Rural Versus Suburban/Urban experiences in a family medicine preceptorship

Purpose: Accreditation standards require physician assistant (PA) programs to ensure students receive adequate clinical experiences. During their clinical year of training, PA students complete rotations with multiple clinical preceptors, introducing them to practice and exposing them to a variety of clinical problems. In this article, we examined Typhon Physician Assistant Student Tracking (PAST) system patient encounter logs' value for program evaluation, but also in research to address questions relevant to PA education. Specifically, we explored the MEDEX Northwest Physician Assistant Training Program student experience across rural versus suburban/urban placements in a 4-month family medicine preceptorship. Methods: Student experience was analyzed from 2 years of collected Typhon PAST encounter data. Encounter characteristics included duration, number of clinical problems, student level of responsibility, and decision type. Patient characteristics included sex, age, race, and clinical problems recorded as ICD-9 codes. Results: Individual student experience varied widely across different preceptors. However, these differences were more specific to the preceptor-student relationship than to whether the site was classified as rural or suburban/urban. Across these settings, significant differences were only noted for percentage of female and 65 or older patient encounters. The most common clinical problems reported across rural versus suburban/urban sites were highly correlated. Conclusions: Physician Assistant Student Tracking data demonstrated that individual student experience in their family medicine rotation varied widely. However, in general, rural and suburban/urban experiences were more similar than different. This study supports the value of the Typhon PAST logging system for not only tracking student activity but also addressing program evaluation and research questions.