Department of Physician Assistant Education
Doisy College of Health Sciences
Saint Louis University
Physician Assistant Education
Learning Outcomes Assessment
June 9, 2014
Preamble
The Department has a primary Mission, Goals, and Objectives. The Department is the
academic home for the Program. The program is accredited by ARC-PA and the
accreditation requirements dictate the essential assessment philosophy that is coincident
with the department activity within the Doisy College and the University.
Mission
The primary mission of the Saint Louis University Physician Assistant (PA) Program is
to educate men and women to become competent, compassionate physician Assistants
dedicated to excellence in healthcare and the service of humanity.
PAs are educated according to the allopathic medical model in a manner that
complements the education of the physician. This similarity of instruction and training
enhances the working relationship between the PA and the physician.
Philosophy
The program's general educational philosophy was founded on the premise that
experiential learning is the most effective form of learning, and that it can be best
achieved within an environment which:




encourages the participation of the "whole person" in the learning process;
promotes self-initiated discovery;
influences the learner's behavior and attitudes and has meaning for the learner;
and
allows the learner to assess the acquisition of new knowledge, skills and attitudes
that occur with effective learning.
This philosophy of education serves as the foundation of the program's goals and
objectives, and in defining the entry-level competencies expected of the graduate
physician assistant.
1. Program Learning Outcomes
Students of the Physician Assistant Education Program are expected to have a
professional fund of knowledge, a prescribed set of professional skills, and a demeanor
consisting of appropriate professional attitudes and behaviors.
The competency-based curriculum provides the entry-level graduate with the
fundamental knowledge, skills and attitudes necessary to function in a variety of roles
within numerous clinical disciplines. The program seeks to produce graduates who are
competent in the following areas:
Knowledge
The PA graduate should have a working knowledge of each of the following:










the clinical preparatory and pre-clinical sciences to include the applied behavioral
sciences;
the range of expected norms in patients of all ages;
the signs and symptoms of disease and their relationship to one another;
pathophysiology sufficient to identify deviations from the expected norms in
patients of all ages;
the norms for psychological and social behaviors and the recognition of
deviations from these expected norms;
fundamental health maintenance and patient management regimens;
the problem solving process and how it may be applied to identifying health
problems;
the technical and human resources available to the primary health care provider;
the role of the physician assistant within the health care team; and
the resources available for continued professional development.
Skills
The PA graduate should acquire the competencies and skills to:








recognize the signs and symptoms of disease, while understanding their
relationship to each other;
obtain, organize and construct a clinical assessment which accurately describes
the information available for a given patient at a given time;
develop a problem list from the clinical assessment;
apply problem-solving methods in clinical situations;
manage common health problems with physician supervision;
communicate empathetically and compassionately with patients;
communicate effectively with physicians and other members of the health care
team; and
competently perform technical procedures.
Attitudes
The PA graduate should embrace and demonstrate the following:







respect for self, others and the right to privacy as well as respect for the PA
profession;
appropriate value judgments with respect to interpersonal relationships with peers,
superiors, patients and their families;
recognition of commitment and service to humanity, especially to the patient and
the patient's family;
recognition of moral, ethical and legal implications of his or her actions;
recognition of patient and provider rights and restrictions;
appreciation of cultural and value system disparities among varied populations of
all socioeconomic levels;
responsibility for maintaining continued clinical and professional competency.
2. Assessment Methods
In general, fund of Knowledge is evaluated by written and oral examination by expert
professional faculty and relevant academic scholars. Skills and Attitudes are evaluated by
practicing professionals in real and simulated clinical settings with patients. The most
important feature is Performance-Based Evaluation, i.e., the determination that students
have the required knowledge, skills, and attitudes by actually observing them
demonstrate with real patients in the clinical setting that they have learned and
understood the requisite knowledge and skills by having them demonstrate to
professionals that they can actually perform (i.e., do) the required actions and explain
them to both the patient and the observing faculty or preceptors.
Measures for evaluating achievement of the skills and attitudes objectives include
professional evaluation by Certified clinicians and Licensed physicians of excellent
patient care and professionalism as assessed by preceptors during practical examination
of simulated patients in the laboratory, clinical rotations, formative and summative
faculty assessments of students, a long history of outstanding scores and first-time pass
rates on the Physician Assistant National Certifying Exam (PANCE), and excellent
job placement rates.
The curriculum has two super partitions, didactic and clinical. It is divided into three
Phases that roughly break down into Courses, Modules, and Clinical Rotations but there
is considerable integration among these.
A. Courses
These include the Basic Sciences fundamental to Clinical medicine such as
Physiology, Anatomy, Pharmacology, Hematology, Laboratory Science, etc.
B. Modules
These include essentially the organ systems of the human body such as
Cardiovascular System, Pulmonary System, Gastro-Intestinal System,
Nervous System, Renal System, etc.
C. Clinical Rotations
These are the classical clinical services of Allopathic Medicine such as Family
Medicine, Pediatrics, Surgery, Women’s Health (OB/GYN) , Psychiatry,
Internal Medicine, etc.
It is not practical, nor even prudent, to attempt to assess all aspects of the program every
year. As the University is entering into a Departmental review system that is expected to
rotate through the entire University on approximately a five year cycle we propose to
follow a similar cycle assessing the Student Learning Outcomes of the Program on a
somewhat analogous cycle that will take approximately five-seven years to complete. So
on average we will assess outcomes of one course, one module, and one clinical rotation
each year. In the Fall Semester we have three classes in session simultaneously. The
newest class is taking basic science courses; the second is in Modules, and the graduating
class is on clinical rotations. Thus we can distribute the load by assessing a course in the
Fall Semester, a Module in the Spring Semester, and a Clinical Practicum in the Summer
Semester. This is an overall focus, as there will have to be some slippage in this scheme
because Clinical Rotations and Modules run for an entire year and some courses run more
than one semester or in different semesters but this supplies a general architecture for the
assessment process. Further there are streamers than run throughout the curriculum
somewhat independent of Phases such as the Objective Structured Clinical Examination
(OSCE). In these exercises students are evaluated interacting with a patient where all
aspects of knowledge, skills, and attitudes are evaluated simultaneously. The interaction
with the patient includes taking a history, performing physical examination, ordering
laboratory testing, interpreting findings, reaching a diagnosis, and prescribing treatment
according to the medical model. Experts who make professional evaluation observe these
patient-encounters, and following the encounter written evaluation occurs where depth
and breadth of pertinent knowledge is evaluated to ensure that cognitive knowledge
assembly is appropriate and accurate. When these aspects are effectively integrated the
correct diagnosis is reached and the appropriate treatment is prescribed. As the students
progress through the curriculum these OSCE evaluations become increasingly difficult
and progressively more stringent in the rigor of evaluation. These evaluations will be the
primary measure of outcomes although performance on course evaluations (classical
tests) will also be considered, and the reports from preceptors on clinical rotations and the
performance on post rotation testing will also be factored into the assessment along with
Patient Presentations made at Grand Rounds. The Capstone Assessment occurs when
students have been graduated and the national certification examination (PANCE) is
passed.
3. Assessment Results
The SLU PA Program remains successful in attaining its objectives related to the
education of PA students, including the following:


The program seeks to produce graduates who are competent in the knowledge
required of a PA program graduate;
The program seeks to produce graduates who are competent in the skills and
abilities necessary for practice as a PA;


The program seeks to produce graduates who are competent in the attitudes and
behaviors imperative for the PA profession.
The program seeks to produce graduates who become certified (PA-C) by the
national certification agency and who may obtain a license to practice in any
State.
4. Use of Assessment Data
Assessment Data includes results of student evaluation. The goal of the
competency based curriculum is that every student succeeds in the
curriculum, successfully completes and passes the certifying national
PANCE becoming a PA-C, obtains a State License to practice, and if desired
obtains appropriate employment. Most often the program is completely
successful in meeting these objectives. The rare failures are carefully
examined to determine whether the unsatisfactory outcome was due to:
 a failure of the academic curriculum in which case the performance of
peers is also considered;
 curriculum delivery systems are evaluated; and
 criteria for admission to the program are reviewed.
In this Department, Evaluation Tools have been carefully developed and
continually revised so that they may also serve as Assessment Instruments.
The purpose of Leaning Outcome Assessment is to determine that students
actually acquire the knowledge, skills, and attitudes necessary to perform the
duties of a professional Physician Assistant. This is managed by actually
requiring students to perform those duties to the satisfaction of Faculty and
Practicing Professional mentors (Performance Based Evaluation).
When a student is unsuccessful the reason is identified and the curriculum or
the instructional modality is modified, the admissions process is adjusted to
not admit a student with similar deficits in the future, or preparation for postgraduate certifying exams and State licensing is enhanced.
The forty plus years of near perfect success of this programs demonstrates
that our Learning Outcomes Assessment loop is closed and remains under
constant observation and revision in perpetual pursuit of the unattainable
perfection in human endeavors.
Saint Louis University
Program Assessment Plan
Program: Physician Assistant, MMS
Department: Physician Assistant Education
Doisy College of Health Sciences
Person Responsible for Implementing Plan: Anne Garanzini1, M.Ed., PA-C, Chair
Date Submitted: June 15, 2014
Program Learning Outcomes
Curriculum Mapping
What do you expect all students Where is the outcome
who complete the program to
learned/assessed? (courses,
know or to be able to do?
practicums, clinical)
1
Assessment Methods
How do students demonstrate
their performance of the
program learning outcomes?
How does the program measure
student performance?
Distinguish direct & indirect
measures.
Use of Assessment Data
How does the program use
assessment results to recognize
success and “close the loop” to
inform additional program
improvement. How is this data
shared and with whom?
After establishment of the Assessment Plan another faculty member will be assigned the task of Assessment Coordinator because
Learning Outcomes Assessment should not become confused with Faculty Performance Evaluation. The executive responsible for
Faculty Evaluation should not use Learning Outcomes Assessment data relative to a particular individual for performance criteria so
that Faculty objectivity is preserved within the Student Learning Outcomes Assessment process.
Evaluate the patient using a
comprehensive history,
physical examination, and
appropriate laboratory tests.
The learning/assessment occurs
in the classroom (courses and
modules), the skills lab
(demonstration and guidance
with peers, simulated patients),
and on clinical rotations. These
settings are consistent for most
outcomes and when applicable
they are noted as (see above).
Students demonstrate
proficiency on course and
module cognitive content by
written and oral examination.
They demonstrate skills
proficiency to experts who
evaluate with rubrics for
consistency. Indirectly they
arrive at appropriate outcomes
on OSCEs in the skills lab and
with real patients on clinical
rotations. Another indirect
measure is the student
presentation of a patient at
grand rounds, evaluated by
faculty using a rubric for
consistency. This performance
evaluation is also applied to
other outcomes and may be
noted as, (See above).
Tests must be passed,
remediated, or failed. A pass is
80% (B), a grade between 60%
(D) and 80% is remediated by
supplemental evaluation, and a
failure will result in
remediation and academic
probation, where probation
allows one semester to recover
a pass and a GPA of 3.0. The
data is shared with the students
(privately), the instructor, the
faculty, the Program Director,
and the Chair. If there are
several students
underperforming then
evaluations/tests and modalities
of instruction are reviewed and
compared with the historical
record. . OSCEs and skills
proficiency evaluations are
rubric scored. These settings
are consistent for most
outcomes and when applicable
they are noted as (see above).
Interpret laboratory and
diagnostic tests.
See above
Formulate diagnosis and
appropriate treatment plan.
Educate the patient about their
medical condition.
See above
See above
Instruct the patient in healthy
See above
lifestyles.
Assist in surgery and perform
See above
such procedures as suturing,
skin tag or nail removal, and IV
line establishment.
The laboratory medicine and
hematology courses are
emphasized here and
professional judgments are
made on the appropriate use of
evidence in interpreting
laboratory tests in OSCEs and
Grand Rounds.
See above
See above
Attitudes and demeanor are
valued here in addition to
cognitive knowledge. Skill is
required to adapt the
explanation to the cognitive
capacity of the patient.
Assessment of this outcome is
difficult as it is difficult to
develop rubrics for evaluation
of this behavior. The content of
the education delivered is
handled as elsewhere. See
above
See above
See above
This relies heavily on the
performance in the surgery
course, skills demonstration in
the lab, and performance on
surgical rotations.
See above
See above
See above
Maintain life-long learning in
the medical literature and apply
evidence-based medical care to
patient management.
See above but this category has
particular demands imposed by
the Evidence Based Medicine
course and the performances of
the student at grand rounds.
Provide compassionate care in
a variety of medical settings.
See above
We can impart the skills of
See above
self-directed learning and can
evaluate them during the course
of the program. We do this in
OSCEs, Grand Rounds, and in
periodic assignments using
rubrics but we cannot ensure
the behavior after graduation.
Attitudes and demeanor are
See above
valued here in addition to
cognitive knowledge. Skill is
required to adapt the behavior
appropriately to the patient. It
is important to establish
guidelines for emotional and
professional behavior when
considering this outcome.
Assessment of this outcome is
difficult as it is difficult to
develop rubrics for evaluation
of this behavior. The content of
the education delivered is
handled as elsewhere. See
above