PA Program Profile: Yale PA Online

Last year, ARC-PA extended provisional accreditation to the Yale Online PA Program. With their first class well under way, we checked in with Program Director James Van Rhee, PA-C to see how it’s going.

Tell me a little bit about how this program came about.

A key reason Yale created the Yale PA Online Program was to enable talented, aspiring PAs from across the country to benefit from a Yale education, while staying in their home communities. The ability to participate in a PA degree-granting program from one’s home community is significant because of the rapidly growing need for qualified PAs in primary care across the United States, including in medically underserved areas, which often are in urban and rural locations. The expectation is that students who are based in or near their hometowns as they engage in didactic work and clinical rotations are more likely to stay and practice in these areas. Yale School of Medicine (YSM) believes there is tremendous value to making a high-quality Yale PA education accessible to a greater number of qualified students, thereby increasing the number of PAs available to meet the nation’s growing health care needs — especially in primary care.

What do you think makes your program unique?

The Yale PA Online Program is a blended program, with both online and in-person experiences. It begins with 12 months of online didactic work, much of it synchronous, with cohorts of 10 to 15 students engaging frequently with each other and a YSM faculty member through an “Online Campus.” Students then embark on 15 months of in-person clinical rotations, which predominantly can be completed near where they live. The students also come to the Yale campus for three separate one-week immersions, as well as have engagement with clinicians during the first year of the program through the Clinical Experience in Early Didactic program.

Significantly, the Online Campus is not just a platform where students independently watch video content. Rather, it is structured to allow Yale faculty to engage extensively with their individual cohorts of 10–15 students and for the students to engage with each other. Faculty cohort leaders spend about six hours each week interacting in a virtual classroom with their students. During these sessions, videos and other materials are able to be viewed simultaneously through a built-in shared screen function. Students can raise their hands to speak, either in writing or using audio with the click of a mouse or touchpad, and the faculty leader can break the group into even smaller virtual “breakout rooms” for small-group work and discussions. Faculty can also hold one-on-one audio conversations with students, and students are encouraged to create student interest groups within the Online Campus. Students also have an individual link to their own virtual classroom where they can conduct independent study sessions.

What has been the biggest challenge your program has had to overcome so far, and how did you accomplish it?

The biggest challenge has been to ensure we create a curriculum delivery method for the didactic online curriculum that provides the students with an outstanding education and builds community among students and faculty. Our success on these measures, after a number of weeks, reflects that this challenge has become a strength of the program.

Our faculty have taken advantage of the online technology capabilities to produce innovative courses that provide students with an outstanding educational experience. The Behavioral Medicine I, II, and III classes, which are intended to develop skills in patient communication, counseling, education, and cultural diversity, as well as an understanding of how these factors influence all aspects of medical practice, provide one of many examples of this. In the Behavioral Medicine classes, Yale faculty member Stephanie Neary, MPA, MMSc, PA-C, conducts interviews or features guests either “live” on location or taped in advance. At multiple times throughout the classes, students will hear from providers around the country, who represent various aspects of primary care, who share insights on the challenges they face in their clinics and how they overcome barriers, as well as provide advice for those first few years as a provider. The tremendous capabilities of the Online Campus enable Neary to both produce high-quality video and share the content with students in an engaging way.

Yale’s conscious efforts to build community have paid off. The structure of the Online Campus creates the feel of a real classroom, complete with hand raising as well as breakout rooms for students to work and study together. The program’s decision to use problem-based learning, with students working in small groups online, has played a significant role in fostering community. The in-person immersion provides a wonderful opportunity to build on this sense of community. The week consists of lots of small-group interactive curricular work, as well as large-group social events including a White Coat Ceremony, campus tours, and a pizza tasting competition. (New Haven is famous for its pizza!)

The success of this strategy is reflected in a student comment during the March immersion: “We’re all very supportive of each other,” said Danae Davis, a student from Loma Linda, California. “Coming here together, working with each other in a lab, and receiving our coats makes this feel all the more real.” The faculty and students in the program are excited to be part of the inaugural class and so are eager to connect with one another.

Are there any new ideas or projects on the horizon to continue the program’s innovation?

Two exercises during the March immersion, one involving augmented reality, the other virtual reality, demonstrate the program’s curricular innovation. While most programs teach surgical scrubbing, one of the most important steps for disease prevention is hand-washing. Therefore, we teamed up with Trinity College in Dublin, Ireland, to use their SureWash Go machine. This is an augmented reality gaming device that allows students to practice proper hand-washing techniques, in part by competing with each other. The instant feedback provided enables students to improve upon their technique. Post-immersion, we have provided students with the SureWash app, so that they can game and practice at home to reinforce the proper techniques.

We also connected with Stanford University to use The Stanford Virtual Heart technology, which allows students to feel like they are inside a human heart as they learn about the anatomy of the heart and congenital heart defects. This innovative pedagogy during the March immersion supplemented their lectures and small online group sessions on the heart.

Additionally, Yale PA Online faculty member Mary Showstark, MS, PA-C, is using interactive technology to teach the Patient Assessment I, II, and III classes. For example, after learning how to check vital signs and perform an abdominal exam, students are given an assignment to record themselves practicing on their friends and family. Faculty review the recordings and provide the students with feedback. Showstark has found that the recording requirement causes students to practice more, which, combined with the feedback, elevates student performance.

Additionally, three observation exercises are used for these classes to strengthen critical observation skills that teach students to differentiate patients’ subjective statements from objective facts derived from observing and examining patients.

• In one exercise, originally developed for and still used by the YSM Physician Associate and MD degree programs, students observe paintings from the Yale Center for British Art. The students are to state objective facts about the painting only.
• The second activity, which is new to the YSM curriculum, is similar, but uses an interactive video of the New Haven Green, a large park in downtown New Haven. This teaches students to observe situations where motion and activity are involved.
• In the third activity, also new to the YSM curriculum, students are given two pictures and must identify the differences between the images, gaining experience with observing changes that happen over time.

Yale PA Online is also collaborating with a few other top universities with online programs in other health care disciplines on a significant interprofessional education project. Yale PA Online students will work with students studying speech and communicative disorders, occupational therapy, physical therapy, social work, and nursing on case studies. They will have virtual breakout groups where they will be working through the cases and learning how to work as teams with other professions.

It is important to note that by obtaining feedback from our first cohort of students throughout their experience, we will learn valuable lessons that will enable us to continually improve the innovative content and delivery of our program.

If you could give developing programs one piece of advice, what would it be?

Don’t be afraid of innovation. The Yale PA Online Program has outstanding faculty and intelligent, mission-driven students — all of whom embrace the opportunities for innovation that the program provides.