Medical Assistant Specialist Technology Enhanced Curriculum High Level Design Wadhwani Foundation & World Education, Inc.

Medical Assistant Specialist Technology Enhanced Curriculum High Level Design Wadhwani Foundation & World Education, Inc.

1. Introduction According to the U.S. Bureau of Labor Statistics, employment of Medical Assistants is projected to grow 29 percent from 2012 to 2022, much faster than the average for all occupations. The growth of the aging babyboom population will continue to spur demand for preventive medical services, which are often provided by physicians. An increasing number of healthcare clinics and centers, hospitals, and private medical offices need support workers, particularly Medical Assistants, to do both administrative and clinical duties. Medical Assistants work mostly in primary care, a steadily growing sector of the healthcare industry. In addition, federal health legislation will expand the number of patients who have access to health insurance, increasing patient access to medical care. Additional demand is expected because of new and changing tasks for Medical Assistants as part of the medical team. As more and more of the healthcare industry switches to electronic health records (EHRs), Medical Assistants job responsibilities will continue to change. Assistants will need to become familiar with EHR computer software, including maintaining EHR security and analyzing electronic data, to improve healthcare information. 2. Needed Competencies According to the curricular framework set out by the Medical Assisting Education Review Board (MAERB), Medical Assistants are expected to have a broad foundation of academic knowledge and clinical practice in order to provide safe and effective clinical care. They demonstrate critical thinking based on that knowledge and skills and are able to communicate clearly, both orally and in writing. Medical Assistants are familiar with medical business practices and can be relied upon to complete office routines in a timely and accurate manner. They use safety practices, are ready for possible emergencies, and provide patient care in accordance with regulations, policies, laws, while upholding patient rights. Incumbent healthcare workers interested in upgrading their skills and others interested in becoming Medical Assistants must be prepared to meet these standards. In addition, input from partnership with employers informs the design of this customized curriculum. Support to pilot this concept is being provided for qualified students through Individual Training Grants funded by the NYC Small Business Services. Based upon this, the rough guide for the courseware is provided in Figure 1.1. Entry and exit skills of graduates.

Entry Skills High School Diploma or GED Computer Knowledge: Basic Reading: TABE D9 10.0 grade level or above Math: TABE D9 9.0 or above Customer Service Skills: Excellent Initial Course Design/Content Based on MAERB Core Curriculum Enhanced through employer feedback regarding major gaps Academic content Clinical concepts Practical experience Professional development Figure 1.1 Entry and exit skills of students. Exit Skills Demonstrate academic subject matter, clinical skills, and professional behavior by competently providing patient care communicating effectively, both orally and in writing performing medical business practices acting in accordance with regulations, policies, laws and patient rights applying quality control measures in following health and safety policies and procedures to prevent illness and injury demonstrating knowledge of the healthcare industry context and knowledge

3. Competencies to be developed The skills mentioned in Fig 1.1 can be translated into rough competencies that need to be developed. Given the entry level skills of the typical students and the need to distribute and reinforce this knowledge throughout the program, allocations may be done for the students as shown in the following table: No. Competency Description Courses 1. Foundations for Clinical Practice 2. Applied Communication 3. Medical Business Practices 4. Medical Laws and Ethics 5. Safety and Emergency Practices Knowledge of basic anatomy & physiology, including spelling and pronunciation of terms Clinical procedures Critical thinking in performing patient care Applied mathematics Applied microbiology Communicate orally and in writing Recognize and address communication barriers Interact professionally in healthcare environment with patients and co-workers Good customer service and teamwork Administrative and time management skills practice finance Managed care/medical insurance Medical coding and use Electronic Medical Health Records Legal scope of practice, licensure and certification Liability, criminal and civil law Confidentiality, HIPPA & Patient Bill of Rights Role of culture, social, and ethnic diversity in practice Protective practices Safety techniques Principles and steps of CPR Body mechanics Materials Safety Data Sheets and hazardous materials Emergency response and preparedness 6. Healthcare Industry Industry context and knowledge Career mapping Anatomy & Physiology; Clinical Practice, Principles & Skills; Internship Clinical Practice, Principles & Skills; Internship; Professional Development & Support Medical Office Business Practices Internship Clinical Practice, Principles, & Skills; Internship Anatomy & Physiology; Clinical Practice, Principles & Support; Internship Medical Office Business Practices Figure 1.2. MAERB competencies described and mapped to current courses.

The broad categories of competencies needed are described below. The curriculum integrates these competencies throughout the course work and practicum, addressing the cognitive (knowledge base), psychomotor (skills), and affective (behaviors) that graduates need to demonstrate to successfully complete the program. These skills rely upon a thorough foundation of Anatomy & Physiology with Medical Terminology. Foundations for Clinical Practice Skills that enable the individual to provide efficient and effective care to patients. Topics include human anatomy and physiology, applied math, applied microbiology/infection control, clinical procedures, and patient assessment. Applied Communications Skills that enable the individual to communicate effectively orally and in writing, recognize and address communication barriers, interact professionally in the healthcare environment with patients and coworkers, apply customer service principles, respect diversity, and use language that enables the patient to understand. Medical assistants need to be good record keepers, with attention to detail, and are responsible for updating patients charts. They also need to be quick about reporting any changes they notice to the physician in charge so that a patient s treatment can be adjusted. Medical Business Practices Skills that enable the individual to complete administrative tasks and direct their time efficiently and effectively. In addition, it includes and understanding of the fundamentals of practice finance, managed, care, medical insurance, medical coding and the use of Electronic Medical Health Care Records. Medical Laws & Ethics Skills that enable the individual to perform within the legal scope of Medical Assistant practice, licensure, and certification; understand the principles of liability; demonstrate a sensitivity to patient s rights and maintain patient confidentiality, follow HIPPA regulations, and attend to culture, social, an ethical diversity in practice. Safety & Emergency Practices Skills that enable the individual to apply quality control measures in following health and safety policies and procedures. This includes demonstrating self-awareness in responding to emergency situations. Healthcare Industry Skills that enable the individual to understand and thrive within the healthcare industry context; describe the employment prospects for the Medical Assistant field; and develop job readiness skills.

4. High Level Curriculum Design Based upon the MAERB competencies described in the previous section, the current course name, curricular topics, and expected hours of instructional coursework. Each course builds key behavioral outcomes identified for each, as parameters of evaluation of learning effectiveness. No. Course Name High Level Content/Mapped to MAERB 1. Medical Assisting 2. Medical Office Business Practices 3. Anatomy & Physiology 4. Clinical Practice, Principles & Skills 5. Professional Development & Support Overview of profession and office practices; employment prospects for the field Emphasis on patient experience Medical laws & ethics Healthcare industry context & knowledge Administrative office skills Finance fundamentals Managed care & medical insurance Diagnostic procedures & codes Electronic Medical Health Records Patient flow, priority setting, & time management Basic body structures, organs, organ systems and functions Diseases related to each system Normal and abnormal conditions Emphasis on most common chronic conditions Clinical skills built on concepts of infection control and patient safety Clinical concepts and skills (vital signs, phlebotomy, lab techniques, specimen handling, etc.) Brief discussion of pharmacology Focus on understanding the profession Job readiness topics (communication, teamwork, self-presentation, and work ethic) Comments Designed to coincide with clinical practice course topics Hands-on and didactic teaching methods; followed by 180 hours of practical experience Half- and fullday workshops throughout program Approx. Hours 45 hours 90 hours 90 hours 90 hours 21 hours 6. Internship 180 hours 7. Test Prep 7 hours TOTAL 523 hours Fig 1.3. MAERB knowledge, skills, and behaviors distributed across the current courses

5. Pedagogical Approach The goal of this technological intervention is to support students by developing engaging learning activities that provide background knowledge and reinforcement of key terms, concepts, and processes, as well as a method for teachers and learners to assess student progress and deficits. Using this approach, we hope to accelerate learning and provide the key knowledge and skill base necessary for students to become successful medical assistants. The approach in designing online lessons addresses three phases, with a primary focus upon pre- and post-class activities. See a typical flow of our technological intervention for a topic: Videos/animations Interactive learning Reading of textbook Knowledge Checks Challenge Activities Pre-class In Class Direct instruction Instructor-led activities Peer learning Video Simulations Review Online assessments Post-class Pre-class Spaced Education Clinical Post-class On the Job Pre-Class Instructors often find that students come to class unprepared, having not read the material assigned to them. Before students begin to read an assigned chapter in their textbook, they view a video or animation. We want to motivate students to become engaged with the topic by watching an introduction that clearly demonstrates the value of learning the content they are about to study. Following this, students will access multimedia drag and drop activities geared to helping them to become more familiar with key terms and concepts used in the text. Whenever possible, to increase participation, we will use a game format and/or gamified activities so students can earn points or badges for their completion.

Providing additional background knowledge prior to class provides learners with necessary vocabulary and concepts to improve comprehension for: reading the textbook in-class instruction individual and peer learning activities, and ultimately accelerate the mastery of concepts before students complete their clinical practice and move to the workplace. After students read the related chapter in their textbook, they will be given an opportunity to discover and correct their misunderstandings via an online assessment or ConcepTest. The added benefit to online assessment prior to class is that teachers can evaluate student performance and identify areas students find challenging and adapt their lesson accordingly. In Class An adapted flipped learning model can accelerate learning. Direct teacher--led instruction will remain a significant part of the overall instructional design, although this may be shortened in duration by the provision of background knowledge in the pre-class phase. This model has the potential to provide additional time for peer learning, synthesis of content, and other activities where students apply and deepen knowledge. By accelerating and deepening learning, students can devote more time to practicing the skills they will need on the job. Post-Class After each class, students will be asked to access a module that includes interactive animations and simulations. The aim here is to give students additional exposure to and reinforcement on the major anatomy and physiology topics covered in class and in the textbook. These will be followed by knowledge checks aimed at assisting them in discovering the areas in which they need further study and thus, helping to prepare students for chapter tests or exams. Spaced Education Research has found that giving students a clinically relevant question or clinical case scenario in multiple-choice question format, followed by the answer, teaching point summary and explanations of the answers can significantly increase mastery of medical knowledge. Suggested by many, in addition to modules, a spaced education approach is planned as part of the ongoing support that instructors and workforce personal say students need. Students will receive regular spaced education notifications and will be able to access brief lessons on new vocabulary and concepts, content reviews and reminders. They will be able to access content via either by email, telephones or the web.

Materials Provided: E-Learning modules will include (for Pre- and Post-class sessions): video and animations interactive images and simulations online formative assessments Spaced education: clinical case scenarios challenge questions teaching point summaries content reviews new vocabulary and concepts Acknowledgements Our thanks to those who have contributed strategies that informed our approach: Wadhwani Skills Development Network Design Team, Dr. Eric Mazur (Professor of Physics and Applied Physics at Harvard University and Area Dean of Applied Physics), Dr. B. Price Kerfoot (Associate Professor, Harvard Medical School), Dr. Robert Talbert (Associate Professor of Mathematics Department at Grand Valley State University), Dr. Pamela E. Barnett (Associate Vice Provost and Director of the Teaching & Learning Center at Temple University), and Drs. Nate Kornell, Matthe Hays, and Robert Bjork (University of California at Los Angeles).