Education Research: Neurologic Education in Physician Assistant Programs

Abstract

Background and ObjectivesA 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.MethodsThe 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.ResultsSixty 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.DiscussionSurvey 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.

An Issue on Innovation: What Makes Curricula Innovative and New Approaches to Neurology Education

“…The 2 articles in this section address gaps in training for APPs and internists. Harrison et al 14 identify important gaps in the training of APPs that hinders exposure to neurology and may reduce the likelihood of APPs pursuing neurology-related fields following graduation. Sanky et al 15 deconstruct the consult process and emphasize the often-discordant expectations between neurology and internal medicine residents.…”

A Modified Delphi Consensus Approach to Define Entrustable Professional Activities for Neurocritical Care Advanced Practice Providers*

“…In some staffing models, APPs rotate through multiple ICUs, including neurologic ICUs. However, APPs and APP program directors report that neurologic education in their degree programs is limited (5, 6). As a result, substantial on-the-job training is required for new NCC APPs.…”