title: The role of physician assistants in pediatric emergency medicine: the physician's view.
abstract: OBJECTIVE
  To define the range of clinical conditions Canadian emergency pediatricians consider appropriate for management by physician assistants (PAs) and the degree of autonomy PAs should have in the pediatric emergency department (PED).
  
  
  METHODS
  We conducted a cross-sectional, pan-Canadian survey using electronic questionnaire technology: the Active Campaign Survey tool. We targeted PED physicians using the Pediatric Emergency Research Canada (PERC) network database (N  =  297). Three outcome measures were assessed: demographic information, familiarity with PAs, and PA clinical roles in the PED. The level of PA involvement was assessed for 57 common nonemergent clinical conditions.
  
  
  RESULTS
  Of 297 physicians, 152 completed the survey, for a response rate of 51.2%. None of the 57 clinical categories achieved at least 85% agreement regarding PA management without direct physician involvement. Twenty-four clinical conditions had ≥ 15% agreement that any PA involvement would be inappropriate. For the remaining 33 clinical conditions, more than 85% of respondents felt that PA could appropriately manage but were divided between requiring direct and only indirect physician supervision. Respondents' selection of the number of conditions felt to be appropriate for PA involvement varied between the size of the emergency department (ED) in which they work (larger EDs 87.7-89.1% v. smaller EDs 74.2%) and familiarity with the clinical work of PAs in the ED (90.5-91.5% v. 82.2-84.7%).
  
  
  CONCLUSIONS
  This national survey of Canadian PED physicians suggests that they feel PAs could help care for a large number of nonemergent clinical cases coming to the PED, but these clinical encounters would have to be directly supervised by a physician.
authors.forename: Quynh
authors.initials: Q
authors.lastname: Doan
authors.forename: Shalea
authors.initials: S
authors.lastname: Piteau
authors.forename: Sam
authors.initials: S
authors.lastname: Sheps
authors.forename: Joel
authors.initials: J
authors.lastname: Singer
authors.forename: Hubert
authors.initials: H
authors.lastname: Wong
authors.forename: David
authors.initials: D
authors.lastname: Johnson
authors.forename: Niranjan
authors.initials: N
authors.lastname: Kissoon
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002170:Canada; D003430:Cross-Sectional Studies; D004635:Emergency Medicine / Q000458:organization & administration*; D004636:Emergency Service, Hospital; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D010372:Pediatrics; D010823:Physician Assistants / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D000078329:Workforce