1 Joint Task Force on the Future of the PA Workforce Notes from the Field April 14-16, 2011 Washington DC

2 Session Overview The charge of the task force is to develop recommendations which can be implemented by AAPA and PAEA for the growth of the PA workforce in a manner that maintains quality and assures the profession’s maximum impact on the health of the nation through The Task Force held an initial Design Session in January 2011 to develop a preliminary list of recommendations for the Boards of AAPA and PAEA to support the growth of the PA Profession. After the initial Design Session, a report was created summarizing the first meeting, a series of interviews were conducted and distributed through the website, and a rough simulation model was built to explore the variables that will drive the number of practicing PA’s in the future. This Design Session is focused on developing the final list of recommendations from the Task Force. Additional resources and information about the work of the Task Force can be found at

3 Keynote Speaker – Dr. Russ Robertson

4 Keynote Speaker

5 Reconnecting With Session I Assignment This activity will be done in pairs. Please find a partner – preferably someone you don’t know very well. On the white boards in the plenary you will find four posters. Each poster contains the preliminary recommendations developed at our meeting in January. These recommendations are divided into the following four categories: Pipeline and Admissions Didactic Curriculum Clinical Curriculum Clinical Practice and Distribution Your pair has been provided four sheets of green dots to ‘invest’ on some of the recommendations. Your pair will use the dots to ‘invest’ in the recommendations on each poster that will help us meet our objectives for responsibly growing the PA and meet our objectives to: To ensure a diverse workforce To provide quality infrastructure for PA education programs To maximize the distribution of PAs across practice areas and geographies To ensure quality across the board On each poster you can ‘invest’ your dots in any way you want – using all four dots for one recommendation or dividing the four dots among several recommendations. Please ONLY invest four dots per poster.

6 Reconnecting With Session I

7

8 Welcome and Introduction

9 Draft Recommendations – Sorted by Objective 1 of 2 Pipeline/ Admissions Didactic Curriculum Clinical CurriculumPractice Setting / Distribution To ensure a diverse workforce 1.Expose K-12 level students to the PA profession. 2.Promote K-12 level science education 3.Develop rural community pipeline programs to produce PAs for rural and underserved areas. 4.Increase PA student outreach to potential feeder institutions 5.Develop resources to promote the PA profession as a career 1.Establish loan repayment resources to recruit faculty from underrepresented minorities 2.Establish loan repayment resources for PA Program faculty. 3.Increase recruitment of students and faculty from underrepresented minorities To provide quality infrastruct ure for PA education programs 1.Integrate service learning curricula into all PA programs 2.Establish loan repayment resources to recruit faculty from underrepresented minorities 3.Establish loan repayment resources for PA Program faculty. 4.Explore opportunities for inter-professional education in the didactic year. 5.Seek out partnerships and funding for broadly based inter- professional education and training 1.Develop a preceptor recruitment, retention, and recognition program to be used by all PA programs. 2.Provide thorough orientation for clinical year rotations 3.Explore use of technology to connect PA programs with remote preceptor locations. 4.Establish a centralized system for sharing of clinical training resources among health professions. 5.Investigate funding sources to develop inter-professional educational models. 6.Develop community partnerships for recruitment and faculty development for clinical preceptors. 7.Develop simulation and alternate clinical teaching strategies and assessment tools. 8.Develop resources to enhance pre-PA shadowing opportunities. 9.Integrate service learning curricula into all PA programs which expose PA students to marginalized populations. 1.Encourage more clinicians to become actively involved as clinical preceptors 2.Advocate for the development of telehealth infrastructure and incentives to improve chronic disease management and team-based care with PAs as clinical leaders.

10 Draft Recommendations – Sorted by Objective 2 of 2 Pipeline/ Admissions Didactic CurriculumClinical Curriculum Practice Setting / Distribution To maximiz e the distributi on of PAs across practice areas and geograp hies 1.Develop rural community pipeline programs to produce PAs who will return to rural and underserved areas. 1.Integrate service learning curricula into all PA programs which expose PA students to underserved populations. 1.Establish a new accreditation standard which requires clinical rotations in rural and underserved areas. 2.Develop community partnerships for recruitment and faculty development for clinical preceptors. 3.Integrate service learning curricula into all PA programs which expose PA students to marginalized populations. 1.Establish consistent practice regulations in each state to eliminate barriers to practice. 2.Advocate for full funding of the new Health Workforce Commission. 3.Create mechanisms to facilitate re-entry into the profession by PAs who have been out of clinical practice. 4.Advocate to revise the reimbursement structure to support team-based and non- visit care. 5.Increase dialogue between PAs and nursing and physicians to explore opportunities to collaborate. To ensure quality across the board 1.Strengthen connections with college advisors 2.Conduct objective review of admission requirements to establish consistency. 3.Investigate best practices utilized in admissions process 4.Establish standardized admission pre- requisite requirements for applicants 5.Develop resources to promote the PA profession as a career. 1.Develop process for external review of content and assessment methodology used in the didactic curriculum. 2.Establish coordinated bank of consultants to serve as resources to PA programs. 3.Develop and integrate new PA program quality metrics and best practices for the didactic year. 4.Explore opportunities for inter- professional education in the didactic year. 5.Seek out partnerships and funding for broadly based inter- professional education and training across health professions. 1.Investigate funding sources to develop inter- professional educational models. 2.Develop simulation and alternate clinical teaching strategies and assessment tools. 3.Develop resources to enhance pre-PA shadowing opportunities. 1.Identify and promote best practice models that are built upon team-based care. 2.Establish consistent practice regulations in each state to eliminate barriers to practice.

11 Draft Recommendations – Sorted by Type 1 of 2 Pipeline/Admissio ns Didactic Curriculum Clinical CurriculumPractice Setting / Distribution Advocacy / Policy 1.Promote K-12 level science education as a basis for future healthcare profession opportunities. 2.Increase PA student outreach to potential feeder institutions to increase applicant diversity. 3.Develop resources to promote the PA profession as a career choice. 1.Increase recruitment of students and faculty from underrepresented minorities to increase diversity. 2.Seek out partnerships and funding for broadly based inter- professional education and training across health professions. 1.Identify and promote best practice models that are built upon team-based care. 2.Encourage more clinicians to become actively involved as clinical preceptors via incentives and faculty development. 3.Establish consistent practice regulations in each state to eliminate barriers to practice. 4.Advocate for full funding of the new Health Workforce Commission. 5.Advocate for the development of telehealth infrastructure and incentives to improve chronic disease management and team-based care with PAs as clinical leaders. 6.Advocate to revise the reimbursement structure to support team-based and non- visit care. Research 1.Conduct objective review of admission requirements to establish consistency. 2.Investigate best practices utilized in admissions process to educational programs. 1.Develop and integrate new PA program quality metrics and best practices for the didactic year. 1.Investigate funding sources to develop inter- professional educational models. 1.Identify and promote best practice models that are built upon team-based care.

12 Draft Recommendations – Sorted by Type 2 of 2 Pipeline/Admissio ns Didactic CurriculumClinical CurriculumPractice Setting / Distribution Practice/ Process 1.Strengthen connections with college advisors to promote PA profession as a career. 2.Explore opportunities to expose K-12 level students to the PA profession. 3.Develop rural community pipeline programs to produce PAs who will return to rural and underserved areas. 4.Establish standardized admission pre-requisite requirements for applicants to PA programs. 5.Establish coordinated network to link pre-PA clubs with feeder institutions. 1.Integrate service learning curricula into all PA programs which expose PA students to underserved populations. 2.Increase recruitment of students and faculty from underrepresented minorities to increase diversity. 3.Develop process for external review of content and assessment methodology used in the didactic curriculum. 4.Explore opportunities for inter-professional education in the didactic year. 1.Establish a new accreditation standard which requires clinical rotations in rural and underserved areas. 2.Provide thorough orientation for clinical year rotations, to include learning outcomes and expectations of students and preceptors. 3.Explore use of technology to connect PA programs with remote preceptor locations. (i.e. lecture presentations, small group discussions, online discussions) 4.Establish a centralized system for sharing of clinical training resources among health professions. 5.Develop simulation and alternate clinical teaching strategies and assessment tools. 6.Develop resources to enhance pre-PA shadowing opportunities. 7.Integrate service learning curricula into all PA programs which expose PA students to marginalized populations. 1.Create mechanisms to facilitate re-entry into the profession by PAs who have been out of clinical practice. 2.Increase dialogue between PAs and nursing specifically and PAs and physicians to explore opportunities to collaborate. Structure 1.Develop rural community pipeline programs to produce PAs who will return to rural and underserved areas. 2.Establish coordinated network to link pre-PA clubs with feeder institutions. 1.Establish loan repayment resources to recruit faculty from underrepresented minorities to increase diversity. 2.Establish loan repayment resources to recruit and retain PA Program faculty. 3.Establish coordinated bank of consultants to serve as resources to PA programs. 1.Establish a new accreditation standard which requires clinical rotations in rural and underserved areas. 2.Develop a preceptor recruitment, retention, and recognition program to be used by all PA programs. 3.Develop community partnerships for recruitment and faculty development for clinical preceptors 1.Identify and promote best practice models that are built upon team-based care. 2.Establish consistent practice regulations in each state to eliminate barriers to practice. 3.Advocate for full funding of the new Health Workforce Commission.

13 Identify Gaps in Recommendations - Assignment There are four small groups. Group 1: The objective is to ensure a diverse workforce Group 2: The objective is to provide quality infrastructure for PA education programs Group 3: The objective is to maximize the distribution of PAs across practice areas and geographies Group 4: The objective is to ensure quality across the board Using the part of the matrix of recommendations provided, review the recommendations and ensure these recommendations will help the PA profession achieve the objective. Identify where there are any gaps. Add additional recommendations where necessary. In looking for gaps one way to think about it is to consider the various types of recommendations: Advocacy/Policy Recommendations Research Recommendations Practice/Process Recommendations Structure Recommendations Be prepared to share the results of your work with the other groups.

14 Identify Gaps in Recommendations – Team 1

15 Identify Gaps in Recommendations – Team 2

16 Identify Gaps in Recommendations – Team 3

17 Identify Gaps in Recommendations – Team 4

18 iThink Recommendations - Assignment During our session in January we asked the group how many PAs ‘should’ there be in 2020 and the group roughly came up with about 130,000. Using that number as a target we developed a ‘scenario’ in which we can achieve that target. That scenario suggests we can achieve the target of having 130,000 PAs in practice by 2020 if we increase the number of programs to 194 (39 more), the number of faculty to 2100 (adding 440 more), and the number of clinical sites to 7400 (adding 2150 more). Assignment This is an activity in four small groups. In your group come up with recommendations for how the PA profession should grow your focus area by the specific number. As you develop your recommendations please consider the following as part of your recommendations: What policies (or rules) could/should be changed? What assumptions do we have that could/should be challenged? What current structures could/should be changed to help achieve this growth?. What practices/processes could/should be changed to help achieve this growth? What research should be done to help achieve this growth? What changes will likely take place over the next 9 years? Group 1: Pipeline Over the next 5 years you need to grow the number of people wanting to be a PA and apply to a PA program by 2144 (currently we have about 6500 people in their first year of a PA program. By 2016 we will need to have about 8644 people in their first year). Group 2: Programs Over the next 5 years you need to grow the number of PA programs by 39 (currently we have 155 programs. By 2016 we will need to have about 194 PA programs in the pipeline. Group 3: Faculty Over the next 5 years you need to grow the number of PA faculty by 440 (currently we have about 1670 faculty. By 2016 we will need to have about 2100 PA faculty. Group 4: Clinical Sites Over the next 5 years you need to grow the number of clinical sites by 2150 (currently we have 5250 clinical sites. By 2016 we will need to have about 7400 clinical sites). You have 60 minutes to complete this assignment, at which point you will report your work to the rest of the group. Use the white boards for collecting ideas and for your final report.

19 iThink Recommendations, Part II - Assignment Now that you have identified ways to grow the PA profession in specific ways, part II of this activity is to challenge yourselves to identify what you would do differently if you had to double the number (grow to twice as large as you’ve been discussing in part I). Group 1: Pipeline What would you do differently if you had to grow the number of participants by 4288 and have about 11,288 people in their first year by 2016? Group 2: Programs What would you do differently if you had to grow the number of programs by 78 in the pipeline by 2016 (in order to have 233 PA programs by 2020)? Group 3: Faculty What would you do differently if you had to grow the number of PA faculty by 880 (having about 2550 by 2016)? Group 4: Clinical Sites What would you do differently if you had to grow the number of clinical sites by 4300 (having 9550 clinical sites by 2016)?

20 iThink Recommendations– Team 1

21 iThink Recommendations– Team 2

22 iThink Recommendations– Team 3

23 iThink Recommendations– Team 4

24 Exploring How Round 1 - Assignment This round of work is focused on continuing to explore ‘how’ we might do some of the things we are suggesting as recommendations. For this activity we’ll use the posters we worked on last night as well as the work we’ve completed so far today. Each group will focus on one of the parts of the continuum: Group1: Pipeline and Admissions Group 2: Didactic Curriculum Group 3: Clinical Curriculum Group 4: Clinical Practice and Distribution Assignment For your focus area, pick two of the recommendations for responsibly growing the PA profession (using the poster and the work we’ve completed so far today) and develop an ‘implementation plan’ for those two recommendations. For each recommendation, answer the question: How should this recommendation be implemented? Make a list of all the things that need to happen in order for that recommendation to be implemented Make a list of who needs to be involved or included in some way Develop a timeline of activities – what needs to happen when? Prepare your plans on the marker board. At the end of this round, you will share your plan with some of the other groups. You have about 60 minutes to complete your work.

25 Exploring How – Team 1

26 Exploring How – Team 2

27 Exploring How – Team 3

28 Exploring How – Team 4

29 Exploring How Round 2 - Assignment This round of work is focused on continuing to explore ‘how’ we might do some of the things we are suggesting as recommendations. For this activity we’ll use the posters we worked on last night as well as the work we’ve completed so far today. Each group will focus on one of the parts of the continuum: Group1: Pipeline and Admissions Group 2: Didactic Curriculum Group 3: Clinical Curriculum Group 4: Clinical Practice and Distribution Assignment For your focus area, pick two of the recommendations for responsibly growing the PA profession (using the poster and the work we’ve completed so far today) and develop an ‘implementation plan’ for those two recommendations. For each recommendation, answer the question: How should this recommendation be implemented? Make a list of all the things that need to happen in order for that recommendation to be implemented Make a list of who needs to be involved or included in some way Develop a timeline of activities – what needs to happen when? Prepare your plans on the marker board. At the end of this round, you will share your plan with some of the other groups. You have about 60 minutes to complete your work.

30 Exploring How – Team 1

31 Exploring How – Team 2

32 Exploring How – Team 3

33 Exploring How – Team 4

34 Exploring How - Scribing

35 Day Two Introduction

36 “Board Presentations” - Assignment

37 “Board Presentations” – Team 1 Diversity

38 “Board Presentations” – Team 2 Infrastructure

39 “Board Presentations” – Team 3 Distribution

40 “Board Presentations” – Team 4 Quality

41 Preparing the Report - Assignment

42 Preparing the Report – Team 3 Preamble

43 Preparing the Report – Team 2 Report Structure

44 Preparing the Report – Team 4 Conclusion

45 Preparing the Report – Team 1 Roll Out Ideas

46 Preparing the Report – Team 5 Quick Wins

47 Thank you