PHYSICIAN ASSISTANT NATIONAL CERTIFYING
EXAM 2026 FINAL REVIEW PACK COMPLETE
QUESTION SET AND CORE CLINICAL
CONCEPT SUMMARY
◉ Describe what medicine and the delivery of health care services
looked like in the first half of the 20th century. Answer: The medical
profession was mostly white and male dominated, there were more
generalists than specialists, most physicians worked in private
office-based practices, fee-for-service was the primary method of
payment (out-of-pocket), and hospital cost per capita was low.
◉ Obj. 3: Describe the impact of WWII and its aftermath on
medicine, and the delivery of health care services in the 1950s and
1960s. Answer: There was an increase in number of specialists
compared to generalists, there was a shift from office to hospital
care, there was an increase in availability of third party health
insurance, there was an increase in diagnostic and therapeutic
procedures that could be offered to the public, and there was an
increase in the nation's gross domestic product, with associated
increase in family incomes, that increased the demand for health
care services.
◉ Explain why efforts to pass national health care insurance failed in
the 1940s and 1950s. Answer: National Health Insurance was
,viewed by the American Medical Association and by right-wing
conservative politicians as "socialized medicine", and was viewed
even as being "communistic" during a
time of cold war fears; national health insurance was viewed by
some as being un-American with a threatened loss of freedom of
choice.
◉ Explain why Medicare and Medicaid national health insurance
plans became necessary in the 1960s Answer: Many Americans
received third-party health insurance as a benefit of employment.
Without employment, older Americans, the disabled and the poor
could not afford third-party insurance - so the federal government
intervened, to assure they received access to health care services.
◉ List four factors that fueled the demand for health care services in
the 1960s. Answer: An increase in per capita income provided more
money to spend on health care, 2) An improvement in hospital
standards and the availability of advanced diagnostic and
therapeutic technologies improved hospital services and outcomes,
3) An increase in availability of employer prepaid health insurance
plans, including hospital insurance, provided greater access to
services, and 4) The enactment of Medicare and Medicaid health
plans for the elderly, disabled and poor, increased access to services.
◉ Name four socioeconomic and political issues that caused civil
unrest during the early 1960s. Answer: 1) Unpopular war in
,Vietnam, 2) Segregation of African Americans, particularly in the
South, 3) Women's Rights and 4) Farm Workers' Rights.
◉ Name three major pieces of legislation that were passed by
Congress in the 1960s to address civil rights and health care issues.
Answer: Civil Rights Act and 2) Equal Opportunity Acts passed in
1964 and 3) Medicare and Medicaid Acts passed in 1965.
◉ Describe the events and name the people and university where
the first attempt was made to provide nurses advanced clinical skills
in the 1950s. Answer: To address shortage in clinical support
personnel, Eugene A. Stead, Jr. MD and Thelma Ingles RN, a
prominent nurse educator, developed an advanced clinical nurse
specialist program at Duke University that was rebuffed (not
accredited) by organized nursing leadership (the National League
for Nursing).
◉ State at least three factors at the time, which led nursing
leadership to reject an excellent and pioneering program to provide
advanced clinical skills to nurses. Answer: There was a shortage of
nurses, 2: Steps were being taken to improve the image of nursing by
requiring RNs to have baccalaureate degrees, 3) The Duke program's
instructors were primarily physicians not nurses and Ms. Ingles did
not have a degree in nursing although she was a highly trained and
skilled RN, 4) Nursing leadership was involved in the feminist
movement; (most physicians were men and most nurses
, were women) and 5) Role identification - nursing leadership could
not envision a hybrid nurse-physician practitioner or nurses
working under the supervision of a physician. Nursing saw its role
and knowledge base to be separate and distinct from the practice of
medicine.
◉ Name the physician who in 1960 called for the education of
doctor assistants recruited from the "nonprofessional" ranks using
the example of corpsmen, mostly high school graduates, who had
been trained to assist doctors in the military. Answer: Charles
Hudson MD
◉ Name two physicians who used former military corpsmen, as
their first recruits to be educated as physician assistants and explain
the differences in their approach. Answer: Eugene Stead, MD
developed a 2-yr academic based program at Duke University in
1965, 2). Richard Smith, MD developed a joint
academic/community-based program at the University of
Washington in 1968. Stead called his students physician's assistants
and Smith called his MEDEX; both used a generalist model of
education. A collaborative (with physicians), rapid deployment
model was also a feature of Smith's approach to educating PAs.
◉ Describe what benefits were derived from using former military
corpsmen as a primary source of PA students in the 1960s. Answer:
Because of the Vietnam War, large numbers of military corpsmen
were being trained and released from the military annually with no
EXAM 2026 FINAL REVIEW PACK COMPLETE
QUESTION SET AND CORE CLINICAL
CONCEPT SUMMARY
◉ Describe what medicine and the delivery of health care services
looked like in the first half of the 20th century. Answer: The medical
profession was mostly white and male dominated, there were more
generalists than specialists, most physicians worked in private
office-based practices, fee-for-service was the primary method of
payment (out-of-pocket), and hospital cost per capita was low.
◉ Obj. 3: Describe the impact of WWII and its aftermath on
medicine, and the delivery of health care services in the 1950s and
1960s. Answer: There was an increase in number of specialists
compared to generalists, there was a shift from office to hospital
care, there was an increase in availability of third party health
insurance, there was an increase in diagnostic and therapeutic
procedures that could be offered to the public, and there was an
increase in the nation's gross domestic product, with associated
increase in family incomes, that increased the demand for health
care services.
◉ Explain why efforts to pass national health care insurance failed in
the 1940s and 1950s. Answer: National Health Insurance was
,viewed by the American Medical Association and by right-wing
conservative politicians as "socialized medicine", and was viewed
even as being "communistic" during a
time of cold war fears; national health insurance was viewed by
some as being un-American with a threatened loss of freedom of
choice.
◉ Explain why Medicare and Medicaid national health insurance
plans became necessary in the 1960s Answer: Many Americans
received third-party health insurance as a benefit of employment.
Without employment, older Americans, the disabled and the poor
could not afford third-party insurance - so the federal government
intervened, to assure they received access to health care services.
◉ List four factors that fueled the demand for health care services in
the 1960s. Answer: An increase in per capita income provided more
money to spend on health care, 2) An improvement in hospital
standards and the availability of advanced diagnostic and
therapeutic technologies improved hospital services and outcomes,
3) An increase in availability of employer prepaid health insurance
plans, including hospital insurance, provided greater access to
services, and 4) The enactment of Medicare and Medicaid health
plans for the elderly, disabled and poor, increased access to services.
◉ Name four socioeconomic and political issues that caused civil
unrest during the early 1960s. Answer: 1) Unpopular war in
,Vietnam, 2) Segregation of African Americans, particularly in the
South, 3) Women's Rights and 4) Farm Workers' Rights.
◉ Name three major pieces of legislation that were passed by
Congress in the 1960s to address civil rights and health care issues.
Answer: Civil Rights Act and 2) Equal Opportunity Acts passed in
1964 and 3) Medicare and Medicaid Acts passed in 1965.
◉ Describe the events and name the people and university where
the first attempt was made to provide nurses advanced clinical skills
in the 1950s. Answer: To address shortage in clinical support
personnel, Eugene A. Stead, Jr. MD and Thelma Ingles RN, a
prominent nurse educator, developed an advanced clinical nurse
specialist program at Duke University that was rebuffed (not
accredited) by organized nursing leadership (the National League
for Nursing).
◉ State at least three factors at the time, which led nursing
leadership to reject an excellent and pioneering program to provide
advanced clinical skills to nurses. Answer: There was a shortage of
nurses, 2: Steps were being taken to improve the image of nursing by
requiring RNs to have baccalaureate degrees, 3) The Duke program's
instructors were primarily physicians not nurses and Ms. Ingles did
not have a degree in nursing although she was a highly trained and
skilled RN, 4) Nursing leadership was involved in the feminist
movement; (most physicians were men and most nurses
, were women) and 5) Role identification - nursing leadership could
not envision a hybrid nurse-physician practitioner or nurses
working under the supervision of a physician. Nursing saw its role
and knowledge base to be separate and distinct from the practice of
medicine.
◉ Name the physician who in 1960 called for the education of
doctor assistants recruited from the "nonprofessional" ranks using
the example of corpsmen, mostly high school graduates, who had
been trained to assist doctors in the military. Answer: Charles
Hudson MD
◉ Name two physicians who used former military corpsmen, as
their first recruits to be educated as physician assistants and explain
the differences in their approach. Answer: Eugene Stead, MD
developed a 2-yr academic based program at Duke University in
1965, 2). Richard Smith, MD developed a joint
academic/community-based program at the University of
Washington in 1968. Stead called his students physician's assistants
and Smith called his MEDEX; both used a generalist model of
education. A collaborative (with physicians), rapid deployment
model was also a feature of Smith's approach to educating PAs.
◉ Describe what benefits were derived from using former military
corpsmen as a primary source of PA students in the 1960s. Answer:
Because of the Vietnam War, large numbers of military corpsmen
were being trained and released from the military annually with no
