Research

Duke Colleagues Earn Their STARs

By Nikki FriasMay 15, 2019

From left to right: from left to right; Nancy Knudsen, Nicholas Hudak, Melinda Blazar, April Stouder. Image courtesy of Nicholas Hudak.

PAEA is proud to announce the recipient of the 2019 Support to Advance Research (STAR) Program.

This year’s STAR Program recipient is Nicholas Hudak, MPAS, PA-C, associate professor at the Duke University PA program. Hudak will be joined by co-investigators and Duke University faculty members April Stouder, MHS, PA-C; Melinda Blazar, MHS, PA-C; and Nancy Knudsen, MD.

Every year, the STAR Program offers PA researchers the opportunity to include their own survey questions in the annual PAEA Program Survey, which every PAEA member program is required to complete. At the close of the Program Survey, STAR recipients receive de-identified data from their survey questions to analyze for their own research.

STAR applicants were asked to submit blinded applications, providing a brief overview of their proposed research and survey questions. The application review process was conducted by the PAEA Grants & Scholarship Review Committee.

Hudak’s survey questions seek to examine the prevalence, content, and dissemination of PA program policies that address and prevent negative events reported by students involving preceptors during supervised clinical experiences. We had the chance to interview Hudak and his team to learn more about their study and its pertinence to PA education and research.

Can you tell us about your research question for this project and its significance to the field of PA education?

In the first two PAEA Student Reports, PA student respondents reported that negative experiences are relatively prevalent yet under-reported, most often involve preceptors, and that there is variable awareness of program policies related to reporting. As negative events emerge as an important issue facing PA students, it is evident that very little is known about PA program policies to address students’ reports of negative events involving preceptors during supervised clinical experiences. Therefore, the purpose of our study is to increase PA educators’ understanding about the prevalence and content of policies pertaining to negative events reported during clinical education and how those policies are disseminated to students, faculty, and clinical preceptors. As health professions education programs and their sponsoring institutions are responsible for maintaining supportive environments to maximize student learning, we were interested in learning more about policies designed to assess, address, and prevent negative events.

What inspired your interest in researching the topic?

Our research team’s interest in this project stems from our several years of experience as health professions educators and direct involvement addressing students’ reports of negative events during supervised clinical experiences. In 2014, I was appointed to serve as PA faculty representative on the School of Medicine Committee on the Appropriate Treatment of Learners. One key function of this new committee was to review and revise institutional and program policies to more effectively assess and address student reports of negative events. In close collaboration with leadership from that committee (including STAR Program collaborator Nancy Knudsen, assistant dean of learning environment), PA program leadership, and clinical faculty colleagues (including STAR Program collaborators April Stouder, associate program director, and Melinda Blazar, director of clinical education), our program’s own policy was revised to better address student reports for the greater purpose of maintaining supportive learning environments. As our institutional and program policies were strengthened by referencing other institutions’ policies, our interest was piqued to further understand policies in other PA education programs.

What kinds of new information or understandings do you hope this research will provide? In what potential ways do you see the results impacting PA education?

In health professions education, one way to create and maintain supportive learning environments is to assess, address, and prevent negative events in classroom and clinical settings. This research will raise awareness about the issue of negative events during clinical education and provide educators with an understanding of current policy prevalence, content, and dissemination. This information could then be used by programs to write and revise policies as well as more effectively disseminate information about policies. While the survey items are not designed to evaluate policy effectiveness, the findings from this study will provide a basis for such evaluation at the program and inter-institutional levels. The ultimate impact of this and future related research is to help programs write and implement policies to improve learning environments for PA students.

Do you see any policy or practice implications for your research?

The information gained from this study could be valuable to PA programs establishing new policies or revising existing policies to prevent and manage negative events reported by learners during supervised clinical experiences. The results of this study could also have policy significance for the ARC-PA with regard to future revisions of the Accreditation Standards. Specifically, the results of this study could generate discussion about the development of a standard related to policies on professional conduct and student mistreatment similar to those that have been established by accrediting bodies for other health professions. The survey findings could also establish a foundation for future policy analysis research, including on policy implementation and effectiveness.

What are your goals as a PA researcher, and how will the STAR Program help advance those goals?

My goal as a researcher is to generate new knowledge and understanding of complex educational processes to help health professions educators ensure that learners are practice- and collaboration-ready providers who will improve the health of individuals and communities. My project collaborators are driven by a similar purpose and have drawn from their unique experiences as educators to strengthen this project and envision the impact it may have. The STAR Program provides an extraordinary opportunity to gather essential information from programs that would otherwise be difficult to obtain in such magnitude. The feedback received from the Grants & Scholarship Review Committee was helpful in focusing the project research question and improving the survey items.

Do you have any suggestions for PA faculty who may be considering applying for this opportunity?

Definitely consider applying to the STAR Program if you have a clear research question on a topic relevant to PA students, educators, and the profession. It is critically important to understand the literature on your potential topic within PA education and more broadly in the health professions education literature to ensure you have identified the gap in knowledge and have the right research question. Involving collaborators and seeking guidance from colleagues can also be instrumental throughout the entire process. To those who have previously applied and not been accepted, I would challenge you to seek feedback from PA educators at your program and from around the country on how your proposal could be strengthened — then apply again.

Congratulations to Nick, April, Melinda, and Nancy on your successful proposal! And special thanks to the Grants & Scholarship Review Committee for devoting their time and expertise to the selection process.

Nikki Frias

Dominique (Nikki) Frias is PAEA's research assistant. She graduated in 2016 from Virginia Commonwealth University with a degree in psychology.