What Works? Fostering Inclusivity in Physician Assistant/Associate Education: The Retention, Outreach, Alignment, and Diversity (ROAD) Framework

Introduction There are well-known strategies to increase diversity in health professions education, evidence is sparse on how such strategies are practically implemented and longitudinally sustained. This study investigated the most widely used strategies across physician assistant/associate (PA) educational programs that have consistently demonstrated the ability to graduate racial and ethnic underrepresented students. Methods Following a grounded theory, qualitative interviews were conducted with 41 nationally accredited PA programs identified as top performers in consistently graduating racial and ethnic underrepresented students. Semistructured interviews were conducted with a program representative focused on ascertaining the characteristics and strategies attributable to the successful recruitment and retention of underrepresented PA matriculants. The interviews comprehensively explored program resources, efforts, and practices. Transcripts were coded, and themes were identified. Results The study revealed 4 overarching themes: (1) Pathways from the Community to the Program and Into Healthcare; (2) Dedication to Student Retention and Support; (3) Commitment to Diverse and Inclusive Learning Environments; and (4) Alignment of Mission, Inclusive Action, and Improving Diversity Outcomes. Based on these emerging themes, we propose a new diversity framework that hinges on Retention, Outreach, Alignment, and Diversity (ROAD Framework). This framework seeks to explain the overarching goals, high-impact behaviors, and actionable steps that can be effectively implemented across PA education to facilitate further diversification. Discussion This study illuminated on What Works to foster diversity in PA programs. By embracing and implementing the ROAD Framework, institutions can effectively address the persistent issue of underrepresentation and contribute to cultivating a more inclusive and representative healthcare workforce.