Academic Program Review
of the
Physician Assistant Studies Program
College of Science and Allied Health (SAH)
April 20, 2004
The Physician Assistant Studies Program submitted its Academic Program Review self
study report in the fall semester of 2003. The Academic Program Review (APR) Committee
studied that report and on March 31, 2004, members of the APR Committee met with
representatives from the Health Professions Department. This provided the Department with an
opportunity to answer some questions and bring the Department's programs into focus for the
Committee.
The University of Wisconsin-La Crosse, in partnership with the Gundersen Lutheran
Medical Foundation of La Crosse and the Mayo School of Health Science of Rochester,
Minnesota, established this physician assistant educational program in 1995, as an undergraduate
program. The program's initial Bachelor of Science program has enrolled eight classes that have
completed courses at the University of Wisconsin-La Crosse, at Gundersen Lutheran (in La
Crosse), and at the Mayo School of Health Sciences (in Rochester, Minnesota). Originally the
goal of the program was to train physician assistants to deliver prima..ryhealth care in rural
settings. In the past five years it was determined that the need for persons to work in the rural
setting declined. At the same time, it was found that our students do very well wherever they go.
This brought about a broadening of vision that is very compatible with the transition to a
graduate program. In August of 2002, the program finalized a transition to the graduate level
under entitlement from the University of Wisconsin System. A curriculum for the Master of
Science degree in Physician Assistant Studies was approved by both UW-L faculty governance
and by the UW Board of Regents. The program will admit its first graduate students' in June
2004. Students completing the program will receive the Master of Science degree in Physician
Assistant Studies.
The Physician Assistant Studies Program is housed within the Department of Health
Professions in the College of Science and Allied Health (SAH) and is accredited with the
Accreditation Review Commission on Education for the Physician Assistant, Inc. (ARC-PA).
Mark Zellmer currently acts as the Program Director for Physician Assistant Studies Program,
and Gwyneth Straker is the Chair of the Department of Health Professions.
SUMMARY OF THE SELF-STUDY:
1. Program Goals (note that this mission statement and goals appropriately are those resulting
from revisions in early 2003)
The program's mission is as follows:
. Operate cooperatively with Mayo School of Health Sciences and Gundersen Lutheran
Medical Foundation to educate highly competent and compassionate physician assistants
who excel in meeting the healthcare needs of the regions served by the partner
institutions.
. Continue to be a nationally recognized program by identifying for admission individuals
with the prerequisite academic background, interpersonal skills, and maturity necessary
for PA education, who have a strong career interest in primary care
. Continue to be a nationally recognized program by educating these individuals to excel in
improving the health and wellness of patients through the supervised practice of medicine
. Continue to be a nationally recognized program by developing students who are
grounded in professional ethics and cultural sensitivity with research skills to improve
patient care.
The Program has identified the following set of five measurable parameters to measure
its success objectively:
. At least 90% of matriculated students will successfully complete and graduate from the
program.
. At least 80% of graduates will pass the NCCPA examination when they first take the
exam.
. At least 80% of graduates will be employed in WI, MN, and IA.
At least 80% of graduates will rate their preparation as good to excellent across the
spectrum of clinical practice tasks.
. At least 80% of graduates supervising physicians will rate their PAs preparation as good
to excellent across the spectrum of clinical practice tasks
(Given the class size of 12, evaluation of these programs will be based on three year averages
rather than individual class averages.)
.
The program's mission fits perfectly with the mission of the Department of Health
Professions at the University of Wisconsin - La Crosse. It also fits well philosophically with all
the other departments of the College of Science and Allied Health. In particular the emphasis on
research as a lifelong pursuit to be developed in students through their program of study at the
UniversitYis
"'"' exactlv in line with the rest of the Colle2e.
~
It is to be mentioned here that the Physician Assistant Program is funded through a
tuition surcharge of 20% for students in the program. Thus the program does not take funds away
from other departments in the college. In fact, the unique tri-institutional partnership that is
carefully maintained by the Department enhances the perceived quality of the whole College and
in that way improves our ability to attract good students to all our programs at every level.
Generally the faculty in the College are very supportive of the PA program, although this has not
always been the case.
2. Overview of Program Success and Strengths
At the graduate level the PA program selects students with a strong, well-rounded
undergraduate preparation in the both the sciences and humanities whose understanding of
healthcare system and the PArole is made more complete by their previous healthcare
experience. Within the program the curriculum is also complete and well-rounded with the
inclusion of basic, behavioral, and clinical sciences as well as a full-year of clinical rotations in
which this knowledge must be applied to the care of patients. The program must meet the
comprehensive curricular and administrative requirements of professional program accreditation
standards.
The PA program has utilized the identified academic planning strategies in developing
the MS PAS curriculum, which will include courses that build clinical critical thinking skills, and
use problem based learning pedagogy in the Preclinical year. The program's Capstone Seminar
series involves a critical review of the medical literature related to a clinical topic that culminates
in a formal written paper and oral presentation of the findings. With PAs working with
physician supervision as part of the multi-disciplinary healthcare team, our curriculum
emphasizes the principles of teamwork and communication in the complex healthcare system.
The PA profession expects life-long learning with a certification process that requires ongoing
continuing education and recertification by examination every six years. Thus, graduates are
prepared to participate in the profession's continuing education process for life-long learning.
The most significa..l1tstrength, as identified by the PA program, is the overall
effectiveness of the program and its curriculum, as demonstrated by:
. 100% of students enrolled in the most recent 6 classes either have graduated or are on a
pathway to graduation.
. Graduates and their supervising physicians consistently rated the program's preparation
for clinical tasks favorably
. The program outcomes measures regarding graduation, PANCE pass rate, primary care,
and rural/underserved practice established 8 years ago have been met.
. All graduateshave passed the PANCE exam with favorable program mean scores.
The program also specifically identifies the following strengths:
. The program's sponsorship by three strong, well-known institutions that provide students
access to a rich and diverse resource of clinical and instructional expertise for both the
didactic and clinical curricula.
. With construction and renovations completed since the last (1999) accreditation site visit,
the program now has excellent facilities including classrooms, labs, and offices on the
campuses of all three of the program's sponsoring institutions. The dedicated physical
exam lab in the Health Science Center represents one of the most significant
improvements.
. The program has been very fortunate to have had excellent continuity of the core faculty
with a low turnover rate. This stability has contributed to the program's achievement of
its outcome goals and has allowed the program to develop and eventually implement the
proposed transition to the graduate degree.
The ARC-PA Self-study report (June 2003, page 28-29) had also identified a number of areas for
needed improvement as described below.
The most significant among these is the
implementation of the graduate level program with a number of curricular changes designed to
increase the efficiency of the program's curriculum and make that curriculum more flexible in
building skills for practice in both primary care and tertiary care settings.
The plans to address the areas of concern identified in the ARC-PA Self-study Report are
ongoing and specifically include the following:
. Planning for implementation of the Preclinical year curriculum for the first class (Fall
2003 and Spring 2004)
. Planning for the implementation of the Clinical year curriculum for the first class
(planning to begin in Spring 2004)
. With the formation of the new Health Professions Department a new support staff has
been recruited (Fall 2003). With this staff in place, an analysis of program need and
availability of staff will be undertaken (Spring 2004). Should additional staff be needed a
proposal for additional funding for support staff will be developed as part of
implementing a Clinical Experience Special Course Fee for PA students in MS PAS
program (Spring 2004).
. With a fixed budget year-to-year for supplies and expenses while expenses critical to the
operation of the program have increased, limited financial resources have become a
concern for the program. Implementation of the Clinical Experience Special Course Fee
will provide additional financial resources to expand the available support staff FTE to
meet the accreditation standards.
PROGRAM DIRECTOR'SRESPONSES
TO THE APRSELF-STUDYREPORT
[Insert optically scanned document]
CONCLUSIONS AND RECOMMENDATION FROM THE APR COMMITTEE:
The APR Committee was impressed with the Department's thorough review provided in
its Self Study Report, and appreciate that it was submitted in a timely manner. The Department
has clearly outlined a mission and vision statement that fits within the mission of the College of
SAH and the Department of Health Sciences and includes specific points related to quality of
student recruitment/selection, student education, ethics, cultural sensitivity, and research skills.
To determine whether its goals are being met, the Pysician Assistant Program utilizes several
assessment methods and the following specific program outcome measures:
. Portion of graduates passing the Physician Assistant National Certification Examination
(PANCE) exam.
. Portion of matriculated students that graduated.
. Portion of graduates selecting primary care
. Portion of graduates selecting rural or underserved practices
Specific strengths identified by the APR Committee are as follows:
1. The program outcomes measures regarding graduation, Physician Assistant National
Certification Examination (PANCE) pass rate, primary care, and rural/underserved practice
established 8 years ago had been met. All of the issues of previous concern were found to meet
the accreditation standards during the 2003 review (with the exception of a support staff issue.)
2. High graduation rate: of the 83 students who have enrolled in the program to date, 82 have
graduated (or are on a path to graduation), giving a 98.8% success rate.
3. All graduates have passed the Physician Assistant National Certification Examination
(PANCE) on their first attempt following graduation. In fact, the mean score of our students on
that exam has generally ranked our program in the top 20% of programs nationally, and has
placed the program among the top 10% of programs in three of the past six years.
4. The unique tri-institutional nature of the program links three sibling institutions together:
Mayo Clinic, Gundersen Lutheran Health Foundation, and University of Wisconsin - La Crosse.
These three institutions each benefit from the strengths of the others.
5. The program is maintained by dedicated UWL faculty members who understand the delicate
nature of the tri-institutional partnership. UWL is the glue that holds the partnership together,
and the UWL faculty have the knowledge and wisdom to anticipate problems and solve them
while they are still below the horizon.
6. The program has faculty resources equivalent to six to eight full time equivalents through the
partnership with Mayo and Gundersen, even though UWL only needs to provide three FTE
faculty positions. The program has been very fortunate to have had excellent continuity of the
core faculty with a low turnover rate. This stability has contributed to the program's achievement
of its outcome goals and has allowed the program to develop and eventually implement the
proposed transition to the graduate degree.
7. The new Department of Health Sciences shows great promise as the ideal organizational
structure within which to house the PA Program. With construction and renovations completed
since the last (1999) accreditation visit, the program now has excellent facilities including
classrooms, labs, and offices on the campuses of all three of the program's sponsoring
institutions. The dedicated physical exam lab in the Health Science Center represents one of the
most significant improvements.
8. The accrediting agency awarded accreditation to the PA Program for a period of 6 years,
indicating great confidence in the Program's trajectory. This is to be expected since previous
concerns about such things as laboratory modernization, curricular matters, etc, have been
diligently addressed by the Program faculty. Only the top 15% of PA programs nationwide
enjoy an accreditation period of more than five years.
9. Graduates and their supervising physicians consistently rated the program's preparation for
clinical tasks favorably, and the program has the support of the SAH faculty generally.
CONCERNS:
The APR Committee notes the following areas of concern:
1. Since accreditation guidelines require a minimum of 1.0 FTE of full-time support staff to
assist the core program faculty members, there is a need for additional clerical support.
2. With the tra..'1sitionto a master's program, the program faculty will need increased funding for
professional development, maintenance of insurance and certifications, etc.
3. Due to the nature of the field, the PA Program has a special burden not encountered in other
programs that includes necessity to maintain OSHA immunization requirements, malpractice
insurance, criminal background checks and other procedural documentation.
4. A collection of curricular improvements have been identified that need to be implemented for
successful transition to the graduate level, specifically including improvements in the preclinical
year and the clinical year.
RECOMMENDATIONS:
In light of these concerns and the self-study report, the APR Committee makes the following
recommendations:
1. The PA Program should be provided a full time program assistant.
2. The PA faculty are encouraged to seek funding from various sources so that certifications and
insurances may be maintained and research skills knowledge may be kept current. Specifically,
as suggested in the self-study document, the program should work to develop a new student fee.
3. With regard to the preclinical year, the PA program should reduce the length of the basic
science curriculum, reducing redundancy while better building on students' undergraduate
prerequisite preparation.
4. With regard to the preclinical year, the PA program should work to integrate clinical
preparatorysciences,buildingcohesivecourses.
.
5. With regard to the clinical year, the PA program should work to enhance curricular flexibility
to allow more experiences in tertiary care settings.
6. With regard to the clinical year, the PA program should work to develop a schedule fonnat
that synchronizes students' experiences with other learners on the clinical services.
7. With regard to the clinical year, the PA program should work to strengthen preparation for
inpatient practice and research skills.
8. Maintain a more regular alumni newsletter, as it may be a tool for recruitment and funding
opportunities.
UNIT DATA SHEETS
(see enclosures)
IYear:
I
1. Staffing (Fan Term)
Instructional FTE(unciassified) .
Number of Full-time Faculty
Number of Tenured Faculty
Number of Graduate Faculty
Number of Support Staff (classified)
2. Instructional Workload (fallterm/iFTE)
a. NumberofCourse CredIts
Group Instruct Lower Div
Group Instruct Upper Div
Group Instruct Graduate
Group Instruct Tot
Individual Study
General Education
b. Number of Contact Hours
Group Instruct Lower Div
Group InstructUpperDiv
Group Instruct Graduate
Group.1nstructT ot
Individual Study
General Education
c. Number of Student CredtHours
UDDS: 36-3070
Unit Physician Asst Proa
Department Data For The Academic Program Review.
I
1998-1999
I
1999-2000
200Q..,2001
I
2.50
2
1
0
1
2.7!j
2
1
1.75
1
1
a
a
1
1
0.00
24.40
0.00
23:64
0.00
37.71
0.00
24;40
0.00
0.00
0.00
23.64
0.00
0.00
0.00
37.71 ,
0.00
0;00
0.00
24.40
0;00
24AO
0;00
0.00
0.00
23.09
0:00
23.09
0:00
0.00
0.00
109.20
0.00
109.20
0.00
0.00
0.00
141:82
0.00 '
141.82
0.00
0.00
2001-2002
I
1.75
1
1
0
1
2002-2003
I
2.25
2
1
0
1
0.00
0.00
37.14
0.00
37:14
0.00
0.00
33:33
0.00
33.33
0.00
0,00
0;00
36:86
0.00
0.00
0.00
34:57
0.00
34,57
0.00
0.00
0.00
40.67
0.00
40:67
0:00
0.00
0.00
202.29
0.00
202.29
0.00
0.00
0.00
243.43
0.00
243.43
0;00
, 0.00
0.00
207.11
0.00
207.11
0.00
0.00
0:00
36:86
.
'
Group Instruct LoWer Div
Group Instruct UpperDiv
Group Instruct Graduate
Group Instruct Tot
Individual Study
General Education
3. Rnancial Support (FY expenses)
a. Supply and Expenses
b. Capital Equipment Expenditures
c. Non-GPR Fuming (grants)
4. Students in Program One (fall enrollment)
a. Number of Majors(1st and 2nd total)
Freshmen
Sophomores
Juniors
Seniors
Undergraduate Majors
Undergraduate Specials
Graduate Students
b. Number of Graduates (FY)
Baccalaureate
CredIts at Time of Graduation
Masters
$71 037:20
$70.368.15
$79625:27
$7407.85
$81701.36
$8.39
$6 168.17
$6.50t..12
. $3970.99
.$66.52
0+54-54
0+34=34
0+16=16
2+10=12
2+114=116
21+2=23
0
0+52=52
0+22=22
0+20=20
2+13-15
2+107=109
23+1=24
0
0+48=48
0+31=31
0+19=19
2+19=21
2+117=119
22+2=24
0+42=42
0+37=37
0+15=15
2+15=17
2+109,..1t1
32+3=35
0+25=25
0+21=21
0+22=22
2+13-15
2+81=83
34+1=35
0
$81.417.13
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:J
(Year:
4 continued
J
1998-1999
I 1999-2000
,
2000-2001
I
2001-2002
I 2002-2003
I
Students for Program Two (fall enrollment)
a. Number of Majors(1st and 2nd total)
Freshmen
'
.
Sophomores
Juniors
Seniors
Undergraduate Majors
Undergraduate Specials
Graduate Students
b. Number of Graduates (annual)
Baccalaureate
Credits at Time of Graduation
Masters
4 continued. Students for Program Three (fall enrollment)
a. Number of Majors(1st and 2nd total)
Freshmen
Sophomores
Juniors
Seniors
Undergraduate Majors
Undergraduate Specials
Graduate Students
b. Number of Graduates (annual)
Baccalaureate
CredIts at Time of Graduation
Masters
4 continued. Students for Program Four (fall enrollment)
a. Number of Majors(1st and 2nd total)
Freshmen
Sophomores
Juniors
Seniors
Undergraduate Majors
Undergraduate Specials
Graduate Students
b. Number of Graduates (annual)
Baccalaureate
Credits at Time of Graduation
Masters
I
I