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March 2023; 2 (1) Research ArticleOpen Access

Education Research: Neurologic Education in Physician Assistant Programs

View ORCID ProfileDaniel S. Harrison, Margaret Naclerio, Kathryn Swider, Carl Garrubba, Andrew T. Yu, Andrew Busler, Lena Liu, Christopher Doughty
First published December 1, 2022, DOI: https://doi.org/10.1212/NE9.0000000000200029
Daniel S. Harrison
From the Harvard Medical School (D.S.H., L.L., C.D.); Department of Neurology (D.S.H., M.N., A.B., L.L., C.D.), Brigham and Women's Hospital; Department of Neurology (D.S.H., K.S., L.L.), Massachusetts General Hospital, Boston; Department of Physician Assistant Studies (C.G.), Dominican University of California, San Rafael; and Department of Neurology (A.T.Y.), University of California San Francisco Medical Center.
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Margaret Naclerio
From the Harvard Medical School (D.S.H., L.L., C.D.); Department of Neurology (D.S.H., M.N., A.B., L.L., C.D.), Brigham and Women's Hospital; Department of Neurology (D.S.H., K.S., L.L.), Massachusetts General Hospital, Boston; Department of Physician Assistant Studies (C.G.), Dominican University of California, San Rafael; and Department of Neurology (A.T.Y.), University of California San Francisco Medical Center.
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Kathryn Swider
From the Harvard Medical School (D.S.H., L.L., C.D.); Department of Neurology (D.S.H., M.N., A.B., L.L., C.D.), Brigham and Women's Hospital; Department of Neurology (D.S.H., K.S., L.L.), Massachusetts General Hospital, Boston; Department of Physician Assistant Studies (C.G.), Dominican University of California, San Rafael; and Department of Neurology (A.T.Y.), University of California San Francisco Medical Center.
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Carl Garrubba
From the Harvard Medical School (D.S.H., L.L., C.D.); Department of Neurology (D.S.H., M.N., A.B., L.L., C.D.), Brigham and Women's Hospital; Department of Neurology (D.S.H., K.S., L.L.), Massachusetts General Hospital, Boston; Department of Physician Assistant Studies (C.G.), Dominican University of California, San Rafael; and Department of Neurology (A.T.Y.), University of California San Francisco Medical Center.
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Andrew T. Yu
From the Harvard Medical School (D.S.H., L.L., C.D.); Department of Neurology (D.S.H., M.N., A.B., L.L., C.D.), Brigham and Women's Hospital; Department of Neurology (D.S.H., K.S., L.L.), Massachusetts General Hospital, Boston; Department of Physician Assistant Studies (C.G.), Dominican University of California, San Rafael; and Department of Neurology (A.T.Y.), University of California San Francisco Medical Center.
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Andrew Busler
From the Harvard Medical School (D.S.H., L.L., C.D.); Department of Neurology (D.S.H., M.N., A.B., L.L., C.D.), Brigham and Women's Hospital; Department of Neurology (D.S.H., K.S., L.L.), Massachusetts General Hospital, Boston; Department of Physician Assistant Studies (C.G.), Dominican University of California, San Rafael; and Department of Neurology (A.T.Y.), University of California San Francisco Medical Center.
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Lena Liu
From the Harvard Medical School (D.S.H., L.L., C.D.); Department of Neurology (D.S.H., M.N., A.B., L.L., C.D.), Brigham and Women's Hospital; Department of Neurology (D.S.H., K.S., L.L.), Massachusetts General Hospital, Boston; Department of Physician Assistant Studies (C.G.), Dominican University of California, San Rafael; and Department of Neurology (A.T.Y.), University of California San Francisco Medical Center.
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Christopher Doughty
From the Harvard Medical School (D.S.H., L.L., C.D.); Department of Neurology (D.S.H., M.N., A.B., L.L., C.D.), Brigham and Women's Hospital; Department of Neurology (D.S.H., K.S., L.L.), Massachusetts General Hospital, Boston; Department of Physician Assistant Studies (C.G.), Dominican University of California, San Rafael; and Department of Neurology (A.T.Y.), University of California San Francisco Medical Center.
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Citation
Education Research: Neurologic Education in Physician Assistant Programs
Daniel S. Harrison, Margaret Naclerio, Kathryn Swider, Carl Garrubba, Andrew T. Yu, Andrew Busler, Lena Liu, Christopher Doughty
Neurol Edu Mar 2023, 2 (1) e200029; DOI: 10.1212/NE9.0000000000200029

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Abstract

Background and Objectives A growing number of advanced practice providers (APPs) are entering neurologic practice, and educational initiatives focused on postgraduate training in neurology for these providers are growing in turn. Neurologic education in APP degree programs is not well defined, which limits the ability to tailor these initiatives to the specific needs of APPs. We aim to describe neurologic education in physician assistant (PA) degree programs to better inform these efforts.

Methods The 2018 American Academy of Neurology clerkship director survey was adapted for directors of PA programs via an iterative approach. The survey was distributed to program directors (PDs) of accredited programs in Fall 2021 and again in Spring 2022 for nonresponders. Simultaneously, websites of accredited programs were systematically reviewed for content related to neurologic education.

Results Sixty of 255 contacted PDs completed the survey (23.5%). All PDs reported education in selected neuroscience topics. Neuroradiology instruction was included less frequently (66.7%) than neuroanatomy (91.7%) or neurologic examination techniques (95.0%). Twenty-six PDs (43.3%) reported a dedicated neuroscience course; 53 of 260 websites reviewed identified dedicated neuroscience courses (20.8%, k = 0.41). Directors of 10 (38.5%) reported neuroscience courses were neuroscience trained. Only 1 program required a neurology clinical rotation in both the website review (0.4%) and the PD survey (1.7%, k = 1.00). Elective neurology rotations were offered by 51 programs (85.0%) and used by less than 20% of students in 46 programs (92.0%). More programs with dedicated neuroscience didactics (80.0% vs 74.2%) and offerings in clinical neurology (78.7% vs 66.7%) reported graduates pursuing careers in neurology, but these differences were not statistically significant.

Discussion Survey respondents reported the inclusion of most of the queried preclinical neuroscience topics, typically distributed throughout the curriculum. Dedicated neuroscience courses were less common and most commonly not taught by a neurologist or neurology APP. Clinical neurology rotations are almost never required, but most programs offer an elective. These results suggest opportunities for augmenting neurologic education in APP degree programs, including encouraging students to take clinical neurology rotations and increasing exposure to APPs practicing neurology. These findings additionally inform key targets for postgraduate educational initiatives.

Glossary

APP=
advanced practice provider;
NCCPA=
National Commission on Certification of Physician Assistants;
PA=
physician assistant;
PANCE=
PA National Certifying Exam;
PD=
program director

Footnotes

  • ↵* These authors contributed equally to this work and are co–first authors.

  • Go to Neurology.org/NE for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Submitted and externally peer reviewed. The handling editor was Roy Strowd III, MD, MEd, MS.

  • Received June 3, 2022.
  • Accepted in final form October 3, 2022.
  • © 2022 American Academy of Neurology

This is an open access article distributed under the terms of the Creative Commons Attribution License 4.0 (CC BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Letters: Rapid online correspondence

  • RE: Education Research: Neurologic Education in Physician Assistant Programs
    • Christopher B. Reeves, Nurse Practitioner, University of Massachusetts Boston
    Submitted January 26, 2023
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