Should the new PANRE Content Blueprint change or impact how I prepare for the alternative PANRE? The answer is absolutely. It’s a new era in PA education. The days of clinically irrelevant questions are done. The NCCPA now has clinicians writing test questions with a much narrower focus, making them more clinically relevant.
How should I study for the Alternative PANRE? With every disease process you are studying, you have to know what level of content it is. With the updated PANRE, you now have to study in one of three levels: Level 1, Level 2 or Level 3; we call it here at CME4Life, Red, Yellow and Green. Just like triage in the emergency department, if someone presents with an emergency condition, their triage is the color red. That means we have to go see them immediately. As physician assistants, we often evaluate patients, and if they’re critically ill, our job is to get a supervising doc or the appropriate consultant. That’s exactly how you need to study.
Level 1 Diseases
If you’re studying a Red (or Level 1) disease process, such as a thoracic dissection, our job is to go immediately get help. Other diseases that are classified as Red are things like a pericardial effusion, Prinzmetal angina, endocarditis, cardiogenic shock and hypertrophic obstructive cardiomyopathies. If you have a 22-year-old that has a syncopal episode and your suspicion is a hypertrophic cardiomyopathy, it is our job, responsibility and focus to go talk to our supervising doc and recruit their involvement. That’s how you have to study for Red disease states.
As the NCCPA puts it, Level 1 diseases require recognition of the most likely diagnosis using signs, symptoms and risk factors; then refer appropriately. So, for Level 1 diseases we don’t have to interpret diagnostic tests. We don’t have to read CAT scans. We don’t have to know first-line treatment, but for Level 2 it is more engaged.
Level 2 Diseases
So, Level 2 content is your Yellow content. Per the NCCPA, we must make an appropriate diagnosis by recognizing signs, symptoms and risks, and/or interpreting results of diagnostic studies and have first-line knowledge of treatment. If it’s a Yellow disease, we have to be able to make the diagnosis by using EKGs, radiography, etc. and know the first-line treatment. Some examples of that would be congestive heart failure or a STEMI. You have to know that they need reperfusion and aspirin. If the heart is getting squeezed like pericardial tamponade, we need to know that a pericardiocentesis is the right answer.
Level 3 Diseases
The last stage is Green (Level 3), where per the NCCPA we need to make the appropriate diagnosis by recognizing signs, symptoms and risks, and/or interpreting results of diagnostic studies and have knowledge of first-line treatment. In addition, you need to have the knowledge required to manage well-known comorbid conditions, contraindications and complications.
For cardiology, those are diseases like hypertension, hyperlipidemia, AFib, coronary artery disease that’s stable and deep venous thrombosis. So, for hypertension, we need to clearly make that diagnosis and then initiate treatment and look at all the comorbid conditions of hypertension, like retinopathy and diabetic nephropathy. We need to look at heart attack and stroke, as they pertain to risk factors for hypertension because it’s a Level 3 bit of information.
So, should the new PANRE Content Blueprint change and impact how you study? The answer is absolutely. I’ve taught physician assistants for the last 15 years, and if you asked me while I was teaching at two PA schools here in Buffalo, NY, “How would I get straight As in PA school?” I would not tell you to study the content. I’d say you have to study the teachers. Every teacher teaches differently, and our boards are no different. You have to know the rules of the game.
The rules of the game are: now that clinicians are writing questions, there’s a much narrower focus of information, and the information that we study is going to be much more clinical as it’s broken down by the levels of knowledge that we need to know. The PANRE is forever changed in a very good way. It’s a strong move for our profession and I really applaud the NCCPA for these positive changes.