The PACAT. An idea whose time has come?

[EMEDPA]

Dr. Davenport brought up the concept of a PA admissions test to replace the gre in another thread.

what should be on it?

I think it should be a test to level the playing field between "academics" and high hce folks including things like basics from A+P as well as medical terminology and basic clinical questions any cna or emt basic could answer but folks with zero hce could not. someone who is well balanced with good hce and a good scholastic background should be able to ace the test.

so, assuming a 100 question multiple choice test and a basic essay to demonstrate the ability to write well , what kind of stuff should be on this?

[CorpsmanUP]

Move it to 200-250 questions for statistical reliability.

·         Math Section involving dosage calculations and conversions

·         Basic biology, A&P

·         Basic Chemistry (i.e. Electron shell, oxidation, ions, isotopes)

·         Basic principles of first aid- first responder

 

·         Writing Section

[EMEDPA]

Ok, I will start.

Essay question. 250 words: describe your most interesting patient encounter.

[whoRyou]

(I would like Dr. Davenport's opinion on this or E's) I am NOT looking to stir up a hornet's nest, but because I respect BOTH of your opinions and because of your last position as the Dean and Program Director at Gardner-Webb University, and what you do now (Associate Dean of Health Professions), Dr. D, & E: Do you believe PA schools will ever have a PACAT or a similar concept like this anytime soon? (I apologize if this is NOT the right thread, just wasn't sure where to ask.) Here or http://www.physicianassistantforum.com/index.php?/topic/12520-do-gres-correlate-with-pa-school-success/page-2#entry166317
G. Davenport, on 22 Apr 2014 - 3:12 PM, said:

... until the PA community standardizes entry requirements and creates its own PACAT ...
 

[EMEDPA]

Move it to 200-250 questions for statistical reliability.

·         Math Section involving dosage calculations and conversions

·         Basic biology, A&P

·         Basic Chemistry (i.e. Electron shell, oxidation, ions, isotopes)

·         Basic principles of first aid- first responder

 

·         Writing Section

agree with most but would remove the underlined as it has no relevance to pa school. this test is meant to be relevant to pa school and practice as a pa, not "MCAT light". most working PAs have zero knowledge of electron shell oxidation, but I would hope they know the anatomic distribution of the sciatic nerve.

[CorpsmanUP]

agree with most but would remove the underlined as it has no relevance to pa school. this test is meant to be relevant to pa school and practice as a pa, not "MCAT light". most working PAs have zero knowledge of electron shell oxidation, but I would hope they know the anatomic distribution of the sciatic nerve.

Yet those ideas are the basics behind much of clinical physiology.

·         HgA1C tests normalized glucose levels over a 3-4 month period, why?

·         100% O2 for respiratory support can be given for how long and why?

·         Almost every electrolyte imbalance and interpreting ABGs are based off that simple information.

pH, ion exchange, osmolality, all chemistry basics

[EMEDPA]

Yet those ideas are the basics behind much of clinical physiology.

·         HgA1C tests normalized glucose levels over a 3-4 month period, why?

·         100% O2 for respiratory support can be given for how long and why?

·         Almost every electrolyte imbalance and interpreting ABGs are based off that simple information.

pH, ion exchange, osmolality, all chemistry basics

yet you can learn all of those things without knowing a lot of chemistry....a1c tests work because 3-4 months is the amt of time a typical red cell is in circulation for. that's physiology, not chemistry. that's really all you need to know about how it works. we are training clinicians, not researchers or medical scientists.

the concept of this test would be that an "ideal applicant" would know all this info cold without studying, as opposed to a test like the mcat that requires applicants to memorize a lot of worthless facts, regurgitate them, and forget them the day after the test. PA school applicants should be from a very different pool of folks than medschool applicants. we need to know different stuff right off the bat to hit the ground running. docs have 3 years + in residency to learn a lot of what we should know before starting pa school....

[G. Davenport]

(I would like Dr. Davenport's opinion on this or E's) I am NOT looking to stir up a hornet's nest, but because I respect BOTH of your opinions and because of your last position as the Dean and Program Director at Gardner-Webb University, and what you do now (Associate Dean of Health Professions), Dr. D, & E: Do you believe PA schools will ever have a PACAT or a similar concept like this anytime soon? (I apologize if this is NOT the right thread, just wasn't sure where to ask.) Here or http://www.physicianassistantforum.com/index.php?/topic/12520-do-gres-correlate-with-pa-school-success/page-2#entry166317

G. Davenport, on 22 Apr 2014 - 3:12 PM, said:

 

... until the PA community standardizes entry requirements and creates its own PACAT ...

Thank you and I love discussing these things even if we don't agree. I was actually going to do a study on this but couldn't fit it in last year. I asked professors in biology, chemistry, stats, medical term, etc to write basic questions that our applicants should know if they took a 101 and 102 course in the topics. I was going to blind it along with a blinded GRE and then track students through academics and NCCPA cert with the goal of identifying predictability based on my exam or GRE. May still do it if someone doesn't now take if n run

 

As I looked at this I got frustrated with how varied our entrance requirements are - from school to school. So I now propose simplicity. 1 yr a and p, 1 year biology, 1 year gen chem, 1 course organic chem, 1 course statistics, 1 medical term course.

 

My test would be on these topics. Written not by a pa professor but by a professor who teaches it.

 

That's what I'd do. Standardize requirement (I'm only talking course work here) and prove the test statistically significant or not.

 

A argumentative essay would be good to.

 

G

 

 

 

Sent from my iPhone using Tapatalk

[EMEDPA]

I would not include the ochem course. if you want an upper level chem course, an intro to biochem (and yes, this can be done without ochem) would be more applicable. I would also require that microbio be one of the bio courses taken.

I think medex has it just about right(both for clinical and academic requirements)-and I'm not just saying that because I want a part time job there in a few years.....:)

http://depts.washington.edu/medex/applicants/program-prerequisites/bachelors-prerequisites/

[G. Davenport]

EMEDPA,

 

For you (my friend), let me clarify a few things about me.  As you know I am a MEDEX graduate, a program where you MUST have 4,000 of paid health care experience to apply.  With that said, my belief on where the profession should be and where it is are far apart.  

 

1.  I believe in the old concepts and the foundation of our profession - the corpsman who enters school with thousands of hours of hands on medical experience and about $125,000 of medical education (2005 value).  I believe in the certification process and NOT in the Bachelor or Master degree.  But this is done.  In fact, old heads who advocate 2,000 or more hours to enter a PA program need to do some research on the applicant pool.  Unfortunately, with the change in the degree, we lost a lot of candidates who just won't do it.  Say what you will or that they are lazy or whatever, but it is what it is.  Many schools have leaned away from 2,000 (DUKE) or 4,000 (UW) hours for entry requirement.  So, I accept that we will have students who are young and without experience.  As an educator I can complain or do whatever I can to create an academic atmosphere that pushes these students beyond previous training processes.  

 

2.  I DO NOT agree with the CAQ exams.  Now, with all that said, times have changed and we WILL not go back to the old days.  Given that, I was one of eight who helped evaluate the ER CAQ exam.  It has been put in place and the fight is over.  Now it is time to make it the best exam we can.  So, I stopped complaining and helped create that exam.   

 

3.  I believe in awarding a Doctor of Medical Science (or whatever) for a graduate of a PA program (without any further education).  These programs require a Bachelor degree to get in and then cover up to or over 120 SH of graduate work.  Given a typical Master's degree is 30 to 36 hours with another 70 SH for a doctorate degree, it is only RIGHT that a PA who graduates from a Master's program is awarded what they earned - a doctorate.  Stop adding classes or rotations or clinical or whatever, just give the degree for what was already earned.  No degree creep, it already is earned.  If you want the PA to graduate with a Master's degree, make the program 36 SH long (don't do this ;-)).  We (sorry if this insults) are ridiculous to argue about "we shouldn't get a doctorate" when we already do the work for it.  What we shouldn't do is identify ourselves as a doctor when we see patients as that is confusing.  I don't agree with the Bachelor or Master's degree but that is done and we do.  I also don't agree with giving a Master's degree when a student earns a doctorate (exceeding graduate work seen by most doctorate work out there).  

 

4.  I am very tired of the profession's failure to change our name.  Do the research on why we have the name and then look at what we do now.  It is not appropriate and we need to take a stand and change it.

 

5.  Finally, I hate that our profession fails to come together on the education front.  We need to standardize pre-requisites and create a standardized entrance test (the reason for this post).  

 

We stand alone and we are a dysfunctional family.  We need to unite and find the strength that our comrades have (NP, MD, and DO).  

 

And NOW, who wants that standardized test?

 

:-).

 

Greg

[EMEDPA]

we agree on most of this Greg, but I still am trying to fight the good fight for applicants with significant experience, which is why I will likely take a teaching position which requires 2 hrs of travel at a program I respect, rather than one 20 min away which I don't.

I want to train students who start from the right place, not try to make clinicians out of inexperienced folks who should have taken the long route via medschool and only applied pa because it is a "top ten hot job" in money magazine and let's you have kids before 25.

re: our name: the aapa has recently said they will promote us as" PAs" and not as "assistants" and will be changing their info to reflect collaboration instead of supervision. they are also going to back terms other than midlevel. all these are positive changes and were brought about mostly by PAFT and similar folks making a lot of noise....

[Maynard]

I'm of the mind that an exam like this should test aptitude at least as much as (if not more than) knowledge. Grades already measure knowledge. I know that the "easiness" of a grade varies by school, but they all have the same accreditation requirements.

 

We're talking hypothetically, but if this were ever to become a real exam it would invariably be compared to the MCAT. If it lacked the tough aptitude type questions that the MCAT has then it's not going to inspire much respect from the community of physicians.

 

As for a writing section, I excel at most standardized tests, but I HATE standardized writing tests. I used to write professionally and I've found that there is a very select group of individuals who can really assess the quality of an essay, and these individuals are not working as judges for exams. Nevertheless, people in general are infinitely capable of convincing themselves that they can judge writing, opinions being like rectums and all.

 

I remember reading the ETS guide to the GRE and being stupefied by what they felt was a "6" level essay, as well as their remarks on it (they praised word choices that almost any professional would agree is bad form). The ETS also has the worst sort of essay questions: they're either excessively broad or flat-out stupid (Respond to this statement: red is a better color than green). A dirty little secret about the MCAT essay is that it has two judges for each essay and one of those judges is a computer program. I think I read somewhere that the MCAT finally came to its senses and decided to scrap the essay altogether in the next generation of tests. Nobody even cared about the writing score.

[G. Davenport]

we agree on most of this Greg, but I still am trying to fight the good fight for applicants with significant experience, which is why I will likely take a teaching position which requires 2 hrs of travel at a program I respect, rather than one 20 min away which I don't.

I want to train students who start from the right place, not try to make clinicians out of inexperienced folks who should have taken the long route via medschool and only applied pa because it is a "top ten hot job" in money magazine and let's you have kids before 25.

re: our name: the aapa has recently said they will promote us as" PAs" and not as "assistants" and will be changing their info to reflect collaboration instead of supervision. they are also going to back terms other than midlevel. all these are positive changes and were brought about mostly by PAFT and similar folks making a lot of noise....

 

Considering I know where you live and what programs are around you, your code has been broken :-)

[EMEDPA]

I think the pacat needs to be very different than the mcat as we are looking at different things from different types of folks. we need to stop comparing ourselves to docs or caring what they think. they have done very little for us as a profession over the years and it's time we stood on our own two feet as a profession without feeling like we always need their approval. we changed the name from associate to assistant to make docs happy and that was a huge mistake that has haunted us to this day. we have altered the typical applicant to be "more like a medschool applicant" and that has ripped the heart and soul out of the profession. I can't reverse the tide, but I can fight it until the day they do away with experience requirements across the board. that will be a sad day and the day the profession should cease to exist.

[CorpsmanUP]

EMEDPA,

 

For you (my friend), let me clarify a few things about me.  As you know I am a MEDEX graduate, a program where you MUST have 4,000 of paid health care experience to apply.  With that said, my belief on where the profession should be and where it is are far apart.  

 

1.  I believe in the old concepts and the foundation of our profession - the corpsman who enters school with thousands of hours of hands on medical experience and about $125,000 of medical education (2005 value).  I believe in the certification process and NOT in the Bachelor or Master degree.  But this is done.  In fact, old heads who advocate 2,000 or more hours to enter a PA program need to do some research on the applicant pool.  Unfortunately, with the change in the degree, we lost a lot of candidates who just won't do it.  Say what you will or that they are lazy or whatever, but it is what it is.  Many schools have leaned away from 2,000 (DUKE) or 4,000 (UW) hours for entry requirement.  So, I accept that we will have students who are young and without experience.  As an educator I can complain or do whatever I can to create an academic atmosphere that pushes these students beyond previous training processes.  

 

2.  I DO NOT agree with the CAQ exams.  Now, with all that said, times have changed and we WILL not go back to the old days.  Given that, I was one of eight who helped evaluate the ER CAQ exam.  It has been put in place and the fight is over.  Now it is time to make it the best exam we can.  So, I stopped complaining and helped create that exam.   

 

3.  I believe in awarding a Doctor of Medical Science (or whatever) for a graduate of a PA program (without any further education).  These programs require a Bachelor degree to get in and then cover up to or over 120 SH of graduate work.  Given a typical Master's degree is 30 to 36 hours with another 70 SH for a doctorate degree, it is only RIGHT that a PA who graduates from a Master's program is awarded what they earned - a doctorate.  Stop adding classes or rotations or clinical or whatever, just give the degree for what was already earned.  No degree creep, it already is earned.  If you want the PA to graduate with a Master's degree, make the program 36 SH long (don't do this ;-)).  We (sorry if this insults) are ridiculous to argue about "we shouldn't get a doctorate" when we already do the work for it.  What we shouldn't do is identify ourselves as a doctor when we see patients as that is confusing.  I don't agree with the Bachelor or Master's degree but that is done and we do.  I also don't agree with giving a Master's degree when a student earns a doctorate (exceeding graduate work seen by most doctorate work out there).  

 

4.  I am very tired of the profession's failure to change our name.  Do the research on why we have the name and then look at what we do now.  It is not appropriate and we need to take a stand and change it.

 

5.  Finally, I hate that our profession fails to come together on the education front.  We need to standardize pre-requisites and create a standardized entrance test (the reason for this post).  

 

We stand alone and we are a dysfunctional family.  We need to unite and find the strength that our comrades have (NP, MD, and DO).  

 

And NOW, who wants that standardized test?

 

:-).

 

Greg

Greg,

I can agree to all five of your points; however, from a professional recognition standpoint I see points 3-5 being the most imperative.  The primary reason D.O.s gained M.D. equivalency recognition was their embrace by the US Military in the 70’s.  As proven by the Baylor program, to say the military, and the Army in particular, is very hierarchal is a vast understatement.  Without a doctoral degree PAs could not compete with the other members of the MSC, and were never seen as equal.  The only other health professions that has the same condensed course structure of the PA is the PharmD, and yet somehow they have been able to convince universities to grant doctorates with an entrance requirement of 60+ credit hours of pre-reqs, how can the AAPA not get this done.   People see MS and think you went to school for a year or two, take 9-12 credit hours in the fall and the spring, and graduate with 35-50 credit hours like everyone else with a masters that they know.  They can’t grasp let alone believe that the PA course load is the equivalency of doing three masters at once, and easily one doctorate.  So since you are in academics, have been a program director and are now an associate dean with a school, how would you suggest going about getting a university on board to grant the degree the education merits?

[Joelseff]

Move it to 200-250 questions for statistical reliability.

· Math Section involving dosage calculations and conversions

· Basic biology, A&P

· Basic Chemistry (i.e. Electron shell, oxidation, ions, isotopes)

· Basic principles of first aid- first responder

 

· Writing Section

I like this but would swap chemistry for physiology like pathways, upregulation, down regulation etc. Seems more relevant for PA school. I also agree with E about an essay on patient interaction etc.

 

Sent from my SAMSUNG-SGH-I537 using Tapatalk

 

 

[EMEDPA]

in addition to the stuff mentioned above the test should contain some info about the pa profession to make sure folks know what they are getting into:

what does "supervision" typically entail?

can a pa own a medical practice? if so, how?

when and where did the pa profession start and what types of applicants were in the early classes?

how is a pa similar and different than an rn/md/do/np?

what types of settings can pas work in?

can PAs work in surgery? ICUs? etc

what are the names of the tests PAs take after graduation and later when they recertify and what organization administers and grades those tests?

can pas write prescriptions?

etc, etc.

you would be surprised how many folks at pa school interviews can not answer these basic questions about the profession that could be learned by talking to a pa for 15 min once. Folks with experience who have spent some time with pas know this stuff. many in the 4.0 high gre/no hce camp do not. they think pa school is "Dr Light" and are always disappointed later when they learn the truth abut the limitations of the profession, typically on rotations....

[CorpsmanUP]

Those would have to be free form/essay questions as they do not lend themselves well to multiple choice.  Do you think they would be better left as questions to be posed during the interview?

[Joelseff]

EMEDPA,

 

For you (my friend), let me clarify a few things about me. As you know I am a MEDEX graduate, a program where you MUST have 4,000 of paid health care experience to apply. With that said, my belief on where the profession should be and where it is are far apart.

 

1. I believe in the old concepts and the foundation of our profession - the corpsman who enters school with thousands of hours of hands on medical experience and about $125,000 of medical education (2005 value). I believe in the certification process and NOT in the Bachelor or Master degree. But this is done. In fact, old heads who advocate 2,000 or more hours to enter a PA program need to do some research on the applicant pool. Unfortunately, with the change in the degree, we lost a lot of candidates who just won't do it. Say what you will or that they are lazy or whatever, but it is what it is. Many schools have leaned away from 2,000 (DUKE) or 4,000 (UW) hours for entry requirement. So, I accept that we will have students who are young and without experience. As an educator I can complain or do whatever I can to create an academic atmosphere that pushes these students beyond previous training processes.

 

2. I DO NOT agree with the CAQ exams. Now, with all that said, times have changed and we WILL not go back to the old days. Given that, I was one of eight who helped evaluate the ER CAQ exam. It has been put in place and the fight is over. Now it is time to make it the best exam we can. So, I stopped complaining and helped create that exam.

 

3. I believe in awarding a Doctor of Medical Science (or whatever) for a graduate of a PA program (without any further education). These programs require a Bachelor degree to get in and then cover up to or over 120 SH of graduate work. Given a typical Master's degree is 30 to 36 hours with another 70 SH for a doctorate degree, it is only RIGHT that a PA who graduates from a Master's program is awarded what they earned - a doctorate. Stop adding classes or rotations or clinical or whatever, just give the degree for what was already earned. No degree creep, it already is earned. If you want the PA to graduate with a Master's degree, make the program 36 SH long (don't do this ;-)). We (sorry if this insults) are ridiculous to argue about "we shouldn't get a doctorate" when we already do the work for it. What we shouldn't do is identify ourselves as a doctor when we see patients as that is confusing. I don't agree with the Bachelor or Master's degree but that is done and we do. I also don't agree with giving a Master's degree when a student earns a doctorate (exceeding graduate work seen by most doctorate work out there).

 

4. I am very tired of the profession's failure to change our name. Do the research on why we have the name and then look at what we do now. It is not appropriate and we need to take a stand and change it.

 

5. Finally, I hate that our profession fails to come together on the education front. We need to standardize pre-requisites and create a standardized entrance test (the reason for this post).

 

We stand alone and we are a dysfunctional family. We need to unite and find the strength that our comrades have (NP, MD, and DO).

 

And NOW, who wants that standardized test?

 

:-).

 

Greg

Wow totally agree! Sounds like a great PA version of Luthers' 95 theses ("Davenport's five theses" has a nice ring to it hehe)....who will lead us towards reformation though?

 

Sent from my SAMSUNG-SGH-I537 using Tapatalk

 

 

[EMEDPA]

Those would have to be free form/essay questions as they do not lend themselves well to multiple choice.  Do you think they would be better left as questions to be posed during the interview?

nope. I think folks who do not know this stuff should not get an interview.

we need to weed out the ones who didn't take the time to learn about the profession early.

multiple choice could work:

1. what organization oversees the PA certification and recertification exams?

A. The NCCPA

B. The AMA

C. The PAEA

D. The USMLE

E. The LCCME

 

2. The first step to control bleeding is:

A. direct pressure

B. apply a tourniquet

C. call 911

D. apply pressure over a nearby artery

E. apply a vaseline coated bandage

[medic25]

I had to take the AHPAT (Allied Health Professions Admission Test) as a prerequisite for PA School admission, which was similar to a scaled down MCAT. I'm not even sure if this exam still exists, but it's probably close to how I'd envision the PACAT.

[EMEDPA]

I had to take the AHPAT (Allied Health Professions Admission Test) as a prerequisite for PA School admission, which was similar to a scaled down MCAT. I'm not even sure if this exam still exists, but it's probably close to how I'd envision the PACAT.

never heard of it. is it similar to the test one takes to get into medic school? we had a 2 hr test with basic math, write an essay, basic ems info, etc.

still exists:

http://www.freeassessmenttools.com/TESTS/Medical__and__Allied_Health/AHPAT.html

[G. Davenport]

Greg,

I can agree to all five of your points; however, from a professional recognition standpoint I see points 3-5 being the most imperative. The primary reason D.O.s gained M.D. equivalency recognition was their embrace by the US Military in the 70’s. As proven by the Baylor program, to say the military, and the Army in particular, is very hierarchal is a vast understatement. Without a doctoral degree PAs could not compete with the other members of the MSC, and were never seen as equal. The only other health professions that has the same condensed course structure of the PA is the PharmD, and yet somehow they have been able to convince universities to grant doctorates with an entrance requirement of 60+ credit hours of pre-reqs, how can the AAPA not get this done. People see MS and think you went to school for a year or two, take 9-12 credit hours in the fall and the spring, and graduate with 35-50 credit hours like everyone else with a masters that they know. They can’t grasp let alone believe that the PA course load is the equivalency of doing three masters at once, and easily one doctorate. So since you are in academics, have been a program director and are now an associate dean with a school, how would you suggest going about getting a university on board to grant the degree the education merits?

Good question. But PAEA and AAPA don't agree with me. See this link

 

http://www.paeaonline.org/index.php?ht=a/GetDocumentAction/i/136700.

 

Until our leadership recognizes this injustice it is doubtful ARC-PA will support it. Just my opinion.

 

We need to first get PAEA and AAPA to revise their stance.

 

Greg

 

 

Sent from my iPhone using Tapatalk

[EMEDPA]

Good question. But PAEA and AAPA don't agree with me. See this link

 

http://www.paeaonline.org/index.php?ht=a/GetDocumentAction/i/136700.

 

Until our leadership recognizes this injustice it is doubtful ARC-PA will support it. Just my opinion.

 

We need to first get PAEA and AAPA to revise their stance.

 

Greg

 

 

Sent from my iPhone using Tapatalk

and yet, 1/2 of their board has doctorate degrees....

[CorpsmanUP]

I am familiar with the policy statement, my question is could it be done on the university level?  If the program has accreditation, would ARC-PA yank it if the university decided to offer a doctorate instead of the MS.  The information being taught is the same, whether it is a certificate program at a CC, a BS, or a MS.  The ONLY difference I have seen are MS programs moving to a research paper/thesis as part of clinical rotations.  Basically the universities saying, "Well, all of our doctorates require x number of credit hours per our regional accreditation standards, and since our PA programs meet those standards we are offering our customers what they are actually paying for."  when the ARC-PA comes calling.

 

As you can see, even though I am entering the profession, I could pretty much care less what the AAPA and PAEA say.  Something I learned in the military, it is better to beg forgiveness than ask permission, you just had better have amazing results to back you up.