Should PA School Be Online 

 

There are a few hot topics these days with regard to the PA profession. The top five that come to mind immediately are: 

1. The PA title 

2. Autonomy 

3. Online programs for initial training (not for practicing PA's with a Bachelor's Degree)

4. Residency requirements

5. The degree required

     I posted a simple question on my Instagram page (@navy_pa) "Should there be online PA schools?" I had an outstanding response. The general response I received was that the majority of people did NOT approve. Out of 188 responders to the "yes" or "no" portion, it came down to 81% against and 19% for (with at least one accidental vote for "yes"). There was also an option for people to voice their reasoning in a very brief text response. Many of the answers were geared towards the obvious comparison to online Nurse Practitioner programs which many people have strong feelings about as well. The greatest fear that I could gather was that there will be depreciation of the degree and the profession itself. 

     Several people argued that because of the nature of medical training, the requirement for proficiency in hands-on skills like physical exam and practical application requires the more traditional "brick and mortar" approach. They feel, as well as I do, that skills like splinting, suturing, and IV insertion simply can't be practiced in an online model. This is not even considering things like the cadaver labs, rectal exams, pelvic exams, or hemorrhage control through live tissue training. 

People that are "for" the online programs argue that several hours are spent in traditional settings wasting away in front of powerpoint presentations or dying a slow and painful death secondary to a poorly prepared and unqualified professor. I agree that the in-class model isn't always awesome and that it has room for improvement. The professors in these programs should be better vetted and if they are not performing up to par, they should be relieved of their jobs.

One responder that I interacted with (@rouxberry) is actually IN the Yale Online PA program and took the time to answer some questions for me. She was very pleasant and also helped to clear up any misunderstandings. She is in the second class right now (the first being the class of 2020). She and I both have the "this is the only program I've been in" issue where she has not experienced a traditional PA program but gets asked to compare the two all the time. I am asked the difference between the Navy's program and civilian programs all the time and don't know how to respond, so I get it. Her main argument FOR online programs relates to the healthcare provider shortage. She stated, and I'm paraphrasing here, that the need for a change in traditional methods of medical education is needed in order to increase the number of annual graduates, closing the gap between providers and patient access to care. She notes that the Yale program requires them to start clinical experiences with a preceptor in their third month of the didactic year. This allows them to work with actual patient's early on in the curriculum. She says that they also, like any other good PA/Med student, practice their physical exam skills on their spouses and family. 

     

Yale's program is both "synchronous" and "asynchronous" meaning they have some live and some pre-recorded lectures. They have live lectures three days a week with the remaining days being pre-recorded. She argues that, while this may not be optimal, it allows for similar classroom discussion you'd experience in the traditional classroom setting. I don't know if I agree with that aspect of her argument but it's better than nothing. The thing she mentioned that I actually agreed with is that because of the flexibility of the schedule for the Professor's, they end up being taught by some very highly qualified and notable experts in their field that may not be able to teach otherwise. I would argue that having the name Yale in your school's title also helps with recruiting highly qualified professors.

Exams: They take proctored exams from home via proctoring software, which she said was very creepy to be watched and listened to during her exam. She also states that prior to starting the exam they have to scan their student ID and room including under their desk to ensure cheating is not happening.

Preceptors: They may request their own preceptors, however, the standard is that Yale has preceptors set up for them ahead of time in their area. Yale also does not pay the preceptors for taking on students (good or bad I don't know). I'd say though, that the fact that Yale finds the preceptors is a plus because from what I have heard, several NP programs require the STUDENTS to find their own preceptors. This is bad because it affords very little if any oversight in the most important aspect of school, clinical experience. By controlling strictly the preceptors, Yale has addressed one of the more difficult issues I would expect online programs to face.

Immersion: They are required to work with other students during immersion weeks for four hours a day. This is also the time that they spend being tested on practical skills. Again, while this is a good attempt at getting hands-on experience for their students, I feel that Yale has failed to attain the number of hours really required to become proficient before the clinical phase of training.

While I greatly appreciated @rouxberry taking the time to give me insight into the Yale program, I don't feel that it has ultimately changed my mind. The thing to consider is that Yale is a HUGE name in universities and therefore will likely be the school that sets the standard for others to follow. With that being said, I'm not worried about the "Yale's" of the online game, I'm worried about the small private organizations with minimal funding creating an "Online PA School" under the facade of a solution for a shortage of healthcare providers in order to increase income without requiring additional staff or infrastructure. I don't personally feel like the demand for more providers should translate to lowering the bar on the education process to become one.


It seems that the common ground between the for and against crowds is that there are SOME classes that should be offered through a hybrid format online allowing for them to get them done at their own pace so that they can focus more time on the medicine courses. I really don't know what I think at this point. I will say that @beau.torbert hit me right in the feels with this comment haha. It's part of becoming a PA. Should that change? I don't know.


Thank you to all those that responded and to @rouxberry for being courageous enough to step up and defend your program. I am sure that you would have had no trouble getting into a traditional program but you took a chance with this format. It was a pleasure chatting with you, I'm sure you'll do very well!

Keep grinding it out people! Good luck and thanks for reading!