Despite differences in schooling and clinical experience prior to practice, advanced practice providers often have similar scopes of practice, which raises concerns about the quality of care being provided. In this paper, we explore if prescribing patterns are comparable between provider types by comparing differences in time spent on pharmacological interventions utilizing a simulated healthcare environment. Physicians (MDs and DOs), Nurse Practitioners (NPs), and Physician Assistants (PAs) actively practicing in Family Practice/Medicine or Internal Medicine in the U.S. state license/recognition were recruited at healthcare conferences and simulation centers. Participants were provided 20 minutes to complete the patient consultation on a Standardized Patient (SP) presenting with a chief complaint of a post-hospitalization follow-up for heart failure, fatigue, and some edema. All encounters were recorded and uploaded to be reviewed by undergraduate evaluators, who were responsible for quantifying the amount of time the participants spent on each of the task categories, including pharmacologic interventions. With a total of 46 participants in this study, the average amount of time spent discussing this activity per visit across each provider type was 14.8 seconds for MDs/DOs, 29.2 seconds for NPs, and 38.8 seconds for PAs. The results of this study suggest that PAs (p= 0.0028) spent significantly more time discussing pharmacological interventions and were significantly more likely to discuss pharmacological interventions (p=0.0243) when compared with physicians (MD/DOs). It is important to note that the sample size of PAs was very small (N=9), which could potentially skew the results and not be representative of the population. With limited literature that examines whether time spent discussing pharmacological interventions is comparable across provider types, it is important for more simulated healthcare research to be conducted on this topic.

Interventions that increase access to care for Latinos lack to account for how trust in healthcare providers impact the usage of expanded access. This thesis looks to identify the levels of trust among US Latinos in health care providers, and how those levels of trust impact quality of care and health outcomes. It will start with a detailed explanation of key terms that will be used throughout the text. Next, an overview of the health profile of US Latinos is presented to pinpoint where health inequities exist. After, it will provide historical context on why mistrust in medical providers might exist amongst US Latinos today. It will then look to establish the levels of trust in health care providers among Latinos currently living within the United States, relative to other racial and ethnic groups. Lastly, it will analyze how those levels of trust impact health behaviors, health outcomes, and quality of care for Latinos.

Minnie Joycelyn Elders, known as Joycelyn Elders, is a pediatrician and professor at the University of Arkansas for Medical Sciences in Little Rock, Arkansas. In 1953, Elders began to work with the US Army, where she trained as a physical therapist, being the only African American woman in her training class. Elders eventually became a medical doctor in 1956, specializing in pediatric endocrinology. In 1993, then US President Bill Clinton appointed Elders as the Surgeon General for the United States Public Health Service Commissioned Corps, which she served as until 1994. At that time, Elders was the first African American to hold the position of Surgeon General in the US. Throughout her career, Elders often spoke about controversial topics, like comprehensive sexual health education and abortion. During her time as Surgeon General, Elders advocated for universal health care coverage, promoting comprehensive sexual health education and bringing awareness to teen pregnancy in the US.