Evaluating physician assistant students’ attitudes toward underserved patients: A mixed methods study


Physician Assistant


Purpose: Medical students' attitudes toward underserved patient populations have been shown to become less favorable as they progress through their education. Since physician assistants (PAs) provide a significant portion of the primary care services in the United States, it is important to examine the attitudes of PA students in order to inform future educational designs and health care policies. The purpose of this mixed methods study was to explore PA students' attitudes toward working with underserved patients to determine whether their attitudes, like those of medical students, change during training, and to explore factors that influence students' attitudes.

Methods: PA students at the University of Nebraska PA Program participated in the study, which utilized qualitative individual interviews and focus groups as well as a quantitative survey instrument to assess changes in attitudes over time.

Results: Students' attitudes remained stable during the didactic phase of the PA program. However, attitudes showed a significant change during the clinical phase of the program. Qualitative themes included perceptions of the students regarding underserved patients, the health care system, and plans for future careers.

Conclusions: PA students' attitudes toward working with underserved patients do change — primarily during the clinical phase of training. Exposure to underserved patients may contribute to negative attitudes and cynicism in students and may result in fewer students choosing to practice in underserved settings. Further research needs to be conducted, focusing on educational and policy efforts to minimize this effect.

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Journal of Physician Assistant Education







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