The Training of Physician's Assistants

Abstract A large-scale audit of patient records was used to educate and evaluate physician's assistants. Clinical algorithms (sets of step-by-step instructions for solving a medical problem) for 11 acute medical complaints were used in patient care by physician's assistant trainees. Each algorithm had a corresponding checklist medical-record form, which was filled out by the physician's assistant as he saw the patient. A computer program analyzed the data from each checklist to determine if the algorithm had been followed correctly. Checklist records from 3024 patients showed that a physician's assistant could have evaluated 45 per cent of these patients accurately without direct physician involvement if he had correctly followed the algorithm logic. This clinical algorithm system provides guidance in problem solving and also measures the ability of a trainee to follow instructions. (N Engl J Med 288:818–824, 1973)