Preparation to Prescribe: Perceptions of Readiness Among Physician Assistant Students and Recent Program Graduates

INTRODUCTION: Physician assistants (PAs) increasingly prescribe medications, yet accreditation standards do not specify prescribing competencies and no validated tool measures PA students' readiness to prescribe. METHODS: In this IRB-approved cross-sectional study, we developed an 88-item Physician Assistant Self-Perceptions of Readiness to Prescribe survey informed by international prescribing frameworks. Validity and reliability were evaluated by PA faculty experts using content-validity indices, factor analysis, Cronbach α, and a 30-day test-retest. The instrument was administered electronically to didactic students, clinical students, and recent graduates from one PA program. RESULTS: The survey demonstrated high content validity and excellent internal consistency (α ≈ 0.98). Exploratory factor analysis identified 4 factors; 15 items loaded below 0.50. Forty-four participants responded to the initial survey. Mean readiness scores rose across training stages (didactic students = 4.16, clinical students = 4.81, and graduates = 5.04 on a 1-6 scale). Respondents felt most prepared in understanding patient needs and learning prescribing "on the job" and least prepared in formulary knowledge and personal prescribing confidence. DISCUSSION: This survey offers educators a validated tool to assess prescribing readiness and identifies specific gaps in formulary knowledge and prescribing confidence. Incorporating explicit prescribing competencies and broader multiprogram testing could promote safer, more effective prescribing by PAs.