Competency Milestones in a Didactic Curriculum: An Innovative Accreditation Compliance Strategy That Enhances Clinical Readiness.

Introduction: This article describes an innovative approach to accreditation compliance and to bridging the gap between didactic education and clinical practice through competency-based assessment (CBA) implemented during the final semester of the didactic phase in a physician assistant program. While CBA is more commonly used in the clinical phase, its application in the didactic curriculum represents a novel strategy for ensuring clinical rotation readiness while demonstrating compliance with Accreditation Review Commission on Education for the Physician Assistant standards.

Methods: This program developed 22 didactic competencies that aligned with programmatic competencies, providing students with multiple opportunities to demonstrate rotation-ready proficiency. Implementation included restructuring classroom time around focused clinical reasoning practice, problem-based learning, and objective structured clinical examinations with comprehensive feedback mechanisms. Assessment of effectiveness triangulated course outcomes, student perceptions, and preceptor evaluations.

Results: The assessment demonstrates strong alignment between CBA experiences and clinical performance expectations. Student feedback highlighted the value of individualized guidance, practical preparation, and enhanced clinical reasoning skills. The approach successfully addressed key accreditation standards: curriculum competency design (B1.01), alignment of outcomes with competencies (B1.03e), and support of demonstrating effectiveness of didactic curriculum (C1.01b). Despite challenges, including resistance to change and assessment complexity, the CBA system improved student self-regulation through deliberate practice and reflection.

Discussion: This compliance strategy offers physician associate/assistant programs an effective framework for developing confident, capable students truly prepared for clinical rotations while providing robust documentation of didactic design, alignment, and curriculum effectiveness for accreditation purposes.