Clinical Practice Data

 
In the comprehensive 2009 Report on Emergency Medicine Physician Assistants survey that was commissioned by the Society of Emergency Medicine Physician Assistants (SEMPA) and the American College of Emergency Physicians (ACEP), and conducted by the National Commission on Certification of Physician Assistants (NCCPA), data pertaining to the clinical practice of EMPAs was collected and analyzed. Results are broken down by SEMPA members, non-members and total respondents.

 
Summary of Procedures Performed by EMPAs | Clinical Skills Practice Frequency |
Years in Clinical PA Practice | Years in Clinical Practice as an EM or Urgent Care PA |
Monthly or Annual Clinical Time | Primary Practice Site | Practice in State of Residence |
Population Size of the Community or Service Area | Number of PAs Providing Locum Work |
Physician Supervision | Method of Logging Procedures |
Method of Tracking Procedures Logged 

 
Summary of Procedures Performed by EMPAs

The table below shows the percentage of EMPAs who report that they perform a number of procedures (irrespective of the frequency with which they perform them). 

Procedure 

Performed by % of PAs 

Multiple layer laceration repair 

73.1% 

Reduction of major joint dislocations 

71% 

Arthrocentesis 

69.8% 

Closed fracture reductions 

68% 

Slit lamp exam 

64.7% 

Procedural sedation 

54% 

Lumbar puncture 

52% 

Rapid sequence intubation 

43.1% 

Write admission orders 

39.5% 

Interosseus line placement 

37.7% 

Central line placement 

35.9% 

Chest tube thoracotomy 

34.7% 

Provide medical direction for EMS 

32.3% 

Prepare admission histories and physicals 

28.8% 

Emergency ultrasonography 

28.1% 

Needle thoracentesis 

26.8% 

Arterial line placement 

18.2% 

Venous cutdown 

11.4% 

Cricothyrotomy 

10.9% 

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Clinical Skills Practice Frequency

Using a six-point scale, survey respondents were asked how often they perform specific clinical tasks. The following table provides data results for all respondents.    

Practice type 

Never 

At least once a week 

At least once a month 

At least once every 6 months 

At least once a year 

Not credentialed 

Total 

Rapid Sequence Intubation 

32.21% 

3.01% 

10.58% 

14.51% 

15.42% 

24.27% 

100.00% 

Cricothyrotomy 

53.28% 

0.00% 

0.18% 

0.73% 

8.12% 

37.68% 

100.00% 

Needle thoracentesis 

45.16% 

0.18% 

1.37% 

6.84% 

15.60% 

30.84% 

100.00% 

Chest tube thoracotomy 

39.05% 

0.00% 

2.65% 

10.40% 

17.97% 

29.93% 

100.00% 

Central line placement 

35.95% 

3.38% 

8.49% 

11.31% 

13.23% 

27.65% 

100.00% 

Interosseus line placement 

45.89% 

0.18% 

2.10% 

11.22% 

20.07% 

20.53% 

100.00% 

Venous cutdown 

57.48% 

0.27% 

0.27% 

1.82% 

7.66% 

32.48% 

100.00% 

Procedural sedation 

16.88% 

13.59% 

27.74% 

18.07% 

4.84% 

18.89% 

100.00% 

Arterial line placement 

48.36% 

1.46% 

2.10% 

5.02% 

8.76% 

34.31% 

100.00% 

Reduction of major joint dislocations 

9.12% 

17.88% 

33.67% 

24.36% 

8.76% 

6.20% 

100.00% 

Closed fracture reduction 

10.86% 

19.89% 

26.55% 

27.55% 

8.21% 

6.93% 

100.00% 

Multiple layer laceration repair 

0.73% 

55.38% 

28.92% 

12.23% 

2.37% 

0.36% 

100.00% 

Arthrocentesis 

14.14% 

10.04% 

25.27% 

33.21% 

11.31% 

6.02% 

100.00% 

Lumbar puncture 

24.00% 

8.30% 

20.26% 

18.80% 

10.68% 

17.97% 

100.00% 

Slit lamp exam 

9.58% 

51.92% 

24.64% 

8.39% 

2.65% 

2.83% 

100.00% 

Emergency ultrasonography performance 

31.66% 

13.59% 

9.76% 

7.12% 

3.28% 

34.58% 

100.00% 

Write admission orders 

31.84% 

41.70% 

8.49% 

3.92% 

1.64% 

12.41% 

100.00% 

Prepare admission histories and physicals 

47.35% 

32.66% 

3.65% 

1.92% 

2.37% 

12.04% 

100.00% 

Provide medical direction for EMS 

42.88% 

23.72% 

9.03% 

5.38% 

3.38% 

15.60% 

100.00% 

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Years in Clinical PA Practice

The following table provides EMPA data results for years in clinical PA practice.                                  

Years Interval 

SEMPA 

Non SEMPA 

All Respondents 

Frequency

Percent

Frequency

Percent

Frequency

Percent

1-10 

176

53.66%

383

49.87%

559

51.00%

11-20 

90

27.44%

246

32.03%

336

30.66%

21-30 

46

14.02%

98

12.76%

144

13.14%

31-40 

16

4.88%

41

5.34%

57

5.20%

Total 

328

100.00%

768

100.00%

1096

100.00%

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Years in Clinical Practice as an Emergency Medicine or Urgent Care PA

The following table provides data results for years in clinical PA practice and emergency medicine or urgent care PA.

Years Interval 

SEMPA 

Non SEMPA 

All Respondents 

Frequency

Percent

Frequency

Percent

Frequency

Percent

1-10 

216

65.85%

499

64.97%

715

65.24%

11-20 

81

24.70%

217

28.26%

298

27.19%

21-30 

27

8.23%

46

5.99%

73

6.66%

31-40 

4

1.22%

6

0.78%

10

0.91%

Total 

328

100.00%

768

100.00%

1096

100.00%

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Current Monthly or Annual Clinical Time Spent in an Emergency Medicine
or Urgent Care Setting

The following table provides EMPA data results for the current monthly or annual clinical time spent in an emergency medicine or urgent care setting.  

Time percentage 

SEMPA 

Non SEMPA 

All Respondents 

Frequency

Percent

Frequency

Percent

Frequency

Percent

Less than 25% 

8

2.44%

37

4.82%

45

4.11%

25%-49% 

8

2.44%

24

3.13%

32

2.92%

50%-75% 

9

2.74%

24

3.13%

33

3.01%

75%-100% 

25

7.62%

64

8.33%

89

8.12%

100% 

278

84.76%

619

80.60%

897

81.84%

Total 

328

100.00%

768

100.00%

1096

100.00%

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Primary Practice Site

The following table provides data results for EMPA primary practice sites. 

Primary Practice 

SEMPA 

Non SEMPA 

All Respondents 

Frequency

Percent

Frequency

Percent

Frequency

Percent

Emergency Department 

246

75.00%

501

65.75%

747

68.53%

Fast Track 

57

17.38%

154

20.21%

211

19.36%

Triage 

5

1.52%

3

0.39%

8

0.73%

Urgent Care 

20

6.10%

104

13.65%

124

11.38%

Total 

328

100.00%

762

100.00%

1090

100.00%

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Practice in State of Residence

The following table provides data results on EMPAs practicing in state of residence.  

Practice in State of Residence 

SEMPA 

Non SEMPA 

All Respondents 

Frequency

Percent

Frequency

Percent

Frequency

Percent

Yes 

311

94.82%

737

95.96%

1048

95.62%

No 

17

5.18%

31

4.04%

48

4.38%

Total 

328

100.00%

768

100.00%

1096

100.00%

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Population Size of the Community or Service Area

The following table provides EMPA data results on population size of the community or service area.  

Population Size 

SEMPA 

Non SEMPA 

All Respondents 

Frequency

Percent

Frequency

Percent

Frequency

Percent

Metro (250,000 - 1 million) 

78

24.30%

225

29.53%

303

27.98%

Metro (1 - 3 million) 

36

11.21%

87

11.42%

123

11.36%

Metro (Greater than 3 million) 

21

6.54%

39

5.12%

60

5.54%

Non-metro(Less than 2500) 

5

1.56%

16

2.10%

21

1.94%

Non-metro (2500-10,000) 

27

8.41%

42

5.51%

69

6.37%

Non-metro (10,000-25,000) 

40

12.46%

55

7.22%

95

8.77%

Non-metro (25,000-250,000) 

114

35.51%

298

39.11%

412

38.04%

Total 

321

100.00%

762

100.00%

1083

100.00%

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Number of PAs Providing Locum Work

The following table provides data results on the numbers of PAs providing locum work.   

Status of Providing Locum Work 

SEMPA 

Non SEMPA 

All Respondents 

Frequency

Percent

Frequency

Percent

Frequency

Percent

Yes 

53

16.16%

107

13.93%

160

14.60%

No 

275

83.84%

661

86.07%

936

85.40%

Total 

328

100.00%

768

100.00%

1096

100.00%

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Percentage of On-site Physician Supervision by an Emergency Medicine Attending

The following table provides data results on the percentage of on-site physician supervision by an emergency medicine attending.  

Frequency 

SEMPA 

Non SEMPA 

All Respondents 

Frequency

Percent

Frequency

Percent

Frequency

Percent

Less than 25% 

30

9.15%

60

7.81%

90

8.21%

25-50% 

15

4.57%

17

2.21%

32

2.92%

50-75% 

6

1.83%

16

2.08%

22

2.01%

75-100% 

11

3.35%

60

7.81%

71

6.48%

100% 

241

73.48%

575

74.87%

816

74.45%

Never on-site 

25

7.62%

40

5.21%

65

5.93%

Total 

328

100.00%

768

100.00%

1096

100.00%

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Method of Logging Procedures

The following table provides EMPA data results on the method of logging procedures.   

Logging Method 

SEMPA 

Non SEMPA 

All Respondents 

Frequency

Percent

Frequency

Percent

Frequency

Percent

Manually 

190

58.10%

410

53.46%

600

54.84%

On line 

50

15.29%

148

19.30%

198

18.10%

Other 

87

26.61%

209

27.25%

296

27.06%

Total 

327

100.00%

767

100.00%

1094

100.00%

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Method of Tracking Procedures Logged

The following table provides EMPA data results on the method of tracking procedures logged.

 

Tracking Method 

SEMPA 

Non SEMPA 

All Respondents 

Frequency

Percent

Frequency

Percent

Frequency

Percent

By professional society 

14

4.28%

30

3.91%

44

4.02%

By the PA 

165

50.46%

380

49.54%

545

49.82%

By supervising physician 

52

15.90%

176

22.95%

228

20.84%

Others 

96

29.36%

181

23.60%

277

25.32%

Total 

327

100.00%

767

100.00%

1094

100.00%

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