Purpose: The present study was conducted to gain comparative knowledge of physician assistants' and supervising physicians' perceptions of adequacy of physician assistant (PA) preparation at entry-level for effective practice in the primary care setting.
Methods: The sample included 1,000 PAs working in their first professional employment and their supervising physicians. Each PA/physician pair independently completed a survey to evaluate knowledge, skills, and patient care as well as diagnosis, management, and treatment of common conditions encountered in primary care. A 3-point scale for Entry-Level and Required Knowledge and Skills was used to assess proficiency: (1) exposed to subject area, but lack confidence in knowledge and/or practice skills; (2) have general knowledge and understanding of subject area and believe prepared for entry-level practice; and (3) have thorough knowledge of subject matter and expertise in practice. Competence was defined at 2.0.
Results: Ten percent (n = 98) of PAs and 5% (n = 46) of physicians responded to the survey. PA means were below 2.0 in 13 of 31 medical knowledge and patient care competencies and four of five medical/surgical procedures evaluated. With regard to diagnosis, management, and treatment of common medical conditions, the PA ranking was > 2.0 in 17 of 18 competencies. Overall, physicians' ranking of PA preparations were higher than PA self-assessments, reaching significance in 13 of the 54 competencies.
Conclusions: While PAs were less confident and competent regarding entry-level medical knowledge and patient care, self-reported ability to diagnose, manage, and treat common conditions was ranked as competent for their current practice setting and met expectations of supervising physicians.