Investigating the Role of Clinical Rotation Payment in Clinical Education Quality and Student Self-Efficacy for Physician Assistant Education

Abstract

As the need for Physician Assistants (PAs) increases in the United States, education programs have a responsibility to graduate competent providers to help fill the nation’s healthcare workforce needs. To do this, PA programs must rely on the commitment of preceptors to train students through clinical rotation experiences. Although precepting has been historically undertaken as an act of professional stewardship, an increasing number of PA programs are paying for clinical rotations in hopes of improving recruitment of quality rotation sites. While there is research regarding PA programs’ perception of paying for clinical rotations, as well as implementation of this practice, there is little exploring how paying for rotations may impact PA student success. To respond to the lack of research on this topic, this study examined the relationship between paying for clinical rotations, student self-efficacy, and perceived clinical education quality. These outcomes were chosen based on the theoretical work of Bandura, work motivation literature, measures of PA student success, and research pertaining to the relationship of clinical rotation payment and outcomes in medical education. This study utilized national data from the Physician Assistant Education Association (PAEA) that represented PA students at the end of their PA education. T tests were used to determine if there were differences between students who attended PA programs that pay for clinical rotations and their peers who attended non-paying programs, in regards to self-efficacy and perception of clinical education quality. Additionally, one-way ANOVA with post-hoc Tukey tests were used to identify any differences the school payment model may have contributed. Multiple linear regression was used to investigate the relationship of school payment status and clinical education quality on self-efficacy, after controlling for student and institutional characteristics. The conclusions from this study suggest that paying for clinical rotations in PA education does not significantly benefit student self-efficacy or perceived clinical education quality. Additionally, clinical site payment does not have a significant predictive relationship with self-efficacy, yet perception of clinical education quality explained some gains in self-efficacy. In light of these findings, the study offers implications for PA program administrators and suggestions for future research.