Thanks for joining me as we continue examining our updated list of the most commonly cited ARC-PA Standards. The list includes four B-Standards, three of which I reviewed in my previous series on common citations and a newcomer. Let’s examine what issues have remained problematic and what has changed. We’ll begin today with B4.01 and B3.06. These two Standards relate to the two sides of student evaluation: the documented evaluations and the preceptors who sign off on them.

B4.01 Language

B4.01 states, “The program must conduct frequent, objective and documented evaluations of student performance in meeting the program’s learning outcomes and instructional objectives for both didactic and supervised clinical practice experience components. The evaluations must:

a) Align with what is expected and taught and

b) Allow the program to identify and address any student deficiencies in a timely manner.

An example finding is, “The evaluation of student performance in meeting the program’s learning outcomes and instructional objectives for supervised clinical practice experience (SCPE) components did not align with what was expected and taught.” 

An example observation stated, “In the application, the program stated that it uses a single preceptor evaluation for all rotations, which was not SCPE specific. The preceptor evaluation form (Student Competencies Assessment) contained assessment items that did not align with learning outcomes and instructional objectives contained in the SCPE syllabi. The preceptor evaluation does not allow evaluation for age groups or acuity of care and did not address clinical and technical skills.”

Alignment and measurability are paramount! If you have a learning outcome that cannot be measured in some direct fashion, especially for SCPEs, it will be an observation or a citation. Each outcome must be evaluated, and then you have to crosswalk everything.

For programs approaching their first validation visit, if you remember nothing else I’ve told you, remember this: You must have discipline-specific SCPE evaluations, preceptor evaluations, learning outcomes, and IOs for every rotation. 

B4.01: Caveats for Success: 

• SCPE learning outcomes and preceptor evaluations must perfectly align.

• Avoid complex learning outcomes and instructional objectives. When learning outcomes have lifespan or settings, ensure there are commensurate evaluation categories on the preceptor evaluation.

• Ensure that learning outcomes and instructional objectives are measurable and aligned with precise assessment modalities. Consider a crosswalk chart, showing how each element is measured.

• For more information, see my blogs published March 27 and April 10, 2024).

B3.06 Language

Standard B3.06 states that “Supervised clinical practice experiences should occur with: a) physicians who are specialty board certified in their area of instruction, b) NCCPA-certified PAs, or c) otherwise licensed health care providers qualified in their area of instruction.”

I hope that the 6th Edition Standards will help with this process, but there continue to be some problematic issues. Let’s look at some of the language we see in the findings and comments:

“The program did not provide evidence that all supervised clinical practice experiences (SCPEs) occur with licensed healthcare providers qualified in their area of instruction.”

“Review of the preceptor certification list and preceptor files provided at the time of the site visit did not include evidence that all active social work preceptors were qualified in the area of instruction.”

B3:06: Caveats for Success

• Failing to have evidence of your preceptors’ board certification is a deal-breaker; it automatically results in a citation. For those preparing for your visit, this is the most critical thing for initial provisional or any program because you must have all that vetting information in place. 

• Consider whether inactive preceptors should be included with your application, especially if they are not board-certified.

• Programs with blended experiences, such as board-certified family medicine providers for pediatrics, are vulnerable. Be really careful about this; it is not seen as equivalent, and it will result in citations here and under other standards, too. 

• Using even long-standing, excellent preceptors who are not board-certified will automatically result in a citation. Transfer the preceptor of record to a PA in the practice whenever possible.

• For more information, see my blogs published on November 27 and December 4 and 11, 2024.

Coming up…

In next week’s blog, I’ll discuss the two remaining B-Standards on the top ten list of citations: B1.03e and B3.03c. Why have these Standards had a sudden surge in frequency? Join me then to learn more.