Targeted Training for Physician Assistant Students Caring for At Risk Populations in Kentucky

The ultimate goal of this proposal is quality care for special, at-risk populations in the Commonwealth of Kentucky, where the percentage of elders living in poverty has been reported to exceed 40%, where in 2003 AIDS was the eighth leading cause of death for those aged 25-44, and where in some rural counties rates of obesity and overweight exceed 75%. The University of Kentucky Physician Assistant program strives to select students from educationally disadvantaged backgrounds who will stay in Kentucky to provide quality care for the Commonwealth. Proposed activities will improve PA students' clinical and communication skills, enabling them to identify, assess and care for special, at-risk populations. Standardized patient encounters (SPEs) are an ideal opportunity for students to develop appropriate communication, identification, and clinical assessment skills essential for empathetic, effective care of special patient populations. SPEs will be developed for three special at risk patient populations in the state of Kentucky: Geriatric patients (with an emphasis on identification of elder abuse), HIV/AIDS patients (with an emphasis on communication), and Obesity (with concomitant low socio-economic status). Early experiences will occur at the University of Kentucky Skills Training and Assessment Center. Subsequently, the student will be expected to practice and demonstrate skills in a clinical setting; the SPE for elder abuse will occur in a local nursing home or private home setting, HIV/AIDs in a primary care clinic, and obesity in SES in a free clinic. This approach encourages early student engagement and acculturation to the setting. Perhaps more importantly, contextual cues are present in these environments that the student may begin to associate with patients' clinical presentations and symptoms. During clinical rotations, preceptors will become active participants in this targeted training. Preceptors will be given audio-visual material (DVDs) describing students' SPEs, and reviewing communication and assessment skills the student is expected to have acquired as a result of the SP program. The preceptor will be asked to review the information with their PA students, identify patients within their practice who may meet the special patient criteria, and allow the student to participate in their care. This clinical training initiative also provides interactive education for the PA's physician preceptor, and the DVD is used as the medium.