Exploring Physician Assistant Entrustable Professional Activities, Integration, and Role Satisfaction Within Academic Hospitals in Hamilton, Ontario, Canada.

Exploring EPA-PA Integration, and Role Satisfaction Within An Ontario Academic Hospitals

Authors

  • Juliana Wadie Michael G. DeGroote School of Medicine, Faculty of Health Sciences
  • Kristen Burrows, PhD MSc BSc BHSc(PA) CCPA Michael G. DeGroote School of Medicine, Faculty of Health Sciences

DOI:

https://doi.org/10.5203/jcanpa.v4i9.932

Keywords:

academic teaching, PA role integration, PA satisfaction, EPA, Entrustable Professional Activity, CanMEDS-PA

Abstract

Physician Assistants (PAs) have been integrated across academic teaching hospitals in Hamilton since 2010.  A survey was administered to practicing PAs at Hamilton Health Sciences Centre (HHSC) or St. Joseph’s Healthcare (SJH) to explore PA role integration and PA satisfaction in working at an academic hospital. The 22 PA respondents reported a considerable amount of autonomy of 76% (with 100% being full autonomy). The PAs felt their respective training programs prepared them for the workforce. It is evident that PAs integrate well into the healthcare system; many are mentoring medical students, and all have excellent relationships with their supervising physician(s) and co-workers. However, many PAs expressed feelings of burnout, lack of compensation, and paucity of PA mentorship. Areas of improvement include increasing PA mentorship, recruiting more PAs, and integrating more specialized clinical experience into PA programs.

Author Biographies

Juliana Wadie, Michael G. DeGroote School of Medicine, Faculty of Health Sciences

Ms. Juliana Wadie is a Physician Assistant student in the Physician Assistant Education Program (PAEP)

at the Michael G. DeGroote School of Medicine, Faculty of Health Sciences.

Kristen Burrows, PhD MSc BSc BHSc(PA) CCPA , Michael G. DeGroote School of Medicine, Faculty of Health Sciences

PA Kristen Burrows (Ph.D.) is the Assistant Dean, Physician Assistant Education Program (PAEP) and
Assistant Professor, Department of Medicine at Michael G. DeGroote School of Medicine, Faculty of Health Sciences. She is an author of several articles related to the Canadian Physician Assistant workforce and other health workforce issues.

References

Hooker, R. S., & Everett, C. M. (2012). The contributions of physician assistants in primary care systems. Health & Social Care in the Community, 20(1), 20–31. https://doi.org/10.1111/j.1365-2524.2011.01021.x

Burrows, K. E., Abelson, J., Miller, P. A., Levine, M., & Vanstone, M. (2020a). Understanding health professional role integration in complex adaptive systems: A multiple-case study of physician assistants in Ontario, Canada. BMC Health Services Research, 20, 365. https://doi.org/10.1186/s12913-020-05087-8

CAPA. PA Facts. (n.d.). Retrieved October 8, 2022, from https://capa-acam.ca/about-pas/pa-fact-sheet/

Jones, I. W., & St-Pierre, N. (2014). Physician assistants in Canada. JAAPA, 27(3), 11–13. https://doi.org/10.1097/01.JAA.0000443808.97164.cb

Hooker, R. S., Kulo, V., Kayingo, G., Jun, H.-J., & Cawley, J. F. (2022). Forecasting the physician assistant/associate workforce: 2020–2035. Future Healthcare Journal, 9(1), 57–63. https://doi.org/10.7861/fhj.2021-0193

The College of Family Physicians of Canada. (n.d). Family Physicians’ Response to the COVID-19 Pandemic. Retrieved October 21, 2022, from https://www.cfpc.ca/en/family-physicians-response-to-the-covid-19-pandemic

Fréchette, D., & Shrichand, A. (2016). Insights into the physician assistant profession in Canada. JAAPA, 29(7), 35–39. https://doi.org/10.1097/01.JAA.0000484302.35696.cd

Cawley, J. F. (2012). Physician Assistants and Their Role in Primary Care. AMA Journal of Ethics, 14(5), 411–414. https://doi.org/10.1001/virtualmentor.2012.14.5.pfor2-1205

Kidd, V. D., Amin, A., Bhatia, N., Healey, D., Fisher, C., Rafiq, M., E. Gallegos, M. J. A., & Munoz, K. (2023). Optimal Use of Advanced Practice Providers at an Academic Medical Center: A First-Year Retrospective Review. https://doi.org/10.7759/cureus.34475

Timmermans, M. J. C., van Vught, A. J. A. H., Peters, Y. A. S., Meermans, G., Peute, J. G. M., Postma, C. T., Smit, P. C., Verdaasdonk, E., de Vries Reilingh, T. S., Wensing, M., & Laurant, M. G. H. (2017). The impact of the implementation of physician assistants in inpatient care: A multicenter matched-controlled study. PloS One, 12(8), e0178212. https://doi.org/10.1371/journal.pone.0178212

Jones, I. W., Burrows, K., Nickell, L., Millham, A. (2021). EPA-PA Competency Framework 2021. CAPA. Retrieved October 8, 2022, from https://capa-acam.ca/about-pas/epa-pa/

CAPA. (2015). CAPA - ACAM CanMEDS-PA. (2015). Retrieved October 8, 2022, from https://capa-acam.ca/about-pas/epa-pa/canmeds-pa-2/

Halasy, M. P., West, C. P., Shanafelt, T., O’Laughlin, D. J., Satele, D., & Dyrbye, L. N. (2021). PA job satisfaction and career plans. JAAPA, 34(6), 1–12. https://doi.org/10.1097/01.JAA.0000750968.07814.d0

Marincic, P. Z., & Ludwig, D. B. (2011). Physician assistant self-assessment of entry-level competency: A comparison with observations of supervising physicians. The Journal of Physician Assistant Education: The Official Journal of the Physician Assistant Education Association, 22(4), 23–33. https://doi.org/10.1097/01367895-201122040-00004

American Psychology Association. (n.d). Integrated Health Care. Retrieved September 10, 2022 from https://www.apa.org/health/integrated-health-care

Goodwin, N. (2016). Understanding Integrated Care. International Journal of Integrated Care, 16(4), 6. https://doi.org/10.5334/ijic.2530

Lyngsø, A. M., Godtfredsen, N. S., Høst, D., & Frølich, A. (2014). Instruments to assess integrated care: A systematic review. International Journal of Integrated Care, 14, e027.

Gillies, R. R., Shortell, S. M., Anderson, D. A., Mitchell, J. B., & Morgan, K. L. (1993). Conceptualizing and measuring integration: Findings from the health systems integration study. Hospital & Health Services Administration, 38(4), 467.

Burgess, A., van Diggele, C., & Mellis, C. (2018). Mentorship in the health professions: A review. The Clinical Teacher, 15(3), 197–202. https://doi.org/10.1111/tct.12756

Bernard, K. S. (2023). Well-being and the early-career PA: Influence of the collaborative physician relationship. JAAPA, 36(2), 35. https://doi.org/10.1097/01.JAA.0000911228.85787.82

Lee, B., D’Souza, M., Singman, E. L., Wang, J., Woreta, F. A., Boland, M. V., & Srikumaran, D. (2018). Integration of a Physician Assistant Into an Ophthalmology Consult Service in an Academic Setting. American Journal of Ophthalmology, 190, 125–133. https://doi.org/10.1016/j.ajo.2018.03.033

Sherer, E. L., & Allegrante, J. P. (2019). Physician Assistant Students’ Perceptions of Cultural Competence in Providing Care to Diverse Populations. The Journal of Physician Assistant Education: The Official Journal of the Physician Assistant Education Association, 30(3), 135–142. https://doi.org/10.1097/JPA.0000000000000260

Malone, R. (2022). The role of the physician associate: An overview. Irish Journal of Medical Science (1971 -), 191(3), 1277–1283. https://doi.org/10.1007/s11845-021-02661-9

DePalma, S. M., Alexander, J. L., & Matthews, E. P. (2019). Job Satisfaction Among Physician Assistants Practicing Cardiovascular Medicine in the United States. The Health Care Manager, 38(1), 11–23. https://doi.org/10.1097/HCM.0000000000000244

Burrows, K. E., Abelson, J., Miller, P. A., Levine, M., & Vanstone, M. (2020b). Professional, Practical and Political Opportunities: Optimizing the Role of Ontario Physician Assistants in Family Medicine: Optimizing the Role of Ontario PAs in Family Medicine. The Journal of Canada’s Physician Assistants, 1(4), Article 4. https://doi.org/10.5203/jcanpa.v1i4.855

Garcia, C. de L., de Abreu, L. C., Ramos, J. L. S., de Castro, C. F. D., Smiderle, F. R. N., dos Santos, J. A., & Bezerra, I. M. P. (2019). Influence of Burnout on Patient Safety: Systematic Review and Meta-Analysis. Medicina, 55(9), 553. https://doi.org/10.3390/medicina55090553

Coplan, B., McCall, T. C., Smith, N., Gellert, V. L., & Essary, A. C. (2018). Burnout, job satisfaction, and stress levels of PAs. JAAPA, 31(9), 42. https://doi.org/10.1097/01.JAA.0000544305.38577.84

Drummond, D., Sinclair, D., Gratton, J. (2022). Troubles in Canada’s Health Workforce: The Why, the Where, and the Way Out of Shortages. C.D Howe Institute, (630), 1-44.

Downloads

Published

2023-07-29 — Updated on 2023-07-31

Versions

How to Cite

Wadie, J. ., & Burrows, K. (2023). Exploring Physician Assistant Entrustable Professional Activities, Integration, and Role Satisfaction Within Academic Hospitals in Hamilton, Ontario, Canada.: Exploring EPA-PA Integration, and Role Satisfaction Within An Ontario Academic Hospitals. The Journal of Canada’s Physician Assistants, 4(9), 20–32. https://doi.org/10.5203/jcanpa.v4i9.932 (Original work published July 29, 2023)