NCCPA examines change in PANCE

[HLReed]

 

 

Very "eat your young" attitude....how very nursing. :O_O: The good ole days syndrome at its finest.

 

 

What is with all the doom an gloom on this board. It's one of the reasons I stopped posting. Seriously, if you don't like your job.....quit it and find another. I will enjoy being a PA and I will take the good with the bad (I know there is some bad). Lighten up folks.

 

Yup.

Here are some happier places to spend your time, if you are interested:

 

http://community.advanceweb.com/blogs/nppa_7/default.aspx

http://www.pastudentessentials.com

http://harrisonreedpa.wordpress.com

 

Good luck!

[EMEDPA]

All PAs school have rigorous didactic education and testing. The whole PANCE is a not necessary as those who are weak will be properly weeded out by programs due to Hugh ARCPA standards.

you're kidding, right?

[LT_Oneal_PAC]

you're kidding, right?

 

Yeah, I was being satirical.

[nhpilot]

A practical segment should also be required for the PANRE.

[mbalaban]

Where do I start.:;;D:

 

Let's start here.

http://www.paeaonline.org/index.php?ht=a/GetDocumentAction/i/61849

"The typical entering student was described as a white/non-Hispanic female over 27 years of age, with a grade point average of 3.30 and 48 months of health care experience prior to admission."

48 months of experience on average. That is about 8000 hours on a 40 hr/wk schedule.

 

Compare that to this : http://www.paeaonline.org/index.php?ht=a/GetDocumentAction/i/149930

Where the average HCE has now diminished to around 3300 hours. Or nearly 1/3. And that's in the last 20 years.

 

This seems to contradict your statement that experience standards have not changed much. Another anecdotal verification would be the entering age being lower.

 

You made the statement that the certification exam would not make you a better clinician, which implies that this exam is somehow there to "teach" you something. I was simply stating that the exam is just to establish a standard.

 

Maybe it isn't about just generating money. Maybe it's also about establishing a baseline competency for the graduates (since the amount of experience they have is tremendously lower than in the past)

 

@taotaox1: How else would you interpret the phrases of "we already have to take these type of tests in school". If you've been tested on it once, at school, why not do it for certification? Money? Please, the worst I've heard on this board is 2k. spend 2k to make 90k? Compare that to EMT's, their CBT and practicals are around 500 and on average around here they might make 20k.

Want cost/benefit/value analysis? Ok, how about this? 2% of one years' salary to get certified. That's peanuts. But that's just 1 year. That one test is good for 10 years. So in essence you are spending 2k to be able to earn 900k (we'll keep the pay at 90k/yr, without any pay increases). So now let's see, 0.2% of salary to be certified? How is that not cost efficient or valuable?

 

And your point about it being a part of school and it's regulations etc. If there is such oversight on the programs then why is there a certification exam in the first place? Whether it's the CBT or hands on. By your argument, everyone that passes school should be automatically granted certification because the ARC has such oversight. If there was such great oversight and "fixing problems before they develop" then why is there not a 100% initial pass rate on the PANCE? Your argument is fundamentally flawed. This is not a personal attack, but an attempt to show the flaws in your logic and thinking based on these statements.

 

 

[Will352ns]

Huh? Reread your data....stick with charts, they are easier to read. I will give you a hint.....page 39 Figure 17.

 

You are really reading into everything I say....agree to disagree because again, I don't know where to start. Have a nice evening.

[taotaox1]

It is reasonable to be of the opinion that a certification exam of base knowledge is a good way of assessing that knowledge, while believing that physical exam skills are a poor choice for this kind of testing and are better handled within the programs themselves. You may disagree, but to imply that it must be all or nothing. (AKA, why have the PANCE at all?) is a false dichotomy that does not exist.

[mbalaban]

Huh? Reread your data....stick with charts, they are easier to read. I will give you a hint.....page 39 Figure 17.

 

You are really reading into everything I say....agree to disagree because again, I don't know where to start. Have a nice evening.

 

Read the note: Note: 2010-2011 CASPA Matriculant Average Health Care Experience (self-reported). Health care experience hours include patient contact experience, other work experience, other health care experience, community service, health care shadowing, and research. Previously, health care experience hours included direct patient care, community service, health-related experience, and observation/ shadowing. The change in the classification of health care experience hours was the likely cause of the jump in total hours in 2010-2011.

in 2010 and 2011 they changed their reporting standards and styles. The "experience" takes into account many other things other than direct patient care experience. Even so, look at 2010 and 1991. In 2010 the hours are 1/2 of the total. Look at your chart. The trend has been decreasing since the 90's, and drastically I might add.

 

@tao, you implied and stated how in such a black and white way, the ARC has such oversight and control over programs that assessing someone's physical skills is not needed because the schools have such over sight. Well, in keeping with your black and white theme, if there is such oversight and control, then why does there need to be any certification exams at all? Why does anyone need to take even the CBT section of the exam? You've had so many tests on psych, ob, anatomy, etc.

Why is it a false dichotomy to use your argument against testing to say why test for this other item (cognitive skills)? Heck you have 2 degrees at this point, you surely must know what you need to know.

 

 

[EMEDPA]

I know there have been folks in the past who have gotten into PA school and done well with minimal experience.

to say that the avg hrs of experience has remained constant however is untrue on several fronts.

the definition of what constitutes "experience" has changed. it used to be that cna type positions for example were not eligible for pa school. now this and things like "scribing" are a typical pathway. in my class of 80 students in the early 90's the LEAST experience member of the class had been an emt basic for 5 years. most of my classmates were nurses(rn or lpn), medics(military or civilian), and RT's.

I decided to pursue a PA path in the late 80's. I had been an er tech for several years at that point and when I inquired was told that most programs would not even consider me with that background so pursued paramedic school and worked as a medic for 5 years before becoming a pa. at this point I already had a bs degree and was one of the few members of my class to have one. at that time there were 52 pa programs in the country and only 2-3 offered an ms. I got bs #2 from pa school.

things have changed dramatically since the gradual conversion to mostly ms level programs. I don't know if anyone has kept track of the avg age of applicants but I would guess it is significantly younger now than it used to be. the avg age in my class was 35 for example. I was a youngin at 27. don't take these comments to mean I have a problem with young applicants. I don't. I have a problem with inexperience. 24 years old with a bs degree and 2 years as a paramedic? bring it on. 22 yrs old with a 4.0 biochem degree, 2 publications and 200 hrs as a candy stripper? go to medschool.

[rcdavis]

I know there have been folks in the past who have gotten into PA school and done well with minimal experience.

to say that the avg hrs of experience has remained constant however is untrue on several fronts.

the definition of what constitutes "experience" has changed. it used to be that cna type positions for example were not eligible for pa school. now this and things like "scribing" are a typical pathway. in my class of 80 students in the early 90's the LEAST experience member of the class had been an emt basic for 5 years. most of my classmates were nurses(rn or lpn), medics(military or civilian), and RT's.

I decided to pursue a PA path in the late 80's. I had been an er tech for several years at that point and when I inquired was told that most programs would not even consider me with that background so pursued paramedic school and worked as a medic for 5 years before becoming a pa. at this point I already had a bs degree and was one of the few members of my class to have one. at that time there were 52 pa programs in the country and only 2-3 offered an ms. I got bs #2 from pa school.

things have changed dramatically since the gradual conversion to mostly ms level programs. I don't know if anyone has kept track of the avg age of applicants but I would guess it is significantly younger now than it used to be. the avg age in my class was 35 for example. I was a youngin at 27. don't take these comments to mean I have a problem with young applicants. I don't. I have a problem with inexperience. 24 years old with a bs degree and 2 years as a paramedic? bring it on. 22 yrs old with a 4.0 biochem degree, 2 publications and 200 hrs as a candy stripper? go to medschool.

 

Agree wholeheartedly.

Having been around at the beginning, I cannot think of a program from middle 60s through late 70s which did not require, at the foremost, significant PRE Ed medical experience.

I'm sure you all know of some, but I don't. Not any programs worth taking about ( and there were very few back then, believe me)

[CAdamsPAC]

It's my observation that "Clinical Medicine" is dying out there..........ordering tests/studies and consults seem to be the sad truth about how "medicine" is practiced now days. The laying on of hands and using hx, exam SUPPORTED by studies is fading away......IMHO. So the current computer guess game reflects the cut and paste of "Laboratory Medicine" that is happening out there. Twenty six years have passed and counting down until I hang up my "C" . Good luck younglings, the grey haired guys and gals are tiring of the circus and are leaving the arena.....

[CAdamsPAC]

Tell me about how hot the water is AFTER you have actually been in it.........OK?

[Guest]

My school requires OSCES... is that not the norm?

[generalfluff]

I'm not too sure what the problem is with some of the posters here, who seem to imagine that their old PANCE and their PA training is far too superior to what the current PA students do today, that a clinical skills exam has to be warranted at the test, because our competency is sure to be poor.

 

Understand that in the decades since you graduated, the information students have to learn has multiplied, and the competition you face to even get an interview for PA school is so fierce, that a 3-8% acceptance rate is normal. Heck, a lot of us even have clinical skills already from the HCE we obtain before PA school. For the ones that were more academic, well they're the students who help at didactics, the experienced folks help at clinicals.

 

The demographics of PA students are changing for sure, but with the growing need for healthcare, the profession has to grow and we need every (competent) hand we can get. I haven't seen any evidence of declining clinical skills, or quality of care in PAs, and schools have to make sure we have clinical skills before they even let us loose on rotations. Adding this testing is just redundant.

[Davo]

I'm up in the air because my program made us do just that before we graduated

 

I had to do it last year before I graduated, and I think its a good thing.

We should be trained in a similar manner as physicians, but thats not the most compelling reason to do this.

Its also about transparency, and a selling point for PA's.

[cinntsp]

C3.04 The program must conduct and document a summative evaluation of each student within

the final four months of the program to verify that each student is prepared to enter clinical

practice.

 

 

ANNOTATION: Evaluation products designed primarily for individual student selfassessment, such as PACKRAT are not to be used by programs to fulfill the summative

evaluation of students within the final four months of the program. The ARC-PA expects

that a program demonstrating compliance with the Standards will incorporate evaluation

instrument/s that correlates with the didactic and clinical components of the program’s

curriculum and that measures if the learner has the knowledge, interpersonal skills, patient

care skills and professionalism required to enter clinical practice.

 

While that is left somewhat open to interpretation, one would hope the school is doing this sufficiently between accreditation reviews.

 

http://arc-pa.org/documents/Standards4theditionwithclarifyingchanges12.2012fnl.pdf

[Corpsman2PA]

I find that hard to believe seeing as the profession started with corpsmen and such that were getting out of the service (4 or more years of service) and giving them a chance to continue their career, so you are looking at 8k hours vs current 250 hrs.

 

Yes, you're right it did start with Corpsmen. Ken Ferrell was 21 at the time of his selection into PA school, with just barely 2 years of experience. Dick Scheele did 4 years as a surg tech (pt contact?) then was a pharmacy rep (yikes) for a little bit...Vic Germino was a research tech, and part time OR tech. So, to say that the pioneers of the profession had "The extensive HCE and appropriate age" that everyone brags about is misguided. The eldest of them was 26 or 27 at time of admission I believe.

 

With that being said, I'm a proponent of getting the HCE side of the fence. But I will say we need to re-evaluate our reasons, and not just pipe off with "The profession starting with salty-dog corpsmen with thousands upon thousands of hours of experience, and that's the way it should be." Let us be thankful these gentlemen didn't go to med school. I do believe prior HCE plays into how we are perceived with others in healthcare, which raises (or diminishes) our clout. Okay, end diatribe.

[SocialMedicine]

I do not think a physical and oral exam is out of the questions. ESPECIALLY since an enormous number of PA Programs with questionable intention and capacity to educate are being produced. Look at some of these schools in the middle of nowhere , how will they provide a comprehensive clinical education to students ? How will they recruit quality faculty. Medical and PA schools in NYC have a hard enough time .... and they can offer faculty status and privilege to those who precept.

[generalfluff]

I do not think a physical and oral exam is out of the questions. ESPECIALLY since an enormous number of PA Programs with questionable intention and capacity to educate are being produced. Look at some of these schools in the middle of nowhere , how will they provide a comprehensive clinical education to students ? How will they recruit quality faculty. Medical and PA schools in NYC have a hard enough time .... and they can offer faculty status and privilege to those who precept.

 

There are much bigger problems if such programs even continue to exist. The regulatory bodies have obviously failed at their task if such programs persist. In most schools, these basic clinical skills are tested before a student can even go out to the clinical portion of the program. In mine, we have to demonstrate these skills at the first half of our didactic year. I'd be extremely worried if a program can't even assure competence at basic skills. How can they expect these students the more complex portions of clinical practice, like decision making?

 

If there are any, they are far and few in between, and can either revise their broken curriculum, or be closed. In general though, the training most PA programs provide eliminate the need for such redundant, additional testing.

[Joane Bergen]

I thinks that this aspect of the exam should be brought back. When I graduated from PA school, we had this as part of the evaluation. Can only inhance the certification process. I am all for this addition for the PANCE. Joanne

[primadonna22274]

Just be prepared for a HUGE increase in certification fees. IMO there is no way to do this for less than an additional $500/ applicant. My COMLEX level 2-PE is $1200 for an all-day mandatory exam, 14 standardized patient encounters, only offered in Philadelphia. I couldn't get a date before January and I scheduled in June. So yay, I get to travel to frigid PA in January. And EVERY DO student in the US has to go there no matter where they train. At least I would hope the NCCPA would see fit to arrange several testing centers nationwide so folks can minimize travel and lodging expenses.

[PACProvider]

It never fails to surprise me how frequently arguments or debates erupt on this forum in the comparison of PAs to Medical Students. There remains this undisputed fiction that if the PA profession models its education in mirror fashion to that of undergraduate medical education, PAs will enjoy some unexplained advantage. I have to remind the curious reader that Nurse Practitioners are eating away at our future practice space and gaining more competitive advantage. They (NPs) do this with inferior training. So, I beg you to stop the internal wars and aim your guns where they should be targeted. On the groups who seek to do professional harm to PAs. Focus gentlemen. Focus.

[Will352ns]

It never fails to surprise me how frequently arguments or debates erupt on this forum in the comparison of PAs to Medical Students. There remains this undisputed fiction that if the PA profession models its education in mirror fashion to that of undergraduate medical education, PAs will enjoy some unexplained advantage. I have to remind the curious reader that Nurse Practitioners are eating away at our future practice space and gaining more competitive advantage. They (NPs) do this with inferior training. So, I beg you to stop the internal wars and aim your guns where they should be targeted. On the groups who seek to do professional harm to PAs. Focus gentlemen. Focus.

 

Bravo.....well said. Stop being our own worst enemy.

[Davo]

It never fails to surprise me how frequently arguments or debates erupt on this forum in the comparison of PAs to Medical Students. There remains this undisputed fiction that if the PA profession models its education in mirror fashion to that of undergraduate medical education, PAs will enjoy some unexplained advantage. I have to remind the curious reader that Nurse Practitioners are eating away at our future practice space and gaining more competitive advantage. They (NPs) do this with inferior training. So, I beg you to stop the internal wars and aim your guns where they should be targeted. On the groups who seek to do professional harm to PAs. Focus gentlemen. Focus.

Fair enough-agreed.

[ventana]

It never fails to surprise me how frequently arguments or debates erupt on this forum in the comparison of PAs to Medical Students. There remains this undisputed fiction that if the PA profession models its education in mirror fashion to that of undergraduate medical education, PAs will enjoy some unexplained advantage. I have to remind the curious reader that Nurse Practitioners are eating away at our future practice space and gaining more competitive advantage. They (NPs) do this with inferior training. So, I beg you to stop the internal wars and aim your guns where they should be targeted. On the groups who seek to do professional harm to PAs. Focus gentlemen. Focus.

 

 

BINGO We have winner....

 

now where is AAPA on this????