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Our study material — which meets our exacting standards and your expectations — has been reviewed by clinicians and PAs. Pain management is evolving, and medical professionals need to be aware of current guidelines and clinical best practices. Pain Management and Opioids can help you earn your state mandated CME while increasing your knowledge of:. The adaptive learning features make it easy for you to focus your time studying exactly where you need the most review. PAs have many choices in the field of medicine. As you progress in your career, you may decide to specialize.

If you focus on a specific discipline, specialty, or treatment modality, how do you retain the important general knowledge you received in your training? Maintaining that base of knowledge provides you with the skills and flexibility for a long and rewarding career as a PA. Read more about features and benefits.


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The Massachusetts Medical Society is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Articles selected for review were limited to clinically practicing PAs, and they described original research related to work-life experiences in the United States. After excluding duplicates, 20 relevant research articles, including 13 not assessed in the review, were identified. To ensure that all relevant articles were detected, the reference lists of the initial 20 selected articles were reviewed, and with the support of the health sciences librarian, five additional searches were constructed in PubMed using combinations of terms designed to identify articles that may have been missed, e.

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After the initial searches were conducted, one additional relevant article published in September was identified. The search yielded 37 articles. Among all studies described in the articles, 10 focused on primary care settings, two on emergency medicine, and two on hospice and palliative care. Other specialties studied included oncology, radiology, orthopedics, and cardiovascular surgery. The majority of research was descriptive in nature; however, three articles on primary care clinicians including physicians, Pas, and NPs assessed interventions for burnout or job satisfaction.

One examined the impact of practice transition to a patient-centered medical home PCMH [33]. The aspects of work-life experience that were examined varied considerably across the various articles. Across those 18 articles, a variety of instruments were used to measure work-life experience. Twelve of these 18 articles that assessed burnout used a version of the Maslach Burnout Inventory MBI , making it the most commonly used measurement instrument. The literature focused on PA burnout is primarily limited to rural and specialty settings.


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  • However, one national survey that assessed work-life experiences—including burnout, happiness, and work-related stress—consisted of responses from 7, PAs from multiple specialties and locations [34]. Results of this national survey revealed that Compared to male PAs, a higher percentage of female PAs had quit a job due to stress Overall, more than 75 percent of PAs surveyed reported feeling happy at work [34]. In a study of rural PAs, Benson and colleagues found that 64 percent of PAs experienced moderate to high levels of both EE and DP, as measured by MBI subscores; 46 percent reported low to moderate scores for personal accomplishment [10].

    28th Annual Emory Certification/Recertification Board Review Conference for Physician Assistants

    Those who reported symptoms of burnout were more likely to report planning to leave emergency medicine within one year. Respondents who self-identified as female were more likely to report symptoms of burnout. Reports of symptoms of burnout were also positively associated with reports of dissatisfaction with supervising physicians SPs , insomnia, and regular alcohol and tobacco use [35].

    Research on PAs in oncology revealed that 35 percent experienced at least one symptom of burnout as measured by the MBI. Positively associated factors included not feeling valued by their SPs, not feeling encouraged professionally, and not receiving recognition for their contributions [36].

    Physician Assistant Review

    Despite the prevalence of burnout, however, most oncology PAs reported very high levels of job and career satisfaction 89 percent and 86 percent respectively [36]. Kamal et al. Kavalieratos et al. Both articles noted the positive influence of team-based, collaborative relationships on professional attitudes and perspectives [37,38]. Clinicians in the military serve in unique and stressful environments and experience higher rates of burnout than civilian providers [11,40].

    Walters, Matthews, and Dailey found a positive correlation between self-reported measures of EE and DP and accrued leave days e. Varner and Foutch found medium to high levels of burnout among air force family medicine clinicians 59 percent EE, 34 percent DP , while 95 percent reported medium to high levels of professional satisfaction. Interestingly, older age being over 44 years was associated with lower burnout levels [11]. Whitebird et al. Burnout positively correlated with number of years in practice and negatively correlated with career satisfaction and comfort in managing complex medical conditions.

    Overcoming Failure and Passing the Boards

    PAs and NPs experienced higher rates of career satisfaction 95 percent compared to physicians 82 percent. In addition, lower career satisfaction was associated with insufficient resources for managing patients with complex clinical conditions [12]. Using cross-sectional data from the Practitioner Resilience, Adaptability and Wellbeing Study [41], Waddimba and colleagues evaluated burnout among rural clinicians in an integrated health care system in New York. Similar to Whitebird et al. Risk factors for burnout included employment in smaller clinics, lower tolerance of stress, more frequent dissatisfaction with practice, and unmet relationship needs [41].

    Linzer and colleagues also used the PWS to evaluate clinician burnout in primary care settings. In their study, involving various interventions designed to improve work conditions, burnout was more likely to improve with workflow and quality improvement interventions, whereas clinician satisfaction was more likely to improve with communication interventions [42]. In a study of clinician burnout pre- and post-implementation of PCMHs in clinics at a large, nonprofit integrated health system, Reid et al.

    The authors felt this finding may be attributable to more supportive and collaborative work environments in PCMHs. Meredith et al. Factors associated with lower EE included higher efficacy for change and engaging in participatory decision making. Although men were slightly more satisfied with their careers and specialty choices than women, women were more likely to refer others to the PA profession [45].

    Overcoming Failure and Passing the Boards

    Helping others and teamwork were among the factors that PAs felt contributed to their satisfaction, whereas general misunderstanding of the PA role role ambiguity resulted in dissatisfaction. Small studies of PAs in rural settings support these findings. Of note, 93 percent felt they were doing important work in their practice, and less than a third reported that work encroached on personal time [48].

    Henry and Hooker conducted an in-depth qualitative analysis of eight PAs working in rural clinics in Texas to assess factors associated with retention in remote areas [49]. They found that retention considered a proxy for satisfaction was closely linked to confidence in clinical abilities and community embeddedness [49]. In studies that compared PAs to other clinicians, PAs generally reported more favorable attitudes toward their profession. Like Whitebird et al. More Details Original Title.

    General CME - NCCPA

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