Development of a Physician Assistant Orientation Program in a Pediatric Emergency Department

Abstract

Introduction The role of physician assistants (PAs) in the care of emergency department (ED) patients has been expanding in recent years. However, little is known about how PAs are prepared to practice in pediatric emergency medicine (PEM), and there is no published literature on how to train PAs in independently managing low-acuity visits in the pediatric emergency department (PED). Methods We created a preorientation, orientation, and postorientation program for PAs who are onboarding in the PED at a large, free-standing pediatric acute care hospital. We implemented an evaluation system that assessed readiness for independent practice based on number and type of patients seen as well as supervising physicians' feedback. Results On average, PAs took care of 877 patients over the course of their first year of employment at the hospital before achieving readiness for independent practice. Most PAs were deemed ready to see low-acuity patients without direct supervision by PEM attendings during their third or fourth quarter of employment. Discussion The successful implementation of a 12-month curriculum and individualized feedback allowed our PED to prepare PAs for independent management of the low-acuity PED patient.