Perspectives Inaugural Issue (Winter 2013)

PERSPECTIVES • WINTER/SPRING 2013 23 Cherilyn Hendrix, D.H.Ed. , assistant professor, possesses a research interest that has always revolved around critical-think- ing skills in graduate and postgraduate stu- dents. Her May 2011 doctoral dissertation entitled “Creating a Critical Thinking Component in Physician Assistant Educa- tion” provided impetus for multiple educa- tional interventions designed to assist her physician assistant students in clinical de- cision making. Her quasi-experimental, tri- angulated study determined whether an educational component dedicated to criti- cal thinking would impact a PA student’s clinical decision making. Her development of a standalone educational intervention was intended to assist PA students in the crucial development and advancement of their complex reasoning skills throughout their matriculation. Dr. Hendrix has been analyzing PA student data since 2007 and has been per- forming studies on their critical-thinking skills as indicated by standardized exam- ination score improvement and as proven by significant student development of the PA profession’s core competencies prior to graduation. Based on the positive results demonstrated by making a peda- gogical change to a clinical correlation course, she presented her initial findings with her poster “Mrs. Lee: A Case Study” at the Physician Assistant Education As- sociation forum in Portland, Oregon, in November 2009. Her initial study revealed improvement of first-year student outcomes on standard- ized patient examinations (SPEs) by intro- ducing an intervention that followed a patient in a primary care setting. Since 2009, enhancements supporting continuity of care were made in an effort to further demonstrate continued improvement of di- dactic year SPE scores. Dr. Hendrix will present the results of further findings spanning from 2009-12 at the Physician Assistant Education Association forum in Seattle, Washington, in November. To conduct her research, a clinical cor- relations laboratory course was designed to align subject matter taught during the first-year PA students’ spring semester courses in clinical medicine, pathophysiol- ogy, pharmacology, and emergency medi- cine. It focused on history and physical examination skills and critical thinking as demonstrated through interpreting diag- nostic data, developing a differential diag- nosis, appropriate treatment planning, and patient education. The laboratory was first designed as a 10-week case study of one fictional patient, Mrs. Lee. After review of 2009 study results, the experience was en- hanced to cover two full semesters, includ- ing the incorporation of electronic medical records (EMR) and psychiatry. After completing this intervention, SPE outcomes for first-year students in 2009 were 12.4 percent higher than the prior class performing SPE encounters in 2008 and remain the highest in that PA program since 2004. Since the initial study results were revealed, first-year student SPE scores from 2009-12 have remained con- sistent, with improvements over 2004-08 data ranging from 4.74 to 12.4 percent. Longtime clinical preceptors continue to comment on student improvement in his- tory taking, physical exam and oral pres- entation skills, and written notes over the span of this study. Significant improvement in first-year student skills has been demonstrated. Sec- ondary to a pedagogical change, Mrs. Lee has been integrated into the curriculum since 2009, incorporating continuity of care and EMR. The design improved out- comes relating to the PA medical know edge core competencies: differential diag- nosis formulation, effective treatments, di- agnostics interpretation, and prevention and screening—all correlating to improve- ment in PA student critical-thinking skills. RESEARCH SPOTLIGHT: Dr. Cherilyn Hendrix PA • ORLANDO