P3.233: Taking the PAth: The Physician Assistant Student Experience of Achieving “Acting Intern” Status during Inpatient Pediatric Clinical Rotation

Background: More than half of graduating physician assistants (PAs) enter hospital settings, where essential skills include executing care plans, writing billable notes, and managing high patient loads. To help PA students develop these competencies, our inpatient pediatric hospitalist preceptor(s) created an Acting Intern Advancement Pathway. Acting Interns take on intern-level responsibilities, including first call for 2-4 patients and reporting to the senior resident. This poster examines students’ perceptions of their Acting Intern status, its impact on advanced clinical skills, knowledge gaps, and future career interests.

Methods: The Advancement Pathway was promoted to all PA students in academic years 2022-2025. Students who qualified for and completed the pathway were surveyed via a web-based questionnaire to assess their educational experience as Acting Interns. Questions were developed in collaboration with a survey methodologist and refined through cognitive interviews. The survey examined characteristics of the clinical experience, perceived changes resulting from Acting Intern status, and the impact of the experience on career trajectory. Descriptive statistics were used for analysis.

Results: Since 2022, twenty-four PA students have participated in the Advancement Pathway, with a 100% survey response rate (24/24). All successfully advanced to Acting Intern status during their rotation. Comparing the first two weeks of the rotation to the last two weeks as Acting Interns, respondents reported significantly greater involvement in care plan development (91.6%) (Figure 1). Nearly 96% of students felt their Acting Intern status enhanced participation in care plan execution, including pending orders, calling consultants, following up on diagnostic results, educating families, writing billable notes and completing handoffs (Figure 1). Confidence in caring for pediatric patients improved in all participants (100%), while confidence in managing inpatient pediatric patients also increased (Figure 2). Additionally, 79% expressed a greater interest in inpatient and pediatric medicine (Figure 2). Furthermore, 87.5% of students reported increased awareness of their personal knowledge and skill limitations (Figure 2).

Conclusion: The Advancement Pathway provides a unique and impactful inpatient pediatric educational experience for clinical year PA students, which was demonstrated by our participants. The acting intern status improved student involvement in essential clinical activities and student confidence in inpatient medicine and pediatrics. Additionally, the students' self-awareness of their own limits in knowledge and skills was identified, which is a crucial skill for graduating PAs. With over half of graduating students nationally being employed in a hospital setting, this pathway is a viable means to equip students with the skills and experiences necessary to embark on successful and rewarding careers in inpatient medicine. To better understand this impact, the next steps include tracking first job placements of Advancement Pathway participants. Results are limited by small sample size; however, further validation of our early findings will continue with ongoing recruitment to the Advancement Pathway.