PACdan Posted June 2, 2015 Share Posted June 2, 2015 In the new issue of JAAPA, Mr. Dehn of NAU's PA program, addresses the recent issue of Yale's online PA program announcement and online PA programs in general. I think he makes a fair and thoughtful argument about what we must consider in their development. To summarize: - Rotation sites are already at a premium for students, so enrolling large classes without the proper network of clinical sites in place may prove taxing for the current system. - Evaluation of professionalism and student communication and interaction abilities would be severely hampered during the didactic phase of education, since students would only be on-site for a few weeks total. - If programs are going to offer distance PA didactic education, they need to pass a substantial tuition savings onto the students (unlike Yale's plan which will charge the same $83,000 regardless), otherwise the motivation is suspect. Also, the ARC-PA ruled that Yale must go through the full provisional accreditation process for their online program, rather than just granting them an enrollment increase for their online expansion. Totally agree with that. Link to comment Share on other sites More sharing options...
Acebecker Posted June 2, 2015 Share Posted June 2, 2015 One of the worst things to happen to the PA profession that I can think of. Online programs will degrade the efforts at excellence that our founders put forth and wish of all of us. What an idiotic move. Link to comment Share on other sites More sharing options...
PACdan Posted June 2, 2015 Author Share Posted June 2, 2015 ^^^^ And at a cost of $83k, I absolutely agree. Shameful. Link to comment Share on other sites More sharing options...
blueridge Posted June 2, 2015 Share Posted June 2, 2015 The general public will find an online PA program a tough pill to swallow. Link to comment Share on other sites More sharing options...
Moderator ventana Posted June 3, 2015 Moderator Share Posted June 3, 2015 Firmly against this! Link to comment Share on other sites More sharing options...
LKPAC Posted June 3, 2015 Share Posted June 3, 2015 I agree with those who are opposed. Becoming a PA via online degree demeans our profession. Link to comment Share on other sites More sharing options...
FfIghter23 Posted June 3, 2015 Share Posted June 3, 2015 Being realistic, I think a solid school could put together a pretty good program in an online setting. The issue is the public perception and the waves of unqualified students looking for an "easy way in." Learning the basics of medicine isn't rocket science. LEARNING the details and intricacies of how to be an excellent clinician will be difficult w/ students relying on books and youtube videos. I learned 10x more participating in lab and running through problem based scenarios and doing actual physical exams on live patients so online students will have a disadvantage there. Will the general population continue to treat us like assistants if this becomes the norm? You betchya. Link to comment Share on other sites More sharing options...
CAAdmission Posted June 3, 2015 Share Posted June 3, 2015 Maybe these students could just practice telemedicine. That should be in their wheelhouse. Look how pleased the patient looks. Link to comment Share on other sites More sharing options...
db_pavnp Posted June 3, 2015 Share Posted June 3, 2015 I learned 10x more participating in lab and running through problem based scenarios and doing actual physical exams on live patients so online students will have a disadvantage there. What if I told you the Yale online students will log more face-to-face lab hours than you did? Link to comment Share on other sites More sharing options...
FfIghter23 Posted June 3, 2015 Share Posted June 3, 2015 What if I told you the Yale online students will log more face-to-face lab hours than you did? Oh no. I am scared. Yale has better academics compared to my program? Should I doubt my education? Please tell me I don't have to go back through didactic year and go through an extra 20 hours of lab time because big bad Yale has revolutionized PA education? No you are right. All of those other wimpy old PA schools who have been doing it for 30 years have it wrong. I'm just going to go to an online NP school so I can get a real education. A doctorate level education at that. Link to comment Share on other sites More sharing options...
GreatChecko Posted June 3, 2015 Share Posted June 3, 2015 What about the UND hybrid program? It's appears to have existed for a very long time and has a purpose in such a rural state. Two semesters fully online... I don't think we need a ton of online programs, but to say they don't work clearly ignores reality. What we need is to ensure the existing programs have enough rotation sites and resources before we continue growing programs, online or not. Part of me thinks we are getting worked up for no reason. The general public will find an online PA program a tough pill to swallow. They don't seem to really care about online NP programs, so I doubt this would even come up on the radar. Let's be honest, there are more important things like Bruce Jenner to talk about. http://www.chamberlain.edu/admissions/graduate/master-of-science-in-nursing/family-nurse-practitioner I love their "Program Highlights": Online classwork with no mandatory login or chat times Engaged, responsive faculty No group work No GRE or entrance exam required Six start-dates per year Link to comment Share on other sites More sharing options...
FfIghter23 Posted June 3, 2015 Share Posted June 3, 2015 Maybe these students could just practice telemedicine. That should be in their wheelhouse. Look how pleased the patient looks. This is the best idea yet. School from home. Work from home. With Amazon and their same day delivery drones... I can now catch up on all of those MASH episodes while ordering percocets for my patients from the couch. Link to comment Share on other sites More sharing options...
db_pavnp Posted June 3, 2015 Share Posted June 3, 2015 Don't get so upset. You were clutching your precious face-to-face hours while the fact is that Yale and every "online" program has the same face-to-face hours. Hell, they might double your hours just to prove the point - online didactic programs have nothing to fear. Link to comment Share on other sites More sharing options...
Acebecker Posted June 3, 2015 Share Posted June 3, 2015 Being realistic, I think a solid school could put together a pretty good program in an online setting. The issue is the public perception and the waves of unqualified students looking for an "easy way in." Learning the basics of medicine isn't rocket science. LEARNING the details and intricacies of how to be an excellent clinician will be difficult w/ students relying on books and youtube videos. I learned 10x more participating in lab and running through problem based scenarios and doing actual physical exams on live patients so online students will have a disadvantage there. Will the general population continue to treat us like assistants if this becomes the norm? You betchya. I agree 100% that labs and physical exams on my classmates made a huge difference in my education. But it's not just the live labs. I have been saying this for years - putting your butt in a chair in a classroom with 20 other brilliant PA students and a (hopefully) even more brilliant instructor makes a huge difference in the way that the information is taught and discussed. Learning facts out of a book is easy. Anybody can do that. As you mentioned - the nuances of being a competent and good clinician are learned face-to-face. Our problem based learning was helpful in that it taught me to think from different perspectives which is not something you'll get from a book. My interactions with the instructors during live classes were indispensable. People have been arguing for years that they can gain the same education by watching filmed lectures at home. Nope. Not gonna' happen. It is not possible. Link to comment Share on other sites More sharing options...
FfIghter23 Posted June 3, 2015 Share Posted June 3, 2015 Don't get so upset. You were clutching your precious face-to-face hours while the fact is that Yale and every "online" program has the same face-to-face hours. Hell, they might double your hours just to prove the point - online didactic programs have nothing to fear. Can you show me the proposal with the amount of face-to-face hours being above average? Because if that is the case... It's not an online program. It's a "you don't really need to come to class for all lectures, but you still need to be here as much as our traditional students" program. I don't get it. We all know its a money grab and it is sad that this what medical education has become. I respect Yale and their medical model and commitment to training good clinicians. Won't this open the door to every "Grand Canyon online university" CNA to PA program! It's the precedent I am concerned about. Link to comment Share on other sites More sharing options...
db_pavnp Posted June 3, 2015 Share Posted June 3, 2015 Because if that is the case... It's not an online program. If you insist upon that verbiage, it is not an online program. There are no online PA or NP programs and there will not be any. re: Acebecker For your opinion to be true, interactions between professor and class must roughly resemble each other between every classroom and be universally positive. I do not feel there is predictable value in those interactions, only hypothetical value. The only controllable factor is the quality of the delivered material. If I may add, I generally find student "interactions" with the professor to be detrimental to my educational experience. Link to comment Share on other sites More sharing options...
SocialMedicine Posted June 3, 2015 Share Posted June 3, 2015 - Rotation sites are already at a premium for students, so enrolling large classes without the proper network of clinical sites in place may prove taxing for the current system. Reasonable concerns. I would imagine Yale or any other program will have agreements in place before students show up. In fact the ARC now requires this for all new programs. Also you need to find a way to maintain and monitor rotation sites not at the local hospital. - Evaluation of professionalism and student communication and interaction abilities would be severely hampered during the didactic phase of education, since students would only be on-site for a few weeks total. This is an out dated understanding of distance education. The way it appears today involves (or has the capacity to involve) significant face to face distance interaction through high resolution video/head sets. So in theory these students would be interacting face to face virtually with colleagues and faculty through a very expensive and interactive digital network. If you want to argue that this virtual interaction is inferior, you can do that, but that is a different argument. - If programs are going to offer distance PA didactic education, they need to pass a substantial tuition savings onto the students (unlike Yale's plan which will charge the same $83,000 regardless), otherwise the motivation is suspect. This is where I disagreed most with this article. We should not measure the success of distance degrees by cost. I accept other concerns proposed here as interesting and valid. Distance degrees are not being developed for cost savings. A HIGH QUALITY virtual experience costs A LOT of money and utilizes the same amount of faculty and admin support. I would argue it may require more administrative support and higher cost technology. True you do not need as much classroom space .... but if you are talking about a clinical distance program you need to have that space for all of the in person experience with anatomy and physical exam class. I would have preferred an analysis of education theory/research adjacent a what this PA program is proposing to accomplish. Link to comment Share on other sites More sharing options...
Acebecker Posted June 3, 2015 Share Posted June 3, 2015 re: Acebecker For your opinion to be true, interactions between professor and class must roughly resemble each other between every classroom and be universally positive. I do not feel there is predictable value in those interactions, only hypothetical value. The only controllable factor is the quality of the delivered material. If I may add, I generally find student "interactions" with the professor to be detrimental to my educational experience. Negative. Negative. And another negative. 1. My opinion is true. I have seen this a million times. I have also heard a million objections and none are well founded. Yes, the only thing that is 100% guaranteed is the content of the lecture. I grant you that. But every interaction had in class - by me or one of my peers - had value. It was a value that I created, perhaps, but still a value. I am a better clinician because of the questions I asked, because of the questions my classmates asked (even if a dumb question was asked, there was still a learning nugget in it). You cannot and should not be denying that fact. 2. There is predictable value *if* you recruit the right candidates (and I think that at this point it's a 75%-25% split between good and not-so-good candidates). Self-motivated candidates will learn from the discussions. Non self-motivated students will tune out discussions - be they good or bad discussions - and learn little. The question is this: do you want the former or the latter? My point of view is that we want to weed out the un-self-motivated candidates and not have them making a hash of our programs. We are not teaching a technical school here. This is not an algorithm driven learning process. We are trying to teach critical thinkers. There's a reason we start with physiology and move to pathophysiology and then to specific disease processes. If we jump from point A to B to C without looking at the path n between, there will be a lot of unnecessary and incorrect conclusions. 3. I'm sorry that the idiots in the class detract(ed) from your learning process. That said, I don't know that it is their problem. Link to comment Share on other sites More sharing options...
SocialMedicine Posted June 3, 2015 Share Posted June 3, 2015 dv_pavnp If your classroom experience was that poor shame on your PA program and medicine faculty. It sounds like they were not good at their jobs. Hopefully you provided good feedback so they can improve. And if they are not improving hopefully disciplinary action takes place. ALSO I recommend everyone read my posted 2-3 above this one. I provided a decent rebuttal to some of the concerns listed in the first post. Essentially, I disagree with cost being a main component of the argument. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted June 3, 2015 Moderator Share Posted June 3, 2015 What if I told you the Yale online students will log more face-to-face lab hours than you did? I would tell you that you are wrong. They are going to do more than 8 hrs/week on campus each semester? on campus component for lab only will be > 100 hrs every 12 weeks? I doubt it. we had small group sections of 4-6 students/instructor for PBL, Physical exam, clinical medicine, history taking, EM, A+P lab, basic science lab, biopsychosocial issues in pt care, ethics, etc Link to comment Share on other sites More sharing options...
SocialMedicine Posted June 3, 2015 Share Posted June 3, 2015 why cant you have a small group 4-6 students through a distance format ? if the program requires the techology of all students you can see the faces of your students while talking to them./ In fact you can see the faces of all students in the group. This technology is used often in corporate meetings and interviews. Face to face in person offers unique benefits do not get me wrong. However, you cannot evaluate a program such as this with the mindset that it will be a blackboard/message board education. This is 20 years ago. It is also the model of degree mills and for profit institutions. I am all about being critical of new and expanding PA programs. I say it on here all the time we are increasing too fast. However, I dislike that people are analyzing this potentially useful innovation as something it is not. It will include those interactions digitally .... if you care to comment that the digital experience is not as productive fine .... but digital programs these days have face to face capacity for dyamic conversations. I have never worked in a distance education format such as this but I think the opinion of those who have would be very useful. This program is unlike what other distance PA programs are doing. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted June 3, 2015 Moderator Share Posted June 3, 2015 why cant you have a small group 4-6 students through a distance format pretty hard to do a cardiac exam over a computer...or intubate a mannequin, or do a knee exam, or listen for carotid bruits, or prepare a gram stain and view it yourself on a microscope, or do any number of things needing hands on guidance required to learn medicine....we had a 12 week lab course 2 hrs/week just in emergency procedures. how do you suture a pigs foot over a computer? how do you insert a foley over a computer? how do you run megacodes as a team leader and interact with other team members over a computer....you can't....it's a hands on in-person skill.... Link to comment Share on other sites More sharing options...
marktheshark89 Posted June 3, 2015 Share Posted June 3, 2015 I am not a proponent of the online program by any means. That being said, each of the skills you mentioned above was planned to be completed during 1-2 week long sessions during didactic year, in person on the Yale campus. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted June 3, 2015 Moderator Share Posted June 3, 2015 I am not a proponent of the online program by any means. That being said, each of the skills you mentioned above was planned to be completed during 1-2 week long sessions during didactic year, in person on the Yale campus. we had over 100 hrs of discussion and practical sections/semester x 4 semesters= 400 + hrs in addition to an entire week seminar before starting rotations of hands on "introduction to clinical medicine" where they went over stuff like the proper way to scrub in for surgery, put on gowns, present at rounds,hold retractors, etc Those of us interested in emergency medicine also had optional full courses in acls and atls on campus before starting rotations. if they do 2 weeks/yr that's less than 200 hrs for the whole program, 1/2 of what we did. I just checked my program's site. they now have a 3 term clinical skills course: PA 559 Clinical Skills I 2.0 Credits This is the first of three courses designed to prepare the PA student with a problem-oriented, clinical approach to the evaluation, diagnosis, and management of common primary care disorders. The course uses clinical reasoning and clinical skills application laboratories based on clinical scenarios to facilitate skill development. pretty hard to condense that online or through brief on-campus visits. Link to comment Share on other sites More sharing options...
db_pavnp Posted June 3, 2015 Share Posted June 3, 2015 Isn't there a minimum number of hours hard coded into accreditation? And certainly Yale will meet them? So what is the malfunction? Link to comment Share on other sites More sharing options...
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