PA Education Programs Prepare Students for Expanding Roles - Jonathan Bowser, Director of the Child Health Associate/Physician Assistant Program at the University of Colorado Denver


Physician Assistant remains one of the fastest growing professions in the US, and the expansion of their role in healthcare delivery seems to be growing just as quickly. One of the biggest changes in that regard, according to Jonathan Bowser of the University of Colorado Denver School of Medicine, is that states are opening up opportunities for PAs to practice with more autonomy to fill needs in the healthcare system. “That requires PA education programs to think about who are we putting out there, what environments they are going into, and how do we best prepare them for those environments,” says Bowser, who runs the school’s Child Health Associate/Physician Assistant Program (CHAPA), one of the oldest PA training programs in the country. The need to adapt their program to these new realities and the desire to take advantage of advances in learning science led CHAPA to overhaul its curriculum in recent years. The result is a ‘spiral curriculum’ - an iterative approach to learning that reinforces key concepts and knowledge as students progress through their years of training. Join host Hillary Acer as she learns about the underpinnings of CHAPA’s curricular approach, what the program is doing to prepare PAs to be leaders and the growing importance of residencies and fellowships to prepare PAs to work in clinical specialties.




Hillary Acer: Hi, I'm Hillary Acer, welcoming you to Raise the Line with Osmosis from Elsevier, an ongoing exploration about how to improve health and healthcare. 


Physician assistant remains one of the fastest growing professions in the U.S., with employment of PAs projected to grow nearly 30% in the next decade, far outpacing the rest of the medical field. There's been a growth in PA education programs as well, with two dozen expected to come online by 2025. Today, we're going to check in with the director of one of the oldest PA programs in the country to take a look at the current state of PA education and how the profession is changing. 


For that, I'm happy to welcome Jonathan Bowser, associate professor at University of Colorado Denver School of Medicine and director of the Child Health Associate Physician Assistant Program, consistently ranked among one of the top PA programs in the nation by U.S. News and World Report. Mr. Bowser worked in family medicine as a PA before moving into the education arena in 2006, eventually rising to lead the CHAPA program a decade ago. He has served on many committees and boards in support of the profession, and is the former president of the Physician Assistant Education Association.


Thanks so much for being with us today.


Jonathan Bowser: Thanks, Hillary. It's great to be here. 


Hillary: I'd love to start with learning more about you and what first got you interested in becoming a PA, especially because you've started your career in biochemistry. So, why the change? 


Jonathan: Yeah, I was on the sort of classic PA path back in the day. It's changed now, but back then, there were quite a few of us who were second career people looking for something different to do, something maybe that provided a little more meaning in our lives and a little more connection with our communities. I had been benchtop research for about ten years, and just needed to find something else that could give you more meaning. So, I explored health professions and zeroed in on the PA profession that was so attractive for so many reasons to me and the rest is history. I started down that path and I have really loved every moment of it.


Hillary: That's amazing, and you actually graduated from the program that you now run. I'd love to learn a little bit more about that path, especially on your journey to becoming a leader.


Jonathan: Yeah, it's interesting. We talk so much about leadership and it's kind of this broad concept. I was certainly that person who didn't see myself as a leader in any context or by any definition of the term. I was just sort of finding my way and discovering what I liked and what was challenging to me and intriguing and so I became a clinical PA. I come from a long line of teachers in my family and I suspected I would always get back to teaching. An opportunity arose in my own program and I came back and began teaching. 


I really didn't see myself pursuing leadership at that time, and then the director of the program stepped down and she talked to me about considering jumping in as the interim director of the program and seeing how that felt. I think she had a suspicion that I would like it. I wasn't sure. I was reluctant. I did it and really enjoyed it. These leadership roles amplify your ability to get things done that you're really passionate about, and that part of it is very satisfying. 


From there, becoming the director of the program gave me some confidence, I think, in my ability to lead. And so that led me down other paths, including leadership roles on this campus and national leadership roles and I just keep letting my curiosity guide me. I’m exploring new things to this day.


Hillary: It sounds like staying open to those kind of possibilities and being curious, as you mentioned, was quite fruitful for you in your career. Maybe if you don't mind, we can go back a little bit in time to the program when you were there. I'd love to hear what that was like for you and what the program was like back then. 


Jonathan: You know, I was a science person, a science nerd, and I had never really explored the clinical side of things until I came to this program.We're a clinical education program, obviously, and it's quite different from just basic science. It's very applied and that was new and exciting for me as a student. Then teaching in this program is really unique. I felt certain that we have this fusion of didactic classroom-based teaching that leads ultimately to clinical teaching, bedside teaching and learning in the clinical setting and that was very new and different and exciting to me.


Just a little bit about our program...we are, as you mentioned in the introduction, we're a very established older program. We were founded in 1968, one of the very early programs, and our program had a very traditional curriculum: basic science, followed sequentially by clinical classes, clinical science, and then a year spent in the clinical setting. That was really the structure of our curriculum until not long ago when I really kind of pushed us to change that. I'd love to talk about the curricular transformation that we underwent if we have time. 


Hillary: We'll definitely get into that. As I think you know, we're seeing a trend across different education programs that they are becoming more multimedia. They're integrating clinical education a lot earlier, for example. But maybe before we get into the curriculum side of things, can you give us just a broad overview of the program and what differentiates it aside from being one of the oldest and most established PA programs? 


Jonathan: Yeah. Sure. We're an odd program that we started in the sixties. Our founder was a pediatrician by the name of Henry Silver and he was talking with Eugene Stead at Duke University and Dick Smith, who was at the University of Washington. Those were the two founding programs for PAs. Silver liked the model, but was really more interested in a model that was more similar to nurse practitioner training in that you would be specialized in the program and go into that specialty. What evolved and has lasted is a generalist model of PA training where all PAs are essentially trained with the same background, and specialization occurs when you go into your practice and that is actually a better model, I think. With my apologies to the late Dr. Silver, the generalist model actually took hold for good reasons.


But interestingly, when we started, we were a Child Health Associate program, not a PA program. We were training in a PA model, but these were pediatric PAs that only practiced in peds. So, for our first ten years, all of our graduates went into peds and then it became clear that that model was not sticking, and we became a PA program. We keep the Child Health Associate name to honor our history, but it really has no legal bearing anymore. In fact, most of our grads now don't practice in pediatrics. We still offer expanded training in peds because it's what we're proud of, and it's something that we're very good at, but we train generalist PAs as do all PA programs. 


Then the other thing I'll just mention is we're a three-year program. We're a bit longer than most. The average length of PA programs is twenty-seven months, and we're thirty-five months. We like the length of our program, but it does differentiate us a little bit. And then our curriculum is quite different, and again, love to go down that path when we get to that point. 


Hillary: Thanks for sharing the history. I actually didn't know that about University of Colorado Denver, as well as some of the partnerships that were established early on to really get PA programs up and running, it sounds like. 


Jonathan: Yeah, I'll mention an interesting, little known fact, except on this campus. The founder of our program was also the co-founder -- with Loretta Ford who was a nurse -- of the nurse practitioner profession. So the NP profession started here on our campus, and it was a pediatric NP program. It was a six-month program and then from that, Dr. Silver was inspired by that work and that led him down this path. So, I had to mention that.


Hillary: That's so interesting. Yeah, we'll need to dig into that side of the program at some point down the road, but big credit to Dr. Silver. It sounds like he was quite a visionary in establishing some of these new fields. You've mentioned the curriculum a few times. It's described as an iterative, spiral approach to learning. Help us understand what that is and what are the advantages to the students and faculty. 


Jonathan: Sure. So, about ten years ago, we decided to redo our curriculum and we spent a solid five years figuring out what we wanted to do, putting it together and actually launching it. We didn't launch it until 2018. We really tried to build a curriculum that was based on theoretical frameworks. One of the theoretical ideas in education we were attracted to, the spiral model, goes way back to Jerome Bruner in the 1960’s who was kind of a legend in education. He created this idea of the spiral curriculum. And then a famous medical educator, Ronald Harden, who's at the University of Dundee in Scotland, sort of took that and applied it to medical training in the 80s. 


We loved the idea. The spiral curriculum is really a framework that can be as loosely applied as you wish, but the idea is that learning is best done in a way that's iterative and circles or spirals back to concepts that are important. So, for example, in our curriculum, we really are quite heavy in basic sciences in the first year and then in the second year, we really expect that we're going to come back to all of those ideas, all of those sort of physiologic principles, but we're going to do it at a deeper level where our expectations for student learning and integration is higher. 


The reason it's not a circular curriculum is that as you continue, the spiral moves upward in terms of the expectation and the level of depth and integration and we love that idea. It's not a very concrete thing, but our curriculum is based upon that notion.


Hillary: I'm envisioning kind of a spiral staircase in my mind as students kind of progress up towards their clinical practice they are adding more complexity and maybe more nuance as they repeat some of these concepts. So, we're familiar with a number of programs that integrate the spiral curriculum and it's really interesting, because the founding team of Osmosis actually built our learning platform on a lot of these evidence-based learning techniques as well. What comes to mind is spaced repetition.


Osmosis actually started as a kind of a flashcard bank that was crowdsourced by students and the key feature was repeating this information at increasingly lengthened intervals of time so that students would come back to this information again and again, but it was built into a product. So, that's actually a core kind of principle for Osmosis as well, and something that the learning science backs up. So, it's great to see that integrated. 


Jonathan: You know, it's one of the things that attracted us to Osmosis. We shifted to Osmosis from a different platform and one of the things that we really liked about Osmosis was that when we were exploring early on, we found the videos on spaced repetition, on testing effect, cognitive load, all these things that are near and dear to us and integrated into our model. We actually use those videos to kind of indoctrinate our students to this new way of learning. So, yeah, that's a very appealing part of Osmosis. 


Hillary: Yeah. I think it's interesting to see the changes over time, right? We're seeing more adoption across these programs. It takes time, though. The older model of education with more lecture-based learning is not outdated, necessarily, but there are so many other resources that can be integrated to make it more effective. So, that's so interesting. 


Jonathan: Yeah. Yeah. And the other thing is we know so much more about how people learn, particularly how adults learn, than we did when our program and our original curriculum was built. It just needed to be changed because we don't want to commit educational malpractice, right? We really know so much better now how to do education. So, that's a very cool part of this. We really had a lot of fun with this actually.


Hillary:  It sounds like it, yeah. And I think it's so interesting that you're also educating your students about these techniques and getting them on board with this process because it's not necessarily something most programs will cover. So, that sounds like a differentiator in and of itself. 


Jonathan: Yeah. We do a ‘learning to learn’ thread in the summer when our first years come in that establishes some of the principles upon which our curriculum is built and connects with expectations that we have for our students in terms of how they can best take advantage of that. We really try to shift studying practices, for example. A lot of our students come in to the program with ineffective ways of studying. They're not using their time well. You mentioned spaced repetition. We talk about that and the testing effect, which is another one of the Osmosis videos. It's a nice, brief video that our students can get a sense of the testing effect from, and then we talk about it in the classroom and apply it and help them understand how to use those bits of learning theory to do this better. 


There’s a learning curve, and there's some resistance to it because these students come in with habits that are ingrained over a lifetime of learning. What's gratifying for us is by the time they're in their second year, we always have students come back and say, “Now I get it. I'm really using these methodologies and they're working for me and it makes sense and my learning is more efficient.” That's always great to see this stuff in action. 


Hillary: Yeah, that's the hope, right? That students can save some time, they can spend more time with their patients, they can spend more time with their families or on their own health. If we succeed at implementing some of these techniques, then I think students will get some of their time back, and hopefully the same is true for faculty. 


I'm curious, especially for some of these programs that might be looking to change their curriculum or implement these ideas, what was the process like for getting your faculty on board? Or were they excited by the fact that they were able to do it? What was the kind of collective decision-making that happened, if any?


Jonathan: This all started in 2013. We had a two-day off-site curriculum retreat as a faculty, and we had talked about it in the lead-up to this meeting that we wanted to really change our curriculum. The very first decision we had to make was, do we make revisions or do we just start over? The terminology we used is, do we paint and move the furniture around, or do we just bulldoze it and build the house over? And we decided to bulldoze it and just go big. 


That was a fateful decision and it was important to establish that at the outset. Then we had a whole process -- and I won't bore you with all the details -- but at the heart of it was creating a set of curricular values, that were really important to us and that would really guide the kind of curriculum we would build and changes that we would make. We still use those values to this day to inform quality. Are we staying on the path that we created or are we drifting? And if we want to make new changes, do they adhere to these values? These are basic things like integration, contextualize, things like that. So, that was really important. Then it was really important to give ourselves enough time, so we gave ourselves several years to get it done and built. 


There are two other things that I would mention. One is the book, Make It Stick, which most educators have either dabbled in or read. I highly recommend this book. Our whole team read that book in advance of our retreat. Many of the things we're doing are actually ideas we got that we started with from that book. I'll just mention one other author. If you are doing a big change like this, there's a book called Managing Transitions by William Bridges. I think he is no longer with us, but that book is a classic and it talks about how to manage big changes and it's really the best book that I've ever encountered on that topic. 


So, if you're going to go big , I think you need to anticipate that it's going to be fraught and painful and brutal and fun and all of that stuff mixed together. That book sets you up for anticipation of what to expect and how to manage it. It’s just a great book. 


Hillary: We'll definitely include these in the show notes in case anyone wants to check them out. As you tell the story, I'm having some flashbacks to the Osmosis founding team and some of the things that we did as an organization which is quite similar to what you’re describing. You mentioned reading a book together as a team and getting everybody on the same page and having the shared language. We did that a number of times. I'm thinking of a Jim Collins book, Good to Great and several others, but we would often read a book and go on a retreat and that was so helpful for our process. In fact, I want to say maybe in 2018, we did a similar retreat where we came up with our core values that really ended up guiding our entire organizational development and how we made decisions.


Jonathan: It’s critical.


Hillary: It is, and I think it's a really interesting piece because it's not something we really touch on in health educationprograms very often. Can you speak a little bit more to the values? You mentioned a few already. What are some of the guiding principles that you have?


Jonathan:Right. So, there were six. Well, interestingly, we started with five and then later we added a sixthwhich was sustainability. What we meant by that was this has to be something that doesn't wear us out and burn us all out and or our students. We were so focused oncreating this great curriculum, we weren't thinking about how exhausting it would be so that was an important value, too. 


The other five are: 

  • Integration, because we really wantedthis to be as integrated as it can be and the spiral curriculum creates an integrated mindset to start with.
  • Learner centeredness, which is a very kind of fluffyvague concept but it is important that whatever we do is really in the best interest of learning and we always come back to saying ‘we're in the business of creatingoptimal learning environments’ and we preach this gospel to our students all the time. “We create an optimal learning environment, it's your job to learn.” It's a learning mindset, not an instructional mindset.
  • Competency based was our third value, and there's a whole literature and many,many discussions on that topic.
  • Contextualized learning was so important to us. We wanted to make as much of what we didin the classroom -- basic anatomy and all the basic sciences and pharmacology and social aspects of medicine -- we wanted to make all of that happen in the context of clinical scenarios, wherever possible. Our curriculum is based on a curriculum that we kind of borrowed from the University of Calgary School of Medicine. They built this curriculum in the 90s and it's called the clinical presentation curriculum. To be brief, each week is a new clinical presentation. For example, our students will spend a week on chest pain and during that week they're learning about things that cause chest pain, but they are in the thorax in the cadaver lab and they're also learning about cardiovascular and pulmonary physiology. So, that's the contextualized part. We try to create all this learning that's in the context of clinical scenarios. We love that.
  • The fifth value is adaptive. We are constantly questioning ourselves about ‘is this the right thing, should we tweak it should we try to improve this’ and that involves a lot of studying. We have an intense, continuous quality Improvement process and we're constantly looking at metrics on how we're doing and how we can be better.


Hillary: Wow. This list is quite comprehensive. I couldn't think of a better list of values to guide a program. So, we've got integration, learner centeredness, competency-based, contextualized learning, adaptability and then your sixth that you added is sustainability. Amazing. A lot of programs can probably learn from these things and hopefully more and more will continue to integrate like this. 


Jonathan: Yeah, and just so you know, we have presented on this nationally and even internationally at the European meeting, so we like to talk about curricular values I think it's such a big part of what we do. 


Hillary: Very aligned with how we've operated Osmosis, so maybe we'll need to pull you in for future conversations on that.


So, let's shift gears just a little bit to talk about the PA profession overall in an environment in which things have been changing. How has PA education changed to keep up with changes in healthcare, and can you speak a little bit about the changes in practice scope as well. 


Jonathan: Yeah, boy...that's a big topic. The PA practice environment has changed so much and a lot of it has just been in response to kind of market forces in medicine and this increasing complexity in medicine. As we all know, there's this curve of doubling time and medical knowledge and that doubling time keeps getting shorter and shorter. There's so much out there and medicine has gotten so hyper-specialized in some ways, so PAs have really had to adapt to that. 

At the end of the day, PAs are subject to the same market forces that physicians and nurses and everyone in health professions is. PAs go where the work is, and the work has gotten increasingly more specialized but also, PAs have been asked to do more and more -- to work at a higher scope of practice, to do more complex medicine -- and that presents some challenges for PA programs. 


In the education space, if we're talking about a generalist approach, an important challenge for PA programs is how do you prepare the generalist who you know is going to go into critical care medicine, which is not a generalist field at all it's highly specialized and demanding? That’s an ongoing challenge and I will say one of the answers to that has been this absolute burgeoning of residencies or fellowships. Both terms are used interchangeably, but they're generally one year or so in length and they're postgraduate programs that prepare you for these more complex environments. I'm sure you're familiar with these. There's a lot that are in critical care, emergency medicine, and surgical fields and the idea is much like a medical residency for a physician to really allow you to get more specialized in that one area so that you can really hit the ground running in practice. So, that's a big a big change. 


Then the other thing I'll just mention briefly is there's an ongoing transition to more and more PAautonomy in certain areas. Now, it's not PA independence. PAs are not striving for independence, but there's a lot of state level changes that have opened up opportunities for PAs to practice as part of the team but with more autonomy to really fill needs in the system. That's been a big change and that also requires PA education programs to think about who are we putting out there and what environments are they going into and how do we best prepare them for those? 


Hillary: It's really fascinating I think to see the changes in healthcare overall, but you mentioned the market changes. We're very familiar with the shortage of healthcare workers as well we've talked a lot about that on the podcast. Do you think PAs are filling kind of a critical gap here? I mean, they've got a shorter program so potentially we can pull in more people into the healthcare field. Is that playing a role here? 


Jonathan: I think that is at the heart of the growth. The PA profession is growing really faster than a number of health professions and I'm not sure exactly why that is but I think PA and advanced practice nursing and nurse practitioner programs are increasing in number. The PA profession is now graduating over 10,000 new PAs a year and I want to say there's between 150-160,000 in practice or at least certified right now. So, it really is growing and I think the growth has been in response to market needs. 


There are these huge gaps in access and we're in the middle of an ongoing physician shortage as more and more of the baby boomer generation physicians retire. It's a demographic issue, really. There's a lot more of folks in that generation also who are retiring and their health needs are more complex as they age. So, there a demand now, and I don't know when that demand will go away. I think that the need for healthcare providers across the spectrum of specialties etc. will continue into the foreseeable future, I expect. 


Hillary: YesI think we're keeping a close eye on some of these changes, I'm curious if there are any other trends you're seeing in healthcare or gaps that PAs are filling? You mentioned the shortage of physicians and particularly access. I'm thinking of rural areas, potentially, or even sometimes larger cities that may not have as many clinicians to fill their practice gaps there. What else is playing a role here if anything? 


Jonathan: You know one of the things that's interesting to us is we're in Colorado, which is a very rural state, actually. It has a swath of humanity down the middle of the state in what we call the Front Range -- that's Denver and other bigger cities -- but really most of Colorado is rural. I think we have fifteen frontier counties. Finding people to practice in rural environments has been a challenge for decades and it continues to be, and I think those rural access issues have gotten probably even worse since I've been in practice. So, that's something that's of great interest to us. 


Hillary:  I don't know if we want to touch on burnout, too, but we're seeing clinicians that have joined the field leave sooner and kind of experience this moral injury. Especially post COVID, we're seeing more and more physicians leave the practice sooner. I don't know if you want to touch on anything related to that.


Jonathan: I think wellness and burnout are a big focus at our institution, in our hospitals, in our in our training programs. It's a big issue that I don't anticipate will go away. I think we continue to try to do our best. The other thing that I think is interesting -- it's really not directly connected to that -- but in the PA world ,and I think more broadly in health professions, there tends to be a leadership vacuum. There are people who go into healthcare knowing they want to be clinicians. Some of those clinicians do research, some end up doing education, some just do clinic and that's what they do. But there's always a need for leadership at all levels -- of institutions, of hospitals, or clinics -- and I think PAs more and more are filling those vacuums. And there are more and more programs to train PAs who see themselves as leaders and need additional training. So, you know, Master of Health Administration programs and things like that. I think that's an area of tremendous growth for my profession. I know so many great PA leaders. 


I always look at my students and say ‘among these students, there's so many future leaders who may not see themselves as such’ so we’re trying to create opportunities for leadership. We have a leadership and advocacy scholarship within the program for four students each year. I think it's really important for our profession to contribute in that way. 


Hillary: Definitely, and it sounds like you're investing a lot in creating this future generation that can fill these gaps and step into these leadership roles. And, you know, I'm very optimistic about the future of our students just knowing and working with so many of them and realizing what they're going through. They’ve got a kind of resilience, especially with everything from COVID to adapting to online learning to increasing climate change crises. There's just a lot that they've got on their hands, so I think it's great to invest in those skills in the program. 


When you're looking for students, are there particular skills or qualifications that you're trying to select for in your program in particular?


Jonathan: That is a question I get from a lot of applicants who want a leg up. I think what I will tell you is something I would tell anyone who is considering applying or pursuing this profession. What we're looking for are a couple of things, just sort of several domains. One is just the academic ability. While we want to welcome as many people into the profession as we can, you have to be able to get it done academically. These are academically intense programs. They're brief and fierce programs in terms of academic expectations, so you do need to be able to maintain that academic intensity. That's important. 


But other things that we’re really interested in include alignment with our mission. Our mission is really around community based health, rural and urban underserved care, and primary care. So, you know, fundamental primary care, and caring for families. So, we like to see people who show a connection and a commitment to their communities and that doesn't need to be anything related to medicine. I'm impressed with somebody who applies to this program and has done the Peace Corps or has spent time volunteering with a Boys and Girls Club or, you know, volunteering in youth athletics or church groups or whatever it is. We really value commitment and longitudinal commitment to your community, to other people in whatever form that takes. That's really important to us. 


Hillary: That makes a lot of sense. And it seems like it's a transferable kind of skill into the program.


Jonathan: Correct. 


Hillary:  Great. Well, we're a teaching company, as you know, and we love to fill in knowledge gaps. Is there a topic you think Osmosis should make a video or course about to fill in a gap that's of particular interest to you? 


Jonathan: Yes. I'm glad you asked. The one thing that I think we almost couldn't get too much of is clinically applied materials. You know, a brief session that may take the learner through a case where there are physiologic concepts, but also clinical concepts. We do a lot of gradual reveal in our program with cases where we start off with a person of a certain age presenting with something and then we'll reveal more information as we go. Things like that. I would never tire of those. Those are great. 


The one area, though, that I think would be really great -- and I'm sure it's absolutely on your radar -- is AI. I don't know how much stuff you have on AI yet on your platform, but, boy, we are immersed in it right now. We're both trying to figure out how to utilize AI in the program to help us just in terms of time savings and efficiency. But also, we know that AI is being used in the clinical space. It's coming fast and furious at everyone. Our health systems in this region are using AI in various ways. I just think it'd be cool to see in stuff on AI on Osmosis as a general idea. 


Hillary: It's definitely on our radar, and something that we're exploring. We're actually hearing from students and faculty that they're already integrating things like ChatGPT to ask questions. And obviously, you know, we hope that we'll be able to play a bigger role in this and serve as a really credible sourcein theAIspace, but I’m glad you touched on that because we're very excited about the emerging kind of field there. 


You mentioned things like clinical cases and clinically applied materials. Hopefully, some of our newer products that are coming out in the next year or so will serve some of those gaps but of course alwaysinterested in that kind of feedback so I’ll pass it along to the team and make sure we're covering those areas.


Jonathan:The thing I’m really curious about is the sort of logical fusion of AI with adaptive learning and these adaptive learning platforms. Imagine you're injecting AI into that. You could do some very, very personalized learning using these using AI platforms with an adaptive mindset where you're really trying to figure out that person's gaps and strengths. I just think personalized learning has always been this sort of dream...like, how can we make each person's learning experience in the program best suited for them and where they are. I think AI blows that opportunity up. There's so many possibilities. I suspect I don't know enough about, it but I’m very excited.


Hillary: I think that's exactly what it could be used for. In fact, early on in the Osmosis days, we had kind of a pre-AI tool actually that was called Workspaces -- and some students still use it --where you could upload your course PowerPoint or something like that and essentially we had an algorithm that would cross-check the different terms and concepts that were mentioned in this PowerPoint or syllabi and then it would actually come up with a study schedule for students. It would say, “Okay, watch these videos, complete these questions.” That was a very basic form of this, but I can imagine in the next year or so we'll see a lot more of these AItools being able to identify gaps in students’ understanding and kind of predict what areas they may need to learn more of and really personalize it as you said. So, I think that's a way that we can better serve our learners and ensure that they're prepared for practice.


Jonathan: Yes, I’m look forward to it. I’ll keep myears to the ground in terms of what you're doing at Osmosis because I really know this is going to happen and it's going to happen quickly, I suspect.


Hillary: We're seeing the changesaccelerate every week. 


So, we have many students and early healthcare professionals in our audience. Given your background and your experience in healthcare over the years, what advice would you offer them about meeting some of these challenges, whether it's technology or burnout or access to care. What are some of the challenges that you've seen and maybe advice that you would give them to address those challenges?


Jonathan: That's a really good question and one that comes up now and again. I think my answer is going to be fairly general. One bit of advice that I would give to my kids or anyone, is to allow your curiosity to lead you to some degree. Pursue the things that you're really interested in because when the going gets tough in clinical medicine, and it does -- you have rough days -- if you're in an area you are excited by and that you're curious about, I think it helps get you through those tough days at work or the tough periods in your job. So, let your curiosity guide you.


Secondly, I think we're such a team-based profession. Most medicine is really focused on team-based care and the PA profession started with team. Team is kind of in our DNA. I think an early career person or someone even contemplating this should decide what that means to you and embrace it. In the classroom, for example, we do a lot of team activities and our classes really support each other and lean on each other. And I think that's the environment, right? That's the thing you're looking for in a medical practice, in a PA program. The value of team is so important.


Hillary: I love that, and even though I mentioned that this advice is for our audience, I'm definitely getting a lot of value from the advice that you and other podcast guests share.  I love the curiosity piece and allowing that to lead you. I think that especially folks in healthcare can sometimes go down the road on a predictable path or think that it's gonna be kind of laid out for them, but there's really so much variety and opportunity alongside that path or even within it. So, we'll pass that along and hope that students really listen to that.


Jonathan:I hope so, too. I mean, it's advice I give to my kids. I have teenagers and they tend to be very goal oriented, and I think goals are so important. The students that we get in our program are super goal oriented. They're students who have kept their nose to the grindstone for most of their academic careers but if the goal becomes the ultimate end, you can lose sight of other things. I think being curious, giving yourself time to step back...we really build that into our program. We try to create opportunities for reflection wherever we can, and I think getting in touch with what really drives your curiosity is so important. 


Hillary: Yeah, I hope to see a lot more of our students joining your programs and listening to this advice and enjoying the spiral curriculum and all that University of Colorado has to offer. I'm very excited about what we talked about today, and think a lot of folks can benefit from hearing these ideas and hopefully integrating them more. Thank you so much, Jonathan, for being with us today. Is there anything else you want to share with our audience before we close up? 


Jonathan: No, it's just great to spend the time with you, Hillary. Appreciate it and hopefully we'll cross paths again in the future. 


Hillary: Well, I'm sure we will. I'm not far away in Colorado up here. We're in Fort Collins, so hopefully we can grab a coffee or something like that. I'm Hillary Acer. Thanks for checking out today's show. Remember to do your part to raise the line and strengthen the healthcare system. We're all in this together.