Journal of surgical education · 2025
Honing the Cutting Edge of Physician Assistant Surgical Education in the US Military: A Curriculum Update Using Kern's Approach and a Modified Delphi Method.
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Chalupa Robyn L, McMahon Ryan A, Tol Lenard W, Rizzo Julie A, Douglas Matthew S
Аннотация
UNLABELLED: The US Army-Baylor University Doctor of Science in Physician Assistant Studies-General Surgery program was developed to address a shortage of trauma- and critical care-trained providers for combat operations. While the original program closed, a restructured version launched in 2013 to provide postgraduate specialty training for military physician assistants focused on battlefield and critical care needs.
PROBLEM: Despite growth in postgraduate physician assistant fellowships, surgical curricula remain inconsistent, making it difficult to validate training and align outcomes with surgeon expectations.
APPROACH: We applied Kern's six-step model for curriculum development and used a modified Delphi method to reach consensus among military surgeons on the clinical skills and competencies expected of graduates. Two survey rounds prioritized procedural skills and mapped performance expectations to Accreditation Council for Graduate Medical Education surgery milestones.
OUTCOMES: The resulting 18-month curriculum integrates extensive clinical experience, structured didactic and lab time, and a mentored research project. Surgeons identified central line placement, chest tube insertion, laceration repair, surgical airways, ventilator management, triage, resuscitation, and fracture management as essential skills. They expected trained physician assistants to function at Accreditation Council for Graduate Medical Education surgery milestone level 3 in the areas of "patient evaluation and decision making," "intraoperative patient care technical skills," and "postoperative patient care."
SIGNIFICANCE: This is the first reported use of Kern's framework and Delphi consensus to develop a postgraduate surgical physician assistant curriculum. The process produced consensus-driven, measurable objectives tailored to military surgical needs and offers a replicable model for curriculum development in other health professions.
PROBLEM: Despite growth in postgraduate physician assistant fellowships, surgical curricula remain inconsistent, making it difficult to validate training and align outcomes with surgeon expectations.
APPROACH: We applied Kern's six-step model for curriculum development and used a modified Delphi method to reach consensus among military surgeons on the clinical skills and competencies expected of graduates. Two survey rounds prioritized procedural skills and mapped performance expectations to Accreditation Council for Graduate Medical Education surgery milestones.
OUTCOMES: The resulting 18-month curriculum integrates extensive clinical experience, structured didactic and lab time, and a mentored research project. Surgeons identified central line placement, chest tube insertion, laceration repair, surgical airways, ventilator management, triage, resuscitation, and fracture management as essential skills. They expected trained physician assistants to function at Accreditation Council for Graduate Medical Education surgery milestone level 3 in the areas of "patient evaluation and decision making," "intraoperative patient care technical skills," and "postoperative patient care."
SIGNIFICANCE: This is the first reported use of Kern's framework and Delphi consensus to develop a postgraduate surgical physician assistant curriculum. The process produced consensus-driven, measurable objectives tailored to military surgical needs and offers a replicable model for curriculum development in other health professions.