The American Academy of Physician Assistants describes physician assistants as "health professionals licensed to practice medicine with physician supervision." Within this relationship, "physician assistants exercise autonomy in medical decision making and provide a broad range of diagnostic and therapeutic services." Their role includes "primary and specialty care in medical and surgical practice settings in rural and urban areas."
The PA profession defines the specific medical knowledge, communication skills, and attitudes required to be a successful PA. CMU will provide educational experiences as needed in order for physician assistants to acquire and demonstrate these competencies.
Medical knowledge includes an understanding of pathophysiology, patient presentation, differential diagnosis, patient management, surgical principles, health promotion, and disease 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, physician assistants are expected to demonstrate an investigatory and analytic thinking approach to clinical situations. PAs are expected to:
- understand etiologies, risk factors, underlying pathologic process, and epidemiology for medical conditions
- identify signs and symptoms of medical conditions
- select and interpret appropriate diagnostic or lab studies
- manage general medical and surgical conditions to include understanding the indications, contraindications, side effects, interactions, and adverse reactions of pharmacologic agents and other relevant treatment modalities
- identify the appropriate site of care for presenting conditions, including identifying emergent cases and those requiring referral or admission
- identify appropriate interventions for prevention of conditions
- identify the appropriate methods to detect conditions in an asymptomatic individual
- differentiate between the normal and the abnormal in anatomic, physiological, laboratory findings, and other diagnostic data
- appropriately use history and physical findings and diagnostic studies to formulate a differential diagnosis
- provide appropriate care to patients with chronic conditions
Interpersonal & Communication Skills
Interpersonal and communication skills encompass verbal, nonverbal, and written exchange of information. PAs must demonstrate interpersonal and communication skills that result in effective information exchange with patients, patients' families, physicians, professional associates, and the health care system. PAs are expected to:
- create and sustain a therapeutic and ethically sound relationship with patients
- use effective listening, nonverbal, explanatory, questioning, and writing skills to elicit and provide information
- appropriately adapt communication style and the messages to the context of the individual patient interaction
- work effectively with physicians and other health care professionals as a member or leader of a health care team or other professional group
- apply an understanding of human behavior
- demonstrate emotional resilience and stability, 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. PAs are expected to:
- work effectively with physicians and other health care 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
- make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment
- develop and carry out patient management plans
- counsel and educate patients and their families
- competently perform medical and surgical procedures considered essential in the area of practice
- provide health care services and education aimed at preventing health problems or maintaining health
Professionalism is the expression of positive values and ideals as care is delivered. Foremost, it involves prioritizing the interests of those being served above one's own. PAs must know their professional and personal limitations. Professionalism also requires that PAs practice without impairment from substance abuse, cognitive deficiency, or mental illness. PAs must demonstrate a high level of responsibility, ethical practice, sensitivity to a diverse patient population, and adherence to legal and regulatory requirements. PAs are expected to demonstrate:
- understanding of legal and regulatory requirements, as well as the appropriate role of the physician assistant
- professional relationships with physician supervisors and other health care providers
- respect, compassion, and integrity
- responsiveness to the needs of patients and society
- accountability to patients, society, and the profession
- commitment to excellence and on-going professional development
- commitment to ethical principles pertaining to provision or withholding of clinical care, confidentiality of patient information, informed consent, and business practices
- sensitivity and responsiveness to patients' culture, age, sex, gender, and disabilities
- self-reflection, critical curiosity and initiative
Guidelines for Attire
The policy established and approved for students in the PA Program is as follows: "While in this institution and specifically in patient care areas or health care delivery settings, a student should be dressed professionally in appropriate attire." ‘Appropriate attire' is determined by societal convention and society's expectation of the medical profession. A student who is engaged in patient contact must keep in mind that members of the professional community are obligated to maintain an acceptable professional standard. Good grooming and personal hygiene are essential for professionals in a health care setting.
Students must adhere to the dress/appearance standards of their assigned clinical sites. Appearances that may potentially offend or distract patients must be avoided. Examples of these appearances include, but are not limited to:
- Easily visible body piercing (e.g., nose, lip, eyebrow, tongue, ears for men). Students with visible body piercings need to obtain the permission of the preceptor and the PA Program prior to attending any clinical site
- Unusual hair coloring or style (must obtain PA Program and preceptor permission before attending clinical sites)
- Casual clothing (e.g., jeans, shoes that are not intact, revealing or ill-fitting clothing)
- Unwashed or unkempt appearance
- Word slogans on clothing or accessories other than professional identification (e.g., cause/position buttons)
Guidelines for General Deportment
A manner of respect for all individuals and recognizing the rights of patients are fundamental to a PA student's professional conduct. Arrogance, superiority, rudeness, and/or disdain for the idiosyncrasies that often appear with illness are manifestations of unprofessional and unacceptable behavior. It is a professional obligation to respect the privacy of patients and the confidentiality of their records. Discussion of patients' problems in a public setting (for example, the elevator, the shuttle, or the cafeteria) constitutes a serious breach of patient rights.
Furthermore, it is inappropriate to be disrespectful, curt, or condescending to any staff member or patient at any time. It is generally understood that, with the exception of children, it is disrespectful to call patients or their parents by first name; rather, it is proper to confer respect by use of surname and title. Sensitivity to individuals' differences also is required.
Practice-Based Learning and Improvement
Practice-based learning and improvement 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. PAs are expected to:
- analyze practice experience and perform practice-based improvement activities using a systematic methodology in concert with other members of the health care delivery team
- locate, appraise and integrate evidence from scientific studies related to their patients' health problems
- obtain and apply information about their own population of patients and the larger population from which their patients are drawn
- apply knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness
- apply information technology to manage information, access on-line medical information, and support their own education
- facilitate the learning of students and/or other health care professionals
- recognize and appropriately address sex, 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. PAs should work to improve the larger health care system of which their practices are a part. PAs are 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 the funding sources and payment systems that provide coverage for patient care
- practice cost-effective health care and resource allocation that does not compromise quality of care
- advocate for quality patient care and assist patients in dealing with system complexities
- partner with supervising physicians, health care managers, and other health care providers to assess, coordinate, and improve the delivery of health 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
- apply medical information and clinical data systems to provide more effective, efficient patient care
- use the systems responsible for the appropriate payment of services
The Oath of the Physician Assistant
I pledge to perform the following duties with honesty and dedication:
I will hold as my primary responsibility the health, safety, welfare, and dignity of all human beings.
I will uphold the tenets of patient autonomy, beneficence, nonmaleficence, and justice.
I will recognize and promote the value of diversity.
I will treat equally all persons who seek my care.
I will hold in confidence the information shared in the course of practicing medicine.
I will assess my personal capabilities and limitations, striving always to improve my medical practice.
I will actively seek to expand my knowledge and skills, keeping abreast of advances in medicine.
I will work with other members of the health care team to provide compassionate and effective care of patients.
I will use my knowledge and experience to contribute to an improved community.
I will respect my professional relationship with the physician.
I will share and expand knowledge within the profession.
These duties are pledged with sincerity and upon my honor.