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Capstone

Assessing the adequacy of documentation curriculum: A Pacific University survey analysis

1 August 2007

Abstract

Objective: The aim of the study is to assess the adequacy of the Pacific University physician assistant curriculum on documentation and determine what progress has been made through changes and new developments in this curriculum. The ultimate goal for which would be to eliminate any superfluous assignments in order to allow time for study of medical knowledge, while improving any problem areas noted in the documentation curriculum.

Methods: A survey was developed and distributed to Pacific University PA program alumni and current students. This survey was designed to assess the students' confidence levels in his or her documentation skills after the didactic year of the program. The students were asked to respond to each question by stating that they strongly agreed, agreed, disagreed, or strongly disagreed with the statement. Each response was assigned a number, 1-4, with J representing strongly disagreed and 4 representing strongly agreed. Using these numbers, average response rates for each question were calculated. Once the results were established, a thorough review of the course syllabi was conducted as well as a Chi-Square test for heterogeneity or independence, and correlations were made between the response rates and developments in the curriculum.

Results: A total of 126 students responded to the survey. The average response rates for each question were calculated for the group as a whole and for each individual class. The Chi-Square test for heterogeneity or independence revealed several statistically significant differences in response rates among the seven classes of students. The class of 2007 rated its ability to develop and document treatment plans lower than expected (p=0.0333). Statistically significant differences were seen in all 5 coding questions, including higher response rates seen in classes 2002-2006 (p=0.0131), with regards to coding new and established visit, lower response rates in classes 2002-2004 (p=0.0005), with regards to understanding reimbursement for level of service, lower response rates in classes 2002-2004 (p=0.0420), with regards to documenting the medical history, lower response rates in classes 2002-2003 and higher response rates in classes 2005 and 2008 (p=0.0171), with regards to documenting the physical exam, and lower response rates in classes 2002-2003 (p=0.0011), with regards to documenting the complexity of the visit. The classes of 2002 and 2003 rated all dictation questions lower than expected and the classes of 2006-2008 rates these questions higher than expected (p=O.OOOO).

Conclusions: Definite variances were seen between the seven classes surveyed. The ChiSquare test revealed statistical differences in the areas of coding and dictation seen in the first few years of students prior to the addition of level of service coding assignments and dictation and transcription modules. Response rates in the areas of coding and dictation have improved significantly and have shown satisfactory confidence levels in latter years: Overall no differences were seen from the first year to the last year in the area of basic charting, thus increasing the number of assignments in this area did not improve response rates.

Recommendations: Reduce the number of chart note assignments and continue with the current curriculum and requirements concerning coding and dictation.


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