To NCCPA From AMC PA Students

To: NCCPA AAPA

Re: NCCPA proposed testing changes

From: David Wallstrom, PA-S MPAS 2017

Albany Medical College 2015-16 AOR Representative

 

Thank you for providing this opportunity to express our concerns regarding the new proposed changes to the NCCPA certification testing process. The following comments and observations represent my observations, the collected opinions of PA students here at Albany Medical Center, as well as outcomes from conversations with faculty and preceptors. All references to NCCPA table information are from the Re-examining Recertification whitepaper released by the NCCPA in December 2015.

 

  • Generally, the proofs offered by the NCCPA Whitepaper for the changes do not stand up to a cursory exam. The graph representing certification scores overtime (using the 6-year cycle data) has been adjusted to show statistical significance where it is not clear any actually exists. The Y-axis starts at 80%, greatly exaggerating the difference between PA cohorts. By starting the Y-axis at zero, the difference appears minimal with all cohorts achieving passing scores. The X-axis uses non-linear data, leaving out the second, fourth, and fifth testing cycles. We assume these adjustments are to present the data showing a significant decline in test scores overtime. This is just that, an assumption as the data was not made available with the white paper. Several of our students and faculty have commented that these are the tactics they associate with authors trying to show effect when none actually exists. As a group, we find this manipulation of data dishonest at best. It puts into question all other arguments and conclusions that the NCCPA makes for the rest of their argument, regardless of its potential validity.
  • The methods used to differentiate specialist from generalist for the data are biased towards specialist with PA respondents having to pick one field, even if they currently work in multiple. The writers also give no credit to PAs with experience in multiple fields, which in our opinion is part of the definition of generalist. The writers also equate family practice with generalist, when in reality family practitioner is just one of many specialty fields practiced by PAs. This approach artificially creates a greater division in PA practice fields.
  • As students, we entered school with the understanding that the PA profession embraces the generalist model. For myself, as an RN, if I had wanted to be a specialist I would have chosen the NP curriculum, it would have been much easier and faster. To move away from this generalist model is distressing to most of the students here at AMC, even those wishing to “specialize”.
  • As noted above, PAs are recognized as generalists. All of the work that constituent groups have invested in improving the legal support for the profession at the state level is based on this. We are concerned with the backlash from state houses if the profession moves away from the legislatively accepted model.
  • The PANRE just changed the testing cycle 2 years ago. Why change again so soon without any new data or changes?
  • Again, even though NCCPA states this will not happen, once specialty certification is offered we feel employers will have to begin requiring it for legal purposes. This will greatly reduce the mobility of PAs in the job market. As students, we are also concerned that it will change how employers regard applications from new graduates. If specialty certification is required, certain jobs may be out of range for new PAs. Also, as more specialty training is required, employers will expect new hires to be competent on arrival instead of understanding that new graduate PAs will need a period of training and orientation to their chosen roles.
  • Liability for those practicing without specialty testing will increase for both providers and agencies/employers.
  • The mobility and generalist nature of the PA model is one of its attractive features. Removing this aspect will reduce appeal both for prospective students and hiring firms.
  • The comments on preparation and testing cost appear, to current students, to be distractors. Of course you have to prepare for a test and review your knowledge base. That is the point of recertification. The cost appears minimal compared with the rewards of practice.
  • The NCCPA’s mission is to provide certification of competence testing for Physician Assistants. The profession has determined this to be competence of a generalist nature. We do not believe it is within the NCCPA’s scope or mission to change the definition of PA-C by encouraging specialization and minimizing generalist knowledge. If this change is truly desired, the discussion should be taking place in constituent organizations and the AAPA as a whole, not at the Certification Agency level.

While some recognition for specialty skills is understandable, a well prepared CV can usually address that need. This recognition does not negate the need to certify and re-certify PAs as generalists. The model the law, public, and profession have indicated is the current practice model preference.

The methods used by the NCCPA, as stated in the first bullet, detract greatly from their already weak argument. While I cannot speak for all of AMCs PA students, the general consensus is that this is a bad idea and will have detrimental effects to the profession and to providers. We do not support the change.

 

Thank you for considering our comments,

 

David Wallstrom PA-S MPAS 2017

Albany Medical College

SAAPA Assembly of Representatives delegate 2015-2016

 

Ananda Brinkman PA-S AMC/MPAS 2017

Shanna Tucker PA-S AMC/MPAS 2017

Melissa Foster PA-S AMC/MPAS 2017

Michelle McElroy PA-S AMC/MPAS 2017

Ryan Romano PA-S AMC/MPAS 2017

Danielle Dolhenty PA-S AMC/MPAS 2017

Caroline Rhodes PA-S AMC/MPAS 2017

Elisabeth Henderson PA-S AMC/MPAS 2017

Elisabeth Penree PA-S AMC/MPAS 2017

Michael Mueller PA-S AMC/MPAS 2017

Mark Yarbrough PA-S AMC/MPAS 2017