Session Abstracts Day 2

The aim of this workshop is to allow delegates to share their experiences of aligning their PA course

with the new FPA draft curriculum (published in September 2022)

https://www.fparcp.co.uk/file/image/media/633c292be9bed_FPA_DRAFT_PA_curriculum_-

_FINAL_FOR_WEB.pdf

Background: with regulation by the GMC expected to commence in 2024, all PA programmes in the

UK have been encouraged to align their programme syllabus/curriculum with the FPA draft

curriculum and to start using this from September 2023. The draft curriculum was developed by the

GMC Physician Associate Curriculum Development Group from 2020-2022. As co-chair of the PASC

Education group, Jia represented all HEIs in the UK at the Curriculum Development Group; this

included consideration of responses to the wider consultation in autumn 2021. Subsequently the

draft curriculum went through the internal GMC Curriculum Advisory Group review process.

Plan for the workshop: the workshop will begin by brainstorming to identify common themes for

focussed discussion about the challenges of preparing for implementing the new curriculum. The

problems and solutions identified and shared will form the basis of a planned FAQ section on the

PASC website when this is developed.

Please email w.doulton@surrey.ac.uk with any suggestions for elements of the curriculum which

have been challenging to include in your programme and how you have found solutions so we can

make best use of the time available.

 The use of OSCEs in the quantitative assessment of competence has become widespread in the field

of medical education (1). It is utilised by the Royal College of Physicians in the Physician Associate

National Examination (PANE) and by many UK PA programmes. Blueprinting is a powerful tool to

help focus the OSCE designers on the exact nature of what they wish to assess (1).

This workshop is designed to support those involved in and with an interest in OSCE assessments. It

will focus on the importance of using a blueprint and factors to consider when creating one. During

this interactive and collaborative session, attendees will work in small groups to develop an example

OSCE blueprint for a Year 2 cohort and will experience first-hand the complexities involved. This will

be followed by a presentation highlighting best practices in blueprinting.

References:

1. Understanding Medical Education Evidence, Theory and Practice third edition Tim Swanwick,

Kirsty Forrest, Bridget C O'Brien. Published 2019.

This workshop will disseminate the findings from doctoral research which explored the

student PA journey from commencement as an undergraduate right through to completion of

their MSc programme taught outside a medical school. The objective was to understand

their journey and what effective support mechanisms the student PAs used; how this would

inform future educators and clinical mentors to enable smoother transitions into their new

professional role. The need for a clear support system within clinical practice that was PA

specific was identified, alongside better understanding of the PA role and the student needs

throughout their clinical placements.

The participants involved represented a convenience sample of students on the MSc in

Physician Associate Studies at University of Bolton in Northwest England. Findings showed

that whilst transitional points within the PA journey were not identified, several key themes

showed (1) PA visibility (2) PA recognition and understanding (3) PA Support Mechanisms

were vital factors to consider when supporting student progression and enhancing

confidence. These themes provided an increased understanding of the student’s journey and

enabled the development of a Physician Associate Clinical and Academic Learning (PCAL)

Support Framework, which has been put in place at Bolton to students on our programme

and may assist future PA students, educators, and clinical mentors.

The development of the PCAL framework resulted in the need for visible PA role models

within practice, a framework that supports both educational and clinical learning, and a

robust communication infrastructure to promote greater support across the clinical and

academic environments to enhance PA resilience and student well-being.

This workshop will give a brief overview of the research, the framework itself and how we

have initially implemented this at University of Bolton.

Presented by Michelle Powell who undertook the research, Rameez Tariq, PA Programme

Leader, and Mikey Hannides Lecturer and Clinical Mentor

Background: Workplace based assessments (WBA) are widely used in undergraduate and postgraduate medical education to support student learning, reflection, and development. The mini-clinical evaluation exercise (Mini-CEX) is a workplace-based assessment involving observed student performance and the provision of feedback. Traditionally, clinical supervisors were the intended assessor, but it has become widely accepted for other appropriate members of the clinical team to also perform this role. Subsequently, little is known about the assessor landscape and their credentials as assessors. A study was conducted to better understand the training and experience of mini-CEX assessors and explore their training preferences.

Approach: Data pertaining to the clinical role of assessors was collected from 5088 mini-CEX forms submitted to the University of Sheffield medical school in 2021. Further quantitative and qualitative data was collected from 106 participant responses to an online survey, exploring assessor experience with WBA, previous training, and training preferences.

Evaluation: Analysis of mini-CEX data found speciality registrars assessed the most mini-CEX forms in 2021 and 11.3% of submitted mini-CEX forms were completed by foundation year 1 doctors, despite not being allowed to act as assessors at this stage. Survey responses found 14.2% of mini-CEX assessments were completed by supervisors, the majority of assessments undertaken were by a healthcare professional supporting the student during their placement. 54.7% of assessors reported not having any previous training on workplace-based assessments, despite 92.5% of respondents being open to training. Preferred training methods included instructional videos and written guidance.

Implications: The findings of this study have shown most assessors have had no training on WBA and research has suggested lack of training impacts the quality of feedback in WBA. Future training provision should recognise the role of the wider multi-disciplinary team and junior medical workforce in WBA.

Under the revised timeline set out by the General Medical Council (GMC), Physician Associates (PAs) are set to be regulated in late 2024 (1). While prescribing rights are not included in the legislation that will bring regulation into effect, preparation for consultation on this is in progress. There is widespread support from key stakeholders for the launch of a consultation on prescribing rights for PAs within 24 months of regulation (2). Pharmacology is an integral part of a medical education and forms the building blocks for the clinical reasoning behind the selection of therapeutics. Aside from potential future prescribing rights, practicing PAs regularly undertake assessment and formulate diagnoses that result in the recommendation of a treatment plan and in many cases therapeutic selection. As such, PA education must provide the knowledge and skills to employ this safely and effectively. This session aims to discuss how the team at Bournemouth University have integrated pharmacology into the course and aligned this to the new GMC curriculum. We also aim to present the findings of our pilot evaluation and guide an open discussion with delegates on how other institutions are delivering pharmacology education.

References

General Medical Council. Bringing physician associates and anaesthesia associates into regulation. GMC, 2022. https://www.gmc-uk.org/pa-and-aa-regulation-hub/map-regulation

NHS. Interim NHS People Plan. NHS, 2019. https://www.longtermplan.nhs.uk/publication/interim-nhs-people-plan

Peer instruction is a form of active learning developed by Professor Eric Mazur. Peer instruction involves students preparing by doing pre-reading before the session (similar to a flipped classroom approach), the instructor then posing a question based on the pre-reading (normally a single best answer)- students then answer the question individually (ideally using an audience response system), students then discuss the question with their peers and talk about their thinking, students then answer the question again (with the opportunity to change their answer) and then the instructor gives the correct answer and give an explanation. This approach gives the opportunity for more confident students to explain their thinking to less confident students thereby facilitating peer teaching. This approach has been adopted to teach second year physician associate students at Norwich Medical School. In this plenary session a description of what peer instruction is and the evidence behind it will be presented. An example will be used to demonstrate how it can be implemented in practice and finally student evaluation and data on impact will be discussed.

Background and Aims

TBL is an effective, active learning strategy that has been validated and used in Medical

schools 1 . It consists of 3 phases; preparation, readiness assurance tests and application

exercise 2 . It follows a ‘flipped classroom’ model where assessment takes place at the

beginning and encourages team discussions that emulate clinical practice. TBL has been

utilized in medical education however there is lack of literature on its use specifically in

Physician Associate education. We therefore explored the perceptions of a Stroke TBL

session among Physician Associate students in a UK PA Program.

Methods

The study took place during the COVID-19 pandemic therefore, TBL was implemented

virtually using online video conferencing platforms. The students’ perceptions were then

analyzed using anonymous online questionnaires sent to them shortly after the session. The

questionnaire included specific questions comparing TBL to other teaching methods such as

PBL.

Results

Overall, the students felt that TBL was an effective teaching method that was better than

other methods such as lectures and PBL.

Conclusions

This was a small study of a single TBL session that provided rich qualitative data around

students’ perceptions. It is a good foundation for developing TBL further in UK PA

Programmes. We encourage further use of this strategy with further studies in this area.

1. Reimschisel, T, Herring, AL, Huang, J, Minor, TJ. (2017) ‘A systematic review of

published literature on team-based learning in health professions education’,

Medical Teacher, 39(12), pp1227-1237.

2. Michaelsen, LK, Parmelee, DX, McMahon, KK, Levine, RE. (2008) Team based

learning for health professions education: A guide to using small groups for

improving learning. Sterling, Virginia: stylus.

As the PA profession has grown, the number of PA programmes and therefore PA educators within HEIs have increased across the UK. Research and guidance has been focused on education within the clinical setting, and there is little research into the background and training of PA educators within a HEI. The University of Sheffield supported by colleagues from the University of Birmingham, University of Swansea and St George’s University of London, are undertaking research into PA educator positions across the UK HEIs.  The aim of our research is to better understand the background of PA educators, including any concurrent clinical roles, educator training, academic title and responsibilities, and to explore and identify what they feel they need to progress in their careers. We are looking for all those who work within PA education at a UK HEI to take part in our research by completing a short questionnaire. As a result of this work, we hope to provide an insight into the PA educator role, and plan to formulate career development guidance for PA educators across the UK.