Future Trends in PA Education Volume 4: Changes in Entry Level Degrees and Assessment

Welcome back to our continuing newsletter series on future trends in PA Education. Last time we finished a look at the potential of hybrid education in our programs. Today we address the entry-level degree. 

The debate regarding the terminal degree has been in existence since the beginning of the PA education profession. In 1988 the baccalaureate degree was the entry-level degree. In 2001 the master’s degree became an entry-level degree. The transition to an entry-level doctorate is inevitable, for better or worse. 

What will it mean for students and programs?

Currently, the ARC-PA is not credentialed to accredit entry-level doctoral PA programs. If PAEA/AAPA adopts the doctoral degree as the entry-level credential, accreditation will soon follow. 

An entry-level doctorate comes with several implications. First, how will the curriculum change? Most likely, when looking at the current add-on doctorates, there will be additional coursework related to a capstone or scholarly project. This will strengthen the graduate’s quality assurance and research abilities. Other than this, it is likely that the curriculum will not significantly change. 

Many advocates of the doctorate maintain that the large number of credits found in graduate-level PA programs already validates the doctoral-level credential. Thus, the transition can be expected to be relatively smooth. I predict that the accreditation requirements for a doctoral-level degree will be minimally prescriptive in terms of the depth and breadth of a scholarly project. 

Another implication is the increased cost to the graduate. Unfortunately, increased costs are inevitable. Current programs range between about 80 and 130 graduate credits and this will most likely increase by approximately two semesters, adding $20-$30,000 to the cost of a degree. Graduates will be compelled to seek higher-paying jobs both because of student debt but also because they have attained a more demanding degree, and the employment market will have to adjust.

Optimal team practice 

The practice of PAs will continue to evolve toward a more collaborative model rather than being directly supervised by a physician. This increased autonomy will undoubtedly impact how PA programs prepare graduates for practice. The heightened expectations of PA graduates when entering practice may accelerate the number of postgraduate residencies to ensure that students are prepared. 

Even at the doctoral level PA programs are not equipped to prepare PAs to be fully independent. Most likely this will result in some sort of bridge training following graduation. This may drive standardization of PA curriculum, such as the number of pharmacology hours, and result in a significant tension between the entry-level credential and the practice expectations. The entry-level doctoral credential may be effective in bridging the gap. 

At the time of this writing, it is already apparent that the impact of COVID-19 on educational methods of PA programs will be seen for years to come. On that note, it seemed fitting to add my projections for the future of PA programs in our rapidly changing world. How can programs prepare for the assessment methods of the future? PA education assessment has been driven primarily by ARC-PA standards and accreditation, which is very prescriptive, leaving little opportunity for diversifying practice. A recent newsletter published by the Council for Higher Education Accreditation, June 2020 (CAHEA provides oversight for ARC-PA) stated that quality assurance going forward needs to focus on three factors:

• Reliable evidence that students learn and succeed 
• Competent and efficient analysis of the evidence 
• Clear and consistent practices for judging evidence of performance 

These factors clearly describe the accountability and measurement required of student outcomes and speak of an evidence-based approach. 

30 years of PA education experience have revealed emerging trends involving assessment and PA education in the future, and I feel I can predict with fair confidence that:

• PA programs will be held responsible for assessment in the same manner as medical schools. This is a fair prognostication because of the perceived influence of LMCE on the future direction of the ARC-PA standards. 
• Assessment will focus on assuring that quality is maintained as well as increased diversity among the students.  
• Publishing and dissemination of research related to PA education will increase. The advancement and evolution of assessment practices will facilitate more research about the unique nature of PA education. 

In our next issue…

We will conclude our discussion of future trends in PA education by identifying a few more considerations concerning the needs of faculty and administrative services as these changes will demand.