Season 2: Episode 40 - Dr. Meredith Davison and the OU-Tulsa PA Program

Season 2: Episode 40 - Dr. Meredith Davison

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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 autumn and Yockey. 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.

Unknown Speaker  0:33  
Welcome to this episode of the PA path podcast, I'm your host Lohenry Glad you could join us as we seek to better understand the PA profession unfortunately.

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Our Medical Director had a play he

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was that kind of doctor. So he said, Well, you we're going to fight the state board. And so he and I went to the state board meetings once a month for the next nine months, it took us to convince them to allow a PA to work with remote supervision. Well, I'm excited to bring Meredith Davidson to you today. Dr. Davidson is a mentor of mine who helped me from the moment I started as a PA. And all too often in life in the PA world. The folks that are not technically pas tend to fly under the radar. And Meredith is one of those she has contributed so much in her leadership as a PA program director, as an Associate Dean in the medical school, as a commissioner on our accrediting body, and as a member of our profession, focusing on research and the data that we need to collect for the profession. And I'm so delighted to have an opportunity to bring her with you today. So that you can learn more about her contributions to the profession, and about the Oklahoma University Tulsa, PA program, which she helped create. As always, you can learn more about our guests on our website at the PA path podcast.com.

Unknown Speaker  2:05  
Kevin, Hi, how are you? Great. Good. It's great to see you. Yes. Well, thank you so much for doing this. It's really delighted that you could and I really want to highlight not only your contributions to the profession, but just the importance of mentorship. And

Unknown Speaker  2:22  
you're such a tremendous mentor to me. It's wonderful to watch kind of the evolution of mentorship, because then you learn that you model that and then people carry that tradition on. Sure. And it's it's wonderful to see all the people through all the years now who are faculty and so forth. Isn't this all? Yeah, I mean, I there's nothing I like better than when I go on a site visit not find one of our graduates or, well, let's go ahead and dive in. Meredith, thank you so much for joining us. We're excited to learn about your rich tradition with our profession, which I know firsthand, from from you being strong as mentors. Maybe we'll just start with how does a PhD get involved in the PA profession like you did? What were the kind of things that lined up for you that ended up having us spend so much time dedicated towards the profession? Well, it's kind of an unusual story, but it actually started when I was in graduate school at the University of Oklahoma. In 1970. Bill Stanhope and Bill Horsley had started the PA program there in Oklahoma. And Bill had been a graduate you know that 1969 First class at Duke. So they had just started the program the year before when I started graduate school there in 1972. I guess it was Yeah. And so it was still a new program. But even though I was a graduate student, and you know, neuro psych, I was our biological psych or whatever they call it these days. I was volunteering every week, two nights a week at a free clinic in Oklahoma City, the Paseo free clinic, and I got some I volunteered so often they had me be the person in charge of recruiting health providers to volunteer in the clinic. And it was I believe it was Stanhope I mean, you know, so long ago, but because I've known Bill Stanhope since he came by one day and said, you know, you keep trying to recruit residents, you ought to be recruiting pas. So he introduced me at that early day into what a PA was. So I started recruiting pas and the graduates the program and some of the faculty that would come over, Bill was working for the VA at that time and Oklahoma City when he started the program. So that's how I learned about PI's was very, very early in my career while I was still a graduate student circle around it's several years later, and I am working for the help

Unknown Speaker  5:00  
department in Tulsa running clinics for maternal and child health. And I had put in an ad for a nurse practitioner and I had a PA that came to me named Karen Matron. This was in the 80s. And Karen said, you probably don't know what a PA is nice and well, actually I do. So Karen went to work for us. But unfortunately, at that time in Oklahoma, they said that pas had to be physically in the same room with a doctor. And we didn't run our clinics that way. As you can imagine, fortunately, our medical director had a plane.

Unknown Speaker  5:39  
He was that kind of doctor. So he said, Well, we're going to find the state board. And so he and I went to the state board meetings once a month for the next nine months, it took us to convince them to allow a PA to work with remote supervision. And we're talking six blocks away. So it worked. It turned out it was just one person on the board who is recalcitrant for a personal reason. So then I worked with Karen and that was during the time when the PA certification first came out that so I worked with her and you know, we paid for her certification. Also for another PA, who I still know who I worked with at the University of Oklahoma who worked for us then. So I got real involved early on a little bit in PA politics. And that's where in the early years, you know, in the 80s? Sure, okay, fast forward against the 90s. So we skipped another generation. And then this story kind of gets obvious. My husband had moved to and well, our whole family had moved to the Chicago area where he was going to head up and they had program for the state of Illinois. And he was at a luncheon and talked to someone from what was at that time, Chicago College of Osteopathic Medicine, Steve cop, who was the Dean at that time, and Steve told him that they wanted to start a PA program, but they needed someone to help write a grant there at what later became Midwestern University. He said, I already have a PA but he's not written grants before. And that was the Skoch Chavez. Sure. And so I said, he said, Well, you know, my wife knows what a PA is. And she's written a lot of grants. And he says, she's home my region. I was actually pulling wallpaper off an old house we bought. So he called me and said, Would you meet with Scott and Steve? And I said, Sure. So we wrote a HERSA grant. And that was in 1994, when the PA program, their Midwest turns started, they changed their name by then, wow. And so Scott told me at that time, I subsequently gotten a job at the University of Illinois in the College of Public Health, but it was part time and he said, as soon as I get this program started, I want you to come in and converted to a master's program. So I started there in 1996. So was that one of the earliest master's programs in the profession? It was, you know, there were only we were, I think, the 53rd PA program in the country. And I think we were in the early teens, I think 12 or 13. Okay, I actually called everyone that was had a master's, when we set it up and talk to them there. Were there were a handful of us. Sure, you know, because there may not have been would have been that many by the time we got to start it. I think we were 12 or 13. But I don't think there were that many I found that there were some other people. I went to the My first VA II meeting, which was a path then and met people and I met some other people who were trying to become a master's program or do like we did have two tracks. Sure. So that was in the mid, you know, early 90s. And then Midwestern quickly started starting a program after we got the one in Downers Grove, established down in Glendale, as you well know. So we, the most of the time seemed to be taken for God Chavez to be down in Glendale. So I worked until he hired someone. I was kind of the Associate Director and Director of the master's program. I'd been the director of the master's program all along. But then Barry Cassidy took over down in Glendale. And Scott was very busy with a lot of other endeavors. He's hard and always been in correctional medicine. So we had a site visit. And Ruth Baldwin was there still remember, and we made it to the site visit and back then the programs got feedback from RPA. And so we got feedback. And they said, well, we need to you know, Ruth was very outspoken still is, since we knew we need to have

Unknown Speaker  10:00  
I have a full time person here who's a program director, not just an associate, like, director, and they said, well, well, we'd like to hire one, but we haven't found one. And Ruth said to them, Well, yes, you have. She's sitting right here. And pointed to me. And I'd always been under the perception that that I couldn't be a programmatic. However, at that time in 1997, you could bake. Okay, so I was actually hired as program director later that afternoon. And they made it Yeah, they were very nice. Dr. Gavin Berger, who's, you know, President of Midwest or made it retroactive until you know, when we started working on the accreditation? So sure, sure. So anyway, that's how I became program director at Midwestern. That's wonderful. So you were the program director, Midwestern for how many years? From 1997 to 2006.

Unknown Speaker  10:54  
That's a good stretch. And since it was retroactive, it actually turned out to be right at 10 years. Okay. So you and I met at Midwestern obviously, we did, the director of the master's program when I was graduating in 1996. Yes, so you were a student there, I remember you and I talking several times, you were kind of the leader, the students, I can't remember what your title was. But you were definitely the one always in our office telling us what we needed to change. And, and I got most of that, because Scott was doubting wooddale all the time. And so I remember seeing that you had great leadership potential, even as

Unknown Speaker  11:39  
you kind of just come in and yelled at us, and you usually had a plan and a way you want to change things. So you were pretty sophisticated, much more so than your other students. Because, you know, you'd had the background of the military, which gave you great leadership skills, even as a student. Thank you. That's, that's very kind I

Unknown Speaker  11:59  
you know, new programs are tough, right? There's

Unknown Speaker  12:03  
gonna have some, some bumps in the road. That's part of the evolution of a program and and so I think the benefit to students is you get into a new program, you have a chance to help shape it. Programs that are willing to take feedback, which you were obviously,

Unknown Speaker  12:19  
well, it was very difficult, because Midwestern had a very aggressive plan for us to grow that program. We had 14 graduates first year, I believe, 36, the second 57, the third and then 84, the fourth? Yes, so we were just pedaling as fast as we could and trying to. And that's how I got a lot of experience, though, even though I was supposed to be just over the master's program. It was all hands on deck. And I lectured a lot in public health areas and research areas. And then I also knew Chicago fairly well by then. And also my husband being head of the A Agnew, a lot of hospitals. So I did a lot of recruiting in the early years for preceptors. And training sites for us. Yeah, that's an interesting connection. Right? The the AHEC connection, I think, is one that is often misunderstood as to how valuable it can be.

Unknown Speaker  13:20  
Oh, yes. And there was still a lot of educating to do in Illinois. I was surprised having come from Oklahoma, where pas had been around, like I said, since 1970. And here it was 25 years later, approximately. And in Illinois, no one knew what a PA was. Or so it seemed, you know, at that time, there was only our program in the small Cook County program. Yeah, that's right. And when I graduated in 96, there were only 29,000 certified pas in the country. So yeah, if we have to introduce ourselves to everybody. Yeah. Everyone explaining what we did, right. So you can imagine that that caused more issues in trying to recruit preceptors. Sure. So you left Midwestern after years. Where did you hit after that? Well, I've left Midwestern in 2006, because my husband had had an opportunity our kids were growing up, and the youngest was leaving for college in 2000, let's say, five. She lived here before. And so we wanted to get back to either Oklahoma or Texas or somewhere in this part of the country. All of our my husband and my parents were aging. His father had been ill a lot in 2004, and so forth. So we began to look for jobs in that part of the country. And by this time, you could no longer be a program director and be a non pa have a PA program and since I've been doing that, I kind of had to look at what I wanted to do. And Richard got a job my husband

Unknown Speaker  15:00  
I've got a job much faster than I did. And he went down to the osteopathic school and became vice president in 2004. So I stayed back to for my daughter to graduate from college, and I've been from high school and for to continue to look for position. And I was about to take a position, I'd been offered a great position with the Tulsa City County Health Department, and I was really looking forward to that I'd started my MPH. Again, this is another strange thing. My husband was at a luncheon and Matt, the dean of the IU School of Community Medicine. And that was Jerry cleansing. He's now at Iowa. And Jerry was telling him that part of his strategic plan and coming there to this regional campus of the value Health Sciences there was to develop a PA program and he wished he knew someone who could start one. And evidently, my husband chuckled and said, Well, you're not going to believe this. But my wife could do that for you. I got a call from Jerry that afternoon and asked if I would interview and I said, Well, I have another job, I have to let them know, bye. It was less than 10 days. Sure. And he said, Well, good. We'll arrange all their interviews, like the next three days or something that's unusual in academia. It is, well, if you ever meet Dr. Clancy, that's why he does things. But he was able to get me interviewed with a recommendation for this position. So I decided not to take the health department position. So I go down to Oklahoma. Do I need to turn? Did that make a sound on your end? Yes, yeah. So let's just start with so I go down to Oklahoma. Okay, what do I just second, that means? Something's still on.

Unknown Speaker  16:47  
I'll turn it off first. Okay. Okay. Yeah. Oh, after I.

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I left my email open. Okay, that's fine. So I went down to Oklahoma, and in May, and I actually retained a position because I was the PI on HERSA grant up in

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Downers Grove. So over the summer, I literally went back and forth, till I guess it was the end of September when that HERSA grant ended. So I met with Jerry once. And he said, Well, I need you to start this program. We'd like it to matriculate its first students in 2006. And I said, Well, I don't think we can do it that fast. He said, Well, I think you can. And he gave me a file and said, basically go to it. He says, I don't have a clue. But here, here's the names of some people.

Unknown Speaker  17:44  
So fortunately, for me, I had a sister who was a practicing pa in the state of Oklahoma, and she knew lots of PAs, and she got me into the PA community in Oklahoma, and I went down, met with the Program Director in Oklahoma City, but it was quite a challenge for the I worked harder probably than I ever have for that year and a half. And, you know, I call John McCarney, who was head of art then told him what I was doing and said, Oh, I don't think you can do it, Meredith. So I had ever you say that I couldn't get it done there. But fortunately, I did. And I met the right people. And we put together a real quality program. Now one thing Jerry wanted to do is he wanted to go back to the original model, he was very knowledgeable about pas himself. And by now Jerry had become the president of new Tulsa. And the new dean, I was very lucky was Dan Duffy. And he was a person who had worked with the original pas too, and also knew the physician who started pas, so he and Dr. Stead had known each other so he knew how it originally was done. So Dr. Duffy at ODU, who's Dean now and Dr. Clancy decided that we were going to put together a program like the original where med students and PA students trained together. And so that's what we have to this day. And I knew there were lots of gnashing of teeth and tears shed particularly by some of the chairs who didn't want to do it this way. But with the dean and the president behind you, all I had to do is just take their flack because I knew that that's what we're going to do. And now I know you they just think is the most wonderful thing. And they are all proud of it. Of course it's some some of those chairs that were problematic are no longer there. Yeah. So tell us about the program. How many months is it and how much time do they spend with them and students? Oh, well, it's 30 months. And frankly, the reason we started is 30 months is because that's we wanted to do it or I wanted to do it as fast as possible. And Oklahoma City's Physician Associate Program was 30 months. So I could I mean it

Unknown Speaker  20:00  
The only people on academia know how this goes but you know, I was able to use some of their course numbers and so I didn't have as many new courses to get through the the appropriate committees and so forth. It's a 30 month program though to this day, it's divided 5050, didactic and 50%. So we have 15 months in the didactic, which is to summer semesters and to a fall on spring. Then we have 15 months, actually about 14 and a half of clinical, okay, and all of the basic science portion is taught and the didactic is taught just to pas, we have a lot of the same actually lectures from the same instructors, but we've never been able, we're not on the same schedule because of our use of the anatomy lab and everyone else in their anatomy lab and we wanted to start with anatomy. Sure. But our clinical they have 15 months and eight months of it is they're on the same teams with medical and PA students together. So all of the basic stuff surgery internal medicine, family, Psych OB GYN peds, I think I named them all, maybe missed one. Now we do have a separate emergency med because the medical students believe it or not, don't have emergency medicine. And then we also have then our students do a second. We call it community medicine. It's usually family where that they go to and it has to have a PA is their instructor. They are the preceptor. And then we did we do an underserved. So we made sure that the last six months is pretty much six to seven months, is pretty much out in the community with practicing pas, though they have practicing pas, of course in our clinical departments, but more more physicians that yeah, so some mindfulness about exposing them to the professionalism of the colleagues that are already out there preceptor Oh, very much. Because we didn't just want to train up a medical student without a residency, we wanted to try to PA. And I think we've really been successful in that because we have so many pas that we have, like in some areas, we have pas like in family medicine, we have so many pas working in our family medicine clinics, that they teach most of the clerkship to the pas en the medical students. Fantastic. It's we, you know, there's such as feeling of collegiality and real interprofessional education at our institution. We also have all our students, we have an integrated longitudinal clinic that they do for the whole 15 months of their clinical training. And that is just with pa mentor. Okay, though, we have what we call our Bedlam clinics, probably not the best of names, but it's been around so long, we can't change it, where our med students state say, do the same thing. And this is all going on in the same clinic. So there's a lot of collaboration asking questions back and forth. Their lectures given to the students about community medicine and responsiveness to the community in this longitudinal clinic. And both the PA faculty and the med school faculty give them together.

Unknown Speaker  23:20  
So if I know you will, Meredith, either you or somebody that you have mentored has done research on that effect of the medical students in PA students having such good twee ality, what have you learned about their attitudes in learning together in those clinics? Well, what we have learned in our own research, and frankly, I haven't pub This is we've got one and publication right now, but we hadn't published it broadly yet. And the national journals we do in presentations, is that both groups like it better, and faculty like it better. It was it's amazing to me that we really can't see any downsides. The only thing we hear sometimes is we have the rotations are slightly different, even though they're together. For example, on OB GYN, we know that the vast majority of our pas will never deliver a baby. But what so what we do is we have the PAs have more sessions in the outpatient prenatal and gynecology clinics, so they get some deliveries. And likewise, we have the medical students doing more of the inpatient gynecology like surgeries and so forth. And that's what I found very useful when I was Associate Dean since I was over the curriculum of both groups. I could or had oversight, I could work so that we, the PA program put together what they needed for their outcomes. And then the medical school faculty did the same and then we says they're going to be trying together then we would arrange it. So it worked. Sure. So I was

Unknown Speaker  25:00  
prize, frankly, how easy it was what I hear for most people. And I will tell you, we put in a grant. And we got this criticism back on the grant, which by the way we didn't get. And this was obviously a PA says, you know, this would never work, you know, physicians would never accept this turkey training in that you must have a very unusual situation. So your model is not generalizable to pas programs in general. You know, I would disagree, I think that model has a lot to go for it to getting to where p it you know, that I'm aware of all the current conflicts and discussions in the profession, about whether you collaborate or supervise, but I think truly once people have trained together, now, what I'm really interested in now is looking at the outcomes of these people, you know, it takes a long for the physicians to be out there only recently out. So now I'm going to go back to see what their attitudes are towards pas, and I would predict they're more positive, they're more prone to be hiring them and so forth. Oh, yeah, I would totally agree. I was just talking to an interventional radiology PA, from the University of Arizona banner Medical Center this week. And it was the Division Chief that they brought in who had worked with pas in a previous institution that really opened up the door for it is to be hired there. So I think to your point, once physicians have had a chance to work collaboratively with pas, in some capacity, I would guess more often than not, they're their advocates, for sure be the role to help their lives be a little bit better in delivering care to their patients. Sure, well, and the patients the real winner, too, in the long run, I just, you know, we have found that it works together so well, because not only what was most interesting to us, and we have a polish on this was also we kept thinking about the academic could the PA students do as well, we use the same what are called shelf exams for the end of rotation exam, and we have the pH, the medical students taking the same shelf exam, we think they should have the same knowledge level at this point. You know, the med students are going to go on to a residency and get a lot more knowledge. But at this point, they should take the same. Well, that gives enormous respect because they end up studying together. And we found that there are all these informal interactions that go on between the students that are it's kind of like the glue that, you know, when you work together, you have friendships together, you get to know each other, you get to see each other's life goals. We've had numerous marriages, we've had numerous other liaison, shall I say, we, you know, they're just they support one another. If the PAs have been on the way our 30 month curriculum, does those students that are doing their last three months, they've been rotating for 12 months? Well, they end up mentoring, the medical students who are just starting saving the way our show works, there's a three month overlap for the the PAs or the seniors, if you will, yeah. So they end up being kind of the clinic guide to helping their orient to getting started. From everything to where they, you know, the Where do you go to get free lunch? Where do you do this? It's very interesting. Does these kind of informal relationships that have been fostered by our model? And I think, you know, it would be interesting to tease apart how much of it is those relationships versus how much of it is is the real training? Yeah, I mean, so much of the RPE literature talks about that importance of socialization, it is spending time together in a social before, kind of pushing them into a professional silo setting. So, but here, they're studying exactly the same thing. And in our case, they've all had the same. They take the same anatomy course, it's just taught two different semesters. So they got all this back experiences similar to Yeah, the being in the trenches together with the same instructors.

Unknown Speaker  29:04  
Yeah. So Meredith, one of the things that I think as I look back at your career that you've contributed so much towards is research, you've served in many different roles for the national associations in research capacities, trying to encourage faculty and pas to consider research. Can you talk a little bit about your national service and what you've learned over the years as you've really served in that capacity with other people like Brett Dean and others?

Unknown Speaker  29:30  
Well, first of all, I'm very fortunate to have had so many great people to mentor me about pa research. I was trained in research in graduate school, but to do it in the PA profession. I think what came about I've actually changed my mind about a lot of things. If you'll recall the program we had at Midwestern we talked quite a bit of research skills to the PA students. I believe we have many 36 extra hours here.

Unknown Speaker  30:00  
something it was a lot, you know, currently, I don't really think that's the way to go for research because I think all pas need some research instruction during their career and during their training. But I really think like in PA programs, you need to have either someone with a PhD or public health degree, who is a researcher who can assist faculty, because I don't think most faculty who want to be pas or even pa faculty have the kind of interest in the research, even if we're talking about not bench research, but translational research, usually, or epidemiological or educational research. But I think I've seen having a person in the department who has that interesting can lead other faculty through the intricacies of the IRB, for example, which is such a barrier, developing a survey going through the steps you need to do to publish. So I really think if we would encourage, and maybe that needs to be encouraged through a standard in the PA, RPI standards, programs to have the capacity to assists their faculty with the research so that we can get research on good educational topics, you know, there's still so many things we don't know, I think there's a need for and you know, a lot of this research is being done on the economics of PA practice, that that's really a niche area that you're not going to get anyone who's not an economist, or who's not working with an economist to do that, there's still a lot of things that we don't know very much about for the PA profession. Instead, we get even today, and I'm still an active reviewer for the journal. So I review a lot more than makes the journal. There's a lot of studies that come through that are just one program that, you know, this worked for us. And I do think you have to expand if we're going to come up with things that's really useful information. Those seem more like pilot studies these days. And you really need to have a collaborative research program to look for generalizability. Right. And, you know, we don't have a standard set, I hear students that I counsel who want to go into PA are so upset by this all the time, we don't have a standard set of prereqs. It's like in the profession, which is I know hard for students. Yeah. And it causes there's a lot of extra cost to that there is extra stress. There's so many I know in LA when I was in LA, so many institutions didn't have the course. So they had a community college to track it down. Yeah. All right. And, you know, so people would be hunting for courses or people would find that courses weren't taught the right semester, it would hold them up a year. And you don't see that in medicine, things are much in medicine, they actually have I was surprised to find luck to your prereqs than we do. Now. Of course they've got four years at a residency, but I don't know I wish there was a an effort towards I think there. I know there have been in previous times. Yeah, I think pa has been chipping away at that. But I have it's still a long way to go. Yeah, in one sense. So you have these these. There's so much development on the new program side. Right and with the aarC not having standards for prereqs, right, it's left to the programs to kind of look to PA and they look back to their old programs to design to do, but there's no data to that. It's just no data. That's what they know. Yeah. And there are many other areas that was just an example of one and education that we need for. But I don't think it's going to happen with your busy pa faculty member and I think that's getting better. So faculty are treated more like more reasonably, at least by a lot of institutions. Sure, so that they have time to do something, but most faculty are not going to choose fellowship of that type. Yeah, well, and I'm just doing this recently, Meredith, I was looking at workload calculations. And I use I use the double AMC methodology that Elias Villareal had utilized at Northern Arizona University as as a starting point just to kind of estimate for accreditation, what would be sufficient to cover our curriculum. And, you know, in that process, you have to build in time for scholarships so they can move down the track to promotion, you have to build in time for service because there's so many committees that we have to write, to manage while running appropriate. Yeah. So and yet we don't we the PA profession doesn't have a national standard for work, you know, we don't know and I think that working in the MD world, you know, my first foray into medical education was at a you know, in with four doctors, I spent my first seven years in that capacity before and then I was 10 years of nursing school before I've made it to PA

Unknown Speaker  35:00  
I. So I've seen from a variety and we have much less research about our education than either of those professions by far. Yeah, I think nursing has done such a great job of recruiting students from a wide variety of perspectives. They have a great pipeline of leadership and the leadership nurses that love research nurses that just want to be clinical practice practitioners. Yeah, yeah. I've never really looked at it. You know, we've always had the the model that everyone and for a long time that everyone was going to be a family practitioner in a rural setting. And, and now partially, that's led by the government HERSA, having given so many grants for people to do that. But on the other hand, I think we have to look at reality of where the profession, my students, at least even here in Oklahoma, find many more jobs, especially than they ever do in family medicine. Yeah. And yeah, it sounds like you have a very strong curriculum built around community medicine. We did. And they still end up in specialty. Yeah, well, but we define community broadly, you know, as everyone does now and try to, you know, you can practice with these principles, regardless of what area you practice in. But it's very interesting, the way things have changed over the years, does the Oklahoma University of Tulsa program look for a certain type of applicants, given the model that you're using? We do, we do. We want someone who's really strong in shows evidence of having worked in community either through volunteer or working, as well as people who have a very interdisciplinary focus.

Unknown Speaker  36:39  
So, you know, our program, we're pretty open with what it's like, but But now, things are changing in Oklahoma when we started this program in 2006, we were the second program in the state and the other programs started in 1970. So then we're 36 years between those two programs. Now, it's 2022. And we have five programs. My goodness, wow. So and I hear there are others opening.

Unknown Speaker  37:12  
You know, the biggest problem we have is what everyone has in every state is finding qualified faculty as people who want to commit to academics. Yeah. And so salaries are so high in this part of the country, as I think they are in Arizona. Also, it's hard for us in academics to keep up with the salary. So let's talk a little bit about accreditation, because you've served as a site visitor and as a commissioner for the AICPA. So maybe if you could share a little bit about your perspective of accreditation, its purpose, how it helps students and programs. And I know that our educators that are listening, it gets a little bit of a knot in the gut, but there's really important reasons for having standards. So can you share a little bit about your experience? Sure. Well, let me start, if you don't mind, Kevin was how I got into accreditation, I was trying to look at some way I could serve the profession, that I didn't need to be a clinician.

Unknown Speaker  38:06  
And as I mentioned previously, I've worked in do education, MD education, nursing education that was at a baccalaureate level. And pa education, of course, for the most years, and I've been been involved, and also with residents, some in the medical school. So I've been involved in accreditation from a lot of different bodies. So I felt like I was fairly cognizant of how accreditation worked, what it was for and some of the current issues. So that's why I first applied to be a site. Mr. So I was assigned Mr. For many years back starting, and I think it was I first started site visiting in the year 2000. So for 22 years, and then I went on to be I served six years on the commission and currently I'm actually Chair of the postgraduate sub commission. Okay, so when we started that up, our PA did a few years ago, they asked me if I would share that first postgraduate commission, because my background and that's backed up was on the phone about that this morning. So what does accreditation do? Well, I always explain it pretty simply. Let's say that I'm going to drive to Arizona to see you. I want to know that if I am taken into the emergency room somewhere and I see a PA or for that matter if I see a nurse or a physician, I want to be sure that anywhere I am in this country that that person is a quality person and that it doesn't matter whether they trained in Wyoming or they trained in New Hampshire or Florida that we know that that pa has graduated from an accredited university and that we can be certain that that education then they got was of a certain quality. So that's

Unknown Speaker  40:00  
What we have in this country, we don't really appreciate it. You know, I was on a trip last year to, I went with a group from my church on a mission trip into New Mexico and I sustained a fall pretty serious fall ended up in the emergency room. And it was, you know, and I was thinking about that as I live for many hours in the emergency room waiting for services in my mask, but that how confident I was that this pa was checking on me every now and then we were waiting, they wouldn't do anything until I ascertained that my I didn't have a head injury, obviously. So that's what we're waiting for. Everything turned out fine set for a few minor scars from

Unknown Speaker  40:45  
but that's what accreditation is for. Accreditation is a way for a group of your peers. And that's one thing I think so important with RPA is that we're all people who've been there on the other side of the table that develop the standards that the standards that are brought forth between for the educators to look at, we go back and change them, people who are on the RPA are individuals who are majority pa educators that they develop these, but the whole thing is just so that you and I can be assured of quality care along with everyone else. Sure. So one of the areas of accreditation, that's changed since 2000, I think there's a greater emphasis is on our self study, and the CCI, the ability to analyze ourselves and manage ourselves. Can you talk a little bit about the evolution of that, from your perspective? Well, it's because when we go ascertain for quality by doing a site visit, if you will, what we're doing is we're doing what's called in statistics across sectional analysis, we're getting we're getting as a cut in time, we're looking at the program that day, but we're not going to be back for maybe 10 years. Okay, so what's going to happen between the time that we're there, and when we go back 10 years from now. So that's what the sales study does it forces of program to be involved in a continuous quality assurance. So it's really the same thing as Qi that goes on clinically, in a hospital, we want to know when what we're doing. So we gathered data, we want to know, when we make errors, which we're humans, we all do. And then we want to be able to reflect, which is analyze and then make changes that are needed, and then complete the circle and go back and see. Did that? Take care of it? Yeah, yeah. So to me, it's not it should be a hard concept for clinicians to understand because now that's what goes on in every hospital, and hopefully, every practice in the country. So it's just the way we do it in education is what we call the self study. And we just have several key factors that are the main major important areas for having quality education for the students, which has to do with the faculty, which has to do with the curriculum, which has to do with the clinical rotations, which has to do with evaluation, these areas, we require the programs to gather data about themselves to reflect on it themselves, and analyze the data in such a way that they can come to conclusions about potential changes they either need to make or that they don't need to make. So it's it shouldn't be it shouldn't be the way that programs should live their lives within the program. You know, every day, ideally, it shouldn't be something that just happens when the people from arc are showing up. And everyone is totally worried. Yeah, I mean, you make some reasonable decisions about your program. But you have to take a look at it retrospectively, to see whether those decisions on target or do you need to shift gears a little bit. So it's, I you know, I was delighted at a recent accreditation meeting that I attended, I was delighted to hear them really emphasize that they don't want complex statistical analysis. Not at all. They just want us to get the simple things out of the way trend analysis, what's working, what's not. Yeah, strengths and weaknesses, areas for improvement, etc. Yeah, I think in to be honest, and I'll say this is a member of Ark, I don't think we've done a good job of bringing people along, you know, as we could have, I'm just terribly complimentary of everything that Sharon Linksys done in the last few years of bringing in more pas into RPA. I mean, for years not to say anything bad about John, but he had to run the thing by himself. He didn't have a lot of systems and now we have lots of educators so we're able to do sessions like the one perhaps you went to, you know, I think complicated statistics is the worst thing because you unless you're a statistician or have studied last

Unknown Speaker  45:00  
Since since you don't understand them, where we can all understand the trend which way a line is going, we can all understand an average. Well, Meredith, when you look back over your career, as you look back at all the contributions you've made and experience with the PA profession, what brings you the most joy? Oh, definitely seeing people like, you

Unknown Speaker  45:21  
know, I read to look at people that I've influenced, I help not only educators that I've been able to influence, but I hope I've also been able to influence some people in their clinical practice, my practice has always focused on using the literature for evidence based practice. So to me, that's the most satisfaction if I've been able to help the clinicians I've trained, be better clinicians. And if I've attracted a few people towards leadership, or education or research, that's very satisfying. Yeah. Well, we talked about that before we started recording, I think your mentorship of me and others has led to us getting involved in the education and leadership. And now that I'm on, you know, I've been in 20 years now, as a director and educator, I'm getting a chance to see what you're talking about. Yeah, I'm seeing my graduates that I had the chance to be part of their training now entering P education are becoming dread. Yeah. And it's really rewarding. You're right. It's so wonderful. I mean, it's what education is all about is hopefully, you know, just think as if, as humans, we had to learn everything for the first time. We're all dependent on each other. And I do think and I feel like pa that's so new, we, it's still a very new profession, we're only talking a few people over 50 years. So

Unknown Speaker  46:47  
there's a lot to do. There is but at the same time, we've done a lot for 50 something years, so 53, I guess this year? Well, I think I'm gonna take the liberty of speaking on behalf of the profession. And just thank you for everything that you've done to contribute to the growth of this profession and the stability of this profession over your career. I think. So often, in our profession, people look to the PAs, but there are a myriad of people that were physicians and PhDs and social workers and others who have contributed to our success. And they often go unrecognized. And I just want to thank you, because I know, I know a lot of the things we're talking about, were influenced by your leadership. And thank you for that. Nonya thank you so much. I appreciate the PAs for always being so accepting and willing to let me be a part of the group. And I think the the proudest awards I've ever gotten, I'm an honorary PA, both in Illinois and in Oklahoma. So

Unknown Speaker  47:49  
you are technically one of us.

Unknown Speaker  47:53  
But, but it's no, the PA profession is a great profession. And I really believe in it. You know, I don't think we need to depend on physicians for everything. And I think pas are I just liked the model. I like the way the collaboration goes and support. So

Unknown Speaker  48:13  
thank you so much for taking time to share with us about the Oklahoma University's program in Tulsa. Thank you and about your your contributions and passions for the profession and we wish you and your colleagues very best. Okay. And I should put in the name of the our program director Shannon ions, who, by the way, was one of the first faculty I hired who's now our program director, if anyone's interested in talking more wisdom about our model. We know it doesn't go everywhere, but there are aspects of it that can be incorporated in almost every program. Absolutely. Well, we want to thank our guest, Dr. Meredith Davidson from the University of Oklahoma, Tulsa PA school, and their medical school. We appreciate her sharing her insights and contributions to the profession over the past several decades.

Unknown Speaker  49:00  
Tune in next week as Steph and I wrap up Season Two with our reflection episode. We look forward to looking back at the last season. And looking ahead to season three. We do plan on taking the summer off to get a little bit of relaxation in but look forward to bringing you a whole series of new and interesting people as we continue to highlight the profession and try to help level the playing field for all applicants.

Unknown Speaker  49:31  
Until next time, I wish you success with whatever path you are watching in life. And thank you for joining us

Unknown Speaker  49:39  
on this podcast to provide news and information on the PA profession is for informational purposes only

Unknown Speaker  49:47  
expressed in this podcast are those of the speakers and guests and do not necessarily reflect the official position or policy of the University of Arizona.

Transcribed by https://otter.ai