Nestled in the tri-state area of Indiana-Illinois-Kentucky, the University of Evansville, located in Evansville, Indiana, is in a unique position to reach thousands of people in their state-spanning medically underserved area. We got the chance to sit down with program director and chair Michael Roscoe, PhD, PA-C, to discuss the future of this much-needed program.
Tell me a little bit about how this program came about.
The idea for the University of Evansville (UE) to have a PA program came about in 2012, when Steve Becker, MD, associate dean/program director for the Indiana University School of Medicine – Evansville campus, approached the president of UE, Thomas Kazee, PhD. Evansville is the third-largest city in Indiana and is located in the southwest corner of the state. It is part of the tri-state area that serves 11 counties in Indiana, 10 counties in Illinois, and nine counties in Kentucky. This entire catchment area is listed as medically underserved and is the primary reason that UE was approached about starting a PA program — there are no other PA programs within two hours of Evansville.
Dr. Becker and many community leaders understood the unique challenges for the tri-state region and the need for true collaboration and interprofessional education (IPE) to fill the gaps in access to medical care in the region. A unique collaboration was formed between three universities (Indiana University, University of Evansville, and University of Southern Indiana), and four regional health systems (Deaconess Health System, Saint Vincent Evansville, Good Samaritan Hospital – Vincennes, and Memorial Hospital and Health Care Center – Jasper). The result is a unique partnership that includes the new 144,000 square foot Health Science Academic and Research Center in downtown Evansville, which will house five different graduate professional health programs from three different universities. This brings students together organically from various professions to learn from, with, and about each other. The facility also will house a large simulation center that will help solidify IPE within the region.
What do you think makes your program unique?
There are several items that we feel make the UE PA program unique. The most defining item is our culture, which is based on strong relationships, trust, and mentoring. We believe that this leads to both students and faculty focusing on the “art” of medicine and not just the “science” of medicine. Employing this approach, our program starts with why we do what we do rather than with what we are (a PA program). This may seem subtle, but there is a distinct difference in approach. We are trying to focus on finding faculty and students who fit our culture rather than a checkbox of achievements. An example of this is shown in this statement: “The University of Evansville Physician Assistant Program believes that the ‘art’ of medicine (focusing on the patient’s values and preferences) is often more important than the ‘science’ (simple treatment of a disease).”
The second item of distinction is the new state-of-the-art facility in downtown Evansville, scheduled to open in August 2018. This is unique not because of the building itself, but because of the collaboration with two other universities (Indiana University and University of Southern Indiana). Together, we plan on bringing a total of five different health care professional programs to the center (PA, physical therapy, medical school, occupational therapy, and advanced nursing). There is also curriculum collaboration between the PA program, the medical school, and the physical therapy program, the intent being to produce “organic” IPE experiences and opportunities for our students.
What do you look for in your students, and how does your program work to encourage and strengthen inclusiveness and diversity both in its admissions process and in the curriculum?
One of the overall goals of the admissions process is to try to identify students who match the “why” culture of our program. We are opposed to anything that makes the program or its students a commodity, which often materializes as a singular focus on cognitive markers. This is important, but we try to focus on applicants who are also interested in civic engagement — making a difference in their communities and serving others. We believe that this service to others is the foundation of leadership.
We attempt to reach this goal through our Multiple Mini Interview (MMI) process. Each student is exposed to a variety of about 12 different community members during their MMI. At a minimum, each student will interact with a preceptor, physician, PA, UE faculty member, non-medical community member, HR person, and students. The community members’ MMI scores then actually determine the interview ranking list. Thus, our community has a major voice in who is ultimately accepted into the program. We believe that this wide exposure of the community encourages and strengthens inclusiveness and the various definitions of diversity.
Additionally, our curriculum sequencing is designed to assist students in meeting the program competencies and the University’s mission and goals. The start of the program (first semester) is focused on a team environment, the needs of a community/population, and the human element (art) of medicine. The goal is to set the stage for clinical practice by developing a sense of “bigger than an individual or simple knowledge” to be able to provide clinical care.
What has been the greatest challenge your program has had to overcome so far, and how did you accomplish it?
There are always numerous challenges for PA programs — especially provisional programs. Everybody struggles with having enough supervised clinical practice experiences (SCPEs). To tackle that issue, the first faculty member hired after the program director was the clinical coordinator/director of clinical education, who has also been designated as the associate program director. Starting with the experiential year and working backward has given the program the time to develop sites early and build relationships within the community. This has resulted in an excitement within the health systems and a partnership mentality.
A second challenge is recruiting strong faculty to come to Evansville, especially for a new program. The Evansville area is a vibrant community, but it is not a major urban setting, which many faculty are looking for. The focus on a strong team and culture has enabled us to overcome this obstacle and build a core of excellent faculty members. We believe that the strong community support, new facilities, and maturing of our “why” culture will continue to help mitigate this challenge.
If you could give developing programs one piece of advice, what would it be?
I would recommend taking the time to step back and look at your program as a dynamic entity composed of a variety of intertwined processes, rather than looking at the program as a series of “checkboxes” that must occur during a year/cycle.
I also strongly recommend working backward and making sure that the program has a clear focus on its goals (program-based items for future decision-making), competencies (those items the program feels are needed for entry-level practice), and outcomes (student items focused on completion of a curricular component). The assessment plan then must be dynamic (formative and summative) to evaluate these items. If the program has a clear vision and a dynamic assessment plan, then program improvement becomes a natural process.