Trauma patient satisfaction with physician assistants: Testing a structural equation model

Berg, Gina M.; Crowe, Robin E.; Nyberg, Sue M.; Burdsal, Charles A.

doi:10.1097/01720610-201205000-00008

Cited by 10 publications

(8 citation statements)

References 29 publications

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“…They are experienced in interactions with patients and in physical contact, which will not only be beneficial in communication with, but also in the physical examination of patients. Other studies reported high levels of patient satisfaction with care provided by PAs [1,8,24]. This could be in accordance with the outcomes on history taking, physical examination and communication skills in our study, as this possibly relates to the same topic.…”

Section: Discussionsupporting

confidence: 91%

Analysis of the level of general clinical skills of physician assistant students using an objective structured clinical examination

Vught

Hettinga

Denessen

et al. 2015

Evaluation Clinical Practice

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Section: Discussionsupporting

confidence: 91%

Analysis of the level of general clinical skills of physician assistant students using an objective structured clinical examination

Vught

Hettinga

Denessen

et al. 2015

Evaluation Clinical Practice

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“…Additionally, patients' views do not appear to have been previously gathered at the time of the visit (and qualitatively), although there have been previous questionnaire studies in the USA of patient satisfaction, administered after the visit. [28][29][30] We reported few differences in the the practice and processes of care-other than prescribing (which PAs currently cannot do independently in the UK)-between PAs and doctors in their second foundation year of training. Our finding of no difference in the primary outcome (ED re-attendance rate within 7 days) for patients of PAs and FY2 doctors-in-training is consistent with the comparisons of nurse-qualified NPCs and FY2 doctorsin-training on which we based our study design 22 23 and other PA literature from the USA.…”

Section: Summary Of Findingsmentioning

confidence: 84%

Comparing physician associates and foundation year two doctors-in-training undertaking emergency medicine consultations in England: a mixed-methods study of processes and outcomes

et al. 2020

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ObjectivesTo compare the contribution of physician associates to the processes and outcomes of emergency medicine consultations with that of foundation year two doctors-in-training.DesignMixed-methods study: retrospective chart review using 4 months’ anonymised clinical record data of all patients seen by physician associates or foundation year two doctors-in-training in 2016; review of a subsample of 40 records for clinical adequacy; semi-structured interviews with staff and patients; observations of physician associates.SettingThree emergency departments in England.ParticipantsThe records of 8816 patients attended by 6 physician associates and 40 foundation year two doctors-in-training; of these n=3197 had the primary outcome recorded (n=1129 physician associates, n=2068 doctor); 14 clinicians and managers and 6 patients or relatives for interview; 5 physician associates for observation.Primary and secondary outcome measuresThe primary outcome was unplanned re-attendance at the same emergency department within 7 days. Secondary outcomes: consultation processes, clinical adequacy of care, and staff and patient experience.ResultsRe-attendances within 7 days (n=194 (6.1%)) showed no difference between physician associates and foundation year two doctors-in-training (OR 0.87, 95% CI 0.61 to 1.24, p=0.437). If seen by a physician associate, patients were more likely receive an X-ray investigation (OR 2.10, 95% CI 1.72 to 4.24), p<0.001), after adjustment for patient characteristics, triage severity of condition and statistically significant clinician intraclass correlation. Clinical reviewers found almost all patients’ charts clinically adequate. Physician associates were evaluated as assessing patients in a similar way to foundation year two doctors-in-training and providing continuity in the team. Patients were positive about the care they had received from a physician associate, but had poor understanding of the role.ConclusionsPhysician associates in emergency departments in England treated patients with a range of conditions safely, and at a similar level to foundation year two doctors-in-training, providing clinical operational efficiencies.

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“…The limited number of research studies that included reports of patients’ experiences of PAs in hospital outpatient settings in the US [11, 12], and inpatient settings in Canada [13, 14], the US [15, 16], the Netherlands [17], and England [18, 19], found generally high levels of patient satisfaction with their PA encounters. There is some evidence that patients appreciate PA communication in hospital encounters [13, 16, 18, 19]. However, there is lack of understanding about the process of PA-patient communication [20] and how this might influence satisfaction, particularly in the context of the acute hospital setting.…”

Section: Introductionmentioning

confidence: 99%

Understanding patients’ satisfaction with physician assistant/associate encounters through communication experiences: a qualitative study in acute hospitals in England

Taylor

Halter

Drennan

2019

BMC Health Serv Res

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Background Physician assistants/associates (PAs) are a recent innovation in acute hospital teams in England and many other countries worldwide. Although existing evidence indicates generally high levels of patient satisfaction with their PA hospital encounters, little is known about the factors associated with this outcome. There is a lack of evidence on the process of PA-patient communication in hospital encounters and how this might influence satisfaction. This study therefore aimed to understand patients’ satisfaction with PA acute hospital encounters through PA-patient communication experiences. Methods A qualitative study was conducted among patients and representatives of patients seen by or receiving care from one of the PAs working in acute hospital services in England. Semi-structured interviews were undertaken face-to-face with study participants in the hospital setting and shortly after their PA encounter. Data were coded and analysed using thematic analysis. The study was framed within a theoretical model of core functions of medical encounter communication. Results Fifteen patients and patient representatives who had experienced a PA encounter participated in interviews, across five hospitals in England. Four interrelated communication experiences were important to participants who were satisfied with the encounter in general: feeling trust and confidence in the relationship, sharing relevant and meaningful information, experiencing emotional care and support, and sharing discussion on illness management and treatment. However, many participants misconceived PAs to be doctors, raising a potential risk of reduced trust in the PA relationship and negative implications for satisfaction with their PA encounter. Participants considered it beneficial that patients be informed about the PA role to prevent confusion. Conclusions PA encounters offer a constructive example of successful clinician-patient communication experiences in acute hospital encounters from the patient’s perspective. Study participants were generally naïve to the PA role. Hospital services and organisations introducing these mid-level or advanced care practitioner roles should consider giving attention to informing patients about the roles. Electronic supplementary material The online version of this article (10.1186/s12913-019-4410-9) contains supplementary material, which is available to authorized users.

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Trauma patient satisfaction with physician assistants: Testing a structural equation model

Cited by 10 publications

References 29 publications

Analysis of the level of general clinical skills of physician assistant students using an objective structured clinical examination

Analysis of the level of general clinical skills of physician assistant students using an objective structured clinical examination

Comparing physician associates and foundation year two doctors-in-training undertaking emergency medicine consultations in England: a mixed-methods study of processes and outcomes

Understanding patients’ satisfaction with physician assistant/associate encounters through communication experiences: a qualitative study in acute hospitals in England

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