Graduate Competencies

Physician Assistant Core Domains and Competencies for New Graduates

The domains, competencies, descriptions, and skills presented below are taken directly from the PAEA document entitled “Core Competencies for New Physician Assistant Graduates.”  The Radford University PA Program has adopted these competencies as measures of student success at the time of graduation.

Definitions

Competency: A specific skill, knowledge, or ability that is both observable and measurable.

Competency framework: An organized and structured representation of a set of interrelated and purposeful competencies.

Domains of competence: Broad distinguishable areas of competence that, in the aggregate, constitute a general descriptive framework for a profession.

New graduate: An individual who has graduated from a PA program and is entering clinical practice as a PA for the first time.

 

1. Patient-Centered Practice Knowledge

Outcome (Domain Description)
Graduates will be able to recognize healthy versus ill patients in the context of the patients’ lives and determine the stage of illness — acute, at risk of illness (emerging), or chronic. Graduates will demonstrate the ability to utilize up-to-date scientific evidence to inform clinical reasoning and clinical judgment (PCSR 1.5).

Competencies
1.1 Recognize normal and abnormal health states
1.2 Discern among acute, chronic, and emerging disease states
1.3 Elicit and understand the stories of individual patients and apply the context of their lives (including environmental influences, cultural norms, socioeconomic factors, and beliefs) when determining healthy versus ill patients
1.4 Develop meaningful, therapeutic relationships with patients and their families (PA Comp. PC, FMM)
1.5 Determine differential diagnosis, order interpret laboratory and imaging, perform necessary core duty procedures, diagnose, treat and manage illness
1.6 Partner with patients to address issues of ongoing signs, symptoms, or health concerns that remain over time without clear diagnosis despite evaluation and treatment (PA Comp. PC)

Essential Skills

  • Information gathering
  • History-taking
  • Physical examination
  • Discernment of important versus extraneous information
  • Prioritization of actions and clinical care decisions based on information available and the patient’s beliefs about their care

 

2. Society and Population Health

Outcome (Domain Description)
Graduates will be able to recognize and understand that the influences of the larger community may affect the health of patients and integrate knowledge of social determinants of health into care decisions.

Competencies
2.1 Recognize the cultural norms, needs, influences, and socioeconomic, environmental, and other population-level determinants affecting the health of the individual and community being served
2.2 Recognize the potential impacts of the community, biology, and genetics on patients and incorporate them into decisions of care
2.3 Demonstrate accountability and responsibility for removing barriers to health, such as health literacy
2.4 Understand the role of structural disparities in causing illness
2.5 Engage members of the health care team in the surveillance of community resources to sustain and improve health
2.6 Engage the health care team in determining the adequacy of individual and community resources
2.7 Reflect on personal and professional limitations in providing care
2.8 Elicit and hear the story of the individual and apply the context of the individual’s life (including environmental influences, culture, and disease) when determining healthy versus ill patients
2.9 Understand and apply the fundamental principles of epidemiology
2.10 Recognize the value of the work of monitoring and reporting for quality improvement
2.11 Use appropriate literature to make evidence-based decisions on patient care

Essential Skills

  • Patient advocacy
  • Shared decision making
  • Self-advocacy
  • Self-agency
  • Active community engagement
  • Resourcefulness
  • Relationship development
  • Self-awareness
  • Interpersonal skills including influence, empathy, and humility
  • Awareness of unconscious biases
  • Information gathering
  • Discernment of important versus extraneous information
  • Prioritization of action steps based on information available
  • Awareness of biases and attitudes towards others
  • Empathetic listening

 

3. Health Literacy and Communication

Outcome (Domain Description)
Graduates will be able to communicate with patients as partners who engage in shared decision-making and who communicate, interpret, and express themselves as individuals with unique personal, cultural, and social values.

Competencies
3.1 Establish meaningful therapeutic relationships with patients and families that allow for a deeper connection and create space for exploration of the patients’ needs and goals to deliver culturally competent care (PA Comp. PC, FMM)
3.2 Interpret information so that patients can understand and make meaning out of the information conveyed to them
3.3 Recognize the need for and governing mandates that ensure patients have access to unbiased, professional interpreters and appropriate resources when barriers to communication arise
3.4 Demonstrate insight and understanding about emotions and human responses to emotions that allow one to develop and manage interpersonal interactions (PCRS 4.7)
3.5 Communicate effectively with patients, families, and the public
3.6 Provide effective, equitable, understandable, and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy, and other communication needs (CLAS)
3.7 Organize and communicate information with patients, families, community members, and health team members in a form that is understandable, avoiding discipline-specific terminology when possible, and checking to ensure understanding (IPEC CC2)

Essential Skills

  • Self-awareness
  • Knowing when to consult
  • Awareness of unconscious biases
  • Interpersonal skills
  • Active listening
  • Patient education
  • Cultural competency
  • Health literacy
  • Trust-building
  • Emotional intelligence

 

4. Interprofessional Collaborative Practice and Leadership

Outcome (Domain Description)
Graduates will be able to recognize that the patient is at the center of all health care decisions and to partner with the patient to define the patient’s health care goals.

Competencies
4.1 Articulate one’s role and responsibilities to patients, families, communities, and other professionals (IPEC RR1)
4.2 Advocate for the focus of the health care team being on the needs of the patient
4.3 Assure patients that they are being heard
4.4 Ensure patients’ needs are the focus over self and others
4.5 Contribute to the creation, dissemination, application, and translation of new health care knowledge and practices (PCRS 2.6)
4.6 Recognize when referrals are needed and make them to the appropriate health care provider
4.7 Coordinate care
4.8 Develop relationships and effectively communicate with physicians, other health professionals, and health care teams (PA Comp. Comm)
4.9 Use the full scope of knowledge, skills, and abilities of available health professionals to provide care that is safe, timely, efficient, effective, and equitable (IPEC RR5)
4.10 Use unique and complementary abilities of all members of the team to optimize health and patient care (IPEC RR9)
4.11 Engage diverse professionals who complement one’s own professional expertise, as well as associated resources, to develop strategies to meet specific health and health care needs of patients and populations (IPEC RR3)
4.12 Describe how professionals in health and other fields can collaborate and integrate clinical care and public health interventions to optimize population health (IPEC RR10)

Essential Skills

  • Interpersonal skills including humility and beneficence
  • Self-awareness
  • Effective communication
  • Empathetic listening
  • Advocacy
  • Teamwork
  • Relationship building
  • Care planning

 

5. Professional and Legal Aspects of Health Care

Outcome (Domain Description)
Graduates will be able to practice medicine in a beneficent manner, recognizing and adhering to standards of care while attuned to advancing social justice.

Competencies
5.1 Articulate standard of care practice
5.2 Admit mistakes and errors
5.3 Participate in difficult conversations with patients and colleagues
5.4 Recognize one’s limits and establish healthy boundaries to support healthy partnerships
5.5 Demonstrate respect for the dignity and privacy of patients while maintaining confidentiality in the delivery of team-based care (IPEC VE2)
5.6 Demonstrate responsiveness to patient needs that supersedes self-interest (PCRS 5.2)
5.7 Demonstrate accountability to patients, society, and the profession (PCRS 5.4)
5.8 Exhibit an understanding of the regulatory environment

Essential Skills

  • Interpersonal skills including humility, compassion
  • Empathetic listening
  • Ethical decision-making
  • Integrity
  • Accountability
  • Humanism
  • Responsibility
  • Help-seeking behaviors
  • Self-advocacy

 

6. Health Care Finance and Systems

Outcome (Domain Description)
Graduates will be able to articulate the essential aspects of value-based health care and apply this understanding to the delivery of safe and quality care.

Competencies
6.1 Recognize financial implications to the provision of healthcare
6.2 Articulate individual providers’ value-add to the health care team in terms of cost
6.3 Appreciate the value of the collaborative physician/PA relationship
6.4 Understand different types of health systems, funding streams, and insurance, including the role of Medicare and Medicare as payors

Essential Skills

  • Systems thinking
  • Adaptability
  • Leadership
  • Stewardship of resources
  • Help-seeking behaviors
  • Reimbursement
  • Coding
  • Care coordination
  • Technology fluency
  • Patient and personal safety
  • Quality improvement
  • Evidence-based practice
  • Practice-based improvement