title: Rural Versus Suburban/Urban Experiences in a Family Medicine Preceptorship.
abstract: OBJECTIVE
  Accreditation standards require physician assistant (PA) programs to ensure students receive adequate clinical experiences. During their clinical year of training, PA students complete rotations with multiple clinical preceptors, introducing them to practice and exposing them to a variety of clinical problems. In this article, we examined Typhon Physician Assistant Student Tracking (PAST) system patient encounter logs' value for program evaluation, but also in research to address questions relevant to PA education. Specifically, we explored the MEDEX Northwest Physician Assistant Training Program student experience across rural versus suburban/urban placements in a 4-month family medicine preceptorship.
  
  
  METHODS
  Student experience was analyzed from 2 years of collected Typhon PAST encounter data. Encounter characteristics included duration, number of clinical problems, student level of responsibility, and decision type. Patient characteristics included sex, age, race, and clinical problems recorded as ICD-9 codes.
  
  
  RESULTS
  Individual student experience varied widely across different preceptors. However, these differences were more specific to the preceptor-student relationship than to whether the site was classified as rural or suburban/urban. Across these settings, significant differences were only noted for percentage of female and 65 or older patient encounters. The most common clinical problems reported across rural versus suburban/urban sites were highly correlated.
  
  
  CONCLUSIONS
  Physician Assistant Student Tracking data demonstrated that individual student experience in their family medicine rotation varied widely. However, in general, rural and suburban/urban experiences were more similar than different. This study supports the value of the Typhon PAST logging system for not only tracking student activity but also addressing program evaluation and research questions.
authors.affiliation: Douglas M. Brock, PhD, is an associate professor at MEDEX Northwest, Department of Family Medicine, School of Medicine, University of Washington, Seattle, Washington. Terry Scott, MPA, PA-C, is the MEDEX program director, MEDEX Northwest, Department of Family Medicine, School of Medicine, University of Washington, Seattle, Washington. Steven Skaggs, MPAS, PA-C, is the clinical coordinator at MEDEX Northwest, Department of Family Medicine, School of Medicine, University of Washington, Seattle, Washington. Timothy C. Evans, MD, PhD, FACP, is the senior medical director, MEDEX Northwest, and an associate professor in the Department of Medicine, School of Medicine, University of Washington, Seattle, Washington.
authors.forename: Douglas M
authors.initials: DM
authors.lastname: Brock
authors.forename: Terry
authors.initials: T
authors.lastname: Scott
authors.forename: Steven
authors.initials: S
authors.lastname: Skaggs
authors.forename: Timothy C
authors.initials: TC
authors.lastname: Evans
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D005194:Family Practice / Q000193:education*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010823:Physician Assistants / Q000193:education* / Q000523:psychology; D011231:Preceptorship / Q000458:organization & administration*; D015397:Program Evaluation; D019035:Rural Health Services; D019037:Urban Health Services; D055815:Young Adult