Diagnostic Imaging Usage by Physician Assistants in Emergency Medicine: An Observational Study
Max Rady College of Medicine, University of Manitoba
How they used Delve
Researchers at the University of Manitoba's Max Rady College of Medicine used Delve to code observational records of emergency physician assistants gathered across multiple Canadian sites over more than two years, running a deductive thematic analysis of which imaging they order, how they interpret it, and how much autonomy they have.
“Data was then input in Delve: Qualitative Data Analysis Software (New York City, USA) to be coded and retrospectively analyzed. Deductive coding themes included chief complaints requiring imaging, image interpretation by the PA, regions of the body imaged, diagnoses requiring imaging, rural versus urban, and autonomy of the [PA].”
- Field
- Emergency medicine and diagnostic imaging; how physician assistants order and interpret imaging in Canadian emergency departments, urban and rural
- Data
- Participant observations of emergency physician assistants across multiple Canadian sites from November 2022 to March 2025, recording chief complaints, imaging ordered (x-ray, CT, MRI, formal and bedside ultrasound), diagnostic and laboratory tests, treatment plans and diagnoses
- Approach
- Deductive thematic analysis of participant-observation records. The coding frame was set in advance: chief complaints requiring imaging, image interpretation by the physician assistant, regions of the body imaged, diagnoses requiring imaging, rural versus urban setting, and PA autonomy.
- Data types
- Observation
Abstract
Background: Diagnostic imaging is an essential and frequently utilized tool in emergency departments across Canada. With the ongoing increase in demand for emergency care and the growing workload faced by emergency physicians, exploring alternative strategies to support and optimize the use of diagnostic imaging is imperative. This study aims to describe how physician assistants (PAs) currently utilize diagnostic imaging in emergency medicine within a Canadian healthcare setting, providing valuable insights into their role and practices. Methods: This retrospective, multi-centre observational study employed participant observations to gather data on emergency PAs and their diagnostic imaging utilization from November 2022 to March 2025. Deductive thematic analysis was conducted, focusing on key areas such as chief complaints prompting imaging, PA interpretation of images, and PA imaging autonomy. Data analysis was performed using Delve: Qualitative Data Analysis Software. Results: Emergency PAs use all imaging modalities in practice, but most frequently utilize x-ray, followed by CT, in which they often interpret results prior to a radiology report. They investigate a variety of chief complaints requiring imaging that are routinely gastrointestinal, orthopedic, cardiovascular, neurologic, respiratory, and skin-related in nature. Common diagnoses made through diagnostic imaging include fractures, pneumonia, osteomyelitis, kidney stones, and appendicitis. They also frequently rule out brain bleeds. Overall, the diagnostic imaging scope of practice was similar for urban and rural PAs.
Citation
Rachel Herzog, Alexa Hryniuk (2025). Diagnostic Imaging Usage by Physician Assistants in Emergency Medicine: An Observational Study. Research Square. https://doi.org/10.21203/rs.3.rs-7447186/v1