UNIVERSITY of the CUMBERLANDS. School of Physician Assistant Studies

Transcription

1 1 UNIVERSITY of the CUMBERLANDS School of Physician Assistant Studies Master of Physician Assistant Studies Program UCPA Policy Manual

2 Table of Contents PART I: GENERAL POLICIES AND PROCEDURES...6 INTRODUCTION Standards A3.01 A PROGRAM ACCREDITATION Standard A3.14a... 7 PROGRAM SPONSORSHIP AND PHILOSOPHY Standard B University Mission Statement... 9 Program Mission Statement... 9 Goals of the Physician Assistant Program DEPARTMENT FACULTY & STAFF - Standards A1.04, A1.08, A2.01,A2.13, A Program Director Standard A Medical Directors Standards A2.11, A Principal Faculty Standard A Instructional Faculty Standards A2.13, A Department Administrative Support Standard A Clinical Preceptors - Standard A PROGRAM ESSENTIAL FUNCTIONS Technical Standards, MPAS Program Details Physician Assistant Studies Degree Requirements Physician Assistant Program Expenses for Cohort 3 Standard A3.14 f CURRICULUM Standards B1.02, B1.03, and B Professional Phase Curriculum MPAS Required Curriculum- Standard A3.14d, e Course Descriptions ACADEMIC POLICIES AND PROCEDURES Absence /Attendance/Timeliness General Policy Absence from Examinations Standard C Absence from Clinical Rotations Absence - Leave of Absence Academic Honesty and Integrity Policy Standard B Admissions - Application Process Admission Requirements Admissions - Conditional Admissions Admissions - Transfer and Course Credit/Advanced Placement Policy Advisement Standard A Appeals and Conflict Resolution Standard A Communication Criminal Background Checks Drugs and Alcohol Grading Policy Harassment Policy Standard A3.11, A3.17g Health and Immunization Documentation Standards A3.21, A Immunization Policy Standard A Injuries and Needle Stick/Blood/Bodily Fluids Contamination Protocol Standard A Name and Contact Information Changes Nondiscrimination Policy Orientation Participation of Students as Human Subjects Performance Standards and Progression Requirements - Standard A3.17c Privacy Rights of Students and Informed Consent Professional Appearance Standard B Professional Development Assessment Tool Standard C Professionalism Standard C Readmission Procedure Remediation Standard C3.03, A3.17f

3 Retention Standards Student Conduct in Clinical Facilities Student Representation Student Security and Safety Withdrawl and Policies and Procedures for Refunds of Tuition and Fees Standards A3.17e, A3.14g MISCELLANEOUS POLICIES Employment During the Program Standard A3.04, A3.05, A3.06, A3.14h Examination Security Holidays Travel to Clinical Sites Weather-Related Emergencies PA Resources Academic Tutoring Standard A Counseling and Career Center Standard A Counseling - Mental Health and Counseling Standard A Disability Services Financial Aid Health Insurance PA Facilities Standard A PA Professional Oath PA Website Student Health Services Standard A1.05, A University Library PART II: POLICIES, PROCEDURES AND OBJECTIVES RELATED TO CLINICAL ROTATIONS CLINICAL ROTATIONS & AFFILIATION AGREEMENTS Standards A1.02, A Core Rotations B3.02, B3.03, B3.04, B Elective Rotations ROTATION-SPECIFIC POLICIES Assignment of Clinical Rotations Charting Confidentiality Holidays Identification in Clinic Standard B Interviews Patient Safety Rotation Schedule Rotations Specific Requirements - Assignments Site Specific Policies Site Visits Standard C Student Scope of Practice - Standard A Student Suggestions for Clinical Rotations Travel to Clinical Sites ACADEMIC REQUIREMENTS FOR CLINICAL COURSES Clinical Logs/Typhon End of Rotation Examinations (EORE) Preceptor Evaluation Seminar/Grand Rounds Student Evaluation of Preceptor/Clinical Site Written Assignments CLINICAL EVALUATION Remediation Procedure in the Clinical Year Standard C Rotation Grading Tips for Success on Rotations ROTATION GOALS AND OBJECTIVES

4 General Goals and Objectives for All Clinical Rotations Goals and Objectives for Specific Rotations Student Responsibilities Before Each Rotation Upon Rotation Arrival During a Rotation Upon Leaving a Rotation FORMATIVE AND SUMMATIVE EVALUATIONS Standard C Formative Evaluation Summative Evaluation MPAS PROGRAM GRADUATION COMPETENCIES PREPARING FOR THE PANCE PART IV: ADDITIONAL RESOURCES PROFESSIONAL ORGANIZATIONS Accreditation Review Commission on Education for the Physician Assistant, Inc. (ARC-PA) American Academy of Physician Assistants (AAPA) National Commission on Certification of Physician Assistants (NCCPA) Kentucky Academy of Physician Assistants (KAPA) PART V: Appendices APPENDIX A: Student Handbook Receipt APPENDIX B: Contact List APPENDIX C: Faculty Advising APPENDIX D: Mid Semester Advising APPENDIX E: PDAT APPENDIX F: PANCE Blueprint APPENDIX G: Academic Mentoring Form APPENDIX H: Incident Report APPENDIX I: Site Visit Evaluation APPENDIX J: Rotation Specific Rubrics Evaluation of Written History and Physical Examination Evaluation of Discharge Note Evaluation of Labor and Delivery Note Evaluation of Operative Note Evaluation of Pre-Operative Note Evaluation of Procedure Note Evaluation of 6 Month (or Infant) Well Baby Exam Oral Presentation Grading APPENDIX K: Mid-Rotation Review of Goals and Objectives 126 APPENDIX L: Preceptor Evaluation APPENDIX M: Student Evaluation of Preceptor APPENDIX N: Competencies Standard B APPENDIX O: Summative Professionalism Assessment Tool

5 5 Notice: POLICY MANUAL UPDATES This Program Policy Manual for the Master of Physician Assistant Studies (MPAS) Program contains policies and procedures unique to the MPAS program and is first distributed to students as they begin the first professional year. Updated versions of this Policy Manual may be provided during a student s enrollment in the program, and the most recent Policy Manual will supersede all previously distributed versions. Where no specific MPAS program policy exists, students are to consult the general guidelines of the University Student Handbook. The MPAS program reserves the right to update this Policy Manual without prior notice. In the event of an update without prior notice, all matriculated students will be provided with a written copy of any updated policies. A student s continuation in the MPAS program will be contingent upon submission of a signed and dated Receipt and Acknowledgement form (see Appendix A) for the most recent update of the Policy Manual. Version: Fall, 2013

6 6 PART I: GENERAL POLICIES AND PROCEDURES Welcome to the School of Physician Assistant Studies at University of the Cumberlands! We are pleased that you have chosen to join us for your education and we look forward to working with you to help achieve your professional goals. This manual is designed to serve as a supplement to other University publications such as the Student Handbook and the University s Catalog. It will provide you with important information as you work your way through your studies.

7 7 INTRODUCTION Standards A3.01 A3.02 Standard A3.01 Program policies must apply to all students, principal faculty and the program director regardless of location. Standard A3.02 The program must inform student of program policies and procedures. The UCPA Policy Manual is designed to give students general information regarding the MPAS program. It is an adjunct to the University academic catalog and the University Student Handbook. These program policies apply to all students, principal faculty and the program director. Please keep this manual in a convenient location so you can refer to it throughout your physician assistant training. This manual provides vital information about the MPAS program and the PA profession. As a beginning MPAS student, you are entering into the professional world. You will be afforded respect and honor as a PA. With this respect comes a great deal of responsibility. Most PAs look back at their student experience as one of the most challenging and rewarding times in their lives. We are confident you will regard becoming a physician assistant as one of your life s most significant milestones. Our faculty and staff are dedicated to your success, and we wish each of you a bright future as a healthcare provider. PROGRAM ACCREDITATION Standard A3.14a Standard A3.14a The program must define, publish and make readily available to enrolled and prospective students general program information to include: the program s ARC-PA accreditation status. University of the Cumberlands voluntarily withdrew accreditation from the ARC-PA in May of 2013, and has begun the process of reapplying for provisional accreditation. Approval of program characteristics, demonstration of preparedness to initiate a program in accordance with the accreditation standards, and the granting of provisional accreditation by ARC-PA is required prior to the University accepting any additional classes into the PA program. This handbook is in part based on the 4 th edition Accreditation Standards for Physician Assistant Education, published in March The Standards will be referenced throughout the manual, as they inform and guide the curriculum, policies and procedures adopted by the MPAS program. The Standards constitute the requirements to which an accredited program is held accountable and provide the basis on which the ARC-PA will confer or deny program accreditation. According to the ARC-PA, these Standards were initially adopted in 1971 and were revised in 1978, 1985, 1990, 1997, 2000, 2005 and ARC-PA commissioners include individuals nominated from the collaborating organizations of the ARC-PA, which include: American Academy of Family Physicians American Academy of Pediatrics American Academy of Physician Assistants

8 8 American College of Physicians American College of Surgeons American Medical Association Physician Assistant Education Association The collaborating organizations cooperate with the ARC-PA to establish, maintain and promote appropriate standards of quality for entry level education of PAs and to provide recognition for educational programs that meet the requirements outlined in the Standards. These Standards are used for the development, evaluation, and self-analysis of PA programs. Physician assistants are academically and clinically prepared to practice medicine under the direction and responsible supervision of a doctor of medicine or osteopathic medicine. The physician-pa team relationship is fundamental to the PA profession and enhances the delivery of high-quality health care. Within the physician-pa relationship, PAs make clinical decisions and provide a broad range of diagnostic, therapeutic, preventive and health maintenance services. The clinical role of PAs includes primary and specialty care in medical and surgical practice settings. PA practice is focused on patient care and may include educational, research and administrative activities. The role of the Physician Assistant demands intelligence, sound judgment, intellectual honesty, appropriate interpersonal skills, and the capability to react to emergencies in a calm and reasoned manner. An attitude of respect for self and others, adherence to the concepts of privilege and confidentiality in communicating with patients, and a commitment to the patient s welfare are essential attributes of the graduated PA. The professional curriculum for PA education includes basic medical, behavioral, and social sciences; introduction to clinical medicine and patient assessment; supervised clinical practice; and health policy and professional practice issues. The Standards recognize the continuing evolution of the PA profession and practice and endorse experiential competency-based education as a fundamental tenet of PA education. While acknowledging the interests of the sponsoring institution as it works with the program to meet the Standards, the Standards reflect a determination that a commonality in the core professional curriculum of programs remains desirable and necessary to offer curricula of sufficient depth and breadth to prepare all PA graduates for practice. The Standards allow programs to remain creative and innovative in program design and the methods of curriculum delivery and evaluation used to enable students to achieve program goals and student learning outcomes. Mastery of learning outcomes is key to preparing students for entry into clinical practice. The PA profession has evolved over time to one requiring a high level of academic rigor. Institutions that sponsor PA programs are expected to incorporate this higher level of academic rigor into their programs and award an appropriate master s degree. The ARC- PA acknowledges ongoing changes in the delivery of health care and in the education of health professionals. - Accreditation Standards for Physician Assistant Education, 4 th Edition

9 9 PROGRAM SPONSORSHIP AND PHILOSOPHY Standard B1.01 Standard B1.01 The curriculum must be consistent with the mission and goals of the program. The faculty and administration of University of the Cumberlands initiated and began developing a Physician Assistant Program in This program was established to extend the institution s historical service to the region and build upon the strengths of its current science programs. The MPAS has been carefully researched, organized, and articulated so that it may be a worthwhile learning experience for degree candidates. The MPAS faculty who has been assembled look forward to the continued opportunity to pursue fulfillment of the program mission in this region. The mission statement of the MPAS Program was developed in 2009 to reflect program outcomes, the developing curriculum, and vision of the founding program director. As demonstrated below, the program mission statement reflects the underlying university mission statement. University Mission Statement University of the Cumberlands has historically served students primarily, but not exclusively, from the beautiful mountain regions of Kentucky, Tennessee, West Virginia, Virginia, Georgia, North Carolina, South Carolina, Ohio and Alabama which have traditionally been described as Appalachia. The University's impact can be seen in the achievements of its graduates who have assumed roles of leadership in this region and throughout the nation. While located in the resort like area of Appalachia, with emphasis primarily on serving the beautiful mountain area, the University now reaches into every state and around the world through its student body and alumni. UC continues to offer promising students of all backgrounds a broad-based liberal arts program enriched with Christian values. The University strives for excellence in all of its endeavors and expects from students a similar dedication to this pursuit. Its commitment to a strong academic program is joined with a commitment to a strong work ethic. UC encourages students to think critically and creatively so that they may better prepare themselves for lives of responsible service and leadership. This focus of its undergraduate programs is extended and extrapolated into its graduate programs. These programs prepare professionals to be servant-leaders in their disciplines and communities, linking research with practice and knowledge with ethical decisionmaking in the pursuit of the life-more-abundant for both the individual and society. Program Mission Statement The mission statement for the program resonates clearly with values and intellectual goals set out in the mission statement for the university: The mission of the MPAS program is to educate competent, compassionate and caring Physician Assistants to be an integral part of the modern professional health care team for underserved areas of Kentucky, the nation and on an international level. The development process, beginning with the genesis of the program, utilized a thoughtful and iterative process to integrate a proposed master s degree in physician assistant studies with the

10 10 vision and strategic plan of the university. The committee envisioned a program that had high ideals for academic rigor and cultural competence, and it affirmed that the program would be built around the ARC-PA fourth edition standards as the foundation. Goals of the Physician Assistant Program In accordance with its mission, the MPAS strives to graduate clinicians fully prepared for employment as competent and caring physician assistants. In order to do this the program has outline several goals aligned professional competencies (See below). It is thus the purpose of the program to: Goal 1: Prepare physician assistants with a strong knowledge base in biomedical and clinical sciences supported by the ability to apply analytic thinking to clinical situations. Goal 2: Instill students with the interpersonal communication skills necessary to develop effective information exchange with patients, their families, and professionals in the healthcare system. Goal 3: Teach students to provide effective patient care necessary for treatment of health problems and the promotion of physical, psychological, and spiritual wellness. Goal 4: Develop physician assistants knowledgeable in legal requirements and respectful of the diversity of the PA profession in order to graduate PAs possessing a high degree of professionalism, commitment to Christian ethics, and integrity. Goal 5: Provide students with the opportunity to understand practice-based learning and improvement by engaging each student in critical analysis of their own experience and medical literature so that they continuously self-improve. Goal 6: Expose students to clinical practice that encompasses the societal, organizational and economic systems that tie into healthcare delivery in order that they may be prepared to deliver optimal patient care. The professional competencies must be achieved upon graduation. Acquisitions of these competencies are measured through the program s assessment system. These competencies are connected to didactic courses in the program which facilitates programmatic improvement. DEPARTMENT FACULTY & STAFF - Standards A1.04, A1.08, A2.01,A2.13, A2.14 Standard A1.04 The sponsoring institution must provide the opportunity for continuing professional development of the Program Director and principal faculty by supporting the development of their clinical, teaching, scholarly and administrative skills. Standard A1.08 The sponsoring institution must provide the program with the human resources necessary to operate the educational program and to fulfill obligations to matriculating and enrolled students.

11 11 Standard A2.01 All faculty must possess the educational and experiential qualifications to perform their assigned duties. Standard A2.13 Instructional faculty must be: a) qualified through academic preparation and/or experience to teach assigned subjects and b) knowledgeable in course content and effective in teaching assigned subjects Standard A2.14 In addition to the principal faculty, there must be sufficient instructional faculty to provide students with the necessary attention, instruction and supervised clinical practice experiences to acquire the knowledge and competence required for entry into the profession. The faculty and staff of the Department of Physician Assistant Studies are dedicated professionals who are focused on preparing you to become physician assistants. Both principal (full-time) and instructional (adjunct) faculty are carefully selected to teach courses based in their academic preparation and professional experience. University of the Cumberlands takes great care in selecting qualified faculty and investing in their continued education and professional growth. Thus, faculty members attend local and national workshops and conferences throughout the year. Some faculty members continue to practice clinically. Thus, when you need to meet with a faculty member about issues related to your education, it is suggested that you make an appointment to meet with the appropriate individual to address your concerns. If you cannot reach your MPAS faculty advisor, or if there is a true emergency, you may contact the Program Director, Ms. Lesley Tipton, or the Vice President of Medical Services, Dr. Eddie Perkins and your issue will be promptly addressed. Program Director Standard A2.06 Standard A2.06 The program director must be a PA or a physician; a) If the program director is a PA, s/he must hold current NCCPA certification. The Program Director, Lesley Tipton, PA-C, MPAS, is responsible for the overall oversight of the MPAS program and participates in financial planning, development and continuous review and analysis of program operations. Any issues which cannot be resolved to your satisfaction with a course instructor or your faculty advisor should be brought to the Program Director s attention. The Program Director will meet regularly with your class to discuss any concerns. Professor Tipton serves as Program Director Physician Assistant Studies Program. Her knowledge base, clinical experience, clinical research, and academic preparation make her highly qualified for this position. She holds certification from the National Commission on Certification of Physician Assistants and is licensed to practice in the state of Kentucky. These credentials meet the ARC-PA expectations for a Program Director as defined in Standard A2.06. Additionally, she is a member of the American Academy of Physician Assistants, the Kentucky Academy of Physician Assistants and the Physician Assistant Education Association. Prof. Tipton graduated from the University of the Cumberlands in 2009 with a Bachelor s Degree in Biology. She then continued her education at the University of the Cumberlands and was part of the first cohort in UC s Master of Physician Assistant Studies.

12 Medical Directors Standards A2.11, A2.12 Standard A2.11 The medical director must be a currently licensed allopathic or osteopathic physician and certified by an ABMS- or AOA- approved specialty board. Standard A2.12 The medical director must be an active participant in the program. Dr. Eddie Perkins and Dr. David Williams serve as the Medical Directors. They are responsible for ensuring that classroom instruction and clinical experiences provide an appropriate level of instruction for students in the MSPAS program and are actively involved in developing the mission statement for the program; providing instruction; evaluating student performance; designing, implementing, coordinating and evaluating curriculum and evaluating the program. Dr. Williams is a practicing physician who serves as the program s Medical Director. Currently he is assigned to teach as a contributing instructor in the MPAS Clinical Medicine series. He is board-certified in Family Medicine by the American Board of Family Medicine approved by the American Board of Medical Specialties and holds licensure as an allopathic physician in the state of Kentucky. He is actively involved in the program, providing instruction, evaluating student performance, evaluating curriculum and the program itself. He meets Standards A2.11 and He received his Doctor of Medicine degree from the University of Tennessee in Knoxville. He serves on various boards and committees as reflected in the faculty roster and has extensive clinical experience. He also serves as Medical Director of the Williamsburg Nursing Home and works for Baptist Health in a family practice. In bringing a wealth of clinical experience to the program, Dr. Williams provides strong leadership in the program and acts as a community advocate for the program. Dr. Eddie Perkins, DO, FACOOG is also a practicing physician serving a Medical Director. He is board-certified in Obstetrics and Gynecology by the American College of Osteopathic Obstetricians and Gynecologists approved by the American Osteopathic Association and holds licensure as an osteopathic physician in the state of Kentucky. He is actively involved in the program, providing instruction, evaluating student performance, evaluating curriculum and the program itself. He meets Standards A2.11 and Additionally, he is a member of the American Medical Association and a Diplomate of the National Board of Osteopathic Medical Examiners. He obtained a Doctor of Osteopathic Medicine degree from Kansas City University of Medicine and Biosciences College of Medicine in 1992 with extensive residency and clinical experience in the area of obstetrics and gynecology. Additionally, Dr. Perkins has clinical research publications. 12 Principal Faculty Standard A2.02 Standard A2.02 The program must have program faculty that include the program director, medical director, and at least three FTE principal faculty positions and instructional faculty. B) Two FTE principal faculty positions must be filled by PA faculty who currently are NCCPA certified. The principal faculty of the MPAS program provides classroom instruction and assist with administration of the program. Dr. Sonia Young, PT, DPT, serves as Associate Director of the School of Physician Assistant Studies with academic assignments in the MPAS Clinical Anatomy series. Dr. Young is licensed as a physical therapist in the state of Kentucky. Additionally, she is a certified clini-

13 cal instructor recognized by the American Physical Therapy Association. She received a Bachelor of Health Science in Physical Therapy from the University of Louisville in 1997, a transitional Doctorate of Physical Therapy from Shenandoah University in 2008 and a Doctor of Education (EdD) in Education Leadership from University of the Cumberlands. She has a variety of clinical experience in multiple settings and with various age groups. She has an understanding of curricular challenges of preparing students for licensure and provides leadership in management for student assessment. With her diverse clinical experience, academic preparation, and knowledge base, Dr. Young contributes to program administration and candidate instruction. Prof. Joseph Reed, M.S., PA-C, currently serves as the Clinical Director and has academic assignments of section instructor on MPAS Clinical Medicine series and serves as instructor of record for the Clinical Rotations, MPAS He was initially appointed to serve as Clinical Coordinator in the University s MPAS program but decided in late 2009 to return to full-time clinical practice. He was succeeded as Clinical Coordinator by Kathleen Flynn in February Mr. Reed received a Master s in Physician Assistant Studies from University of Nebraska, holds certification from the NCCPA as a certified physician assistant, as well as licensure in Kentucky. He has served as an adjunct clinical faculty for the Debusk College of Osteopathic Medicine at Lincoln Memorial University and a clinical preceptor for the University of Kentucky, College of Allied Health Professions. His professional clinical experience includes work as a physician assistant in medical clinics and a hospital. In these settings he has served as a family medicine practitioner, as a hospitalist, and as first assistant in general surgery, obstetrical and gynecological surgery, vascular surgery and orthopedics. The quality of his experience, in addition to his academic preparation and professional certification, qualify him for his adjunct teaching assignments. Prof. Kenneth Reed, M.S., PA-C, initially served the program as an adjunct professor from January - December He is now serving as full-time, principal faculty as an Assistant Professor with teaching assignments of MPAS Physical Diagnosis series, Instructor of record and contributing instructor of MPAS Clinical Medicine series and MPAS Practical Applications in Medicine series. He received a Master of Physician Assistant Studies from the University of Nebraska, holds NCCPA certification as a physician assistant, and is licensed in both Tennessee and Kentucky. He has over 30 years of extensive clinical experience. In addition to family medical practice, he has served in United States Air Force and Army National Guard as a Medical Service Specialist and later as a Physician Assistant. The practical focus of his academic assignments requires a sound clinical background in physical diagnosis, examination and procedural skills, as well as an appropriate academic preparation. Mr. Reed exceeds all of these requirements. Prof. Kendall Gilbert, RN, BSN, MPAS, PA-C currently serves as Academic Coordinator/Assistant Professor of Physician Assistant Studies. Kendall Gilbert is a licensed registered nurse in the state of Kentucky. Additionally, he received a Bachelor of Science degree in Nursing at Eastern Kentucky University in Later, he attended the University of the Cumberlands and graduated earning a physician assistant degree. Prof. Gilbert has worked as a Physician Assistant in Cardiology and as a Hospitalist. He has also worked in a variety of healthcare settings as a registered nurse for many years with various age groups. Prof. Gilbert, given his years of healthcare experience, knowledge base and academic preparation will contribute significantly to our program administration and candidate approval/instruction. 13

14 You will be assigned a faculty member as an advisor who will serve as your primary point of contact while you are with us. Instructional Faculty Standards A2.13, A2.14 Standard A2.13 Instructional faculty must be: qualified through academic preparation and/or experience to teach assigned subjects and knowledgeable in course content and effective in teaching assigned subjects. Standard A2.14 In addition to the principal faculty, there must be sufficient instructional faculty to provide students with the necessary attention, instruction and supervised clinical practice experiences to acquire the knowledge and competence required for entry into the profession. We are fortunate to have access to qualified instructional faculty to assist in teaching the curriculum. We also have a number of physicians, physician assistants and other healthcare providers who will teach courses or lecture to you during your time with us. Dr. Jim Moss served as a general and advanced laparoscopic surgeon for 27 years. He has subsequently been the Medical Director of United States Surgical Corporation (Covedien) and Medical Director of the Special Investigations Unit of Humana. He is presently assigned to teach the MPAS Practical Applications in Medicine courses. Dr. Moss is certified by the American Board of Surgery and a Fellow of the American College of Surgeons. He is a member of honorary and professional societies, has published original data, and holds medical patents. He received his Doctor of Medicine degree from the University of Louisville and is recognized for contributions to his specialty and profession both in innovation and leadership. 14 Department Administrative Support Standard A2.18 Standard A2.18 There must be at least a 1.0 FTE position, which should be dedicated exclusively to the program, to provide administrative support for the program. Our support staff includes Gregory S. Manning who serves as the full-time MPAS Office Administrator and Brad Hall who serves as the Clinical Coordinator. Brad Hall serves as Clinical Coordinator for the Physician Assistant Program. He has over 20 years of experience in healthcare management in long term care, acute and community health, nearly 10 of which include graduate medical education, as Clinical Coordinator he develops partnerships with providers and healthcare facilities that will provide clinical training opportunities for UC Health Programs. Included in his experience is healthcare disaster preparedness and planning. Brad completed Bachelor s Degree from the University of the Cumberlands in Public Health Administration and will complete his Master of Business Administration degree in December 2013 from the University of the Cumberlands. In addition to his duties in the UC Health Programs, he serves as an Assistant to the President, the Vice President of Institutional Advancement and the Vice President for Medical Services and works extensively in the Northern Kentucky Area with the UC Center in Florence.

15 Clinical Preceptors - Standard A2.16 Standard A2.16 All instructional faculty serving as supervised clinical practice experience preceptors must hold a valid license that allows them to practice at the clinical site. You will be assigned to a Clinical Preceptor at each of your clinical sites while on rotation during the second year of the program. Your preceptor will set your schedule and guide you through the daily routine of each rotation. The MPAS program ensures that each Clinical Preceptor holds valid licensure for the state in which he or she practices. 15 PROGRAM ESSENTIAL FUNCTIONS The University of the Cumberlands MPAS program is committed to the education of all qualified individuals, including persons with disabilities who, with or without reasonable accommodation, are capable of performing the essential functions of the educational program in which they are enrolled and the profession that they pursue. It is the policy of the program to comply with the Americans with Disabilities Act, Section 504 of the Rehabilitation Act of 1973, and state and local requirements regarding students and applicants with disabilities. Under these laws, no otherwise qualified and competent individual with a disability shall be denied access to or participation in services, programs, and activities solely on the basis of the disability. In accord with federal regulations established by the Americans With Disabilities Act, the following standards are described to assist each candidate in evaluating his/her prospect for academic and clinical success. General standards for the MPAS program are followed by standards that apply to the professional discipline to which you have applied (see additional standards below). When a student s ability to perform is compromised, the student must demonstrate alternative means and/or abilities to perform the essential functions described. It is important that you read each standard carefully. Each student is given the opportunity to read and acknowledge their understanding of the standards prior to beginning of the program. Technical Standards, MPAS A candidate for the University of the Cumberlands Master of Physician Assistant Studies program must have, at a minimum, demonstrably acceptable skills in observation, communication, motor, intellect and behavior/socialization. Reasonable accommodation for persons with documented disabilities will be considered on an individual basis, but candidates must be able to perform in an independent manner. To qualify for admission to the Master of Science in Physician Assistant Studies program, candidates must demonstrate to program principal faculty the ability to meet the following technical standards in timed settings and under stressful conditions:

16 16 Sufficient capacity for observation in academic, clinical, and other medical settings; functional vision, hearing, and tactile sensation sufficient to observe a patient s condition and perform procedures regularly required during a physical examination Sufficient skills to communicate verbally and in writing in academic and healthcare settings Sufficient motor function to carry out movements necessary for patient diagnosis and care; for free movement in patient care and between facilities and buildings in academic and healthcare environments; physical stamina to complete didactic and clinical coursework Sufficient intellectual ability to measure, calculate, reason, analyze, and synthesize, in the context of medical problem-solving and patient care Sufficient emotional health and stability required for exercising good judgment and promptly completing all academic and patient care responsibilities Professional Responsibility: Students must exhibit the ability to meet the challenges of any medical situation that requires a readiness for immediate and appropriate response without interference of personal or medical problems. This requires training for emergencies (e.g., CPR, infection control). It is each student s responsibility to attend and be able to travel to and from classes and clinical assignments on time, and possess the organizational skills and stamina for performing required tasks and assignments within allotted time frames. This involves frequent oral, written, and practical examinations or demonstrations. The student must have the ability to perform problemsolving tasks in a timely manner. Students will exhibit adherence to policies of the university, their program, and clinical sites. This includes matters ranging from professional grooming, dress, and behavior, to attending to their program s academic schedule, which may differ from the University s academic calendar and be subject to change at any time. Students must demonstrate knowledge of and commitment to the code of ethics of their profession and behavior that reflects a sense of right and wrong in the helping environment. Students will take initiative to direct their own learning. They need to work cooperatively and collaboratively with other students on assigned projects, and participate willingly in a supervisory process involving evaluation of abilities and reasoning skills. Additional standards relevant to specific discipline, Physician Assistant Program: In addition to the general standards above, students applying to the Physician Assistant program must consider that they will be required to: Participate in patient assessment and evaluation. Participate in invasive and non-invasive procedures Participate in emergency care Work lengthy and irregular hours Attend and participated in didactic and clinical education training on or off campus.

17 17 Perform physical examinations on male and female peers along with being examined by both male and female peers during laboratory instruction. Program Details Physician Assistant Studies Degree Requirements The Master of Science in Physician Assistant Studies Degree (MPAS) is earned through the continuous twenty-four-month program of studies consisting of 101 master s level credit hours. These hours are divided into sixty-one credit hours of classroom focused instruction and forty credit hours of clinical rotations. A complete list of courses with course descriptions is located in the curriculum section. Physician Assistant Program Expenses for Cohort 3 Standard A3.14 f Standard A3.14f The program must define, publish and make readily available to enrolled and prospective students general program information to include: f) estimates of all costs (tuition, fees, etc.) related to the program. 1. Program Tuition: 68,000 *First Year (May May 2014) 34,000 *Second Year (May May 2015) 34,000 TOTAL 68,000 *Estimated Tuition/Fees based on rates as of academic year. Prices may increase for the academic year. This price change will take effect on May 2014 for the summer term. Cost in all categories is subject to change without notice. The most current information on graduate level tuition can be obtained through the University Business Office. 2. Institutional Fees for Cohort 3: 1,900 *First Year (May 2013-May 2014) 950 *Second Year (May 2014-May 2015) 950 Total 1,900 *Fees include Malpractice Insurance Premiums, Lab Fees and Tech Fees. Price may be adjusted for the academic year. Cost in all categories is subject to change without notice. The most current information on graduate level institutional fees can be obtained through the University Business Office. 3. Living, Transportation, and Conference Travel Expenses: Varies Students are responsible for arranging their own housing accommodations, transportation, and any expenses associated with relocations and travel to/from clinical assignments for clinical rotation courses. All Program participants can anticipate temporary relocation for at least one of their required clinical practice experiences during the final year of the Program. A campus parking permit ($15 per academic year) is required. During both years, students will be attending one or two preselected Physician Assistant conferences. Students will be responsible for travel, conference registration fees, lodging, and meals during the conference. 4. Textbooks and Information Resources: Varies

18 Each student will be required to purchase textbooks. The approximate cost will be $1500. Most of these resources will need to be purchased at the onset of the program and used throughout the duration of the 24 months. A trainee subscription to UpToDate (~ $ per year), an online evidence-based peer reviewed medical information resource, is also required. A one-time fee of $75 is required for a TYPHON PAST membership (used for clinical experience tracking). Membership into KAPA (one-time fee of $25) and AAPA (one-time fee of $75) is required. A one-time fee of is required for the KAPLAN Qbank. Subscription and Dues will be provided through the institution and charged to the student s account. 5. Personal Computer: Each student must have a laptop computer for use throughout the program. 6. Medical Equipment: Each student must purchase a high quality Stethoscope, a half length white lab coat, Tuning Fork 512 cycles, Tuning Fork 256 cycles, and a reflex hammer The total cost of these items may range from $150 to $ Name Badge: Students will be provided one student ID by the institution which will also serve as their ID badge for use in the clinic and at certain times in the didactic year. 8. Insurance: varies Medical Insurance: All graduate level medical students participating in clinical rotations are required to have adequate medical insurance. Students must present evidence of an individual, family, or government plan with adequate coverage in order to waive out of the mandatory student health insurance policy. It is the student s responsibility to file the required waiver with the University of the Cumberlands Business Office by the required deadlines. If your waiver is not received by the required deadline, you will be enrolled and charged for our current student medical insurance plan. *Changes to rates are determined in the Fall of each year. Malpractice Insurance: Malpractice insurance premiums are included in the institutional fees. Worker s Compensation Insurance: Many clinical practice sites require students to provide proof of compensation coverage in addition to personal health insurance coverage. If assigned a clinical rotation at a facility that mandates this added insurance, the cost of purchasing the required policy must be borne by the student. 9. Background Check: 18

19 Each student must obtain and provide the Program with a copy of a cleared background check. This will need to be done once before matriculation and again before clinical rotations. The student is responsible for any costs associated with this background check. For further information about the process, please refer to the KY police webpage at: _check_forms.htm. CURRICULUM Standards B1.02, B1.03, and B1.04 Standard B1.02 The curriculum must include core knowledge about established and evolving biomedical and clinical sciences and the application of this knowledge to patient care. Standard B1.03 The curriculum must be of sufficient breadth and depth to prepare the student for the clinical practice of medicine. Standard B1.04 The curriculum design must reflect sequencing that enables students to develop the competencies necessary for current and evolving clinical practice. Professional Phase Curriculum The courses offered by the MPAS program have been specifically designed and sequenced to prepare students to administer health care to patients. According to the ARC-PA 4 th Edition Standards, the program curriculum should prepare students to provide patient centered care and collegially work in physician-pa teams in an inter-professional team environment. The curriculum establishes a strong foundation in health information technology and evidence-based medicine and emphasizes the importance of remaining current with the changing nature of clinical practice. Further, according the ARC-PA 4 th Edition Standards, the professional curriculum for PA education should include, applied medical, behavioral and social sciences; patient assessment and clinical medicine; supervised clinical practice; and health policy and professional practice issues. In accordance with the ARC-PA Standards and with the desire to graduate competent health practitioners who are capable of delivering high quality health care, rigorous academic standards have been established for continued matriculation in the MPAS program. Students are expected to complete all course assignments as outlined in the individual course syllabus and to meet the university s academic standards as outlined in this manual. Students will be given updates to these standards as they occur. MPAS Required Curriculum- Standard A3.14d, e Standard A3.14d The program must define, publish, and make readily available to enrolled and prospective students general program information in include: d) all required curricular components, e) academic credit offered by the program. Semester one: Total: 18 credit hours. MPAS Clinical Anatomy I 2 credit hours MPAS Health Care Issues I 2 credit hours MPAS Physical Diagnosis I 2 credit hours MPAS Clinical Medicine I 6 credit hours MPAS 551 Pathology/Pathophysiology I 2 credit hours 19

20 20 MPAS Pharmacology I MPAS 571 Practical App. of Med. I 2 credit hours 2 credit hours Semester two: Total: 18 credit hours. MPAS 512 Clinical Anatomy II 2 credit hours MPAS Clinical Medicine II 6 credit hours MPAS Pharmacology II 2 credit hours MPAS 552 Pathology/Pathophysiology II 2 credit hours MPAS Physical Diagnosis II 2 credit hours MPAS Health Care Issues II 2 credit hours MPAS 572 Practical App. of Med. II 2 credit hours Semester three: Total: 18 credit hours. MPAS 513 Clinical Anatomy III 2 credit hours MPAS Health Care Issues III 2 credit hours MPAS 533 Physical Diagnosis III 2 credit hours MPAS Clinical Medicine III 6 credit hours MPAS 553 Pathology/Pathophysiology III 2 credit hours MPAS Pharmacology III 2 credit hours MPAS 573 Practical App. of Med. III 2 credit hours Semester four: Total: 16 clinical credit hours Four clinical rotations (4 weeks each) Semester five: Total: 16 clinical credit hours Four Clinical rotations (4 weeks) Semester six: Total: 8 clinical credit hours plus 7 hours of coursework Two clinical rotations (4 weeks each) MPAS 680 Professional Development 1 credit hour MPAS 691 CAPSTONE 1 credit hour MPAS 692 PANCE Review/Summation 5 credit hours Clinical rotations MPAS 600- Family Medicine I 4 credit hours (4 weeks) MPAS 605- Family Medicine II 4 credit hours (4 weeks) MPAS 610- Emergency Medicine 4 credit hours (4 weeks) MPAS 620- Internal Medicine 4 credit hours (4 weeks) MPAS 630- Pediatrics 4 credit hours (4 weeks) MPAS 640- Psychiatry 4 credit hours (4 weeks) MPAS 650- Surgery 4 credit hours (4 weeks) MPAS 660- Women s Health 4 credit hours (4 weeks) MPAS 670- Clinical Elective I 4 credit hours (4 weeks) MPAS 675- Clinical Elective II 4 credit hours (4 weeks) 40 credit hours Commencement held in May following Year II.

21 21 Course Descriptions MPAS 511 Clinical Anatomy I Course Description: This course is part one in a series of three anatomy courses aligned with Clinical Medicine in a modular format. It provides an introduction to human anatomy and basic survey of the body. Students will learn basic concepts related to anatomy as well as examine human morphology and the fundamental relationships between the integument, HEENT, pulmonary, and cardiology systems with conceptual presentations of these regions of the human body. The clinical application of this knowledge is applied through case studies. Students will have ample time to explore anatomy during laboratory sessions using models and computer anatomy technology. MPAS 512 Clinical Anatomy II Course Description: This course is part two in a series of three anatomy courses aligned with Clinical Medicine II in a modular format. It builds upon concepts and systems studies in Clinical Anatomy I. Students will develop knowledge of anatomical concepts and examine human morphology and the fundamental relationships between gastrointestinal, renal, men s anatomy, women s anatomy, pediatrics, endocrine and hematological systems with conceptual presentations of these regions of the human body. The clinical application of this knowledge is applied through case studies. Students will have ample time to explore anatomy during laboratory sessions using models and computer anatomy technology. MPAS 513 Clinical Anatomy III Course Description: This course is the final in a series of three anatomy courses aligned with Clinical Medicine in a modular format. It builds upon concepts and systems studies in Clinical Anatomy I and II. Students will build a comprehensive knowledge of anatomical concepts. They will examine human morphology and the fundamental relationships between neurologic and musculoskeletal modules with conceptual presentations of applicable regions of the human body. The clinical application of this knowledge is applied through case studies. Students will have ample time to explore anatomy during laboratory sessions using models and computer anatomy technology. MPAS 521 Health Care Issues I Course Description: The purpose of this course is to introduce the first semester PA student to the inner workings of the PA profession and research for physician assistants. Students will trace the history, development, and current status of the physician assistant profession. Students will explore the role of the physician assistant as part of the healthcare team. Students will become familiar with state and national legislation that governs the profession. This course will also introduce initial steps on a path toward learning to use research to inform medical reasoning (also known as evidence-based medicine). Students will continue to learn this skill throughout this program and throughout their career. Concepts addressed include: the diagnostic reasoning process, the use of relevant research evidence, and proper and adequate review and analysis of medical literature. MPAS 522 Health Care Issues II Course Description: This course will focus on ethical, socioeconomic, and cultural issues which affect health care. The course will examine the premise that a very high percentage of morbidity rates are social- behavioral in nature, and that this has important implications for the medical

22 practitioner. Students will develop counseling and preventive education skills that foster treatment compliance, promote positive change, and enhance ability to cope with pain and illness. Through this course students will gain a respect for self and others, a sense of professional responsibility and integrity, and a commitment to patient welfare. Students will be given opportunity to develop skills in the application of medical ethics to clinical cases. Students will learn stress management and how to care for the caretaker when interacting with real life patient care issues. Students will also build upon their research and community involvement by continuing their community outreach project which was begun in Health Care Issues I. MPAS 523 Health Care Issues III Course Description: Health Care Issues III is designed to tie together concepts of professional responsibility, medical ethics, and research skills learned in the prior two classes. Students will also explore the topics of health care policy and medico-legal issues related to practicing medicine. Through this course, students will culminate sense of professional responsibility and integrity and a commitment to patient welfare. Students are given opportunity to develop skills in the application of medical ethics to clinical cases. Students will also build upon their research and community involvement by continuing the community outreach project which was begun in Health Care Issues I. Students will have an opportunity to integrate what they are learning into this project and give feedback. MPAS 531 Physical Diagnosis I Course Description: This is one of a series of three classes designed to teach methods of interviewing and obtaining a complete history and physical exam. In the first section, physical diagnosis and proper examination techniques of problems relating to the systems covered in Clinical Medicine I will be covered. Those systems include: dermatology, otorhinolaryngology, ophthalmology, cardiology, and pulmonology. Emphasis is placed on professionalism in the manner and approach to patients; sophistication in taking a history; expertise in the techniques of physical examination; the ability to integrate, correlate, and interpret the data obtained; and the ability to record findings accurately, succinctly, and in an organized, logical sequence. The students will have ample time to practice their skills among themselves with faculty observation and critique. Students will also be expected to self-assess their strengths and deficiencies, and seek out tutorials and advice to remedy perceived problems. Opportunity will be given for students to present and document their findings and receive constructive criticism. MPAS 532 Physical Diagnosis II Course Description: This is part two in a series of courses where the student will acquire knowledge required to complete a thorough physical examination related to the modules studied. Students will integrate the knowledge obtained in Clinical Medicine II coupled with laboratory sessions emphasizing the proper use of diagnostic equipment and technique for performing a physical examination. The semester will include the modular education in: gastroenterology, men s health, OBGYN, and pediatric. Emphasis is placed on professionalism in the manner and approach to patients; sophistication in taking a history; expertise in the techniques of physical examination; the ability to integrate, correlate, and interpret the data obtained; and the ability to record findings accurately, succinctly, and in an organized, logical sequence. The students will have ample time to practice their skills among themselves with faculty observation and critique. Students will also be expected to self-assess their strengths and deficiencies, and seek out tutorials and advice to remedy perceived problems. Opportunity will be given for students to present and document their findings and receive constructive criticism. 22

23 23 MPAS 533 Physical Diagnosis III Course Description: This is the third course in a series of three where the student will acquire knowledge required to complete a thorough physical examination. Students will integrate the knowledge obtained in Clinical Medicine III coupled with laboratory sessions emphasizing the proper use of diagnostic equipment and technique for performing a comprehensive physical examination. The semester will include the following modules: allergy and immunology, rheumatology, infectious and parasitic diseases, neurology, genetics, orthopedics, psychiatry, geriatrics and special topics. Emphasis is placed on professionalism in the manner and approach to patients; sophistication in taking a history; expertise in the techniques of physical examination; the ability to integrate, correlate, and interpret the data obtained; and the ability to record findings accurately, succinctly, and in an organized, logical sequence. The students will have ample time to practice their skills among themselves with faculty observation and critique. Students will also be expected to self-assess their strengths and deficiencies, and seek out tutorials and advice to remedy perceived problems. Opportunity will be given for students to present and document their findings and receive constructive criticism. MPAS 541 Clinical Medicine I Course Description: This is one of a series of three courses in the study of medicine that will be taught in succession a modular format aligned with the other courses in the PA program. The purpose of this course is for the first semester PA student to explore the common medical and surgical disorders encountered in general adult medicine pertaining to modules defined below. Through this course these students will be learn to integrate their knowledge to properly identify clinical presentation of defined illnesses; order appropriate diagnostic work-up; formulate an accurate diagnosis based on view of clinical presentation and interpretation of laboratory results; determine a viable acute and chronic care plans for the patients involved; understand and describe the etiology and pathophysiology of the patient s condition in common terms; understand how the condition is prevented and explain preventative techniques to the patient; identify where genetic inheritance may be involved and how that impacts the diagnosis and treatment of that patient; identify when and to what systems or specialties referral is appropriate; and demonstrate the ability to manage disorders pertaining to the following modules: dermatology, HEENT, cardiology, and pulmonology. Through this course, students will develop a deeper curiosity about the art and science of clinical medicine, a passion about the field of medicine, and learn the skills of self directed learning to accomplish appropriate care of patients. MPAS 542 Clinical Medicine II Course Description: The student will build upon the knowledge and skills attained in MPAS 541 to study the presentation in the following modules: gastroenterology, urology, men s health, women s health, gynecology, obstetrics, pediatrics, endocrinology, hematology and oncology. This is part two of a series of three courses in the study of medicine that will be taught in a modular format utilizing a combination of lecture and interactive techniques. It is designed to explore the common medical and surgical disorders encountered in general adult medicine. This will include: clinical presentation, acute care, etiology, pathophysiology, prevention, genetic involvement, diagnostic work-up, lab interpretation, appropriate referral, and management of disorders pertaining to the listed modules. Students will develop a deeper curiosity about the art and science of clinical medicine, a passion about the field of medicine, and learn the skills of self directed learning.

24 MPAS 543 Clinical Medicine III Course Description: The student will build upon the knowledge and skills attained in MPAS 542 to study the following modules: allergy and immunology, rheumatology, infectious and parasitic disease/tropical medicine, neurology, genetics, orthopedics, rheumatology, psychiatry, alternative medicine, geriatrics and special topics such as palliative care, occupational medicine, rehabilitative care, long term care. This is part three of a series of three courses in the study of medicine that will be taught in a modular format utilizing a combination of lecture and interactive techniques. It is designed to explore the common medical and surgical disorders encountered in general adult medicine. This will include: clinical presentation, acute care, etiology, pathophysiology, prevention, genetic involvement, diagnostic work-up, lab interpretation, appropriate referral, and management of disorders pertaining to the listed modules. Students will develop a deeper curiosity about the art and science of clinical medicine, a passion about the field of medicine, and perfect the skills of self directed learning. MPAS 551 Pathology/Pathophysiology I Course Description: The Pathology & Pathophysiology course series will combine lectures and student-centered learning for an in-depth exploration of this foundational science. Students will have the opportunity to reinforce and expand their knowledge-base beyond what they established as undergraduates. This course also intends to introduce motivated students to strategies for lifelong learning in the basic and applied sciences. The primary focus will be on solidifying content pertinent to Physician Assistant practice, but current events and/or other applied physiology may be discussed. The studies of pathophysiology in this course will be aligned in a module format to what is being studied in clinical medicine. Modules include: dermatology, otororhinolaryngology/ophthalmology, cardiology, and pulmonology. MPAS 552 Pathology/Pathophysiology II Course Description: The Pathology & Pathophysiology course series will combine lectures and student-centered learning for an in-depth exploration of this foundational science. Students will have the opportunity to reinforce and expand their knowledge-base beyond what they established as undergraduates. This course also intends to introduce motivated students to strategies for lifelong learning in the basic and applied sciences. The primary focus will be on solidifying content pertinent to Physician Assistant practice, but current events and/or other applied physiology may be discussed. The studies of pathophysiology in this course will be aligned in a module format to what is being studied in clinical medicine. Modules include: gastroenterology, nephrology, urology, men s health, gynecology, obstetrics, pediatrics, endocrine, hematology and oncology. MPAS 553 Pathology/Pathophysiology III Course Description: Students will learn integrative human physiology and pathophysiology involving the immune system, neurological, and musculoskeletal systems. Additionally, modules in rheumatology, infectious and parasitic diseases, genetics, psychiatry, alternative medicine, geriatrics and special topics with an emphasis upon homeostatic mechanisms and the etiologies of disease states. MPAS 561 Pharmacology I Course Description: The first in a 3-course series designed to introduce the student to principles that provide the foundation for the study of pharmacology and therapeutics. Students will be given a thorough introduction to pharmacologic terms, definitions and principles which are essential to understanding drug properties and actions. Focus will be on the pharmacologic agents related 24

25 to cardiology, and pulmonary disorders. Students will gain knowledge of pharmacokinetic principles of drug absorption, distribution and metabolism, and elimination. We will also cover an introduction to prescription writing and legal issues surrounding prescription writing. When completed with this series of courses students will acquiesce a working knowledge of commonly prescribed drugs, their pharmacological actions/properties, and classification MPAS 562 Pharmacology II Course Description: Building on the knowledge and skills obtained in Pharmacology I, this course will enhance pharmacologic and therapeutic principles in relation to patient treatment. Focus will be on the basic pharmacodynamic, pharacokenetic and phamacotherapeutic principles and pharmacologic agents of gastrointestinal, autacoids, local and parenteral anesthetics, men and women s health, endocrine, renal, hematological and oncological disorders. We will also cover prescription writing of those medications. MPAS 563 Pharmacology III Course Description: Students will build upon the knowledge and skills obtained in MPAS 561 and 562. Combined lecture and active learning exercises are designed to develop the pharmacologic and therapeutic skills that a physician assistant will need to enhance patient care in clinical practice focusing on the following areas: Allergy and Immunology, Rheumatic Diseases/Antiinflammatories, Orthopedics/Pain Management, Infectious Diseases, Neurology, Psychiatric disorders, and Anti-Depressants. We will also cover prescription writing of those medications. MPAS 571 Practical Applications in Medicine I Course Description: This course introduces the application of medical procedures in the fields of general medicine, emergency medicine and general surgery. Skills are learned which are necessary to treat patients in a variety of routine, life threatening and surgical situations. Students learn appropriate diagnostic and hands on therapeutic and procedural measures relating to the following modules: Dermatology, HEENT, Cardiology, and Pulmonology. This class is taught using a variety of learning methods, including traditional lectures, case-based learning, simulated patient encounters, field experiences and laboratory exercises. MPAS 572 Practical Applications in Medicine II Course Description: This course builds upon previous acquisition of procedural and emergency care skills and focuses on applying that knowledge to additional emergency and surgical situations. Students learn appropriate diagnostic, therapeutic, and surgical measures relating to the following modules: gastroenterology, nephrology, men s health, OBGYN, pediatrics, endocrinology, hematology and oncology. This class is taught using a variety of learning methods, including traditional lectures, case-based learning, simulated patient encounters, and laboratory exercises. MPAS 573 Practical Applications in Medicine III Course Description: This culminating course ties together previous acquisition of procedural and emergency care skills and focuses on applying that knowledge to additional emergency and surgical situations. Students learn appropriate diagnostic, therapeutic, and surgical measures relating to the following modules: allergy and immunology, rheumatology, infectious and parasitic diseases, neurology, genetics, orthopedics, psychiatry, geriatrics and special topics. This class is taught using a variety of learning methods, including traditional lectures, case-based learning, simulated pa- 25

26 tient encounters, and laboratory exercises. Students will also learn principles of surgery including pre-operative, intra-operative, and post-operative care. MPAS 680 Professional Development / 1 Credit Hour Students will prepare to transition to the professional role by developing employment skills and learning about professional practice issues. Students will develop a framework necessary to achieve and maintain certification. MPAS 691 Capstone / 1 Credit Hour Students synthesize knowledge and skills obtained during the program through successful completion of a summative evaluation (Objective Skills Clinical Evaluation) and a comprehensive written exam. By displaying competency in both analyzing and integrating patient data, students demonstrate skills necessary for competent PA practice. Students also develop individual clinical portfolios to provide a framework for lifelong learning. MPAS 692 PANCE review / 5 Credit Hours This course prepares students for successful completion of the Physician Assistant National Certifying Examination (PANCE), necessary for entering medical practice. Students learn study strategies that lead to successful completion of board-style exams. Students are prepared to take a systems approach, integrating all aspects of medicine encountered in the practice of medicine. Topics also include typical clinical presentation, etiology, pathophysiology, diagnostic work-up, lab interpretation and management of disorders. MPAS 600/ Family Medicine I /II (4 Credit Hours each). Due to the importance of primary care to the practice of a PA, students will rotate at an outpatient family medicine office for two four-week periods. The first rotation will count as MPAS 600, and the second for MPAS 605. Students will work under the supervision of a physician preceptor or his or her PA or NP designee(s). Students will start by shadowing the preceptor and then will evaluate patients by themselves, determining a potential treatment plan that will be discussed with the preceptor. By the time that the rotation is complete, the student should feel comfortable examining patients in an outpatient setting. MPAS Emergency Medicine (4 Credit Hours) This four-week rotation provides practical clinical experience in emergency medicine. Students engage in all aspects of patient care, including history, physical exam, treatment plan design and evaluation. Students application of patient and family education to treatment and preventive measures is emphasized. MPAS Internal Medicine (4 Credit Hours) This four-week rotation will provide clinical experience in the pathophysiology, evaluation, diagnosis and management of systemic and chronic diseases and conditions unique to the practice of Internal Medicine. As a hospital based clerkship, the rotation will help the student to become proficient in the process of admission, inpatient care, discharge and disposition. Students will engage in all aspects of patient care from history and physical exam to treatment plan design and evaluation. Patient and family education will be stressed as they apply both to treatment plans and preventative issues. MPAS Pediatrics (4 Credit Hours) This 4-week rotation will provide clinical experience with all pediatric populations as well as exposure to disease processes and presentations. Students will engage in all aspects of patient care from history and physical exam to treatment plan design and evaluation. Patient and family education will be stressed as they apply both to treatment plans and preventative issues. 26

27 27 MPAS Psychiatry (4 Credit Hours) This 4-week rotation will provide clinical experience in psychiatry. Students will engage in all aspects of patient care from history gathering to treatment plan design and evaluation. Patient and family education will be stressed as they apply to treatment plans. MPAS Surgery (4 Credit Hours) This 4-week rotation will provide clinical experience in general surgery. Emphasis will be on preoperative evaluation and preparation of the surgical patient, proper surgical etiquette and techniques, intra-operative assisting techniques and post operative care Understanding of the surgical team member roles and operative procedures and the management postoperative patient and complications will engage in all aspects of patient care from history and physical exam to treatment plan design and evaluation including operative procedures. Patient and family education will be stressed as they apply both to treatment plans and after care / recovery. MPAS Women s Health (4 Credit Hours) This 4-week rotation will provide clinical experience in prenatal care, gynecology and in some practice settings, obstetrics. Students will engage in all aspects of patient care from history and physical exam to treatment plan design and evaluation. Patient and family education will be stressed as they apply both to treatment plans and preventative issues. MPAS 670/ Clinical Elective (4 Credit Hours) These rotations will provide clinical experience in a specialty of medicine determined by the student. The purpose of these rotations is to allow students to explore more completely an area of interest in clinical medicine or surgery. Students will engage in all aspects of patient care for patients within that specialty s patient population from history and physical exam to treatment plan design and evaluation. Patient and family education will be stressed as they apply both to treatment plans and preventative issues. ACADEMIC POLICIES AND PROCEDURES The responsibility for the routine administration of the policies and procedures of the Master of Physician Assistant Studies resides with the Program Director with the assistance of the Academic Coordinator, the Medical Director, and the Clinical Coordinator. This day-to-day administration of the program is ultimately under the oversight of the Vice President for Medical Services. Any appeals concerning program policies and procedures must be made in writing through this chain of administrative oversight. Absence /Attendance/Timeliness General Policy Physician assistant education is intensive. In general, attendance is required at all MPAS program educational sessions. We recognize that situations beyond your control occasionally arise, but you should make every attempt to attend all scheduled sessions. Students should exercise sound decision making skills when making decisions regarding missing course lectures, assignments, examinations, or clinical rotations. Mild upper respiratory infections may not warrant missing course work or examinations. Weddings, family vacations, or expensive airline reservations may not be considered a valid excuse for missing an examination or requesting an alternative examination date. Unexcused absences may result in a score of zero on assignments and examinations. Make-up examinations may be offered at the discretion of the

28 course instructor on a case-by-case basis. Make-up examinations may be given in an alternate format. Attendance and timeliness are important aspects of professional behavior. Students must report to all classes, laboratories, seminars, call-back days, clinical sites, and other scheduled activities on time. Timely return from designated breaks is required. Students must return messages from Program staff, faculty, Clinical Preceptors and clinical sites in a timely manner (i.e., in less than 36 hours). Students must submit all required assignments and forms on or before the designated date, and/or time, they are due. In formal classroom and clinical situations, students should address faculty and lecturers using the appropriate form of address (Professor/Doctor/Mr./Ms.). Under no circumstances are children allowed in the classrooms during formal lectures. Anticipated Absence Students who know in advance that they will be absent due to events such as employment interviews and religious observances not provided for on the university calendar should clear the absence at least 30 days in advance. Time off must generally be made up within one week. 28 Anticipated Absence First Professional Year Second Professional Year Action Contact your Faculty Advisor at least 30 days in advance to discuss clearance. Contact the Director of Clinical Education and your Clinical Preceptor at least 30 days in advance to discuss clearance. Unanticipated Absence Occasionally, a student is unable to attend class or rotation due to an unexpected personal or family emergency. Documentation of the event may be required by the Program. Unanticipated Absence First Professional Year Second Professional Year Action Contact your Faculty Advisor or program secretary as soon as possible. Contact the program secretary, the Director of Clinical Education, and your Clinical Preceptor as soon as possible. Absence from Examinations Standard C3.01 Standard C3.01 The program must conduct frequent, objective and documented evaluations of students related to learning outcomes for both didactic and supervised clinical education components. Students are expected to take examinations at the designated time. In the event of an illness, the student must contact the program director BEFORE the test to inform her/him of the anticipated absence. All absences of examinations must be excused by the Vice President for Academic Affairs. A student who has missed an examination due to excused illness or personal crisis will have NO MORE than 48 hours in which to complete that examination or the first day back in classes, whichever occurs first. Students with a prolonged illness or personal crisis will be reviewed individually and arrangements made accordingly. Student absences from scheduled ex-

29 aminations and laboratory sessions will be excused only under extraordinary circumstances. Examinations will not be administered prior to the scheduled examination time without the approval of the Program Director. Absence from Clinical Rotations Attendance at clinical sites is an absolutely essential component of a student s education. Students must inform their Clinical Preceptors and the program when, for any reason, they will not be at their clinical site. Students should contact the program secretary and the Director of Clinical Education via phone or ; they will in turn inform the Program Director. As graduation approaches, it is expected that students will need to schedule employment interviews. As with any other absence, these must be cleared with the Clinical Preceptor and Faculty Advisor. Absence - Leave of Absence A leave of absence from the MPAS program may be granted by the Program Director for medical or personal reasons. Requests for leaves of absence must be made in writing to the Program Director. A student on a leave of absence may be permitted to resume course work upon receipt of documentation that satisfactory resolution has occurred of the problem necessitating the leave of absence. Repetition of course work satisfactorily completed prior to the leave of absence will not be required provided resumption in training occurs within one academic year from the date the leave of absence begins. Academic Honesty and Integrity Policy Standard B1.05 Standard B1.05 The curriculum must include instruction about intellectual honesty and appropriate academic and professional conduct. In order to ensure that the MPAS program graduates competent and ethical practitioners, the faculty of the program have developed the following information regarding academic honesty and integrity. This information will be reviewed with all students entering the program during orientation. Students will be given a short quiz to demonstrate their understanding of policies related to academic integrity. It is the responsibility of the student to visit these policies regularly to refresh their understanding. At a Christian liberal arts university committed to the pursuit of truth and understanding, any act of academic dishonesty is especially distressing and cannot be tolerated. In general, academic dishonesty involves the abuse and misuse of information or people to gain an undeserved academic advantage or evaluation. The common forms of academic dishonesty include: cheating - using deception in the taking of tests or the preparation of written work, using unauthorized materials, copying another person s work with or without consent, or assisting another in such activities; lying - falsifying, fabricating, or forging information in either written or spoken presentations; plagiarism - using the published writings, data, interpretations, or ideas of another without proper documentation. Episodes of academic dishonesty are reported to the Vice President for Academic Affairs. The potential penalty for academic dishonesty includes 1) a failing grade on a particular assignment, 29

30 2) a failing grade for the entire course, or 3) charges against the student with the appropriate disciplinary body. Any breach of integrity may serve as grounds for dismissal, even on a first offense. Breaches in integrity will be reported to licensing agencies as required by law. 30 Admissions - Application Process Admission to the University of the Cumberlands Physician Assistant Program is competitive. All applications are carefully reviewed by the Graduate Admissions Office and the PA Admissions Committee. Each application is evaluated for completion of required coursework as well as characteristics that show promise of successful completion of the program and professional achievement. Submission of a completed application packet does not guarantee an interview, selection or admission into the Physician Assistant Program. The Physician Assistant Program utilizes the Central Application System for Physician Assistants (CASPA) system for admissions. Because admission information is updated regularly, applicants should verify current requirements on the program website. Please review Admission Requirements prior to filing an application. Admission Requirements The following requirements must be documented before an applicant will be considered for admission to the MPAS program: Bachelor s degree. The degree major area of study is not specific; however, coursework must include, at minimum, the required prerequisite courses. OR Completion of the preprofessional program at UC. Students who have completed the pre-professional program and who meet all admission requirements will automatically be invited to an interview. Cumulative GPA of 3.0 on a 4-point scale. (Written appeals of this requirement may be made to the program director and must be submitted directly to the program at the time of your application.) Prerequisite course GPA 3.0. No prerequisite may be lower than a C. (Written appeals of this requirement may be made to the program director and must be submitted directly to the program at the time of your application.) Documentation of English fluency for non-native English speakers. 100 hours of clinical experience through direct patient care and/or shadowing is recommended. GRE scores taken within the past five years. The GRE requirement is waived for those who have completed a graduate degree (Master s degree or higher) by proposed matriculation. The M-CATS or other graduate level exam scores may be substituted for the GRE. 2 Reference letters Essay stating your personal interest in the PA profession. Meet the technical standards for the Physician Assistant Profession.

31 31 Admissions - Conditional Admissions Otherwise qualified candidates who are deficient in one or two specific criteria for admission may be admitted conditionally. These candidates will be given a specific timeframe in which to remediate these deficiencies (usually one semester). If these deficiencies have not been remediated by the end of the specified time, the student may not continue in the Physician Assistant Studies program. Admissions - Transfer and Course Credit/Advanced Placement Policy No transfer credit is normally accepted for courses in the MPAS program. Advisement Standard A3.09 Standard A3.09 Principal faculty, the program director and the medical director must not participate as health care providers for students in the program. In the first professional year, students are assigned to a faculty member who will act as an advisor for the duration of the MPAS program (see Appendix C). Faculty advisors will meet with students at least once during the semester to discuss academic progress and other issues. Students must take responsibility for their own learning and will be asked to self-evaluate their progress by filling out the Mid-Semester Advisement Sheet (see Appendix D sample for fall semester) prior to meeting with their advisor. Mid-semester evaluations will be placed in student files. Students with academic concerns should address the issue first with the course instructor. Should a student require further assistance, he/she should consult with the faculty advisor. The advisor will involve the Program Director, Associate Director or other university administrative personnel as the situation warrants. Your advisor will assist you in identifying areas of strength and weakness to help you focus your studies. When problems arise, your advisor will discuss them with you in an attempt to clarify your options and devise a plan of action. Your advisor, or any other faculty member, is not able to act as a medical provider for you. If you have a medical problem, you should seek assistance from student health services or another provider. Your advisor is also not able to act as a mental health counselor for you. If you have nonacademic problems that require formal counseling, your advisor will be happy to help you access mental health services available at University of the Cumberlands. Faculty schedules tend to be unpredictable due to clinical and research obligations. If you have a non-emergent need, it is best to make an appointment with your advisor via telephone or . If you feel your need is emergent and your faculty advisor is not available, you may contact Dr. Eddie Perkins, Program Director for assistance. Appeals and Conflict Resolution Standard A3.11 Academic Appeals Standard A3.11

32 Standard A3.11 The program must define, publish and make readily available to faculty and students the policies and procedures for processing student grievances and allegations of harassment. Both undergraduate and graduate students have the right to challenge a grade. If discussions with the course instructor and department chair do not lead to a satisfactory conclusion, students may file a formal written appeal with the Vice President for Academic Affairs, who will forward the appeal to the chair of the Academic Appeals Committee. This formal written appeal must be filed by the end of the 4 th week of classes in the next regular term following the term in which the course in question was taken. The Academic Appeals Committee then gathers information from the student, the instructor, and any other relevant parties. The Committee will deliver its recommendation on the complaint to the Vice President for Academic Affairs After reviewing this recommendation and concurring or amending it, the Vice President for Academic Affairs will inform the student and instructor of the disposition of the complaint no later than the last day of classes of the term in which the complaint was filed. Records of all actions regarding academic grade appeals, including their final disposition, are maintained by the Vice President for Academic Affairs and the Academic Appeals Committee. Program Policy Appeals The Program recognizes the rights of a student to appeal decisions affecting student progress. Appeals must be based upon the Program s failure to follow established policies or procedures. Students must present evidence that supports their appeal of a program decision according to the appeal process as defined herein: All appeals must be submitted to the Program Director, in writing, within 5 working days of the grievance. Appeals will be reviewed and a decision will be rendered to the student within 10 working days of receipt of the appeal. Students who wish to challenge the Program s decision may initiate a subsequent appeal to the Office of the Academic Vice President in writing within 10 working days of the Program s appeal decision. 32 Conflict Resolution during Rotations Problems during rotations can occur, be they academic, professional, or personal in nature. Students should use the following guidelines in dealing with problems: 1. Attempt to resolve problems with the appropriate individual directly. 2. If this is not possible, discuss it with the clinical preceptor. 3. If unable to resolve the problem, contact the Clinical Coordinator. Communication CELLULAR PHONES

33 Out of respect for your classmates and lecturers, please turn your cellular telephone off prior to class. S While enrolled as a student in the program, the address of record shall be the University of the Cumberlands address assigned upon admission to the program. It is strongly encouraged that students check their UC account as well as any ILEARN course announcements at least once every 24 hours. The student is advised that the program may track the opening, reading, and response of all s. 33 EMERGENCY PHONE CALLS Please inform friends and family that they should contact the program secretary if an emergency should arise while class is in session. A message will be delivered to the student, as cellular telephones must be switched off while in class. Please contact Mr. Gregory S. Manning; Criminal Background Checks Candidates for admission must satisfy a criminal background check before being accepted to the program and may be required to repeat at discretion of clinical site. This background check is carried out at the prospective student s expense. Information for this check is provided by the Graduate Admissions Office. Each student must obtain and provide the Program with a copy of a cleared background check. This will need to be done once before matriculation and again before clinical rotations. The student is responsible for any costs associated with this background check. For further information about the process, please refer to the KY police webpage at: _check_forms.htm. Drugs and Alcohol The use or possession of alcoholic beverages and the use, possession, or distribution of illegal controlled drugs and any other substance that is inconsistent with the philosophy of the University is strictly prohibited. Violation of this policy will result in the imposition of one or more of the disciplinary sanctions set forth in the Disciplinary Sanctions section of the University Student Handbook, and may result in severe criminal penalties under local, state and federal law. A detailed explanation of such penalties is found in the University Student Handbook. In addition to procedures carried out by the institution, the program will follow the procedure outlined below concerning student drug/alcohol use: 1. The program director should be notified in writing upon any suspicion of drug or alcohol abuse by a student. 2. The program director is responsible for meeting with that student and making a referral, if appropriate, to student services.

34 3. Student services may refer that student for evaluation and treatment by a licensed substance abuse counselor. 4. If a student refuses treatment for behaviors that are hindering academic and professional performance, he or she may be dismissed from the program at the discretion of the program director and Dean of Student Affairs. Grading Policy Grades are calculated on a percentage basis. All final course grade percentages are rounded to the nearest integer. Final course grades are assigned according to the following standards: Percent Grade Letter Grade A student has exceeded expectations B student has met expectations C student is below expectations Less than 69.5 F student has failed expectations An I may be temporarily awarded to individuals who fail to complete course requirements within the defined time. A final grade of F in any PA course is a non-passing grade and results in automatic and immediate dismissal from the PA Program. The student may reapply to rejoin the program the following year at the discretion of the program director. Reapplying does not guarantee admissions. The program must be completed within three years. 34 Harassment Policy Standard A3.11, A3.17g Standard A3.11 The program must make readily available to faculty and students policies and procedures for processing student grievances and allegations of harassment. Standard A3.17g The program must define, publish and make readily available to student upon admission academic performance and progression information in include g) policies and procedures for processing allegations of harassment. University of the Cumberlands prohibits harassment and intimidation on the basis of one's age, disability, sex, race, color, religion or national origin. Examples of conduct prohibited by these policies include, but are not limited to, repeated insults, humor, jokes and/or anecdotes that belittle or demean an individual's or group's sex, race, color, religion or national origin and physical conduct or verbal innuendo which, because of one's sex, race, color, religion or national origin creates an intimidating hostile or offensive environment. Examples of conduct prohibited by the policy against sexual harassment include, but are not limited to: a. persistent, unwelcome flirtation advances and/or propositions of a sexual nature; b. repeated unwelcome comments of a sexual nature about an individual's body or clothing; c. unwanted displays of sexually suggestive objects or pictures; d. unnecessary touching, such as patting, pinching, hugging, or repeated brushing against an individual s body; e. suggestions that submission to or rejection of sexual advances will affect decisions regarding such matters as an individual s employment, work assignments or status, salary, academic stand-

35 35 ing, grades, receipt of financial aid, or letters of recommendation; f. sexual assault. It is in the perception of the target of the behavior that sexual harassment is defined; or in other words, harassment is in the eye of the beholder. The law defines sexual harassment from the point of view of the target of the harassment and as such excludes any consideration of intent. Bullying is prohibited behavior. Bullying may be a form of illegal harassment. Whether the conduct is illegal or not, bullying is prohibited by the University. Bullying is any kind of conduct, speech, gesture, communication or other act which causes or is intended to cause one to suffer fear of physical harm, alarm, intimidation, humiliation or embarrassment, or which creates a hostile environment. Persons wishing to file a complaint relative to a violation or violations of this policy should do so within 30 days of the occurrence to Ms. Pearl Baker, Human Resources Director and Title IX Coordinator, Gatliff Administration Office 116. An investigation of the complaint will be completed within 45 days. Recommendations on the merits of the complaint will be made to the President of University of the Cumberlands and the President shall render a decision which shall be final. The complainant shall be advised of the decision on the merits of the complaint within 90 days. Health and Immunization Documentation Standards A3.21, A3.07 Standard A3.21 Student health records are confidential and must not be accessible to, or reviewed by, program, principal or instructional faculty, or staff except for immunization and tuberculosis screening results which may be maintained and released with written permission from the student. Standard A3.07 The program must have and implement a policy on immunization of students, and such policy must be based on current Centers for Disease Control recommendations for health professionals. Student Health Records & Immunizations In order to meet the accreditation standards of the ARC-PA for the Master of Science in Physician Assistant degree at University of the Cumberlands and satisfy confidentiality requirements, all health records are stored, monitored and maintained in the office of the Registrar. The Physician Assistant Program Staff do not have access to these records. Each student is expected to maintain their own health record file and secure ready access to pertinent documents during the course of their clinical year. It is imperative that the student complete all required health records and immunizations forms prior to their first rotation. Failure to provide complete health records may delay entry or the ability to participate in required clinical rotations. Specific health screening and immunization requirements are based on current Centers for Disease Control Recommendations for health professionals. The decision to update any records ultimately rests with the facility sponsoring a student for rotation and it will be the student s responsibility to submit to unannounced drug screens, repeated background checks, updated immunizations or repeated serology titers as appropriate to specific facility policy and procedure.

36 Students on clinical year rotations should maintain a file with quick availability of the following Documents: 1. Proof of personal health insurance throughout the entire program; 2. Proof of a satisfactory physical examination; 3. Proof of TB Tine Test (positive results will require the student to receive a chest x-ray and further evaluation); 4. Proof of Hepatitis B vaccine and positive Hep B Ab; 5. Proof of MMR vaccine or immunity; 6. Proof of Varicella history or vaccination. 7. Proof of Tetanus/Diphtheria/Pertussis vaccine 8. Pneumococcal polysaccharide PPV vaccine 9. Drug Screen Prior to entering the clinical phase of the program, students must again update their immunization record and provide proof of the following: 1. Provide proof of current CPR, ACLS, BCLS,PALS certification 2. Provide proof of blood-borne pathogen orientation course; and 3. Provide proof of current personal health insurance, throughout the clinical year. 4. Background check 5. Satisfactory physical examination 6. Satisfactory drug screen Note: Health Screening and student immunizations may not be conducted by faculty or staff of University of the Cumberlands. Student health records will not be released without written permission from the student. Health screening, immunizations and/or healthcare services will not be conducted by program personnel. Immunization Policy Standard A3.07 Standard A3.07 The program must have and implement a policy on immunization of students, and such policy must be based on current Centers for Disease Control recommendations for health professionals. The program implements a policy on immunization of students based on current Centers for Disease Control recommendations for health professionals. Students must provide documentation demonstrating current immunization or laboratory evaluations of immunity for those infectious conditions required by the state of KY or prespective clinical practice rotation site specific requirements and or those recommended by the CDC for Health Care Workers. These immunizations include: Measles (Rubella) German Measles (Rubella) Mumps Chicken Pox (Varicella) Tetanus Hepatitis B 36

37 37 Influenza Injuries and Needle Stick/Blood/Bodily Fluids Contamination Protocol Standard A3.08 STANDARD A3.08 The program must inform students of written policies addressing student exposure to infectious and environmental hazards before students undertake any educational activities that would place them at risk. Accidents will occasionally occur in the laboratory or in the clinical setting. If a student is injured in a laboratory or classroom setting, the instructor should be notified immediately. If a student is injured at a clinical site, the Clinical Preceptor should be notified immediately and the student must follow that site s protocol for dealing with injuries. In many facilities, this will require students to seek treatment in the employee health department, the occupational medicine department, or the emergency department. If the clinical site lacks these resources, treatment should be sought in the nearest emergency department. Exposure to blood borne pathogens is a risk assumed by all healthcare providers. Students will receive training to minimize their risk during orientation. Individual clinical sites may also provide orientation sessions regarding blood borne pathogens. Observing universal precautions is one method to reduce risk. The principle of universal precautions recognizes that any patient may be infected with microorganisms that could be transmitted to other persons. Of particular concern are the primarily blood-borne pathogens HIV (human immunodeficiency virus) and HBV (hepatitis B virus). However, body fluids other than blood, secretions, and excretions are included in universal precautions. Since infected patients may be asymptomatic, it becomes necessary to use basic precautions with every patient. Observance of universal precautions will help to provide better protection for every staff member. Students should also familiarize themselves with the hospital/clinical sites specific policies regarding universal precautions. Universal Precautions Guidelines: Act as though all patients you have contact with have a potentially contagious blood borne disease Avoid direct contact with blood, body fluids, secretions, excretions, mucous membranes, non-intact skin, and lesions Avoid injuries from all sharps Avoid direct contact with items, objects, and surfaces contaminated with blood, body fluids, secretions, and excretions Dispose of all sharps promptly in special puncture resistant containers Dispose of all contaminated articles and materials in a safe manner prescribed by law In practice, using Universal Precautions also requires: Washing hands frequently and thoroughly, especially if they become contaminated with blood, body fluids, secretions, and excretions.

38 38 Depending on job duties and risk of exposure, using appropriate barriers, including gloves, gowns, aprons, caps, shoe covers, leggings, masks, goggles, face shields, and equipment such as resuscitation devices. These barriers are to be used to protect: A. Skin, especially non-intact skin (where there are cuts, chapping, abrasions, or any other break in the skin) B. Mucous membranes, especially eyes, nose, and mouth NOTE: These items of protective apparel, including gloves are removed after each use and are properly disposed. The same pair of gloves, etc,. are NOT to be worn from one patient or activity to another. Students will wear protective equipment as directed by their Clinical Preceptor or facility protocol All patient specimens are bagged per facility protocol before transport to the laboratory In the event a student is injured by a contaminated sharp or is exposed in any manner to blood or potentially infectious bodily fluids in the course of their assigned clinical work, the following steps should to be followed for proper treatment and follow-up for the student. Upon possible exposure to a blood borne pathogen: 1. For skin and wounds, wash the affected area with soap and water. Eyes and mucous membranes should be copiously flushed with water. Notify your Clinical Preceptor immediately. 2. Follow facility protocols regarding evaluation. Most facilities will require you to report immediately to employee health or the emergency department following exposure. Failure to follow up properly may make it difficult or impossible to obtain source patient blood in facilities in cases in which this may be possible. 3. In sites without employee health or emergency departments, or if the site protocol is unclear, proceed immediately to the nearest emergency department for assessment. In cases in which prophylactic medical treatment is indicated, it is believed to be most effective when administered as quickly as possible. 4. The treating healthcare professional will request information about your medical history, the source patient s history (if known) and the nature of the exposure. They may request permission to draw baseline laboratory studies. They will discuss your risk of contracting a blood borne disease and the risks and benefits of prophylactic treatment. In deciding whether to receive post-exposure prophylactic treatment, students might also wish to consult with the National Clinicians Post-Exposure Prophylaxis Hotline: Students should follow up as directed by their treating healthcare provider. Ongoing follow-up may take place at the initial treating facility or the student may be referred to a healthcare provider with expertise in infectious disease. The program may be able to assist the student in finding an infectious disease specialist as requested or required. 6. Since students are neither employees of University of the Cumberlands nor the clinical sites, payment for assessment and treatment is the responsibility of the student and their insurance carrier.

39 39 Should a student sustain an injury or exposure at a clinical site, the student should report the incident immediately to the preceptor, complete the site incident form (if required), the Incident Reporting Form in Appendix H and receive appropriate medical care. The student is then required to contact the Program Director, Associate Director or Clinical Director. Completion of additional UC Incident Reporting forms may be required. Students are responsible for initiating care and obtaining recommended follow up after injury or exposure to possible infectious pathogens. Injuries which occur at clinical sites and any costs associated with an incident are not covered or reimbursed by the University. All costs for evaluation and treatment are the responsibility of the student. Each student is required to carry their own individual Health and Accident Insurance. Name and Contact Information Changes It is every student s responsibility to keep the Program Administrative Assistant informed of current contact information throughout their program and enrollment. Changes of name, address and telephone number must be reported within seven days of occurrence. Students are required to use the address provided by the University. The Program will not be held responsible for consequences incurred as a result of our inability to contact students in a timely manner due to contact information changes that were not reported to the Program. Nondiscrimination Policy Standard A3.12 The program must define, publish and make readily available to faculty and students policies and procedures for processing student grievances and allegations of harassment. University of the Cumberlands does not illegally discriminate on the basis of race, color, national or ethnic origin, sex, disability, age, religion, genetic information, veteran status, because a person is a smoker or nonsmoker, or any other basis on which the University is prohibited from discrimination under local, state, or federal law, in its employment or in the provision of its services, including but not limited to its programs and activities, admissions, educational policies, scholarship and loan programs, and athletic and other University -administered programs. In order to fulfill its purpose, the University may legally discriminate on the basis of religion in employment, and the University has sought and been granted exemption from certain regulations promulgated under Title IX of the Education Amendments of 1972 which conflict with the University's religious tenets. The following person has been designated to handle inquiries or complaints regarding the disability non-discrimination policy, including compliance with Section 504 of the Rehabilitation Act of 1973: Dr. Tom Fish, Dean of Undergraduate Studies, Retention, and Assessment Library 021, (606) The following person has been designated to handle inquiries or complaints regarding the sex nondiscrimination policy including compliance with Title IX of the Education Amendments of 1972:

40 40 Ms. Pearl Baker, Human Resources Director and Title IX Coordinator Gatliff Administration Office 116, (606) The following person has been designated to handle inquiries or complaints regarding all other portions of the non-discrimination policy: Mr. Steve Morris, Vice President for Business Services Gatliff Administration Office 001, (606) Orientation All students are required to attend the two-day program orientation. During the orientation vital program information will be given and questions answered. Each student will have access to a copy of the handbook containing program policies and procedures, and will be given assistance in understanding the program policies and practices. It is at this time that students will have opportunity to meet the faculty and learn program expectations. There will also be a study skills workshop as well as training in the use of health-related internet databases and the University of the Cumberlands medical resources located in the Hagan Memorial Library. Participation of Students as Human Subjects All students are required to participate in physical exam training in a professional and cooperative manner. They will be asked to wear clothing that will allow physical examination by another student. Students will be asked to drape patients properly. Students will never be asked to perform pelvic/rectal examination procedures on one another. Students demonstrating unprofessional behaviors (including but not limited to inappropriate physical contact, unpreparedness, unwillingness to participate, inappropriate patient draping, or unsuitable verbal comments) will be counseled by the course instructor. Students continuing to demonstrate unprofessional behaviors will be counseled by the program director and documentation of the incident will be placed in the student file. If the issue remains unresolved, the Vice President for Academic Affairs will be notified and appropriate action will be taken including but not limited to a failing grade for the course or dismissal from the program. Performance Standards and Progression Requirements - Standard A3.17c Standard A3.17c The program must define, publish and make readily available to students upon admission academic performance and progression information to include: c) requirements for progression in the program. In addition to fulfilling university requirements and following all university policies for graduate program standing and progression, students enrolled in the MSPAS curriculum or entering from a proposed undergraduate component (please see below) must observe the following progression requirements: Adherence to all course pre-requisites

41 41 Adherence, as developmentally appropriate, to codes and standards of the Physician Assistant profession and demonstration of generic abilities in professional behavior Maintenance of good program standing, as defined by the university, for entrance into the clinical year of the curriculum Demonstration, as is developmentally appropriate, of progress toward graduation competencies of the MSPAS curriculum Academic Progress Successful completion of each course is required in order to progress within the program. Students are required to maintain a minimum cumulative grade point average (GPA) of 3.0 and achieve a course letter grade of C or better in all courses to make appropriate academic progress within the Program. Any individual who does not meet the specified end-of-semester GPA requirements will be placed on Academic Probation for one semester. See Academic Probation. In addition, a student who earns a grade of C in one or more courses but who maintains the minimum GPA requirement will receive academic and career counseling with the student advisor. Students with a grade of C in multiple courses jeopardize their continued enrollment in the program. Academic Probation A student is placed on Academic Probation when the cumulative GPA falls below 3.0. Probationary status is determined and monitored by the Program Director in consultation with the Academic Coordinator and the Registrar. Normally a student has one semester to remove probationary status. After a probationary semester, a student with a cumulative GPA of less than 3.0 normally will be suspended and not permitted to continue in the program. However, such a student may apply to the Program Director for re-entry into the program the following year. If readmitted to the program, the student must complete the program within three years of initial program enrollment. Privacy Rights of Students and Informed Consent Students pursuing a Masters in Physician Assistant Studies are granted privacy trough the Family Educational Rights and Privacy Act of 1974 (FERPA) enacted to protect the privacy associated with educational records, to establish the rights of students to inspect and review their educational records and to provide guidelines for the correction of inaccurate or misleading data through informal and formal hearings. More details are provided below. The University is subject to the provision of the Family Educational Rights and Privacy Act (FERPA). This federal law affords students certain rights with respect to the student's education records. These rights are: The right to inspect and review the student's education records within 45 days of the day the University receives a request for access. Students should submit to the Office of the Registrar written requests that identify the record(s) they wish to inspect. The Registrar will make arrangements for access and notify the student of the time and place the records may be inspected.

42 The right to request the amendment of the student's education records that the student believes are inaccurate. Students may ask the University to amend a record that they believe is inaccurate. They should write the Registrar, clearly identify the part of the record they want changed, and specify why it is inaccurate. If the Registrar decides not to amend as requested, the Registrar will notify the student of the decision and advise the student of his or her right to a hearing regarding the request and will provide the student with additional information regarding the hearing procedures. The right to consent to disclosures of personally identifiable information contained in the student's education records, except to the extent that FERPA authorizes disclosure without consent. One exception which permits disclosure without consent is disclosure to school officials with legitimate educational interests. A school official is a person employed by the University in an administrative, supervisory, academic, research, or support staff position (including law enforcement unit personnel and health staff); a person or company with whom the University has contracted (such as an attorney, auditor, or collection agent); a person serving on the Board of Trustees; or a student serving on an official committee, such as a disciplinary or grievance committee, or assisting another school official in performing his or her tasks.. A school official has a legitimate educational interest if the official needs to review an education record in order to fulfill his or her professional responsibility. Upon request, the University discloses education records without consent to officials of another school in which a student seeks or intends to enroll. The University may also disclose without the student's consent "directory information" unless the student has advised the Registrar in writing at least five days following registration that the student does not wish part or all of the directory information to be made public. Once filed, this instruction becomes a permanent part of the student's record until the student instructs the University, in writing, to have the request removed. The primary purpose of directory information is to allow the University to include this type of information in certain University publications, the media, and outside organizations. The University has designated the following as examples of directory information: The student's name, addresses including electronic mail address, telephone numbers, date and place of birth, major field of study, degree sought, attained class level, expected date of completion of degree requirements and graduation, degrees and awards received, picture, dates of attendance, full or part-time enrollment status, the previous educational agency or institution attended, class rosters, participation in officially recognized activities and sports, weight and height of athletic team members and denominational preference. The University may disclose education records in certain other circumstances, but shall do so only upon the authorization of the Registrar. The right to file a complaint with the U.S. Department of Education concerning alleged failures by the University to comply with the requirements of FERPA. The name and address of the office which administers FERPA and to which complaints are to be sent is: Family Policy Compliance Office, U.S. Department of Education, 400 Maryland Avenue, SW, Washington, DC, In compliance with FERPA, University of the Cumberlands Department of Physician Assistant Studies requires its students informed consent to the sharing of personal information with its educational partners (clinical rotation sites) strictly on a need-to-know basis. This personal information may include, but is not limited to, social security numbers, immunization records, e- 42

43 mail addresses, telephone numbers, results of health care tests, results of credit checks and criminal records known to University of the Cumberlands. Notice is hereby given that random drug screenings or additional criminal background checks may be requested of the students at anytime during the didactic or clinical years as well as for placement in certain clinical rotation sites as standard operating procedure. The student may be responsible for the cost of drug screenings or additional criminal background checks. 43 Professional Appearance Standard B3.01 A professional appearance demonstrates respect for patients and helps to build their confidence. Physician assistant students must dress in professional, neat, and conservative attire. Good personal hygiene is always required. It is the responsibility of the student and faculty to dress appropriately by remaining clean, modest, professional and well-groomed at all times. Students whose dress and grooming do not adhere to this standard may be given a written warning. Continued display of inappropriate dress and/or grooming is considered unprofessional and will be documented in the student file and may have a negative effect on the student s professionalism grade. Students may be requested to wear their University of the Cumberlands name tag during some lectures and should have them readily available. Guidelines for all Program Related Experiences (the First Professional Year) All students will be expected to wear business casual attire No hats (men and women) No shorts, sweats or cutoff pant legs No midriff, or halter tops No body jewelry/piercing that interferes with class function, especially during laboratory sessions No visible tattoos No open-toed shoes during laboratory sessions in which sharps are handled Dress requirements for physical examination laboratory sessions may be found in the appropriate course syllabus. When required to be present at clinical sites, please observe guidelines below. Guidelines for All Clinical Experiences (in addition to the criteria noted above) Standard B3.01 PA students must be clearly identified in the clinical setting to distinguish them from physicians, medical students, and other health profession students and graduates. Professional dress is necessary for all clinical experiences and evening classes: Students will wear a clean, short white consultation jacket Males should wear a collared shirt with a tie if required by preceptor Hair should be worn in a neat manner All attire will be clean and pressed

44 44 Jeans, shorts and cutoffs are prohibited Open toed shoes are prohibited, sneakers when wearing scrubs only Students must display prominently at all times their nameplate issued from University of the Cumberlands, which contains the student s name and the title Physician Assistant Student (supplied by the program). Any additional dress requirements imposed by a clinical site supersede those of the program. Scrubs should be worn in accord with facility policy. In general, they should not be worn outside of the operating or delivery room. Soiled scrubs should be left at the facility for laundering at the end of the assigned shift. Scrubs are not permitted on campus except as previously noted. Students who appear in class or at a clinical site with inappropriate attire or hygiene may be directed to leave, and will not be permitted to make up missed assignments. Professional Development Assessment Tool Standard C3.02 Standard C3.02 The program must document student demonstration of defined professional behaviors. The professional conduct of physician assistant students is evaluated on an on-going basis throughout the didactic and clnical years of the program. Violations of standards of conduct are subject to disciplinary actions administered by the university, and by the program As a PA student, you are expected to achieve the highest level of professionalism. The Professional Development Assessment Tool (PDAT) (see Appendix E) is an example of an assessment tool that will be used to determine if you have achieved professional competency to graduate and practice as a physician assistant. This instrument is completed at the end of each semester by your faculty advisor and upon completion of the program. If there are issues in professional behaviors that occur during the course of a semester, your advisor and/or the Program Director will request a meeting with you to discuss any concerning behavior. The PDAT will be used to document such behaviors and will remain in the student file for the remainder of the academic year. If the behavior does not improve, the student can be subject to reprimand, disciplinary probation, or dismissal. Professionalism Standard C3.02 Standard C3.02 The program must document student demonstration of defined professional behaviors. The MPAS Technical Standards consider the physical, cognitive, and behavioral abilities required for satisfactory completion of the physician assistant curriculum. The essential required abilities for a physician assistant student include motor, sensory, communicative, intellectual,

45 behavioral, and social aspects. Academic, clinical, and professional development are intertwined and related to each other. A student s growth in the academic and clinical areas may be dependent on their growth as a professional. Physician assistant students must recognize themselves as clinicians providing services to both the physician supervisor as well as to the patient. PA students must be aware that, even as students, they are viewed by both patients and medical providers as part of the larger medical community. It is critical, therefore, that professional development be assessed, just as academic and clinical skills are measured, during a student s growth. As healthcare practitioners, physician assistants are required to conform to the highest standards of ethical and professional conduct. Physician assistant students also are expected to adhere to the same high ethical and professional standards required of physician assistants. The American Academy of Physician Assistants (AAPA) has identified four primary bioethical principles autonomy, beneficence, non-maleficence, and justice that form the foundation of the Statement of Values of The Physician Assistant Profession. The Statement of Values provides a guideline for ethical conduct by physician assistants. (A complete discussion of the ethical conduct required of physician assistants can be found at the American Academy of Physician Assistant website, In addition to the AAPA s guidelines, The National Commission on Certification of Physician Assistants (NCCPA) recently adopted a code of conduct for certified and certifying physician assistants. The NCCPA s code of conduct outlines principles that all certified or certifying physician assistants are expected to uphold. A complete discussion can be found at In addition to understanding and complying with the principles and standards promulgated by the AAPA, the NCCPA, and the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA), physician assistant students are required to know and comply with the policies, procedures, and rules of the MPAS program and the university; and the policies, procedures, and rules of each clinical site to which the student is assigned. Further, physician assistant students are required to conduct themselves in a manner that complies with the following principles and standards: At a minimum, University of the Cumberlands Physician Assistant students are required to abide by the profession s Code of Ethics. Faculty who believe a student is in direct breech of the code of ethics will make this aware to the Program Director. Contact and discussion with the student will take place and a course of action will be taken to remediate the problem. Unwillingness to resolve the dispute and continual failure to demonstrate the qualities defined in the AAPA Professional Code of Ethics will serve as grounds for dismissal. The rubric used in evaluating professional behavior is found in this document. RESPECT Physician assistant students are expected to treat all patients, faculty, staff, Clinical Preceptors, healthcare workers, and fellow students with dignity and respect. For example: 45

46 Physician assistant students must recognize and embrace their roles as members of a team and interact with others on the team in a cooperative and considerate manner. Physician assistant students train closely with other students, including in physical examinations of fellow students and discussion groups that may reveal personal information. Students must maintain and exhibit respect for the privacy and confidentiality of fellow students. Students should offer criticism or suggestions in a thoughtful and reasoned manner that fosters respect and trust. When confronted with conduct by another member of the team that may be inappropriate, students are not to respond angrily; rather, they must remain calm and respectful, and respond in accordance with the standards of professional conduct required of physician assistant students. FLEXIBILITY Although every effort is made to provide training activities at times and places scheduled in advance, physician assistant students often will be required to be flexible because of changes in the schedule. For example, instructors who are also practicing clinicians may not have a regular schedule, and lectures or clinical sessions may, at times, need to be rescheduled with short notice. In addition, clinical sites create the student schedules for each rotation, and such schedules may require physician assistant students to work weekends and nights. HONESTY AND TRUSTWORTHINESS Physician assistant students shall be honest and truthful in all respects. Students shall not intentionally mislead others. STUDENT ROLE AND ACCOUNTABILITY Physician assistant students have a unique role in health care delivery. In that role, students are accountable for such things as: Students shall perform only those procedures authorized by the program, clinical site, supervisor, and/or preceptor. Physician assistant students at clinical sites must always work under the supervision of a preceptor, and are prohibited from assuming primary responsibility for a patient s care. For example, students shall not treat or discharge a patient without prior consultation with, and approval of, a Clinical Preceptor or supervisor. Students are responsible for timely completion of all assignments and duties effectively and to the best of their ability. Students are responsible for identifying and reporting unprofessional, unethical, and/or illegal behavior by healthcare professionals and students, faculty, and staff 46

47 of the MPAS program. If a physician assistant student has a reasonable belief that such conduct has occurred, he or she should report it to the Program Director, preceptor, supervisor, or Director of Clinical Education, as may be appropriate under the circumstances. Physician assistant students are expected to accept and apply constructive feedback. Physician assistant students are always required to exercise sound judgment. CONCERN FOR THE PATIENT Physician assistant students must, by their words and behavior, demonstrate concern for the patient. Concern for the patient is manifested in many ways, including, but not limited to, the following: Physician assistant students must treat patients and their families with dignity and respect. At all times, the physical and emotional comfort of the patient are of paramount importance. Students must use appropriate verbal and non-verbal communication to convey concern, pleasantness, compassion, and professionalism to the patient. The patient s modesty should be considered and respected at all times. Students shall deliver healthcare services to patients without regard to their patients race, religion, national origin, age, sex, marital status, citizenship, sexual orientation, creed, disability, medical condition, socioeconomic status or political beliefs, or any status protected by law. Students may not accept gifts or gratuities from patients or their families. Sexual or romantic relationships with patients are prohibited and will not be tolerated. MAINTAINING COMPOSURE Physician assistant students must maintain a professional and calm demeanor at all times, even in emergency and other highly stressful situations. Professionalism Conclusion The requirements for professional performance have been established to protect the rights of patients and communities and to foster the team concept in the delivery of health care. More detailed information may be found in Part II of this manual. 47

48 Readmission Procedure Students who have been dismissed from the program may wish to be considered for readmission. They may reapply at the next admissions cycle. If enrollment in the program was terminated due to academic difficulty, the student must also submit evidence of improved performance in accordance with applicable University policies in order to be considered for re-enrollment. Such students will compete with other applicants in the current admissions cycle, on a space-available basis. There is no guarantee of readmission. Remediation Standard C3.03, A3.17f Standard C3.03 The program must monitor and document the progress of each student in a manner that promptly identifies deficiencies in knowledge or skills and establishes means for remediation. Standard A3.17f The program must define, publish and make readily available to students upon admission academic performance and progression information to include: f) polices and procedure for remediation and deceleration. The MPAS program at the University of the Cumberland's will utilize the following remediation policy. A midterm warning system exists to facilitate communication between the department chair /program director, the advisors and the students. When a student completes an exam in each PA course all students with a score of 75% or below will be contacted by by his or her advisor. The student is required to make an appointment with the advisor. The advisor will utilize the academic encounter form to gather information from the student and make recommendations for further action. Students will be required to self-analyze each exam when the score is below 75%. The test self-analysis form will be placed in the students file. When two or more classes demonstrate lower performance, the program director generates a letter to the student. To better coordinate and communicate performance in all classes the following procedure has been implemented to assure that students receive prompt academic assistance, remediation and referral for special accommodations if either is necessary. The purpose of this system is to identify study skill deficiencies early in the academic year and provide assistance for students to strengthen performance. Based on individual assessments, students will be referred to one of the following: program director, director of the didactic education, Academic Support Services, Counseling Services or instructed to follow-up with a faculty member. At the completion of the meeting a Student Encounter Form Student Academic Mentoring Form (see Appendix G) will be completed and signed by the faculty member and the student. The form was forwarded to the appropriate department and a copy place in the student s file. After each round of exams the same protocol will take place. Students may be referred to one or more of the following services as needed: 48 Referred to tutoring services and or the Teaching and Learning Center Referred to Disability Services Referred to course coordinator/instructor Referred to Program Director study skills Referred to Career Counseling and or Mental health counseling services

49 Retention Standards Earning an MPAS Degree is predicated on the faculty s determination that a student is suitable for the practice of medicine in terms of his/her personal professionalism, personal conduct, and academic achievement. Grades alone are not sufficient to warrant promotion to the next semester, clinical phase, or graduation. The faculty reserves the right to dismiss any student when the student s documented behavior is not in keeping with the standards of the medical profession or when the student s presence in the PA Program is considered detrimental to the student in question, the other students in the college, or to society in general. Student Conduct in Clinical Facilities Students enrolled in the MPAS program are expected to conduct themselves in a professional manner at all times. The criteria for evaluating professional performance include, but are not limited to, demonstrating professional competencies and skills; adhering to program and facility policies; displaying sensitivity to patients and community needs; demonstrating an ability to relate appropriately to peers and other members of the health care team; displaying a positive attitude; maintaining regular and punctual attendance; and maintaining acceptable physical appearance. Student Representation Each class may elect a class representative who will bring issues that affect the entire class to the attention of the Program Director. The Physician Assistant Student Society of University of the Cumberlands will represent the entire student body of the PA Program. The students will elect officers and hold class meetings as needed to determine the consensus of the entire student body regarding any issues affecting the entire class. A Faculty Advisor will be assigned to the student society to aid in the use of resources and will coordinate activities of the student body within the Student Academy of the American Academy of Physician Assistants (SAAAPA). Student Security and Safety The Program and the University strive to assure the security and safety of students in all locations in which instruction occurs throughout the curriculum. Students should assume responsibility for notifying the Program and/or University when security or safety concerns arise. 49 Withdrawl and Policies and Procedures for Refunds of Tuition and Fees Standards A3.17e, A3.14g Standard A3.17e The program must define, publish and make readily available to students upon admission academic performance and progression information to include: e) policies and procedures for withdrawl and dismissal Standard A3.14g The program must define, publish and make readily available to enrolled and prospective students general program information to include: g) policies and procedures for refunds of tuition and fees A student desiring to withdraw from University of the Cumberlands within any semester must complete required paperwork and receive permission from the Vice President for Academic Affairs. The following policies and procedures govern withdrawal from the University for the current term.

50 1. The permanent record of a student who withdraws from University of the Cumberlands up until the last day to drop a class published on the Academic Calendar for that semester or bi-term will list a mark of W for all courses for which another grade (such as an af ) has not been previously posted. A W carries no grade point penalty. 2. Students withdrawing after the last day to drop a course for the semester or bi-term will receive a grade as determined by the professor. In many cases this may be an F. 3. A student who does not attend or ceases to attend a class but never officially drops or withdraws will receive an af for each class when appropriate. An administrative withdrawal will be posted when af s are posted for all courses on a student s schedule. 4. No student who withdraws from University of the Cumberlands is entitled to a grade report or transcript of credits until the student s account is cleared by the Bursar s Office. 5. The official date of withdrawal will be used by the Bursar s Office and the Office of Financial Planning to determine any adjustments involving financial aid and financial charges. Students must officially withdraw through the Office of Academic Affairs. Students who fail to officially withdraw forfeit all rights to a refund or reduction in fees. Any student that does not cancel prior to their required deadline will be assessed a minimum fee of $150 for classes and a minimum fee of $150 for room & board. Deadline dates are posted with the Registrar Office and Bursar Office. Refund Schedule Courses Fifteen Weeks or Greater in Length Official Date of Withdrawal Charge Refund Last day to Register 0% 100% Week 2 of classes 20% 80% Week 3 of classes 40% 60% Week 4 of classes 60% 40% Week 5 of classes 80% 20% After 5 th week of classes 100% 0% 50 Courses Greater than Six Weeks but Less than Fifteen Weeks in Length Official Date of Withdrawal Charge Refund Last day to Register 0% Week 2 of classes 50% 50% After 2 nd week of classes 100% 0% Courses Six Weeks or Less in Length Official Date of Withdrawal Charge Refund Last day to Register 0% 100% After 1 st week of classes 100% 0% If a student officially withdraws after the posted cancellation deadline and on or before the first day of the term, they will be charged a non-cancellation fee of $150 for tuition and $150 for room and board for the fall and spring term. There is no non-cancellation fee for the summer term(s).

51 51 If a student officially withdraws after the first day of classes, they will be charged an administrative withdrawal fee of $100 for the fall and spring terms and $50 fee for the summer and bi-terms. A student is not eligible for any financial aid prior to the first day of class attendance. No Refund of Tuition or fees will be applied for dropping a course after the last day to add a course for the term has expired. Medical/Emergency Withdrawal. Students who must withdraw from classes for medical reasons or because of dire personal circumstances may submit a written request to the Academic Affairs Office as soon as the student intends to stop attending classes. This request must be supported by a letter from a medical professional or other source supporting the student s request with specific information on the student s diagnosis, current condition and continuing treatment requirements, or on the student s personal emergency that necessitates the withdrawal request. If the medical/emergency withdrawal is granted, the student will receive a grade of W in all current classes. NOTE: Normally, partial medical/emergency withdrawals are not permitted (that is, withdrawal from one or two courses while the student continues in others). TREATMENT OF TITLE IV AID WHEN A STUDENT WITHDRAWS The law specifies how your school must determine the amount of Title IV program assistance that you earn if you withdraw from school. The title IV programs that are covered by this law are: Federal Pell Grants, Academic Competitiveness Grants, Nation al SMART grants, TEACH Grants, Stafford Loans, PLUS Loans, Federal Supplemental Educational Opportunity Grants (FSEOGs), and Federal Perkins Loans. When you withdraw during your payment period or period of enrollment (your school can define these for you and tell you which one applies) the amount of Title IV program assistance that you have earned up to that point is determined by a specific formula. If you received (or your school or parent received on your behalf) less assistance than the amount that you earned, you may be able to receive those additional funds. If you received more assistance than you earned, the excess funds must be returned by the school and/or you. The amount of assistance that you have earned is determined on a prorated basis. For example, if you completed 30%of your payment period or period of enrollment, you earn 30% of the assistance you are originally scheduled to receive. Once you have completed more than 60% of the payment period or period of enrollment, you earn all the assistance that you were scheduled to receive for that period. If you did not receive all of the funds that you earned, you may be due a post-withdrawal disbursement. If your post-withdrawal disbursement includes loan funds, your school must get your permission before it can disburse them. You may choose to decline some or all of the loan funds so that you don t incur additional debt. Your school may automatically use all or a portion of your post-withdrawal disbursement of grant funds for tuition, fees, and room and board charges (as contracted with the school). The school needs your permission to use the post-withdrawal

52 grant disbursement for all other school charges. If you do not give your permission (some schools ask for this when you enroll), you will be offered the funds. However, it may be in your best interest to allow the school to keep the funds to reduce your debt at the school. There are some Title IV funds that you were scheduled to receive that cannot be disbursed to you once you withdraw because of other eligibility requirements. For example, if you are a firsttime, first-year undergraduate student and you have not completed the first 30 days of your program before you withdraw, you will not receive any FFEL or Direct loan funds that you would have received had you remained enrolled past the 30 th day. If you receive (or your school or parents receive on your behalf) excess Title IV program funds that must be returned, your school must return a portion of the excess equal to the lesser of: 1. Your institutional charges multiplied by the unearned percentage of your funds, or 2. The entire amount of excess funds The school must return this amount even if it didn t keep this amount of your Title IV program funds. If your school is not required to return all of the excess funds, you must return the remaining amount. Any loan funds that you must return, you (or your parent for a PLUS loan) repay in accordance with the terms of the promissory note. That is, you make scheduled payments to the holder of the loan over a period of time. Any amount of unearned grant funds that you must return is called an overpayment. The maximum amount of a grant overpayment that you must repay is half of the grant funds you received or were scheduled to receive. You must make arrangements with your school or the Department of Education to return the unearned grant funds. The requirements for Title IV program funds when you withdraw are separate from any refunds policy that your school may have. Therefore, you may still owe funds to the school to cover unpaid institutional charges. Your school may also charge you for any Title IV program funds that the school was required to return. If you don t already know what your schools Refund policy is, you can ask your school for a copy. Your school can also provide you with the requirements and procedures for officially withdrawing from school. If you have questions about your Title IV program funds, you can call the Federal Student Aid Information Center at fedaid ( ). TTY users may call Information is also available on Student Aid on the Web at 52 MISCELLANEOUS POLICIES Employment During the Program Standard A3.04, A3.05, A3.06, A3.14h Standard A3.04 PA students must not be required to work for the program. Standard A3.05 Students must not substitute for or function as instructional faculty.

53 53 Standard A3.06 Students must not substitute for clinical or administrative staff during supervised clinical practical experiences. Standard A3.14h The program must define, publish and make readily available to enrolled and prospective students general program information to include: h) policies about student employment while enrolled in the program. Employment during the didactic or clinical year is strongly discouraged and must be approved by the Program Director. In order to enhance student learning and assure student success in the physician assistant program, it is recommended that students minimize the hours worked outside of the program. If a student chooses to work during the academic year, the work schedule must not interfere with class performance or clinical rotation schedules. Students are strongly discouraged from seeking or maintaining employment while enrolled in the Program. If a student does work and encounters academic and/or disciplinary problems, the student may be counseled to cease employment. Under no circumstances will employment be considered as a reason for excused absence from the student s didactic or clinical education commitments nor will student employment considerations mitigate evaluation of outcomes. Matriculated PA students will not be employed by the Physician Assistant Program under any circumstances. Students will not be allowed to perform clerical or administrative work for the Program. Additionally, students will not substitute for or function as instructional faculty. During clinical rotations, students will not be used to substitute for regular clinical and/or administrative staff. If a student is asked to substitute for regular staff on a rotation, he/she should inform the Clinical Coordinator or Program Director immediately. Examination Security To maintain security during examinations, examination proctors reserve the right to inspect anything a student brings with them into an examination room. Holidays During the first year of the program, students will observe the usual academic calendar issued by the university. While on rotation during the second year of the program, students will experience an irregular schedule. No student should make travel arrangements without consulting with his/her faculty advisor, the Director of Clinical Education, and his/her Clinical Preceptor. Students are not required to attend their rotations on holidays designated at the discretion of the clinical sites. Students may request time off for bona fide religious observances, but patient needs take priority, and there is no guarantee that such requests will be honored by a clinical site.

54 Travel to Clinical Sites Students are responsible for arranging travel to all clinical sites and any associated fees (i.e., parking). Some sites may be reached by public transportation, but most students will require a car for reliable transportation. Weather-Related Emergencies In the event of severe weather, students should check with the University webpage or call the university. Students are expected to use their best judgment in deciding to travel. Students on rotation sites not affected by the adverse weather conditions are required to attend their rotation even if the University is closed. Conversely, students at a clinical site with significant adverse weather conditions must use their best judgment in consultation with their preceptors in determining their attendance at the site regardless of the University s status. Students must notify the Program of non-attendance as noted above. 54 Academic Tutoring Standard A1.05 PA Resources STANDARD A1.05 The sponsoring institution must provide academic and student health services to PA students that are equivalent to those services provided other comparable students of the institution. The Teaching and Learning Center is available on campus to provide assistance with academic insufficiencies. Students may be required to report to this center as part of an action plan as appropriate. Counseling and Career Center Standard A1.05 STANDARD A1.05 The sponsoring institution must provide academic and student health services to PA students that are equivalent to those services provided other comparable students of the institution. Students experiencing a personal problem, whether it is interfering with academic performance or not, are encouraged to contact their instructor/advisor. If the instructor is unable to resolve the issue with the student the student will be referred the program director who will, if the issue remains unresolved, refer the student to Academic Affairs and the Director of Counseling and Career Services. The Director of Counseling and Career Services will determine if the student needs to be referred to for further personal counseling. (Confidentiality waivers are signed and records filed with the agency to which the student is referred.) Counseling - Mental Health and Counseling Standard A3.10

55 STANDARD A3.10 The program must have written policies that provide for timely access and/or referral of students to services addressing personal issues which may impact their progress in the PA program. Counseling Center Students experiencing a personal problem, whether it is interfering with academic performance or not, are encouraged to contact their instructor/advisor. If the instructor is unable to resolve the issue with the student the student will be referred the program director who will, if the issue remains unresolved, refer the student to Academic Affairs and the Director of Counseling and Career Services. The Director of Counseling and Career Services will determine if the student needs to be referred to for further personal counseling. (Confidentiality waivers are signed and records filed with the agency to which the student is referred.) 55 Disability Services University of the Cumberlands accepts students with certified disabilities and provides reasonable accommodations for their certified needs in the classroom, in housing, in food service or in other areas. (Please see the University s Non-Discrimination Policy on the inside front cover.) Students with disabilities may incur additional costs for services not provided by the University. The University s obligation to reasonably accommodate any student s disability ends where the accommodation would pose an undue hardship on the University or where accommodation in question would fundamentally alter the academic program. For accommodations to be awarded, a student must submit a completed Accommodations Application form and provide documentation of the disability to the Disability Services Coordinator, Dr. Tom Fish Library 021, (606) Documentation may include copies of accommodation records from a high school or previously attended educational institution, testing results and evaluation by a licensed psychometrician, and/or statements from a physician describing the disability and the necessary restrictions. When all paperwork is on file, a meeting between the student and the Coordinator will be arranged to discuss possible accommodations before accommodations are formally approved. Students must then meet with the Coordinator at the beginning of each semester before any academic accommodations can be certified for that term. Certifications for other accommodations are normally reviewed annually. All accommodations may be reviewed at any time at the request of the student or the Disabilities Coordinator. MPAS students must meet the technical standards published in the UCPA Policy Manual. Financial Aid Student Financial Services Administrative Regulation and Payment of Tuition and Fees University students are expected to pay their bills in a timely manner. The Office of Financial Planning assists students in meeting their obligations and will discuss reasonable payment schedules in extraordinary cases. In order to assure the collection of money

56 due to the University, students with an unpaid balance for tuition, fees, bookstore charges, library fines, parking fines, or any other University approved fee or fine will be denied the following privileges or services: 56 Class registration Participation in graduation ceremonies and the awarding of diplomas; also, seniors may be denied final examinations Transcript issue The Office of Financial Planning is available from 8:30am to 4:30pm to discuss individual problems and to advise students in matters regarding financial aid. Health Insurance Insurance is required for all students. Students not covered by their parents' insurance are eligible to purchase a student group health insurance selected by the University. Student insurance forms are available in the Vice President of Financial Services. All resident students and students in athletic programs must carry health insurance. If a student is covered by their own or parent's plan, a Xeroxed copy of the insurance card must be provided to the Health Center and updated on a yearly basis. PA Facilities Standard A1.09 Standard A1.09 The sponsoring institution must provide the program with the physical facilities to operate the educational program to fulfill obligations to matriculating and enrolled students. The Physician Assistant Program is housed in the first floor the Correll Science Building in the Forcht Medical Wing. Offices. The Physician Assistant Program Office is in Room 133. Faculty and staff offices are adjacent and immediately across from the lecture halls, lounge and laboratories. Classrooms. The Physician Assistant Program has two lecture classrooms. Each of the classrooms has a seating capacity for 24 students and a desk for the instructor. Mounted from the ceiling at the front of each classroom is a projector and projection screen. Each classroom has a sink and cabinetry with each door and drawer equipped with a lock.

57 57 Laboratories. The Physician Assistant program has two laboratories built specifically for the department. The Procedures/Skills Laboratory is housed in Room 130. Two round tables are centrally located in the lab to accommodate 24 students. Equipment supplied to lab include (3) patient beds, (3) x-ray illuminators, (3) ceiling mounted privacy curtains, (2) sinks, (2) microscope stations, (1) projection screen, (1) marker board, (1) reach-in refrigerator, and multiple sets of cabinets complete with locks on each of the doors and drawers. The second lab is the Physical Assessment Laboratory. The lab has seating for twenty-four students and an instructor s desk for pre-lab instruction purposes. Also located in the lab are (8) patient assessment tables each with (1) privacy curtain. Also supplied to the room is a wash sink. Student Lounge. A lounge for the physician assistant students is located in the upstairs corridor of the Correll Science Building in Room 226. Furnished in the lounge are lockers, cabinets, a microwave, refrigerator and a sink.

58 PA Professional Oath All Physician Assistants make the pledge to perform the following duties with honesty and dedication: Hold as my primary responsibility the health, safety, welfare and dignity of all human beings. Uphold the tenets of patient autonomy, beneficence, nonmaleficence and justice. Recognize and promote the value of diversity. Treat equally all persons who seek my care. Hold in confidence the information shared in the course of practicing medicine. Assess my personal capabilities and limitations, striving always to improve my practice. Seek to expand my knowledge and skills, keeping abreast of advances in medicine. Work with other members of the health care team to provide compassionate and effective care of patients. Use my knowledge and experience to contribute to an improved community. Respect my professional relationship with the physician. Share and expand knowledge within the profession. (Source: 58

59 59 PA Website Student Health Services Standard A1.05, A3.09 As you progress through your education, it is important that you pay attention to your own health. A career in medicine is stressful, and medical providers are frequently guilty of setting a poor example for their patients. Proper nutrition, exercise and stress coping skills will contribute to your success as a student. Standard A1.05 The sponsoring institution must provide academic and student health services to PA students that are equivalent to those services provided other comparable students of the institution. Standard A3.09 Principal faculty, the Program Director, and the Medical Director must not participate as health care providers for students in the program. Core faculty will not participate as health care providers for any student in the PA program. If a student approaches faculty for health care they will to refer him/her to another available provider not associated with the program. The following list of local providers is given so students may select a physician to meet medical needs during their time at the University. 1. Cumberland River Clinic, 402 Cumberland Avenue, Williamsburg, KY 2. Durham Lee G, MD, 475 North Highway 25 West, Williamsburg, KY 3. Wilkens Charles H, MD, 475 North Highway 25 West, Williamsburg, KY University Library Library Resources. Available to PA students through the electronic resources supported by the Hagan Memorial Library are many electronic and online databases to which the Library subscribes. The databases have become a major segment of the learning resources available on campus and provide scholarly support for all academic programs, including those in the medical field. Most of these databases include full-text journals and other information resources. Of the available electronic resources, those that are considered particularly useful to the PA program consist of the following: ACP Medicine Health Source: Nursing/Academic Edition MD Consult STAT!Ref Encyclopedia of Environmental Microbiology Encyclopedia of Molecular Biology CINAHL

60 60 CINAHL with Full Text Health Source-Consumer Edition Lexis-Nexis Academic Universe MEDLINE Oxford Reference Online Wilson Web OmniFile Full Text Mega Psychology and Behavioral Sciences Collection Library s support of the MPAS program extends beyond the efforts to enhance its collections described above. In addition, the Librarians provide instruction in the use of library resources, including databases. A library instruction session was provided to the initial PA cohort in January Strategies for effectively using the new databases were included in this session. Several online tutorials for medical databases are also available through the Library Tutorials link ( on the Library s homepage. Furthermore, interlibrary loan services have been improved through the creation of an online electronic request forms. Off-campus students are able to have materials mailed rather than needing to come to the Library for pickup. The collaborative agreements of KYVL members facilitate access of students of University of Cumberlands to other libraries and expedite no-fee interlibrary loans from member institutions. The library catalog, all with all electronic resources, may be accessed on-campus or off-campus through the Library s website at Also available on the Library s homepage are links to online forms for Interlibrary Loan requests and to tutorials on accessing and using library resources.

61 PART II: POLICIES, PROCEDURES AND OBJECTIVES RELATED TO CLINICAL ROTATIONS 61

62 62 CLINICAL ROTATIONS & AFFILIATION AGREEMENTS Standards A1.02, A3.03 STANDARD A1.02 There must be written and signed agreements between the PA program and/or sponsoring institution and the clinical affiliates used for supervised clinical practice experiences that define the responsibilities of each party related to the educational program for students. STANDARDS A3.03 Students must not be required to provide or solicit clinical sites or preceptors. The program must coordinate clinical sites and preceptors for program required rotations. Most physician assistant students eagerly look forward to beginning clinical rotations. Each clinical environment holds different challenges and different rewards and serves as the starting point in your transition from student to clinician. University of the Cumberlands has affiliation agreements in place with physicians and healthcare institutions allowing for a complete course of clinical rotations to be set up for each student by the program. In general, rotations are assigned randomly based upon their availability. Students will be afforded the opportunity to select an elective rotation, and it is also occasionally possible for a student to set up a rotation outside of the program s presently-established clinical sites. More information on these situations may be found below. Core Rotations B3.02, B3.03, B3.04, B3.07 STANDARD B3.02 Supervised clinical practice experiences must enable students to meet program expectations and acquire the competencies needed for clinical PA practice. STANDARD B3.03 Supervised clinical practice experiences must provide sufficient patient exposure to allow each student to meet program-defined requirements with patients seeking: medical care across the life span to include, infants, children, adolescents, adults, and the elderly, women s health (to include prenatal and gynecologic care), care for conditions requiring surgical management, including preoperative, intra-operative, and postoperative care, and care for behavioral and mental health conditions. STANDARD B3.04 Supervised clinical practice experiences must occur in the following settings: outpatient, emergency department, inpatient, and operating room. STANDARD B3.07 Supervised clinical practice experiences should occur with preceptors practicing in the following disciplines: family medicine, internal medicine, general surgery, pediatrics, ob/gyn, and behavioral and mental health care. After all of information is compiled and is satisfactory, faculty of the PA program will meet a to discuss placement of each student individually on the basis of many factors, including, but not limited to those relating to the student in the following categories: financial, geographical, per-

63 sonal situation (i.e., married, children, sickness in the family, etc), academic needs, clinical skill needs, professional development needs, etc. Every attempt will be made for convenient placement, however, the university may not have ample rotation sites to chose from in scarce areas (i.e., women s health or pediatrics) and travel may be involved. Should a student be required to travel, all attempts will be made to facilitate housing arrangements and other needed resources to make the travel as convenient as possible for the student. A large network of community and faculty members as well as alumni, support these efforts and are known to frequently assist students in temporary housing. Should a student chose to dispute a rotation assignment, they should do so initially in writing and request that a committee of faculty hear their concerns with regard to the rotation. Alternative placement will be discussed at this time and decided upon by faculty process. 63 Elective Rotations Students will have the opportunity to select an elective rotation in one of several specialties. The specialties available may vary from year to year depending upon site availability. Students will be afforded the opportunity to indicate interest in an elective rotation at the end of the second professional year. Students who fail a core rotation will forfeit the opportunity to select an elective rotation, as a repeated core course will be assigned to them by the Clinical Director. The program is seeking to develop specialized Elective Tracks in Emergency Medicine, Geriatrics, Women s Health and Pediatrics. Interested students should contact the Clinical Director and or Clinical Coordinator regarding specific information. Assignment of Clinical Rotations ROTATION-SPECIFIC POLICIES 1. After all of information is compiled and is satisfactory, faculty of the PA program will meet a to discuss placement of each student individually on the basis of many factors, including, but not limited to those relating to the student in the following categories: 2. Financial, geographical, personal situation (i.e., married, children, sickness in the family, etc), Academic needs, Clinical Skill needs, Professional Development needs, etc. 3. Every attempt will be made for convenient placement, however, the university may not have ample rotation sites to chose from in scarce areas (i.e., women s health or pediatrics)and travel may be involved. 4. Should a student be required to travel, all attempts will be made to facilitate housing arrangements and other needed resources to make the travel as convenient as possible for the student. A large network of community and faculty members as well as alumni, support these efforts and are known to frequently assist students in temporary housing.

64 5. Should a student choose to dispute a rotation assignment; they should do so initially in writing and request that a committee of faculty hear their concerns with regard to the rotation. 6. Alternative placement will be discussed at this time and decided upon by faculty process. Charting Some rotations may allow a student to record information into the medical record. It should be remembered that such entries into the chart serve as a permanent part of the patient s legal medical record. Any time a student makes an entry into the chart, it will be signed by the student. The student will indicate that they are a physician assistant student by writing PA-S following his or her signature. Students must ensure that their chart entries are countersigned by their preceptor as soon as possible or as required by facility policy. Learning to document properly is an essential medical skill. On rotations where students are not permitted to record information in the chart, they are encouraged to practice documentation separately and have it reviewed by their preceptor or Faculty Advisor. Confidentiality As noted previously, all patient information must be held in strict confidence. The sharing of medical information is to be limited to that needed for patient care or legitimate medical education purposes. An intentional breach of patient confidentiality will be regarded as a serious offense. Holidays Students are not required to attend their rotations on holidays designated at the discretion of the clinical site. Students may request time off to meet other religious obligations. Such requests should be cleared by both the Clinical Preceptor and the Clinical Director. Holidays can be difficult times for staffing a healthcare institution. Please be as flexible as possible. Identification in Clinic Standard B3.01 Standard B3.01 PA students must be clearly identified in the clinical setting to distinguish them from physicians, medical students and other health profession students and graduates. In addition to displaying an appropriate identification badge prominently, students shall state truthfully and accurately their professional status in all transactions with patients, health professionals, and other individuals for whom, or to whom, they are responsible. While in the program, students may not use previously earned titles (i.e., RN, MD, DC, PhD). Students will sign all documentation with their full name followed by PA-S. Students will also be required to wear facility specific badges or nametags when applicable. Additionally, students are required to wear a short white lab coat while in the clinic to distinguish them from other students and disciplines. Interviews As graduation approaches, it is expected that students will need time to interview for employment. Requests for time off for interviews should be cleared with the Director of Clinical Education, the Clinical Preceptor, and the Clinical Coordinator. 64

65 65 Patient Safety A student s primary concern should be the health and safety of the patient. Students are expected to exercise good judgment and immediately notify their preceptor of any circumstances which may lead to patient harm. The student shall have ongoing consultation with the supervising physician as required to safeguard and enhance the care of the patient and to ensure the development of clinical skills. Students will perform only procedures authorized by the preceptor, and all procedures should be performed under the supervision of a preceptor until the student and preceptor are comfortable that the student is proficient. Rotation Schedule While on rotation, physician assistant students function as part of a healthcare team. As such, it is frequently necessary to put the needs of the team ahead of personal interest. Your schedule will vary widely among specialties and clinical sites. On some rotations students may be required to take overnight call or cover weekend or overnight shifts. Sites will appreciate flexibility on your behalf, and some of the best learning opportunities occur after hours. Students are required to their rotation schedule to the Clinical Coordinator upon arrival to each new rotation site. Rotations Specific Requirements - Assignments In addition to assignments required by the program, some rotation sites may have specific assignments that they require of students rotating with them. Such assignments may include (but are not limited to) papers, examinations, presentations, or attendance at lectures. Students should regard these assignments as requirements for successful completion of the rotation. Site Specific Policies Most rotation sites will have their own policies and procedures that cannot be described here. Such policies may relate to orientation sessions, parking, identification, etc. If questions regarding these policies arise, please consult with your Clinical Preceptor or Director of Clinical Education. Site Visits Standard C4.01 Standard C4.01 The program must define, maintain and document effective processes for the initial and ongoing evaluation of all sites and preceptors used for supervised clinical practice experiences to ensure that sites and preceptors meet program defined expectations for learning outcomes and performance evaluation measures Standard C4.02 The program must document that each clinical site provides the student access to physical facilities, patient populations and supervision necessary to fulfill program expectations of the clinical experience. A faculty member will be performing on-site visits. The purpose of the site visit is two-fold. First, as per the ARC-PA standards, clinical sites must be assessed continually to make sure that the site is student ready and is an appropriate and quality teaching environment. Second, site visits help faculty observe the progress of each student and observe the interactions between student, patient, and preceptor.

66 During a site visit, a faculty member will meet with the student and discuss the overall rotation. In an effort to improve presentation skills, students will usually be asked to present one or more patients during a site visit. Students may be asked to be prepared to present a patient in any and potentially all of these 3 formats: 66 Comprehensive: Complete HPI, PMH, FH, SocH, ROS, PE, laboratory studies, assessment, including differential diagnosis, and plan, not to exceed 7 minutes speaking at an understandable pace. Detailed: Relevant features of all elements of presentation, but able to use terms such as "non-contributory," "unremarkable" for categories. Acceptable to say that laboratory studies are normal and PE is normal except for [specified condition]. The intention is to highlight pertinent positives and negatives, but not specifically to mention irrelevant information. The presentation should not exceed 3 minutes. Brief: HPI and PMH should be limited to one sentence; physical examination and laboratory studies should be limited to one sentence; and differential diagnosis, assessment, and plan should be limited to one sentence. The presentation should not exceed 30 seconds, and it should not total more than 6 sentences. The purpose of this exercise is to provide a student with individual feedback in a safe, protected environment that will improve communication skills. During the site visit, the faculty member may ask to observe the student interacting with a patient including obtaining a medical history, performing an appropriate physical examination, collecting pertinent data specific to the case, and presenting the case to the clinical preceptor. The faculty member may also ask to inspect any documentation recorded by the student. Site visits for all rotations may be arranged randomly at the discretion of the program. Site visits may occur during any rotation and may be unannounced. A Site Visit Evaluation form (see Appendix I) or an online equivalent will be completed by faculty after each site visit and will be placed in the student s file. Student Scope of Practice - Standard A3.06 Standard A3.06 Students must not substitute for clinical or administrative staff during supervised clinical practical experiences. The student is not considered an employee of any clinical affiliate and should not be a substitute for, or take on any responsibilities of, regular staff. If a student has a concern about the responsibilities assigned by the clinical site, the Director of Clinical Education should be contacted immediately The following are some guidelines regarding what a PA student may be permitted to do by the preceptor. Please note that these are guidelines only. The judgment of the preceptor regarding how much responsibility a student is ready to assume should be the guideline for determining which tasks are assigned and how much supervision is needed. Students come to our program with a variety of life experiences, which may affect their comfort level with certain tasks. All students should exhibit a baseline of medical knowledge and clinical skills. Typical tasks assigned to PA students include:

67 67 1. Taking histories and performing physical examinations; 2. Assessing common medical problems and recommending appropriate management; 3. Performing and assisting in diagnostic and therapeutic procedures; 4. Assisting the preceptor in hospital/nursing home rounds, recording progress notes, transcribing specific orders of the preceptor as allowed by the facility; 5. Following protocols or standing orders of the preceptor. 6. Presenting patient cases orally and in a written problem-oriented format. 7. Discussing the basic pathophysiologic mechanisms that have produced the signs, symptoms, and disease processes under investigation. 8. Completing assigned readings and preparing presentations as requested by Clinical Preceptors and/or program faculty. 9. Attending all teaching rounds and conferences. 10. Following the assigned on-call schedule. Students will deliver needed care to patients without regard to race, age, gender, creed, socioeconomic status, political persuasion, sexual preference, or national origin. Student Suggestions for Clinical Rotations Students may suggest a clinical rotation site, however, are not responsible for securing sites. Provision of rotation sites is the responsibility of the University of the Cumberlands PA Program and under the direct supervision of the Director of Clinical Education. Students wishing consideration of a site should provide to the Clinical Coordinator and Director of Clinical Education the following information: 1. The name of the possible preceptor and their title (MD, DO, PA). 2. The name of the practice/clinic/hospital or other facilities where they practice and might take a student on rounds, to do charting, etc. The student must be welcome in ALL the facilities in order for the suggestion to be valid. 3. The name of the practice/clinic/hospital or other facility's administrative liaison and a contact phone number. This individual will be responsible for getting our university affiliation signed and checking the schedule to assure rotation availability during the time desired. Additionally, the program will need to forward to this individual information about the PA program and verify accreditation status, as well as provide a copy of liability insurance. 4. The program will need to know if this preceptor has had students before, what type of students and how many years they have served as a preceptor. A copy of their resume or CV should be provided. 5. The program will need to know if this preceptor is BOARD CERTIFIED and in what specialty. The program will then verify their licensure and credentials. 6. Please be mindful that preceptors oftentimes take many students and may promise a rotation that their practice manager has already given to another student in another university, of which they are not aware. The University of the Cumberlands PA Program must coordinate schedules

68 68 such that two students do not show up at the same time. By program standards, one preceptor cannot supervise two students simultaneously. Travel to Clinical Sites Students are responsible for arranging travel to all clinical sites and any associated fees (i.e., parking). Some sites may be reached by public transportation, but most students will require a car for reliable transportation. ACADEMIC REQUIREMENTS FOR CLINICAL COURSES Clinical Logs/Typhon The MPAS program uses an Internet-based system to assist with collecting documentation. The system is called Typhon PAST System. Orientation regarding the operation of this system will be provided to students prior to beginning clinical rotations. Clinical logs are designed to help the program track your experiences through your clinical rotations. Filling out logs thoroughly and accurately will help us to ensure that you are receiving a quality clinical education. Documentation for diagnoses seen and procedures performed will be submitted through the Typhon PAST system. Typhon submissions will be required in a timely manner and failure to meet requirements will result in automatic loss of 20% from final rotation grade. Typhon entries will be monitored throughout the rotation via the course instructor. If any inconsistencies are found by the course instructor, the student will be contacted via and/or phone. The first set of Typhon submissions will be due midway through the rotation (the second Sunday of the rotation, at Midnight). From this time, students will no longer be able to submit patients seen prior to this date. The second round of Typhon submissions will be due by midnight (12:00 am) the day of the EORE pertaining to that rotation. After this time, students will no longer be able to submit patients seen on that rotation. Typhon will be graded based on timeliness of submission and completion. End of Rotation Examinations (EORE) An End of Rotation Examination (EORE) is given after each core rotation and is based on a specific reading list for that rotation. The program attempts to emulate the national certifying examination by using the NCCPA Content Blueprint as a guide for reading topics. Also like the national certifying examination, EORE will be administered via computer. The Program reserves the right to re-administer an examination at a later date if technical difficulties occur on the scheduled examination date. On occasion, it may be necessary to administer an EORE in a hardcopy format. The program reserves the right to determine when a hardcopy EORE is appropriate. The majority of EOREs are given on call-back days or the Friday of the last week of the scheduled rotation.

69 Preceptor Evaluation The program has adopted a standard grading rubric for Clinical Preceptors. Clinical preceptors are to submit a paper evaluation (see Appendix L). Students will be evaluated by each Clinical Preceptor on the basis of their general medical background, knowledge, and ability to obtain a medical history and perform an appropriate physical examination. Included in the evaluation will be the student s ability to organize a database, propose a management plan, present cases, and demonstrate rapport with patients and co-workers. Dependability, attitude toward learning, and work habits are also part of the evaluation. Students are encouraged to discuss the evaluations with their preceptors. Students are responsible for ensuring that an evaluation is completed for each clinical rotation. They must make every reasonable effort to follow-up with the site to ensure that the evaluation is completed in a timely fashion. Some sites choose to mail their evaluations to the Program. In this case students should check with their Faculty Advisor to ensure that the form has been received. Failure to receive evaluations in a timely fashion may result in a student receiving a grade of incomplete (I) In some instances a resident or another attending physician may complete a preceptor evaluation form in addition to the Clinical Preceptor of record. In those cases a maximum of two evaluations will be averaged to comprise this portion of the rotation grade. Seminar/Grand Rounds All students in the clinical phase of the program are required to attend regularly scheduled Grand Rounds seminars. These seminars are integral to the clinical phase of the MPAS Program, and are generally used to prepare for the Physician Assistant National Certifying Examination (PANCE). Attendance is mandatory. Specific information relating to the seminar schedule will be sent to the students by the faculty member facilitating the seminar. Student Evaluation of Preceptor/Clinical Site The student evaluation is designed to provide the program with student feedback regarding each clinical site. It is used to evaluate and improve the site and in turn the student s clinical experience. This process is important for continued quality control and feedback. A student s rotation grade will not be released until he or she has completed an evaluation of the clinical site. Evaluations of clinical sites will be submitted to the Clinical Coordinator (for a sample of this evaluation form, see Appendix M). Written Assignments For each clinical rotation, students will submit one written assignment. Most commonly, students will be assigned to complete and document an appropriate history and physical examination (H&P) (see Appendix J) for a patient under their care. With the approval of the student s Faculty Advisor, an alternate assignment such as a topic paper may be substituted for the H&P. History and Physical Examination Write-Up On most rotations, students will complete a handwritten history and physical examination writeup. Written H&P requirements may be altered by a Faculty Advisor, depending upon the quality of previous work. The written H&P must be submitted prior to completing the post-rotation examination. Grading of Written History and Physical Examination Write Ups 69

70 Learning proper medical documentation is an essential skill. Building upon the knowledge gained during the first year of the program, students will record an appropriate history and physical examination (H&P) for each rotation unless other arrangements are made with their Faculty Advisor. All H&Ps submitted for grading from all rotations must be complete, consisting of the following parts: 70 Chief Complaint History of Present Illness Past Medical History Social History (as relevant) Family History (as relevant) Review of Systems (as relevant) Physical Examination Findings Diagnosis Study Findings (as indicated) Assessment/Differential Diagnosis Plan H&Ps written during inpatient experiences should be comprehensive. A student s Faculty Advisor may require that a student submit additional documentation, including but not limited to admission notes, admission orders, progress notes, procedure notes, discharge orders, and a discharge summary. H&Ps written during outpatient experiences will generally be more problem-focused, depending upon the nature of the patient s condition. For further information, please consult with your Faculty Advisor regarding expectations. Grading of H&Ps will be performed according to a rubric established by the program and published as the Clinical Rotation Written History and Physical Examination form (see Appendix J). Unless previous arrangements are made with the Clinical Director, late submission will result in grade reduction by one letter grade. Medical Interest Presentations for Elective Rotations For specialty rotations with no End of Rotation Evaluation (EORE), students will be required to perform a medical interest presentation. Medical Interest presenters are to the course instructor with presentation topic 2 weeks before EOR day. If not received from student, one reminder will be sent to the student. If student again does not send the topic of choice, the student will receive a zero for the presentation. The student will be required to submit a final copy of the presentation via to the course instructor before presentation can be given. Failure to instructor before presentation will result in an automatic zero. Required format and guidelines for the presentation can be found on ILEARN under lessons tab. CLINICAL EVALUATION Remediation Procedure in the Clinical Year Standard C3.03 STANDARD C3.03: The program must monitor and document the progress of each student in a manner that promptly identifies deficiencies in knowledge or skills and establishes means for remediation. Written Assignments

71 71 All required written assignments related to rotations are submitted by every student to their faculty advisor or Clinical Director for evaluation. The Faculty Advisor or Clinical Coordinator will counsel the student regarding the quality of the work and assist with any needed corrections. Rotation specific documents/assignments will be graded based on a rubric that can be found on ilearn under the lesson tab for that particular rotation. Failure to complete/submit these items will result in an incomplete for that course and the student will not proceed to the next rotation until they are submitted. Specific items per course can be found below. Family Medicine MPAS 600 Family Medicine MPAS 605 Emergency Medicine MPAS 610 Internal Medicine MPAS 620 Pediatrics MPAS 630 Psychiatry MPAS 640 Surgery MPAS 650 Women s Health Clinical Elective MPAS 670 Clinical Elective MPAS 675 History and Physical Examination History and Physical Examination Procedure Note History and Physical Examination Discharge Summary 6 month well baby check Adolescent History and Physical History and Physical Examination Pre-operative Note Operative Note Labor and Delivery Note Prenatal History and Physical Medical Interest Presentation Medical Interest Presentation End of Rotation Examinations End-of-Rotation Examinations will be given after each rotation including elective rotations. If a student receives a grade below a 60%, the student will be required to perform a self-analysis of the EORE topics missed. This will consist of a student making a high-impact outline of the topic (specifics given in individual course syllabi). The students will submit the outlines before the end of the next rotation, or an incomplete will be given for that course. The student will then be required to meet with the Clinical Director for counseling and to develop a plan of action. Preceptor Evaluations Preceptor evaluation forms will be collected at 9 am the day of the EORE. Students will be expected to review completed evaluation with preceptor before leaving site. Once reviewed, both student and preceptor should sign evaluation form and seal in an envelope. Preceptor should then sign over seal of envelope. Failure to meet any of these requirements may result in an incomplete grade for that rotation and may delay the following rotation until requirements are completed. Rotation Grading A grade for each clinical rotation is derived as follows: Rotation grades will be determined from the list below. If the student s grand rounds-type presentation is given at the end of this rotation, it will be graded as Pass/Fail. If a passing grade is not given, the student will receive an Incomplete until competency is achieved. The final grade for this course will be calculated using the following percentages for each

72 72 module: Category Weight Preceptor Evaluation of the Student 30% End Of Rotation Examination (EORE) 25% Attendance/Participation at EORE, Grand Rounds, and/or 10% OSCE Electronic submissions (Typhon) 20% Rotation Specific Documents/Assignments 15% TOTAL 100% 1. Preceptor evaluation forms will be collected at 9 am the day of the EORE. Students will be expected to review completed evaluation with preceptor before leaving site. Once reviewed, both student and preceptor should sign evaluation form and seal in an envelope. Preceptor should then sign over seal of envelope. Failure to meet any of these requirements may result in an incomplete grade for that rotation and may delay the following rotation until requirements are completed. 2. End-of-Rotation Examinations will be given after each rotation including elective rotations. If a student receives a grade below a 60%, the student will be required to perform a self-analysis of the EORE topics missed. This will consist of a student making a high-impact outline of the topic (specifics given in individual course syllabi). The students will submit the outlines before the end of the next rotation, or an incomplete will be given for that course. The student will then be required to meet with the Clinical Director for counseling and to develop a plan of action. 3. Attendance and/or participation in EORE, Grand Rounds, and/or OSCE will be required from all students. Attendance will be taken at the beginning of EOR day as well as the end. Students are given a travel day, thus are expected to attend all EORE, Grand Rounds, and/or OSCEs. Students that fail to attend without valid medical excuse will lose 10% automatically from final rotation grade. a. Ground Rounds presenters will be assigned a particular month to present and will be notified before the start of the clinical year. The list will be posted on ILEARN. Presenters for a particular month are to the course instructor with presentation topic 2 weeks before EOR day. If not received from student, one reminder will be sent to the student. If student again does not send the topic of choice, the student will receive a zero for the presentation. The student will be required to submit a

73 73 final copy of the presentation via to the course instructor before presentation can be given. Failure to instructor before presentation will result in an automatic zero. Required format and guidelines for the presentation can be found on ILEARN under lessons tab. b. Practice OSCEs will be provided for the students once per summer semester and fall semester on the day of the EORE. Participation in the OSCE will be required for all students and those that fail to attend without a valid excuse will lose 10% from final rotation grade. 4. Typhon submissions will be required in a timely manner and failure to meet requirements will result in automatic loss of 20% from final rotation grade. Typhon entries will be monitored throughout the rotation via the course instructor. If any inconsistencies are found by the course instructor, the student will be contacted via and/or phone. The first set of Typhon submissions will be due midway through the rotation (the second Sunday of the rotation, at Midnight). From this time, students will no longer be able to submit patients seen prior to this date. The second round of typhon submissions will be due by midnight (12:00 am) the day of the EORE pertaining to that rotation. After this time, students will no longer be able to submit patients seen on that rotation. Typhon will be graded based on timeliness of submission and completion. 5. Rotation specific documents/assignments are to be submitted electronically in a timely manner to the course instructor (specific times can be found below). a. For every rotation, a student must submit a mid-rotation evaluation. The evaluation can be found under the lesson tab for that particular rotation. The evaluation will be due by Midnight the second Sunday of the rotation. The student will be given one reminder via if evaluation is not submitted. Failure to submit beyond this point will result in contact of preceptor and the student will not be allowed to participate in the rotation until the document is received. If the students have any issues before the evaluation is due, the student is to contact the course instructor immediately and a site visit may be scheduled. b. For every rotation, a student evaluation of the preceptor must be submitted electronically. The evaluation will be due the day of the EORE by 9am. The student must submit this document to proceed to next rotation. Without the evaluation, the student

74 74 will receive an incomplete for that course and cannot continue until the document is submitted. c. For each rotation, there will be specific documents/assignments that will be required. These documents must be submitted electronically by 9 am the day of the EORE. Rotation specific documents/assignments will be graded based on a rubric that can be found on ilearn under the lesson tab for that particular rotation. Failure to complete/submit these items will result in an incomplete for that course and the student will not proceed to the next rotation until they are submitted. Specific items per course can be found below. Family Medicine MPAS 600 Family Medicine MPAS 605 Emergency Medicine MPAS 610 Internal Medicine MPAS 620 Pediatrics MPAS 630 Psychiatry MPAS 640 Surgery MPAS 650 Women s Health Clinical Elective MPAS 670 Clinical Elective MPAS 675 History and Physical Examination History and Physical Examination Procedure Note History and Physical Examination Discharge Summary 6 month well baby check Adolescent History and Physical History and Physical Examination Pre-operative Note Operative Note Labor and Delivery Note Prenatal History and Physical Medical Interest Presentation Medical Interest Presentation d. Medical Interest presenters are to the course instructor with presentation topic 2 weeks before EOR day. If not received from student, one reminder will be sent to the student. If student again does not send the topic of choice, the student will receive a zero for the presentation. The student will be required to submit a final copy of the presentation via to the course instructor before presentation can be given. Failure to instructor before presentation will result in an automatic zero. Required format and

75 75 guidelines for the presentation can be found on ILEARN under lessons tab. A student may be required to repeat a failed clinical rotation at the discretion of the Program Director. The Program Director will consult with the Director of Clinical Education and the student s faculty advisor in deciding whether a student will be allowed to repeat. The time and location of the repeated rotation will be at the discretion of the Director of Clinical Education and may result in delayed graduation. This may result in a delay of graduation. Tips for Success on Rotations Know the Clinical Site You must contact most preceptors at least 2-3 weeks prior to starting a new clerkship. Find out about parking, IDs, etc. Every effort has been made to maintain and update appropriate contact information for clinical sites. Nevertheless, minor problems may occur. It is necessary to maintain professionalism and flexibility when faced with such changes. First, try to resolve any discrepancies on your own. Call the Director of Clinical Education if this is not possible. Notify the Director of Clinical Education of any errors in supplied instructions so corrections can be made. Find out what available conferences you might attend (grand rounds, daily/weekly conferences, CME presentations, etc.). Things to Discuss with Your Preceptor Confirm your time schedule and specific duties (when to report to your clerkship, on-call schedule, rounds, weekend hours, etc.). Identify special interests, whether it is procedures or particular cases relevant to the clerkship. Talk to preceptors about remaining mandatory technical procedures required and your eagerness to complete them. Ask what is expected of you. Where you are to be and at what time? Additional Considerations What you gain from the clerkship is equal to the effort you put forth. In general, preceptors will give students as much hands-on experience as the preceptor feels you are capable of handling. Be courteous and pleasant to everyone. Develop and maintain a professional attitude. Be helpful to the preceptor and staff. Read about the disease processes you encounter each day. Take initiative. You may encounter harsh criticisms at times. Try to learn from the feedback. Do not be argumentative.

76 76 Be prepared to discuss and answer questions about any disease or procedure encountered during your rotation. Be prepared to study and read at least two hours per day. You may not always be permitted to write on charts. If this is the case at your site, practice writing notes on separate sheets and have preceptors critique them. While on rotations, actively look for work that you can do to help improve patient care. Report early, stay late, volunteer for call If any concerns arise during rotations, please notify the Director of Clinical Education or the Clinical Coordinator as soon as possible. If unable to contact the DCE, please contact another program faculty member. ROTATION GOALS AND OBJECTIVES General Goals and Objectives for All Clinical Rotations The goals within each clinical rotation are designed to help you achieve the knowledge, proficiency, and expertise cited below. This is a guide, however, and not an all-inclusive list. Each service should make available a full range of experiences that will provide the student with exposure to each discipline's special procedures, techniques, and problems. The following general goals and objectives are expected of all students while on clinical rotations. MEDICAL HISTORY Approach a patient in any clinical setting and establish appropriate rapport with the patient and the patient's family. Determine the appropriate format of historical data collection, which may include a complete history, a directed outpatient history, or a directed inpatient follow-up history. Determine the best (most appropriate) source of historical data when the patient is unable to provide the information. Elicit a complete medical history that should include: o Determination of the chief complaint o Analysis of the primary symptomatology: onset and duration; precipitating and predisposing factors; characteristics of symptoms from onset to present including quality, location, radiation, and intensity or severity; temporal character; aggravating and relieving factors; and associated symptoms o Review of the course since onset of primary symptom: incidence, progress, and effect of therapy

77 77 o Organization of a clear and concise history of present illness that carefully outlines the chief complaint in addition to the pertinent past medical history, family history, social/occupational history, allergies, and appropriate review of systems o Organization of a complete past history that includes childhood medical history, adult medical history, history of previous surgery, history of previous hospitalizations, history of injuries, allergies, and immunizations o Organization of a complete family history that includes a review of the health status of all members of the immediate family as well as a history of familial disease o Organization of a complete social history that includes social habits, military history, occupational history, marital history, educational history, sexual history, environmental conditions, and social support systems o Organization of a complete review of symptoms that includes all of the positive and negative symptomatology that the patient may have experienced in the recent past. Provide written documentation of a complete medical history in a format approved by the faculty of the MPAS program. PHYSICAL EXAMINATION Determine the appropriate parts of the physical examination that should be performed in a variety of clinical settings, including inpatient, outpatient, emergency, and long term care facilities. Perform an appropriate physical examination and recognize normal and abnormal findings. Perform the physical examination while maintaining an awareness of, and responding to, the patient's discomfort and/or apprehension. Perform the physical examination utilizing all diagnostic equipment properly (e.g., stethoscope, otoscope, ophthalmoscope, tuning fork, percussion hammer, etc.). Perform the physical examination using proper techniques of physical examination (e.g., technique of percussion, palpation, auscultation, and inspection, as well as special maneuvers such as straight leg raise or testing for meningeal or peritoneal irritation). Provide written documentation of the findings of the physical examination in a clear and concise manner using a format approved by the faculty of the MSPAS program.

78 78 ANCILLARY STUDIES Make recommendations, based on the data gathered in the history and physical examination, for ancillary studies that should be ordered to evaluate further the patient's problem. This may include radiologic studies, blood, urine or sputum analysis, and any other special studies that may be of value. DIAGNOSTIC ANALYSIS Analyze the data gathered in the history, physical examination, and ancillary studies in order to: o Develop a problem list o Formulate a differential diagnosis (assessment) THERAPEUTIC ANALYSIS: Formulate an appropriate plan of specific treatment and supportive care based on the problem list and assessment. Revise the therapeutic approach as the patient's condition changes and/or as new data are available. Counsel, educate, and instruct patients in specific disease-related and preventive medicine areas such as diabetes care, breast self-examination, etc. Acquire general knowledge of, and utilize appropriately, the referral sources within the health care facility and the community. GENERAL SKILLS AND PROCEDURES Perform and become proficient in the following procedures: A. Venipuncture B. Initiation of intravenous infusions C. Placement of nasogastric tubes D. Administration of intradermal tests E. Administration of medications - i.e., topical, oral, IM, and IV F. Obtain and interpret electrocardiograms G. Aseptic technique H. Isolation technique I. Perform CBC, urinalysis and other office laboratory procedures as indicated including gram stains, acid-fast stain, stool guaiac, etc. J. Collect specimens for blood cultures, urine cultures, stool cultures K. Draw arterial blood

79 79 L. Prepare and interpret cultures M. Obtain Papanicolaou cytosmears N. Perform CPR and defibrillation O. Assisted respiration - i.e., familiarity with respirators P. Insertion of urinary bladder catheters Q. Proctoscopy R. Wound care and dressing changes S. Suturing and suture removal T. Insert central lines U. Perform endotracheal intubation V. Insert chest tubes W. Perform thoracentesis X. Perform paracentesis The students will, under direct or indirect supervision, observe, assist in, or perform all appropriate procedures relative to the patients they are following at the discretion of the students' supervising physician. The students will also be available, when time permits, to assist in other procedures involving patients other than their own. Goals and Objectives for Specific Rotations Throughout all clinical rotations, the student will continue to refine the knowledge and skills outlined above as general goals and objectives. These are found in the specific clinical rotation syllabi available on the Blackboard Learn LMS system. Student Responsibilities The student is responsible for accomplishing the objectives of rotation. The preceptor functions as a role model, facilitator of learning, and a guide to the student in terms of professional behavior and role. The ultimate responsibility of learning however, falls on the student. Student responsibilities include satisfactory completion of the following: 1. Devote full-time effort to the program. This may include hospital rounds, weekend rounds, conferences, and on-call duty, in addition to clinical responsibilities. 2. Conduct oneself in a professional manner at all times. 3. Complete each rotation objectives. 4. Maintain patient encounter entries and time logs for all clinical rotations and complete preceptor/site evaluation for each rotation as directed in Typhon logging system. 5. Complete and submit to program all required rotation documents in a timely manner. 6. Attend all scheduled Professional Seminars at each end of rotation day. 7. Arrange own transportation and housing/housing costs with regard to each rotation. 8. Call the preceptor 2-3 weeks before the beginning of each rotation to introduce yourself, confirm with the preceptor the dates of the rotation, and to arrange a meeting on the first day. 9. For all rotations, you are to complete all paperwork and other instructions as noted in the electronic web-based student placement system for hospital or hospital-owned sites in a timely

80 80 manner as prescribed by the site. If completion is not accomplished according to hospital or site specifications, the results will be postponement of rotation as well as postponement of graduation. 10. Collect mid and final evaluations from preceptor(s) and return to the Clinical Director per their instruction. A final evaluation is required for each clinical rotation. Students are required to attempt to obtain the paperwork before leaving each rotation and evaluations should be reviewed with the preceptor personally. The lack of completion of required paperwork will result in an Incomplete grade for the rotation until paperwork is submitted. 11. The student must maintain access with the University at all times and check daily. Communication from the program will be via . All s sent from the program are tracked with respect to their receipt, their opening and their review and this information is monitored by the Program Administrator. 12. If injured on rotation, please notify the clinical site preceptor immediately and also the Clinical Director who will direct you subsequently in the following of protocol. Before Each Rotation 1. Call your preceptor at least two weeks before your rotation begins and confirm your rotation, the time and place of your arrival and who you report to. notice of your confirmation to Mr. Reed and Mr. Hall. 2. Verify what facilities you will be visiting with your preceptor: i.e., hospitals, Free-standing clinics, out-patient treatment centers, etc. It will be the student s responsibility to make sure that the administrators of these facilities are aware of the fact that you will be coming to their facilities. Some may require orientations, updating or repeated drug screens, background checks, etc. and each facility has their own individual regulations. If you are going to surgery or will be in labor and delivery, please notify the administrator of these departments that you will be coming. Once again, some facilities require that you personally demonstrate skills or go through specific training before you will be permitted into these areas. Provide a list of all facilities you will go to by to Mr. Reed and Mr. Hall. 3. Each student will be responsible for maintaining a current health/ and information file containing copies of TB skin tests, immunizations, drug screens, etc. for presentation to preceptors as requested. The PA department cannot maintain these records due to privacy laws. Upon Rotation Arrival 1. Present the Preceptor with a copy of the course syllabus 2. Present the Preceptor with the PAEA Preceptor Orientation Handbook 3. Present the Preceptor with a copy of the Student Evaluation Assessment Form and advise them that they will be responsible for filling this information out about your final rotation grade and that you will need a face-to-face time to review it with them.

81 81 4. Give the Preceptor a list of your site specific documents that they will be responsible for grading throughout your rotation (i.e., history and physical, procedure notes, etc). 5. Get a copy of your daily schedule for the entire month and make sure it is forwarded to Mr. Reed and Mr. Hall. During a Rotation 1. Any absences or deviation from schedule are to be reported to Mr. Reed, Mr. Hall and Mr. Manning immediately. 2. Students will be responsibility for typhon logging. 3. Students will be responsible for checking their UC DAILY. Mr. Manning will be tracking the reading and responses to s sent from the university. 4. Students will be responsible for filling out mid-rotation assessments and returning them to Mr. Reed. Upon Leaving a Rotation 1. Students MUST review their preceptor evaluation with the preceptor before leaving a rotation. Both student and preceptor should sign the evaluation form at the end of the meeting and this form should be placed in an envelope, sealed and signed by the preceptor over the seal. This sealed and signed envelope will be presented to Mr. Reed on the EOR day. No grades will be assigned without this evaluation. 2. Students MUST make sure that their preceptor has graded and signed their site-specific documents and that these are presented to Mr. Reed on the EOR day. 3. Students should present a thank you letter or note along with a UC CME certificate to the preceptor on the last day of rotation and also to various ancillary personnel who have been helpful during a rotation.

82 82 PART III: PREPARING FOR GRADUATION AND THE PANCE As graduation approaches, you will have amassed a great deal of knowledge and skills. The Program uses a variety of means throughout the course of your education to ensure that you have achieved the competencies expected of a graduating physician assistant student.

83 83 FORMATIVE AND SUMMATIVE EVALUATIONS Standard C3.04 STANDARD C3.04 The program must conduct and document a summative evaluation of each student within the final four months of the program to verify that each student is prepared to enter clinical practice. Formative Evaluation Formative Evaluation of students is a multi-step process which begins in the 2 nd year: 1. SUM I: 350 multiple-choice questions, board-style simulation examination based on the NCCPA Content Blueprint. This examination tests the student s knowledge base in all organ systems. After completion, students will receive a detailed report showing their strengths and weaknesses. Students will be able to discuss with their advisors a study strategy that students can pursue over the summer to prepare for the third year and the PANCE evaluation. 2. Physician Assistant Competencies: A Self Evaluation Tool (see Appendix Q): The public demand for higher quality and greater accountability in health care has been growing steadily over the last several years, and various health care professions are responding in different ways. To address that issue within the PA profession, the PAEA, ARC-PA, NCCPA, and AAPA, joined together to define PA competencies, a critical starting point to identify opportunities for improvement in the development and assessment of those competencies. The four organizations involved in the development of the seminal document, Competencies for the Physician Assistant Profession, have developed this selfevaluation tool to help individual PAs identify areas of personal strength and opportunities for personal growth, which you may use to guide future CME activities, on-the-job training, or other self-improvement activities. Students will complete this document and review it with their advisor at the end of the 1 st year and again at the end of the 2 nd year to show progress. 3. Fall Semester, 2 nd Year: PACKRAT (Physician Assistant Clinical Knowledge Rating and Assessment Tool) examination is a self-assessment tool administered at the end of the clinical year and is a requirement for graduation. The results of the examination provide students with a report of their areas of strength and areas for improvement. This report may be utilized in formulating study plans for success in the PANCE examination. The examination report also allows the program to compare student performance with national scores. Cost of the examination is the responsibility of the student. Summative Evaluation Summative Evaluation in the 2nd year occurs by utilizing five tools:

84 84 1. Spring Semester, 2 nd Year OSCE: This hands-on examination is designed specifically to test the PA student s clinical competence. 2. Spring Semester, 2 nd Year: SUM II is 700 question multiple-choice examination given over 2 days. This examination tests the student s knowledge base for all organ systems. Students will be able to meet with their advisor and discuss a study strategy that students can pursue to prepare for the PANCE. 3. Spring Semester, 2 nd Year: Physician Assistant Competencies: Self Evaluation will be completed and reviewed by students with their advisor at the end of the clinical year. 4. Spring Semester, 2 nd Year: Summative Professionalism Assessment Tool (see Appendix R). Evaluation of professionalism is an on-going process throughout the program. Prior to graduation, students and their advisor will complete the summative tool and discuss their strengths and weakness in this area. Students will be recommended to fulfill a remediation study program, if the predicted score generated by the SUM I/II, PACKRAT, and the pre-curved raw average from the EO- RE is below 475. MPAS PROGRAM GRADUATION COMPETENCIES These competencies outline the expected outcomes for MPAS graduates from University of the Cumberlands. These outcomes or program graduation competencies are endorsed by the NCCPA, AAPA, and PAEA to guide PA programs in modifying and improving their curricula. All didactic and clinical experiences contribute cumulatively to these outcomes. Upon graduation, students must successfully complete the NCCPA certifying examination in order to practice in all states. The NCCPA blueprint outlines the required knowledge and skills areas as well as the list of diseases and disorders to help guide the student toward successful completion of the program and the certifying examination. Any PA program can be challenging at times. During those times, the PA faculty and staff suggest that you refer to the program outcomes, required knowledge/skill areas, and disease and disorder list to help keep you focused on the final goal. Mastery of these areas will be gradual and will not occur with any single examination, course, or rotation. It is a process that takes time, study, and effort. There are several instruments used to measure acquisition and achievement of these competencies, including preceptor evaluations, graduate exit surveys, and employer surveys. These competencies were adopted by the faculty and staff of the UC PA program to serve as a roadmap to enter practice as a competent physician assistant. Medical Knowledge

85 85 Medical knowledge includes an understanding of pathophysiology, patient presentation, differential diagnosis, patient management, surgical principles, health promotion, and disease prevention. Physician assistants must demonstrate core knowledge about established and evolving biomedical and clinical sciences and the application of this knowledge to patient care in their area of practice. In addition, physician assistants are expected to demonstrate an investigatory and analytic thinking approach to clinical situations. Physician assistants are expected to: Understand etiologies, risk factors, underlying pathologic process, and epidemiology for medical conditions Identify signs and symptoms of medical conditions Select and interpret appropriate diagnostic or laboratory studies Manage general medical and surgical conditions to include understanding the indications, contraindications, side effects, interactions, and adverse reactions of pharmacologic agents and other relevant treatment modalities Identify the appropriate site of care for presenting conditions, including identifying emergent cases and those requiring referral or admission Identify appropriate interventions for prevention of conditions Identify the appropriate methods to detect conditions in an asymptomatic individual Differentiate between the normal and the abnormal in anatomic, physiological, laboratory findings, and other diagnostic data Appropriately use history and physical examination findings and diagnostic studies to formulate a differential diagnosis Provide appropriate care to patients with chronic conditions Interpersonal & Communication Skills Interpersonal and communication skills encompass verbal, nonverbal, and written exchanges of information. Physician assistants must demonstrate interpersonal and communication skills that result in effective information exchange with patients, their patients families, physicians, professional associates, and the healthcare system. Physician assistants are expected to: Use effective listening, nonverbal, explanatory, questioning, and writing skills to elicit and provide information Appropriately adapt communication style and messages to the context of the individual patient interaction

86 86 Patient Care Work effectively with physicians and other health care professionals as a member or leader of a health care team or other professional group Apply an understanding of human behavior Demonstrate emotional resilience and stability, adaptability, flexibility, and tolerance of ambiguity and anxiety Accurately and adequately document and record information regarding the care process for medical, legal, quality, and financial purposes Patient care includes age-appropriate assessment, evaluation, and management. Physician assistants must demonstrate care that is effective, patient-centered, timely, efficient, and equitable for the treatment of health problems and the promotion of wellness. Physician assistants are expected to: Work effectively with physicians and other health care professionals to provide patient-centered care Demonstrate caring and respectful behaviors when interacting with patients and their families Gather essential and accurate information about their patients Make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment Develop and carry out patient management plans Counsel and educate patients and their families Competently perform medical and surgical procedures considered essential in the area of practice Provide health care services and education aimed at preventing health problems or maintaining health Professionalism Professionalism is the expression of positive values and ideals as care is delivered. Foremost, it involves prioritizing the interests of those being served above one s own. Physician assistants must know their professional and personal limitations. Professionalism also requires that PAs practice without impairment from substance abuse, cognitive deficiency, or mental illness. Physician assistants must demonstrate a high level of responsibility, ethical practice, sensitivity to a

87 87 diverse patient population, and adherence to legal and regulatory requirements. Physician assistants are expected to demonstrate: Understanding of legal and regulatory requirements, as well as the appropriate role of the physician assistant Professional relationships with physician supervisors and other health care providers Respect, compassion, and integrity Commitment to ethical principles pertaining to provision or withholding of clinical care, confidentiality of patient information, informed consent, and business practices Sensitivity and responsiveness to patients culture, age, gender, and disabilities Self-reflection, critical curiosity, and initiative Practice-Based Learning & Improvement Practice-based learning and improvement includes the processes through which clinicians engage in critical analysis of their own practice experience, medical literature, and other information resources for the purpose of self-improvement. Physician assistants must be able to assess, evaluate, and improve their patient care practices. Physician assistants are expected to: Locate, appraise, and integrate evidence from scientific studies related to their patients health problems Apply knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness Apply information technology to manage information, access online medical information, and support their own education Systems-Based Practice Systems-based practice encompasses the societal, organizational, and economic environments in which healthcare is delivered. Physician assistants must demonstrate an awareness of, and responsiveness to, the larger system of health care to provide patient care that is of optimal value. PAs should work to improve the larger health care system of which their practices are a part. Physician assistants are expected to:

88 88 Use information technology to support patient care decisions and patient education Effectively interact with different types of medical practice and delivery systems Understand the funding sources and payment systems that provide coverage for patient care Advocate for quality patient care and assist patients in dealing with system complexities Apply medical information and clinical data systems to provide more effective, efficient patient care

89 89 PREPARING FOR THE PANCE The clinical phase of training comes at the end of the MPAS program, as does studying for the PANCE. It is difficult to study for the PANCE during rotations, because parallel processes are occurring: you are acquiring new clinical skills and studying specific topics for the end of rotation examination, while trying to prepare broadly for the PANCE by studying many other diseases perhaps unrelated to your rotation. For this reason, we have attempted to integrate the process to minimize duplication of study and create synergy. As a result, if you study all the topics we have listed for each rotation, by the time you finish your rotations, you will have studied all of the topics on the NCCPA Content Blueprint for PANCE & PANRE (see Appendix F) and will be thoroughly prepared for the PANCE. Many questions on the certification (PANCE) examination are drawn from the NCCPA Content Blueprint. The Content Blueprint contains two helpful documents: the Content Blueprint Sample Disease/Disorders by Organ System, and the Content Blueprint Physician Assistant Practice Task Areas. Both students and faculty use these documents to know which topics are important and the depth and breadth to which they should be covered. The organ-system blueprint is a comprehensive list of diseases and disorders commonly encountered in clinical practice and thus on the certification examinations. The list is arranged by organ system and also indicates the approximate percentage of questions per organ system that you may expect on the PANCE (See Appendix F, Table 1). This information is important to consider when deciding the depth and breadth of study. Because cardiovascular, pulmonary, gastrointestinal/nutritional, and musculoskeletal topics comprise a large portion of the examination (about 48 percent of the questions), faculty and students spend more time on them. Students who have a poor knowledge base in these four organ systems generally receive poor grades on the PANCE. The task-areas blueprint is a list of seven main PA knowledge areas that have been identified as important to clinical practice. It details the cognitive skills and knowledge in each area that students must attain for competence. Many of these task areas are covered on the PANCE. Since it is impossible to study everything about every item in the Content Blueprint, this document helps you determine what is most important to know. The task-areas blueprint also indicates the approximate percentage of questions per task you may expect on the PANCE and PANRE (See Appendix F, Table 2). This is helpful as you begin studying, so that you can focus your efforts on task areas more commonly seen on the exams. The organ systems and task areas that are more heavily weighted by the NCCPA receive more indepth treatment on the NCCPA examination. The formulation of a comprehensive and effective study plan requires consideration of many factors. Haphazard, non-strategic studying that does not take into account the NCCPA Content Blueprint, the weighting of task areas and organ systems, and your own strengths and weaknesses can lead to disaster. This Rotation Study Program was developed by taking each item on the Content Blueprint Sample Disease/Disorders by Organ System and placing it in the appropriate discipline. For example, it makes sense to include cardiovascular system conduction disor-

90 90 ders such as atrial and ventricular blocks in the emergency medicine rotation. Emergencyoriented eye disorders such as glaucoma also may be found there. You will discover a large number of organ-system blueprint items in the outpatient medicine and inpatient medicine rotations. This is because there is greater depth and breadth of disorders seen in internal medicine than in family practice. In the general surgery rotation, items were chosen from the respective system areas that are most likely to be treated surgically. For example, valvular insufficiencies, malignancies of the pulmonary system and gastrointestinal system, gallbladder disease, and appendicitis all may be found in the general surgery chapter. Because many diseases and disorders can be treated in multiple settings, items repeat across different rotations. While the result is not perfect, considerable effort has been expended to match the Content Blueprint Sample Disease/Disorders by Organ System items to the most appropriate discipline. In addition to testing-specific blueprint topics, there will also be some case-based questions that are not specifically linked to a blueprint topic, but are discipline related, and will test knowledge and skills gained at the rotation site. PA students typically are overwhelmed by the amount of time they must spend at the clinical site during a rotation, and how little time is left for actual study. Therefore, it is important to set short-term (daily), intermediate (weekly), and long-term (end-of-rotation) study goals. For example, you should calculate how many topics you must cover daily to be ready. As the student, you must take charge of your learning by determining how you will manage your schedule so that you are able to complete and study the required topics within the timeframe you have set. You should also dedicate a few extra days before any testing cycle for review and reinforcement of materials learned. Because you know how you best learn, taking the time thoughtfully to set a study schedule is critical.

91 PART IV: ADDITIONAL RESOURCES 91

92 92 PROFESSIONAL ORGANIZATIONS Accreditation Review Commission on Education for the Physician Assistant, Inc. (ARC-PA) The Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) is the recognized accrediting agency that protects the interests of the public and PA profession by defining the standards for PA education and evaluating PA educational programs within the territorial United States to ensure their compliance with those standards. The ARC-PA encourages excellence in PA education through its accreditation process, by establishing and maintaining minimum standards of quality for educational programs. It awards accreditation to programs through a peer review process that includes documentation and periodic site visit evaluation to substantiate compliance with the Accreditation Standards for Physician Assistant Education. The accreditation process is designed to encourage sound educational experimentation and innovation and to stimulate continuous self-study and improvement. American Academy of Physician Assistants (AAPA) The AAPA is the national professional organization of physician assistants. Its membership includes graduate and student physician assistants as well as affiliate membership for physicians and physician assistant educators. The Academy provides a wide range of services for its members, including representation before federal and state governments and health related organizations, public education, pamphlets and brochures, insurance and financial programs, and employment assistance. As an AAPA member, you also receive multiple publications and are entitled to a membership discount for the annual spring conference. Student Physician Assistant Societies are an integral part of the AAPA and make up a body referred to as the Student Academy of the American Academy of Physician Assistants (SAAAPA). The Student Academy meets yearly at the national spring conference to elect officers and representatives. Release time to attend the national conference held in May of each year can be requested from the Program and will be allowed on a case-by-case basis. The national organization represents you and as such deserves your support during your student years and as a graduate Physician Assistant. Support for membership in professional organizations is another benefit also routinely covered by employers. National Commission on Certification of Physician Assistants (NCCPA) All graduates of Physician Assistant Programs accredited by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) are eligible to sit for the national certifying examination (PANCE) offered by the NCCPA.

93 93 Registration applications are completed during the senior year of the Physician Assistant Program. Most states require graduates to take and successfully pass the national boards to continue employment. Please refer to the link below for exam scheduling requirements. Once certified through the NCCPA, each graduate must obtain and report 100 hours of accredited CME every two years. Recertification examinations are also required every six years, in addition to the CME requirement. Kentucky Academy of Physician Assistants (KAPA) The Kentucky Academy of Physician Assistants (KAPA) serves the needs of certified PAs and PA Students who work or reside in the state of Kentucky. KAPA's Website serves its members and the public by providing a forum for services and ideas designed to strengthen and promote the PA profession throughout Kentucky. KAPA will strive to publicize the contributions of PAs to patients, employers, and policy makers. As the voice and advocate of PAs in Kentucky, KA- PA promotes continuing education for its members, provides PA employment information to PAs and physicians, and strengthens the role of PAs by supporting and encouraging membership in KAPA.

94 94 PART V: Appendices This section contains examples of forms that you will use frequently during your time with us.

95 95 APPENDIX A: Student Handbook Receipt STUDENT HANDBOOK AND POLICY MANUAL RECEIPT AND ACKNOWLEDGMENT I acknowledge that I have received and read the Physician Assistant Program Policy Manual. I have had an opportunity to have any questions answered with regard to its content. I agree to abide by the policies and procedures contained therein. I have been made aware that, as a student enrolled in a University of the Cumberlands program, I am required to comply with the University's policies on Health and Immunization and Student Health Insurance. I have also been made aware that I am bound by policies and procedures contained in the University of the Cumberlands Student Handbook and University Catalogue. Print Name Signature Date

96 96 APPENDIX B: Contact List Department of Physician Assistant Contact List Vice President of Medical Services Eddie Perkins, DO, FACOOG; Program Director Lesley Tipton, MPAS, PA-C; ; Medical Director David Williams, MD; ; Eddie Perkins, DO, FACOOG; Faculty Joe Reed, MS, PA-C; ; Kenneth Reed, MS, PA-C; ; Sonia Young, PT, DPT; ; Department Administrative Assistant Gregory S. Manning; ; Kendall Gilbert, MPAS, PA-C Jim Moss, MD; Clinical Coordinator Brad Hall;

97 97 Class of 2014 Advisor Class of 2014 Mr. Kendall Gilbert Javed Akhktar Mr. Kendall Gilbert Jo Lisa Ashley Mr. Kendall Gilbert Elizabeth Barnes Mr. Kendall Gilbert Evan Bennett Mr. Kendall Gilbert Adam Blanton Mr. Kendall Gilbert Roger Butler Mr. Kendall Gilbert Oran Click Mr. Kendall Gilbert Tasha Cockrum Mr. Kendall Gilbert Kristi Dolen Mr. Joe Reed Justin Edwards Mr. Joe Reed Courtney Hamm Mr. Kendall Gilbert Josh Prewitt Mr. Joe Reed Charles Hatmaker Mr. Joe Reed Robin Hayden Mr. Kenneth Reed Daniel Herth Mr. Kenneth Reed Kayla Johnson Mr. Kenneth Reed Ashley Leopold Mr. Kenneth Reed Scott Rector Mr. Kenneth Reed Shaun Rowe Mr. Kenneth Reed Kendra Sammons Mr. Joe Reed Michael Schuler Mr. Joe Reed Chelsea Sexton Mr. Joe Reed Brittney Strunk Mr. Joe Reed Mallory Vinsant Mr. Joe Reed Kendall Warner Mr. Joe Reed Shelby Wilson APPENDIX C: Faculty Advising

98 98 Class of 2015 Last First Advisor Atcher Morgan Mr. Gilbert Diehl Lauren Mr. Gilbert Buchanan Natasha Mr. Gilbert Choudry Saira Mr. Gilbert Elliotte Larrietta Mr. Gilbert Gabbard Deana Mr. Gilbert Hardin Mary Mr. Gilbert Huey Monica Mr. Gilbert Johnson Tracy Mr. Gilbert Kalman Cassaundra Mr. J Reed Kleinmann Taijha Mr. J Reed Lawson Adam Mr. J Reed Minton Whitney Mr. J Reed Owens Sheree Mr. J Reed Parrott Jordan Mr. J Reed Parten Patrick Mr. J Reed Perkins Suzanna Professor K. Reed Racic Alisa Professor K. Reed Riportella Jake Professor K. Reed Risner Laura Professor K. Reed Shepherd Morgan Professor K. Reed Tharpe Shonda Professor K. Reed Thomas Dylan Professor K. Reed Vangapandu Sri Professor K. Reed

99 99 APPENDIX D: Mid Semester Advising Mid Semester Advisement Sheet: Summer 2013 Student: Date: General Information How do you feel about your performance in the program so far? What do you feel has been your greatest strength? What has been your greatest weakness? Coursework Course Projected Grade Comments How is your stress level related to school? How is your stress level apart from school? Describe your study habits.

100 100 How many hours per day do you usually study? How happy are you with your study habits? Is there anything else that is important to you that your Faculty Advisor should know? Signature Date Faculty Notes/Follow Up:

101 Always Usually Occasionally Seldom Not Applicable 101 Professional Development Assessment Tool APPENDIX E: PDAT Assessment Category General Does the student exhibit a positive and professional attitude? Does the student exhibit emotional stability, maturity, empathy, and physical and mental stamina? Does the student maintain current immunizations, CPR, and background checks? N/A N/A N/A Does the student act appropriately in stressful situations? N/A Did the student report any physical handicap or health issues that may affect his/her ability to provide safe, effective medical care? N/A Professional Does the student show respect for other students and faculty members? N/A Does the student comply with dress codes on campus and/or clinical sites? N/A Is the student and on time for classes and clinical rotations? N/A Does the student exhibit unprofessional behavior (including unnecessary conversations in class during lectures or laboratory sessions)? Is the student able to work cooperatively, promoting and preserving relationships with peers and other members of the health care team? N/A N/A Academic Does the student demonstrate ability to learn and function in a wide variety of didactic and clinical settings? This includes demonstrating cognitive abilities necessary to master relevant content in basic science and clinical courses to provide the standard of care. Is there evidence that the student can communicate effectively, both verbally and written, using appropriate grammar, spelling, and vocabulary? N/A N/A

102 102 Does the student exhibit academic integrity? N/A Does the student demonstrate adaptability relative to changing situations, environments, and new information? N/A Clinical Does the student protect the patient s safety and promote the patient s well being? N/A Does the student uphold ethical standards for health care? N/A Does the student provide competent medical care and extend to each patient the full measure of professional ability as a dedicated, empathetic student healthcare provider during clinical rotations? Does the student provide competent medical care under the supervision of an assigned preceptor? Does the student demonstrate the ability to learn and function in a wide variety of clinical settings? N/A N/A N/A Comments Faculty Signature Date Student Signature Date

103 103 NCCPA Content Blueprint for PANCE & PANRE APPENDIX F: PANCE Blueprint Table 1: PANCE Organ System Breakdown Organ System Exam Content (%) Cardiovascular 16 Pulmonary 12 Endocrine 6 EENT 9 Gastrointestinal/Nutritional 10 Genitourinary 6 Musculoskeletal 10 Reproductive 8 Neurologic 6 Psychiatry/Behavioral 6 Dermatologic 5 Hematologic 3 Infectious Disease 3 Table 2: PANCE Exam Content by Task Area Task Area Exam Content (%) History-taking and performing physical examinations 16 Using laboratory and diagnostic studies 14 Formulating most likely diagnosis 18 Health maintenance 10 Clinical interventions 14 Pharmaceutical therapeutics 18 Applying basic science concepts 10 Tables 1 and 2 are adapted from the National Commission on Certification of Physician Assistants: NCCPA-Connect. Accessed June 29, 2009.

104 104 PANCE Content Blueprint Cardiovascular System Cardiomyopathy Dilated Hypertrophic Restrictive Conduction Disorders Atrial fibrillation/flutter Atrioventricular block Bundle branch block Paroxysmal supraventricular tachycardia Premature beats Ventricular tachycardia Ventricular fibrillation/flutter Congenital Heart Disease Atrial septal defect Coarctation of aorta Patent ductus arteriosus Tetralogy of Fallot Ventricular septal defect Congestive Heart Failure Hypertension Essential Secondary Malignant Hypotension Cardiogenic shock Orthostasis/postural Ischemic Heart Disease Acute myocardial infarction Angina pectoris Stable Unstable Prinzmetal's/variant Vascular Disease Acute rheumatic fever Aortic aneurysm/dissection Arterial embolism/thrombosis Chronic/acute arterial occlusion Giant cell arteritis Peripheral vascular disease Phlebitis/thrombophlebitis Venous thrombosis Varicose veins Valvular Disease Aortic stenosis/insufficiency Mitral stenosis/insufficiency Mitral valve prolapsed Tricuspid stenosis/insufficiency Pulmonary stenosis/insufficiency Other Forms of Heart Disease Acute and subacute bacterial endocarditis Acute pericarditis Cardiac tamponade Pericardial effusion Pulmonary System Infectious Disorders Acute bronchitis Acute bronchiolitis Acute epiglottitis Croup Influenza Pertussis Pneumonias Bacterial Viral Fungal HIV-related Respiratory syncytial virus infection Tuberculosis Neoplastic Disease Bronchogenic carcinoma Carcinoid tumors Metastatic tumors Pulmonary nodules Obstructive Pulmonary Disease Asthma Bronchiectasis Chronic bronchitis Cystic fibrosis Emphysema Pleural Diseases Pleural effusion Pneumothorax Primary Secondary Traumatic Tension Vascular Disease Acute rheumatic fever Aortic aneurysm/dissection Arterial embolism/thrombosis Chronic/acute arterial occlusion Giant cell arteritis Peripheral vascular disease Phlebitis/thrombophlebitis Venous thrombosis Varicose veins Valvular Disease Aortic stenosis/insufficiency Mitral stenosis/insufficiency Mitral valve prolapsed Tricuspid stenosis/insufficiency Pulmonary stenosis/insufficiency Other Forms of Heart Disease Acute and subacute bacterial endocarditis Acute pericarditis Cardiac tamponade Pericardial effusion

105 105 Endocrine System Diseases of the Thyroid Gland Hyperparathyroidism Hypoparathyroidism Hyperthyroidism Hypothyroidism Thyroiditis Neoplastic disease Diseases of the Adrenal Glands Cushing's syndrome Corticoadrenal insufficiency Diseases of the Pituitary Gland Acromegaly/gigantism Dwarfism Diabetes insipidus Diabetes Mellitus Type 1 Type 2 Hypoglycemia Lipid Disorders Hypercholesterolemia Hypertriglyceridemia EENT Eye Disorders Blepharitis Blowout fracture Cataract Chalazion Conjunctivitis Corneal abrasion Dacryoadenitis Ectropion Entropion Foreign body Glaucoma Hordeolum Hyphema Macular degeneration Orbital cellulitis Pterygium Retinal detachment Retinal vascular occlusion Retinopathy Diabetic Hypertensive Strabismus Ear Disorders Acute/chronic otitis media Barotrauma Cerumen impaction Hearing impairment Mastoiditis Meniere's disease Labyrinthitis Otitis externa Tympanic membrane perforation Vertigo Nose/Sinus Disorders Acute/chronic sinusitis Allergic rhinitis Epistaxis Nasal polyps Mouth/Throat Disorders Acute pharyngitis Acute tonsillitis Aphthous ulcers Dental abscess Epiglottitis Laryngitis Oral candidiasis Oral herpes simplex Oral leukoplakia Peritonsillar abscess Parotitis Sialadenitis Neurologic System Alzheimer's Disease Cerebral Palsy Diseases of Peripheral Nerves Bell's palsy Diabetic peripheral neuropathy Guillain-Barre syndrome Myasthenia gravis Headaches Cluster headache Migraine Tension headache Infectious Disorders Encephalitis Meningitis Movement Disorders Essential tremor Huntington's disease Parkinson's disease Multiple Sclerosis Seizure Disorders Generalized convulsive disorder Generalized nonconvulsive disorder Status epilepticus Vascular Diseases Cerebral aneurysm Stroke Transient ischemic attack

106 106 Gastrointestinal System/Nutrition Esophagus Esophagitis Motor disorders Mallory-Weiss tear Neoplasms Strictures Varices Stomach Gastroesophageal reflux disease Gastritis Neoplasms Peptic ulcer disease Pyloric stenosis Gallbladder Acute/chronic cholecystitis Cholelithiasis Liver Acute/chronic hepatitis Cirrhosis Neoplasms Genitourinary System Benign Conditions of the GU Tract Benign prostatic hyperplasia Cryptorchidism Erectile dysfunction Hydrocele/varicocele Incontinence Nephro/urolithiasis Paraphimosis/phimosis Testicular torsion Pancreas Acute/chronic pancreatitis Neoplasms Small Intestine/Colon Appendicitis Constipation Diverticular disease Inflammatory bowel disease Intussusception Irritable bowel syndrome Ischemic bowel disease Neoplasms Obstruction Toxic megacolon Rectum Anal fissure Anorectal abscess/fistula Fecal impaction Hemorrhoids Neoplasms Pilonidal disease Polyps Infectious/Inflammatory Conditions Cystitis Epididymitis Orchitis Prostatitis Pyelonephritis Urethritis Neoplastic Diseases Bladder carcinoma Prostate carcinoma Renal cell carcinoma Testicular carcinoma Wilms' tumor Hernia Hiatal Incisional Inguinal Umbilical Ventral Infectious Diarrhea Nutritional Deficiencies Niacin Thiamine Vitamin A Riboflavin Vitamin C Vitamin D Vitamin K Metabolic Disorders Lactose intolerance Phenylketonuria Renal Diseases Acute/chronic renal failure Glomerulonephritis Nephrotic syndrome Polycystic kidney disease Electrolyte and Acid/Base Disorders Hypo/hypernatremia Hypo/hyperkalemia Hypo/hypercalcemia Hypomagnesemia Metabolic alkalosis/acidosis Respiratory alkalosis/acidosis Volume depletion Volume excess

107 107 Reproductive System Uterus Dysfunctional uterine bleeding Endometrial cancer Endometriosis/adenomyosis Leiomyoma Metritis Prolapse Ovary Cysts Neoplasms Cervix Carcinoma Cervicitis Dysplasia Incompetent Vagina/Vulva Cystocele Neoplasm Rectocele Vaginitis Menstrual Disorders Amenorrhea Dysmenorrhea Premenstrual syndrome Menopause Breast Abscess Carcinoma Fibroadenoma Fibrocystic disease Mastitis Pelvic Inflammatory Disease Contraceptive Methods Infertility Uncomplicated Pregnancy Prenatal diagnosis/care Normal labor/delivery Complicated Pregnancy Abortion Abruptio placenta Dystocia Ectopic pregnancy Fetal distress Gestational diabetes Gestational trophoblastic disease Molar pregnancy Multiple gestation Placenta previa Postpartum hemorrhage Pregnancy-induced hypertension Premature rupture of membranes Rh incompatibility Musculoskeletal System Disorders of the Shoulder Fractures/dislocations Rotator cuff disorders Separations Sprain/strain Disorders of the Forearm/Wrist/Hand Fractures/dislocations Boxer's Colles' Gamekeeper's thumb Humeral Nursemaid's elbow Scaphoid Sprains/strains Tenosynovitis Carpal tunnel syndrome de Quervain's tenosynovitis Elbow tendinitis Epicondylitis Disorders of the Back/Spine Ankylosing spondylitis Back strain/sprain Cauda equina Herniated nucleus pulposis Kyphosis/scoliosis Low back pain Spinal stenosis Disorders of the Hip Aseptic necrosis Fractures/dislocations Slipped capital femoral epiphysis Disorders of the Knee Bursitis Fractures/dislocations Meniscal injuries Osgood-Schlatter disease Sprains/strains Disorders of the Ankle/Foot Fractures/dislocations Sprains/strains Infectious Diseases Acute/chronic osteomyelitis Septic arthritis Neoplastic Disease Bone cysts/tumors Ganglion cysts Osteosarcoma Osteoarthritis Osteoporosis Rheumatologic Conditions Fibromyalgia Gout/pseudogout Juvenile rheumatoid arthritis Polyarteritis nodosa Polymyositis Polymyalgia rheumatic Reiter's syndrome Rheumatoid arthritis Systemic lupus erythematosus Scleroderma Sjogren's syndrome

108 108 Psychiatry/Behavioral Science Anxiety Disorders Panic disorder Generalized anxiety disorder Posttraumatic stress disorder Phobias Attention-Deficit Disorder Autistic Disorder Eating Disorders Anorexia nervosa Bulimia nervosa Obesity Mood Disorders Adjustment Depressive Dysthymic Bipolar Personality Disorders Antisocial Avoidant Borderline Histrionic Narcissistic Obsessive-compulsive Paranoid Schizoid Schizotypal Psychoses Delusional disorder Schizophrenia Schizoaffective disorder Somatoform Disorders Substance Use Disorders Alcohol abuse/dependence Drug abuse/dependence Tobacco use/dependence Other Behavior/Emotional Disorders Acute reaction to stress Child/elder abuse Domestic violence Uncomplicated bereavement Dermatologic System Eczematous Eruptions Dermatitis Atopic Contact Diaper Nummular eczematous Perioral Seborrheic Stasis Dyshidrosis Lichen simplex chronicus Papulosquamous Diseases Dermatophyte infections Tinea versicolor Tinea corporis/pedis Drug eruptions Lichen planus Pityriasis rosea Psoriasis Desquamation Stevens-Johnson syndrome Toxic epidermal necrolysis Erythema multiforme Vesicular Bullae Bullous pemphigoid Acneiform Lesions Acne vulgaris Rosacea Folliculitis Verrucous Lesions Seborrheic keratosis Actinic keratosis Insects/Parasites Lice Scabies Spider bites Neoplasms Basal cell carcinoma Melanoma Squamous cell carcinoma Hair and Nails Alopecia areata Androgenetic alopecia Onycomycosis Paronychia Viral Diseases Condyloma acuminatum Exanthems Herpes simplex Molluscum contagiosum Verrucae Varicella-zoster virus infections Bacterial Infections Cellulitis/vasculitis Erysipelas Impetigo Other Acanthosis nigricans Burns Decubitus ulcers/leg ulcers Hidradenitis suppurativa Lipomas/epithelial inclusion cysts Melasma Urticaria Vitiligo

109 109 Hematologic System Anemias Aplastic anemia Vitamin B12 deficiency Folate deficiency Iron deficiency G6PD deficiency Hemolytic anemia Sickle cell anemia Thalassemia Coagulation Disorders Factor VIII disorders Factor IX disorders Factor XI disorders Thrombocytopenia Idiopathic thrombocytopenic purpura Thrombotic thrombocytopenic purpura Von Willebrand's disease Malignancies Acute/chronic lymphocytic leukemia Acute/chronic myelogenous leukemia Lymphoma Multiple myeloma Infectious Diseases Fungal Disease Candidiasis Cryptococcosis Histoplasmosis Pneumocystis Bacterial Disease Botulism Chlamydia Cholera Diphtheria Gonococcal infections Salmonellosis Shigellosis Tetanus Mycobacterial Disease Tuberculosis Atypical mycobacterial disease Parasitic Disease Amebiasis Hookworms Malaria Pinworms Toxoplasmosis Spirochetal Disease Lyme borreliosis Lyme disease Rocky Mountain spotted fever Syphilis Viral Disease Cytomegalovirus infections Epstein-Barr virus infections Erythema infectiosum Herpes simplex HIV infection Human papillomavirus infections Influenza Mumps Rabies Roseola Rubella Measles Varicella-zoster virus infections

110 110 STUDENT ACADEMIC MENTORING FORM APPENDIX G: Academic Mentoring Form Student: Date: Faculty: Time Start: End: Mode of Contact: Student Initiated Faculty Initiated Other: Describe the reason for this encounter: Academic Remediation Methods Reviewed: Organization of Notes Group Study Plan Study Strategies Other (see below) COMMENTS/NOTES: PLANS and/or REFERRALS TO STUDENT Referred to Graduate Assistant for Tutoring Referred to Disability Services Referred to Course Coordinator Referred to Program Director Study Skills Referred to counseling services Referred to Faculty Advisor

111 111 FOLLOW-UP SUMMARIES Date: Faculty: Date: Faculty: Date: Faculty:

112 112 APPENDIX H: Incident Report Incident Report In the event you are injured, your highest priority is prompt treatment. Do not delay seeking appropriate treatment to fill out paperwork or make notifications. Students should comply with all accident/injury protocols in place at the clinical site. In the absence of a protocol, seek treatment in the nearest emergency department. Student Name: Date: Rotation: Nature of Incident Date of Incident: Approximate Time of Incident: Did Incident Involve Possible Exposure to Bloodborne Pathogen? No Yes (see below) Description of Incident: Actions/First Aid Taken Immediately Following Incident: Bloodborne Pathogen Exposure Students who are potentially exposed to bloodborne pathogens should seek prompt evaluation. Evidence suggests that prophylactic medications are more likely to be effective when taken soon after an exposure. Students should also consider contacting the National Clinicians Post- Exposure Prophylaxis Hotline:

113 113 Notifications Date and Time Notified Clinical Preceptor Onsite Health Services / Employee Health/Occupational Health or Emergency Department Director of Clinical Education or Program Director Student Signature Date Submit this form to the Director of Clinical Education Additional Follow Up / For Program Use SITE VISIT EVALUATION APPENDIX I: Site Visit Evaluation

114 114 Student: Date: Rotation: Preceptor: Site / Preceptor Evaluation Category Yes No N/A Physical layout of facility is adequate and conducive for learning Preceptor/facility provides orientation to facility/staff Preceptor available to meet Preceptor appears enthusiastic about teaching Student work hours are appropriate Student integrated into healthcare team Site provides appropriate responsibilities Site allows students to document in chart Number and diversity of patients provide well-rounded experience Site provides formal lectures/conferences/teaching rounds Site provides access to the following educational resources: Medical Library Internet Formal lectures/conferences/teaching rounds Inpatient: Number of patients followed by student Outpatient: Approximate number of patients seen by student daily What procedures is student permitted to perform on this site? Comments regarding site: Student Evaluation

115 N/A Above Average Average Below Average Deficient 115 Category Yes No N/A Student on site Student readily identifiable as a PA student Attire / Appearance is appropriate for clinical environment Able to observe student taking history? Able to observe student performing physical examination? Patient Presentation: Ask student to present one or more patients in one or more of the following formats: Comprehensive Detailed Brief Complete HPI, PMH, FH, SocH, ROS, PEX, laboratory studies, assessment, including differential diagnosis, and plan. Not to exceed 7 minutes speaking at an understandable pace. Assessment Areas Relevant features of all elements of presentation, but able to use terms such as noncontributory" or "unremarkable" for categories. Acceptable to say laboratory studies are normal, PE normal except for... Highlights pertinent positives and negatives; avoids irrelevant information. Not more than 3 minutes. Limited HPI and PMH. Limited Physical Examination and laboratory studies. Limited differential diagnosis, assessment, and plan. Certainly no more than 6 sentences total. 30 seconds 1 minute Student communicates clearly N/A Student able to integrate findings from PE, history and diagnostic studies N/A Student able to articulate a logical differential diagnosis N/A Student develops management plan that logically follows from differential diagnosis N/A Student shows awareness of preventive/health maintenance concerns N/A Student demonstrates sufficient knowledge of patient s medications, including classes, indications, contraindications, and potential interactions N/A Comments regarding student performance: Evaluator Signature Date

116 116 APPENDIX J: Rotation Specific Rubrics Evaluation of Written History and Physical Examination Student Name: Date: Rotation Location and Specialty: Evaluation of Written H&P Evaluation Instructions: Please carefully read each of the narratives associated with each of the evaluation criteria found below. After becoming familiar with each of the narratives assign a numeric rank for the student based on the narrative that best describes the student s level of performance. Once you have assigned a rank each category, average the ranks to obtain an overall rating of student performance. Date/Time/Signature/ID/Source/Reliability/CC Incomplete or inaccurate with deficiencies throughout. Incomplete or inaccurate involving no more than 4 items or details. Incomplete or inaccurate involving no more than 2 items or details. Complete and accurate with all data presented. Errors in formatting, spelling or abbreviations only. Complete and accurate with all data presented in the appropriate format History of Present Illness (HPI): Content Incomplete or inconsistent or inaccurate with one or more major details omitted. One or two details omitted or impertinent ROS included. All major and minor details presented, but with a substantial amount of extraneous information. All major and minor details presented with a minimal amount of extraneous information. Complete, consistent and accurate. All major and minor details presented without any extraneous information History of Present Illness (HPI): Chronology Fragmented and confusing. Can not get a clear picture of the sequence of events. Occasionally fragmented or difficult to follow. Chronology not entirely clear or understandable as to the sequence of events. Chronology of events presented in a clear, understandable progression. Could be more concise. Chronology of events presented in a clear, understandable, concise progression History of Present Illness (HPI): Organization Major data items not grouped appropriately. Disorganized throughout. Three or four minor data items not grouped appropriately. Reader has to look for information. One or two minor data items not grouped appropriately. All data grouped appropriately and presented in an organized, concise manner, in the appropriate format. Errors with formatting only. All data grouped appropriately and presented in an organized, concise manner, in the appropriate format Allergies/ADR s/medications One medication ADR or allergy missing. All allergies ADR s and medications present. One or more medications spelled incorrectly AND/OR dose or route or frequency missing for one or more medications. All allergies ADR s and medications present and spelled correctly. Dose or route or frequency missing for only one medication. All allergies ADR s and medications present. Dose route, frequency included for each medication. One medication spelled incorrectly. All allergies ADR s and medications present and spelled correctly. Dose, route, frequency included for each medication Past Medical History (PMH) Event(s) missing Family History (FH) Multiple problems with format AND/OR associated details omitted for multiple events. All events presented, but associated details omitted for one or two events. Complete, consistent and accurate with all events presented. Formatting problems only. Complete, consistent and accurate with all events and associated details presented in the appropriate format One pertinent positive illness omitted OR deficiencies throughout the pedigree diagram. One or two pertinent negative illness omitted AND minor inaccuracies on the pedigree diagram. OR family members omitted. All pertinent positive illnesses presented. One or two pertinent negative illness omitted. Complete and accurate with all pertinent positive and negative illnesses presented. Minor inaccuracies on the pedigree diagram. Complete; with all pertinent positive and negative illnesses and pedigree diagram presented accurately Social History (SH)

117 117 Incomplete or inconsistent or inaccurate or with organizational deficiencies throughout. One or two required data items omitted AND needs better organization. One or two required data items omitted. Complete, consistent and accurate with all required data presented. Needs better organization. Complete, consistent and accurate with all required data presented in an organized, concise fashion Review of Systems (ROS) Multiple pertinent negative data AND/OR pertinent positive data item omitted OR data in ROS that belongs in HPI. Positive data not presented first OR one or two pertinent positive data items omitted. Consistent and accurate with only one or two pertinent negative data items omitted Complete, consistent and accurate with all pertinent positive and negative data presented. Errors in formatting only. Complete and accurate with all pertinent positive and negative data presented in the appropriate format Physical Examination (PE) Incomplete or inconsistent or inaccurate or with organizational deficiencies throughout. One or two required data items omitted AND needs better organization. One or two required data items omitted. Complete, consistent and accurate with all required data presented. Needs better organization. Complete, consistent and accurate with all required data presented in an organized, concise fashion Assessment Assessment does not logically follow data obtained from history and examination. Plan Assessment not comprehensive or minor flaws in logical thinking. Minor flaw in assessment or significant flaw in organization. Complete and comprehensive, minor flaws in organization. Completely and logically addresses all issues raised in history and examination Plan inappropriate, impractical or fails to address significant issue raised in assessment. Significant problems with organization OR fails to address minor issue. Addresses all issues, minor flaws in organization. Comprehensive but with some impractical choices. Comprehensive plan which appropriately addresses all issues raised in assessment Mechanics/Medical Terms/Abbreviations Any miscategorization of data. Frequent spelling and/or grammar errors OR frequently fails to use or improperly uses medical terminology and/or abbreviations. Patient identifiers not removed. All information categorized properly. Occasional grammar or spelling errors AND instances of not using or inappropriate use of medical terminology or abbreviations. All information categorized properly. One or two instances of not using medical terminology and/or abbreviations where appropriate. All information categorized properly. One or two grammar or spelling errors. All information categorized properly. No grammar or spelling errors. Appropriate use of medical terminology and abbreviations. Patient identifiers removed Overall Rating of WRITTEN HISTORY AND PHYSICAL EXAMINATION Take an average of the criteria listed above and circle this result on the top scale provided below. H&P Score Letter Grade C- C C+ B- B B+ A- A A+ Percentage 70 % 73% 77% 80% 83% 87% 90% 93% % Comments: Faculty Advisor: Date:

118 118 Evaluation of Discharge Note Student Name: Date: Rotation Location and Specialty: Evaluation of Discharge Note Evaluation Instructions: Please carefully read each of the narratives associated with each of the evaluation criteria found below. After becoming familiar with each of the narratives assign a numeric rank for the student based on the narrative that best describes the student s level of performance. Once you have assigned a rank each category, average the ranks to obtain an overall rating of student performance. Scale Criteria Not Present Present but with errors Present with no errors Admission/Discharge Dates 0% 8% 16% Admission/Discharge Diagnosis 0% 3.5% 7% Service 0% 3.5% 7% Referring Physician 0% 3.5% 7% Consults 0% 3.5% 7% Procedures 0% 3.5% 7% H & P (pertinent findings) 0% 3.5% 7% Course 0% 3.5% 7% Discharge Condition 0% 3.5% 7% Patient Disposition 0% 3.5% 7% Medications 0% 3.5% 7% Instructions 0% 3.5% 7% Follow-up 0% 3.5% 7% Percent Grade Letter Grade Explanation of Grade A Student has exceeded expectations B student has met expectations C student is below expectations Less than 70 F student has failed expectations

119 119 Evaluation of Labor and Delivery Note Student Name: Date: Rotation Location and Specialty: Evaluation of Labor and Delivery Note Evaluation Instructions: Please carefully read each of the narratives associated with each of the evaluation criteria found below. After becoming familiar with each of the narratives assign a numeric rank for the student based on the narrative that best describes the student s level of performance. Once you have assigned a rank each category, average the ranks to obtain an overall rating of student performance. Scale Criteria Not Present Present but with Present with no errors errors Date/Time/Patient information (age, race, gravida x, para x, Group B strep Results) 0% 8% 16% Anesthesia 0% 3.5% 7% Infant Condition 0% 3.5% 7% Infant information (weight, APGAR score) 0% 3.5% 7% Method of Delivery 0% 3.5% 7% Description of Delivery 0% 3.5% 7% Condition of Placenta 0% 3.5% 7% Medications Used 0% 3.5% 7% Procedure Performed during Delivery 0% 3.5% 7% Estimated Blood Loss 0% 3.5% 7% Patient Disposition 0% 3.5% 7% Infant Disposition 0% 3.5% 7% Physician 0% 3.5% 7% Percent Grade Letter Grade Explanation of Grade A Student has exceeded expectations B student has met expectations C student is below expectations Less than 70 F student has failed expectations

120 120 Evaluation of Operative Note Student Name: Date: Rotation Location and Specialty: Evaluation of Operative Note Evaluation Instructions: Please carefully read each of the narratives associated with each of the evaluation criteria found below. After becoming familiar with each of the narratives assign a numeric rank for the student based on the narrative that best describes the student s level of performance. Once you have assigned a rank each category, average the ranks to obtain an overall rating of student performance. Scale Criteria Not Present Present but with errors Present with no errors Date/Time/Patient information if applicable 0% 8% 16% Pre-Op Diagnosis 0% 3.5% 7% Post-Operative Diagnosis 0% 3.5% 7% Procedure 0% 3.5% 7% Surgeons 0% 3.5% 7% Findings 0% 3.5% 7% Anesthesia 0% 3.5% 7% Fluids 0% 3.5% 7% Estimated Blood Loss 0% 3.5% 7% Drains 0% 3.5% 7% Specimen 0% 3.5% 7% Complications 0% 3.5% 7% Patient Disposition 0% 3.5% 7% Percent Grade Letter Grade Explanation of Grade A Student has exceeded expectations B student has met expectations C student is below expectations Less than 70 F student has failed expectations

121 121 Evaluation of Pre-Operative Note Student Name: Date: Rotation Location and Specialty: Evaluation of Pre-Operative Note Evaluation Instructions: Please carefully read each of the narratives associated with each of the evaluation criteria found below. After becoming familiar with each of the narratives assign a numeric rank for the student based on the narrative that best describes the student s level of performance. Once you have assigned a rank each category, average the ranks to obtain an overall rating of student performance. Scale Criteria Not Present Present but with errors Present with no errors Date/Time/Patient information if applicable 0% 8% 16% Pre-Operative Diagnosis 0% 7% 14% Procedure 0% 7% 14% Lab/Diagnostic Tests Findings 0% 7% 14% (ie. Chest XRAY, EKG) Blood 0% 7% 14% Orders 0% 7% 14% Permit 0% 7% 14% Percent Grade Letter Grade Explanation of Grade A Student has exceeded expectations B student has met expectations C student is below expectations Less than student has failed expectations F 70

122 122 Evaluation of Procedure Note Student Name: Date: Rotation Location and Specialty: Evaluation of Procedure Note Evaluation Instructions: Please carefully read each of the narratives associated with each of the evaluation criteria found below. After becoming familiar with each of the narratives assign a numeric rank for the student based on the narrative that best describes the student s level of performance. Once you have assigned a rank each category, average the ranks to obtain an overall rating of student performance. Scale Criteria Not Present Present but with errors Present with no errors Date/Time/Patient information if applicable 0% 6% 12% Procedure 0% 5.5% 11% Permit (Procedure, Risks, and Benefits discussed) 0% 5.5% 11% Indications 0% 5.5% 11% Physician(s) 0% 5.5% 11% Description 0% 5.5% 11% Complications 0% 5.5% 11% Estimated Blood Loss 0% 5.5% 11% Patient Disposition 0% 5.5% 11% Percent Grade Letter Grade Explanation of Grade A Student has exceeded expectations B student has met expectations C student is below expectations Less than 70 F student has failed expectations

123 123 Evaluation of 6 Month (or Infant) Well Baby Exam Student Name: Date: Rotation Location and Specialty: Evaluation of 6 Month (or Infant) Well Baby Exam Evaluation Instructions: Please carefully read each of the narratives associated with each of the evaluation criteria found below. After becoming familiar with each of the narratives assign a numeric rank for the student based on the narrative that best describes the student s level of performance. Once you have assigned a rank each category, average the ranks to obtain an overall rating of student performance. Scale Criteria Not Present Present but with errors Present with no errors Date/Time/Patient information if applicable 0% 6% 12% Reason for Visit 0% 4% 8% Diet 0% 4% 8% Sleep Routine 0% 4% 8% Parental Concerns 0% 4% 8% Developmental Milestones 0% 4% 8% Complete Physical Exam 0% 4% 8% Anticipatory Guidance 0% 4% 8% Safety 0% 4% 8% Immunizations 0% 4% 8% Growth Chart 0% 4% 8% Assessment/Plan 0% 4% 8% Percent Grade Letter Grade Explanation of Grade A Student has exceeded expectations B student has met expectations C student is below expectations Less than 70 F student has failed expectations

124 Excellent Very Good Average Below Average Unacceptable 124 Oral Presentation Grading Student Name: Date: Rotation: Please assess the oral presentation according to the following rubric. Please provide comments for any area assessed as unacceptable or regarded to be a critical omission. Patient History and Physical Examination Chief Complaint stated (with indication of duration if appropriate) N/A HPI addresses onset, intensity, duration, alleviating/exacerbating factors, etc N/A HPI chronology clear N/A HPI contains appropriate ROS systems N/A HPI free of extraneous information N/A Childhood history described as appropriate Pregnancy and delivery history included if appropriate N/A Adult history described as appropriate N/A Medications described as appropriate. Student demonstrates knowledge of all of patient s medications, medication classes, and potential side effects. Recognizes potential for interactions as appropriate. Social history described as appropriate. Should almost always cover: Alcohol Tobacco Drugs N/A N/A Family history described as appropriate N/A Adult history described as appropriate N/A ROS described as appropriate. Systems well-selected. Pertinent positives and negatives addressed. If not previously addressed, should almost always cover: Pulmonary Cardiac Abdomen N/A ROS positive findings appropriately addressed. ROS description avoids extraneous systems N/A Physical Examination described as appropriate. Should always cover: General appearance Vital Signs Pulmonary Cardiac Abdomen N/A Physical examination description avoids extraneous systems N/A

125 125 Diagnostic Studies Describes diagnostic studies performed N/A Provides rationale for studies selected N/A Discusses contraindications and limitations of studies N/A Accurately interprets findings of studies, recognizing ambiguous results N/A Suggests additional diagnostic studies as appropriate N/A Assessment Student demonstrates ability to develop logical differential diagnosis based upon the history, physical exam and diagnostic studies N/A Student demonstrates awareness of any chronic conditions in need of maintenance N/A Student recognizes issues related to prevention (smoking, obesity, etc.) N/A Plan Plan follows logically from assessment, addresses all issues N/A Plan is practical given patient s education level, socioeconomic status, support system N/A Presentation Presentation organized, flowed logically N/A Responded appropriately to questions N/A Presented without prompting Take an average of the criteria listed above and circle this result on the top scale provided below. Oral Presentation Letter Grade C- C C+ B- B B+ A- A A+ Percentage 70 % 73% 77% 80% 83% 87% 90% 93% % Evaluator #1 Evaluator #2

126 N/A Deficient Average Very Good Excellent 126 APPENDIX K: Mid-Rotation Review of Goals and Objectives Mid-Rotation Review of Goals and Objectives Student Name: Rotation Dates: Clinical Site: Preceptor: STUDENT SELF-ASSESSMENT Self Assessment How do you rate your ability to obtain an appropriate, accurate patient history? How do you rate your ability to perform an appropriate, comprehensive physical examination? How do you rate your ability to present your findings orally to your preceptor/other clinicians? How do you rate your ability to formulate a differential diagnosis? How do you rate your ability to formulate and implement a patient management plan? How do you rate your ability to perform clinical procedures appropriate to this rotation? How do you rate your professional behavior on this rotation? What are your greatest strengths on this rotation? What improvements do you need to make?

127 N/A Deficient Average Very Good Excellent 127 PRECEPTOR ASSESSMENT OF STUDENT PERFORMANCE Student Assessment How do you rate this student s ability to obtain an appropriate, accurate patient history? How do you rate this student s ability to perform an appropriate, comprehensive physical examination? How do you rate this student s ability to present findings orally to you as preceptor or to other clinicians? How do you rate this student s ability to formulate a differential diagnosis? How do you rate this student s ability to formulate and implement a patient management plan? How do you rate this student s ability to perform clinical procedures appropriate to this rotation? How do you rate this student s professional behavior on this rotation? Does this student s current performance in this rotation merit a passing grade? Yes No Uncertain What are the most important things this student should do to improve his/her performance? Additional Comments/Suggestions: Preceptor s Signature: Date: Student s Signature: Date:

128 128 APPENDIX L: Preceptor Evaluation End of Rotation Evaluation Preceptor Evaluation Student Name: Date: Rotation: For each of the following sections, please indicate the degree to which each of the statements is reflective of student performance. Please use the following scale in your evaluation: 5 Consistently exceeds expectations; outstanding performance 4 Occasionally exceeds expectations; above average performance 3 Meets expectations; average performance 2 Occasionally meets expectations; below average performance 1 Does not meet expectations; poor performance N/A Not applicable to this clinical experience Medical Knowledge Demonstrates appropriate knowledge of disease pathophysiology, clinical presentation, treatment options, and prognosis. The student can explain disease etiologies, risk factors, underlying pathologic process, and epidemiology for medical conditions. The student can describe signs and symptoms for disease states related to the most frequent presentation for a given disorder. The student can form appropriate differential diagnoses during patient presentations. The student can manage general medical and surgical conditions to include understanding the indications, contraindications, side effects, interactions and adverse reactions of pharmacological agents and other relevant treatment modalities. The student can identify the appropriate site of care for presenting conditions, including identifying emergent cases and those requiring referral or admission. The student selects and interprets appropriate diagnostic or laboratory studies. The student can identify appropriate interventions for prevention of pathophysiologic conditions. The student derives sufficient, essential, and accurate history to direct NA NA NA NA NA NA NA NA

129 129 physical examination and develops appropriate diagnoses. Demonstrates ability to use historical information to direct a focused physical examination. (Evidence: Case presentations to preceptor reflect a logical connection between historical information and physical examination findings.) Demonstrates knowledge of normal physical examination findings. Demonstrates knowledge of abnormal physical examination findings and their relationship to possible diagnoses. Evidence: Case presentations reveal appropriate recognition of findings and incorporation of findings into assessment and plan NA NA NA Patient Care The student can develop and carry out patient management plans. Demonstrates appropriate physical examination skills. Evidence: Findings are reproducible by preceptor. Demonstrates competent performance in medical and surgical procedures that are considered essential in the area of practice. Evidence: Articulates completely the steps of a given procedure, materials needed, follow-up care/patient instructions, possible adverse reactions and contraindications. Student demonstrates correct use of instruments, skills in performing procedures, gives clear instructions to assistants, and maintains calm in the face of unplanned complications. Sets appropriate boundaries for effective patient relationships. Counsels and educates patients and their families appropriately NA NA NA NA NA NA Interpersonal and Communication Skills The student appropriately adapts communication style to the context of all patient interactions. Produces reliably accurate, concise, organized documentation for patient interactions. Evidence: Documentation demonstrates an accurate record of patient encounters with attention to legibility, correct physical examination findings, patient identifiers, logical assessment of case presentation, clear treatment plans with prescriptions, follow up appointments, consultations, and ensures co-signature of preceptor. Documentation demonstrates improvement over the course of the rotation with regard to physical exam descriptions and economy of words. Conducts respectful interviews, with empathy and sensitivity NA NA NA NA Professionalism

130 130 Demonstrates a respectful attitude toward, and works appropriately with, preceptors, staff, and patients at all times. Demonstrates timely attendance and appropriate dress, and accomplishes assigned tasks on time. Demonstrates self-directed study. Recognizes personal learning needs and limitations and seeks to rectify them. Promptly completes assigned tasks. Openly seeks, and positively responds to, constructive criticism from preceptors and staff. Demonstrates the ability to use criticism to change behavior/attitudes NA NA NA NA NA NA NA Practice-based Learning Locates, appraises and integrates evidence from scientific studies related to patients health problems. Applies knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness NA NA Systems-based Learning Acts as an advocate for patients and their families. Applies information technology to manage information; is able to access online medical information and support didactic and clinical education NA NA

131 131 Additional Comments Please add comments regarding this student s individual strengths/weakness. Please add any comments regarding UCPA students in general with regard to weaknesses or suggestions to improve their preparedness for this rotation. Preceptor Information If this form is completed by someone other than the primary preceptor, it must be signed by the primary preceptor. Please check the item which best describes your knowledge of, and contact with, this student. Daily Contact Intermittent Occasional Contact None at All I have discussed this evaluation with the student. I have directly observed the student s clinical performance. Yes No Yes No Evaluator s Signature and Title Date Primary Preceptor s Signature (if other than the above) For PA Program Use Grade Faculty Initial Student Review Date

132 Not Applicable Strongly Agree Agree Neutral Disagree Strongly Disagree 132 APPENDIX M: Student Evaluation of Preceptor Student Evaluation of Preceptor/Clinical Site Student Name: Rotation Dates: Clinical Site: Name(s) of Preceptor(s): Preceptor Evaluation Category The Clinical Preceptor: Discussed goals and objectives of rotation with me at the beginning of the rotation. Was readily available to me. Set aside time for teaching. Appeared enthusiastic about teaching and having me as a student. Encouraged me to ask questions. Provided feedback regarding my strengths and weaknesses in a constructive manner. Encouraged me to accept appropriate responsibilities in working with patients. Provided appropriate supervision during history taking, physical examinations and procedures. Encouraged discussion of patient treatment plans. Assisted me in meeting most of the goals and objectives for this rotation. Formally discussed my final evaluation. Served as a model of the type of healthcare provider I would like to become.

133 Not Applicable Strongly Agree Agree Neutral Disagree Strongly Disagree 133 The Clinical Site Category The Clinical Site: Provided an orientation to the practice/site. Incorporated me into the team of healthcare providers. Administrative and support staff were supportive. Demonstrated an active interest in medical education/teaching. Provided an adequate opportunity to practice clinical skills. Provided an adequate patient load (in terms of number and variety). Provided access to learning experiences such as lectures, conferences and teaching rounds. Provided access to other educational resources, such as a library or the internet. Inpatient rotations: Approximately how many patients did you follow on a daily basis? Outpatient rotations: How many patients did you evaluate on an average day? What did you like best about this rotation? What did you like least about this rotation? What could be done to enhance this clinical site? Signature: Date:

134 134 APPENDIX N: Competencies Standard B3.02 Self-Evaluation of Competencies Standard B3.02 Supervised clinical practice experiences must enable students to meet program expectations and acquire the competencies needed for clinical PA practice. Student Name: Date: The following competencies were developed by the American Academy of Physician Assistants, the Physician Assistant Education Association, the Accreditation Review Commission on Education for Physician Assistants, and the National Commission on Certification of Physician Assistants. Physician Assistant Competencies: A Self-Evaluation Tool Rate your strength in each of the competencies using the following scale: 1 = Needs Improvement 2 = Adequate 3 = Strong 4 = Very Strong MEDICAL KNOWLEDGE Medical knowledge includes an understanding of pathophysiology, patient presentation, differential diagnosis, patient management, surgical principles, health promotion, and disease prevention. Physician assistants must demonstrate core knowledge about established and evolving biomedical and clinical sciences and the application of this knowledge to patient care in their area of practice. In addition, physician assistants are expected to demonstrate an investigatory and analytic thinking approach to clinical situations. Physician assistants are expected to: understand etiologies, risk factors, underlying pathologic process, and epidemiology for medical conditions identify signs and symptoms of medical conditions select and interpret appropriate diagnostic or laboratory studies manage general medical and surgical conditions to include understanding the indications, contraindications, side effects, interactions, and adverse reactions of pharmacologic agents and other relevant treatment modalities identify the appropriate site of care for presenting conditions, including identifying emergent cases and those requiring referral or admission identify appropriate interventions for the prevention of pathophysiologic conditions identify the appropriate methods to detect pathophysiologic conditions in an asymptomatic individual differentiate between the normal and the abnormal in anatomic, physiological, laboratory findings, and other diagnostic data appropriately use history and physical findings and diagnostic studies to formulate

135 a differential diagnosis provide appropriate care to patients with chronic pathophysiologic conditions INTERPERSONAL & COMMUNICATION SKILLS Interpersonal and communication skills encompass verbal, nonverbal and written exchange of information. Physician assistants must demonstrate interpersonal and communication skills that result in effective information exchange with patients, their patients families, physicians, professional associates, and the health care system. Physician assistants are expected to: create and sustain a therapeutic and ethically sound relationship with patients use effective listening, nonverbal, explanatory, questioning, and writing skills to elicit and provide information appropriately adapt communication style and messages to the context of the individual patient interaction work effectively with physicians and other health care professionals as a member or leader of a health care team or other professional group apply an understanding of human behavior demonstrate emotional resilience and stability, adaptability, flexibility, and tolerance of ambiguity and anxiety accurately and adequately document and record information regarding the care process for medical, legal, quality, and financial purposes PATIENT CARE Patient care includes age-appropriate assessment, evaluation, and management. Physician assistants must demonstrate care that is effective, patient-centered, timely, efficient, and equitable for the treatment of health problems and the promotion of wellness. Physician assistants are expected to: work effectively with physicians and other health care professionals to provide patient-centered care demonstrate caring and respectful behaviors when interacting with patients and their families gather essential and accurate information about their patients make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment develop and carry out patient management plans counsel and educate patients and their families competently perform medical and surgical procedures considered essential in the area of practice provide health care services and education aimed at preventing health problems or maintaining health PROFESSIONALISM

136 136 Professionalism is the expression of positive values and ideals as care is delivered. Foremost, it involves prioritizing the interests of those being served above one s own. Physician assistants must know their professional and personal limitations. Professionalism also requires that PAs practice without impairment from substance abuse, cognitive deficiency, or mental illness. Physician assistants must demonstrate a high level of responsibility, ethical practice, sensitivity to a diverse patient population, and adherence to legal and regulatory requirements. Physician assistants are expected to demonstrate: understanding of legal and regulatory requirements, as well as the appropriate role of the physician assistant professional relationships with physician supervisors and other health care providers respect, compassion, and integrity responsiveness to the needs of patients and society develop and carry out patient management plans accountability to patients, society, and the profession commitment to excellence and on-going professional development commitment to ethical principles pertaining to provision or withholding of clinical care, confidentiality of patient information, informed consent, and business practices sensitivity and responsiveness to patients culture, age, gender, and disabilities self-reflection, critical curiosity, and initiative PRACTICE-BASED LEARNING AND IMPROVEMENT Practice-based learning and improvement includes the processes through which clinicians engage in critical analysis of their own practice experience, medical literature, and other information resources for the purpose of self-improvement. Physician assistants must be able to assess, evaluate, and improve their patient care practices. Physician assistants are expected to: analyze practice experience and perform practice-based improvement activities using a systematic methodology in concert with other members of the health care delivery team locate, appraise, and integrate evidence from scientific studies related to their patients health problems obtain and apply information about their own population of patients and the larger population from which their patients are drawn apply knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness apply information technology to manage information, access on-line medical information, and support their own education facilitate the learning of students and/or other health care professionals recognize and appropriately address gender, cultural, cognitive, emotional, and other biases; gaps in medical knowledge; and physical limitations in themselves and others SYSTEMS-BASED PRACTICE Systems-based practice encompasses the societal, organizational, and economic environments in which health care is delivered. Physician assistants must demonstrate an awareness of, and responsiveness to, the larger system of health care to provide patient care that is of optimal value. PAs should work to im-

137 prove the larger health care system of which their practices are a part. Physician assistants are expected to: use information technology to support patient care decisions and patient education effectively interact with different types of medical practice and delivery systems understand the funding sources and payment systems that provide coverage for patient care practice cost-effective health care and resource allocation that does not compromise quality of care advocate for quality patient care and assist patients in dealing with system complexities partner with supervising physicians, health care managers, and other health care providers to assess, coordinate, and improve the delivery of health care and patient outcomes accept responsibility for promoting a safe environment for patient care and recognizing and correcting systems-based factors that negatively impact patient care apply medical information and clinical data systems to provide more effective, efficient patient care use the systems responsible for the appropriate payment of services

138 Always Usually Occasionally Seldom Not Applicable 138 APPENDIX O: Summative Professionalism Assessment Tool Summative Professionalism Assessment Tool Assessment Category General Did the student exhibit a positive and profession attitude? Did the student exhibit emotional stability, maturity, empathy, and physical and mental stamina? Did the student maintain current immunizations, CPR, and background checks? N/A N/A N/A Did the student act appropriately in stressful situations? N/A Did the student report any physical handicap or health issues that may affect their ability to provide safe, effective medical care? N/A Professional Did the student show respect for other students and faculty members? N/A Did the student comply with dress codes on campus and/or clinical sites? N/A Was the student on time for classes and clinical rotations? N/A Did the student exhibit unprofessional behaviors (including unnecessary conversation in class during lectures or laboratory sessions? Was the student able to work cooperatively, promoting and preserving relationships with peers and other members of the healthcare team? Academic Did the student demonstrate the ability to learn and function in a wide variety of didactic and clinical settings? This includes demonstrating cognitive abilities necessary to master relevant content in basic science and clinical courses to provide the standard of care. Was there evidence that the student can communicate effectively, both verbally and written, using appropriate grammar, spelling, and vocabulary? N/A N/A N/A N/A

139 139 Did the student exhibit academic integrity? N/A Did the student demonstrate adaptability relative to changing situations, environments and new information? N/A Clinical Did the student protect the patient s safety and promote the patient s well being? N/A Did the student uphold ethical standards for health care? N/A Did the student provide competent medical care and extend to each patient the full measure of professional ability as s dedicated, empathetic student healthcare provider during clinical rotations? Did the student provide competent medical care under the supervision of an assigned preceptor Did the student demonstrate the ability to learn and function in a wide variety of clinical settings? N/A N/A N/A Comments Faculty Signature Date Student Signature Date