1. Development and Evaluation of a Research Extension Experience in Directed Studies (REEDS) for Physician Assistant Students
Tiffany Kindratt, MPH
Department of Physician Assistant Studies
Texas Society of Allied Health Professionals Conference
September 21, 2017
Houston, Texas

2. Background
Efforts have been made to equip allied health professionals with clinical research knowledge and skills
Few curriculum models have been developed to train research skills to allied health students, in particular physician assistant (PA) students
Master’s programs require completion of graduate project yet have limited time for teaching research methodology in already packed curriculum

3. Literature Review
Reasons for lack of research training in PA curriculum:
Lack of curriculum requirements for accreditation
Lack of curriculum models published
Lack of faculty expertise

4. Literature Review Lack of curriculum requirements for accreditation
ARC-PA requires that PA programs educate students how to search and critically appraise medical literature in order to apply it to patient care
No curriculum requirements for teaching research methods
Lack of curriculum models published in scientific journals
Cipher and colleagues (2003) reported on research agenda used at the University of North Texas PA program
Curriculum focused on educating PA students how to develop research questions, conduct literature reviews, read and review literature, write a final research paper and give an oral presentation of results
No evaluation of student baseline or post-curriculum outcomes reported

5. Background Lack of PA faculty expertise
Swanchak and colleagues (2013) evaluated whether PA educators were prepared to facilitate master’s level research projects
Found a lack of preparedness and deficits in research training among PA faculty
Ways to address barriers
Development of research training programs
Collaboration with departments with established research programs and mentors

6. Purpose
To develop, implement and evaluate the Research Extension Experience in Directed Studies (REEDS) online curriculum designed to train PA students how to conduct research during their clinical year of training
Original goal was to enroll PA students into an online program to learn the entire research process throughout their clinical year based on Community Health Fellowship Program and Research Methods Course

7. Specific Aims
Conduct annual needs assessment of PA student research knowledge and skills (phase 1)
Develop a set of online modules to train PA students how to conduct primary and secondary research studies (phase 2)
Track online module completion and satisfaction (phase 3)

8. Methodology: Phase 1
Setting: University of Texas Southwestern School of Health Professions
Subjects/Students:
Master of Physician Assistant Studies (n=201)
Class of 2015 (n=34)
Class of 2016 (n=29)
Class of 2017 (n=42)
Class of 2018 (n=43)
Class of 2019 (n=53)
Measures
Students answered 23 questions on research knowledge, confidence in skills and attitudes
5-point Likert scales
1=strongly disagree to 5=strongly agree
Check questions

9. Methodology – Phase 1 Measures
Knowledge
Institutional review board (IRB) procedures
Importance of Human Subjects Protection and HIPAA Research
Steps of the research cycle
Community-based participatory research methods
Basic research designs
Basic statistical terms (i.e. t-test, chi square, ANOVA)
Advanced statistical terms (i.e. logistic regression)
Components of research articles
Methods for creating oral and poster presentations
Modes of dissemination for research studies

10. Methodology – Phase 1 Measures
Confidence in Skills (Self-Efficacy)
Formulate research questions
Design a descriptive or exploratory study
Perform literature search using MEDLINE/PubMed
Critical appraisal of research articles
Develop survey instruments
Collect data and create databases
Analyze and interpret data
Write formal research manuscript
Develop and deliver formal research presentations

11. Methodology – Phase 1 Measures
Attitudes
Research is important to the PA profession
Interested in working on projects with faculty
Interested in presenting project results by poster at local or national conferences
Interested in presenting project results by oral presentation at local or national conferences

12. Methodology – Phase 1 Measures
Statistical Analysis Methods
Responses dichotomized
Strongly disagree/disagree/undecided
Strongly agree/agree
Proportions of strongly agree/agree presented

13. Methodology – Phase 2 Curriculum Development
Seven (7) online modules were developed based on PA students’ self-assessed research needs, previous literature and interests including:
Responsible conduct of research
Research project development
Database creation and analysis
Analysis and interpretation using SPSS
Analysis and interpretation using STATA
Secondary data analysis using SAS
Dissemination
Online modules were made available to medical students in the UTSW Community Health Fellowship Program and Research and Scholarly Activity rotations

14. Methodology – Phase 3 Track online module completion and satisfaction
Total number of PA and medical students who viewed online modules
7-item online lecture evaluation on Survey Monkey to provide feedback on ways that the online curriculum can be improved (1=strongly disagree to 5=strongly agree).

15. Methodology – Phase 3 Online Lecture Evaluation
Identify what online lecture was completed
Rate level of agreement with the following:
The online presentation was organized.
The examples provided were helpful in the development of my research project.
The content provided in the online presentation met my learning needs.
Overall, I was satisfied with this online presentation.
This education format suits my learning style.
Please provide any additional feedback to enhance the online presentation

16. Results: Phase 1 – Knowledge (%Agree/Strongly Agree)

17. Results: Phase 1 – Skills (%Agree/Strongly Agree)

18. Results Phase 1 – Attitudes (%Agree/Strongly Agree)

19. Results: Phase 2 - Curriculum Objectives
Curriculum Module
Learning Objectives
Developing Research Questions and Objectives
Define “research questions”
Describe ways to develop research questions based on general topic
Explain characteristics of good research questions
List examples of previous research questions
Develop research objectives from research questions
Developing Survey Instruments
Describe 11 step process for developing surveys
Visualize research question
Review literature for existing surveys
Select specific topics for questions
Choose question types (open or close ended)
Choose response types (nominal or ordinal)
Review wording
Check order of questions
Format layout
Pilot test
Revise
Implement
Discuss tips for survey development

20. Results: Phase 2 - Curriculum Objectives
Curriculum Module
Learning Objectives
Database Creation and Coding
Visualize your data as you develop your research question
Discuss 6 steps for data management and control
Describe ways to annotate your data for future reference
Develop database and codebook for entry and analysis
Reporting and Writing
Identify 5 principles of scientific writing
Draft a manuscript using these principles using “The Recipe”
Create tables and figures to describe your methods and results

21. Results: Phase 2 - Online Curriculum

22. Results: Phase 3 - Online course enrollment and tracking
18 students enrolled in online course
10 online lecture evaluations completed
50% viewed database creation and coding module
40% viewed reporting and writing module
10% viewed developing survey instruments

23. Results: Phase 3 - Lecture Evaluations, N=10 (means)

24. Limitations
Although positive attitudes towards research, no PA students were interested in completing entire online program
Future interest may be higher if a distinction in research is offered
Limited faculty time required modules to be developed on “as-needed” basis

25. Next Steps Transition from Moodle to D2L Brightspace
Modules will be included in UTSW new medical school curriculum’s 12-week Research and Scholarly Activity rotation
Develop data analysis specific modules for using STATA and SAS
Develop section for quality improvement methods
Contact:
Tiffany Kindratt, MPH

26. References
1. Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). Accreditation Standards for Physician Assistant Education. September
2. Harding KE, Stephens D, Taylor NF, Chu E, Wilby A. Development and evaluation of an allied health research training scheme. J Allied Health. 2010;39(4):e
3. Cipher DJ, Lemke, H., Coleridege, S.T.,. Establishing a Research Agenda in Master’s- level Physician Assistant Studies Programs. Perspective on Physician Assistant Education ;14(2):84-87.
4. Swanchak LE, Walters H. Are physician assistant educators prepared to facilitate master's level research among their students? J Physician Assist Educ. 2013;24(2):42-43.
5. Dehaven MJ, Gimpel NE, Dallo FJ, Billmeier TM. Reaching the underserved through community-based participatory research and service learning: description and evaluation of a unique medical student training program. J Public Health Manag Pract ;17(4):