title: Analysis of the level of general clinical skills of physician assistant students using an objective structured clinical examination.
abstract: OBJECTIVE
  The physician assistant (PA) is trained to perform clinical tasks traditionally performed by medical doctors (MDs). Previous research showed no difference in the level of clinical skills of PAs compared with MDs in a specific niche, that is the specialty in which they are employed. However, MDs as well as PAs working within a specialty have to be able to recognize medical problems in the full scope of medicine. The objective is to examine PA students' level of general clinical skills across the breadth of clinical cases.
  
  
  METHODS
  A cross-sectional study was conducted. PA students and recently graduated MDs in the Netherlands were observed on their clinical skills by means of an objective structured clinical examination comprising five stations with common medical cases. The level of mastering history taking, physical examination, communication and clinical reasoning of PA students and MDs were described in means and standard deviation. Cohen's d was used to present effect sizes.
  
  
  RESULTS
  PA students and MDs score about equal on history taking (PA 5.8 ± 0.8 vs. MD 5.7 ± 0.7), physical examination (PA 4.8 ± 1.3 vs. MD 5.4 ± 0.8) and communication (PA: 8.2 ± 0.8 vs. MD: 8.6 ± 0.5) in the full scope of medicine. In the quality of the report, including the patient management plan, PA students scored a mean of 6.0 ± 0.6 and MDs 6.8 ± 0.6.
  
  
  CONCLUSIONS
  In this setting in the Netherlands, PA students and MDs score about equal in the appraisal of common cases in medical practice. The slightly lower scores of PA students' clinical reasoning in the full scope of clinical care may have raise attention to medical teams working with PAs and PA training programmes.
authors.affiliation: Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands.
authors.forename: Anneke J A H
authors.initials: AJ
authors.lastname: van Vught
authors.affiliation: Institute for (Bio) Medical Education, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Agatha M
authors.initials: AM
authors.lastname: Hettinga
authors.affiliation: Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands.
authors.forename: Eddie J P G
authors.initials: EJ
authors.lastname: Denessen
authors.affiliation: Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands.|Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Martin J T
authors.initials: MJ
authors.lastname: Gerhardus
authors.affiliation: Institute for (Bio) Medical Education, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Geert A M
authors.initials: GA
authors.lastname: Bouwmans
authors.affiliation: Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands.
authors.forename: Geert T W J
authors.initials: GT
authors.lastname: van den Brink
authors.affiliation: Institute for (Bio) Medical Education, Radboud University Medical Center, Nijmegen, The Netherlands.|Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Cornelis T
authors.initials: CT
authors.lastname: Postma
mesh_terms: D002983:Clinical Competence; D000066491:Clinical Decision-Making; D003142:Communication; D003430:Cross-Sectional Studies; D004501:Education, Medical / Q000379:methods* / Q000592:standards; D004521:Educational Measurement / Q000379:methods*; D006801:Humans; D008487:Medical History Taking; D009426:Netherlands; D010808:Physical Examination; D010823:Physician Assistants / Q000193:education* / Q000592:standards; D015203:Reproducibility of Results
keywords: clinical skills; physician assistant; substitution of care