A national agenda in support of research on the PA profession
A national agenda in support of research on the PA profession
BACKGROUND
The physician assistant (PA) profession has grown rapidly since the creation of the first PA education program in 1965. In the four-plus decades since, PAs have become established and well-accepted clinical members of the US health care system.1 However, PA-focused research has not matured as quickly. It has lacked overall strategic goals, and research needs have not been clearly defined. As a result, PA-focused research has been conducted unsystematically, producing more breadth than depth.
With this in mind, the American Academy of Physician Assistants (AAPA) was asked by its Board of Directors to develop the first national PA research agenda. As specified by the AAPA, the primary goal of the agenda is to identify research areas and priorities and establish a solid foundation for future research.
METHODS
The development of the National PA Research Agenda is shown in Figure 1. The first step was taken in March 2010 when AAPA sponsored a PA Research Summit to begin developing a framework for the research agenda aimed at guiding the production of accurate, relevant, and usable findings.2Figure 2 shows the 20 topics in four major PA research areas that were identified at the Summit as addressing compelling research needs. The AAPA Board of Directors then commissioned a Research Steering Committee (RSC) of nationally recognized experts in health workforce research, chaired by Rear Admiral Kenneth Moritsugu, MD, MPH, FACPM (chair). The committee convened in November 2010 to begin prioritizing topics on the proposed PA research agenda, delineating goals, establishing timelines, and identifying synergies for funding.3 Subjects of discussion at this meeting included the value PAs add to the health care system, the state of efforts to collect data on PAs, issues of health care access and cost-effectiveness, workforce diversity within the profession, and the need to enhance our research infrastructure.
After in-depth discussions of four broad research areas—PA value, PA workforce, PA roles, and PA education—were completed, a draft of the meeting proceedings was circulated and feedback from committee members was solicited. All members were asked to provide their final personal priority rankings of the 20 research topics by assigning a numerical value between 1 and 20 to each (with 1 being the highest priority and 20 the lowest). Their feedback has been aggregated into one priority table displaying their preferences for which topics ought to be part of the National PA Research Agenda.
RESULTS
Research topics and their research areas are listed in
Table 1 in order of descending importance. Note that the ranking of importance is relative and that all research topics are important and correlated with one another; that is,
a lower-ranked topic may be reflected through other relevant topics with a higher rank. Thus, assessing research topics requires a comprehensive and systematic understanding of all PA issues.
High-priority research topics and the rationale for their importance include cost-effectiveness—to demonstrate the use of PAs as a cost-effective model of care, which will increase opportunities for PAs in various settings; access to care—to show how PAs can increase access to care and help offset physician shortages and maldistribution; PA workforce composition—to help establish the baseline to improve how future projections are made, make known the factors that influence PA workforce composition and productivity, and determine the important characteristics of PA workforce composition; and PA shortages—to allow projection of future needs and address the changing workforce economics of medical teams as paramount information to inform policy makers and health care systems.
Medium-high priority research topics include outcomes of currently identified teams—to assist health care teams in optimizing their value to individual patients and the health care system as a whole; medical teams—to determine common characteristics shared by the most effective teams; and patient safety—to help measure the impact that PAs have and the role they play because patient safety is a priority for patients, practices, and society overall.
