From Battlefield to Bedside: Prioritizing Procedural Skills and Competency Expectations for Military Physician...

Area of Science:

• Medical Education
• Surgical Training
• Physician Assistant Studies

Background:

• The U.S. Army-Baylor University Doctor of Science in Physician Assistant Studies General Surgery program trains PAs in extensive clinical, procedural, and operative skills.
• Efficient medical provider utilization is critical for future military conflicts with anticipated high casualties and limited resources.
• This study assessed if fellowship-trained military PAs meet surgeon expectations in garrison and deployed environments.

Purpose of the Study:

• To prioritize essential skills for fellowship-trained physician assistants (PAs) in general surgery.
• To establish surgeon expectations for PA competency levels in both garrison and deployed military settings.
• To ensure PA training aligns with the demands of modern military medical operations.

Main Methods:

• The Delphi method was employed to achieve consensus on prioritized skills and performance levels for PAs.
• Surveys utilized a 5-point Likert scale to gauge agreement on skill performance in garrison and deployed environments.
• Accreditation Council for Graduate Medical Education Surgery milestones were used to define expected competency levels for patient evaluation, intraoperative, and postoperative care.

Main Results:

• Consensus was achieved on 18 essential skills applicable to both garrison and deployed military environments.
• Surgeons expect PAs to achieve an average competency level of 2.7 in patient evaluation and decision-making.
• Expected competency levels for intraoperative and postoperative patient care were 2.5 and 2.8, respectively, based on surgery milestones.

Conclusions:

• Expert consensus provides a foundation for refining PA training curricula and competency assessments.
• Aligning PA training with military surgeon expectations enhances preparedness for interprofessional team collaboration in conflict zones.
• Graduates will be better equipped to manage surgical patient care in resource-limited, high-casualty military scenarios.