Implementation and utilization of Physical Examination Teaching Associate (PETA) programs: a scoping review

Physical Examination Teaching Associates (PETAs) are individuals trained to instruct health professional learners regarding the technical and communication skills to conduct physical examinations. PETAs refer to their body to instruct and provide feedback in a supportive, non-threatening environment. Such programs are highly rated by learners and support learner outcomes, but implementation and utilization characteristics vary widely. This scoping review aims to review the literature addressing (1) the broad outcomes of PETA programs, (2) the utilization of PETA programs to instruct, and (3) the implementation of Domains of the ASPE SOBP and ASPE GTA/MUTA SOBP within PETA programs. PubMed, CINAHL, ERIC, PsycINFO, and Sociological Abstracts were searched to identify all publications addressing the administration of PETA programs and/or engagement of PETAs in instructional sessions. Studies were charted in tandem using an iterative process aligned with the PRISMA Extension for Scoping Reviews. The scoping review protocol was registered prospectively. Thirty-four studies were identified. Most articles were from the United States and highlighted positive PETA program-level outcomes and learner outcomes. PETAs most frequently instructed individuals or groups of four second-year medical students learning the musculoskeletal examination. Half of the articles discussed engaging with PETAs with stable pre-existing pathology. Nearly all addressed some information related to the Domains of the ASPE SOBP and/or ASPE GTA/MUTA SOBP. Only two articles referred to the individual(s) engaging in the PETA role as a PETA. PETA programs have published positive outcomes for over 45 years. This scoping review reports on the available evidence highlighting the program structure and instructional patterns represented in the literature and the importance of consistent terminology and role description, alignment with publication standards, and implementation of the relevant ASPE SOBP. https://osf.io/rj5wp/.