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Geisinger internship that provides shadowing

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This article was in AAPA's daily med watch email. It sounds like it could be an interesting experience for some pre-PAs and maybe other places will begin to pick up on the idea.


Innovative approach to obtaining pre-physician assistant hours

By Michael J. Smith, MS, and Ronald H. Byerly, PA-C


According to The U.S. Department of Labor, there were an estimated 74,800 physician assistants in clinical practice at the end of 2008. Also, the Bureau of Labor Statistics reported that “Employment of physician assistants is expected to grow 39 percent from 2008 through 2018, much faster than the average for all occupations. Projected rapid job growth reflects the expansion of healthcare industries and an emphasis on cost containment, which results in increasing us of PAs by healthcare establishments.” This, of course, is due to many factors, including that of an aging population that is living longer, impending physician shortages, broadened insurance coverage, and the new restrictions to shorten physician resident working hours.


Due to this rapid growth, the desire to attend school to become a physician assistant has also increased. In order to apply to a physician assistant program, a prospective student is required by most schools to complete pre-physician assistant observation/shadowing hours. During these hours, the students generally shadow and observe a current PA or physician and have direct patient contact. Some schools require up to 1,000 direct patient-care shadow hours.


This has become a process that is difficult to accomplish. Many hospital systems have closed their doors to shadowing opportunities due to the Health Insurance Portability and Accountability Act (HIPPA) and numerous other security and screening issues. Without these patient contact hours, many prospective students cannot attend school. This is an area where one can see a need for an alternative to the traditional shadow hours.


The Department of Academic Affairs at Geisinger Health System has developed an initial approach to obtaining these hours with less provider resource expenditure. Geisinger Health System partnered with a local state university to work with pre-PA students. Students, who are working toward their bachelor’s degree from the local university, complete a summer internship program that provides them with 120 hours of service or shadow hours. The students are required to observe direct patient care 24 hours a week for five weeks which enables them to take other classes or work their normal jobs.


This 24-hour-per-week participation leads to 120 direct patient-care observation hours and the student would also receive three academic credits from the local university for participation in the program. During the length of the summer internship, the student attends biweekly medical lectures, receives operating room orientation/observations hours and has direct patient-care observation experiences. This partnership allows the students the opportunity to engage in academic medical discussions with healthcare providers and learn more about the healthcare professions. This unique experience is offered to a select group of students who are carefully screened by the university, the APC physician assistant director and the advanced practice academic liaison.


The summer internship program consists of five weeks of clinical rotations with a predetermined advanced practice (PA or NP) preceptor. The students receive five different clinical rotations in five unique departments at Geisinger Medical Center in Danville, Pa. This type of rotation allows for the prospective PA student to gain a better understanding of how advanced practitioners go about their days and the qualities that a PA must possess, and they receive direct patient-care observation hours while learning proper bedside mannerisms.


The first summer internship took place in the summer of 2012. Prior to the summer internship program, students were given a survey which looked at their knowledge of: 1) the skills needed to become a PA, 2) the core values of PAs, 3) their motivation to become a PA, 4) qualities and competencies needed to be a PA, and 5) the knowledge required to be a practicing PA.


At the end of the Summer Internship program, the students completed the same survey; in order to compare how they felt about these points both prior to, and after the program. A scale was employed that ranged from 1, which represented almost no understanding/no confidence, to a 5, which represented very high understanding/very high confidence of the points assessed. At the start of the program the average of these ranged from 2 to 3, depending on the exact topic of the question. At the completion of the summer internship, the student’s average scores ranged from a 4 to the highest score of a 5 for knowledge of the PA profession.


After completion of the five-week summer internship program at Geisinger Medical Center, the prospective student had a better understanding of the role of a physician assistant and the knowledge needed to become a practicing PA. Further, the students’ knowledge of the skills needed by practicing PAs, and the students’ overall understanding of how to become a PA vastly increased. The pre-PA student also gained 120 valuable direct-observation hours. More importantly, the student gained valuable insight into the teamwork utilized in an integrated healthcare setting, in a manner that appeared to increase the students’ confidence in their personal knowledge base.




Bureau of Labor Statistics (2012). Occupational Outlook Handbook. United States Department of Labor. Retrieved fromhttp://www.bls.gov/ooh/Healthcare/Physician-assistants.htm

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