PANCE 2019 and Beyond

Content Blueprint Task Areas

The list of tasks below include knowledge and skill areas that were identified as important to physician assistant practice through an intensive practice analysis. These knowledge areas and cognitive skills are covered on PANCE.

Each question you encounter will address an organ system and a task area from the table below.



A. History Taking and Performing Physical Examination


B. Using Diagnostic and Laboratory Studies


C. Formulating Most Likely Diagnosis


D. Managing Patients


     D1. Health Maintenance, Patient Education, and Disease Prevention


     D2. Clinical Intervention


     D3. Pharmaceutical Therapeutics


E. Applying Basic Scientific Concepts


F. Entry-Level Professional Practice


*Percentage allocations may vary slightly


A. History Taking & Performing Physical Examinations (17%)

Knowledge of:

  • General physical examination components and techniques

  • Pertinent historical information

  • Risk factors for development of significant medical conditions

  • Significant physical examination findings

  • Signs and symptoms of significant medical conditions

Skills in:

  • Conducting comprehensive and/or problem-based interviews and physical examinations

  • Eliciting patient information from other sources

  • Identifying conditions requiring referral to or consultation with specialists

  • Identifying pertinent patient and family historical information from patients and caregivers

  • Identifying pertinent physical examination information

  • Triaging of patients based on recognition of abnormal vital signs, examination findings, and/or general observations

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B. Using 
Diagnostic and Laboratory Studies (12%)

Knowledge of:

  • Appropriate patient education relating to diagnostic and laboratory studies

  • Indications for initial and subsequent diagnostic and laboratory studies

  • Indications for preventive screening tests

  • Risks associated with diagnostic and laboratory studies

Skills in:

  • Collecting diagnostic and laboratory specimens

  • Communicating risks, benefits, and results effectively to other members of the health care team

  • Communicating risks, benefits, and results effectively to patients, families, and caregivers

  • Reviewing and interpreting results of diagnostic and laboratory studies, and correlating the results with history and physical examination findings

  • Selecting appropriate diagnostic and/or laboratory studies

  • Using diagnostic equipment safely and appropriately

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C. Formulating Most Likely Diagnosis (18%)

Knowledge of:

  • Significance of diagnostic and laboratory studies as they relate to diagnosis

  • Significance of history as it relates to the differential diagnosis

  • Significance of physical examination findings as they relate to diagnosis

Skills in:

  • Developing multiple differential diagnoses for complicated and/or multisystem cases

  • Formulating most likely differential diagnoses

  • Incorporating history, physical examination findings, and diagnostic data into medical decision-making

  • Recognizing the need for referral to a specialist

  • Selecting the most likely diagnosis in light of presented data

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D. Managing Patients
D1. Health Maintenance, Patient Education, and Disease Prevention (10%)

Knowledge of:

  • Appropriate patient education regarding preventable conditions and lifestyle modifications

  • Barriers to care

  • Early detection and prevention of medical conditions

  • Effects of aging and changing family roles

  • Epidemiology of medical conditions

  • Genetic testing and counseling

  • Human growth and development

  • Human sexuality and gender identity, gender transition, and associated medical issues

  • Immunization schedules and recommendations for infants, children, adults, and foreign travelers/adoptions

  • Impact of patient demographics on risks for medical conditions

  • Knowledge of relevant databases/resources

  • Prevention of communicable diseases

  • Preventive screening recommendations

  • Psychosocial effects of illness, stress, and injury as well as related healthy coping strategies

  • Signs of abuse and neglect

  • Wellness of health care providers

Skills in:

  • Adapting health maintenance to an individual patient’s context

  • Addressing barriers to vaccination

  • Communicating effectively with and educating patients, family members, and caregivers

  • Conducting education on modifiable risk factors with an emphasis on primary and secondary prevention

  • Using counseling techniques

  • Using evidence-based practice guidelines

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D2. Clinical Intervention (14%)

Knowledge of:

  • Clinical procedures and their indications, contraindications, complications, risks, benefits, and techniques

  • Conditions that constitute medical emergencies

  • Criteria for admission to or discharge from the hospital or other facilities

  • Management, treatment, and follow-up of medical conditions

  • Palliative care and end-of-life issues

  • Roles of other health professionals

  • Sterile technique

  • Therapeutic regimens

  • Universal precautions and special isolation conditions

Skills in:

  • Demonstrating technical expertise related to performing specific procedures

  • Evaluating patient response to treatment/intervention

  • Facilitating patient/caregiver adherence to and active participation in treatment

  • Formulating and implementing treatment plans in accordance with applicable practice guidelines

  • Interfacing in multidisciplinary teams, including education of other health care professionals

  • Making appropriate dispositions

  • Monitoring and managing nutritional status

  • Prioritizing tasks

  • Recognizing and initiating treatment for life-threatening conditions

  • Using community resources to meet the needs of patients/caregivers

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D3. Pharmaceutical Therapeutics (14%)

Knowledge of:

  • Adverse effects, reactions, and toxicities

  • Common alternative/complementary therapies and their interactions and toxicities

  • Contraindications

  • Drug interactions, including presentation and treatment

  • Indications for use

  • Mechanism of action

  • Methods to reduce medication errors

  • Monitoring and follow-up of pharmacologic regimens

  • Presentation and treatment of allergic reactions

  • Regulation of controlled substances

  • Special populations requiring drug/dose modification

  • Substances of abuse

Skills in:

  • Assessing patient adherence to drug regimens

  • Drafting a prescription

  • Evaluating, treating, and reporting adverse drug reactions and/or adverse effects

  • Identifying and managing medication misuse

  • Interacting with pharmacists to address medication issues

  • Maintaining knowledge of relevant pharmacologic agents

  • Monitoring pharmacologic regimens and adjusting as appropriate

  • Prescribing controlled substances appropriately

  • Selecting appropriate pharmacologic therapy and dosing

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E. Applying Basic Science Concepts (10%)

Knowledge of:

  • Basic biochemistry

  • Basic genetics

  • Human anatomy and physiology

  • Microbiology

  • Pathophysiology and immunology

Skills in:

  • Evaluating emerging medical trends critically as they relate to patient care

  • Maintaining awareness of trends in infectious disease

  • Relating pathophysiologic principles to specific disease processes

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F. Entry-Level Professional Practice (5%)

Legal/medical ethics

      Knowledge of:

  • Cultural and religious beliefs related to health care

  • Informed consent and refusal process

  • Living will, advance directives, organ donation, code status, do not resuscitate, do not intubate, medical power of attorney, etc.

  • Medicolegal issues

  • Patient/provider rights and responsibilities

  • Privacy, security, and responsibility related to medical record documentation and management

      Skill in:

  • Caring for patients with cognitive impairment

Medical informatics

      Knowledge of:

  • Billing/coding to maintain accuracy and completeness for reimbursement and administrative purposes

      Skill in:

  • Demonstrating appropriate medical record documentation

  • Using appropriate medical informatics sources

Patient care and communication (individual patients)

      Knowledge of:

  • Affordable and effective health care that is patient specific

  • Cultural and religious diversity

  • Stewardship of patient and community resources

      Skill in:

  • Acknowledging and applying patient/provider rights and responsibilities

  • Ensuring patient satisfaction

  • Providing patient advice and education regarding the informed consent and refusal process

  • Providing patient advice and education related to end-of-life decisions

  • Providing patient-specific education, advice, counseling, and referral

Physician/PA relationship

      Knowledge of:

  • Professional and clinical limitations, scope of practice, etc.

  • Supervision parameters: malpractice, mandated reporting, conflict of interest, impaired provider, ethical principles

      Skill in:

  • Communicating and consulting with the supervising physician and/or other specialists/consultants

Professional development  

      Knowledge of:

  • Continuing medical education resources

Skill in:

  • Critically analyzing evidence-based medicine

  • Identifying and interpreting data from medical informatics sources and identifying appropriate reference sources

  • Using epidemiologic techniques to evaluate the spread of disease

Public health (population/society)

Knowledge of:

  • Basic disaster preparedness

  • Infection control measures and response to outbreaks

  • Occupational health issues as they pertain to health care as well as non–health care workers

  • Population health, travel health, and epidemiology of disease states

      Skill in:

  • Protecting vulnerable populations and recognizing disparities in provision of and access to health care

Risk management

      Knowledge of:

  • Quality improvement and patient safety

  • Resource stewardship

      Skill in:

  • Ensuring patient safety and avoiding medical errors

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