title: Self-assessment of cancer competencies and physician assistant cancer education: instrument development and baseline testing.
abstract: OBJECTIVE
  Although the benefits of primary and secondary prevention of cancer are well recognized among health care providers, insufficient knowledge or skill often leads to inadequate assessment and management, particularly in the primary care setting. The scant literature on physician assistant (PA) cancer-related competencies suggests that PAs may not be well-prepared in this arena. Thus, curriculum reform in PA education is paramount for improving PAs' abilities to provide cancer risk assessment and management services. The Physician Assistant Cancer Education (PACE) project was designed for such a purpose. Following instrument development, baseline measurement of perceived abilities for cancer-related core competencies was assessed in a representative cohort of PA students.
  
  
  METHODS
  Literature search strategies, expert review, and a nationwide survey of PA program directors yielded the 26-item Competencies in Cancer Assessment and Management (C-CAM) instrument. Baseline self-efficacy data were gathered from students across eight PACE-affiliated PA programs. Statistical analysis focused upon instrument quality and comparisons of reported self-efficacy among respondent cohorts.
  
  
  RESULTS
  Data were collected from 544 PA students. Overall instrument reliability was excellent (Chronbach's alpha 0.97). Exploratory factor analysis identified three factors explaining 72.83% of response variance. Mean values varied somewhat across institutional cohorts. Clinical students demonstrated higher self-efficacy than preclinical students.
  
  
  CONCLUSIONS
  The C-CAM is an effective instrument to assess PA student self-efficacy in cancer prevention, risk assessment, and risk management competencies. Although a trend toward higher self-efficacy was observed among clinical students, further research is required to assess the extent to which reported self-efficacy may be expected to change over time.
authors.affiliation: Baylor College of Medicine, Physician Assistant Program, One Baylor Plaza MS: BCM 115, Houston, TX 77030, USA. lspence@bcm.edu
authors.forename: Laurel R
authors.initials: LR
authors.lastname: Spence
authors.forename: Carl E
authors.initials: CE
authors.lastname: Fasser
authors.forename: Robert J
authors.initials: RJ
authors.lastname: McLaughlin
authors.forename: J David
authors.initials: JD
authors.lastname: Holcomb
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D004521:Educational Measurement / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000209:etiology*; D010823:Physician Assistants / Q000193:education*; D012196:Review Literature as Topic; D018570:Risk Assessment; D012647:Self-Assessment; D011795:Surveys and Questionnaires; D013781:Texas