Yale: Thinking Outside the Classroom

If you haven’t heard by now that Yale is planning to launch an online PA program, you’ve clearly been on sabbatical in the South Pacific. When the news was announced last month, it caused a firestorm, and not just within the PA education community. Major media outlets covered the story — The Atlantic, The Wall Street Journal, and BuzzFeed among them — and shares for 2U, Inc., the online education provider Yale is partnering with, jumped 20 percent.

The program recently made headlines again when the ARC-PA determined that Yale could not piggyback on its current program, and denied the university’s request to expand its number of students. Instead, Yale’s online school will now need to apply as a separate program, likely delaying its start date. (ARC-PA was contacted for this story but declined to comment.)

Not the First
Despite news coverage reporting that Yale is launching the country’s first online PA degree (more accurately described as a blended program), the University of North Dakota (UND) has held its didactic courses online for 12 years.

UND’s online coursework is primarily run through the learning management system Blackboard, but includes a slew of other resources — discussion boards, video conferencing, blogs, and Skype among them. Recently, the program implemented “clicker” response ware, which allows students to respond to quiz questions in real time.

UND Program Director Jeanie McHugo, PhD, PA-C, noted that patience, availability, and flexibility are essential to ensure success. “Increased communication and the feeling of connectedness is important to all involved,” McHugo said.

When the clinical portion of the program begins, students visit the UND campus four times, for three to five weeks at a time, for additional didactic instruction. In 2014, the program’s first-time PANCE pass rate was 95 percent.

Meanwhile, the PA program at the University of Wisconsin-Madison offers a part-time “distance track” that brings students to the campus several times for labs (including 10 weeks at the start) but otherwise conducts lectures and discussions asynchronously.

These programs often attract students from rural and underserved communities where they already feel grounded and have families, and where they can later increase access to quality patient care. Yale’s PA Program Director Jim Van Rhee, MS, PA-C, foresees Yale’s online program attracting a similar cadre of students. “Not every student can move to Yale to go to PA school,” he said. “With the online program, Yale can move to them.”

The experience the online students receive won’t be exactly the same as those on campus, but Van Rhee doesn’t think it has to be. “It’s still going to give them the same high quality didactic education and clinical experience,” Van Rhee said. “It’s going to be a different type of community, but I still think it’s going to be a community.”

Lessons
Online lectures for Yale’s program will be produced in two new studios, and faculty will learn video production and voice editing skills.

There will also be live, small group discussions. In a typical classroom, Van Rhee notes, it’s difficult to tell which students are grasping the material because only one person at a time can be called upon to answer. With an online platform, faculty can ask students to complete questions throughout the lecture, giving both the faculty and students immediate feedback on student comprehension.

Van Rhee said there’s little the online program can’t do. “I’m a big fan of the Socratic method, but I told the people at 2U that it couldn’t be done online asynchronously,” he said. “They just laughed at me and showed me an example. It blew my mind.”

Some current and former Yale students advocated that a different name be used to distinguish the on-campus and blended degrees, and the ARC-PA ultimately made the same request. The two programs, however, will not be completely separate. Blended program students will attend intensive sessions at the Yale campus twice during the didactic year — when they’ll learn clinical skills like drawing blood — and on-site students will benefit from the new technology that’s developed. “I don’t want this to be us versus them,” explained Van Rhee. “I want both groups to work together.” This includes faculty, all of whom will take part in a new intensive faculty development program.

Clinical Sites
To date, 2U has facilitated more than 20,000 field placements in clinics, hospitals, and schools on behalf of their partner degree programs, which— in addition to Georgetown Nursing — include the USC graduate program in social work and the Northwestern University graduate program in counseling.

As far as concerns about “taking” spots at clinical sites from students at nearby brick-and-mortar PA schools, Van Rhee said they’ll follow their current policy: If Yale finds that a clinical site already has a relationship with another program, they will contact that program.

The clinical sites Yale chooses will need to meet its standard requirements regarding patient volumes, certification, etc. Van Rhee anticipates that in many instances, placement at sites will be easier. There will be fewer students to place at each site, and they will already be immersed in the community and thus more likely to stay there — an incentive for potential preceptors.

Regional faculty members will be the program’s eyes and ears on the ground, visiting clinical sites when necessary.

Apprehension
There have been mixed reactions since Yale announced the blended program. Chip Paucek, the CEO and co-founder of 2U, said there were similar doubts when the company worked with Georgetown University to launch its blended nursing graduate program. “It’s no secret the preconceived notions about online education are terrible,” he said. “Eventually, those concerns subside as the program delivers successful field placement experiences and outcomes for students.”

Bill Tozier, a lecturer at MEDEX Northwest’s PA program, is not convinced. “When you develop professional students, you give them the content — which certainly can be delivered by non-resident means — but you also develop their professional behaviors and attitudes. I don’t believe that can be done via the Internet.”

Van Rhee acknowledges that the blended program will need to produce successful alumni before many critics are won over. “All I ask of people is that they keep an open mind just like we asked people 50 years ago to keep an open mind about this profession,” he said. “Watch, be critical, but be constructive and help us make this better.”

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