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"Public Knowledge and Beliefs Regarding Licensure and Certification of Physician Assistants"

National Commission on Certification of Physician Assistants

Contact: Andrzej Kozikowski, PhD, Director of Research, andrzejk@nccpa.net.

Poster Authors
Andrzej Kozikowski, PhD; Sheila Mauldin, MNM; Colette Jeffery, MA; Grady Barnhill, MEd; Greg Thomas, MPH, PA-C Emeritus; and Dawn Morton-Rias, EdD, PA-C. 

Abstract
Purpose:The National Commission on Certification of Physician Assistants (NCCPA) is dedicated to assuring the public that certified physician assistants (PAs) meet standards of clinical knowledge and skills. PAs need to pass a certification exam to become licensed, and to remain certified must earn continuing medical education credits as well as pass an assessment every ten years. All US states rely on NCCPA certification as one of the criteria for licensure or regulation of PAs. The objective of our study was to explore public knowledge and beliefs regarding licensure and certification of PAs and assess differences based on demographics.

Methods: After IRB approval, we conducted an online survey in late 2018 using quota sampling to approximate the proportions in demographics (N=1,388) of the U.S. population. The survey assessed whether the public knew that PAs must pass a national certifying exam as one requirement for obtaining an initial license to practice medicine and beliefs related to whether PAs are well educated in medicine and should be licensed by state medical boards, continually learn about new medical information, be assessed regularly on their medical knowledge, and be held to the same standards of care as physicians. A number of demographic/background variables were collected, including age, gender, race/ethnicity, education, urban-suburban-rural home setting, number of visits to provider in the last year, health status, and health insurance type. Chi-square tests for independence and post-hoc z-tests for column proportions were used with a Bonferroni correction to analyze the association between demographic/background variables and knowledge and beliefs.

Results: The majority (75.9%) correctly indicated "true" to the statement that PAs must pass a national certifying exam as one requirement for obtaining an initial license to practice medicine. Respondents 65+ compared to 18-34 (p=0.010; 80.2% vs. 70.8%), those with a bachelor’s degree or higher compared to less education (p<0.001; 81.5% vs. 73.0%) and those with private health insurance compared to none and Medicaid only (p<0.001; 82.2% vs. 69.3% vs. 65.9%) were more likely to answer correctly. Regarding beliefs, most indicated "strongly agree/agree" that PAs should: be licensed by state medical boards (87.6%), continually learn about new medical information (91.7%), be assessed regularly on their medical knowledge (82.0%), be held to the same standards of care as physicians (78.6%), and are well educated in medicine (77.7%). However, beliefs significantly differed by age and education, with participants that were older and with more education being more likely to believe PAs should be licensed, continually learn about new medical information, and be held to the same standards of care as physicians. Public members with more education were also more likely to believe that PAs are well educated in medicine and that they should be assessed regularly on their medical knowledge.

Conclusion: NCCPA strives to meet the needs of the public by ensuring that only qualified PAs practice medicine with a high standard of care. The majority of the public knew that PAs must pass a national certifying exam and had favorable beliefs regarding licensure and certification. Evaluation of public knowledge and beliefs regarding licensure and certification of PAs is important, as it informs decision making about healthcare and provides insight for policymakers and medical regulators in developing appropriate measures to meet patient expectations regarding high quality and safe medical care.

Additional Information
  • Physician Assistants Certified by NCCPA: all U.S. states, the District of Columbia and the U.S. territories rely on NCCPA certification as one of the criteria for initial licensure or regulation of physician assistants. As of Dec. 31, 2019, there were more than 139,000 certified PAs.
  • NCCPA Website
  • NCCPA Fact Sheet


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