Inaugural PA Online Class - YALE

[corpsman89]

It's all about how things are perceived. It goes something like this:

"PAs can gain their education by attending online programs directly after college with zero medical experience." 

None of this is inaccurate. It's grossly negligent and a mischaracterization of reality but its technically correct. 

We have programs that accept students right out of college.

We have programs that accept students with ZERO medical experience.

And we now have online programs. 

[Kilian12]

16 minutes ago, corpsman89 said:

It's all about how things are perceived. It goes something like this:

"PAs can gain their education by attending online programs directly after college with zero medical experience." 

None of this is inaccurate. It's grossly negligent and a mischaracterization of reality but its technically correct. 

We have programs that accept students right out of college.

We have programs that accept students with ZERO medical experience.

And we now have online programs. 

Things would be perceived better if PAs themselves took the care to understand and present things accurately.

It sounds to me like you want to take all of your perceived faults with trends in PA education and dump them onto Yale's program, but the correlation just isn't there, even a comparison between this "online" program (which is really a hybrid program) and other online programs isn't yet there. What other online program do you know with clinical placement in didactic? With constant live, synchronous problem based learning? With on campus immersions? With School of Medicine faculty, etc etc?

I also don't love the trend of larger numbers of people being accepted into PA school right out of college with zero clinical training. What does that have to do with us? I already mentioned our cohort has an average of over 8000 hours of PCE/HCE. That's almost three times the national average.

Should PAs always let fear of uneducated and unfair perceptions get in the way of their innovation and progress? Should we always play second fiddle to the physicians and wait for them to do something first before we do it? If a program can produce competent PAs while doing didactic education from a distance, should we stand in its way because it's not how it used to be done? Seems to me like the "back in my day we used to walk to school uphill both ways" vibe.

[Kilian12]

1 hour ago, Acebecker said:

Look at ACLS training.  Since we've gone to the online program, I don't think we're learning it as well.  Yes, we get more reps at the mega-codes and scenarios, but are we actually any good at managing a team of people running a code?  No, because we don't do it in person with real people in real time.

Hi Andrew,

Incidentally Yale PA Online is doing its ACLS training on campus.

As far as I'm aware there are no other programs (maybe one?) similarly structured to Yale's out there, so I'm not sure how we can make conclusions about performances yet while comparing apples to apples. We are face to face with our classmates and faculty in real time constantly. When I go to clinic every week I am working with real people under the supervision of board certified PA-Cs. I am practicing my skills every day on real people in real time. I'm not just watching a video on how to take blood pressure or do an abdominal exam. The only portion of my work that is done the traditional "online" way, on my own time independently, is when I'm listening and taking notes during a hematology or nephrology lecture, for example. Even then, if I don't keep up with my daily lectures I'm SOL during the PBL case discussions the next day and the upcoming quizzes.

[corpsman89]

19 minutes ago, Kilian12 said:

Things would be perceived better if PAs themselves took the care to understand and present things accurately.

It sounds to me like you want to take all of your perceived faults with trends in PA education and dump them onto Yale's program, but the correlation just isn't there, even a comparison between this "online" program (which is really a hybrid program) and other online programs isn't yet there. What other online program do you know with clinical placement in didactic? With constant live, synchronous problem based learning? With on campus immersions? With School of Medicine faculty, etc etc?

I also don't love the trend of larger numbers of people being accepted into PA school right out of college with zero clinical training. What does that have to do with us? I already mentioned our cohort has an average of over 8000 hours of PCE/HCE. That's almost three times the national average.

Should PAs always let fear of uneducated and unfair perceptions get in the way of their innovation and progress? Should we always play second fiddle to the physicians and wait for them to do something first before we do it? If a program can produce competent PAs while doing didactic education from a distance, should we stand in its way because it's not how it used to be done? Seems to me like the "back in my day we used to walk to school uphill both ways" vibe.

You're not getting my point. 

I understand that Yale doesn't allow zero PCE experience, and that in no way does Yale's program compare to to crappy NP online schools around the country. My point is that it is perceived that way. No patient, layman, or legislator is going to do the research to find out how NP online programs compare to PA online programs, that fact is we are now equal--we both have online programs. The reality however, is that NP standards for online programs are way LOW, and PA standards are way HIGH, but is anybody gonna take the time figure that out? NO! 

Once again, it is how it is perceived by the general public.

Look, PAs today are living in a crucial time where we are seeing NPs advance in the country with nearly no opposition and basically full support from the public, yet their educational standards are way down and people are beginning to see it. Once PAs begin to implement OTP we will want every argument that shows we have an outstanding education model which is superior to NPs education standards. We need the ability to create arguments, and one of those is that--like our MD/DO colleagues--PA school requires in-class learning. 

 

 

[Acebecker]

Kilian,

First - good luck, hope it goes well (and I truly do).

Second - I don't know you.  I don't know any of the students in your class.  What I know about online programs and the associated baggage that comes with them comes from my limited experience with online programs and from my experience with NPs who attended online programs (your anecdote about ACLS is not the point).  And this is largely the same as what the general public knows about online programs.  In general, they turn out substandard practitioners.  Whether Yale's will or not really does not matter at this point.  What matters is that now there is an online path to becoming a PA whereas that didn't exist before.  Now PAs can get degrees online, same as the NPs can.  And *boom* just like that the PA profession was dropped to the level of the NP profession as far as quality of education *when we talk about it from the public's perspective*.

Third - the nature of the program (online vs. in person) is not the only factor that determines quality of practitioners.  I will grant you that.  You, as an individual, may be very engaged and very dedicated to paying wholehearted attention to every point in the online lectures.  I applaud you and I'm sure you will be a good PA (see point #1).  But your classmates who are less than dedicated, who applied to the program that was the *least inconvenient* and the *easiest to get into* are not the people who benefit from online education; I anticipate huge learning gaps in this population.  The people who have that mindset benefit most from being required to sit in a seat and receive instruction live, where they cannot fall through the cracks and cannot develop such learning gaps.  There are NP students who have done well with their online programs and are good clinicians because they were very dedicated and didn't just shadow for their 600 contact hours.  There are NPs who are not good, though, and in general this is the standard that I see when an NP student comes to me from an online program.  They don't know basic exam maneuvers, they don't have skills, they don't know differentials or how to read EKGs.  Now - my hope is that your class does not have the same lack of skills that these NP students have had - you will be doing clinicals to the same level as your PA colleagues.  But this goes back to #2.  It is my experience that online programs turn out substandard clinicians.

Listen, I do not want you to take this as a personal attack on you or that I think you are going to fail because you are in the inaugural class of online learning for PAs.  If you are dedicated, if you pay attention, if you work your butt off (and I know you're ready and excited to do that), you will probably do just fine and you will be a good PA.  My major concern is about point #2.  I'm also annoyed that Yale hasn't listened to anyone else on this, but that's another topic for another time.

[Kilian12]

55 minutes ago, corpsman89 said:

You're not getting my point. 

I understand that Yale doesn't allow zero PCE experience, and that in no way does Yale's program compare to to crappy NP online schools around the country. My point is that it is perceived that way. No patient, layman, or legislator is going to do the research to find out how NP online programs compare to PA online programs, that fact is we are now equal--we both have online programs. The reality however, is that NP standards for online programs are way LOW, and PA standards are way HIGH, but is anybody gonna take the time figure that out? NO! 

Once again, it is how it is perceived by the general public.

Look, PAs today are living in a crucial time where we are seeing NPs advance in the country with nearly no opposition and basically full support from the public, yet their educational standards are way down and people are beginning to see it. Once PAs begin to implement OTP we will want every argument that shows we have an outstanding education model which is superior to NPs education standards. We need the ability to create arguments, and one of those is that--like our MD/DO colleagues--PA school requires in-class learning. 

 

 

I understand your point about perception and I addressed it above as well.

Did the public and legislators and regulators understand or respect the quality difference between in class PA education and in class NP education before? Did they care that NPs who don't learn how to interpret an EKG are running their own practices? No. Were NPs given full practice authority at the VA despite having some crappy online schools? Yes. If crappy online education didn't hold NPs back, why should good online education hold PAs back? Because we can't advocate for ourselves as well as they do?

Again, as long as PAs can maintain the quality of their education high, I don't see why we should limit our access, reach and growth and only piggyback on others' education models. If a medical school had implemented an online didactic model would people be half as outraged that PAs are doing it? Isn't it a shame if we never dare to do something first? Our education is still consistent with MD/DO education: we learn in depth biology and science based medicine.  Requiring someone to learn it sitting in a classroom is not an education standard, it's an arbitrary rule that only serves to protect "the way it's always been done."

[marktheshark89]

Ironically the current Yale dean has stated in public forums at Yale that the medical students would never have an online option while he was in charge, because he didn’t think it would provide good enough training. I witnessed this in person. That went over well with the PA students...not. (Just an example of the perception issue, even within the very medical school that started the program). I hope and think that the program can produce quality graduates, and if anyome can put together a quality online program I think it would be Yale, having seen the resources and faculty at their disposal. I’m not sure how to tackle the perception issue, from the public perspective, but it isdefinitely something we need to figure out. I suspect that though Yale is one of the first, it won’t be the only program that attempts the online format. I also suspect that it will be ammunition for physicians to argue against OTP or independent practice in the future, that we were trained online and the perception of that. It may not have hurt the nurses for many reasons, chief of which is that there are probably 10 fold more nurses than there are PAs and this many more who lobby and donate, and 2nd of which is that NPs learn under a completely different paradigm and as a result aren’t thought of necessarily as MD-lite by legislators like we may be and aren’t as tightly coupled with physicians as we are. 

[Joelseff]

Things would be perceived better if PAs themselves took the care to understand and present things accurately.

It sounds to me like you want to take all of your perceived faults with trends in PA education and dump them onto Yale's program, but the correlation just isn't there, even a comparison between this "online" program (which is really a hybrid program) and other online programs isn't yet there. What other online program do you know with clinical placement in didactic? With constant live, synchronous problem based learning? With on campus immersions? With School of Medicine faculty, etc etc?

I also don't love the trend of larger numbers of people being accepted into PA school right out of college with zero clinical training. What does that have to do with us? I already mentioned our cohort has an average of over 8000 hours of PCE/HCE. That's almost three times the national average.

Should PAs always let fear of uneducated and unfair perceptions get in the way of their innovation and progress? Should we always play second fiddle to the physicians and wait for them to do something first before we do it? If a program can produce competent PAs while doing didactic education from a distance, should we stand in its way because it's not how it used to be done? Seems to me like the "back in my day we used to walk to school uphill both ways" vibe.

Just curious what the positions you all held for the 8000 hours? (not trying to start crap just really curious...)

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[Boatswain2PA]

Yale probably has a terrific online PA program.  There is probably also a terrific online NP program.

Problem is that most online programs suck.

We used to require significant real-world HCE, and we used to require butt-in-seat learning.

Now we don't require either. 

Again, instead of the NPs bringing their educational STANDARD up to ours, we are slipping down the slope to meet theirs.

[Marinejiujitsu]

No they didn't

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UC Davis tried or was going to if I remember right. Joel could likely way in. Lol.

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[corpsman89]

10 hours ago, Kilian12 said:

I understand your point about perception and I addressed it above as well.

Did the public and legislators and regulators understand or respect the quality difference between in class PA education and in class NP education before? Did they care that NPs who don't learn how to interpret an EKG are running their own practices? No. Were NPs given full practice authority at the VA despite having some crappy online schools? Yes. If crappy online education didn't hold NPs back, why should good online education hold PAs back? Because we can't advocate for ourselves as well as they do?

Again, as long as PAs can maintain the quality of their education high, I don't see why we should limit our access, reach and growth and only piggyback on others' education models. If a medical school had implemented an online didactic model would people be half as outraged that PAs are doing it? Isn't it a shame if we never dare to do something first? Our education is still consistent with MD/DO education: we learn in depth biology and science based medicine.  Requiring someone to learn it sitting in a classroom is not an education standard, it's an arbitrary rule that only serves to protect "the way it's always been done."

NPs can afford to advance their agenda while having crappy online schools and < training because they have a POWERFUL lobby. 

PAs do not.

That's the difference. We cant afford this. We must strive to have every talking point available to us in order to advance our profession. We can no longer say that all PAs must attend class on a full time schedule. 

And yes, I believe MD/DO schools should absolutely be the first to implement online schooling. They are the leaders of medicine, and they should start the trend. It's the worst idea to start with NPs -> PAs THEN move to MD/DO schools (if that even ever happens). At least they are still firm believers in in-class education.

 

[Kilian12]

2 hours ago, corpsman89 said:

1) We can no longer say that all PAs must attend class on a full time schedule. 

2) And yes, I believe MD/DO schools should absolutely be the first to implement online schooling. They are the leaders of medicine, and they should start the trend. It's the worst idea to start with NPs -> PAs THEN move to MD/DO schools (if that even ever happens). At least they are still firm believers in in-class education.

 

1) Of course we can.

2) I’m sorry you feel that way.

[Kilian12]

9 hours ago, Joelseff said:

Just curious what the positions you all held for the 8000 hours? (not trying to start crap just really curious...)

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Pharmacist, paramedic, army medic, physical therapist, PT aide, respiratory therapist, dental hygienist, radiology technician, blood bank supervisor, medical technologist, dietician, medical assistant, scribe, cardiac rehabilitation, public health, clinical research... just some of the ones I can remember.

[mmiller3]

2 hours ago, corpsman89 said:

NPs can afford to advance their agenda while having crappy online schools and < training because they have a POWERFUL lobby. 

PAs do not.

That's the difference. We cant afford this. We must strive to have every talking point available to us in order to advance our profession. We can no longer say that all PAs must attend class on a full time schedule. 

And yes, I believe MD/DO schools should absolutely be the first to implement online schooling. They are the leaders of medicine, and they should start the trend. It's the worst idea to start with NPs -> PAs THEN move to MD/DO schools (if that even ever happens). At least they are still firm believers in in-class education.

 

NPs have a powerful lobby because of their numbers. The more PA schools we have, the more PAs we have. The more PAs practicing means we have a louder voice. We need to stop living in the shadow of NPs and MDs, and start doing what provides PAs with the best future. None of the hospital systems I have dealt with give a damn about NP training versus PA training, and I am willing to bet the general public doesn't know or doesn't care. I hope the Yale program is wildly successful, and that online programs bring more good PAs into the field.

[Joelseff]

Pharmacist, paramedic, army medic, physical therapist, PT aide, respiratory therapist, dental hygienist, radiology technician, blood bank supervisor, medical technologist, dietician, medical assistant, scribe, cardiac rehabilitation, public health, clinical research... just some of the ones I can remember.

That's good! Looks like an "old school" program (except the scribes imo but that's here to stay) I'm glad they are not taking down HCE requirements. I am not a big fan of online education as primary training (for post graduate degrees I'm ok with it. I got my masters online after pa school) for many of the reasons stated above and my experience as a preceptor for both online and brick and mortar NP programs (quite frankly I am not a fan of NP training period) but I wish you all the best and this seems to be the trend. As mentioned above UC Davis tried one or two years of online didactics and IIRC, they canned it. Maybe Yale has a different approach.

 

Again I wish you all the best.

 

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[mmiller3]

2 minutes ago, Kilian12 said:

Pharmacist, paramedic, army medic, physical therapist, PT aide, respiratory therapist, dental hygienist, radiology technician, blood bank supervisor, medical technologist, dietician, medical assistant, scribe, cardiac rehabilitation, public health, clinical research... just some of the ones I can remember.

Good thing you are not a nurse--I think you would have to list all that on your white coat...

[Kilian12]

9 minutes ago, Joelseff said:

That's good! Looks like an "old school" program (except the scribes imo but that's here to stay) I'm glad they are not taking down HCE requirements. I am not a big fan of online education as primary training (for post graduate degrees I'm ok with it. I got my masters online after pa school) for many of the reasons stated above and my experience as a preceptor for both online and brick and mortar NP programs (quite frankly I am not a fan of NP training period) but I wish you all the best and this seems to be the trend. As mentioned above UC Davis tried one or two years of online didactics and IIRC, they canned it. Maybe Yale has a different approach.

 

Again I wish you all the best.

 

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Thank you. It is our goal and program mission as well to show up to clinical rotations as prepared as possible and on par with anyone else. I’m not sure how online NP education is done, but my hope is that they are continuously assessing their students’ learning and making adjustments accordingly.

[Kilian12]

33 minutes ago, mmiller3 said:

Good thing you are not a nurse--I think you would have to list all that on your white coat...

Kilian12 PA-S B.Sc. K12  =D

[fireguy]

1 hour ago, mmiller3 said:

 None of the hospital systems I have dealt with give a damn about NP training versus PA training, 

I receive a lot of locums request on a regular basis, and I do a fair amount.  I frequently get emails and announcements for a locums job for NP only.  I have NEVER received one that was PA only.  There is a sizeable cross section of employers and locations that will only hire an NP, presumably because of autonomy issues.  

[cinntsp]

I have no issue with online education in general, but I do think online PA programs will hurt the drive for professional change/progress.  It's just more ammo that can be used against the profession, just like it's used against NPs(not that it really matters to them, but we don't have the political clout they do).  Heaven help us if these programs do clinical rotations the same way NP programs do where the student goes for a few hours a couple times per week.  At that point there will be no reason not to become an NP over a PA.  Same crappy education...worse state practice laws.

[cvilleUVA]

I think the people who are shooting down the idea or are hoping that the Yale online PA program will fail out are just near sighted. In a respectful way, I am sure a stout university like Yale have throughly planned this out. It is not some no name PA new program trying to make a quick buck. 

For those who are doing the online PA program, congrats! I think regardless of what some may think on this thread, you all worked hard to get where you are and your dedication and commitment to the profession will be evident. I am sure your didactic year may even be more difficult than some of the traditional on site PA programs across the country. 

I tend not frequent this forum very much and I recommend reddit.com/r/physicianassistant for a better experience and might a suggest even a more helpful community. Also many of the pre-pas are redirected to another subreddit (r/prepa) devoted to their questions. 

[sas5814]

I sat this one out for a while because it didn't really interest me but more and more responses kept popping up so I thought I'd drop in. I find some of the post thoughtful even when disagreeing with someone and some a bit knee jerk reactionary.

I have always said if you change a lightbulb someone is going to complain. This is a huge change for PA education and there will be lots and lots of folks who will disparage it. I think it is part of an inevitable change in learning models just because of the non stop changes in technology.

I didn't have a clue there were tools for people taking computer tests to be monitored in such a way. Fascinating. can it be cheated? Probably by someone who wants to work at cheating that hard but I am weary of everything having to be structured for the lowest common denominator. Banks get robbed despite how hard it is. Nobody is shutting down bank locations because of it.

I get the perception issue. 10 or 15 years ago distance learning was a pretty shady deal but has grown a legit cache in the past couple of years. Done right it is just another tool and soon it will have no stigma at all. Bad actors will always be bad and the world shouldn't stop moving forward because of them.

I'm going to keep watching how this program develops and what happens with its graduates. It seems it is being done about as well as something this new can be done. I hope the students are wildly successful and become great representative of the profession.

cvill I am a lurker on Reddit (multiple forums) because it is lousy with very young very sensitive very very liberal folks of which I am none. Some subs I can have a civil dialogue and polite disagreement. Most I get down-voted into oblivion for not sharing their world view. It's all about whose ox is getting gored.

[TrekkieByDay]

On 4/9/2018 at 5:07 PM, corpsman89 said:

First it was expanding the definition of "PCE"

Then it was reducing the hours of said PCE

Then it was reducing the hours of PCE to Nothing. 

Now it is online. 

We are losing every argument that shows that PAs have better education and training. These arguments are more important than ever too. 

I haven't seen any evidence that said "No PCE" was acceptable for admissions....anywhere. Where are these hidden gems? 

 

[katieo]

1 hour ago, cvilleUVA said:

 

I tend not frequent this forum very much and I recommend reddit.com/r/physicianassistant for a better experience and might a suggest even a more helpful community. Also many of the pre-pas are redirected to another subreddit (r/prepa) devoted to their questions. 

Reddit ftw but the PA sub is not that lively. I stay on the nursing and med school subs cause they got jokes

[TrekkieByDay]

On 4/13/2018 at 11:25 AM, Kilian12 said:

Kilian12 PA-S B.Sc. K12  =D

Killian, how many clinical hours of training do you think you acquired, total? 
A NP gets between 500-1500. 

A PA typically gets just over 2000. 

It seemed, when I looked into this program, that Yale Online PAs would get MUCH fewer hours, and I didn't want that--so how many did you accrue? 

Thanks! 

 

54 minutes ago, sas5814 said:

 

I didn't have a clue there were tools for people taking computer tests to be monitored in such a way. Fascinating. 

....

I'm going to keep watching how this program develops and what happens with its graduates. It seems it is being done about as well as something this new can be done. I hope the students are wildly successful and become great representative of the profession.

 

Thank you for admitting that you didn't know about how they fixed one of the common objections to this program. THAT is a huge step forward for me--knowing they take academic integrity seriously.