Although the U.S. population is becoming more diverse, there remain gaps in representation in healthcare.  The OHSU PA program is committed to enhancing and diversifying the healthcare workforce by using a holistic admissions process that evaluates each applicant as a whole person, considering their experiences, perspectives, academic achievements, and potential to contribute to the profession and their communities. Bringing together diverse students with varied backgrounds and skills enriches the learning environment and maximizes the potential for creativity, innovation, quality patient care, outstanding service.

BENCHMARK: A minimum of 50% of matriculants in each cohort will come from a diverse background.

Definitions:  The PA program considers many aspects of diversity, including educational, environmental and economic disadvantage and matriculants from an underrepresented minority group. The PA program uses the definitions below:

• Disadvantaged:  An individual who has experiences significant economic, cultural, educational, or family adversity or disadvantage.
• Underrepresented racial or ethnic group:
  • Hispanic/Latino; any race (except Spanish from Spain or Portuguese from Portugal)
  • American Indian or Alaska Native
  • Black or African American
  • Native Hawaiian or Other Pacific Islander
• From a rural environment is defined as the majority of childhood years lived in a frontier environment or rural town (i.e. town of less than or equal to 40,000 population and at least 10 miles from a community of that size or larger).
• First generation college student: Neither parent completed 4-year college or university degree.

*Includes students from an isolated rural environment only.  The definition for rural environment was broadened to include towns < 40,000 and at least 10 miles from a community of that size or larger beginning with the Class of 2025.

The academically rigorous and integrated curriculum incorporates a variety of teaching methodologies, learning approaches and clinical experiences that prepare graduates to achieve the competencies for physician assistants and that comply with the Standards for Accreditation.  The program measures success in achieving this goal by setting the following benchmarks.

BENCHMARK: 

1. 90% of each cohort will achieve scores at the level of satisfactory or advanced medical knowledge on the PAEA end-of-curriculum exam.

The Physician Assistant Education Association (PAEA) End of Curriculum (EOC) exam is an objective, standardized, comprehensive multiple-choice examination that assesses a PA student’s medical knowledge as one component of their readiness for graduation.  The scale of the EOC exam is 1200-1800. The EOC exam uses categorical performance levels to indicate whether the student has limited (score below 1400), satisfactory (1400-1554), or advanced (1555-1800) medical knowledge.

The OHSU Program began administering the PAEA EOC exam in 2023. We will continue to track performance in the coming years.

BENCHMARK:

1. 100% of each cohort will achieve satisfactory scores in clinical reasoning skills on their clinical preceptor evaluations.

  We define clinical reasoning as the students’ ability to:

• Formulate a most likely diagnosis based on an appropriate history, physical examination, and diagnostic workup for a variety of acute, chronic, and emergent medical conditions, for patients across the lifespan.
• Recommend appropriate laboratory and diagnostic studies relevant to the chief complaint, history, and physical exam for patients across the lifespan.
• Relevant to the history, physical examination, and diagnostic workup, determine the appropriate interventions and management plan, including pharmacologic, non-pharmacologic, and health screening recommendations.

Students complete eleven rotations over the course of the clinical year. A minimum score of 80% is considered satisfactory.

BENCHMARK:

1. The mean score for each cohort will indicate agreement or strong agreement that the program curriculum effectively prepared them for clinical practice, as reflected in the end-of-program student survey results.

Beginning with the Class of 2023, students are asked at the end of their program completion to indicate their level of agreement with the following statement: Overall the program's curriculum was effective in preparation for clinical practice.  Students select a response based on the following Likert scale:

1 = strongly disagree; 2 = disagree; 3= neutral; 4 = agree; 5 = strongly agree

The curriculum is designed to enhance students' understanding of how social determinants of health, health inequities, personal biases, racism, language barriers, and health literacy influence the quality of care. Students participate in a variety of instructional and experiential activities to improve their ability to deliver effective, quality care to patients who have diverse beliefs, attitudes, values and backgrounds. Additionally, students gain insight into the complexities and rewards of working with rural and medically underserved communities.

BENCHMARK:

1. For each cohort, at least 20% (1 in 5) of patient encounters during the clinical year will occur with rural and/or medically underserved patients.

During the clinical phase of the program students are required to track each patient encounter in which they participated.  For each patient encounter, students indicate if the patient is from a rural and/or medically underserved area. Medically underserved includes both rural and urban areas.

BENCHMARK:

1. A minimum of 20% of students in each cohort will complete the AHEC Scholars program.

The AHEC Scholars program is a two-year national certificate program funded by the Health Resources and Services Administration, designed to better prepare health professions students for future practice serving rural and urban underserved communities. The program blends a didactic curriculum centered on eight core topic areas with community-based experiential learning at clinical practice sites throughout Oregon.  AHEC Scholars work in interprofessional teams and graduate with a more thorough understanding and appreciation of the complexities and rewards of working with rural and underserved populations. Students must apply and be accepted to the program. Our benchmark is grounded in the PA program’s historic robust participation in the AHEC Scholars program.

BENCHMARK:

1. All second year (clinical) students will receive passing scores on preceptor evaluations on their ability to provide patient centered care.

One way to evaluate the program’s effectiveness in achieving this goal is to use end-of-rotation assessments by clinical preceptors during students’ primary care rotations.  The first table presents data from 2020 to 2023. In 2024, the evaluation was adjusted to pose a slightly different question, though it maintains the same purpose.

OUTCOMES:

The student demonstrated sensitivity and awareness regarding patients’ culture, age, gender, abilities, and care preferences.

The student’s ability to deliver accurate patient education to the patient, their family/friends, and care team, that centers on shared decision making, that considers disease prevention, health awareness, and equitable access to care in this setting/discipline meets or exceeds expectations.

The student identifies the impact of structural factors, social justice, and equity on community health outcomes.