Why develop a PA admissions exam?

Jun 13, 2018 | Our Activities

Exam Master is sponsoring a multi-year research project exploring whether an admissions exam tailored to the PA profession can be predictive of PA student success in the PA curriculum and on the PANCE.  Last month we started piloting early versions of this exam with participating PA programs. More programs will be getting involved over the coming months. We welcome their participation (and yours!) as we seek to have as diverse a sampling of programs and students as possible.
Most PA educators we have spoken with tell us they see significant value in having an admissions exam to help them make informed decisions about who to admit into their demanding programs.  Most also tell us that relying on criteria such as GRE scores and prior GPA is not sufficiently predictive of student success. The GRE is not specific to the health professions. GPA comparisons are made difficult by grade inflation and the high degree of variability in the quality and content coverage of the pre-requisite courses students have taken prior to entering the PA program. PA educators tell us that use of an admissions exam would add consistency to the admissions process and help them have an evidence-based tool for use as part of a holistic or comprehensive admissions protocol.

However, the value of having a standardized exam for use as a PA admissions tool is not uniformly supported by everyone in the profession.  We certainly respect differences of opinion, and frank discussions on the value of a PA admissions exam are important and necessary to ensure that we serve the needs of the PA community at large and not just some narrow constituency.  To this end, we’d like to address some of the questions, concerns, and ideas that have bubbled up from our many conversations and good exchanges with folks tasked with admitting and successfully preparing future, high-quality Physician Assistants.


The Importance of Academic Preparedness


PA students must acquire and learn to apply a vast quantity of knowledge and information in a comparatively short curriculum, averaging just over two years.  Programs must have a high degree of certainty that those they admit can handle the course-load as they seek to minimize student attrition at all cost. PA programs, with often small teaching staffs, are not always well-equipped to handle students who fall behind.  Often there is little slack in the curriculum for this type of support or remediation. As PA programs have moved to a graduate-level educational model, an admissions exam is needed to ensure that, at a minimum, incoming students are at low-risk for falling behind or failing academically.  With hundreds of applications per PA program, having a tool to better discern student differences is paramount.


Impact of a PA Admissions Exam on Underrepresented Minorities


Students from all backgrounds and experiences must be able to successfully get through the didactic and clinical phases of their training, and they absolutely must pass the PANCE to be licensed PAs.  The concept of an admissions exam is not intended to disrupt or eliminate minority students.  A PA admissions exam can serve to help programs improve their diversity by helping them admit candidates who may not appear as strong by common metrics such as GPA or science-GPA or a list of their pre-requisite courses, but who otherwise demonstrate academic preparedness through their scores on an objective admissions exam.  Furthermore, for otherwise qualified candidates, a PA admissions exam that provides detailed outcomes can help mission-based programs identify those areas where these students may need some additional support either before or during early phases of the curriculum.


What Subjects Should Be Covered on an Admissions Exam?


We sometimes hear that given the seemingly wide variety of pre-requisite subjects required or recommended by PA programs for admission that a standardized exam would not be practical or focused enough for use by the majority of PA programs.  Our research and our many conversations with PA educators tell us that there is a common core of subjects typically required for admissions by a majority of PA programs, particularly now that these programs have adopted a graduate-education curricular model.  The pilot PA admissions exam is focused on assessing these core subjects including anatomy, physiology, biology, and chemistry. Moreover, a goal of our research is to help identify which pre-requisite subjects seem most predictive of subsequent student performance.


Measuring Soft-Skills and Non-Cognitive Traits


PA educators also tell us that just as important to them as the discernment of applicant academic preparedness and cognitive ability is the identification of those traits that also inform whether a person is likely to succeed in the PA curriculum and as a practicing PA.  These include empathy, professionalism, grit and determination, and other attributes which make up the whole applicant. While we will be exploring whether an admissions exam can include assessment of these “soft skills”, our initial focus is to develop a predictive, cognitive assessment that would be used as one important tool in the admissions process.  Programs need a baseline assessment of what applicants know and don’t know.

Many or most PA programs interview their leading candidates, a process that can be used for identifying these important non-academic characteristics.  Our belief is that an admissions exam might help serve this important task by helping programs better identify those applicants who have the minimum academic qualifications so that interviews can be properly targeted to the best candidates overall.


Looking Ahead


A PA admissions exam is intended to be a “real-time” measure of cognitive ability that goes beyond GPAs as indicative of what applicants truly know, particularly since GPAs can vary vastly depending on what institution the applicant attended and who their instructors were, knowledge and retention that may also vary depending on when the applicant completed their pre-requisite courses.  It is specifically designed to measure knowledge in the most common pre-requisite science subjects required or recommended by the majority of PA programs.

As with the GRE or MCAT, Exam Master nor our research team would ever recommend that a PA Admissions exam be used in isolation to make admissions decisions.  It is not intended to take the place of interviews and will not and probably cannot be the primary measure the of the “soft” or “noncognitive skills” that many programs value as equally as they do the cognitive skills.  One approach that has been suggested to us in the context of use of a standardized exam is that those programs particularly concerned with improving the diversity of their incoming cohorts use the PA admissions exam to identify students who may lack the opportunities to gain the pre-requisite cognitive knowledge from traditional settings.  This insight can be used to provide targeted “pre-entry” PA training preparation in the basic sciences for those students and grant them “conditional admission”. While this may not work for all PA programs, we see value in this approach and examples of this type of intervention in other health professions. We are working with a college of pharmacy on this type of program and we would welcome an opportunity to partner with PA programs interested in doing this early intervention to improve the diversity and preparedness of their incoming cohorts.

For more information or to get involved with our PA admissions research project, please drop us a note and we’ll set up a call.  We look forward to speaking with you.