SAN FRANCISCIO — More needs to be done to improve physician assistant student participation in quality improvement projects during clinical rotations, results of a poster presented at the American Academy of Physician Assistants 2015 meeting indicate.

The United States health care system has gone through many transformations to improve the quality of the patient experience, improve population health, and reduce health care costs.

These transformations, partly needed to respond to the Affordable Care Act mandates, “require parallel curricular reforms that provide health professional students opportunities for early exposure to the principles quality improvement, care coordination, and patient-centered care,” wrote Gerald Kayingo, PhD, MMSc, PA-C and colleagues.

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To investigate the extent to which physician assistant (PA) students report learning about quality improvement during the didactic and clinical phases of their education, the researchers conducted a two-phase study.

In phase one, an electronic survey was sent to faculty members at all accredited PA programs who met the study inclusion criteria, inquiring about curricula central to quality improvement education. In phase two, the investigators surveyed select second-year PA students who had completed at least four weeks in a primary care rotation.

Of the 87 faculty who responded to the survey, more than 60% reported that they teach concepts related to physician-directed teams, principles of quality improvement, care coordination, and electronic health records in the didactic phase.

With regard to participation in quality improvement projects, 38% of faculty stated that their students do not participate in quality improvement projects, 26.7% stated that some students participate, and only 14.7% reported that all students participate. Of the respondent faculty, 20% answered that they did not know if their students participated in a quality improvement project.

Only 23% of responding students reported encountering quality improvement projects during their primary care rotation and only 9% reported that they participated in these projects.

“Our study suggests that many PA programs have started teaching some of the concepts of quality improvement during the didactic phase, but participation in quality improvement projects during clinical rotations remains limited,” wrote the researchers.

“Many employers are now expecting PA graduates to have basic knowledge of quality improvement, a concerted effort is needed to better prepare PA students to function in these emerging quality care-driven environments.”


  1. Kayingo G et al. “Quality Improvement Education for Physician Assistant Students: A National Cross-sectional Study.” Presented at: AAPA 2015. May 23-27, 2015.