Purpose. The Interservice Physician Assistant Program (IPAP) located at Fort Sam Houston, Texas, provides the education for the majority of all Army, Navy, and Air Force physician assistants. As such, ensuring that program maintains premier performance to support combat and peacetime healthcare is vital to the interests of the Department of Defense. To support this mission, an analysis of structure, process, and outcomes for the program was conducted using survey data and Physician Assistant National Certifying Examination (PANCE) scores. Methods. Methods employed included Chi Square analysis, regression, small multiple comparisons. Graphical and statistical results provided evidence of program strengths and weaknesses.Results. Analysis of survey data (33% response rate) revealed that students who had graduated four or more years ago were more likely to self-report that IPAP prepared them for clinical work (Chi-Square = 8.16, p<.006, Odds Ratio: 3.1:1). Students reported high-confidence in the disciplines of EENT, orthopedics, and dermatology as well as low-confidence in hematology and dentistry. Analysis of performance deltas provided statistically significant and practically relevant results (F(16,48) = 17.59, p < .001, adj. R^2 = .806). IPAP student first-time test-takers routinely performed above the national average; however, performance in recent years has declined. Areas of strength identified in the analysis included EENT and dermatology confirming student self-assessments. One area of weakness identified was psychiatry and behavioral health.Conclusions. Based on the analysis of structure, process, and outcome, IPAP leadership is evaluating specific performance improvement initiatives to maintain program strengths and address weaknesses. Disclaimer Notice: The opinions or assertions contained herein are the private views of the authors and are not to be construed as reflecting the views of either the Department of the Army, the Department of Defense, the U. S. Government, or Baylor University. Introduction The Interservice Physician Assistant Program (IPAP) located at Fort Sam Houston, Texas, provides the education for the majority of all Army, Navy, and Air Force physician assistants. Ensuring that program maintains premier performance to support combat and peacetime healthcare is vital to the interests of the Department of Defense. IPAP began as an Army-only program for training physician assistants in 1972 [1], and became a tri-service (Army, Air Force, and Navy) program in 1996. The program, similar to other physician assistant education programs, consists of a didactic year with three trimesters followed by 53 week rotations in one of 20 medical facilities.[2] Unlike typical programs which are composed mainly of women [3], the majority (nearly 80%) of IPAP's attendees are male. The program awards a Master of Physician Assistant Studies degree in conjunction with the University of Nebraska. [4] This study evaluates structure, process, and outcome measures of the IPAP as part of performance improvement initiatives. Three management questions provide the basis for this research. Structure: Is the students’ perceived preparation for their career related to military pay grade at entry, service component, prior field service, and recency of graduation? Process: What topic areas are perceived by students to be strengths and weaknesses? Outcome: Are there differences in performance on the Physician Assistant National Certifying Examination (PANCE) over time and by discipline area for IPAP first-time test takers versus all first-time test takers? Physician assistant educators might benefit from both the structure of this analysis and the methods employed to evaluate program efficacy.Some analysis of IPAP performance exists in the literature. A previous study of IPAP (1998 through 2002) revealed that overall pass rates of first-time test-takers on the PANCE were higher than civilian programs.[5] The results are not surprisi
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