Thank you for joining us once again! In our previous two newsletters, we have discussed the benefits of hybrid learning (a combination of online and classroom learning) to PA education of the future. Today, I present the components of design for just such a PA program.

Curricular Design 

The overall approach to the didactic instruction in each course is to integrate asynchronous and synchronous online didactic courses as primary methodology, with focused, in-person “immersion” laboratory experiences associated with each didactic course. 

The didactic content is presented asynchronously, like an in-class lecture, but using interactive state-of-the-art online educational activities (including virtual patients, high-definition recording and submission of student skills, and telemedicine-style encounters with standardized patient actors) to promote knowledge acquisition. Following the assignment and completion of these asynchronous activities, synchronous online activities led by course instructors provide opportunities for application and synthesis. 

Additionally, the immersion experiences are used for further practice of skills and application of knowledge, as well as opportunities for faculty to assess competence in-person. This mix of methods allows students to acquire and demonstrate competence in the required knowledge, skills, and abilities for PA clinical practice. 

Asynchronous Online Activities 

In general, didactic content is presented asynchronously in a manner like a traditional in-class lecture by providing foundational information and explanations of concepts. Required reading and other preparation exercises can be assigned, and these activities may maintain a level of interactivity through such mechanisms as “knowledge check” quiz questions built into recorded lectures (with rationales added by faculty to reinforce and redirect based on response) or brief application exercises. Using a learning management system as the main repository of and communication method for these activities is recommended.  

Synchronous Online Activities 

In most cases, synchronous sessions are led by a course instructor as an opportunity to clarify or answer questions on the asynchronous material and exercises that allow learners to synthesize and apply new knowledge or skills. Activities that may be used during these collaborative sessions include group work, peer-to-peer tutoring and feedback, and other active learning methods. Additionally, synchronous sessions allow instructors to demonstrate skills and provide feedback in real time. 

Immersion Experiences  

In-person immersion experiences on campus provide opportunities for students to practice and demonstrate competence in the key skills necessary for PA practice. Planning includes three immersion experiences to occur at the end of the first term, at the end of the didactic year, and at the end of the clinical year (as part of the summative evaluation). 

Each immersion experience, especially those before clinical year, includes hands-on laboratory instruction, supervised open lab experiences for practicing skills, and assessments of competence. The immersion experiences serve as an “all hands on-deck” event, with all faculty and staff expected to be present for the experience as an opportunity to connect with students and to provide in-person support to the greatest extent possible. 

Additionally, the campus footprint for the immersion experiences is primarily focused on existing space already dedicated to the residential PA program for each institution. Specifically, this includes the large classroom and clinical skills lab spaces with capacities of 60 students each, as well as 10 breakout mock clinical rooms, study lounge, and kitchen lounge. Availability of these spaces for hybrid program students can be coordinated with the leadership of the residential program.  

The clinical education component of a PA studies hybrid program consists of the same clinical education experiences as those included in the residential program, in compliance with the accreditation standards. Each supervised clinical practice experience is a credit-bearing course that occurs over five weeks of full-time clinical experiences and the courses are spread evenly across three consecutive terms. Clinical education is guided by the competencies of the program. 

Assessment 

The successful completion of the program and the progress of each student is guided by the program’s main outcomes, termed competencies. This list of the key knowledge, skills, and behaviors determined by the faculty to be necessary for entry into professional, clinical practice is program-specific and informs the curriculum and all its courses, assessments, and instruction. Student progress is assessed using a mix of the following methods: 

Objective examinations are used to assess knowledge in all phases of the curriculum.  

Quizzes are utilized throughout the didactic courses to assess knowledge based on assigned readings and other asynchronous content, with quiz results identifying areas of strength or in need of further discussion at the following synchronous session.   

Competency assessments are critical to assessing the psychomotor and clinical decision-making skills that are developed in the clinical science courses related to the evaluation and treatment of patients. These assessments primarily occur during the immersion experiences.  

Conclusion

Obviously in a newsletter we are limited by space, and there are several aspects of a hybrid curriculum that were not addressed here. Nevertheless, I hope this gives you some ideas and points for discussion regarding the benefits of hybrid PA education going forward. In our next newsletter, we will expand our discussion of coming PA trends to the question of entry-level degrees as well as changes in the nature of assessment.