The role of the Physician Assistant is demonstrated in a wide range of organizational and clinical practice settings alongside physicians and other care providers. The profession has defined the knowledge, skills and attitudes required and the needed educational experiences requisite to the acquisition of the following six competencies. The original document adopted by the profession can be accessed at: http://www.nccpa.net/PAC/Competencies_home.aspx. The elements within each of the six competencies that appear below have been adopted by the faculty of the Indiana University Master of Physician Assistant Studies Program to communicate expected entry-levels of performance at the time of graduation from the IU MPAS Program.
1. Medical KnowledgeMedical knowledge includes understanding pathophysiology, clinical presentations, differential diagnosis, disease and injury management and clinical prevention. PAs must demonstrate core knowledge about established and evolving biomedical and clinical sciences and the application of this knowledge to patient care in their area of practice. In addition, PAs are expected to demonstrate an investigatory and analytic thinking approach to clinical situations. Specifically, PAs are expected to:
- Describe etiologies, risk factors, pathophysiology and epidemiology for medical conditions.
- Recognize the signs and symptoms of medical, surgical and behavioral disorders.
- Select and interpret appropriate diagnostic or lab studies.
- Understand indications, contraindications, side effects, interactions and adverse reactions of pharmacologic agents and other relevant treatment modalities.
- Identify appropriate sites of care for emergent, acute, and chronic presenting conditions.
- Identify appropriate interventions for prevention of conditions.
- Identify appropriate opportunities for counseling patients on the impact that proper nutrition has on health and wellness.
- Identify appropriate methods to detect conditions in an asymptomatic individual.
- Differentiate between medical and surgical conditions based upon alterations in anatomy, physiology, laboratory findings and other diagnostic data.
- Formulate differential diagnoses using results of interview, exam and diagnostic studies.
- Provide appropriate care to patients with emergent, acute and chronic conditions.
Interpersonal & communication skills encompass verbal, nonverbal and written exchanges of information. PAs must demonstrate interpersonal and communication skills that result in effective information exchange with patients, their families, physicians, professional associates and the health care system. Specifically, PAs are expected to:
- Demonstrate ability to establish a therapeutic and ethically sound relationship with patients.
- Elicit and convey information using effective interpersonal listening, questioning, written and verbal communication skills.
- Adapt communication style and messages to the context of the individual patient interaction.
- Demonstrate capacity to work effectively as a member of a health care team or professional group.
- Demonstrate an understanding of human behavior.
- Demonstrate emotional resilience, adaptability, flexibility and tolerance of ambiguity and anxiety.
- Accurately and adequately document and record information regarding the care process for medical, legal, quality and financial purposes.
Patient care includes age appropriate assessment, evaluation and management. PAs must demonstrate care that is effective, patient-centered, timely, efficient and equitable for the treatment of health problems and the promotion of wellness. Specifically, PAs are expected to:
- Work effectively with physicians and other health professionals to provide patient-centered care.
- Demonstrate caring and respectful behaviors when interacting with patients and their families.
- Gather essential and accurate information about their patients, by eliciting a detailed history and by performing a thorough physical examination.
- Make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence and clinical judgment.
- Demonstrate ability to develop and carry out patient management plans.
- Demonstrate the ability to counsel and educate patients and their families.
- Demonstrate the ability to perform medical and surgical procedures essential to PA practice.
- Demonstrate ability to assess health and illness risk to prevent disease and maintain health.
Professionalism involves the expression of positive values and ideals and prioritizing the interests of those being served above one’s own as care is being delivered. PAs must know their professional and personal limitations and practice without impairment from substance abuse, cognitive deficiency or mental illness. Further, PAs must demonstrate a high level of responsibility, ethical practice, sensitivity to a diverse patient population and adherence to legal and regulatory requirements. Specifically, the PA is expected to:
- Function within legal and regulatory requirements effecting the role of the physician assistant.
- Exhibit a professional relationship with physician supervisors and other health care providers.
- Exhibit respect, compassion and integrity.
- Exhibit responses appropriate to the needs of the patient and society.
- Commit to being accountable to patients, society and the profession.
- Commit to excellence and ongoing professional development.
- Commit to the ethical principles pertaining to the provision or withholding of clinical care, confidentiality of patient information, informed consent and business practices.
- Demonstrate sensitivity and responsiveness to a patient’s culture, age, gender and disabilities.
- Demonstrate self-reflection, critical curiosity and initiative.
A practice-based learning environment includes the processes through which clinicians engage in critical analysis of their own practice experience, medical literature and other information resources for the purpose of self-improvement. PAs must be able to assess, evaluate and improve their patient care practices. Specifically, the PA is expected to:
- Demonstrate ability to analyze practice experience and perform practice-based improvement activities using a systematic methodology in concert with other members of the health care team.
- Demonstrate ability to locate, appraise and integrate evidence from scientific studies related to patients’ health problems.
- Demonstrate ability to appraise clinical studies and other information on diagnostic and therapeutic effectiveness using knowledge of study designs and statistical methods.
- Demonstrate ability to access online medical information using information technology to support patient care and personal professional development.
- Demonstrate ability to facilitate the learning of students and/or other health care professionals, and demonstrate a commitment to professional growth and life-long learning.
- Demonstrate ability to appropriately address gender, cultural, cognitive, emotional and other biases; gaps in medical knowledge; and physical limitations in themselves and others.
Systems-based practice encompasses the societal, organizational and economic environments in which health care is delivered. PAs must demonstrate an awareness of and responsiveness to the larger system of health care to provide patient care that is of optimal value, and should work to improve the larger health care system of which their practices are a part. Specifically, the PA is expected to:
- Use information technology to support patient care decisions and patient education.
- Effectively interact with different types of medical practice and delivery systems.
- Understand funding sources and payment systems that provide coverage for patient care.
- Participate in the delivery of cost-effective quality health care, and interact within an inter-professional health care environment.
- Advocate for quality patient care and assist patients in dealing with system complexities.
- Participate with precepting physicians and other providers in efforts to assess and improve the delivery of care and patient outcomes.
- Accept responsibility for promoting a safe environment for patient care and recognizing and correcting systems-based factors that negatively impact patient care.
- Acknowledge the value of medical information and clinical data systems to the provision of effective and efficient quality patient care.
- Use the systems responsible for the appropriate payment of services.
- Contribute to the Physician Assistant profession through scholarship, leadership, education and service to the profession and community.
