Perri Morgan, PhD, PA-C, and her research team at the Duke University PA program have been awarded the 2018 PAEA Faculty-Generated Research Grant to study best practices in onboarding new PAs. Colleagues Mara Sanchez, MMS, PA-C, RD, Christine Everett, PhD, MPH, PA-C, and Brandi Leach, PhD, will join Morgan in this study.
Over the next year, the team will conduct interviews with clinic administrators, medical directors, and others with expertise in onboarding new PA graduates in primary care practices in underserved settings to better understand which onboarding practices are most effective and efficient. The goal of the study is to improve employment outcomes such as retention, quality, safety, productivity, and job satisfaction among PAs new to their practice settings — especially primary care and safety net practices.
Morgan said that the idea of the study was spurred by seeing “a number of students over the years who had dreamed of working in underserved settings providing primary care, but who changed their minds after a year or so.” This led the team to wonder if better onboarding could help.
In addition to her students’ experiences in the job market, Morgan also cites what she heard from employers at the 2016 PAEA Stakeholder Summit, specifically about hiring and onboarding PAs.
“One of the recurrent themes at this meeting was that employers need information about how to best support new PAs as they transition into their first jobs,” said Morgan. “New graduate PAs face challenges in adapting to their first jobs. Employers eager for these new PAs to become economically productive may pressure them to increase their patient load or stretch their autonomy, creating job stress for the PA and safety concerns for patients. Inadequate support for new PAs can contribute to high turnover, which is costly for employers and can hinder high-quality care. Appropriate onboarding practices can alleviate some of these problems, but best practices for onboarding new PAs have not been described.”
This latest study elaborates on earlier research that Morgan and her team conducted on the question of why students who wish to work in primary care in undeserved settings had trouble finding such positions. That was Morgan’s 2015 PAEA Faculty-Generated Research Grant-funded investigation into the frequency and location of primary care positions available for PAs (as opposed to specialty positions), which found that that there are fewer primary care positions available than specialty positions.
The issue of how to onboard new PAs is an increasingly important topic in the context of an impending optimal team practice (OTP) environment. Regarding Morgan’s study, PAEA Chief Policy & Research Officer Dave Keahey, MSPH, PA-C, said, “There are many pressing issues facing PA education, but few are more timely or foundational than understanding how to effectively prepare new graduates to be practice-ready. As OTP legislation efforts move forward to change the practice environment, educators will need to adapt. Dr. Morgan’s vital research will describe where we are now and suggest where we might need to be.”
The decision to fund Morgan’s project came after two phases of blinded peer review.