High-Fidelity Simulation During the Physician Assistant Clinical Year: Evidence for Improving Learner Confidence, Clinical Competence, and Educational Equity

Authors

• Nicole Grange, University of LynchburgFollow

Specialty

PA education

Advisor

Thomas P. Colletti, DHSc, MPAS, PA-C Emeritus, DFAAPA

Abstract

Physician assistant/associate (PA) clinical education is structured around the premise that supervised patient encounters provide the primary vehicle for clinical and professional development. In practice, the inherent variability of clinical rotations produces inconsistent exposure to essential clinical scenarios, creating structural inequity in graduate preparation that rotation assignment alone cannot resolve. This article synthesizes current evidence on high-fidelity simulation (HFS) as an adjunctive educational intervention during the PA clinical year, to evaluate its impact on learner confidence and clinical competence, and to examine its role in promoting educational equity by ensuring student exposure to essential clinical scenarios. A structured literature search was conducted using PubMed, Google Scholar, the Journal of Physician Assistant Education (JPAE), and institutional library databases, including studies from PA, nursing, medicine, physiotherapy, and allied health education spanning 2010 through 2026. HFS consistently improves self-reported learner confidence across clinical domains, health professions, and study designs. These gains compound across exposures and extend demonstrably beyond the training environment. The evidence from randomized and crossover trials supports improvements in objective clinical competence. Extended clinical rotation experience has been shown to produce predictable preparation gaps, leaving confidence in essential competency areas statistically unchanged after rotation completion. HFS addresses this structural gap by ensuring standardized access and exposure. These findings support the intentional integration of HFS during the PA clinical year as an evidence-based strategy to strengthen clinical preparation and promote educational equity. This is achieved by ensuring every student encounters the essential clinical scenarios their education was designed to guarantee. Future research should examine whether HFS-produced gains translate into board examination results, objective structured clinical examination performance improvement, and patient care outcomes in early practice.

Recommended Citation

Grange N. High-Fidelity Simulation During the Physician Assistant Clinical Year: Evidence for Improving Learner Confidence, Clinical Competence, and Educational Equity. University of Lynchburg Doctoral Project Assignment Repository. 2026; 8(2).