Presented By: Dawn Morton-Rias, National Commission on Certification of Physician Assistants
Co-Authors: Mirela Bruza-Augatis, National Commission on Certification of Physician Assistants
Andrew Dallas, National Commission on Certification of Physician Assistants
Joshua Goodman, National Commission on Certification of Physician Assistants
Andrzej Kozikowski, National Commission on Certification of Physician Assistants

Background
COVID-19 significantly impacted physician assistant/associate (PA) education programs. Most programs transitioned didactic and clinical education from in-person to remote, and clinical training opportunities diminished. Graduates of accredited PA programs take the Physician Assistant National Certifying Examination (PANCE), a five-hour exam with 300 multiple-choice questions, and must attain or exceed the scaled passing score of 350 (range: 200-800). We examined whether the pandemic impacted first-time examinees' PANCE scores and passing rates.

Methods
We analyzed data (N=59,459) from the National Commission on Certification of PAs. The two primary outcomes were PANCE scores and pass rates. The main exposure was the timeframe, categorized as pooled three years pre-pandemic (2017-2019) and three years during the pandemic (2020-2022). The 2017-2018 scores were equated to the new passing standard implemented in 2019. Covariates included age, gender, years the PA program has been accredited, program region, and rural-urban setting. Analyses consisted of descriptive, bivariate, and multivariate statistics.

Results
The mean PANCE score and pass rate during the six-year study period were 463 and 93%, respectively. When comparing the pooled three-year pre-pandemic mean PANCE score (462), it was lower than the first pandemic year (473; p<0.001), not significantly different from the second (465; p=0.051) and higher than the third (453; p<0.001). These results remained when adjusting for test-taker and PA program covariates. Similarly, pass rates decreased from 92.3% during the pre-pandemic period to 91.7% (p<0.001) in 2022. When controlling for covariates, examinees had 24% higher odds of failing in 2022 compared to the pre-pandemic period.

Conclusion
Findings suggest that PANCE scores and pass rates were impacted during the third year of the pandemic. PANCE assesses if examinees have essential clinical knowledge to enter the PA profession. It is crucial to determine whether the pandemic affected PANCE scores and pass rates to ensure PAs provide safe and high-quality patient care.