PA Core Competencies

Core Competencies for the Physician Assistant Profession

Entry into the PA profession today requires successful attainment of a master’s degree, which, according to the requirements set forth in the Degree Qualifying Profile (DQP), demands higher-order thinking skills and evidence of learning through the design, development, creation, and articulation of knowledge and skills via projects and papers. Beyond attaining the necessary knowledge and skills, PA education requires practical application in various patient care settings. Entry into the profession also requires passing a national certifying examination, and PAs must maintain their certification throughout their careers via continuing medical education and periodic recertification.

In the Core Competencies for New Physician Assistant Graduates, there is a distinct focus on health rather than on disease — a focus in which the needs of patients are considered above those of educators, students, or providers in determining the knowledge, skills, attitudes, and behaviors that new PA graduates need to demonstrate.  The core competencies are built upon six domains:

1. Patient-Centered Practice Knowledge

• Recognize normal and abnormal health states
• Discern among acute, chronic, and emerging disease states
• Elicit and understand the stories of individual patients and apply the context of their lives (including environmental influences, cultural norms, socioeconomic factors, and beliefs) when determining healthy versus ill patients
• Develop meaningful, therapeutic relationships with patients and their families
• Determine differential diagnosis, order interpret laboratory and imaging, perform necessary core duty procedures, diagnose, treat and manage illness
• Partner with patients to address issues of ongoing signs, symptoms, or health concerns that remain over time without clear diagnosis despite evaluation and treatment

2. Society and Population Health

• Recognize the cultural norms, needs, influences, and socioeconomic, environmental, and other population-level determinants affecting the health of the individual and community being served
• Recognize the potential impacts of the community, biology, and genetics on patients and incorporate them into decisions of care
• Demonstrate accountability and responsibility for removing barriers to health, such as health literacy
• Understand the role of structural disparities in causing illness
• Engage members of the health care team in the surveillance of community resources to sustain and improve health
• Engage the health care team in determining the adequacy of individual and community resources
• Reflect on personal and professional limitations in providing care
• Elicit and hear the story of the individual and apply the context of the individual’s life (including environmental influences, culture, and disease) when determining healthy versus ill patients
• Understand and apply the fundamental principles of epidemiology
• Recognize the value of the work of monitoring and reporting for quality improvement
• Use appropriate literature to make evidence-based decisions on patient care

3. Health Literacy and Communication

• Establish meaningful therapeutic relationships with patients and families that allow for a deeper connection and create space for exploration of the patients’ needs and goals to deliver culturally competent care
• Interpret information so that patients can understand and make meaning out of the information conveyed to them
• Recognize the need for and governing mandates that ensure patients have access to unbiased, professional interpreters and appropriate resources when barriers to communication arise
• Demonstrate insight and understanding about emotions and human responses to emotions that allow one to develop and manage interpersonal interactions
• Communicate effectively with patients, families, and the public
• Provide effective, equitable, understandable, and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy, and other communication needs
• Organize and communicate information with patients, families, community members, and health team members in a form that is understandable, avoiding discipline-specific terminology when possible, and checking to ensure understanding

4. Interprofessional Collaboration Practice and Leadership

• Articulate one’s role and responsibilities to patients, families, communities, and other professionals
• Advocate for the focus of the health care team being on the needs of the patient
• Assure patients that they are being heard
• Ensure patients’ needs are the focus over self and others
• Contribute to the creation, dissemination, application, and translation of new health care knowledge and practices
• Recognize when referrals are needed and make them to the appropriate health care provider
• Coordinate care
• Develop relationships and effectively communicate with physicians, other health professionals, and health care teams
• Use the full scope of knowledge, skills, and abilities of available health professionals to provide care that is safe, timely, efficient, effective, and equitable
• Use unique and complementary abilities of all members of the team to optimize health and patient care 
• Engage diverse professionals who complement one’s own professional expertise, as well as associated resources, to develop strategies to meet specific health and health care needs of patients and populations
• Describe how professionals in health and other fields can collaborate and integrate clinical care and public health interventions to optimize population health 

5. Professional and Legal Aspects of Health Care

• Articulate standard of care practice
• Admit mistakes and errors
• Participate in difficult conversations with patients and colleagues
• Recognize one’s limits and establish healthy boundaries to support healthy partnerships
• Demonstrate respect for the dignity and privacy of patients while maintaining confidentiality in the delivery of team-based care
• Demonstrate responsiveness to patient needs that supersedes self interest
• Demonstrate accountability to patients, society, and the profession
• Exhibit an understanding of the regulatory environment
• Health Care Finance and Systems
• Recognize financial implications to the provision of healthcare
• Articulate individual providers’ value-add to the health care team in terms of cost
• Appreciate the value of the collaborative physician/PA relationship
• Understand different types of health systems, funding streams, and insurance, including the role of Medicare and Medicare as payors

6. Health Care Finance and Systems

• Recognize financial implications to the provision of healthcare
• Articulate individual providers’ value-add to the health care team in terms of cost
• Appreciate the value of the collaborative physician/PA relationship
• Understand different types of health systems, funding streams, and insurance, including the role of Medicare and Medicare as payors

Excerpted from the PAEA Core Competencies for New Physician Assistant Graduates, September 20, 2018

Adopted by CBU 03/16/2023