Season 3: Episode 50 - Dr. Sharon Luke and the ARC-PA

Transcribed by Otter.ai

Unknown Speaker  0:00  
We respectfully acknowledge the University of Arizona is on the land and territories of indigenous peoples. Today, Arizona is home to 22 federally recognized tribes. With Tucson being home to the Ogden and yaki. committed to diversity and inclusion the university strives to build sustainable relationships with sovereign Native nations and indigenous communities through education offerings, partnerships and community service. Welcome to this episode of the PA path podcast, I'm your host, Kevin Lohenry. Glad you could join us as we seek to better understand the PA profession.

Unknown Speaker  0:50  
If we really are trying to diversify our profession, ethnically, we need to save.

Unknown Speaker  0:57  
Well, hello, and thank you for joining us for our 50th episode here in season three. Today we speak with Dr. Sharon Luke, the executive director of the accreditation review commission on the education of the physician assistant or the arc pa as we call it. She had served in this role since 2016. But prior to that was a clinical ba as well as a PA educator, Preceptor and national leader, Dr. Luke shares her insights about accreditation and about the PA profession. And she pulls back the curtain on some of the accreditation processes that they do in order for them to stay on top of things and ensure that they're being fair and equitable in their work. It's a real privilege to hear from her perspective, and I hope you enjoy it. To learn more about our guests, you can go to our website at pa path podcast.com. Well, Sharon, thank you so much for joining us today. I know Steph is really bummed she couldn't make it. This was a long overdue conversation to talk to you, not only about your own perspective as a PA, the kind of grew up in the profession over the past several decades, but ultimately, about your role as the executive director of our accrediting body as well, which is the only agency that oversees pa education for accreditation. But also you have such a rich history as a PA educator and leader. And as a PA. So I thought we could start with you telling us about your path to becoming a PA. And then we'll move into education and accreditation a little bit later if that's okay.

Unknown Speaker  2:25  
Sure. So my path to becoming a PA is a little convoluted, as you might imagine. I started as a medical school student. And once I got to medical school and had some challenges there, I decided it wasn't for me. And I moved on to working in a lab at the Cleveland Clinic for tissue typing. And as part of that I ended up running into a PA, just as I was looking to return to medical school and thinking, how would I make that happen this return in medical school now that I had a young family. And so I started to have some discussions with a PA and decided I'm going to try this instead i i really like what I'm hearing about it, I done some research, there was a school nearby that I could get into. And I apply very nilly Willy at the last second. And the reason that I did that was because if you put in a failed application, you could get a one on one appointment with the program director, which is what I wanted. And so I threw this application together not expecting to get in, and then had that coveted appointment with the program director who kept saying, Why didn't you put all this about yourself in the application, you definitely would have gotten in. But I really wanted to understand what would make me successful in a PA program. And so that's how I got there. I worked alongside of this PA for some time and got to see what he did. But then I worked and did some shadowing with other pas to see what they did that was the same or different than the one I saw every day and decided that this was a better fit for me and my family at the time.

Unknown Speaker  4:21  
So what were some of those key attributes or characteristics of the PA role that you were able to witness that convinced you that medical school wasn't the right path?

Unknown Speaker  4:29  
What was really that medical school convinced me that medical school wasn't the right path. So every time that I thought about it I met with someone actually are more well known medical school to say what were my chances of being readmitted into medical school and he said, Well, you've been out for a couple of years. You would want to take these courses show us this kind of performance on the MCAT and I can pretty much guarantee you're gonna get in and my heart sank. I just couldn't see To help my family with survive it based on what I learned through my first run during med school, and so I had less of a positive vibe when he told me that I was surprised. In fact, myself when I felt my heart sank, and there was this, oh, no feeling, I really didn't feel my young family can survive it. But the PA program that I attended happened to be in community college. And my own bias at the time was that can't be too hard. But I also was

Unknown Speaker  5:37  
able to many a person has had that thought,

Unknown Speaker  5:40  
foolishly, but I also was able to see their class schedule, and I can see how it would be more achievable if me and my family situation. And then I had also spoken to pas who talked about, oh, you know, I started off here and this discipline, and then I moved over here. And so I felt that I would have some leeway to make decisions, as my family grew about where I might really practice medicine as a PA.

Unknown Speaker  6:11  
Sure so so when you get through with PA school.

Unknown Speaker  6:16  
So when I finished, I ended up doing two rotations and women's health and throughout school, I was not sure if I wanted to do women's health, or if I wanted to do family medicine, and I was equally torn between the two. But then I went to a fantastic practice, private practice and family or sorry, women's health and fell in love, and so did women's health rotation there and then did my dissertation there. When the physician and I just clicked, we really did. And so we decided that we wanted to work together, the patients came to know me over those two rotations. And so when I started to work, I really had a schedule filled up for myself right away. Awesome. My very first day of working officially in the practice is my first day of also being a preceptor, I walked in the door, the physician goes, Do you know the ropes, the ropes here, here's your student ID. And I'm over here during the other stuff. And so from day one, I also had a student which was which was great

Unknown Speaker  7:26  
to me. So that's always been the interesting thing about our culture of our profession. There seems to be a fear from new grads to be teachers to be preceptors. But the medical education system has done that for ever. We're a second year resident teaches a first year resident and a third year resum teaches dissection, and the attending kind of maybe oversees all of it. And I think, you know, yeah, you had already had a year of experience as a clinical student. And then you had already done some rotations there. So that makes perfect sense.

Unknown Speaker  7:57  
It did it was, especially because I wasn't learning that practice. You know, I done the two rotations. And so the I knew their system, I knew their charting, I knew a lot of things from that. And so having a student made it great for me, because it made me know what I needed to study to be able to teach. So right away, I wasn't just studying to take care of the patients that I you know, had under my responsibility. I was also studying and making sure that I was taking care of this student and getting them information that I thought was pertinent to this discipline of medicine.

Unknown Speaker  8:34  
Yeah, I agree. I was a preceptor for seven years. And I think it just keeps you on your toes. Nobody wants to look like they don't know what they're doing. So you're always trying to stay a step ahead of the student, when in fact, they're just so eager to learn anything. There's nothing to fear. So just for those clinicians that are listening to us, we need to train our own. So get at it so that our programs can have you training them. All right, yes. on my soapbox. So still, you did when it's up for how

Unknown Speaker  9:02  
long? I did Women's Health for just under four years, the practice started to have issues that had nothing to do with medicine. It had to do with just the physician and the types of patients that were coming into the office. And so I decided that it was time for me to move and I had taken students as a preceptor every chance that I could. And so one of the students went on to be a practicing pa at Cleveland Clinic and palliative medicine and called me and said you know just how's it going? I haven't talked to you for a while. And I said no, I think it's time for me to leave here and find another place to work. And she said Are you stuck on women's health? Are you just stuck doing that or you want to do something new? And I said I you know, I'm open and she said well because I'm leaving and that's why I was calling you to see Have you had any recommendations for anyone who can replace me in palliative medicine and so we had a whole discussion about it, I went up to visit, where she worked and spoke to people who she worked with and decided that I would have an interest in palliative medicine. And so enter that realm of medicine, and learned a great deal about life and death. Not to be so obvious, but life and death in ways that I had never thought about it before. I learned what's important in life, what dying people care about what they don't care about what they'll tell you, Oh, that doesn't matter. This is what matters. And always I learned that family and relationships and people that matter to us, is what matters in life. And so that was eye opening. For me, I always knew that I had always been taught that and my own family, but to see it play out time and time again, in the life and death situations that we encounter was incredibly affirming, to me. And it also gave great purpose to the work that I did. Because we didn't just treat impoundment, we didn't just treat the patients, we also treated their families and make sure that they had support that they need it while their patient was going through their changes to our end of

Unknown Speaker  11:26  
life. And for our listeners who don't know what palliative medicine is, can you just give us the brief elevator pitch on that?

Unknown Speaker  11:33  
Sure, the biggest best way to talk about palliative medicine is that its treatment, usually of symptoms, symptoms like pain, nausea, vomiting, but we use it more broadly to treat patients who are usually at end of life are facing some termination of life, to make them comfortable, to make them have the best quality of life that they can for whatever time they have. And we also, like I said, He's social services and all types of support ancillary staff to help guide patients and their family on that path to the end of life to get what we often call a good death, where the patient was accepting of their fate and their family was ready to manage things to that point. And then beyond that,

Unknown Speaker  12:25  
I would imagine, Sharon that one of the aspects of that job is that you're in people's homes quite a bit. So you get a chance to really see the the home dynamic and the impact of that that surrounding on their health. Is that Is that accurate.

Unknown Speaker  12:40  
So it is for a portion of the team that I was on. So we had a hospice nursing staff who did that. And I did get to do home visits with them as I was being oriented into the service. But as a PA, we didn't do the home visits unless there was some unusual circumstances. The nurses handled it and we manage the inpatient service hospice service.

Unknown Speaker  13:04  
Okay, so you were at Cleveland Clinic. And then at one point in time you decided to move into PA education. Can you talk about that transition?

Unknown Speaker  13:13  
Sure. So the transition to PA education came from the program I graduated from, they called me to say you're working in women's health at the time you're working in women's health. And we know that you're doing well as a preceptor, there's a summer course about women's health that we would like you to teach. It's the clinical medicine where we're focused on women's health, would you teach that for us? And I, of course, had been a student in that course some years ahead. And he said, Sure, I think I can do that. And it was an evening course. So I would work my hours in the office and then go a couple of nights a week to teach the course. And that, again, was another way to really keep me on my toes in my women's health work. Because now I'm not just teaching pertinent, clinical things. I'm also teaching the entire course work, you know, the the physiology, the pathophysiology, all of the pieces that are associated the normal labor and delivery and all of those things that students would need to know not just to rotate through a rotation or clinical, but to be able to pass those questions on pants. And so there was a different focus for me making sure that they had foundational information, which would then allowed them to go into a clinical site, or to just take care of patients. And so that's how it began. One of the years I did that for a few summers and then one of the years that I was there, it was announced to be that the program director was leaving. And I said, Oh, which one View is taking her place. To which previous faculty member said, Well, we were actually thinking maybe your likes. And I laughed heartily, I laughed heartily and said, Oh, you've got the wrong person. I don't know anything about that. I wouldn't be good at that. And they say, No, seriously, we were, we've already talked to her about it. And she agrees that you shouldn't maybe come and speak to her about it. And so I did that I spoke to her about it and decided, in the end, that it was something I always was interested in doing. I remember looking at her as our program director, when I was a student and going, wonder if I could do that job one day, not everything being the opportunity, whatever arise, just randomly having some thoughts as a student. And here, the door opened. And so I did apply, and eventually got hired to be the program director for that program.

Unknown Speaker  16:05  
Wow, that's so the classic reluctant leader story that we saw often talked about on the podcast, it seems like so many of the people that we have, as colleagues in PA education finished and couldn't see themselves in it, realistically, yet. Here we are. Oh, that's good. And so you at some point in time as you transition like so as I recall, you went through the transition of the accrediting body and the PA profession as at large, moving from a bachelor's degree to a master's degree. And that had some impact on the program that you were originally at, as I recall, is that right? That's correct.

Unknown Speaker  16:45  
So the program that I was originally at was a community college program. And we gave an associate's degree at completion of the program. At the same time that RPA was moving toward a master's level, the state of Ohio also had some legislation for prescribing writes, that needed to happen. And one of the things that the Ohio Association of PAs had done was to say, we're going to have to make sure that every program in our state has the capacity to give a master's level degree. And so that was going to be a challenge for for me, but I had already started that work. And working with Cleveland State University, developed a plan to have that institution join with the community college have a blended program that would allow students to graduate with a master's degree upon completion, that took a little bit of a challenge for the community college culture too, because, you know, their culture was accept everyone into our system. And to have this program have to say no, this program will need to require a bachelor's degree for entry was a little bit challenging for the institution. But they understood that this had been the first PA program in the state of Ohio, that they had been cutting edge before I had to remind them that you've been cutting edge before it's time to be cutting edge again. And we're going to require that students even though they're coming Community College will need a bachelor's degree, the benefit was, of course, it, the tuition gets remain at a lower level than if we had done everything at the larger public school or even a private institution. And that was, I think, enough to encourage the community college officials that it was the right move at the time. And so that was important for both the laws in Ohio. And for what was new was happening on a national level with RPA.

Unknown Speaker  19:04  
Yeah, one of the challenges of being a director is to try to read the tea leaves and stay a step ahead or be prepared to adapt and flex when you need to. Right,

Unknown Speaker  19:12  
absolutely. And to bring people along because even when you have a vision, or can see the writing on the wall as it is you still have to educate the people above, we still have to educate those people who are not part of the PA profession about why this is important to them, and to the communities that they will serve and to the PA profession as a whole. And so I spent a lot of time in meetings with our administrators from both institutions, getting them to understand what the role for each would be and what the benefit for each could be. And then making them come together to create curricula and just processes that would make the program successful.

Unknown Speaker  19:57  
Yeah, I remember hearing somebody speak about leader Should once and this philosophy that this individual espoused I just I just so struggled with it. And it was his contention that leaders, leaders never need to look back. They just look forward and know that people follow them. And I just felt it was so arrogant because I do think leadership is about collaboration and about consensus. In many instances, there are some times we have to make decisions that we can't get complete consensus on. But to me, what I hear you saying is a real collaborative style of leadership?

Unknown Speaker  20:29  
I generally do Yes, and I am contextual in my approach to my leadership, meaning I was looking at the history, because I don't want to repeat the mistakes. So I look at historic information, I want to make sure that I understand what happened already. And in order to make best decisions about which way we need to go. And so I think people on my team sometimes giggle because I'll go start my conversation. Well, 10 years ago, this or that happened, they just sort of not like, of course, she starts there because you know, I but I think it helps me keep perspective of we don't want to repeat mistakes. We don't want to forget key instances of success, or, or failure, we really want to keep those things in our I do I want to keep those in my mind. So that as I lead, I already know where the landmines could be, I already understand that this occurrence, or this instance of something could occur again. And so what do I do to fix that? Or what do I do to avoid it? What do I do to fix it? Before we get there, I think those are important for leaders to to believe I can't put blinders on. I can't, and have a whole team and a whole profession, relying on us to some degree. And just, you know, go whichever way I really want to be intentional in the moves that we make, and especially in my role as a leader of RPA.

Unknown Speaker  22:02  
Yeah, you're reminding me of a classic Paul Lombardo statement at a PTA meeting where he says, leaders who failed to recognize history are doomed to repeat it. So that's a that is a very good policy and life philosophy. Sharon, one of the things you now are the executive director of the AICPA, which is our the accreditation review commission on physician assistant education, Incorporated, and you you took on this role voluntarily, like you were not coerced to do this, you decided to put your name into the hat when our esteemed colleague John McCarty retired. And so I'm sure people in PA education want to know about that transition, and why you decided to do this, and how are things going for you?

Unknown Speaker  22:47  
So, interestingly enough, Kevin, I did not automatically put my hat in that ring I did not know,

Unknown Speaker  22:58  
fully. I'm not surprised.

Unknown Speaker  23:02  
The leaders of our game knew about their pending retirements for a few years, and did approach me and a couple of others to say, you know, we think you might be able to serve in this role. We were commissioners at the time, you know, we don't know what your interest was. And again, I laughed. I was like, You're not talking to me. That's the wrong person. This person, does that mean? So it was interesting that a had been a state visitor been on the commission for six years, just under six years, and knew these retirements were happening, and it was posed to me again, are you sure? Are you sure? And I knew that I had just started working for our PA as a staff member, and got to see more of the internal workings that I couldn't even see as a commissioner. And I thought, well, here's the truth about arrogance. I don't know who might be working being my new boss to the least I know, this will be a devil. I know versus one. I don't that I did have the qualifications, the right experience the right understanding, not just from the Commission standpoint, but also from a programmatic standpoint. I had inherited a program that was in deep accreditation peril, and actually got what I will always tell people the nasty Graham from RPA said we're withdrawing your accreditation, heard of why I rebuilt that program. At the community college. We were facing accreditation withdrawal and as a last pitch, I said RPA here's just what I was going to change. Here's all the new program I've been developing. Here's everything A to Z that I am working on to move because I agree that this program It's not where it needs to be. And they back then and said, Okay, proceed, we're giving you a very little bit of time to do it. But proceed, let's see how far you get with that. And so, having been there, it's, it's never beyond me, you know what it feels like to get a citation from our PA, it's painful, I know, I've had that pain, it's never beyond me to understand what it's like to get a letter that says you're on probation, or a letter that says worse, that we need to withdraw your accreditation. So all of that was part of why I did come into this executive director role, I really felt that RPA has a strong mission, and protecting students and the public. And I think that that's an important role that's been granted by our entire profession to our accrediting body, to say, we want to make sure that the programs that exist are definitely preparing students to practice medicine at a particular quality, a level of quality, not just that, institutions are saying, we're going to take 100 students, and you're going to place them wherever you want to, and we hope they'll be able to pass the pants, or we hope they'll be able to practice. Now, our role is very serious. And I take that role very seriously. I saw through my own experience, what accreditation can do for a program, because the program that I had inherited was a hot mess, it was a hot mess. And once we got into a place where we were meeting the standards, you could visibly see that change, and our students and our performances and everything just about, and you could see that there was a great improvement for the outcomes for the program based on us getting more into compliance with the standards. So that became the Kool Aid that I drank, and I still drink it every day. Because I consistently see that and we're I have to tell you, you know, it's always interesting that, you know, like I said, it's painful, and we don't ignore that. But it's also painful for the commission. And I know that's hard for people to believe. But it's painful for the commission to provide an adverse action to a program because really, the Commission honestly wants all of our programs to strive to be amazing to be the best. Because it's all of our profession, right? We're all pas and we want that we want our profession to to be amazing. And so it's difficult for the commission. I mean, literally around the table, there's like probation, you know, there's this, okay, we got to do it, you know, they don't, they're not going yeah, got on probation. Now, they're really upset and they want to see programs improved, and nothing makes the commission happier. I think when we see that improvement, that commission is like, oh, my gosh, look at how this program has turned it around. It's great. They feel so much better about their difficult decision. Because there is positive outcome for the very thing we're after, which is quality for the students and for our profession as a whole.

Unknown Speaker  28:28  
Well, in the commission, just to pull the curtain back a little bit. The commission is made up of our colleagues, there are their pa educators, their PA program directors, their Dean's there, I believe you have a few public members, and so they have a vested interest in our collective success, and also probably a personal interest in ensuring that people are happy, because you know, it's uncomfortable going to a meeting when you know, you might have been part of that tough decision that was probably earned by the program or the institution. So

Unknown Speaker  28:58  
Right. And that is the other part. You know, most of the time our letters are maybe written or program director, I can remember I went received a letter, but it's really not written to you as the program director, not to you alone or to the faculty group. It's written to the institution who is sponsoring the program and so that that is difficult. And yes, we have commissioners who are pa educators, we have commissioners, who are physicians, but most of our physician commissioners have a tie to a PA program either as their medical director or someone who lectures or as a preceptor. And so everyone has an interest in assuring that the PA profession is producing quality in their in their education programs.

Unknown Speaker  29:49  
It's from my perspective, it's a complex balancing act for the aarC because the standards that you write and and rewrite every day So many years based on evidence based on feedback, there are strings of pull for institutional support. And I've seen the standards increase the ACE standards related to institutional support to let institutions know, look, you're not just going to collect cash from the students, you're going to have to be actively involved in the program success, or we're not going to let you just run away with things. But you also have the family of educators that are having to do the work to keep up with the standards to ensure that there's continued consistency among programs around the country. Is that fair?

Unknown Speaker  30:33  
That is fair. And what's more is how did we get to that, you know, those increase in the ACE standards? Back when I started in PA education, the same people have been at the institution for years and years and years and years? Well, now we see lots of changes and presidents and provosts and high administration levels on positions. And so it becomes we're, we were finding these programs that were in trouble. We're talking now to the administrators, and we'll say, I've been here six months, we have a PA program, question mark, you know, and so that leads us to understand that all of our programs are not necessarily receiving the sponsoring institutional support that we want to believe everyone was receiving. And so a lot more strength given to the ACE standards, to better support programs to let the institutions know, we expect the support to come from you consistently, and not just want to programs in trouble. Should you be going, Oh, we have a PA program, you should understand and have a mechanism for assuring that the program has the resources that it needs to be effective to educate the students. And so that was a large impetus for us. beefing up if you will, some of the A standards. Sure.

Unknown Speaker  31:59  
And we actually had the chance to speak with Matt McQuillan about accreditation on a previous season in our podcast. So he kind of went through the various provisional and continuing education terms and things like that. I guess one of the things I'd like to ask you about when you talk about the FCPA, protecting the public and protecting students, I know that you the recent addition of the standards of fifth edition includes language around diversity and inclusion. And I wonder if you could talk a little bit about the evolution of thought related to that, and maybe where you see pa education moving, to try to truly develop a cadre of graduates that reflects the entire United States.

Unknown Speaker  32:39  
So the diversity and inclusion standard was originally a proposal from pa EA, from members of PA who said, you know, we really think this needs to happen and they provide it, you know, my response back was provide some language, you know, because to me, I've been in some discussions with pas members, certain members of PA EA to try to get a feeling for what was meant by diversity. What do you mean when you say diversity? So the truth is, you know, there's all types of diversity. And that's what our PA standard relates to. And when we talk about pa education right now, we're talking about ethnic diversity, trying to create enough ethnic diversity, like you said, to have providers that look like populations of our patients. That's something that we haven't had blatantly stated yet. And so our PA wrote this broad scale diversity standard, but after their represent summit, I think it's important and I said this a long time ago to our colleagues, if we really are trying to diversify our profession, ethnically, we need to say that because you know, there's not a lot, it doesn't mean that the other things aren't important. They are, you know, rural communities being addressed and making sure that we have certain socio economic backgrounds in our diverse profile. That is not what we're talking about, though. We're talking about that we have a lower percentage of underrepresented minority members of our our providers. And so we need to think about that. And I think not just us, we have other colleagues in the medical field who are also looking at this exact same issue. How do we advance our diversities, the RPA created standard A 111 Because we realize, I realize, as an African American PA program director and a smaller Ohio community, that's where the PA program was, wasn't in a big city. I could not make certain folks apply to my program. I couldn't I tried, but I couldn't And so we would see the more diverse groups tended to head in Ohio, at least to those schools that were in a larger city, more metropolitan cities tended to get those students apply to them. And so that was what we saw. And we have to keep that in mind. You know, for me, and rpa, we have to keep that in mind. But we are looking at what the standard requires. The standard right now requires institutions to tell us about their strategies for recruitment and retention of staff, students and faculty. And then they have to tell us how they provide resources in order to advance diversity and their diverse meant missions within the PA program, not just that the institution has a diversity initiative of the institutions, but how they apply that in the PA program. And so now we're collecting data about citations, and what was the content of those citations? Because eventually, there's going to be some need for us to determine accountability. The standard was always written for programs and institutions to tell us about their efforts, not necessarily their outcomes. And that's for the very reason that I stated, I was a certain program director in a certain region. And what did I do? I didn't just go oh, well, nobody applied. So oh, well, no, I did things. I participated in medical camps for the inner city schools that were nearby. I sent information to guidance counselors, I participated in med camps that we had on campus, teaching those inner city students, simple thing like hairs, let's do it interrupted suture on a sponge, you know, and they got the geek out, because they're doing, you know, sutures like a surgeon does. And they're like, like a PA does in surgery, yes, we get to teach them all these little fun things that they remember and remember what a PA was, and spin. And we'd be more interested to hear more about it. So in all of that, though, it's still important to recognize that down the row programs are probably going to have to show us some level of accountability toward that standard at a 111. But the commission has not yet made that determination. We're in a place of collecting data to see what the next steps might be, and what our next goal may be in advancing diversity in the PA profession through the use of the standard.

Unknown Speaker  37:38  
Yeah, I think it's a really complex challenge. Because this isn't just we aren't actively recruiting and educating students from a variety of ethnic backgrounds, but society and systemic racism has an impact on how many of those students make it through high school, make it to college, make it to a level that we could recruit them into our educational systems. And, as you know, having done a pipeline or pathway kind of things, you plant those seeds really early on in a 12 year olds mind, but we can't control what happens day to day in their home,

Unknown Speaker  38:10  
right. Even in my own home, I was telling someone a story that I have a six, almost seven year old niece, and I have my stethoscope laying around for some reason. And she goes, let's play doctor. And so she starts to play with me really well, this game doctor. And so she mentioned nurse, she mentioned doctor and I was like, Well, what about PA and she goes, What's that, I realized I have fallen down on my job. And so I spent some time talking about pa with her and and what it is. And I happened to have the NCCPA coloring book and I pulled up the coloring book and we started to read a little bit. So I think 12 years old is too young. I really think that most children know about doctor nurse before they go to kindergarten. And so we really need to start to think about how to do that in our communities ahead of them entering school. I think we have a fabulous product in Project Access, we maybe just need to revise that a little bit in order to further develop it to do more as well as used as tools NCCPA has and whatever else we can create because the one thing I love about this profession is we are educators are creative people who can come up with fantastic ideas if given the chance. And I was given the challenge and I think that this is one thing that we need to turn back out with a different with a different focus so that we are doing a better job of promoting ourselves to young people.

Unknown Speaker  39:45  
So Sharon, the aarC pa has you kind of I don't want to say gatekeeper but you're you're such a an important part of the profession success and and consistency of our programs across the country. We always say you see when people A program we've seen one TAA program. But truthfully, the standards ensure that we're all kind of meeting this consistency, regardless of where we're at, or what our mission or focus is, what are the things that are not necessarily keeping you awake at night, but maybe the commission and you and your team are wrestling with and looking to get more data on that might impact future iterations of the standards and program development?

Unknown Speaker  40:23  
So a couple of things that I think we're considering is what is the reality of program growth? You know, it's really hard to predict this right now. And it's not something that keeps us up at night, per se. But it is something that we have questions about, you know, what is the growth of PA education program going to look like? So the pandemic taught us a lot, we're still in, I think, in stages of that, I hope and stages of that. And we're learning. Yeah. And so we're learning, you know, how to program spare. And now it's time for rpa, to look at how the program's fair programs had to give us a COVID-19 report telling us what they were going to change. And a lot of programs in the interim have written to us to say, this is what we're going to keep, because we learned some really nifty stuff here that we didn't anticipate in this drama of the pandemic, but we'd learned these things. And this is a better way for us to operate. So in that, you know, we're wondering about programmed growth with institutions having to so quickly revamp themselves, many of them were strictly brick and mortar, and you come to class in the buildings, and suddenly had to spend a lot toward getting to a virtual environment for your students, we see that some institutions pump the brakes a little bit who thought they were going to open programs, and they're like, so fast, we've got to deal with this first. So we really don't know how far the post pandemic growth is going to change. We don't know. If one looked at the graphic that I use every year. Some may say, Oh, look, it's it's leveling off, you can see our growth is leveling off, there's not this exponential slope anymore. I'm not so sure yet, you know, because we have lots of still interest, lots of inquiry still, but it's just about timing for some institutions as they recover from what they had to produce in a pandemic. So I don't know what that was. But that's something that the commission is certainly taking a look at. And I'm always taking a look at it to determine if we're ready from a business perspective to manage that growth. And I think that we are I don't have angst about it, I just am watching it. And then I already talked about the diversity standard accountability, I think that's another thing that the commission is definitely has an eye on it. And we'll make some determination probably before the next aeration on the standards about what to do with that. If there's something that needs to happen more readily, or there's something that we just need to gather more data, or before making another proclamation about what programs should be expected to do in relation to diversification of the PA profession. And that always for the commission, is our own review of our own process and our own decisions that are made. And so there's always self evaluation by the Commission about decisions that is made and consistency of those decisions. It's really hard for programs sometimes to look at a listing of here's the citations program, a receipt and they got a particular continued accreditation, and then Program B got the same observations or the same citations, and they get probation. How is that favorite? Well, it's all about the content, you know, so sort of, like you said, you see, one PA program, you've seen one PA program pictured there is that it's not about just the standards or the numbers of citations. It's about the content of that what caused those citations. Sometimes citations are a bit technical. Hey, you didn't have that on your website, you need to get that on your website. Okay, you get a citation versus another program that might also get, for example, a website citation that has three different websites listed out they're all saying different things. That's a very different dynamic for students trying to understand what's happening at the program and those issues about fairness and admissions processes. So you may see a very different outcome. It's different when you say, Oh, you guys don't have quite enough faculty versus you don't have many faculty in me. Maybe the same citation, but very different situations at a program. So in that the Commission looks readily at what our decisions have been, especially if there have been adverse actions behind some of the decisions to do a review or so many meetings and to say, is that consistent decision making? Is it not that we falter? Was there something so different at this program than others? Or what would we do if we were making that decision again, and so I think that work is very important to the commission. And we, we continue to look at it regularly. And then you asked about the degree, the doctorate degree, that is still up in the air. So as the accrediting body, it's important for me to say that, and I've said before, we will not leave certain initiatives, because what we say is often mandated, and it's not appropriate, or the accrediting body to say, we will all go to the masters level RPA was very last to say, is that what the profession wants, okay, then we will go to the masters level, once that's decided by the Education Group, they, you know, American Academy, once, that's all decided by the other organizations, then we will find ways to enforce that for the profession. But for us to be the leaders on that is not appropriate, to just say we're going to doctorate as RPA says, we're going that's not our role, that's not our role.

Unknown Speaker  46:33  
The genie in the bottle says Your wish is our command,

Unknown Speaker  46:38  
we make sure that we bring up you know, in the doctoral phase, for example, and there's been discussion about this on in PA that and forum that RPA is going to potentially pose an obstacle to us achieving the doctorate. And nothing is further than the truth. RPA would not be the obstacle, the obstacle may lie may lie in institutions and the regional accrediting bodies. So it's not us, that's gonna say, especially hearing some of the discussion without really seeing anything in writing, but hearing certain things where a program may say, Oh, if we do it, we're only going to add one semester, that might not be sufficient. Even with all that's being taught in PA education, it's really going to be important for programs to know that they're able to meet the requirements of the institution curriculum committees, who will say whether something rises to the level of a doctorate degree or not. And the regional creditors, who also may have some really strong questions about a particular scenario like that you added a semester from what you already had. And now you're calling that a doctorate degree. I'm not sure how that's going to play out institution institutions state to state region or region

Unknown Speaker  47:59  
to region. Yeah. Well, Sharon, is there anything else that we haven't discussed that you'd like to share before we say goodbye?

Unknown Speaker  48:06  
I don't think so. I just want to thank you for this opportunity to speak with you. And I hope that your listeners get something valuable from our conversation.

Unknown Speaker  48:16  
Yeah, I think they must, right. I think there's the accrediting body has this aura about them that I would equate to the black star from Star Wars, right? People think there's this this big, huge black star up there that's controlling us. But in fact, you've increased the number of assistant directors with the staff. And they're all former colleagues of ours in PA education. And they're all really well respected people. And I know you're all doing a really great job of trying to improve the the culture of accreditation, and also help us all protect the public and the students in our process. So thank you for all the work that you do. And please give my best to your team and the Commission as well.

Unknown Speaker  48:56  
Thank you. Well, and on that note, Kevin, I just want to add one thing, if people have questions, please email us. I know, nobody wants to think they're on RPAS radar, right? But we answered questions every day from programs and we're not holding anything against anyone who needs a question answered, we may not tell you how to do it. We won't tell you that. But we will certainly explain what we mean by our standards and what we're trying to get you to tell us about. So please don't hesitate. We do have this as part of what we do. We have people email accreditation services every day and get a response to their questions. So don't hesitate. There's no need to fear doing that.

Unknown Speaker  49:40  
It's very helpful. And from a leadership role. It's very helpful with the administration of institutions to be able to help them understand the context of what your responses so I would support that 100% Well, I'd like to thank our guests Dr. Sharon, Luke, for sharing your time and talents and helping us understand a little bit more about the background of accreditation. And the decision making they make to improve our PA educational process. Tune in next week as we're going to bring you a regular episode and a special episode. First we speak with Dr. Jed grant, the Vice Chair for the Department of physician assistant education at the University of the Pacific PA program in Sacramento, California. We talked with Dr. Grant about his program about his military career as a PA and about serving on the California Physician Assistant Board. In addition, we're bringing you a special edition to talk with Dr. Fred Sadler, one of the founders of our profession, about his new book, clutch, which is now out and available on Amazon and other booksellers, and is an incredibly interesting story about several historic aspects of healthcare and the roles that he and his twin brother Blair Sadler played.

Unknown Speaker  50:56  
Until next time, we

Unknown Speaker  50:57  
wish you success with whatever path you are watching in life. And thank you for joining us. The purpose of this podcast is to provide news and information on the PA profession and is for informational purposes only. The views and opinions expressed on this podcast are those of the speakers and guests and do not necessarily reflect the official position or policies of the University of Arizona.

Transcribed by https://otter.ai