Defining Differential Diagnosis Skill Progression in Physician Assistant/Associate Students, A Cross-Sectional...

Area of Science:

• Medical Education
• Clinical Reasoning
• Physician Assistant Studies

Background:

• Differential diagnosis is a core competency for healthcare professionals.
• Assessing and benchmarking this skill in physician assistant (PA) students is crucial for training.
• Comparing student performance to experienced clinicians provides valuable insights.

Purpose of the Study:

• To establish benchmarks for differential diagnosis competency in PA students.
• To compare the differential diagnosis skills of PA students across different training years.
• To evaluate these skills against those of experienced clinicians.

Main Methods:

• A cross-sectional survey design was employed.
• Participants included three cohorts of PA students (PAS-1, PAS-2, PAS-3) and experienced clinicians.
• Clinical vignettes were used to assess top slot diagnosis, differential concordance, emergent diagnoses, organ system consideration, list length, and completion time.

Main Results:

• Second-year (PAS-2) and third-year (PAS-3) students demonstrated improved diagnostic accuracy and concordance compared to first-year (PAS-1) students.
• Student diagnostic lists expanded in breadth, including more emergent diagnoses and organ systems with increased training.
• Experienced clinicians and PAS-1 students completed the diagnostic tasks significantly faster than PAS-2 and PAS-3 students.

Conclusions:

• Differential diagnosis ability in PA students develops in both accuracy and breadth throughout their training.
• Training interventions should focus on enhancing list length and considering a wider range of diagnoses, including emergent and less common ones.
• The findings suggest a developmental trajectory for clinical reasoning skills in PA education.