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JAAPA. 2019 May;32(5):47-53. doi: 10.1097/01.JAA.0000554742.08935.99.

Exploring the effect of PAs on physician trainee learning: An interview study.

Author information

Maura N. Polansky is department chair and an associate professor in the PA program at George Washington University in Washington, D.C., and a PhD candidate in the School of Health Professions Education at Maastricht University in Maastricht, Netherlands. In the School of Health Professions Education at Maastricht University, Marjan J.B. Govaerts is an associate professor and Renée E. Stalmeijer is an educational scientist and assistant professor. At the University of Texas MD Anderson Cancer Center in Houston, Texas, Ahmed Eid was an associate professor in the Department of General Oncology at the time of this study and Diane C. Bodurka is vice president of education and a professor in the Department of Gynecologic Oncology and Reproductive Medicine. Diana H.J.M. Dolmans is a professor in the School of Health Professions Education at Maastricht University. The authors have disclosed no potential conflicts of interest, financial or otherwise.



Physician assistants (PAs) often have been embedded in academic medical centers to help ensure an adequate patient care workforce while supporting compliance with work-hour restrictions for residents and fellows (also called trainees). Limited studies have explored the effect of PAs on trainee learning. This qualitative study explored, from the perspective of physician faculty and PAs, how PAs working in the clinical learning environment can enhance or hinder trainee learning.


Using purposive sampling, 12 PAs and 12 physician faculty members in one US teaching hospital were selected for semistructured interviews. Data collection and analysis were characterized by an iterative process. Data analysis was informed by principles of conventional content analysis.


Participants identified various ways in which PAs may affect trainee learning, intrinsically linked to the roles PAs assume in the clinical learning environment: clinician, teammate, and clinical teacher. Trainee learning may be enhanced because learning time can be optimized by having PAs in the clinical learning environment. Trainees can learn about PAs and how to collaborate with them, and PAs can enculturate and provide clinical instruction to trainees. Trainee learning may be hindered if learning opportunities for trainees go to PAs, trainees feel intimidated by experienced PAs, or trainees become too dependent on PAs.


Our findings demonstrate enhancements and hindrances to trainees' learning linked to three key roles PAs perform in the clinical learning environment. These findings can inform how PAs are integrated into teaching services. Further investigation is needed to understand how PAs can balance their professional roles to foster effective collaborative practice and learning.

[Indexed for MEDLINE]

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