silver

What was considered the foundation for NP programs

Child Health Associate Program

How was Child Health Associate Program models

Originally recruited nurses and other applicants with diverse backgrounds for 5 years (later changed to 3) training to assist pediatric physicians

What was the first progam to offer postgrad degree

Child Health Associate Program

What was the prerequisite to joining the Child Health Associate Program

2 years of college

MEDEX Program

A program developed at University of Washington in 1969

Richard Smith

Founder of MEDEX

What was the model of MEDEX

1 year certificate program (later 2)

Designed to augment training of military corpsman

Graduates would refer to themselves as “medex,”

students had to have sponsoring physician who agreed to be their mentor,

the student’s training was largely “on the job”

Often physicians became their subsequent employers

Alderson-Broaddus Program

A PA program developed in 1968 in Phillipi West Virgina

Hu C. Meyers

Founder of the Alderson-Broaddus program

Characteristics of the Alderson-Broaddus program

provide clinical training for those with no medical experience

offered access to non-military candidates

Students enrolled directly from high school

give both a liberal arts education and training as physician assistants, became the first college to offer a baccalaureate degree to its students

Who developed the first speciality program for PA and when

University of Virginia 1967

What was the first speciality PA education

Surgical

Comprehensive Health and Manpower Training Act

1971 legislation provided funds for medical schools and physician assistant training programs to meet perceived shortage of medical personnel

Educational Essentials

Guidelines that where established in 1972 for accerdiation standards for PA programs

Who established the Educational Essentials

Harvey Estes

Who processed accreditation for PA programs

Joint Review Committee (JRC-PA)

Later, became Accreditation Review Committee (ARC-PA),

When did ARC-PA become the indendepent accrediting agency for educational PA progams

2000

American Academy of Physician Assistants (AAPA):

The association of individuals that critical for the development of essential standards, and accreditation of programs

Who and when was APPA established?

Duke Stundents in 1968

Journal of the American Academy of Physician Assistants (JAAPA)

The medical journal published by AAPA

Association of Physician Assistant Programs (APAP):

Organization of member programs that acted as a network for curriculum

changed to Physician Assistant Education Association (PAEA)

Who publishes the PA program directory

APAP

syniatrist

The term used to describe the graduate Child Health Assiocate Program

When did the AAPA define the Physician Assisant

1995

Physician Assistant (AAPA Defintiion)

health professionals licensed or, in the case of those employed by the federal government, credentialed, to practice medicine with physician supervision

What are the competencies of the PA profession

Medical knowledge

Interpersonal and communication skills

Patient care

Professionalism

Practice-based learning and improvement

Systems-based practice

What are the AAPA Competencies

Knowledge for Practice

Interpersonal and Communication Skills

Person-Centered Care

Interprofessional Collaboration

Professionalism and Ethics

Practice-Based Learning and Quality Improvement

Society and Population Health

What are the PAEA core competencies

Patient-Centered Practice Knowledge

Society and Population Health

Health Literacy and Communication

Interprofessional Collabative Practice and Leadership

Professional And Legal Aspects of Healthcare

Health Care Finance and Systems

What are the DeSales PA Program Competencies

Knowledge for Practice

Interpersonal and Communication Skills

Person-centered Care

Interprofessional Collaboration

Professionalism and Ethics