SAN FRANCISCO — Clinical simulation is widely used to teach and assess clinical skills in physician assistant (PA) education, according to findings presented at the American Academy of Physician Assistants 2015 meeting.

Karen Beer, PA-C, and James Stoehr, PhD, from the Midwestern University PA Program in Glendale, Arizona sought to examine the extent of clinical simulation use during the didactic and clinical phases of PA education and determine the various forms of simulation used to teach and assess clinical skills. 

They sent a web-based survey to PA program directors of all existing programs, requesting information on clinical simulation activities.

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Based on data from 63 responding PA programs, 90% of programs use standardized patients, 88.3% use task trainers, and 85% use low-fidelity mannequins. In addition, 73.3% of programs use high-fidelity mannequins, 71.7% use heart/lung sound machines, and 26.7% use virtual reality simulators.

A large majority of PA programs use clinical simulation during the didactic portion of the program: 98% use low-fidelity mannequins, 94.8% use standardized patients, 94.7% use task trainers, and 93.5% use heart/lung sound machines.

In comparison, fewer programs reported using clinical simulation during the clinical phase: 79% use standardized patients, 59.2% use high-fidelity mannequins, and 36.7% use low-fidelity mannequins.

“Clinical skills are more frequently taught than assessed using clinical simulation,” noted Beer. “Heart/lung sound machines, task trainers, low-fidelity mannequins, high-fidelity mannequins, and virtual reality are used more frequently to teach clinical skills, while standardized patients are used more often to assess clinical skills — 96.3% vs. 74%.”

Furthermore, 72% of programs use a dedicated clinical simulation center. In 47.6% of these programs, the simulation center is owned by the university, and in 33.3% of the programs it is owned by the medical school. Among programs that use a simulation center, 45.2% pay for its use. In addition, PA program faculty debrief cases with students 92.7% of the time, write cases 85.4% of the time, and operate high-fidelity mannequins or computers 51.2% of the time.

About one-quarter of programs (21.4%) report collecting data indicating that student performance has improved as a result of simulation use, and 69% of respondents intend to expand their use of clinical simulation in the future.

“Widespread plans among programs to increase their use of simulation suggest that faculty find the use of simulation beneficial,” stated Beer.

“In the future, simulation could be used to augment unscheduled experiences students get on clinical rotations with scheduled, deliberate practice of less commonly encountered patient scenarios,” she concluded. “In this way, simulation could be used to alleviate clinical rotation shortages currently seen in PA education.”


  1. Beer K, Stoehr J. “Utilization of Clinical Simulation in Physician Assistant Education.” Presented at: AAPA 2015. May 23-27, 2015. San Francisco, California.