Rocky Vista University in picturesque Parker, Colorado, is one of the newest members of the PA family, having gained provisional accreditation in the spring of 2018. Program Director Cathy Ruff, MS, PA-C, spoke with us about the fledgling program and their successes so far.
Tell me a little bit about how this program came about.
The RVU PA program began as a vision to meet the medical needs of the people of Colorado. More than half of Colorado counties — primarily in rural and mountain areas — are struggling to attract and keep enough primary care providers. For example, Denver County has a full-time practicing primary care physician for every 1,348 residents; however, just an hour’s drive to the east and a single provider serves nearly 6,000 residents.
Community providers, the Colorado Health Institute, the Colorado Rural Health Center, and the Colorado Department of Public Health and Environment have all advocated for local programs to educate and train additional primary care physicians; however, with the influx of newly insured patients under the Affordable Care Act and the accelerated training offered by PA programs, the use of PAs is seen as an excellent way to bridge the provider gap.
A steering committee consisting of a variety of providers serving rural areas across the state, with expertise in primary care, internal medicine, surgery, wilderness medicine, and other subspecialties, provided the RVU executive leaders with data to support an additional PA program in the state. In addition, members of that committee currently serve in an advisory role to the PA program faculty to ensure training will meet the needs of the population.
The inaugural cohort successfully completed their first didactic semester, and the second semester is fully underway. Supervised clinical rotations begin in June.
What do you think makes your program unique?
PA training programs in the United States have just recently begun to examine how the use of entrustable professional activities (EPAs) and competency-based medical education (CBME) may play a role in curriculum design and assessment. The RVU PA program’s entire curriculum is based on the core components of CBME.
The desired graduate outcomes are based on core clinical tasks and societal needs, and there is progressive sequencing of competencies to support learner progression from novice to competent clinician. The learning experiences resemble the practice environment and are tied to an essential graduate skill, while clinical teaching emphasizes learning through experience and application — not just knowledge acquisition. Also, the progression of learners is based on multiple data points before entrustment decisions are made. This model ensures robust programmatic assessment. Unlike graduate medical education, the use of EPAs, competencies, and milestones spans the didactic and clinical curricula of the RVU PA program.
Do you do any team-building or philanthropic activities with your cohorts?
The members of the institution as a whole are quite active in the community. Faculty and students regularly volunteer at an annual summer clean-up of the local grasslands. Students participate in service learning projects, and the institution collaborates with the local fire and police departments to host mass casualty trainings. RVU provides volunteer medical and surgical personnel as well as volunteer “patients” to realistically simulate mass casualties to ensure that all emergency response systems have an opportunity to prepare for such events.
Some of the more recent community service events that medical and PA students participated in together included: fundraising efforts for the nonprofit group “Health for Hands” benefitting global health outreach, providing free dental care for underserved communities in rural Colorado with the Colorado Mission of Mercy organization, cleaning up the Colorado mountain trails, therapeutic dance for persons with disabilities, providing care at a local free clinic, participating in local health fairs, and raising funds for breast cancer awareness.
We hear a lot about networking and collaboration in the PA world. How have you been able to collaborate with other programs or community members?
The RVU College of Osteopathic Medicine was just beginning to incorporate interprofessional education into its curriculum when the PA program joined the institution. They already had a collaborative relationship with a local nursing program in place, and members of the PA program faculty joined the two programs in developing an interprofessional education (IPE) course. The DO and PA students have weekly sessions together throughout two didactic semesters, with the nursing students and students from a Denver Metro pharmacy training program participating in targeted sessions. Students also take part in service learning projects outside of the classroom educational activities. PA and DO students will be placed in clinical rotations together whenever possible to ensure that IPE activities continue across the curriculum.
What are you doing to foster innovation in your program?
Because CBME is relatively new, we are continuously educating both PA faculty and students in what it means to be “competency-based” and how a competency-by-design curriculum impacts teaching and assessment strategies. Faculty and students are adjusting to this unique model, and both will ultimately become leaders in this latest shift in medical education. Students will model how entrustable professional activities are used in medicine and as part of clinical training for our community preceptors, as well as for other students-in-training. We are developing informational materials to aid in this transition.
If you could give developing programs one piece of advice, what would it be?
Get an early start on development, find experienced educators to lead the charge, and work with your institution to ensure an understanding of the unique requirements of PA programs. Such things as where PA programs “fit” within an institution, how accreditation standards differ between medical disciplines, the structure and roles of the PA program faculty, the length of training, and even the role of the PA may be new to the institution. While this can pose challenges to a developing program, it also affords your new team an opportunity to educate your colleagues about our profession.