The University of Iowa’s integrated PA/MD curriculum took the spotlight at a workshop during the Institute of Medicine’s (IOM’s) recent conference in Washington, D.C. IOM’s “Envisioning the Future of Health Professional Education” was the fourth in a series of conferences aimed at providing the IOM leadership and health professions stakeholders with broadly defined data and insight into the changing health and education landscape across the globe. Having served on the planning committee for the Envisioning the Future workshop, I was anxious to attend the IOM’s Forum and witness the fruits of our labor.
With more than 70 prominent health- and education-related groups sponsoring Forum activities, the event offered a valuable chance to bring the PA experience to the table for discussions focused on the future of health education. What better opportunity to showcase our relationship with physicians, our leadership as the pioneers of teamwork in the health professions space, as well as the efficiency that teamwork creates when PA and MD students are educated together?
And that’s exactly what’s happening at the University of Iowa, where the PA and MD second-year curriculums are completely merged. Presented by the Chair of Physician Assistant Studies and Assistant Dean for Iowa’s Carver College of Medicine’s Office of Student Affairs and Curriculum, David Asprey, PhD, PA-C, an overview of this innovative education model grabbed the attention of IOM workshop attendees, offering evidence of the value that PAs bring to our health care system.
When Curriculum and Collaboration Converge
First implemented in 2014, the University of Iowa education model was a natural extension of the ongoing collaboration between PA and MD students throughout the history of the health professions at Iowa. Dr. Asprey summed up the advantages of the program: “The new curriculum provides a win-win situation for our students and the college by providing an excellent education, the benefits of interprofessional training, and the efficiencies associated with eliminating the resources required to run separate courses for the two groups of learners.”
Dr. Asprey discussed some of the concerns about taking interprofessional education to new levels of curricular integration, including concern over loss of professional identities, student desires to change professions, accreditation issues, and overall apprehension about the ability to educate different professions using the same curriculum. However, there are numerous avenues available to mitigate those concerns — through education, accreditation, and effective integration, to name a few. He explained that, at Iowa, care has been taken to have PA-specific small groups and other activities in order to address PA-specific issues such as professional identity. In short, for Iowa, the initial concerns have simply not been substantiated.
One consequence of this curriculum model is its positive effect on the health professions’ chronic condition — “curriculum obesity,” which also came up as a topic of discussion among Forum participants. Curriculum obesity is a health-related metaphor for the trend toward expanding the curriculum without eliminating traditional topics that may no longer be relevant or could be taught in other ways. Dr. Asprey demonstrated how Iowa’s merged curriculum for PA students and second-year medical students creates efficiencies that can address this problem.
Buy-in from All Is Essential
In response to audience questions, he emphasized the importance of cultural readiness — ensuring that the institution’s administration and faculty are all onboard — when undertaking such a curricular transition, noting that the recent change at Iowa was embraced by both the administration and PA program faculty.
“As we near the completion of two semesters of course work, this revised curriculum combining our students is working extremely well,” said Asprey. “We will continue to assess all aspects of the experience and associated outcomes to identify any areas that may need to be modified.”
So far at Iowa, they have learned that the shared curriculum is producing similar results for both PA and MD students. In fact, PA students appear to be thriving in this curricular environment, performing at or above the level of medical students.