Transitions Between Clinical Practice and Academia in PA Education: 10 Years of Quantitative and Qualitative Findings

• In Event: Comings and Goings: Entering, Staying, and/or Leaving PA Education

Abstract

Introduction. Recruiting and retaining a workforce of career PA educators is vital in this era of rapid expansion of the PA profession. However, 40.8% of faculty have worked in PA education for under five years.1 Historically, faculty retention has been a challenge in PA education, with high attrition rates back to clinical practice.2 This presentation summarizes and synthesizes a line of research addressing the PA faculty retention problem via multiple methodologies spanning the past decade.
Methods. The first investigation used mixed methods to study intention to stay in academia for PA faculty. The construct was first conceptualized via a qualitative analysis of interviews with experienced PA educators. After refining and pilot testing a survey instrument based on the indicators of intention to stay that emerged from the qualitative phase, the survey was administered to the PA faculty population. A measure of PA faculty intention to stay in academia was then developed and validated using Rasch methodology.3 A follow-up study was later conducted to study the inverse concept of intent to leave academia. A Rasch regression analysis was used to determine whether items from the previously validated measure could predict intent to leave, a dichotomous outcome.4 Most recently, a qualitative study of former PA faculty who returned to clinical practice was performed to better understand the process of PA faculty attrition.5
Results. A set of 19 items related to a supportive academic environment met the strict Rasch model expectations for a linear measure and represented a logical progression of “intention to stay in academia” for PA faculty, allowing for the creation of profiles of PA faculty with high, moderate, and low intention to stay based on items endorsed. A subset of 5 of those 19 items (recognition by administration, sense of institutional community, support of the PA program by administration, support for scholarly work, and fair promotion process) subsequently emerged as a single linear measure that explained 55.1% of the variance in the intent to leave variable. Key themes from the qualitative investigation of PA faculty who had left academia to return to clinical practice included ineffective leadership, erroneous expectations of academic work, inadequate mentorship or training, and the desire for more clinical practice opportunities. These findings provided a model for understanding PA faculty attrition.
Discussion. Each methodology used in this line of research has advantages and limitations; in particular, a finding from the most recent investigation underscores the limitation of using intent to leave as a proxy for actual turnover. Overall, the body of research highlights the critical role that institutional and program leadership play in PA faculty retention. Most aspects of the academic environment that support intention to stay and all five predictors of intent to leave are administrators’ purview and can be utilized to focus retention efforts for PA faculty. Additionally, most cases of attrition could have been prevented by effective leadership that adequately supported PA faculty in their transition to academia. Thus, leadership development and institutional support should be priorities for the PA education profession.

Author

• Karen Graham-Burnet, Cedarville University