Lake Erie College. Master of Science in Physician Assistant Studies. Program Proposal

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Lake Erie College

Master of Science in Physician Assistant Studies

Program Proposal

Spring 2011

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Master of Science in Physician Assistant Studies Center for Health, Environmental and Life Sciences

Lake Erie College A. ABSTRACT

Objectives:

This is a proposal for a full-time professional Master of Science in Physician Assistant Studies to be housed in the Center for Health, Environmental and Life Sciences at Lake Erie College. The primary objective of the program is to equip Physician Assistant graduates with the competencies necessary to provide preventative and therapeutic health care that is safe, current and evidence-based and to deliver quality health care services under the supervision and direction of a licensed doctor of allopathic or osteopathic medicine. Graduates of the program will have necessary research and critical thinking skills to serve as academic and professional leaders in the physician assistant community. The program will offer students a comprehensive primary care education and training program that combines didactic course work with clinical experiences that balance academic and clinical orientation, provides extensive access to healthcare resources and a delivery model that maximizes training opportunities in Ohio and beyond in urban, rural and under-served populations.

The proposed Master of Science in Physician Assistant Studies will meet the educational needs of students at Lake Erie College who are interested in earning a professional graduate degree in Physician Assistant practice. Upon graduation from the proposed program, students will be eligible to sit for the certification examination developed by the National Board of Medical Examiners and administered by the National Commission on the Certification of Physician Assistants. The objective of the proposed Master of Science in Physician Assistant Studies is aligned with the objective of LEC’s academic plan to attract high quality faculty and graduate students. A certified PA is a graduate of an accredited PA educational program and has passed the Nation Competency Exam. All graduates of the degree program would have the potential to contribute to the healthcare workforce in Ohio.

Clientele to be served:

The Center for Health, Environmental and Life Sciences proposes to offer a professional Master of Science in Physician Assistant Studies program to meet the education needs of individuals who are interested in becoming trained physician assistants. Potential candidates for this program will consist of individuals who have strong basic science backgrounds and direct patient care experience and who seek to work under the supervision of licensed doctors of allopathic or osteopathic medicine to take medical histories, perform physical examinations, order and interpret diagnostic tests, diagnose illnesses, develop treatment plans, prescribe medication, assist in surgery and perform minor procedures. Curriculum:

The curriculum of the proposed professional Master of Science in Physician Assistant Studies will be designed to provide students with the skills that enhance their professional and personal growth as physician assistants through course objectives which will cover three areas of learning: cognitive skills (knowledge base), psychomotor skills (manipulative and motor skills), and affective skills (attitudes and values). Bloom’s Taxonomy of education objectives will be used as a framework to assess the three areas of learning. Reflected in this proposal are specific examples of cognitive, psychomotor, and affective objectives students will be expected to demonstrate. The curriculum will be based on the concepts of adult learning and professional education which focus on helping students become self-

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directed learners with the capacity to move from basic to more advanced skills and apply what they have learned in the classroom to the clinical setting. In order to progress and graduate from the program, the student will be required to have completed all courses contained within the physician assistant curriculum with a minimum grade of C+, maintain a grade point average of 3.0, satisfactorily complete all didactic and clinical objectives and comprehensive examinations, and satisfy all program requirements.

Total credit hours The total credit hours required for the proposed program is significantly higher than the credit hours required for a typical graduate program. The terminal degree for physician assistants is a Master’s degree in Physician Assistant Studies and physician assistant programs are required to offer prescribed didactic courses and clinical experiences for students. The range of required total credit hours for physician assistant studies is from 91 to 125 while the length of study ranges from 24 to 36 months. For the proposed program at LEC, students will be required to complete 66 credit hours of didactic courses and 39 credit hours of clinical rotations for a total of 106 credit hours. Duration of the program will be 27 months.

Subject areas of required courses Gross Anatomy, Physiology, Pathophysiology, Clinical Medicine, Pharmacology, Health Care Trends and Issues, Health Promotion, Critical Inquiry, Values and Ethics, and Interpersonal Communication Skills.

Internships or practicum Students will be required to complete 9 compulsory clinical rotations to include: internal medicine, family medicine, psychiatry, emergency medicine, pediatrics, general surgery, women’s health and public health rotations and one elective clinical rotation.

Unique and innovative features The availability of several outstanding and nationally recognized health and medical facilities in the greater Cleveland area and surrounding counties will increase student access to clinical sites as well as top health professionals in the state. In addition, partnership with University Hospitals will provide students with exposure to excellent clinical rotations. Service learning activities will be developed with the possibility of students enrolled in the proposed Master of Science in Physician Assistant Studies to have the opportunity to participate in international service learning. Employment possibilities:

National The physician assistant is a health care professional licensed to work under the supervision of a licensed physician to perform medical duties from basic primary care to technically advanced

procedures in emergency medicine or within medical specialties under the supervision of a physician. Employment opportunities for physician assistants exist in Ohio as well as throughout the United States. Physician assistants held about 74,800 jobs nationally in 2008. According to the American Academy of Physician Assistants, about 15% of actively practicing PAs worked in more than one clinical job concurrently in 2008, indicating that the number of available jobs is greater than the number of practicing PAs. Of the PA jobs available in 2008, more than 53% were in physician offices, while 24% were in general medical and surgical hospitals, public or private. According to the most recent National Occupational Outlook Handbook, employment of physician assistants is expected to grow 39% from 2008 to 2018. Projected rapid job growth reflects the expansion of healthcare industries and an emphasis on cost containment. It is anticipated that physicians and institutions will employ additional PAs to provide primary care as part of an effort to be more cost-effective while maintaining a level of quality care. According to the American Academy of Physician Assistants’ 2008 Census Report, median

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income for physician assistants in full-time clinical practice was $85,710 in 2008; median income for first-year graduates was $74,470.

State of Ohio According to the Ohio Job Outlook 2018 report, Ohio’s population and income are

expected to grow at a rate slower than that of the nation, and as a result, overall employment in Ohio is also projected to lag behind national averages. Even so, during the period of 2008-2018 the Ohio economy is projected to create nearly 250,000 new jobs, primarily in service-providing industries. On average, during this same period, the Ohio economy is expected to have over 166,000 annual openings. Most job openings will result from the need to replace workers who leave the labor force, usually upon retirement or transfer to another occupation. It is anticipated that individuals with more education and training will enjoy better job opportunities. Growth rates over the 2008-2018 period are 9.8% for those occupations requiring any level of postsecondary training.

The number of jobs for Ohioans is anticipated to rise from 5.726 million in 2008 to 5.975 million by 2018. Service-providing industries will account for almost all of the job growth; education and health services will add 45% of new jobs. At a more detailed level, the fastest growing industry is expected to be individual and family services, with a 50 percent growth expected between 2008 and 2018. Hospitals are part of the almost 150,000 new jobs being added in private health care, which also includes 22,900 jobs in the offices of physicians, 21,900 jobs in nursing care facilities, 19,600 jobs in individual and family services, and 18,700 jobs in home health care services. Home health aides top the list of fastest growing occupations, while athletic trainers, physician assistants and physical therapist assistants round out the top four. Overall, healthcare occupations (both practitioners and support) in Ohio are projected to grow by 20.7%. According to the Ohio Job Outlook Report 2018, the median salary for PAs employed full-time in Ohio is $83,885. Table 1 below indicates the top 9 industries in Ohio with the highest employment prospects for 2008-2018.

Table 1: 2008-2018 Ohio Industries with High Employment Prospects*

2008 Projected Employment

NAICS Annual Employment Change Percentage

Code Industry Title Employment 2008-2018 2008-2018 Change

6211 Offices of physicians 81,700 104,600 22,900 28

5415 Computer systems

design 52,500 72,900 20,400 38.9

6241 Individual Family

Services 38,900 58,500 19,600 50.4

4529 Other merchandise 72,500 91,300 18,800 25.9

6216 Home Health Care 44,300 63,000 18,700 42.2

6213 Offices of other health

practitioners 27,600 38,200 10,600

38.4

5416 Mgt & Technical

consulting 24,600 34,700 10,100

41.1

6214 Outpatient care

centers 25,800 33,900 8,100

31.4

8121 Personal care services 30,000 33,900 8,100 26.7

*Industries expected to have the most new jobs and growth rates of at least 25 percent.

Retrieved from Ohio Job Outlook 2018 at http//www.ohiolmi.com/proj/ohiojoboutlook on March 13, 2011

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In addition, Table 2 shows employment projections for physician assistants in the entire state as well as indicating separate growth numbers for the metropolitan area which includes Lake County as well as Economic Development Region 8.

Table 2: Ohio - Occupational Employment* Projections Report, 2008-2018

Change in Total

2008 2018 Employment Annual

Code Occupational Title Annual Projected 2008-2018 Percent Openings

State of Ohio

29-1071 Physician Assistant 1910 2550 640 33.5 99

Metropolitan Statistical Area for Cuyahoga, Geauga, Lake, Lorain and Medina Counties

29-1071 Physician Assistant 480 570 90 18.8 16

Economic Development Region 8

29-1071 Physician Assistant 490 560 70 14.3 14

*Occupations with 100 or more workers

Retrieved from Ohio Job Outlook 2018 at http//www.ohiolmi.com/proj/ohiojoboutlook on March 13, 2011

Licensure All States and the District of Columbia have legislation governing the practice of physician assistants, requiring candidates to pass the Physician Assistant National Certifying Examination

administered by the National Commission on Certification of Physician Assistants (NCCPA) and open only to graduates of accredited PA education programs. Only those who have successfully completed the examination may use the credential “Physician Assistant-Certified.” To remain certified, PAs must complete 100 hours of continuing medical education every 2 years and every 6 years pass a recertification examination or complete an alternative.

Educational Program Capacity and Market Analysis:

The Center for Health, Environmental and Life Sciences, the academic unit in which the PAS program is housed, is funded primarily by student tuition, gifts and grants from outside organizations and corporate partners. Lake Erie College is committed to providing a quality education and producing the best health care providers possible, and will position itself to be a leader in the current health care movement in the United States shifting from a reactionary, crisis-driven model to a proactive self-maintained health management model that allows optimal levels of wellness to be maintained and reduces overall healthcare costs.

Demographic Trends in Physician Assistant Programs In 2010, 154 educational programs for physician assistants were accredited or provisionally accredited by the Accreditation Review Commission on Education for the Physician Assistant. Ninety-two percent, or 142, of these programs offered the option of a master's degree, while the remainder offered either a bachelor’s or associate’s degree and/or a certificate. According to the preliminary information provided in the 26th Annual Report on Physician Assistant Educational Programs, (which is published by the Physician Assistant Education Association), 63% of all PA programs are offered at private institutions, with 35% of all programs being offered in New York, Pennsylvania, Florida and California. The percentage of seats that go unfilled has trended

downward over the years, even though overall capacity has increased. The PAEA report shows that

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63.9% of programs filled first-year student capacity at 100% while 17.6% enrolled less than capacity and 18.5% exceeded their capacity. Total first-year capacity was filled at 99.3%. Average attrition was 2.4 students per year while average deceleration occurred at the same rate, 2.4 students. Figure 1 below illustrates PA Enrollment and Capacity in the United States form 1985-2009, while Figure 2 provides information regarding first-year enrollments for the same time period. Figure 3 indicates the total number of graduates from PA programs from 1985-2009

Figure 1 PA Program Enrollment and Capacity retrieved from Twenty-Fifth PAPE Annual Report, 2008-2009, pg 31

Figure 2 First-Year Class Enrollment retrieved from Twenty-Fifth PAPE Annual Report, 2008-2009, pg 32

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Figure 3 PA Program Graduates, retrieved from Twenty-Fifth PAPE Annual Report, 2008-2009, pg 37

Enrollment Projections PA programs in the United States have seen a significant increase in applications through the CASPA process, which has translated into an increase in program matriculants. During the 2009-2010 enrollment cycle, CASPA received 14,682 unique applicants resulting in 91,386 total applications or 6.2 program designations per applicant and 3.04 unique applicants per available seat. The overall matriculation rate was 4,827 students or 33%. Applications for the 2010-2011 enrollment cycle are up 16% from last year with an average of 6.5 designations per application. Figure 4 and Table 3 below provide applicant and matriculation information over the past 5 cycles as well as general demographic information regarding applicants and matriculants during the 2009-2010 cycle.

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Figure 4 retrieved from Physician Assistants Education Assoc. Cycle 9 Report at www.paeaonline.org on March 11, 2011

TABLE 3: General Demographic Information of Applicants and Matriculants 2009-2010

Applicant Matriculant

Average Age 27 26

Gender 72% Female 73% Female

Ethnicity/Race

Asian 14.5% 10.8%

African-American 8.6% 4.1%

White 78.1% 86.2%

Average Overall GPA 3.25 3.46 Years of Health Care Experience 2.2 2.0

Data retrieved from Cycle 9 Report at www.paeaonline.org

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Based on past experience of the core group of administrators, and the above statistical information regarding physician assistant programs offered in the United States, Table 4 shows conservative enrollment projections which are being used for budgeting and planning purposes.

TABLE 4: Enrollment and Completion Data

PAS Student Enrollment Projections

Term within program

2013/2014 2014/2015 2015/2016 2016/2017 2017/2018

Spring Summer Fall Spring Summer Fall Spring Summer Fall Spring Summer Fall Spring Summer

Term 1 20 27 35 40 40

Term 2 20 27 35 40 40

Term 3 20 27 35 40

Term 4 20 27 35 40

Term 5 20 27 35 40

Term 6 20 27 35

Term 7 20 27 35

Total 20 20 20 47 47 47 82 62 62 102 75 75 115 80

As mentioned, these projections are conservative and it is anticipated, particularly after the first year, that the numbers will increase. An initial goal is to generate 1200 inquiries per year. During the first years, it is anticipated that conversion rates would be as follows:

Inquires to Applications – 240 or 20% Applications to Acceptances – 120 or 50% Acceptances to Matriculants – 40 or 33%

This would result in the 40 new students per year as shown above by year 4. It is anticipated that inquires may be higher than 1200 in the first year due to curiosity about the program, however 1200 legitimate inquiries is an acceptable goal. Prospective students will be required to have earned a bachelors degree with specific requirements in science and math coursework. As is true with many health care programs, prospective students will matriculate from regional institutions primarily in Ohio, Kentucky, Illinois, Indiana, West Virginia, Michigan and Pennsylvania. However, due to the unique circumstance of more applicants than openings in PA programs in the United States, LEC should anticipate the possibility of attracting students from all regions of the country. At this time, LEC

anticipates capping the entering class at 40 students, however this cap will need to be revisited once the program has been established based on institutional capacity and market demand.

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Critical Issues Lake Erie College must overcome two critical hurdles in order to move forward with recruitment and enrollment of students. The first is securing appropriate partnerships for delivery of clinical rotations. The second is obtaining appropriate equipment and facilities for didactic courses or partnering with other institutions/organizations to utilize existing facilities with excess capacity. Beyond these immediate needs, LEC must also address the following:

 Securing appropriate accreditation approvals from the Ohio Board of Regents, the Higher Learning Commission and the Accreditation Review Commission on Education for the Physician Assistant

 Budget deficits during the first years of operation

 Rejuvenation of professional support among alumni base

 Market penetration

Keys to Success In an effort to take advantage of the strengths and opportunities identified by the institution, as well as overcome challenges, administrators will need to place institutional focus on the following key items in order to successfully meet its mission:

 Explore and leverage collaborative efforts with University Hospitals

 Development of positive institutional image in the health care education arena

 Support of traditional medical community and research entities

 Securing necessary funding for stability and support of on-going operations, student tuition assistance, faculty endowment funds and research

 Wide marketing exposure

 Support of local public officials, politicians and private philanthropic organizations

B. PROGRAM DESCRIPTION

Proposed Program and Stated Objectives:

The mission of the Physician Assistant Studies program is to support the healthcare sector in Lake County, Northeast Ohio and beyond by supporting the needs of healthcare providers in the region for a prepared workforce; raising public awareness of community health issues; and creating expertise on community health issues. In support of the mission, the LEC-PAS program will prepare students to become generalist physician assistants oriented toward service to underserved populations, in both rural and urban areas, through an education based on the medical model and team approach to medicine and health care. To fulfill the mission the PAS program commits itself to:

 provide future-oriented health management by educating health care providers to deliver a product focused on prevention and wellness

 provide leadership in health and wellness to improve the quality of life for all people

 provide education, training and service that promotes the highest quality of health and wellness care, affords solace and enhances the lives of others

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 cultivate advances in health and wellness research that result in effective and efficient ways to lead others to a healthy lifestyle

 attract and support students of the highest quality ensuring the greatest skill and service to others in promoting healthy lifestyles

 provide a quality educational program which meets Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) accreditation standards

 engage in on-going review and evaluation of program effectiveness in preparing competent physician assistant graduates

Consistent with the recommendations of the Physician Assistant professional organizations, the program will ensure that graduates have the skills, knowledge, dispositions and abilities to:

 elicit a detailed accurate history and perform a thorough physical examination of a patient of any age, gender, and ethnicity/race

 perform or assist in the performance of diagnostic and therapeutic procedures

 recognize life-threatening emergencies and manage them under the supervision of a licensed physician

 communicate in a medically professional manner both orally and in writing

 present patient data and document it appropriately in the medical record

 use knowledge of medical nutrition therapy to counsel patients on the impact of proper nutrition on health and wellness

 evaluate medical literature critically and apply this knowledge and the principles of evidence- based medicine to clinical practice

 contribute to the Physician Assistant profession through scholarship, leadership, education, and service to the profession and community

 support the concepts of evidence-based medical care and the health of the community

 value diversity of cultures, people and lifestyles

 integrate electronic information technology into clinical practice

 successfully complete the National Certifying Examination for Physician Assistant

 practice safe and cost effective medicine

 interact as professionals within an interdisciplinary health care environment

 develop an awareness and appreciation of the ethical, legal, and social issues impacting the delivery and practice of health care

 demonstrate commitment to professional growth and life-long learning

 perform technical and surgical procedures within the scope of practice

 monitor and manage patient care in acute, long term, and ambulatory settings

 facilitate patient referral to appropriate specialty practices and community agencies

 use clinical problem solving skills to integrate knowledge from the biological and behavioral sciences with medical knowledge and current standards or clinical practice

 understand the basic sciences of anatomy, physiology, and pathophysiology and be able to utilize this knowledge in the diagnosis and treatment of diseases

 understand the principles of public health and incorporate health promotion and disease prevention into a patient care practice

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 understand common pathophysiological problems that occur in each of the organ systems and those disease processes in human beings resulting from immunological disorders or from infectious organisms

 demonstrate working knowledge of the principles of pharmacotherapeutic, drug absorption, distribution, action, toxicity and elimination

 use the results from clinical laboratory in the diagnosis and management of disease states

 apply the knowledge of genetics in diagnosis and management of disease

 recognize and be guided by important of legal and ethical concepts related to medical care

 understand the PA profession, its origin and development and the role of PA/Physician team within the health care and social service system

Admissions Requirements and Anticipated Student Clientele:

Admission requirements Admissions will be highly selective and enrollment will be limited. To be eligible for admission, students must have earned a bachelor’s degree from a regionally accredited college or university by the date of enrollment in the professional program, have a minimum cumulative grade point average of 3.0 on a 4.0 point scale, submit three letters of reference (one of which must come from a physician assistant), a 500 word personal statement, and GRE or MCAT scores taken within the last five years. Students will be required to use the Centralized Application Service for Physician Assistant (CASPA). CASPA offers applicants a Web-based application service that will allow them to apply to several physician assistant programs by completing a single application.

A Physician Assistant Admissions Committee, a committee of faculty, practicing physician assistants and program administration, will be established and assigned the responsibility of reviewing application packets and interviewing a selected group of students. The on-campus personal interview or video conference conducted by the Physician Assistant Admissions Committee will be used to identify important traits and skills which may not be apparent in the applicant’s packet. Some of the attributes to be considered by the Committee will include:

 Knowledge and understanding of the profession

 Strength and breadth of academic record

 Type and depth of prior health care experience

 Strength of letters of recommendation

 Ability to work with individuals from diverse backgrounds and communities

 Motivation toward to career as a physician assistant

At the time of application submission, applicants must provide evidence of a minimum of 500 hours (paid or volunteer) of experience with direct patient (hands on) contact in a health care setting. Shadowing a Physician Assistant is recommended and accepted as part of the 500 hour requirement. Complete criminal background checks will be performed on all incoming students prior to the first day of classes and again prior to the start of the clinical rotation phase of the program. A felony or

misdemeanor conviction may result in denial to participate in clinical rotations and/or rejection by professional certification agencies or state licensing boards. The program reserves the right to dismiss any student for failure to declare a criminal record. Admitted students must have current CPR and First Aid certification for health care providers completed prior to the beginning of the first semester of the program.

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The total credit hours required for the proposed program is significantly higher than the credit hours required for a typical graduate program. The terminal degree for physician assistants is a Master’s degree in Physician Assistant Studies. To satisfy program accreditation requirements, physician assistant programs must offer prescribed didactic courses and clinical experiences for students. The length of study, required credit hours, and admission requirements for the proposed master’s degree program are comparable with the requirements adopted by other reputable physician assistant programs located in academic medical centers and research intensive institutions. Provided below (Table 5) is a summary of the length of study and admission requirements of selected Physician Assistant Programs located at academic health center and research intensive institutions, as well as those located in Ohio.

Prerequisite coursework and/or degrees Applicants will be expected to have an earned bachelor’s degree from a regionally accredited institution and completed all prerequisite courses prior to enrolling in the program. Prerequisite science courses must be completed with a grade of “C+” or higher and must be taken on a graded basis within the last five years. A minimum cumulative grade point average of 3.0 on a 4.0 point scale will be required. All prerequisites must be taken at regionally accredited institutions (or foreign equivalent). Courses taken on a pass/fail, satisfactory/unsatisfactory basis or by correspondence will not be accepted. Science prerequisite courses must be for science majors and include a laboratory component. Applicants will be expected to provide documented evidence of satisfactory completion of the following prerequisite courses:

 Biological sciences with lab ( human anatomy, human physiology, microbiology, genetics, or immunology)

 Chemistry (must take general chemistry and biochemistry with labs along with other chemistry courses) )

 Statistics or biostatistics (one course)

 Psychology or sociology (one course)

 Medical terminology (one course)

 Nutrition (one course)

 Mathematics – college algebra or higher (one course)

 English to include communication or speech (two courses)

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TABLE 5: Summary of Program Credit, Program Length and Admission Requirements for Selected PA Programs Located at Academic Health Centers and Research Intensive Institutions AND Ohio Programs

Program

Total Credits

Length of Program

Minimum Number of

Patient Care Exp.

Minimum GPA

GRE

Requirement

Duke University 110 24 Months 1000 hours

3.0 on a 4.0 Scale

1000 – Combined Verbal & Quant University of South

Alabama 121 27 Not specified

3.0 on a 4.0 Scale

1100 – Combined Verbal & Quant

George Washington

University 98 24 960 hours

3.0 on a 4.0 Scale

Required, but no minimum score stipulated University of

Florida

102 24 2000 hours

Not

specified Not specified

Emory

University 119 28 2000 hours

2.8 on a 4.0 Scale

Required, but no minimum score stipulated

Marietta College 103 26

Required, not specified

3.0 on a 4.0 Scale

Required, but no minimum score stipulated

Seton Hall

University 106 36 100 hours 3.0

Required, but no minimum score stipulated SUNY Downstate

Medical Center 110 27 100 hours

2.85 on a

4.0 Scale Not Required

Drexel University 117 27 500 hours

2.75 on a

4.0 Scale Not Required

University of Findlay 91 27 500 hours

3.0 on a 4.0

Scale Not Required

Mount Union University 97 27 40 hours shadowing

3.0 on a 4.0 Scale

Required, but no minimum score;

>1000 preferred

University of Toledo 79 27 Not required

3.0 on a 4.0 Scale

Not specified Kettering School of

Medical Arts 98 27 1000 hours

3.0 on a 4.0

scale Not required

Tri-C/CSU 95 27

3 years of experience

3.0 on a 4.0

Scale Not Required

Lake Erie College 105 27 500 hours

3.0 on a 4.0 scale

Required, but no minimum score

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Anticipated clientele The proposed degree will be attractive to individuals interested in becoming a mid- level health practitioner in the health care delivery system. A second group of individuals will be those already practicing (i.e., dieticians, physician therapists, emergency medical technicians, etc) in health care who desire a more expanded role.

Enrollment limitations This is a limited access program. Availability of space and clinical rotation sites will limit the number of students accepted in any given year. Enrollment will be capped at 40 per cohort, with the initial cohort limited to 20, growing to 27 in the second year and entering 40 by the fourth year. This cap will need to be revisited once the program is established and a review of institutional capacity and market demand conducted to determine if the cap should be increased or decreased.

Planning Assumptions:

A key assumption, that is the foundation for all timelines indicated in this strategic plan, is that all accrediting bodies will grant authority for the program with ARC-PA, the programmatic accrediting body, granting provisional accreditation no later than Fall 2013. The site visit with ARC-PA has been set for April 11-12, 2013. If consent to grant degrees is delayed, the entire timeline for the plan will need to be adjusted. Executing this provision is a priority for senior administration. Due to the status as a “start-up” program, another important assumption is that initial staffing will be minimal until sufficient funding is obtained to allow for additional positions to be filled. The program will employ individuals to fill the key positions as indicated in the ARC-PA standards, which includes a program director, medical director and 3 FTE principal faculty members, including 2 FTE of PA certified principal faculty. Many objectives outlined have specific budget dollars identified as necessary to complete the task. If funding is not secured in amounts sufficient to support all initiatives, a revision will be needed and objectives will need to be prioritized to maximize the dollars available.

Profile of Institutional/Program Priorities LEC has created a strategic enrollment plan to assist in developing a desirable educational experience for students in the PAS program. The institutional analysis identified many strengths and opportunities, but also a number of challenges for a program in its beginning stages. Having identified the key items for success, a list of institutional priorities has been developed. These areas of focus are viewed as being necessary groundwork to move forward in

establishing Lake Erie’s PAS program as a viable competitor. The institutional priorities include:

 Financial Sustainability

 Student Recruitment and Enrollment

 Student Financial Support

 Student Persistence

 Student and Patient Satisfaction

 Human Resources, Infrastructure and Services

 Image/Reputation

 Accountability

 Research

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Strategy Framework:

Exhibit A provides a visual map of the institutional strategies selected to support and accomplish identified priorities within the Center for Health, Environmental and Life Sciences. The strategies are separated into four major categories representing the workforce, internal processes, financial stability and our students and various constituents. Each stage provides a foundation for the next level to build upon. Each outcome supports at least one, and perhaps more, of the institutional priorities. This institutional strategy map provides a framework for each department to develop their own strategy map that indicates how the department will support and participate in accomplishing the institutional

priorities for the PAS program. The strategy map will also serve as a guide for the annual strategic planning process.

Given the LEC-PAS program is in the business of promoting health and wellness, the desired outcomes identified in the strategy map represent the College’s attempt to develop and promote a healthier staff, healthier communication, healthier financial resources and healthier students and communities. These outcomes provide the framework for the “bigger picture” into which everything else must fall. As goals are accomplished, the picture will begin to take shape and give purpose to decisions that are made at the departmental level. Departmental leaders will have a clear indication of what is expected and can therefore implement strategies with confidence. It is the sincere hope that identification of institutional priorities for this program will boost morale and allow employees throughout the organization to identify where they fit in the “bigger picture”. Another benefit in achieving these outcomes is the bond that will naturally form between employees, students and outside constituents. This bond, a sense of common goals and objectives, will serve the College and program well, not only in the short-term, but in the future.

Shaping Our Workforce The four strategies that have been identified to shape the desired workforce are:

WF 1: Encourage innovation and targeted research.

WF 2: Recruit, develop and retain a workforce to meet changing needs. WF 3: Create a rewarding, safe work environment.

WF 4: Right information, at the right time, in the right place and in the right medium.

The workforce strategies can be accomplished through activities such as conducting performance reviews that incorporate professional development for each employee; establishing collaborative partnerships with medical professionals, organizations and teaching methods; routine renewal and renovation of buildings and grounds to ensure their integrity, usefulness and appearance; and ensuring accuracy and timeliness of state, federal and departmental reporting.

Internal Processes The five strategies identified as essential to shaping efficient communication are: IP 1: Recruit and retain students who become outstanding successful graduates.

IP 2: Deliver cutting-edge curricula with an integrated/interdisciplinary approach. IP 3: Build productive, collaborative research groups.

IP 4: Build strong local, regional and national partnerships.

IP 5: Develop effective information, management and academic processes.

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Internal process strategies may be supported by identifying students who represent a best fit for the LEC-PAS program; providing a quality student educational experience; creating an academic relationship between clinic and basic science faculty; engaging and creating opportunity for corporate and business partnerships; and streamlining academic and administrative processes and procedures.

Financial Stability The four strategies identified to provide a solid financial platform are: FS 1: Prioritize resource allocation to areas of strategic importance.

FS 2: Grow income.

FS 3: Develop a base for student financial aid and leverage to meet income goals. FS 4: Diversify income base to meet budget targets.

Through connecting student enrollment and retention designed to ensure strategic enrollments; developing fund raising initiatives that provide start-up funding; developing financial aid packaging strategies that provide an attractive mix of institutional, scholarship, state and federal aid; and seeking grant opportunities to provide additional funding, the financial outcomes can be achieved successfully. Students and Communities The four strategies contributing to development of positive relationships with all constituents are:

SC 1: Deliver flexible, innovative education.

SC 2: Provide high quality educational and clinical experiences for student and patients. SC 3: Involve and inform our students and communities.

SC 4: Excel in research and research training.

Providing effective academic assistance and system-wide process improvements that support educational goal attainment for PAS program students; collecting data on patient and student

satisfaction to provide information for retention purposes; development of a quality and performance base system; and establishment of clinical experiences across the region will provide a solid base for attaining the strategies identified for positive student and community relationships.

Enrollment Management Goals and Action Plans The institutional strategies, as illustrated in Exhibit A, are supported by the Enrollment Management Services through a series of four goals. Each goal further identifies an objective and/or action to be taken to assist in achieving the Enrollment Management (EM) goals. The first of the EM goals, while somewhat outside the EM group is essential to success of all other goals, institutional and departmental, and therefore is included here. The EM goals and actions are as follows:

EM Goal 1: Develop and execute fund raising initiatives that result in minimal start-up funding of $1 million.

 Develop and implement solicitation strategies to identify and engage 500 potential donors.

 Design annual fund/capital campaigns that develop and build a base of donors to raise annual unrestricted and restricted monies of at least $1 million.

 Develop direct mail and email solicitation as a tool to find and enlist new prospective donors, assist in identifying new market segments and serve as a medium for keeping in contact with current donors.

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 Develop process for solicitation of at least 35 foundations and Federal grants to support special programs and outreach opportunities within the community; support expansion of existing programs and support research into the efficacy of treatment programs.

EM Goal 2: Implement a recruitment plan that will generate 1200 inquiries per year by 2013.

 Collaborate with health science counselors at a minimum of 25 colleges and universities throughout the Midwest to identify prospective students.

 Conduct campus open-house/orientation sessions on a quarterly basis for counselors and instructors of health science programs throughout the Midwest.

 Conduct bi-monthly recruitment efforts with local and regional health care professionals through use of open-house events.

EM Goal 3: Matriculate 40 new PA students per year by 2016.

 Identify prospective students through systematic grading and qualifying of inquiry and applicant pools, utilizing the CASPA application process.

 Develop and implement a comprehensive telecounseling program to enhance conversions and yield rates.

 Develop and implement a comprehensive written communication flow to increase conversions and yield rates as well as coordinate with and enhance the telecounseling program.

EM Goal 4: Integrate and utilize a variety of instructional techniques and strategies to include real- world relationships, hands-on instructional practices, current technologies, early intervention and faculty development.

 Stimulate student interest in the PAS program through use of curriculum emphasizing interdisciplinary and real-world relationships.

 Develop and incorporate interactive, relevant hands-on instructional practices.

 Utilize education technologies to enhance instruction.

 Develop and utilize early intervention programs to identify and assist students experiencing difficulty.

 Develop a center for teaching excellence to support faculty development. Roles and Responsibilities

Student recruitment and retention at any university or college is a complex issue. Complex because much of what an institution must address is student perception which can be difficult to understand and monitor. The senior administrative team at Lake Erie College is taking proactive steps to create and implement recruitment initiatives that attract students wanting to become physician assistants by creating a learning environment where students are challenged, respected and accountable. Over a decade ago, Tinto (1999) suggested that student recruitment and retention should be at the core of all campus activities. He further suggested that the conditions necessary for retention include

“expectation, advice, support, involvement and learning” (p. 2). This remains true today.

Considering these “requirements” for success, ultimately student recruitment and retention is the responsibility of every one associated with the institution. Faculty, staff, administration, trustees,

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students and outside constituents all play a role in attracting and maintaining the desired student population. At Lake Erie, it is recognized that everyone must contribute to this effort. As the overall strategic operating plan is being developed for the PAS program, there is an element of institutional recruitment and retention that will become part of every employee and department performance evaluation. By doing so, the perception of creating a desirable educational setting becomes everyone’s responsibility, everyone’s reality.

Evaluation Methodology The institutional process for planning and assessment will guide the evaluation of the EM strategic goals for the PAS program. Lake Erie has developed tactical strategies to assist in designing effective strategic plans, institutionally as well as at the department level. To achieve the goal of incorporating strategic planning into the daily operations of every level of the institution, LEC is utilizing an integrated process that will collectively pursue the tactical strategies that support the overall strategic direction of the institution. The tactical strategies include:

TS One: Lake Erie College will utilize an integrated planning process that links budget, enrollment management, information technology, facilities and institutional development processes to strategic planning. This integrated planning process ensures that the strategic plan can be successfully implemented. The process includes:

 A matrix of planning processes that integrates the mission, the strategic plan, and departmental plans, ongoing evaluation and assessment.

 A planning calendar that coordinates the timing of all major planning activities.

 A clearly articulated statement of the scope and purpose of each level of planning, including its relationship to other planning activities.

 A clearly identified effectiveness criteria, a plan for evaluation and a mechanism for using evaluation results.

 The President’s Cabinet will be responsible to ensure the planning processes are adequately and effectively integrated.

TS Two: Lake Erie College will develop and apply institutional accountability measures to assess the results of strategic initiatives. These include:

 The College will use its list of peer institutions to establish accountability measures and benchmarks for performance in areas such as student retention and graduation rates, faculty work load and salaries, research funding, community outreach, instructional technology and review of academic programs.

 The College will utilize a plan for periodic review of all programs to include a description of the program mission and analysis of its relationship to the institutional mission; program costs; actual and projected student enrollments, retention and graduate rates over the past five years and employment of its graduates; quantity and quality of faculty in teaching, research and discipline-related public service; assessment of student attainment of program learning goals; and student and alumni satisfaction information using institutional survey instruments.

 The College will incorporate other review criteria as appropriate to ensure financial accountability including: beneficial collaborations and partnerships; process analysis to

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increase efficiency; and use of technology to enhance student learning, provide distance- learning opportunities or improve operations.

The Institutional Research Coordinator will provide support for institutional research, data collection and data analysis through coordination of information for the President’s Cabinet. The President will report back to the campus each September the highlights of the annual report.

C. PROPOSED CURRICULUM

Curriculum requirements: Physician Assistants are expected to be educated in the basic sciences, patient assessment, and clinical medicine in order to provide a broad range of primary health care services to patients under the supervision of a licensed doctor of allopathic or osteopathic medicine. Services performed by Physician Assistants include history and physical assessment, development and implementation of appropriate therapeutic interventions, and patient education and counseling. In order to enable Physician Assistant students to acquire necessary technical capabilities, behavioral characteristics, and judgment to deliver competent care in a professional capacity, the innovative curriculum of the Physician Assistant program (Table 6) will be divided into two major parts: 15 months of classroom study and 12 months of clinical experience in internal medicine, family medicine,

psychiatry, emergency medicine, pediatrics, general surgery and women's health, public health, and an elective rotation. The curriculum will be delivered in a combination of flexible (i.e.,

compressed/intensive, online, mixed mode, laboratory, and on-campus) formats. The didactic curriculum will include course work in basic sciences, patient evaluation, behavioral medicine, laboratory and diagnostic medicine, pharmacology, physiology, clinical medicine, legal and ethical issues, research methods, health disparities, role of physician assistants in the health care delivery systems, health promotion and disease prevention, and medical nutrition therapy. The didactic curriculum will emphasize the interrelationships of various functions and organs of the body and the socioeconomic, psychological, and demographic factors impacting access, outcomes, and utilization of health services. During the clinical rotation phase of the program, students will have the opportunity to apply classroom material to the clinical setting. Students will learn interpersonal skills necessary to provide culturally competent health care to underserved populations.

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TABLE 6: Master of Physician Assistant Sample Curriculum (To be finalized upon hiring of Medical Director). Courses will have to be taken in sequence.

First Semester Course Title Credits

Intro to PA Profession 2

Gross Anatomy 8

Trends & Issues in Health Services 3 Legal & Ethical Issues in PA 2

Total First Semester Credits 15

Second Semester Course Title Credits

Clinical Physiology & Pathophysiology I 4 Clinical Medicine for PA I – Internal 8 Pharmacology for Physician Assistant I 2 Clinical Laboratory & Diagnostic Medicine 3

Total Second Semester Credits 17

Third Semester Course Title Credits

Clinical Physiology & Pathophysiology II 4 Pharmacology for Physician Assistant II 2 Patient Evaluation I 3 Medical Genetics & Embryology 1 Clinical Medicine for Physician Assistant II- 6 Pediatric, gynecology, Obstetrics, Geriatric & Dermatology

Total Third Semester Credits 16

Fourth Semester Course Title Credits

Clinical Medicine for Physician Assistant II - 6 Surgery and Emergency Medicine

Medical Nutrition Therapy 3 Behavioral Medicine 2 Health Promotion & Disease Prevention 2 Pharmacology for Physician Assistants III 2 Patient Evaluation II 3

Total Fourth Semester Credits 18

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Fifth Semester Course Title Credits

Clinical Rotation 4

Clinical Rotation 4

Clinical Rotation 4

Evidence-Based Critical Inquiry I 3 Seminar in Physician Assistant

Clinical Practice I 1 Total Fifth Semester Credits 16

Sixth Semester Course Title Credits

Clinical Rotation 4

Clinical Rotation 4

Clinical Rotation 4

Seminar in Physician Assistant

Clinical Practice II 1

Total Sixth Semester Credits 13

Seventh Semester Course Title Credits

Clinical Rotation 4 Clinical Rotation – Public Health 2 Clinical Rotation – Elective 2 Concepts in Leadership in Management

In PA 2 Total Seventh Semester Credits 10

Program Faculty and Administrators Current faculty and administrators

While the PAS program is in the development stage, LEC will commit a portion of time of the VP for Academic Affairs and the Associate Dean of Arts and Science. Other expertise from within the institution, as well as with any existing partner organizations, will be utilized as needed. The accreditation process with the Ohio Board of Regents, the Higher Learning Commission and the Accreditation Review Commission on the Education of Physician Assistants are among the initial priorities for this group, along with development of detailed curriculum.

New faculty positions required

Three new full-time faculty members, a program director, a clinical coordinator, and a medical director, will be hired to deliver the curriculum and administer this program during the first year. Additional faculty will be hired in Years 2, 3, and 4 as needed. At full capacity, the program will have a total of 6 faculty members (which includes the clinical coordinator and the medical director). Faculty at the

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College with expertise and appropriate credentials will be hired to teach selected courses and to serve as guest lecturers. Practicing physicians and physician assistants in the community will also be invited to teach specialized courses and to serve as guest speakers and mentors.

Needed Learning Resources

Library holdings: Students enrolled in the proposed degree program will have access to library holdings at Lake Erie College. The College is prepared to increase its holdings to include the necessary

publications, as well as medical and research journals appropriate for the PAS program. Provisions will be made to acquire necessary equipment and space for teaching, research and laboratory activities. Lake Erie College will look to develop collaborative agreements with other higher education institutions and medical organizations in the region that have resources which will enhance the delivery of the LEC- PAS program.

Instructional, clinical, and research space: Exhibit B illustrates the floor plan of the recently renovated, state of the art, Austin Hall of Science which provides facilities for programs within the Center for Environmental, Health and Life Sciences. However based on information gathered from other PA programs throughout the United States, it is estimated that a minimum of 10,000 square feet will be needed for faculty offices, conference room, classrooms, computer lab, clinical observation laboratories and physical examination rooms. More specifically it is estimated that the program will require three dedicated classrooms, one multi-purpose skills laboratory, five (5) examination rooms and 7 faculty and staff offices. Lake Erie College will look to institutional partners for collaboration on additional space utilization and availability.

Student Assistance: Lake Erie College would like to establish a scholarship fund (funded from outside the operating budget) that would provide a Diversity Scholars Fellowship award of up to $10,000 per year that would be given to up to five (5) incoming students in Year 2. The Scholars Fellowship is designed to attract academically talented students from underrepresented backgrounds pursuing a PAS degree in the Center for Health, Environmental and Life Sciences. To be eligible, students will be required to meet all program admissions requirements at the time of application, be full time students as defined by the program and be of good academic standing throughout the program. Students will be required to submit an essay describing the particular aspect of diversity they bring to the program and the profession. It is anticipated that this type of scholarship program will enhance the quality of student that is drawn to LEC and will provide the health care community, specifically University Hospitals, with outstanding employees upon completion of the PAS program.

Audiovisual equipment: It is estimated that approximately $40,000 will be needed to retrofit and equip each of the three classrooms with appropriate audiovisual resources with an additional $7500 annually for maintenance and upgrade. The classroom will have a dedicated personal computer, laptop

connection, interactive pen display and a document camera.

Simulation Center Given that Lake Erie College does not currently have a training facility equipped to offer multidisciplinary training to health-care professionals and other medical personnel, students and residents, a feasibility study will need to be conducted to determine to what extent opportunities exist to partner with a health-care institution that currently has such a facility. If appropriate facilities cannot be secured through an operational agreement, Lake Erie College will need to embark on a capital

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campaign to raise adequate finances to build a simulation center on the main campus or at other locations owned by the college.

Budget Projections

Utilizing the projected enrollment numbers as shown on page 8, and based on a projected program cost of $70,000, the following shows the projected revenues and expenses for the period 2011-2012 through 2017-2018. The tuition and fee revenue assumes an “all inclusive” price with the exception of medical malpractice insurance which will be secured by the college and billed to the student on an annual basis. The program would be responsible for providing books, laptops, pda, labcoats/equipment, etc.

Table 7: Projected Budget

2011-2012 2012-2013 2013-2014 2014-2015 2015-2016 2016-2017 2017-2018

Tuition 0 0 207,407 1,182,222 1,980,741 2,478,519 2,800,000

Salary

Admin 25,000 111,610 240,990 324,585 324,585 324,585 324,585

Didactic 129,375 165,610 165,610 165,610 165,610 165,610

Clinical 250,880 84,040 168,075 168,075 168,075 168,075

Total Salary 25,000 491,865 490,640 658,270 658,270 658,270 658,270

Benefits 0 122,965 122,660 164,568 164,568 164,568 164,568

Total S & B 25,000 614,830 613,300 822,838 822,838 822,838 822,838

Operating Ex 250,000 100,000 176,920 350,000 500,000 525,000 525,000

Total Direct Ex 275,000 714,830 790,220 1,172,838 1,322,838 1,347,838 1,347,838 Net Surplus (275,000) (714,830) (582,813) 9,385 657,904 1,130,682 1,452,163

Program Implementation and Evaluation

Program Implementation It is anticipated that the first class of students will be admitted in Fall 2013. To meet this deadline, the activities outlined in Table 8 will be implemented in stages.

Program Evaluation The physician assistant program will be responsible and accountable for the formative and summative assessment of educational outcomes and for developing and implementing a process for continuous improvement in all aspects of the program. Exhibit C illustrates the components of the program assessment plan in the areas of mission/policies/procedures, student learning outcomes, and retention/graduation/employment. In each case, results will be noted and corrective action taken to continuously improve the program and its outcomes. Each of the goals listed has been identified as critical to the mission and success of the program. While attainment of most of these goals can be determined while students are still enrolled, some goals are best assessed by determining what students do after graduation, such as pass certification examination, enroll in doctoral degree program, secure employment, etc. These goals are best assessed through graduate surveys.

Many of the goals will be assessed annually, especially those related to policies and procedures and availability of necessary resources. Other more complex goals may best be assessed in a review format such as a five year review that would include reviewers both internal and external to the campus.

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TABLE 8: Program Implementation Timeline

SCHEDULE OF KEY EVENTS

LAKE ERIE COLLEGE PHYSICIAN ASSISTANT STUDIES PROGRAM IMPLEMENTATION PLAN

Fiscal Year

Academic Term

Fall Spring Summer Break

2010- 2011

Complete internal feasibility study.

Plan organizational structure. Plan & execute external relationships.

Initiate plans for location. Plan preliminary budgets for next 5 years.

Secure position on ARC-PA site visit schedule.

Establish advisory committee.

Finalize outside healthcare institutional relationship. Determine approval process & timeline with OBOR to offer degrees. Initiate conversations with HLC and ARC-PA regarding accreditation. Begin detailed curriculum outline. Finalize plans for permanent facilities. 2011-

2012

Finalize curriculum. Submit proposal to EPP for Faculty approval.

Secure funds & financial commitment from Board of Trustees.

Submit proposal to OBOR for Chancellor’s approval. Begin ARC-PA self-study report.

Launch preliminary marketing campaign.

Obtain final approval from OBOR. Submit proposal to HLC for approval to offer PA Masters’ degree.

Finalize enrollment mgt and recruitment plan. *

Finalize course syllabi including key assessments.

Launch enrollment campaign. Provide update to ARC-PA. Identify & appoint Program Director, Medical Director and Clinical Coordinator.

Begin process for hiring initial faculty. Launch website page w/ detail information.

Publish on-line catalog. Follow-up with HLC regarding approvals and site visit. Develop student handbook. Choose textbooks/on-line resources.

2012- 2013

Obtain final approval from HLC.

Complete ARC-PA self study report and submit for review. Complete process for hiring faculty.

Final review of curriculum & facilities requirements.

ARC-PA Site visit for provisional accreditation, April 11 & 12.

Provide response to ARC-PA visit and prepare for entering 1st cohort of 20 students.

2013- 2014

Obtain provisional accreditation from ARC-PA. Accept initial cohort of students.

Classes begin for 1st cohort of students.

Prepare follow-up reports for OBOR, HLC and ARC-PA.

2014- 2015

Begin process for hiring clinical faculty.

Enter 2nd cohort of students.

Classes begin for 2nd cohort of 27 students.

Annual program review and report.

*NOTE: Includes development of all marketing materials.

Figure

Updating...

References

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