Clinical Year Handbook - Long Island University
Transcription
Clinical Year Handbook - Long Island University
Division of Physician Assistant Studies CLINICAL YEAR HANDBOOK 2014 - 2015 TABLE OF CONTENTS I. GENERAL INFORMATION General Policy Statement …………………………………………………………… 3 Program Accreditation ……………………………………………………………….. 3 Projected Expenses for the Physician Assistant Program……………………….. 4 Withdrawal and Refunds …………………………………………………………….. 4 Clinical Year Textbooks and Equipment …………………………………….......... 5 Demands and Requirements of the Clinical Year Student ………………………. 8 Students Used as Instructional Faculty ……………………………………………. 9 Functions and Tasks of the LIU Physician Assistant Graduate …………………. 9 Competencies for the Physician Assistant Profession …………………………… 10 Accreditation Review Commission on Education for the Physician Assistant … 14 American Academy of Physician Assistants Guidelines for Ethical Conduct for the Physician Assistant Profession ……………………………………………… 15 II. ATTENDANCE ISSUES Attendance in the Division of Physician Assistant Studies ……………………... Absence from Clinical Rotations …………………………………………………… Unexcused Absences ……………………………………………………………..... Absence Due to Death in the Family …………………………………………….... Absence Due to Religious Observance .………………………………………….. Absence Due to Personal Business ………………………………………………. Leaves of Absence ……………………………………………………………......... Holidays and Academic Calendar ………………………………………………..... Weather-Related Emergencies ……………………………………………………. Work Policies ………………………………………………………………………… Student Certification …………………………………………………………………. Student Records …………………………………………………………………...... Background Checks, Criminal Records and Drug Testing ……………………… Advanced Standing ………………………………………………………………….. Technical Standards ….……………………………………………………………… Notification of Adverse Actions ………………………………………………........ 24 24 24 25 25 25 25 25 26 26 26 26 27 27 27 28 III. ACADEMIC AND PROFESSIONAL GUIDELINES AND POLICIES Introduction…………………………………………………………………………… Performance Expectations in the Clinical Year……………………………….….. Attendance and Punctuality………………………………………………………… Scoring…………………………………………………………………………… ….. General Policy Regarding Photography, Copying etc…………………………… Clinical Rotations……………………………………………….………………….. Clinical Electives.…………………………………………………………….……… External Rotations.………………………………………………….……….………. Range of Clinical Experiences……………………………………...………….….. Learning Objectives…….………..…………………………………………………. Clinical Year Grading Policies.………………..……………………………….…... Academic Performance Criteria………………………………………………… Physician Assistant Student Tracking (PAST) …..…………………….………... Histories and Physicals/SOAP Notes .……………………………………….…… End-of-Rotation Examinations…………. ………………….………………….….. Policy Regarding Review of Examinations ………………………………………. Failure of the End-of-Rotation Examination or Research Paper …..………….. Failure of Three (3) End-of-Rotation Examinations .……………………………. Failure of more than Two (2) Rotations during the Clinical Year …………….. End-of-Rotation Meetings …………………………………………………......... Attendance at End-of-Rotation Meetings ………………………………………… End-of-Rotation Examinations …………………………………………………….. Case Presentations – Clinical Seminar I&II - (MS 611&MS 612)……………… 29 29 31 31 31 32 32 33 33 33 34 35 35 35 35 35 36 36 36 37 37 37 38 LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 1 of 206 Research Papers...…………………………………………………………………. Regarding Plagiarism ….................................................................................. Preceptor Evaluation ...…………………………………………………….…....... Standards of Professionalism………………………………………….…….…… Failure to Meet Academic Performance Criteria……………………………….. Maintenance of Student Standing……………………………………………….... Grievances…………………………………………… ………………………….. PACKRAT Examination……………………………………………………………. PANCE Preparation Course – Clinical Seminar III – (MS 613)……………….. Grades……………………………………………………………………………….. Successful Completion of the Senior Year ……………………………………… Summative Evaluation – (MS 614)……………………………………………….. Mid-Rotation Evaluation …………………………………………………………… Site Visits………………………………………………………………….……..... Inadequate Supervision ………………………………………………….……….. Dismissal from Rotation……………………………………………………………. Communication during the Clinical Year …………………………………………. Malpractice Insurance …………………………………………………….…........... Health Insurance…..……………………………………………………….……….. Student Health Forms …………………………………………………………........ Influenza Vaccination………………………………………………………….......... Health Practitioners…………………………………………………………..…...... Non-Discrimination Policy………………………………………………………….. Pregnancy……………………………………………………………………………. Students with Disabilities…………………………………………………………… Senior Awards Ceremony..………………………………………………………… 38 39 39 39 40 41 41 41 41 42 42 42 43 43 43 44 44 44 45 45 46 46 46 47 47 47 IV. EMERGENCIES, PUBLIC SAFETY, ALCOHOL AND DRUG USE, AND SEXUAL HARASSEMENT Exposure to Bloodborne Pathogens, Reporting Incidents, Public Safety………. Policy on Drug and Alcohol Use on Campus or on Rotation……………….……. Sexual Harassment………………………………………………………………....... Consensual Relationships……………………………………………………........... Academic Freedom, False and Malicious Accusations, Procedures, Investigation Enforcement and Campus Contact Persons……………………………………… 48 49 49 50 51 52 V. PROFESSIONALISM - PROFESSIONAL DRESS AND APPEARANCE Attire…………………………………………………………………………….……… Hair……………………………………………………………………………………… Fingernails…………………………………………………………………………..…. Fragrances ………………………………………………………………………….... Tattoos and Piercings…..…………………………………………………………..… Jewelry………………………………………………………………………................ Protective Eyewear………................................................................................... Identification Badges………..………………………………………………………... Breaches of Professionalism Form….................................................................. Professional Accolades and Testimonials Form…………………………..………. 53 53 54 54 54 54 54 54 55 56 VI. INDEX OF APPENDICES ………………………………………………………………. Appendix A: Clinical Rotation Schedule………………………….. Appendix B: Clinical Rotation Affiliations/Sites…………………. Appendix C: Where to Report on the First Day of Rotation….... Appendix D: Directions to Clinical Affiliations/Sites……………. Appendix E: Clinical Year Grievance Procedure………………… Appendix F: Clinical Evaluation Form…………………………….. Appendix G: Clinical Year Course Syllabi………………………… Appendix I: Clinical Year Course Objectives…………………… 57 58 59 61 66 72 75 79 146 LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 2 of 206 I. GENERAL INFORMATION GENERAL POLICY STATEMENT All students of the Division of Physician Assistant Studies are subject to the rules and regulations of Long Island University (LIU), of the Division of Physician Assistant Studies, and all clinical sites in which they practice. The Division of Physician Assistant Studies is committed to producing physician assistants of high moral, ethical, academic and professional caliber. To ensure the integrity of the profession and the University as well as to ensure the safety of all patients, students must comply with all professional and academic standards. The student who violates these regulations is subject to disciplinary proceedings up to and including dismissal from the Division of Physician Assistant Studies. All students must sign the “Receipt of Guidelines and Policies and Statement of Understanding” form, which documents his or her receipt of, understanding of, and adherence to all rules, regulations and procedures of the Division and of the University. These policies and procedures may be modified or amended at any time by the faculty of the Division of Physician Assistant Studies. PROGRAM ACCREDITATION The Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) has granted Accreditation-Continued to the Physician Assistant program sponsored by Long Island University. Accreditation- Continued is an accreditation status granted when a currently accredited program is in compliance with the ARC-PA Standards. Accreditation remains in effect until the program closes or withdraws from the accreditation process or until accreditation is withdrawn for failure to comply with the Standards. The approximate date for the next validation review of the program by the ARC-PA will be December 2014. The review date is contingent upon continued compliance with the Accreditation Standards and ARC-PA policy. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 3 of 206 PROJECTED EXPENSES FOR THE PHYSICIAN ASSISTANT PROGRAM Tuition and fees listed below are at the projected prevailing rates for the 2014-2015 academic year. Fees noted below do not include expenses for room, board, cost of living, and other personal expenses. • • • • • Tuition per credit for PA students: $1,130 Number of credits in the curriculum: 86 Tuition for the entire curriculum: $97,180 Fees: $850 per semester (x 7 semesters): $5,950 Kaplan PANCE prep course fee: $395 Projected Expenses for the Didactic Year Didactic year: 40 credits @ $1,130 per credit: $45,200 Fees: $850 per semester @ 3 semesters: $2,550 Total: $47,750 Projected Expenses for the Clinical Year Clinical year: 46 credits @ $1,130 per credit: $51,980 Fees: $850 per semester @ 4 semesters: $ 3,400 Kaplan PANCE prep course fee: $395 Total: $55,775 Subtotal for Tuition & Fees $103,525 Estimate of additional expenses per year*: $ 2,450 (*Does not include housing and other personal expenses) Grand Total for All Expenses: $105,975 WITHDRAWAL AND REFUNDS To withdraw, a student must give a valid reason and obtain an Application for Permission to Withdraw from the Office of the Registrar or from the Division of Physician Assistant Studies, fill it out as indicated, have it approved by the Office of the Dean, and clear his or her financial accounts. Students who withdraw from all classes in the clinical year of the Division of Physician Assistant Studies may appeal to the faculty to decelerate. This will require the student to repeat the entire clinical year, beginning with the next class in August. The decelerating student will also be placed on academic probation. When a student withdraws from courses, the University refunds tuition according to the following schedule: Time of Withdrawal Cancellation prior to beginning of semester Cancellation after beginning of semester or session Summer 5 or 6 Week Session Complete refund except for deposit and applicable registration fee Fall/Spring Semester No refund of Dining Club fee During 1st calendar week 90% 60% During 2nd calendar week 75% 25% During 3 calendar week 50% No refund During 4th calendar week 25% rd th After 4 calendar week No refund LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 4 of 206 CLINICAL YEAR TEXTBOOKS AND EQUIPMENT The textbooks recommended for use in the clinical year are generally those used in the didactic year. The faculty will not release sources of examination questions to students. Course Textbook - Bickley, LS et al., Bates’ Guide to Physical Examination and History Taking, 10th edition. Philadelphia: Lippincott, Williams and Wilkins, 2008. MS 601 Internal Medicine - Goldman, L et al., Cecil Textbook of Medicine, 24th edition. Philadelphia: Elsevier, 2011. & MS 611 Clinical Seminar I - Gomella, L et al., Clinician’s Pocket Reference, 11th edition. New York: McGraw-Hill, 2006. - Tierney, LM et al., Current Diagnosis and Treatment, 51st edition. New York: McGraw-Hill, 2011. MS 602 Surgery & MS 612 Clinical Seminar II - Bickley, LS et al., Bates’ Guide to Physical Examination and History Taking, 10th edition. Philadelphia: Lippincott, Williams and Wilkins, 2008. - Doherty, GM et al., Current Surgical Diagnosis and Treatment, 13th edition. New York: Lange Medical Books / McGraw-Hill, 2009. - Gomella, L et al., Clinician’s Pocket Reference, 11th edition. New York: McGraw-Hill, 2006. - Bickley, LS et al., Bates’ Guide to Physical Examination and History Taking, 10th edition. Philadelphia: Lippincott, Williams and Wilkins, 2008. MS 603 Pediatrics - Gomella, L et al., Clinician’s Pocket Reference, 11th edition. New York: McGraw-Hill, 2006. - Marcdante, K. et al., Nelson Essentials of Pediatrics, 7th edition. Philadelphia: Saunders, 2013. MS 604 Family Medicine Use textbooks for MS 601, MS 603, and MS 606. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 5 of 206 - Bickley, LS et al., Bates’ Guide to Physical Examination and History Taking, 10th edition. Philadelphia: Lippincott, Williams and Wilkins, 2008. MS 605 Emergency Medicine - Gomella, L et al., Clinician’s Pocket Reference, 11th edition. New York: McGraw-Hill, 2006. - Stone, K., Current Diagnosis & Treatment Emergency Medicine, 7th edition. New York: McGraw-Hill, 2011. - Beckman, CRB et al., Obstetrics and Gynecology, 7th edition. - Philadelphia: Lippincott Williams and Wilkins, 2013. MS 606 Obstetrics and Gynecology - Bickley, LS et al., Bates’ Guide to Physical Examination and History Taking, 10th edition. Philadelphia: Lippincott, Williams and Wilkins, 2008. - Gomella, L et al., Clinician’s Pocket Reference, 11th edition. New York: McGraw-Hill, 2006. MS 607 Psychiatry - Bickley, LS et al., Bates’ Guide to Physical Examination and History Taking, 10th edition. Philadelphia: Lippincott, Williams and Wilkins, 2008. - Sadock, BJ et al., Kaplan and Sadock’s Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry, 11th edition. Philadelphia: Lippincott Williams and Wilkins, 2014. MS 613 Clinical Seminar III All textbooks listed on the clinical year textbook list MS 614 Summative Evaluation All textbooks listed on the clinical year textbook list MS 615 Capstone Project All textbooks listed on the clinical year textbook list as well as peer-reviewed journal articles, additional textbooks, and online medical databases Students will need the same equipment purchased during the didactic year. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 6 of 206 CLINICAL YEAR TEXTBOOK LIST - Beckmann, CRB et. al., Obstetrics and Gynecology, 7th edition. Philadelphia: Lippincott Williams and Wilkins, 2013. - Bickley, LS et al., Bates Guide to Physical Examination and History Taking, 10th edition. Philadelphia: Lippincott Williams and Wilkins, 2008. - Costanzo, LS., Physiology, 4th edition with Student Consult Online Access. Philadelphia: Elsevier, 2009. - Doherty, GM et al., Current Surgical Diagnosis and Treatment, 13th edition. New York: Lange Medical Books / McGraw-Hill, 2009. - Fishbach, Francis, A Manual of Laboratory and Diagnostic Tests, 9th edition. Philadelphia: Lippincott Williams and Wilkins, 2014. - Goldman, LS et al., Cecil’s Medicine: Expert Consult Premium Edition: Enhanced online features and print, 24th edition. Philadelphia: Elsevier, 2011. - Gomella, LG et al., Clinician’s Pocket Reference, 11th edition. New York: McGraw-Hill, 2006. - Katzung, B., Basic and Clinical Pharmacology, 12th edition. New York: McGraw-Hill, 2011. - Kumar, V et al., Basic Pathology, 9th edition. Philadelphia: Saunders, 2012. - Marcdante, K. et al., Nelson Essentials of Pediatrics, 7th edition. Philadelphia: Saunders, 2013. - McPhee, SJ et al., Current Medical Diagnosis and Treatment, 51st edition. McGraw-Hill, 2011. - Moore, K et al., Clinically Oriented Anatomy, 6th edition. Philadelphia: Lippincott Williams and Wilkins, 2009. - Sadock, BJ et al., Kaplan and Sadock’s Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry, 11th edition. Philadelphia: Lippincott Williams and Wilkins, 2014. - Stone, K., Current Diagnosis &Treatment Emergency Medicine, 7th edition. New York: McGraw-Hill, 2011. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 7 of 206 DEMANDS AND REQUIREMENTS OF THE CLINICAL YEAR STUDENT Physical demands - Must be able to stand for long periods of time in class and on clinical rotations. - Must be able to have adequate eye-hand coordination and gross and fine motor dexterity to perform history, physical exam, and clinical laboratory procedures. - Must have normal visual and hearing acuity (with or without correction). Mental demands - Must be able to comprehend, synthesize and retain a large volume of material related to medicine, surgery, and related fields. - Must be able to tolerate long hours of classroom work, lecture, laboratory, clinical experiences, Grand Rounds, self- or group study, etc. - Must be able to accept constructive criticism from core and adjunct faculty and clinical preceptors and respond appropriately. - Must be able to communicate appropriately and effectively in written and spoken English and in medical terminology. - Must be able to participate appropriately in examinations, practical exams, and the like. - Must be able to work appropriately with patients in a compassionate, professional, effective and efficient manner. Working conditions - Must be able to tolerate difficult and stressful environments, including: potential repeated exposure to hazardous substances, including bloodborne pathogens; difficult, demanding patients. - Must be able to work with patients from all cultures, countries, backgrounds, ages, with a variety of medical problems. Performance requirements - Will be able to perform in the following clinical arenas: inpatient units, clinics, private practices, long-term care facilities, Emergency Departments. - Will be able to perform required and relevant invasive and noninvasive procedures (see below). - Will be able to perform at the appropriate level as determined by the faculty. - Will participate in community activities as required. - Will display an ability to work long hours and to complete required clinical examinations. - Will display understanding of the appropriate ethical and medico-legal considerations. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 8 of 206 STUDENTS USED AS INSTRUCTIONAL FACULTY No PA student in either year may serve in the capacity of an instructional faculty member, regardless of the student's previous experience in health care or medicine. Students with specific prior knowledge, experiences and skills may assist faculty in didactic and laboratory sessions to share their experiences and skills. FUNCTIONS AND TASKS OF THE LIU PHYSICIAN ASSISTANT GRADUATE The new graduate will be able to: 1. Take a thorough history and perform a comprehensive physical examination; 2. Order and interpret laboratory, radiologic and other studies needed to formulate a working diagnosis; 3. Perform relevant clinical laboratory procedures as necessary for ongoing care of the patient; 4. Formulate a treatment plan based on history, physical and relevant diagnostic studies obtained; 5. Counsel patients about diagnoses, risk modification and treatment regimens; 6. In the hospital, perform all of the above, and also: conduct patient rounds; order consults; perform consultations; assist at surgery; and other tasks as assigned by the supervising physician; 7. Be an advocate for the patient and the community by performing community outreach and other community services so as to ensure the well-being of the community at large; 8. Continue to be a lifelong learner by attending continuing medical educational activities, reading journals, and the like; 9. Be a culturally competent practitioner. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 9 of 206 COMPETENCIES FOR THE PHYSICIAN ASSISTANT PROFESSION1,2 Preamble In 2003, the National Commission on Certification of Physician Assistants (NCCPA) initiated an effort to define PA competencies in response to similar efforts being conducted within other health care professions and growing demand for accountability and assessment in clinical practice. The following year, representatives from three other national PA organizations, each bringing a unique perspective and valuable insights, joined NCCPA in that effort. Those organizations were the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA), the body that accredits PA educational programs; the Physician Assistant Education Association (PAEA), the membership association for PA educators and program directors; and the American Academy of Physician Assistants (AAPA), the only national membership association representing all PAs. The resultant document, Competencies for the Physician Assistant Profession, is a foundation from which each of those four organizations, other physician assistant organizations, and individual physician assistants themselves can chart a course for advancing the competencies of the PA profession. Introduction The purpose of this document is to communicate to the PA profession and the public a set of competencies that all physician assistants regardless of specialty or setting are expected to acquire and maintain throughout their careers. This document serves as a map for the individual PA, the physician-PA team, and organizations that are committed to promoting the development and maintenance of these professional competencies among physician assistants. The clinical role of PAs includes primary and specialty care in medical and surgical practice settings. Professional competencies for physician assistants include the effective and appropriate application of medical knowledge, interpersonal and communication skills, patient care, professionalism, practice-based learning and improvement, systems-based practice, as well as an unwavering commitment to continual learning and professional growth, and the physician-PA team, for the benefit of patients and the larger community being served. These competencies are demonstrated within the scope of practice, whether medical or surgical, for each individual physician assistant as that scope is defined by the supervising physician and appropriate to the setting. The PA profession defines the specific knowledge, skills, and attitudes required and provides educational experiences as needed in order for physician assistants to acquire and demonstrate these competencies. 1 In 1999, the Accreditation Council for Graduation Medical Education (ACGME) endorsed a list of general competencies for medical residents. NCCPA's Eligibility Committee, with substantial input from representatives of AAPA, PAEA and ARC-PA, has modified the ACGME's list for physician assistant practice, drawing from several other resources, including the work of Drs. Epstein and Hundert; research conducted by AAPA's EVP/CEO, Dr. Steve Crane; and NCCPA's own examination content blueprint. 2 American Academy of Physician Assistants. Competencies for the physician assistant profession. Available at: http://www.aapa.org/policy/competencies.html. Accessed on: July 10, 2007. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 10 of 206 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; Identify signs and symptoms of medical conditions; Select and interpret appropriate diagnostic or lab 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 anatomy, physiology, laboratory findings, and other diagnostic data; Appropriately use history and physical findings and diagnostic studies to formulate a differential diagnosis; and Provide appropriate care to patients with chronic 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 physician 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. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 11 of 206 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 patientcentered 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 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; Accountability to patients, society, and the profession; Commitment to excellence and ongoing 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. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 12 of 206 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 online 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 improve 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; Use information technology to support patient care decisions and patient education; Apply medical information and clinical data systems to provide more effective, efficient patient care; Utilize the systems responsible for the appropriate payment of services. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 13 of 206 ACCREDITATION REVIEW COMMISSION ON EDUCATION FOR THE PHYSICIAN ASSISTANT3 The Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) is the 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 practices and innovation by programs and to stimulate continuous self-study and improvement. In addition to establishing educational standards and fostering excellence in PA programs, the ARC-PA provides information and guidance to individuals and organizations regarding PA program accreditation. The American Academy of Family Physicians, the American Academy of Pediatrics, the American Academy of Physician Assistants, the American College of Physicians, the American College of Surgeons, the American Medical Association, and the Physician Assistant Education Association (formerly the Association of Physician Assistant Programs) all cooperate with the ARC-PA as collaborating organizations to establish, maintain, and promote appropriate standards of quality for entry level education of physician assistants (PAs) and to provide recognition for educational programs that meet the minimum requirements outlined in these Standards. These Standards are to be used for the development, evaluation, and selfanalysis of physician assistant programs. The ARC-PA is recognized by the Council for Higher Education Accreditation (CHEA). The CHEA scope of recognition is for programs preparing individuals for entry-level PA practice located in institutions in the US that are accredited by recognized regional or specialized or professional accrediting bodies. The CHEA scope does not cover the accreditation of clinical postgraduate PA programs. The ARC-PA is also a member of the Association of Specialized and Professional Accreditors (ASPA) and, as such, subscribes to its code of ethics, as posted on the ASPA web site. This web site (www.arc-pa.org) has been designed for use by the general public, currently accredited PA programs, those interested in starting PA programs, students and potential students, and ARC-PA site visitors. The ARC-PA welcomes your comments (webmaster@arcpa.org) about how the site can be more useful. 3 Accreditation Review Commission on Education of the Physician Assistant, Inc. Available at: www.arc-pa.org (Accessed on: July 10, 2007). LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 14 of 206 AMERICAN ACADEMY OF PHYSICIAN ASSISTANTS (AAPA) GUIDELINES FOR ETHICAL CONDUCT FOR THE PHYSICIAN ASSISTANT PROFESSION (ADOPTED MAY 2000) Introduction The physician assistant profession has revised its code of ethics several times since the profession began. Although the fundamental principles underlying the ethical care of patients have not changed, the societal framework in which those principles are applied has. Economic pressures of the health care system, social pressures of church and state, technological advances, and changing patient demographics continually transform the landscape in which PAs practice. Previous codes of the profession were brief lists of tenets for PAs to live by in their professional lives. This document departs from that format by attempting to describe ways in which those tenets apply. Each situation is unique. Individual PAs must use their best judgment in a given situation while considering the preferences of the patient and the supervising physician, clinical information, ethical concepts, and legal obligations. Four main bioethical principles broadly guided the development of these guidelines: autonomy, beneficence, nonmaleficence, and justice. Autonomy, strictly speaking, means self-rule. Patients have the right to make autonomous decisions and choices, and physician assistants should respect these decisions and choices. Beneficence means that PAs should act in the patient’s best interest. In certain cases, respecting the patient’s autonomy and acting in their best interests may be difficult to balance. Nonmaleficence means to do no harm, to impose no unnecessary or unacceptable burden upon the patient. Justice means that patients in similar circumstances should receive similar care. Justice also applies to norms for the fair distribution of resources, risks, and costs. Physician assistants are expected to behave both legally and morally. They should know and understand the laws governing their practice. Likewise, they should understand the ethical responsibilities of being a health care professional. Legal requirements and ethical expectations will not always be in agreement. Generally speaking, the law describes minimum standards of acceptable behavior, and ethical principles delineate the highest moral standards of behavior. When faced with an ethical dilemma, PAs may find the guidance they need in this document. If not, they may wish to seek guidance elsewhere −possibly from a supervising physician, a hospital ethics committee, an ethicist, trusted colleagues, or other AAPA policies. PAs should seek legal counsel when they are concerned about the potential legal consequences of their decisions. The following sections discuss ethical conduct of PAs in their professional interactions with patients, physicians, colleagues, other health professionals, and the public. The "Statement of Values" within this document defines the fundamental values that the PA profession strives to uphold. These values provide the foundation upon which the guidelines rest. The guidelines were written with the understanding that no document can encompass all actual and potential ethical responsibilities, and PAs should not regard them as comprehensive. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 15 of 206 Statement of Values of the Physician Assistant Profession • • • • • • • • • • • Physician assistants hold as their primary responsibility the health, safety, welfare, and dignity of all human beings; Physician assistants uphold the tenets of patient autonomy, beneficence, nonmaleficence, and justice; Physician assistants recognize and promote the value of diversity; Physician assistants treat equally all persons who seek their care; Physician assistants hold in confidence the information shared in the course of practicing medicine; Physician assistants assess their personal capabilities and limitations, striving always to improve their medical practice; Physician assistants actively seek to expand their knowledge and skills, keeping abreast of advances in medicine; Physician assistants work with other members of the health care team to provide compassionate and effective care of patients; Physician assistants use their knowledge and experience to contribute to an improved community; Physician assistants respect their professional relationship with physicians; Physician assistants share and expand knowledge within the profession. CONDUCT FOR THE PHYSICIAN ASSISTANT PROFESSION THE PA AND PATIENT PA Role and Responsibilities Physician assistant practice flows out of a unique relationship that involves the PA, the physician, and the patient. The individual patient–PA relationship is based on mutual respect and an agreement to work together regarding medical care. In addition, PAs practice medicine with physician supervision; therefore, the care that a PA provides is an extension of the care of the supervising physician. The patient–PA relationship is also a patient–PA–physician relationship. The principal value of the physician assistant profession is to respect the health, safety, welfare, and dignity of all human beings. This concept is the foundation of the patient–PA relationship. Physician assistants have an ethical obligation to see that each of their patients receives appropriate care. PAs should be sensitive to the beliefs and expectations of the patient. PAs should recognize that each patient is unique and has an ethical right to self-determination. While PAs are not expected to ignore their own personal values, scientific or ethical standards, or the law, they should not allow their personal beliefs to restrict patient access to care. A PA has an ethical duty to offer each patient the full range of information on relevant options for their health care. If personal moral, religious, or ethical beliefs prevent a PA from offering the full range of treatments available or care the patient desires, the PA has an ethical duty to refer a patient to another qualified provider. That referral should not restrict a patient’s access to care. PAs are obligated to care for patients in emergency situations and to responsibly transfer patients if they cannot care for them. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 16 of 206 Cost Containment Cost containment and resource allocation policies can present particular ethical challenges to clinicians. Physician assistants should always act in the best interests of their patients and as advocates when necessary. PAs should actively resist policies that restrict free exchange of medical information. For example, a PA should not withhold information about treatment options simply because the option is not covered by insurance. PAs should inform patients of financial incentives to limit care, use resources in a fair and efficient way, and avoid arrangements or financial incentives that conflict with the patient’s best interests. THE PA AND DIVERSITY The physician assistant should respect the culture, values, beliefs, and expectations of the patient. Discrimination Physician assistants should not discriminate against classes or categories of patients in the delivery of needed health care. Such classes and categories include gender, color, creed, race, religion, age, ethnic or national origin, political beliefs, nature of illness, disability, socioeconomic status, or sexual orientation. Initiation and Discontinuation of Care In the absence of a preexisting patient–PA relationship, the physician assistant is under no ethical obligation to care for a person unless no other provider is available. A PA is morally bound to provide care in emergency situations and to arrange proper follow-up. PAs should keep in mind that contracts with health insurance plans might define a legal obligation to provide care to certain patients. A physician assistant and supervising physician may discontinue their professional relationship with an established patient as long as proper procedures are followed. The PA and physician should provide the patient with adequate notice, offer to transfer records, and arrange for continuity of are if the patient has an ongoing medical condition. Discontinuation of the professional relationship should be undertaken only after a serious attempt has been made to clarify and understand the expectations and concerns of all involved parties. If the patient decides to terminate the relationship, they are entitled to access appropriate information contained within their medical record. Informed Consent Physician assistants have a duty to protect and foster an individual patient’s free and informed choices. The doctrine of informed consent means that a PA provides adequate information that is comprehendible to a competent patient or patient surrogate. At a minimum, this should include the nature of the medical condition, the objectives of the proposed treatment, treatment options, possible outcomes, and the risks involved. PAs should be committed to the concept of shared decision making, which involves assisting patients in making decisions that account for medical, situational, and personal factors. In caring for adolescents, the PA should understand all of the laws and regulations in his or her jurisdiction that are related to the ability of minors to consent to or refuse health care. Adolescents should be encouraged to involve their families in health care decision making. The PA should also understand consent laws pertaining to emancipated or mature minors (See the section on Confidentiality). LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 17 of 206 When the person giving consent is a patient’s surrogate, a family member, or other legally authorized representative, the PA should take reasonable care to assure that the decisions made are consistent with the patient’s best interests and personal preferences, if known. If the PA believes the surrogate’s choices do not reflect the patient’s wishes or best interests, the PA should work to resolve the conflict. This may require the use of additional resources, such as an ethics committee. Confidentiality Physician assistants should maintain confidentiality. By maintaining confidentiality, PAs respect patient privacy and help to prevent discrimination based on medical conditions. If patients are confident that their privacy is protected, they are more likely to seek medical care and more likely to discuss their problems candidly. In cases of adolescent patients, family support is important but should be balanced with the patient’s need for confidentiality and the PA’s obligation to respect their emerging autonomy. Adolescents may not be of age to make independent decisions about their health, but providers should respect that they soon will be. To the extent they can, PAs should allow these emerging adults to participate as fully as possible in decisions about their care. It is important that PAs be familiar with and understand the laws and regulations in their jurisdictions that relate to the confidentiality rights of adolescent patients (See the section on Informed Consent.) Any communication about a patient conducted in a manner that violates confidentiality is unethical. Because written, electronic, and verbal information may be intercepted or overheard, the PA should always be aware of anyone who might be monitoring communication about a patient. PAs should choose methods of storage and transmission of patient information that minimize the likelihood of data becoming available to unauthorized persons or organizations. Computerized record keeping and electronic data transmission present unique challenges that can make the maintenance of patient confidentiality difficult. PAs should advocate for policies and procedures that secure the confidentiality of patient information. The Patient and the Medical Record Physician assistants have an obligation to keep information in the patient’s medical record confidential. Information should be released only with the written permission of the patient or the patient’s legally authorized representative. Specific exceptions to this general rule may exist (e.g., workers compensation, communicable disease, HIV, knife/gunshot wounds, abuse, and substance abuse). It is important that a PA be familiar with and understands the laws and regulations in his or her jurisdiction that relate to the release of information. For example, stringent legal restrictions on release of genetic test results and mental health records often exist. Both ethically and legally, a patient has certain rights to know the information contained in his or her medical record. While the chart is legally the property of the practice or the institution, the information in the chart is the property of the patient. Most states have laws that provide patients access to their medical records. The PA should know the laws and facilitate patient access to the information. Disclosure A physician assistant should disclose to his or her supervising physician information about errors made in the course of caring for a patient. The supervising physician and PA should disclose the error to the patient if such information is significant to the patient’s interests and well being. Errors do not always constitute improper, negligent, or unethical behavior, but failure to disclose them may. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 18 of 206 Care of Family Members and Co-workers Treating oneself, co-workers, close friends, family members, or students whom the physician assistant supervises or teaches may be unethical or create conflicts of interest. For example, it might be ethically acceptable to treat one’s own child for a case of otitis media but it probably is not acceptable to treat one’s spouse for depression. PAs should be aware that their judgment might be less than objective in cases involving friends, family members, students, and colleagues and that providing “curbside” care might sway the individual from establishing an ongoing relationship with a provider. If it becomes necessary to treat a family member or close associate, a formal patient-provider relationship should be established, and the PA should consider transferring the patient’s care to another provider as soon as it is practical. If a close associate requests care, the PA may wish to assist by helping them find an appropriate provider. There may be exceptions to this guideline, for example, when a PA runs an employee health center or works in occupational medicine. Even in those situations, the PA should be sure they do not provide informal treatment, but provide appropriate medical care in a formally established patient-provider relationship. Genetic Testing Evaluating the risk of disease and performing diagnostic genetic tests raise significant ethical concerns. Physician assistants should be informed about the benefits and risks of genetic tests. Testing should be undertaken only after proper informed consent is obtained. If PAs order or conduct the tests, they should assure that appropriate pre-and post-test counseling is provided. PAs should be sure that patients understands the potential consequences of undergoing genetic tests − from impact on patients themselves, possible implications for other family members, and potential use of the information by insurance companies or others who might have access to the information. Because of the potential for discrimination by insurers, employers, or others, PAs should be particularly aware of the need for confidentiality concerning genetic test results. Reproductive Decision Making Patients have a right to access the full range of reproductive health care services, including fertility treatments, contraception, sterilization, and abortion. Physician assistants have an ethical obligation to provide balanced and unbiased clinical information about reproductive health care. When the PA's personal values conflict with providing full disclosure or providing certain services such as sterilization or abortion, the PA need not become involved in that aspect of the patient's care. By referring the patient to a qualified provider who is willing to discuss all treatment options and perform those services, the PA fulfills their ethical obligation to ensure the patient’s access to all legal options. End of Life Among the ethical principles that are fundamental to providing compassionate care at the end of life, the most essential is recognizing that dying is a personal experience and part of the life cycle. Physician Assistants should provide patients with the opportunity to plan for end of life care. Advance directives, living wills, durable power of attorney, and organ donation should be discussed during routine patient visits. PAs should assure terminally-ill patients that their dignity is a priority and that relief of physical and mental suffering is paramount. PAs should exhibit non-judgmental attitudes and should assure their terminally-ill patients that they will not be abandoned. To the extent possible, patient or surrogate preferences should be honored, using the most appropriate measures consistent with their choices, including alternative and LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 19 of 206 non-traditional treatments. PAs should explain palliative and hospice care and facilitate patient access to those services. End of life care should include assessment and management of psychological, social, and spiritual or religious needs. While respecting patients’ wishes for particular treatments when possible, PAs also must weigh their ethical responsibility, in consultation with supervising physicians, to withhold futile treatments and to help patients understand such medical decisions. PAs should involve the physician in all near-death planning. The PA should only withdraw life support with the supervising physician's agreement and in accordance with the policies of the health care institution. THE PA AND INDIVIDUAL PROFESSIONALISM Conflict of Interest Physician assistants should place service to patients before personal material gain and should avoid undue influence on their clinical judgment. Trust can be undermined by even the appearance of improper influence. Examples of excessive or undue influence on clinical judgment can take several forms. These may include financial incentives, pharmaceutical or other industry gifts, and business arrangements involving referrals. PAs should disclose any actual or potential conflict of interest to their patients. Acceptance of gifts, trips, hospitality, or other items is discouraged. Before accepting a gift or financial arrangement, PAs might consider the guidelines of the Royal College of Physicians, “Would I be willing to have this arrangement generally known?” or of the American College of Physicians, “What would the public or my patients think of this arrangement?” Professional Identity Physician assistants should not misrepresent directly or indirectly, their skills, training, professional credentials, or identity. Physician assistants should uphold the dignity of the PA profession and accept its ethical values. Competency Physician assistants should commit themselves to providing competent medical care and extend to each patient the full measure of their professional ability as dedicated, empathetic health care providers. PAs should also strive to maintain and increase the quality of their health care knowledge, cultural sensitivity, and cultural competence through individual study and continuing education. Sexual Relationships It is unethical for physician assistants to become sexually involved with patients. It also may be unethical for PAs to become sexually involved with former patients or key third parties. Key third parties are individuals who have influence over the patient. These might include spouses or partners, parents, guardians, or surrogates. Such relationships generally are unethical because of the PA’s position of authority and the inherent imbalance of knowledge, expertise, and status. Issues such as dependence, trust, transference, and inequalities of power may lead to increased vulnerability on the part of the current or former patients or key third parties. Gender Discrimination and Sexual Harassment It is unethical for physician assistants to engage in or condone any form of gender discrimination. Gender discrimination is defined as any behavior, action, or policy that adversely affects an individual or group of individuals due to disparate treatment, disparate LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 20 of 206 impact, or the creation of a hostile or intimidating work or learning environment. It is unethical for PAs to engage in or condone any form of sexual harassment. Sexual harassment is defined as unwelcome sexual advances, requests for sexual favors, or other verbal or physical conduct of a sexual nature when: • • • Such conduct has the purpose or effect of interfering with an individual's work or academic performance or creating an intimidating, hostile or offensive work or academic environment; or Accepting or rejecting such conduct affects or may be perceived to affect professional decisions concerning an individual; or Submission to such conduct is made either explicitly or implicitly a term or condition of an individual's training or professional position. THE PA AND OTHER PROFESSIONALS Team Practice Physician assistants should be committed to working collegially with other members of the health care team to assure integrated, well-managed, and effective care of patients. PAs should strive to maintain a spirit of cooperation with other health care professionals, their organizations, and the general public. Illegal and Unethical Conduct Physician assistants should not participate in or conceal any activity that will bring discredit or dishonor to the PA profession. They should report illegal or unethical conduct by health care professionals to the appropriate authorities. Impairment Physician assistants have an ethical responsibility to protect patients and the public by identifying and assisting impaired colleagues. “Impaired” means being unable to practice medicine with reasonable skill and safety because of physical or mental illness, loss of motor skills, or excessive use or abuse of drugs and alcohol. PAs should be able to recognize impairment in physician supervisors, PAs, and other health care providers and should seek assistance from appropriate resources to encourage these individuals to obtain treatment. PA–Physician Relationship Supervision should include ongoing communication between the physician and the physician assistant regarding patient care. The PA should consult the supervising physician whenever it will safeguard or advance the welfare of the patient. This includes seeking assistance in situations of conflict with a patient or another health care professional. Complementary and Alternative Medicine When a patient asks about an alternative therapy, the PA has an ethical obligation to gain a basic understanding of the alternative therapy being considered or being used and how the treatment will affect the patient. If the treatment would harm the patient, the PA should work diligently to dissuade the patient from using it, advise other treatment, and perhaps consider transferring the patient to another provider. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 21 of 206 THE PA AND THE HEALTH CARE SYSTEM Workplace Actions Physician assistants may face difficult personal decisions to withhold medical services when workplace actions (e.g., strikes, sick-outs, slowdowns, etc.) occur. The potential harm to patients should be carefully weighed against the potential improvements to working conditions and, ultimately, patient care that could result. In general, PAs should individually and collectively work to find alternatives to such actions in addressing workplace concerns. PAs as Educators All physician assistants have a responsibility to share knowledge and information with patients, other health professionals, students, and the public. The ethical duty to teach includes effective communication with patients so that they will have the information necessary to participate in their health care and wellness. PAs and Research The most important ethical principle in research is honesty. This includes assuring subjects’ informed consent, following treatment protocols, and accurately reporting findings. Fraud and dishonesty in research should be reported so that the appropriate authorities can take action. Physician assistants involved in research must be aware of potential conflicts of interest. The patient's welfare takes precedence over the desired research outcome. Any conflict of interest should be disclosed. In scientific writing, PAs should report information honestly and accurately. Sources of funding for the research must be included in the published reports. Plagiarism is unethical. Incorporating the words of others, either verbatim or by paraphrasing, without appropriate attribution is unethical and may have legal consequences. When submitting a document for publication, any previous publication of any portion of the document must be fully disclosed. PAs as Expert Witnesses The physician assistant expert witness should testify to what he or she believes to be the truth. The PA’s review of medical facts should be thorough, fair, and impartial. The PA expert witness should be fairly compensated for time spent preparing, appearing, and testifying. The PA should not accept a contingency fee based on the outcome of a case in which testimony is given or derive personal, financial, or professional favor in addition to compensation. THE PA AND SOCIETY Lawfulness Physician assistants have the dual duty to respect the law and to work for positive change to laws that will enhance the health and well being of the community. Executions Physician assistants, as health care professionals, should not participate in executions because to do so would violate the ethical principle of beneficence. Access to Care / Resource Allocation Physician assistants have a responsibility to use health care resources in an appropriate and efficient manner so that all patients have access to needed health care. Resource allocation LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 22 of 206 should be based on societal needs and policies, not the circumstances of an individual patient– PA encounter. PAs participating in policy decisions about resource allocation should consider medical need, cost-effectiveness, efficacy, and equitable distribution of benefits and burdens in society. Community Well Being Physician assistants should work for the health, well being, and the best interest of both the patient and the community. Sometimes there is a dynamic moral tension between the well being of the community in general and the individual patient. Conflict between an individual patient’s best interest and the common good is not always easily resolved. In general, PAs should be committed to upholding and enhancing community values, be aware of the needs of the community, and use the knowledge and experience acquired as professionals to contribute to an improved community. CONCLUSION The American Academy of Physician Assistants recognizes its responsibility to aid the PA profession as it strives to provide high quality, accessible health care. Physician assistants wrote these guidelines for themselves and other physician assistants. The ultimate goal is to honor patients and earn their trust while providing the best and most appropriate care possible. At the same time, PAs must understand their personal values and beliefs and recognize the ways in which those values and beliefs can impact the care they provide.4 4 American Academy of Physician Assistants. Guidelines for ethical conduct for the physician assistant profession. Available at: http://www.aapa.org/policy/23-EthicalConduct.pdf (Accessed on: July 17, 2007). LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 23 of 206 II. ATTENDANCE ISSUES ATTENDANCE IN THE DIVISION OF PHYSICIAN ASSISTANT STUDIES The physician assistant curriculum is by definition intense and rigorous. It is not possible for the student to obtain all the necessary information and knowledge only by attending lectures. However, it is also not possible for the student to gain sufficient knowledge and understanding of the material at hand without attending all classes, practice groups, seminars, clinical rotations, clinical experiences and the like. Your absence in the clinical year may disrupt the activities of the entire clinical team. In the clinical year, you are a real participant in the work of your service. If you are not there, someone else must stay and complete your work or else patient care may well be jeopardized. Clinical year students are required to spend a minimum of 35 hours a week at the clinical site. This is a requirement of the Accreditation Review Commission on Education of the Physician Assistant, Inc. (ARC-PA). There is no maximum amount of time that students may spend at the clinical site. The American Council on Graduate Medical Education (ACGME) sets policies governing work hours of interns and residents, who are employees of the hospital or medical center. These policies do not apply to students. ABSENCE FROM CLINICAL ROTATIONS Each student has five authorized absences for illness only over the entire clinical year. These days are not to be considered: Free days; “Days in the bank”; Personal days. They are available only in the event that you are ill and must miss clinical rotation. After the five days have been exhausted, all other time must be made up. Please note that it is possible to take a leave of absence should your health require you to do so. A note from a medical practitioner is required for any personal illness of two (2) days or more. If you are unable to report to your clinical site for any reason, you are required to call the clinical preceptor before the time you are expected to report to the site. You must also call the Director of Clinical Education of the Division of Physician Assistant Studies at (718) 488-1505 by 9 AM. If the Director of Clinical Education is unavailable, you must speak with some other member of the faculty. You may not leave a message with the Administrative Assistant. You may not contact the preceptor or the faculty via electronic mail, nor may you have another student call on your behalf. Failure to report an absence in the correct manner will mean that the absence will be considered unexcused. UNEXCUSED ABSENCES A student whose absence is considered by the faculty of the Division of Physician Assistant Studies to be either unexcused or unauthorized will be required to make up two days for each day lost from the clinical rotation. Such behavior may also result in other disciplinary measures. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 24 of 206 ABSENCE DUE TO DEATH IN THE FAMILY In the event that you must attend a funeral for a member of your immediate family, you will be granted up to three days absence from clinical rotations. In this case, “immediate family” is defined as: a spouse or partner, children, stepchildren, parents, step-parents, parents-in-law, siblings, grandparents, grandparents-in-law, and grandchildren or step-grandchildren. In the event of such a death, the student must submit the following information to the Director of Clinical Education in writing (electronic mail is acceptable): name of the deceased; name, address, and telephone number of funeral home, church, synagogue, or temple where service is being held; name and telephone number of funeral director or clergyperson officiating at service; funeral date; relationship of the deceased to the student. The student is responsible for notifying both the clinical preceptor and the Director of Clinical Education by telephone in the manner noted above. ABSENCE DUE TO RELIGIOUS OBSERVANCE A student may miss time from the clinical rotation for religious observance of holy days with permission of the Director of Clinical Education and of the clinical preceptor. All time must be made up. In certain circumstances, the Director of Clinical Education may require a note from a clergyperson certifying that the student is known to the clergyperson, and that the particular date is indeed a holy day in the particular religion of the clergyperson and student. ABSENCE DUE TO PERSONAL BUSINESS Students are to make every effort to conduct personal business (medical appointments, work done on one’s home, automobile service, etc.) at a time when the student is not at the clinical site or attending end-of-rotation meetings or other Division-related events at which attendance is mandatory. However, if such an appointment is unavoidable, the student must make arrangements with the Director of Clinical Education. Documentation of the appointment may be required. LEAVES OF ABSENCE Students may apply for leaves of absence due to medical or personal reasons by speaking with the Director of Clinical Education. Depending on the nature of the request, students may need to speak with the Division Director or, in rare cases, with the Dean of the School of Health Professions. Students must complete the PA curriculum no later than twenty two (22) months after beginning the clinical year. Leaves of absence are not automatically granted. A leave will not be granted because of a student’s upcoming wedding. HOLIDAYS AND ACADEMIC CALENDAR The Division of Physician Assistant Studies publishes two separate academic calendars each year for didactic and clinical year students. Students are not expected to attend clinical LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 25 of 206 rotations on holidays or vacation periods noted on the academic calendar. Students may make up time on holidays or vacations when prior arrangements have been made with the clinical preceptor and the Director of Clinical Education. WEATHER-RELATED EMERGENCIES Students should check the LIU website (www.liu.edu) to determine the status of University events and classes in the event of severe weather or other emergencies. Students may also call the LIU main number at (718 )488-1000 to determine if the University is closed. If the University is closed, students are excused from clinical rotations. Students should inform their clinical preceptors by telephone of the reason for the absence by 9 AM on the day of the absence. Students may elect to attend rotations in the event of weather-related emergencies if the student wishes to do so, and if the student can safely travel to the site and to home again. WORK POLICIES In order to maximize the clinical learning environment and to adhere to the Accreditation Review Commission on Education for the Physician Assistant, Inc. (ARC-PA) Accreditation Standards for Physician Assistant Education Guidelines, students must not be used to substitute for regular clinical or administrative staff while on clinical rotations, nor may they be used to accept payment for services rendered in connection with the performance on their rotations. Students must notify the Program office immediately if they are put in such a position, or if they have any questions or other concerns regarding this policy. According to the Standards of the Accreditation Review Commission on Education for the Physician Assistant, Inc. (ARC-PA), students may not be required to work for the Division of Physician Assistant Studies. In addition, any student considering in engaging in gainful employment, or who is already doing so during his or her time in the Program, must make the Program Director aware of his or her employment. The appropriateness of such employment will be reviewed by the Program Director with the student in light of the student’s personal academic history. STUDENT CERTIFICATION Each student must have a valid American Heart Association Basic Life Support for Healthcare Providers card while enrolled in the Division of Physician Assistant Studies. Recertification must be maintained during the complete course of the program and is required for the clinical year. All students are also required to be certified in Advanced Cardiac Life Support (ACLS) to attend clinical rotations. Students are responsible for obtaining such certification. This course may not be offered on the LIU campus. There is an additional fee for the ACLS class to be paid by the student. STUDENT RECORDS In accordance with University policy and the Family Educational Rights and Privacy Act of 1974, the University and Division of Physician Assistant Studies provides students access to their records. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 26 of 206 BACKGROUND CHECKS, CRIMINAL RECORDS AND DRUG TESTING Many of our clinical/field experience affiliates now require the completion of criminal background checks and/or drug testing for employees, volunteers and students affiliated with the site. Therefore, LIU students who will participate in a clinical/field experience may be asked to undergo a criminal background check, and/or a drug screen. A criminal conviction and/or the use of illegal drugs may impede your progress in your chosen field of study. Students desiring to enroll and remain in the School of Health Professions should be aware that our clinical/field affiliates can reject or remove a student from the site if a criminal record is discovered or if a drug test is positive. In the event that a student is rejected from a clinical/field site due to information contained in the criminal background check, or drug screen, you may be unable to complete a required clinical/field experience. If you are unable to complete program requirements, you may be advised to withdraw from the program. If a clinical affiliate requires a background checks and/or drug testing: The student has the responsibility to fulfill the appropriate requirements of the clinical site and absorb all costs associated with these checks if they are not covered by the clinical site. In addition, students seeking to enter into and remain in health and human service professions should be aware that the presence of a criminal record can result in the refusal of licensing/ certification/registration agencies to issue the credential needed to practice in that field of study. Students are urged to contact the pertinent state and/or federal licensing board to inquire whether a criminal record will have an impact on your eligibility to obtain licensure or certification. ADVANCED STANDING The Division of Physician Assistant Studies of Long Island University does not grant advanced placement, give credit for required Medical Science (MS) and Health Science (HS) courses, or accept transfer of credit for Medical Science (MS) or Health Science (HS) courses. Previous experience with direct patient care is required for admission, but no academic credit is granted for such prior experience. TECHNICAL STANDARDS The technical standards for admission developed by the Division of Physician Assistant Studies have been written so as to establish the qualities needed to develop and achieve the levels of competency required of physician assistants. All students are expected to demonstrate competency in the technical standards that appear below. Every student admitted to the Division of Physician Assistant Studies is expected to be able to meet these standards through both years of the curriculum. In the event that the student is unable to meet these standards, the student may be dismissed from the Division of Physician Assistant Studies. Candidates for admission to the Division of Physician Assistant Studies must meet the following Technical Standards: 1. Observation: The ability to observe is required for demonstrations, visual presentations in lectures and laboratories, laboratory evidence and microbiological cultures, microscopic studies of microorganisms and tissues in normal and LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 27 of 206 pathological states. A candidate must be able to observe patients accurately and completely, both closely and from a distance. Observation requires functional vision and somatic sensation and is enhanced by a sense of smell. 2. Communication: A candidate should be able to speak, hear, and observe patients in order to elicit information, perceive non-verbal communications, and describe changes in mood, activity and posture. The candidate must be able to communicate effectively and sensitively with patients including not only through speech but also through reading and writing. Communication in oral and written form with the health care team must be effective and efficient. 3. Motor: A candidate should have sufficient motor function to elicit information from patients by palpation, auscultation and percussion, as well as carry out diagnostic maneuvers. A candidate should have motor function sufficient to execute movements reasonably required to provide general care and emergency treatment to patients. Such skills require coordination of gross and fine muscular movements, equilibrium and sensation. 4. Intellectual-Conceptual, Integrative and Quantitative Abilities: Problem solving is a critical skill demanded of physician assistants; this skill requires all these abilities. The candidate must also be able to comprehend three-dimensional relationships as well as the spatial relationship of structures. 5. Behavioral and Social Attributes: A candidate must have sufficient emotional health to fully use his or her intellectual ability, to exercise good judgment, complete all responsibilities, and attend to the diagnosis and care of patients. A candidate must be able to develop mature, sensitive and effective relationships with patients and colleagues. A candidate must be able to tolerate physical and emotional stress and continue to function effectively. A candidate must possess qualities of adaptability, flexibility and be able to function in the face of uncertainty. He or she must have a high level of compassion for others, motivation to serve, integrity, and a consciousness of social values. A candidate must possess sufficient interpersonal skills to interact positively with people from all levels of society, all ethnic backgrounds, and all belief systems. The faculty of the Division of Physician Assistant Studies recognizes its responsibility to present candidates for the PA certificate who have the knowledge and skills to function in a broad variety of clinical situations and to render a wide spectrum of patient care. The responsibility for these technical standards is primarily placed on the Admissions Committee of the Division of Physician Assistant Studies to select entering PA students who will be the candidates for the PA certificate and degree. NOTIFICATION OF ADVERSE ACTIONS Students are required to inform the Division faculty of any adverse actions that occur while enrolled in the professional phase of the Program, including but not limited to: Suspension or revocation of licenses; Cancellation of malpractice insurance; Arrests and/or misdemeanor/felony convictions, including DUI; Notification of legal action in a malpractice case. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 28 of 206 III. ACADEMIC AND PROFESSIONAL GUIDELINES AND POLICIES FOR CLINICAL YEAR PA STUDENTS Introduction During the clinical year, the student will have the opportunity to demonstrate the knowledge and skills acquired during the didactic year of the curriculum. Students will be assigned to an educational setting, which will promote the development of a greater understanding of the medical environment and patient management skills. The responsibility entrusted to the student is significant. Therefore, commitment to a high level of professionalism, clinical skills and knowledge is an integral part of the student’s obligation to one’s patients, preceptors, faculty, the profession, and oneself. It is believed that medicine, law and the ministry were the first professions recognized as such in Western civilization. These three honored professions still have a great deal in common. Among these commonalities is the commitment to the concept of accountability. Medical professionals are expected to conform to certain behaviors. The physician assistant student in the clinical year is expected to demonstrate such professional behavior. You will find many examples and standards of professional behavior in this handbook. The student is expected to be completely cognizant of these criteria on which he or she will be evaluated. The importance of attendance, punctuality, team participation, motivation for learning, ability to accept criticism, and recognition of personal and professional limitations cannot be stressed enough. At no other time during your professional career are you likely to be exposed to the variety of medical experiences available to you this y0065ar. It is up to you to make the most of this opportunity. PERFORMANCE EXPECTATIONS IN THE CLINICAL YEAR On each clinical rotation, the student will be evaluated by at least one clinical preceptor. The evaluation completed by the preceptor is the basis for the largest component of the student’s grade for the clinical rotation. The clinical evaluation is composed of the following criteria: Fund of Knowledge The student will demonstrate extensive and well-applied knowledge. The student knows the mechanisms of disease, as well as clinical signs and symptoms associated with diseases; the student is able to integrate information into clinical diagnosis. Data Acquisition A. History Skills: The student will gather data in a logical, thorough and reliable manner. The student will establish a broad base of information about the patient. B. Physical Examination: The student will perform a complete and accurate physical exam in a compassionate manner. The student relates clinical findings to altered physiology. The student will establish a complete, prioritized differential diagnosis. Data Interpretation (Problem - Solving): Differential Diagnosis The student will identify the patient’s problems in order of importance. The student will elicit both obvious and subtle findings. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 29 of 206 Development of Diagnostic and Treatment Plans The student will provide appropriate sequence of testing and therapeutic recommendations, considering the patient’s age, gender, lifestyle, genetics, and comorbidities. The student will involve the patient and his or her family in planning. Patient Care and Follow-up The student will seek results of tests, and will communicate results in chart notes; by reporting them to the clinical team, and to the patient and his or her family, if the patient so desires. The student will re-evaluate the plan of management accordingly. The student re-evaluates the patient’s clinical condition. The student will conduct an additional history and physical examination as needed in the process of re-evaluating the patient’s condition and progress Relationship with Patients The student always shows integrity, respect, compassion and empathy to patients. The student will establish trust in his or her relationships with all patients. The student’s primary concern will always be for the patient’s welfare. The student maintains credibility and an excellent rapport with patients and their families; the student respects the patient’s needs for information as well as the patient’s personal preferences. Relationship with Clinical Team The student participates actively in discussions and works with clinical team at all levels. The student has excellent rapport with peers; the student maintains collegiality and demonstrates respect for peers, teachers and the staff. The student will be friendly, trustworthy, and interested in the welfare of the group. Reliability The student will be present and on time for all clinical activities and teaching sessions. The student will prepare materials for presentation. The student will communicate clinical information in a timely fashion. The student readily takes on additional assignments and stays late when extra help is needed for patient care or other tasks. Effort to Learn The student will be self-motivated to acquire knowledge about all aspects of medicine. The student will not limit his or her interest to only specific cases. The student will demonstrate excellent use of available resources, including specialty texts, journals, Medline, and the like. The student will be aware of his or her own strengths and weaknesses. The student will direct his or her own learning agenda. The student is able to think and to work independently. Professionalism and Integrity The student will be responsible, reliable, and committed. The student is respectful and honest in professional situations. The student will maintain high standards for his or her own self and for others. The student establishes trust. The student always demonstrates respect, compassion and empathy for all individuals. The student will readily accept the rights and opinions of others and will do so without judgment or prejudice. The student will respect the privacy and trust of patients. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 30 of 206 ATTENDANCE AND PUNCTUALITY The student will be consistently present and on time. The student will arrive sufficiently early at the clinical site so as to begin work at the scheduled time and place. The student will begin assignments on time and will be willing to stay late to complete assignments, The student will understand that the practice of medicine cannot be limited to particular hours; thus, when patient care needs are such that extra help is required, the student will be willing to remain at the site past the assigned hour. The student will understand that flexibility is an important part of professional behavior in the senior year and in one’s career as a physician assistant. SCORING Each of the attributes listed above is graded on a letter scale, ranging from a score of (D), meaning Unsatisfactory, to a score of five (A), meaning Outstanding. A student who has performed acceptably should receive a score of (C). All attributes are equally weighted. GENERAL POLICY REGARDING PHOTOGRAPHY, COPYING ETC. PA student may not take photographs of items on PA Studies bulletin boards, including: exam and class schedules, posted grades, and any all other materials. PA student may not take photographs of patients, body parts, cadavers, etc. unless directly ordered to do so by an attending physician for use in direct patient care or research, and while under the direct supervision of the attending physician and/or his or her delegate. At no time may any PA student reproduce or copy for his or her own personal use (social networking sites, photo albums, scrapbooks, etc.) any image of a patient, body part or cadaver taken from a clinical site. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 31 of 206 CLINICAL ROTATIONS The clinical year includes ten (10) clinical rotations. Of these, seven (7) are in required disciplines. Each rotation is five (5) weeks in length. Clinical Course Number MS 601 MS 602 Clinical Rotation Internal Medicine Surgery MS 603 Pediatrics MS 604 Family Medicine MS 605 Emergency Medicine MS 606 Obstetrics and Gynecology MS 607 Behavioral Medicine MS 608 Internal Medicine Elective MS 609 Surgical Elective MS 610 Clinical Elective There are many hospitals, outpatient facilities, private practices and long-term care facilities that serve as clinical education sites for the Division of Physician Assistant Studies. The Division faculty reserve the right to assign or remove a student from any clinical site. Students are not required to supply their own preceptor or clinical sites for required clinical rotations. CLINICAL ELECTIVES (MS 608, MS 609, MS 610) There are three (3) clinical elective rotations, Internal Medicine Elective (MS 608), Surgical Elective (MS 609), and Clinical Elective (MS 610), which are required courses. The purpose of the elective rotations is to expand the student’s fund of knowledge and experience in the fields of medicine and surgery while also allowing each student an opportunity to select rotations in areas of special interest to him or her. Specific assignments of elective rotations are based upon approval of the Director of Clinical Education as well as the availability of sites. The Internal Medicine Elective may be taken in general internal medicine or in a specialty of internal medicine, including but not limited to: allergy and immunology, cardiology, critical care, dermatology, endocrinology, geriatrics, hematology, infectious diseases, nephrology, neurology, oncology, pulmonology, psychiatry, radiology, or rheumatology. The Surgical Elective may be taken in general surgery or in a specialty of surgery, including but not limited to: anesthesiology, bariatric surgery, cardiothoracic surgery, neurosurgery, oncological surgery, orthopedic surgery, pathology, plastic and reconstructive surgery, transplant surgery, or trauma and surgical critical care. The Clinical Elective may be taken in any field of medicine or surgery. All electives are subject to approval by the Director of Clinical Education. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 32 of 206 EXTERNAL ROTATIONS In some cases, the student may arrange a clinical elective rotation and/or one of the required core clinical courses or rotations with a private practice, hospital, or long-term care facility with which the Division does not currently have an affiliation agreement. If the student wishes to rotate at an external site, it is the student’s responsibility to: Make contact with a physician (MD or DO) or physician assistant who is willing to serve as the clinical preceptor; Obtain a letter of agreement (not in email) from the prospective clinical preceptor stating his or her willingness and ability to serve as a clinical preceptor, to provide a clinical learning experience which will meet the course objectives, and to abide by the Guidelines and Policies of the Division of Physician Assistant Studies; Provide the Director of Clinical Education with all relevant data so that a clinical contract may be prepared with the practice or institution; To do so well in advance of the expected time of the clinical rotation (e.g., six months in advance). It is also incumbent upon the student and prospective clinical preceptor to assure the Division that: The preceptor is not a relative or a future in-law of the student; The preceptor or facility is not a former employer of the student; The student’s spouse, partner, or future spouse is not employed by the preceptor or the facility. In no case will a student be permitted to spend more than one clinical rotation at an external site. An elective rotation requires that the student have the requisite maturity to function at an appropriate level when away from the University. Therefore, the faculty of the Division of Physician Assistant Studies reserves the right to decline a student’s request for an external rotation. RANGE OF CLINICAL EXPERIENCES Clinical learning experiences may vary from site to site and from student to student. At some sites, the student may be permitted a full range of participation in all patient care activities. At other sites, there may be restrictions imposed on students regarding: access to electronic medical records; laboratory results available on computer; chart documentation; clinical procedures; administration of medication; and required on-call, among others. Restrictions are usually based on institutional protocols, but some preceptors may restrict a student’s activity if the preceptor has reservations about the student’s ability or professional conduct. LEARNING OBJECTIVES It is the professional obligation of the clinical year student to supplement clinical experiences with reading from textbooks and other sources of medical information. By developing a disciplined approach to reading, the student will build upon his or her fund of medical knowledge that will prepare the student for the end-of-rotation exams, for the PA National Certifying Examination (PANCE), and for the rest of the student’s professional life as a physician assistant. The learning objectives are published separately. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 33 of 206 CLINICAL YEAR GRADING POLICIES Each clinical rotation is a course unto itself and each course is graded on the basis of the following components: Course Number MS 601 MS 602 MS 603 MS 604 MS 605 MS 606 MS 607 MS 608 MS 609 MS 610 Clinical / Preceptor Evaluation H&Ps / SOAP Notes Mandatory Mandatory Mandatory Mandatory Mandatory Mandatory Mandatory Mandatory Mandatory Mandatory End-ofRotation Examination Research Paper Each component is weighted as follows: Course Number MS 601 MS 602 MS 603 MS 604 MS 605 MS 606 MS 607 MS 608 MS 609 MS 610 Clinical / Preceptor Evaluation 50% 50% 50% 50% 50% 50% 50% 50% 50% 50% H&Ps/ SOAP Notes Mandatory Mandatory Mandatory Mandatory Mandatory Mandatory Mandatory Mandatory Mandatory Mandatory End-ofRotation Examination 50% 50% 50% 50% 50% 50% 50% 50% 50% Research Paper 50% Each of these components must be satisfactorily completed in order to achieve a passing grade of C for the clinical rotation and thus for the course. If the preceptor evaluation form has not been received by the Director of Clinical Education by the end of the semester, the student will receive a grade of Incomplete. If the evaluation is received after an Incomplete has been placed on the transcript, the new grade will appear with the I (for Incomplete) before it. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 34 of 206 ACADEMIC PERFORMANCE CRITERIA To successfully complete a clinical course and to maintain good academic standing in the clinical year, the student must meet or exceed all of the following criteria. Physician Assistant Student Tracking (PAST) In order to ensure that students have access to a variety of clinical experiences during the clinical year, the Division of Physician Assistant Studies subscribes to the Typhon Group’s Physician Assistant Student Tracking (PAST) system. This system allows students to submit data regarding patient encounters, diagnoses, and other information in a secure, paperless system. Students must enter data within 7 days of the date the patient was seen. If students do not do so, they will be locked out and will forfeit entry of these data. The Typhon Group system is monitored by the Division faculty and staff. Students who do not enter patient data on this system will lose 10 points of the final rotation grade. Students may use personal digital assistants (PDAs), telephones with styluses or a personal computer to enter data. The PAST is provided to students free of charge. Every patient seen by the student must be entered into Typhon for each rotation. Histories and Physicals / SOAP Notes The requisite number of these notes must be entered on Typhon by your last day on rotation. The number and type of required notes varies with each rotation and is specified in the learning objectives for each rotation. The student must submit notes on a computer. In accordance with HIPAA, patient names and medical record numbers must not appear anywhere on H&Ps, SOAP notes, or other documentation submitted to the Division of Physician Assistant Studies. Failure to submit the required number of notes will result in a deduction of 10 points from the final rotation grade. Students will have 10 points deducted from their final grade for not being in compliance with HIPAA standards with regard to H&Ps, SOAP notes, and other documentation. End-of-Rotation Examinations The end-of-rotation examination will cover all material related to the clinical rotation that appears in the learning objectives for the rotation. Sources of exam questions are not revealed to students. A grade of 74 is required to pass the clinical rotation. After all examinations are given, the faculty review the examinations and related statistical scores to determine the accuracy of the examination, to identify any errors and to correct them. Failure to sit for the exam, unless due to extenuating circumstances, will result in a grade of zero (0) and will result in a failure for the rotation. The student taking Clinical Elective (MS 610) will submit a research paper in lieu of taking an end-of-rotation examination. The research paper is discussed in detail below. Policy Regarding Review of Examinations A student may request to review an examination at any time during the semester in which the examination was administered. The Division maintains Scantron and other answer forms until the student has graduated or has separated from the Division. Examinations are shredded immediately after the examination is administered. As a result, a student requesting a review LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 35 of 206 will be provided with a copy of the examination other than that used by the student during the actual test. In all cases, the final arbiter of the grade earned by the student will be the grade obtained from the Scantron or other answer form. Failure of the End-of-Rotation Examination or Research Paper If the student does not pass the examination with a grade of at least 74, the student must sit for a make-up examination to be taken within 14 calendar days from the date of the original examination. If the student passes the make-up examination with a grade of 74 or better, the student will receive a passing grade of 74 for the EOR examination, provided all other course requirements have been met. If the student fails the make-up examination with a grade less than 74, the student will receive a grade of F for the rotation. If the student fails the research paper for Clinical Elective (MS 610), the student will be required to rewrite a research paper. If the student fails the rewritten paper with a grade of less than 74, the student will receive a grade of F for the course. The student who has failed either the make-up examination or the rewritten research paper will need to repeat the entire rotation and all rotation requirements after completing all other coursework in the clinical year. This also means that the student will complete the curriculum at least five weeks after students who have not failed a clinical course. The student will also have to sit for the PANCE later. The student will also need to pay additional tuition for the rotation to be repeated. A student may not take more than one make-up examination for the same rotation. The faculty reserve the right to assign the clinical rotation site to any student who has failed a clinical rotation. Failure of Three (3) End-of-Rotation Examinations A student may not take more than 2 make-up examinations in the clinical year. If a student fails three end-of-rotation examinations, the student is dismissed from the Division of Physician Assistant Studies after completing the deceleration application procedure. A student will be considered for re-application to the clinical year by the faculty if approved. The student will repeat the entire clinical year, beginning with the next class in September. The decelerating student will also be placed on academic probation. Failure of More Than Two (2) Rotations during the Clinical Year Under no circumstances will a clinical year physician assistant student be permitted to continue in the clinical year after having received a failing grade in more than two rotations. If a student has failed more than two rotations, the student must decelerate in the curriculum. This will require the student to repeat the entire clinical year, beginning with the next class in September. The decelerating student will also be placed on academic probation. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 36 of 206 END-OF-ROTATION MEETINGS Students are responsible for attending all end-of-rotation meetings, which are almost always held on the last two days of the rotation. In few instances, the dates may deviate from this pattern in order to accommodate University or national holidays. The purpose of end-of-rotation meetings is to: to administer end-of-rotation written examinations; to conduct case presentations (Clinical Seminar I&II); to hold administrative meetings as needed. In general, the schedule of events for the end-of-rotation meeting follows this pattern: Day One Day Two End-of-rotation examinations Board Review lecture Administrative tasks Case presentations Attendance at End-of-Rotation Meetings Attendance at end-of-rotation meetings is mandatory. Students with an unauthorized absence from end-of-rotation meetings, or a student who leaves an end-of-rotation meeting early without permission will lose 10 points from the end-of-rotation exam or research paper grade. If the score on the examination or research paper is below 74% because of the unexcused absence, the student will be required to take a make-up examination or to rewrite the research paper. The event will be considered a failed end-of-rotation examination. End-of-Rotation Examinations The end-of-rotation examination is held during the end-of-rotation meeting. This exam is administered to all students at the same time, except for those students taking Clinical Elective (MS 610). These students do not need to report for the examination, as there is no exam given for MS 610. Students must submit their research paper during “Administrative Tasks” held on the same day as the examination. Students will be assigned seats for the end-of-rotation examination. Before the exam, students must place all personal belongings in the front or back of the examination room. Students must not have any access during the examination to items including but not limited to: notes of any kind; food or beverages of any kind, including water; personal digital assistants (PDAs) of any type; cellular telephones; recording devices of any kind; watches with any type of function other than timekeeping; notes, formulae, or the like written on articles of clothing, the student’s body, the wall, seat, the desk, etc. If a student completes the examination before time is called, the student is to approach the proctor to submit the examination and answer sheet. The student is then to take his/her seat. The student may not pick up any personal items, nor may the student leave the room, until the LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 37 of 206 examination is concluded. Students are not to engage in any kind of discussion while the exam is in progress. When the examination has ended, the proctor will immediately begin the next task in the end-of-rotation schedule. Failure to comply with examination rules will result in disciplinary action. Case Presentations – Clinical Seminar I &II (MS 611 & MS 612) Students taking MS 601 must create and deliver a case presentation based on the course of a patient seen during the Internal Medicine rotation (MS 601). Students taking MS 602 must create and deliver a case presentation based on the course of a patient seen during the Surgery rotation (MS 602). The presentation is similar to a formal presentation made at Grand Rounds, Morbidity and Mortality, or Tumor Board and must include the entire history, physical exam, diagnostic studies, assessment, plan, and hospital course of the patient. Students are required to use PowerPoint for such presentations and should also incorporate techniques used in the Clinical Problem-Solving component of Research Methodology II: Evidence-Based Medicine (MS 508B) in the didactic year. The presentation should last approximately 30 minutes and not exceed 45 minutes. Students will be expected to cite and to discuss within the presentation one current article related to the case. The article must come from a peerreviewed, nationally recognized medical journal published no more than ten (10) years ago. Students are required to submit a copy of the case presentation and a journal article to the designated faculty member at end-of-rotation. Students should be prepared to send the case presentation and the journal article to a faculty member, if requested, up to one week before the end-of-rotation. Research Papers The research paper is submitted in partial fulfillment of the requirements of Clinical Elective (MS 610). The student is to identify a topic of interest to him or her that is related to the discipline of the clinical elective. The paper MUST NOT BE A REVIEW OF THE LITERATURE regarding a particular topic. The student should also discuss the topic with the clinical preceptor. The Director of Clinical Education, as well as any faculty member, will be pleased to review drafts of research papers if submitted at least two weeks before the paper is due. Research papers are due on the first day of the end-of-rotation meeting. The paper must be submitted to: the Director of Clinical Education. Failure to properly submit the paper in person will result in a failing grade for the paper. Students who are unsure of how to research the chosen topic may also consult the reference librarians of the Long Island University Library. The research paper must be at least 6 double spaced pages. There is no maximum length. Margins must be set equally at one (1) inch in a font equal to or less than 12 point. At least ten references are required which must be dated within the last 10 years. References must be from peer-reviewed journal articles or from standard medical textbooks. Lay materials should not be used as references. Footnotes and bibliographic citations should follow American Medical Association guidelines. These guidelines are available in: Iverson C et al. American Medical Association manual of style, 10 th edition. Philadelphia: Lippincott Williams and Wilkins, 2007. The research paper will be graded by the faculty on the basis of content, clarity as well as the proper use of basic grammar, syntax and spelling. Equal emphasis will be placed on the utilization of appropriate research sources as well as the incorporation of the topic’s relevance LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 38 of 206 to the elective rotation experience. This paper will be worth 50% of the final grade for MS 610. As noted above, a grade of less than 74% is a failing grade. The student receiving less than a 74% on the research paper will be held to the same requirements of a student failing an endof-rotation examination, except there will be no make-up examination offered. Instead, the student will be required to rewrite the research paper. REGARDING PLAGIARISM Plagiarism is defined as “the unauthorized use or close imitation of the language and thoughts of another author and the representation of them as one’s own original work.”5 Plagiarism is considered a form of academic dishonesty, and as such is grounds for punishment up to and including suspension from the Division of Physician Assistant Studies or expulsion from the University. PRECEPTOR EVALUATION The student must receive a satisfactory evaluation from the clinical preceptor. The evaluation standards are discussed in detail on page 29 of these Guidelines and Policies. The student is to hand the evaluation form physically to the preceptor designated by the Division of Physician Assistant Studies on the first day of the clinical rotation. Students may ask for an evaluation from other practitioners with whom the student performed clinical work, with the permission of both the preceptor and the Director of Clinical Education. The preceptor may also ask other clinicians for an evaluation of the student. Ideally, students should review the evaluation form with the preceptor before the last day of the rotation. Students must receive a passing score of 74% on the preceptor evaluation in order to successfully complete the rotation. Each of the attributes in the preceptor evaluation form is weighted equally. If a student receives a failing grade on the preceptor evaluation, the student will receive an F for the course. The student will have to repeat all components of the rotation and will have to pay additional tuition for the rotation. The Director of Clinical Education and the Division Director reserve the right to assign the student to an appropriate clinical site, which may be the original site or a new site. STANDARDS OF PROFESSIONALISM Students must adhere to the standards of professionalism outlined in these Guidelines and Policies in order to complete successfully the course or rotation. Failure to adhere to the Division’s rules and regulations, and all expectations concerning professional behavior, will result in failure of the clinical course or rotation, even if all other components of the academic and clinical performance criteria have been met. Behavior that is deemed unprofessional is grounds for dismissal from the Division of Physician Assistant Studies. Examples of unprofessional behavior include but are not limited to: Failure to comply with program rules and regulations; Failure to accept constructive criticism; 5 Flexner SB et al., editors. The Random House dictionary of the English language, 2 nd edition, unabridged. New York: Random House, 1987, p. 1479. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 39 of 206 Poor attendance; Lateness; Failure to follow protocol, or directions of supervising physician, physician assistant or program faculty; Performing unauthorized procedures or administering services not permitted by the supervisor, the facility, or the Division of Physician Assistant Studies; Lack of cooperation; Violation of the Health Insurance Portability and Accountability Act (HIPAA); Not respecting the rights of patients; Failure to perform all or part of assigned tasks and responsibilities; Leaving the clinical setting without permission of supervising physician or physician assistant; Performing any activity which is beyond the scope of your role as student; Failure to identify yourself as a physician assistant student; Failure to inform a patient, staff member or any other individual who addresses or refers to you as “Doctor” of your identity as a physician assistant student; Failure to report all observed unethical conduct by other members of the health profession, including other students; Associating professionally with those who violate ethical practice; Endangering the health and welfare of any patient. It is rare that a student fails a clinical course or rotation because of academic deficiency. In the majority of cases, students have failed rotations or clinical courses because of unprofessional behavior. The faculty of the Division of Physician Assistant Studies will not permit a student to continue on clinical rotations if the faculty believe that the student represents a threat to patient welfare, or is acting in a manner which is detrimental to patients, to the reputation and integrity of the Division of Physician Assistant Studies, the University, or to the physician assistant profession. In order to assist students in developing proper professional behavior, the faculty of the Division of Physician Assistant Studies at their discretion may bring to your attention areas of deficiency or of particular excellence. To this end, two instruments have been developed. The Breach of Professionalism (BOP) and Professional Accolades and Testimonials (PAT) appear below. Students should make themselves familiar with these instruments. If a student receives a PAT or BOP during the didactic or clinical years, a copy of the relevant form will be placed in the student’s permanent record. The presence of PATs or BOPs will be noted in any letters of reference written on a student’s behalf by members of the faculty. Also, the faculty may take disciplinary action against a student if a number of minor infractions are committed or if a serious infraction of professionalism is committed. FAILURE TO MEET ACADEMIC PERFORMANCE CRITERIA To pass a clinical course or rotation, a student must: Achieve a grade of at least 74% on the written examination or research paper; Achieve a grade of at least 74% on the preceptor evaluation; Achieve a final score of at least 74% for the clinical course or rotation; Maintain acceptable professional behavior while on clinical rotation. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 40 of 206 If the student fails a clinical course or rotation, the student will receive an F for the course. The student will have to repeat all components of the rotation and will have to pay additional tuition for the rotation. The student will complete the curriculum at least five weeks later than scheduled. This may affect employment eligibility, access to board review courses, and other matters. The Director of Clinical Education and the Division Director reserve the right to assign the student to an appropriate clinical site, which may be the original site or a new site. MAINTENANCE OF STUDENT STANDING It is expected that students will fulfill the requirements for the degree by registering over successive semesters, either by attending classes or maintaining matriculation. A degree candidate who does not reregister for classes must apply to his or her Dean for maintenance of matriculation before or during the registration period, if the student wishes to continue under the requirements in effect when admitted. A fee must be paid during the registration period of each inactive semester (excluding summer sessions). GRIEVANCES A student who wishes to appeal a decision rendered by the faculty of the Division of Physician Assistant Studies must follow the procedure of the School of Health Professions and of this Division. This policy is outlined in great detail in Appendix E within this Handbook. Students seeking a grievance must follow this policy exactly. THE PHYSICIAN ASSISTANT CLINICAL KNOWLEDGE RATING AND ASSESSMENT TOOL (PACKRAT) EXAMINATION The Physician Assistant Clinical Knowledge Rating and Assessment Tool – PACKRAT- is an online test that consists of 225 questions in all areas of medicine and surgery. The Division administers at least one (1) PACKRAT exam to clinical year students in order to help students prepare for the Physician Assistant National Certifying Examination (PANCE). This examination/s simulates the national certifying examination and thus helps students prepare for this major undertaking. This exam/s does not serve as part of the Summative Evaluation or of the PANCE Preparation Seminar (Clinical Seminar III). PHYSICIAN ASSISTANT NATIONAL CERTIFYING EXAM (PANCE) PREPARATION COURSE - Clinical Seminar III - ( MS 613) This course will take place at the conclusion of all clinical rotations. The preparation will be based on board review lectures presented via video and in person, and performance will be based on examinations from a variety of sources. If students do not perform well, they will need to remediate this particular course, but will not need to repeat clinical clerkships. There is an additional fee per student for this material. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 41 of 206 GRADES The grading system currently used for clinical year students in the Division of Physician Assistant Studies is as follows: Numerical Grade Letter Grade Equivalent ≥ 93 A 90 - 92.99 A- 87 - 89.99 B+ 83 - 86.99 B 80 - 82.99 B- 77 - 79.99 C+ 74 - 76.99 C SUCCESSFUL COMPLETION OF THE CLINICAL YEAR To complete the clinical year and to graduate from the Long Island University Division of Physician Assistant Studies, the student must meet all of the aforementioned academic performance criteria, maintain standards of professional behavior, and satisfactorily complete the following: All didactic year courses with a grade of at least C; All clinical year courses with a grade of at least C; Maintain a semester GPA of 2.85 or higher and a cumulative GPA of a minimum of 3.0 per academic year. All prerequisite courses required by the Division of Physician Assistant Studies and Long Island University; All financial obligations to the University; All health forms required by the Division of Physician Assistant Studies and the University Health Service; Successful completion of the summative evaluation (Sim-Man scenario and comprehensive examination). The faculty will document successful completion of the Physician Assistant curriculum by completing a Summative Evaluation for each student. SUMMATIVE EVALUATION (MS 614) Within the last four months of the curriculum, all clinical year physician assistant students must demonstrate that he or she has the knowledge, interpersonal skills, patient care skills and professionalism required for entry into the profession. The one is the summative practical examination that utilizes the Simulation Laboratory and Sim-Man3G. A list of potential topics that may be encountered in the practical exam is distributed to students in the second semester of the clinical year. The other is the summative written examination. The summative written examination covers all material presented in the curriculum offered by the Division of Physician Assistant Studies. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 42 of 206 Students are urged to use the NCCPA Blueprint as a study guide. The student must receive a score of 74% or better for each examination in order to pass the course. Students may take up to three attempts to pass each examination. A student who has failed the exam on all three attempts will receive an F for the course and must repeat the course in order to complete the curriculum. MID-ROTATION EVALUATION During the third week of the rotation, the preceptor must complete and submit to the Division a mid-rotation evaluation of the student. This evaluation gives the preceptor and student the opportunity to address any concerns while there is still time for the student to remediate any deficiencies or problems. It also allows the Division to be aware of students who may be having difficulty on rotation. The student is to give the preceptor the mid-rotation evaluation form on the first day of the clinical rotation, and is to remind the preceptor of the need for the midrotation evaluation on the third week of the rotation. The form should be faxed back to the Division by the preceptor. It is the student’s responsibility to ensure that the mid-rotation evaluation is completed during the third week of the rotation. Students are encouraged to maintain an open dialogue with the preceptor in order to promote a positive educational experience. It is important to be aware of one’s areas of weakness and strengths. Students are strongly encouraged to meet with the preceptor at regular intervals. If there are problems that cannot be readily resolved by discussion with the preceptor, the student should notify the Director of Clinical Education without delay. SITE VISITS Site visits are made occasionally through the clinical year. A faculty member of the Division of Physician Assistant Studies will contact the student and preceptor during the clinical rotation, either by visiting the site, by having the student come to the Division offices, or by telephone. Students will be informed of upcoming site visits either by telephone or by electronic mail. It is understood that preceptors may not be available at all times to meet with Division faculty. The purpose of the site visit is to ensure that the student is having an acceptable educational experience. The student will be asked to present a case seen during the clinical rotation. Students are not formally graded on the site visit, though it may present opportunities for constructive criticism and feedback. INADEQUATE SUPERVISION The clinical year PA student is assigned to clinical settings in which adequate and appropriate supervision is available. In the event that the student is asked or expected to perform without adequate or appropriate supervision, the student must politely but firmly decline, and then immediately contact the Director of Clinical Education. In any of the following circumstances, the student must not engage in any patient care activity, and must immediately contact the Director of Clinical Education. There is reason to believe that the procedure may be harmful to the patient; The authorized preceptor or his or her delegate is not on the immediate premises; LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 43 of 206 The student has not received adequate instruction, or is not knowledgeable or proficient enough about the care s/he is asked to deliver; There is no appropriate supervision available at the time the student is expected to carry out the assignment; The student decides that a particular procedure is indicated and decides to perform it himself/herself; The procedure or assigned task is beyond the scope of the role of the physician assistant student. DISMISSAL FROM ROTATION If a student is dismissed from the clinical site, e.g., if the student is asked to leave and not to return, the student will automatically fail the clinical course or rotation. The student will receive a grade of F for the course. The student will have to repeat all components of the rotation and will have to pay additional tuition for the rotation. If the student fails the same rotation twice, the student must decelerate in the curriculum. This will require the student to repeat the entire clinical year, beginning with the next class in August. The decelerating student will also be placed on academic probation. COMMUNICATION DURING THE CLINICAL YEAR The clinical year is a time when students may only see Division faculty members once or twice during the clinical course or rotation. However, there are many reasons why the faculty or staff may need to speak with a student throughout the rotation. Students are expected to read electronic mail messages at least once per day. Students must use only the e-mail address provided by the University (jane.doe@my.liu.edu). Anonymous e-mail will not be accepted by the faculty. Students are also expected to check their e-mail spam folders and other issues that may interfere with receipt of electronic mail. Students are expected to be available via cellular phone or email throughout the clinical day. It is recognized that there are areas of the hospital in which cellular phones are unavailable. However, the student must check his or her voice mail frequently during the day to ensure that there are no messages from the Division. There are numerous clinical facilities or hospital units that will not permit the use of cellular telephones. Additionally, reception may be poor in a number of clinical facilities. Failure to respond appropriately to electronic mail or telephone messages from the faculty will be considered an act of unprofessional behavior. MALPRACTICE INSURANCE Malpractice insurance is provided to students by Long Island University. A certificate of liability is sent to each clinical affiliate each year. Any clinical affiliate has the right to require students to buy individual malpractice insurance policies in addition to the insurance provided by the University. It is the responsibility of the student to determine if a particular site requires the additional insurance policy. If the student does not obtain the additional insurance, the student will be removed from the rotation until the student has an active policy. All students rotating at sites at which additional insurance is required, must provide the Director of Clinical Education with a copy of the policy before beginning the malpractice insurance policy rotation at the site. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 44 of 206 HEALTH INSURANCE All physician assistant students in both the didactic and clinical years are required to carry health insurance. This is a policy of the University. Students are automatically billed for the health insurance by the Bursar. If the student has his or her own health insurance policy, he or she can produce evidence of the policy to the Bursar’s office. If the policy is found to be satisfactory, the cost of the University health insurance policy will be waived. Please contact the Bursar’s office about all such policies and inquiries regarding this matter. STUDENT HEALTH FORMS Students must complete student health forms as required by the University and by the Division of Physician Assistant Studies. The University requires that all students enrolled in clinical courses must have proof of immunity to the following infections by submitting titers and vaccination date (influenza). Test Required by Frequency Measles titer University Once (at entry to curriculum) Mumps titer University Once (at entry) Rubella titer University Once (at entry) Varicella titer University Hepatitis B surface antibody Division Purified protein derivative (PPD) Division Once (at entry) Once after completion of hepatitis B series Yearly Physical examination Division Yearly Influenza Division Yearly Students who do not have the required tests submitted to the Division will not be permitted to engage in clinical experiences. Students who fail to participate in clinical experiences will receive a grade of zero (0) for associated coursework. As it may be difficult to obtain medical appointments, and as clinical laboratory results may take several days to be received, students should be prudent when arranging to complete all health requirements of the Division and University. It is the responsibility of the student to ensure that s/he is in full compliance with the health policies of the Division, the University, and the State of New York. Students who have not met these regulations will not be able to participate in clinical activities. A student will lose credit for clinical assignments if the student is unable to attend due to an incomplete health form. The student may be required to make up the clinical assignment after the health form has been completed. Forms are available from the Division of Physician Assistant Studies. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 45 of 206 INFLUENZA VACCINATION As PA students are exposed to patients throughout the curriculum, it is crucial that they take all the necessary measures to reduce the risk of transmitting illness to patients and to reduce the risk of personal illness. Influenza is responsible for over 30,000 deaths in the United States annually, and the influenza vaccine is 90% effective against this potentially deadly viral illness. To that end, all PA students must provide documentation to the faculty of annual influenza vaccination by November 30 of each year unless the student has: A religious or philosophical conviction that prohibits such vaccination; A history of anaphylaxis with exposure to eggs; A history of Guillain–Barré syndrome. Any such student who meets the criteria above must sign a statement regarding his or her ability to comply with his policy. Students who do not provide documentation of vaccination or who do not provide the contraindication/refusal statement noted above will face disciplinary action. Clinical year students will not be able to attend clinical rotation until vaccination has been documented or until the contraindication/refusal statement has been completed. If a clinical year student has missed time from clinical rotation because of noncompliance with his policy, the student will make up two (2) days for each day missed from rotation. Any student who does not receive the influenza vaccine must wear a facemask whenever assigned to patient care for the duration of influenza season. HEALTH PRACTITIONERS It is a policy of the Accreditation Review Commission on Education of the Physician Assistant, Inc. (ARC-PA) that no member of the core (full-time) faculty may participate as health care providers for students in the program. Additionally, health screening and immunization of students must not be conducted by Program personnel NON-DISCRIMINATION POLICY Long Island University does not discriminate on the basis of sex, sexual orientation, race, color, creed, national origin, religion, age, handicap, or political belief, in any of its educational programs and activities, including employment practices and its policies relating to recruitment and admission of students. Additionally, Long Island University takes affirmative action to recruit applicants from among women, members of protected minority groups, handicapped individuals and veterans, including disabled veterans and Vietnam-era veterans. It is the policy of the School of Health Professions to comply with Title IX of the Education Amendments of 1972, which prohibits discrimination on the basis of sex (including sexual harassment and sexual violence) in the University's educational programs and activities. Title IX also prohibits retaliation for asserting or otherwise participating in claims of sex discrimination. Title IX states that: No person in the United States shall, on the basis of sex, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any education program or activity receiving Federal financial assistance. The University’s Policy on Title IX can be found at: http://www.liu.edu/About/Administration/University-Departments/HumanResources/HR-Policies/Anti-Harassment-Discrimination-Policy LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 46 of 206 PREGNANCY From time to time, female students may become pregnant in the course of their studies. Pregnant students should notify the Director of Clinical Education as soon as possible so that the student may avoid working in potentially hazardous environments. The student should also inform the clinical preceptor of any special needs that might arise. STUDENTS WITH DISABILITIES In accordance with Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990, including changes made by the Americans with Disabilities Amendments Act of 2008, the PA Program does not discriminate against qualified individuals with disabilities. Under the ADA, a person with a disability is defined as one who has any physical or mental impairment that substantially limits any major life activity, has a record of such an impairment (documentation), or is regarded as having such an impairment Request for Reasonable Accommodations If you are a student with a documented disability/impairment (Psychological, Neurological, Chronic Medical, Learning Disability, Sensory, and Physical) and require reasonable accommodations, please contact Student Support Services (SSS): Location: Pratt Building 410 Contact Number: (718) 488-1044 Hours of operation: Monday – Thursday 9-7, & Friday 9-5. Email address: studentsupportservices@brooklyn.liu.edu Website: http://www.liu.edu/Brooklyn/SSS SENIOR AWARDS CEREMONY Each year, the Senior Awards Ceremony is held in November to commemorate the completion of the clinical year, as diplomas are not issued until January. At the Senior Awards Ceremony, the following awards may be presented: The Program Director’s Award, given to the student with the highest grade point average in the curriculum The Stanley Bergen, Jr. Award, given to the senior student with the highest evaluation in clinical work as judged by his or her clinical preceptors The Rudy Bruner Award, given to the student who, in the opinion of the faculty, best demonstrates clinical and academic excellence and consummate professionalism The Peer Award, given to the student who best exemplifies the qualities of the consummate physician assistant in the opinion of his or her peers The Maureen Sullivan Award, given to a student who, in the opinion of the faculty, has done the most for the Division of Physician Assistant Studies The Senior Awards Ceremony is held on the Brooklyn campus. Therefore, on average, each student may invite no more than 4 guests (depending on the venue) to attend the ceremony. A reception is held afterward and light refreshments are served. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 47 of 206 IV. EMERGENCIES, PUBLIC SAFETY, ALCOHOL AND DRUG USE, AND SEXUAL HARASSMENT EXPOSURE TO BLOOD BORNE PATHOGENS It is possible for students to be exposed to hazardous substances, including blood-borne pathogens, in the course of clinical work. If such exposure occurs, students should immediately undertake the following steps: Remove soiled clothing; Wash exposed skin; If eyes were exposed, remove contact lenses and flush eyes for 10-15 minutes; Notify your clinical preceptor immediately; Obtain name and medical record number of patient, if known; Immediately seek care at the appropriate clinical department. During regular business hours, this site is probably the Employee Health Service. After regular business hours, or on weekends, it is probably the Emergency Department. You will be offered testing for HIV and hepatitis C, and may be offered post-exposure prophylaxis depending on the nature of the exposure and the serostatus of the patient. Updated guidelines on post-exposure prophylaxis are available from the Centers for Disease Control and Prevention at: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5011a1.htm. REPORTING INCIDENTS After seeking care for any exposures or other incidents in which the student is involved while on clinical rotation, the student should inform the Director of Clinical Education of the event. The student should obtain copies of all relevant paperwork regarding the exposure and all treatment offered and/or administered to the student and sends them to the Director of Clinical Education. PUBLIC SAFETY No part of our society can be kept completely safe at all times, especially places and institutions that are open to the public. This is particularly true of hospitals and other health care facilities that serve persons who are ill, in pain, in a state of uncertainty or anxiety, or who are suffering from mental illness. Students must recognize the potential for patients to become hostile and even violent. Students will be educated in ways to anticipate and manage a difficult and violent patient during the didactic year. Should the student encounter any type of emergency while on the University campus, the student should immediately contact the Public Safety office by calling 55. The Public Safety office is located on the campus level just east of the campus entrance to the Sloan Wing building, where the Division of Physician Assistant Studies is located. Additionally, public safety officers are stationed at the Flatbush Avenue gate, the DeKalb Avenue gate, and at the Metcalfe Building entrance. While on clinical rotations, students should be certain to learn how to call the Security Department in the event of any type of emergency. In private practices and outpatient facilities, staff may have various codes to report via intercom if a particular emergency occurs. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 48 of 206 POLICY ON DRUG AND ALCOHOL USE ON CAMPUS AND ON ROTATION Students are absolutely forbidden from knowingly using any type of recreational drug or alcohol while on clinical rotation. Attending clinical rotations under the influence of recreational drugs or alcohol is grounds for immediate dismissal from the Division of Physician Assistant Studies. Students may face more severe consequences, such as suspension or expulsion from the University, as well. Students are also held to the regulations of the Long Island University Student Handbook, which is prepared and edited by the Office of Student Activities of the Brooklyn campus. Relevant portions of the regulations regarding alcohol use on campus appear below. The consumption of alcoholic beverages is not permitted on campus property except in areas or at functions approved by the Dean of Students or designee. No open containers of alcoholic beverages are permitted in public areas with the exception of approved locations and/or functions. No persons under 21 years of age may acquire, possess, and/or consume any alcoholic beverage on the campus. Alcoholic beverages will not be served at any student function except with the approval of the Dean of Students or designee. Outside organizations or groups using campus facilities must secure permission to serve alcoholic beverages from the Office of Student Activities and the Special Events Coordinator. Arrangements for the serving of alcoholic beverages must be made through the above offices. Failure to comply with any provision of the Alcohol Policy and Regulations will constitute a violation of campus regulations. Individuals or organizations that violate the alcohol policies will be subject to appropriate disciplinary action including possible suspension from the Campus.6 SEXUAL HARASSMENT It is the policy of Long Island University to promote a cooperative work and academic environment in which there exists mutual respect for all University students, faculty and staff. Sexual harassment is inconsistent with this objective and contrary to the University policy of equal employment and academic opportunity without regard to age, sex, sexual orientation, alienage or citizenship, race, religion, color, national or ethnic origin, disability, and veteran status. Sexual harassment is illegal under Federal, State and City laws, and will not be tolerated within the University. It is a violation of University policy for any member of the University community to engage in sexual harassment or to retaliate against any member of the University community for raising an allegation of sexual harassment, for filing a complaint alleging sexual harassment, or for participating in any proceeding to determine if sexual harassment has occurred. Definition: For purposes of this policy, sexual harassment is defined as unwelcome sexual advances, requests for sexual favors, and other oral or written communications or physical conduct of a sexual nature when: 1. submission to such conduct is made either explicitly or implicitly a term or condition of any individual’s employment or academic standing; 6 Long Island University. Office of Student Activities. Long Island University student handbook, 2006-2007. Lafayette, IN: School Datebooks, 2006, pp. 37-38. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 49 of 206 2. submission to or rejection of such conduct by an individual is used as a basis for employment or academic decisions affecting such individual; OR 3. such conduct has the purpose or effect of unreasonably interfering with an individual’s work or academic performance or creating an intimidating, hostile or abusive work or academic environment. Examples: Examples of sexual harassment include, but are not limited to, the following: requesting or demanding factors in exchange for employment or academic opportunities (such as hiring, promotions, grades or recommendations); submitting unfair or inaccurate job or academic evaluations or grades, or denying training, or academic opportunity, because sexual advances have been rejected; sexual comments, teasing or jokes; sexual slurs, demeaning epithets, derogatory statements, or other verbal abuse; graphic or sexually suggestive comments about an individual’s attire or body; inquiries or discussions about sexual activities; pressure to accept social invitations, to meet privately, to date, or to have sexual relations; sexually suggestive letters or other written materials; sexual touching, brushing up against another in a sexual manner, graphic or sexually suggestive gestures, cornering, pinching, grabbing, kissing or fondling; coerced sexual intercourse or sexual assault. It is the policy of the School of Health Professions to comply with Title IX of the Education Amendments of 1972, which prohibits discrimination on the basis of sex (including sexual harassment and sexual violence) in the University's educational programs and activities. Title IX also prohibits retaliation for asserting or otherwise participating in claims of sex discrimination. Title IX states that: No person in the United States shall, on the basis of sex, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any education program or activity receiving Federal financial assistance. The University’s Policy on Title IX can be found at: http://www.liu.edu/About/Administration/University-Departments/HumanResources/HR-Policies/Anti-Harassment-Discrimination-Policy CONSENSUAL RELATIONSHIPS Amorous, dating, or sexual relationships that might be appropriate in other circumstances have inherent dangers when they occur between a faculty member, community and any person for whom she or he has a professional responsibility. These dangers can include: ● ● that a student or employee may feel coerced into an unwanted relationship because he or she fears the refusal to enter into the relationship will adversely affect his or her education or employment; that conflicts of interest may arise when a faculty member, supervisor, or other member of the University community is required to evaluate the work or make personnel or LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 50 of 206 ● ● academic decisions with respect to an individual with whom he or she is having a romantic relationship; that students or employees may perceive that a fellow student or co-worker who is involved in a romantic relationship may have received an unfair advantage; and that if the relationship ends in a way that is not amicable, either or both of the parties may wish to take action to injure the other party. Faculty members, supervisors and other members of the University community who have professional responsibility for other individuals, accordingly, should be aware that any romantic or sexual involvement with a student or employee for whom they have such a responsibility may raise questions as to the mutuality of the relationship and may lead to charge of sexual harassment. For the reasons stated above, such relationships are not permitted. ACADEMIC FREEDOM This policy shall not be interpreted so as to constitute interference with academic freedom. FALSE AND MALICIOUS ACCUSATIONS Members of the University community who make false and malicious complaints of sexual harassment, as opposed to complaints, which, even if erroneous, are made in good faith, will be subject to disciplinary action. PROCEDURES The University has developed procedures to implement this policy. The Provost of each residential campus or the chief operating officer of each nonresidential campus has ultimate responsibility for overseeing compliance with this policy. In addition, each dean, director, department chairperson, administrator, or other person with supervisory responsibility is required to report any complaint of sexual harassment to an individual or individuals to be designated in the procedures. All members of the University community are required to cooperate in any investigation of a sexual harassment complaint. Please be advised that if any employee fails to report any incident of a sexual harassment and/or refuses to participate in the investigation, said employee may effectively waive and/or forfeit any available remedies at law. INVESTIGATION The representative/investigator will schedule a meeting with the person making the complaint. Thereafter, the University will thoroughly investigate the complaint, which will include an interview with the alleged harasser and any potential witnesses. Upon completion of the investigation, the person making the complaint will be contacted and advised of the outcome of the investigation. The University will conduct the investigation as expeditiously as possible given the nature of the academic calendar that includes summer vacation and intersession periods. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 51 of 206 ENFORCEMENT There is a range of corrective and penalties available to the University for the violations of this policy. Employees who are found to have violated this policy are subject to various penalties, up to and including termination of employment. All such disciplinary actions will be subject to the provisions of the relevant collective bargaining agreement, if applicable. CAMPUS CONTACT PERSONS Complaints may be filed with the Campus Provost or Chief Operating Officer or a Dean. In addition, the University has retained Prefix to accept sexual harassment complaints 24 hours a day, seven days a week by calling (888)LIU-5559.7 7 Long Island University. Office of Student Activities. Long Island University student handbook, 2006-2007. Lafayette, IN: School Datebooks, 2006, pp. 33-35. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 52 of 206 V. PROFESSIONALISM PROFESSIONAL DRESS AND APPEARANCE Students should wear clothing that is deemed suitable for those in a professional capacity. If particular attire interferes with the policies of the Division of Physician Assistant Studies but is required for religious observance, the student should speak with the Director of Clinical Education. Attire For women: Pants or skirt and blouse, or dress Stockings or socks Shoes with heel less than 2” Short white uniform jacket For men: Slacks Dress shirt with tie Shoes and socks Short white uniform jacket Unacceptable clothing includes: Failure to wear short white uniform jacket at all times Low cut, revealing blouses for women Sandals Short skirts (more than 2” above the knee) Stirrup pants or leggings T-shirts, sweatshirts or sweatpants Any clothing made of denim Clothing that exposes the mid-abdomen Clothing that is soiled, in poor repair, or not well maintained Students may wear scrubs only while on the following experiences: On Surgery rotation On Labor and Delivery or Gynecology On call On North Shore - Long Island Jewish Hospital rotations. Students may wear sneakers only while wearing scrubs as listed above. Students may not wear scrubs while outside the hospital, or while traveling to or from the hospital. Hair Hair must be pulled back away from the face if it is longer than shoulder length. This regulation is to avoid contamination or interference during medical procedures. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 53 of 206 Fingernails Fingernails must be less than ¼“ long. Nail polish should not be worn while on Surgery or Obstetrics and Gynecology rotations. During other rotations, if nail polish must be worn, it should be kept neat. No artificial nails, wraps, multicolored or designer nail polish or paintings are permitted. Fragrances Some patients may be particularly sensitive to fragrances when ill. Students should be sensitive to the needs of patients and should avoid wearing fragrances, or at least should use fragrances sparingly. Tattoos and Piercings One earring in each ear is permitted. All tattoos should be concealed. Other body piercings should not be worn during rotations. Jewelry Students may wear two rings per hand and two neck chains, as long as the chains are worn within clothing. Bracelets are not permitted on clinical rotations. Each student should wear a watch with a second hand. Pins are not permitted except for purposes of identification. Students should avoid wearing insignia, buttons or decals of a political nature while on clinical rotation. Protective Eyewear Students should carry protective goggles on rotation. These are available in the hospital. Students must apply standard precautions on all clinical experiences, including wearing face shields or goggles if a splash is likely to occur. Students who wear corrective glasses may wear face shields or goggles in the Operating Room, or alternatively may have protective sidepieces placed on their glasses by their opticians. Identification Badges While on the LIU campus, students should carry their identification cards; they are required for entry onto the campus. Students may be issued identification cards at various clinical sites. When these are issued, students should wear them prominently. LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 54 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES BREACHES OF PROFESSIONALISM FORM Student Name: ________________________________ Class of: ___________ Date: __________ Faculty Member: _________________________________________________________________ The student exhibited one or more of the following behaviors requiring improvement (circle all that apply): Reliability and Responsibility Self-Improvement and Adaptability Relationships with Peers, Supervisors and Patients Upholding Precepts of Integrity and Honesty Student does not complete tasks in a timely manner Student resists constructive comments Student has insensitive rapport with patients and families Student is dishonest Needs continual reminders in order to fulfill responsibilities Student remains unaware of inadequacies Student is insensitive to individual or family needs Student does not contribute to a good learning environment Student cannot be relied upon to complete tasks Student lacks respect for peers or faculty Student uses his/her position to engage in inappropriate relationships Student shows insensitivity to cultural concerns, race, gender, religion, age, sexual orientation, disability or socioeconomic status Student misrepresents or falsifies information Student does not accept responsibility for errors Student lacks empathy Student does not maintain patient confidentiality Student is abusive, angry or overly critical Student demonstrates inadequate commitment to honoring the wishes of a patient or family member Student is arrogant Student does not function as a team member Student does not present himself or herself in a professional manner by dress or demeanor Student communicates inappropriately verbally or in writing Student does not relate well to staff or faculty in the learning environment Explain the specific problem that requires improvement: Define the plan for remediation: LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 55 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES PROFESSIONAL ACCOLADES AND TESTIMONIALS FORM Student Name: ______________________________ Class of: ____________ Date: ___________ Faculty Member: _________________________________________________________________ The student exhibited one or more of the following behaviors that are to be commended (circle all that apply): Reliability and Responsibility Self-Improvement and Adaptability Relationships with Peers, Supervisors and Patients Upholding Precepts of Integrity and Honesty Student consistently completes tasks in a timely manner Student can be relied upon consistently to exceed expectations Student seeks and incorporates constructive comments Student has outstanding rapport with patients and families Student is honest and shows great integrity Student recognizes difficulties and makes efforts toward self-improvement Student is remarkably sensitive to individual or family needs Student is an integral part of a good learning environment Student demonstrates exceeding respect for faculty and peers Student demonstrates great empathy Student shows unusual sensitivity to cultural concerns, race, gender, religion, age, sexual orientation, disability or socioeconomic status Student recognizes and accepts responsibility for errors and mistakes and makes a great effort to correct them Student demonstrates an unusually strong commitment to honoring the wishes of a patient or family member Student is able to resolve conflict unusually well Student functions as an invaluable team member Student demonstrates exceptional communication skills in writing or verbally Explain the specific problem that is deserving of special recognition: LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 56 of 206 VI. APPENDICES Appendix A: Clinical Rotation Schedule Appendix B: Clinical Rotation Affiliations/Sites Appendix C: Where to Report on the First Day of Rotation Appendix D: Directions to Clinical Affiliations/Sites Appendix E: Clinical Year Grievance Procedure Appendix F: Clinical Evaluation Form Appendix G: Clinical Year Course Syllabi Appendix I: Clinical Year Course Objectives LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 57 of 206 Appendix A: DIVISION OF PHYSICIAN ASSISTANT STUDIES SENIOR PHYSICIAN ASSISTANT STUDENT CLINICAL ROTATION SCHEDULE 2014 - 2015 ROTATION# ROTATION DATES END-OF-ROTATION MEETINGS #1 September 8 - October 8, 2014 October 9 - 10, 2014 #2 October 13 - November 12, 2014 November 13 - 14, 2014 #3 November 17 - December 17, 2014 December 18 - 19, 2014 Thanksgiving Day – November 27, 2014 VACATION: #4 #5 DECEMBER 22, 2014 - JANUARY 4, 2015 January 5 - February 4, 2015 February 5 - 6, 2015 February 9 - March 10, 2015 March 11 - 13, 2015 President’s Day: February 16, 2015 #6 March 16 - April 15, 2015 April 16 - 17, 2015 #7 April 20 - May 19, 2015 May 20 - 22, 2015 VACATION: MAY 25 – May 31, 2015 #8 June 1 – June 30, 2015 July 1 - 2, 2015 Independence Day: July 3, 2015 #9 July 6 - August 4, 2015 August 5 - 7, 2015 # 10 August 10 - September 9, 2015 September 9 - 11, 2015 Labor Day: September 7, 2015 Appendix B: LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 58 of 206 CLINICAL ROTATION AFFILIATIONS/SITES 2014 - 2015 MS 601 - Internal Medicine MS 603 - Pediatrics Bellevue Hospital 462 First Avenue New York, NY 10016 Brooklyn Hospital Center, The 121 DeKalb Avenue Brooklyn, NY 11201 Brooklyn Hospital Center, The 121 DeKalb Avenue Brooklyn, NY 11201 Coney Island Hospital 2601 Ocean Pkwy Brooklyn, NY 11235 Coney Island Hospital 2601 Ocean Pkwy Brooklyn, NY 11235 Preferred Health Partners 233 Nostrand Avenue Brooklyn, NY 11205 Long Island Jewish Medical Center 270-05 76th Avenue New Hyde Park, NY 11040 MS 604 - Family Medicine Maimonides Medical Center 4802 10th Avenue Brooklyn, NY 11219 St. Luke’s - Roosevelt Hospital Center Roosevelt Hospital 1000 10th Avenue (at 59th St.) New York, NY 10019 Brooklyn Hospital Center, The 121 DeKalb Avenue Brooklyn, NY 11201 Preferred Health Partners Flatbush Center 1000 Church Avenue Brooklyn, NY 11218 MS 602 - Surgery Schiowitz, Emanuel, M.D. 1701 59th Street Brooklyn, NY 11204 Bellevue Hospital 462 First Avenue New York, NY 10016 Weiner, Robert, M.D. 2352 Ralph Avenue (Between Avenue M & N) Brooklyn, NY 11234 Beth Israel Medical Center First Avenue, East 16th Street New York, NY 10003 MS 605 - Emergency Medicine Brooklyn Hospital Center, The 121 DeKalb Avenue Brooklyn, NY 11201 Coney Island Hospital 2601 Ocean Pkwy Brooklyn, NY 11235 Kingsbrook Jewish Medical Center 585 Schenectady Avenue Brooklyn, NY 11203 Long Island Jewish Medical Center 270-05 76th Avenue New Hyde Park, NY 11040 Brooklyn Hospital Center, The 121 DeKalb Avenue Brooklyn, NY 11201 Coney Island Hospital 2601 Ocean Pkwy Brooklyn, NY 11235 Maimonides Medical Center 4802 10th Avenue Brooklyn, NY 11219 New York-Presbyterian/Lower Manhattan Hospital 170 William Street New York, NY 10038 LIU - Division of Physician Assistant Studies Clinical Year Handbook 2014-2015 Page 59 of 206 MS 606 – Obstetrics & Gynecology Bellevue Hospital 462 First Avenue New York, NY 10016 Brooklyn Hospital Center, The 121 DeKalb Avenue Brooklyn, NY 11201 Coney Island Hospital 2601 Ocean Pkwy Brooklyn, NY 11235 Eastchester Medical Associates 2426 Eastchester Rd., Ste. 208 Bronx, New York 10469 Lutheran Medical Center 150 55th Street Brooklyn, NY 11220 MS 607 - Behavioral Medicine Bellevue Hospital 462 First Avenue New York, NY 10016 Beth Israel Medical Center First Avenue, East 16th Street New York, NY 10003 Coney Island Hospital 2601 Ocean Pkwy Brooklyn, NY 11235 Manhattan VA Hospital 423 East 23rd Street New York, NY 10010 MS 608/MS 609/MS 610 - Internal-, Surgical-, Clinical Elective Bay Ridge Skin & Cancer Dermatology 9921 4th Avenue, Brooklyn, NY 11209 Bellevue Hospital (Acute Care/Trauma & Breast/Plastic & Surgery) 462 First Avenue New York, NY 10016 Brooklyn Hospital Center, The (Cardiology & Neurosurgery & Infectious Diseases) 121 DeKalb Avenue Brooklyn, NY 11201 Hospital for Joint Diseases (Orthopedics) 301 East 17th Street, # 322 New York, NY 10003-3899 Island Cardiac Specialists 1401 Franklin Avenue Garden City, NY 11530 Long Island Jewish Medical Center (SICU) 270-05 76th Avenue New Hyde Park, NY 11040 Memorial Sloan-Kettering Cancer Center (Medical & Surgical Oncology) 1275 York Avenue New York, NY 10065 New York-Presbyterian/Lower Manhattan Hospital (Orthopedics) 170 William Street New York, NY 10038 Office of Chief Medical Examiner Kings County Hospital Center 599 Winthrop Street Brooklyn, New York 11203 & Queens General Hospital 160-15 82nd Drive Jamaica, New York 11432 Parker Jewish Institute for Health Care & Rehabilitation (Geriatrics) 271-11 76th Avenue New Hyde Park, NY 11040-1433 St. Luke’s-Roosevelt Hospital (Orthopedics) Roosevelt Hospital 1000 10th Avenue (at 59th St.) New York, NY 10019 St. Luke’s-Roosevelt Hospital (Geriatrics) 1111 Amsterdam Avenue New York, NY 10025 LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 60 of 206 Appendix C: WHERE TO REPORT ON THE FIRST DAY OF ROTATION 2014 - 2015 Bay Ridge Skin & Cancer Dermatology (718) 833 - 7617 Dermatology Grace Cutugno-LaSelva, PA-C (glaselva@aol.com) Bellevue Hospital (212) 562-1000 Behavioral Medicine: (212) 263-4626 Terrence A. Leingang, M.D. Maridza Molina (Admin. Asst.) 18 East Conference Room 9:00 am Internal Medicine: vccmorais@gmail.com Michael Janjigian, M.D. Vanessa Morais, PA-C / Fariha Asef, PA-C 17North 22B 10:00 am OB/GYN: (212) 263-3897 Kim Thien Lam, M.D. Nessa Ryan (Admin. Asst.) Room: 9 East2 9:30 am Surgery: Kenneth M. Rifkind, M.D. Fayrose Abodeshisha, PA-C Anita Llyod (Admin. Asst.) Linda Paray, PA-C (Trauma) Room: 15 S5 (NBV15N1) (212) 562-3917 8:00 am Beth Israel Medical Center (212) 420-2000 - 4262 & Page Operator Behavioral Medicine: Ext. 2788: Morris J. Bernstein Pavilion (9th floor) Elaine Earlington, PA-C / Harold Chisholm, PA-C 11:00 am Report to Security & ask them to page Elaine Earlington, PA-C Surgery: (212) 420 4116 (212) 844 1308 Scott Gould, PA-C Burton Surick, M.D. OR Adnan Isa, PA / Shirley Hewlett, PA 10 Silver Building LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 6:00 am Page 61 of 206 WHERE TO REPORT ON THE FIRST DAY OF ROTATION 2014 - 2015 Brooklyn Hospital Center, The (718) 250-8000 Emergency Med.: Ext. 8075: Ext. 8369: Michael Hochberg, M.D. / Anton Wray, M.D. Yolanda Hayes Report to office Friday before 9th Fl. Maynard Bldg., #9C rotation begins for schedule Family Medicine: Ext. 8819: Vasantha Kondamudi, M.D. Maynard Bldg., 1st Fl. / Preceptor Room Dahlia Davidson (admin. Asst.) 9:00 am Kenneth Ong, M.D. / Ahmar Butt, M.D. Madeline Betances (Admin. Asst.) 7W 8:15 am Ext. 8817 Internal Medicine: OB/GYN:: Ext. 6925: Ext. 8830 Ext. 8318: Ext. 6930: (718) 616 -3257 Michael Cabbad, M.D. 10:00 am See Edith Olmeda in Dr. Cabbad’s office Janet Wenger (Student Coordinator) janet.wenger@nychhc.org Maynard Bldg., 3rd Fl. Pediatrics: Ext. 6857: Bpr. # 2608: Lewis Krata, M.D.(Children’s Health Center) NICU Conference Room, 5th Fl. Surgery: Ext. 6088: Asarian Armand, M.D. Student Coordinator See Marina for schedule Maynard Bldg., 8th Fl., Rm. #8C 8:00 am (lecture) 8:45 am (to report) Report to office Friday before rotation begins for schedule Coney Island Hospital (718) 616-3000 Behavioral Medicine: Sophya Kagan, M.D. (718) 616-3793 Report to Liz D’Amato, Room 4N98 (4th Fl., Main Bldg) Emergeny Medicine: Regina Hammock, M.D. (718) 616-3793 Report to Liz D’Amato, Room 4N98 (4th Fl., Main Bldg) Internal Medicine: Celestine Ishiekwene, M.D. 4th Fl. (718) 616-3793 Report to Liz D’Amato, Room 4N98 (4th Fl., Main Bldg) OB/GYN: (718) 616-3793 8:30 am 8:30 am 8:30 am Uchenna Nwobu, M.D. 8th Fl. Report to Liz D’Amato, Room 4N98 (4th Fl., Main Bldg) 8:30 am Pediatrics: Warren Seigel, M.D. (718) 616-3793 9th Fl. Report to the Pediatric Department, Room 901 (Main Bldg) at 8:00 am sharp for Orientation. Then, see Liz D’Amato, Room 4N98 (Main Bldg) at 8:30 am Surgery: (718) 616-3440 (718) 616-3793 Edita Babayev, PA-C 7th Fl. Report to Liz D’Amato, Room 4N98 (4th Fl., Main Bldg) LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 8:30 am Page 62 of 206 WHERE TO REPORT ON THE FIRST DAY OF ROTATION 2014 - 2015 Eastchester Medical Associates (718) 708 – 5650 OB/GYN: Nereida Correa, M.D. (eastchestermds@gmail.com) 10:00 am Adrian Dominguez (Admin. Asst.) Hospital for Joint Diseases (212) 598-6000 - Page Operator Orthopedics: Noel Henry, RPA-C Report to C-1 7:00 am Kingsbrook Jewish Medical Center (718) 604-5422 Surgery: William Lois, M.D. Katz Building, 4th Fl., Surgery office 8:30 am Long Island Jewish Medical Center (718) 470-7000 (718) 470-7700 (page) Medicine: Bpr.# 6745: Michael Cheng, PA-C Report to Dept. of Medicine 8:00 am Surgery: Bpr.# 3935 Matthew L. Shebes, RPA-C & Elissa Wolff, PA-C 2nd Fl., Dept. of Surgery 7:00 am Lutheran Medical Center (718) 630-7000 OB/GYN Ext. 7095 Meera Kesavan, M.D. (mkesavan@lmcmc.com) Ext. 7368 Diana Calderon Main Building - 3rd Fl. Executive Ste -Station 3-03- Room# 35-24 LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 8:45 am Page 63 of 206 WHERE TO REPORT ON THE FIRST DAY OF ROTATION 2014 - 2015 Maimonides Medical Center (718) 283-6000 Emergency Med.: Ext. 6295: Peter Kolb, PA-C Ground Floor Emergency Room Internal Medicine: Ext. 8506: Ext. 8137: Ignazio Dimino, PA-C 9:00 am Cathy Albanese 3rd Fl., Dept. of Medicine (Administration Building) 9:00 am Manhattan Veterans Affairs Hospital (212) 686-7500 Behavioral Medicine: Ext. 3787: David Wiley, M.D. / Phoebus Dhrymes, M.D. Karen Roe (Admin. Asst.) 17 South 9:00 am New York – Presbyterian /Lower Manhattan Hospital (212) 312 - 5000 or -5070 Emergency Medicine: Dwayne Williams, PA-C Orthopedics Heather Hensl, PA-C/Alyse Wayne, PA-C Kathy Leahy (Admin. Asst.) Orthopedic Inpatient Floor, 5C Call ahead for time to report 6:15 am Office of Chief Medical Examiner (718) 239 – 8426 Pathology Dennis Cavalli, Assistant Deputy Director of Investigation (dcavalli@ocme.nyc.gov) Parker Jewish Institute for Health Care & Rehabilitation (718) 289-2100 Geriatrics: Ext. 2281: Igor Israel, M.D. Report to Medicine Office, 2nd Fl. Mary Legg (Office Manager) / Cathy Sciacca LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 9:00 am Page 64 of 206 WHERE TO REPORT ON THE FIRST DAY OF ROTATION 2014 - 2015 Preferred Health Partners Family Medicine: 1000 Church Avenue Brooklyn, NY 11218 (718) 826 - 4000 Pediatrics: 233 Nostrand Avenue Brooklyn, NY 11205 (718) 826 - 5900 Ext# 5967 Ext# 5910 Noor Rajpar, MD & Randolph Mapp, MD Donna Taylor, Administrator 9:00 am Nissim Bassoul, MD Report to 1st Fl. - Administration 9:00 am Schiowitz, Emanuel M.D. (718) 259-0222 Family Medicine: Emanuel Schiowitz, M.D. 12:30 pm (Monday) St. Luke’s-Roosevelt Hospital Center (212) 523-4000 St. Luke’s Hospital 1111 Amsterdam Avenue 440 West 114th Street New York, NY 10025 Geriatrics: Ext. 5918: Roosevelt Hospital 1000 10th Ave. (at 59th St.) New York, NY 10019 Howard Arabelo, M.D. Jose Cabral, Secretary St. Luke's Hospital, Clark Bldg. 7th Fl., Room# 5732 Email jcabral@chpnet.org for time to report Internal Medicine: (212) 523-7333 Nicole Sevransky, PA-C Sheryl/Brucy, Secretaries Roosevelt Hospital Dept. of Medicine, 3rd Fl. 11:00 am Orthopedics: 212-523-2515 Danielle Kaufman, PA-C 7:00 am Rodriguez Ezequiel, PA-C St. Luke's Hospital, Clark Building, 7th Fl. Email preceptor one (1) week before rotation starts. (dodigila@gmail.com) (ezeerodriguez@gmail.com) (please make the secretary page Ms. Sevransky) Weiner, Robert M.D. (718) 251-0200 Robert Weiner, M.D. Call ahead for time to report (Start time varies) LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 65 of 206 Appendix D: DIRECTIONS TO CLINICAL AFFILIATIONS/SITES 2014 – 2015 Bay Ridge Skin & Cancer Dermatology 9921 Fourth Avenue Brooklyn, NY 11209 (718) 833 - 7617 By Train: Walk to DeKalb Ave. and take the R train towards Bay Ridge – 95th Street and get off at 86th Street station. Bellevue Hospital 462 First Avenue New York, NY 10016 (212) 562-1000 By Bus: M15 to 27th Street and 1st Avenue M16 cross-town to 34th Street and 1st Avenue, walk 7 blocks south M26 cross-town to 23rd Street and 1st Avenue, walk 4 blocks north By Train: Take # 6 local (Lexington IRT line) subway to 28th Street stop. By Car: To Bellevue’s South Lot entrance coming from 34th Street (Eastbound): Take 34th Street as far east as possible, and make a right on the service road adjacent to the entrance to the southbound entrance to the FDR drive. Follow service road (past NYU) and you will see a tall, grayish/brown building (Bellevue) in front of you. Bellevue is now on your right and the FDR is to your left. Go past the building and turn right, into the Kinney Parking Lot. Coming from southbound down FDR: Take FDR to 34th Street exit. Follow service road (parallel to FDR) for about 6 blocks, continuing across 34th Street continuing on the service road (past NYU) and you will see a tall, grayish/brown building (Bellevue) in front of you. Bellevue is now on your right and the FDR is to your left. Go past the building and turn right, into the Kinney Parking Lot. Beth Israel Medical Center First Avenue at 16th Street (10 Nathan D. Perlman Place) New York, NY 10003 (212) 420-2000 - 4262 Page By Train: Take #4 or #5 to 14th Street-Union Square station or take R or N to 14th Street Station and either walk or take the L train towards Brooklyn and get off on First Avenue or walk four blocks to 16th Street and First Avenue to Nathan D. Perlman Place. It is a small street between 1st and 2nd Avenues. Bernstein Pavilion: Bernstein Pavilion is between 15th and 16th Streets. By Car: There is limited parking available LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 66 of 206 DIRECTIONS TO CLINICAL AFFILIATIONS/SITES 2014 - 2015 The Brooklyn Hospital Center 121 DeKalb Avenue Brooklyn, NY 11201 (718) 250-8000 Coney Island Hospital 2601 Ocean Pkwy Brooklyn, NY 11235 (718) 616-3000 By Train: Walk to DeKalb Ave station and take the B train towards Brighton Beach (21 mins - 7 stops) and get off on Sheepshead Bay station and then walk about 14 minutes to 2601 Ocean Pkwy. OR Take the B train towards Brighton Beach (23 mins, 8 stops) and get off on Brighton Beach station. Then, walk to Brighton Beach Av/Brighton 5 St (about 2 mins (8 mins to make transfer)) and take B1 Bus towards BAY RIDGE 4 AV via 86 ST until Ocean Py/Shore Py (7 mins, 7 stops). By Car: From LIU Brooklyn campus, head north on Flatbush Avenue Extension toward Fleet St. Turn left onto Tillary St. Take the 1st right onto Jay St. Turn right onto Sands St. Merge onto I-278 W via the ramp to Bklyn- Qns Expy/Staten Island. Keep left to continue on Belt Pkwy, follow signs for I-278 W/Staten Island. Take exit 7 toward Ocean Pkwy. Merge onto Shore Pkwy. Turn left onto Ocean Pkwy. Hospital will be on the right Eastchester Medical Associates 2426 Eastchester Road, Suite 208 Bronx, NY 10469 Telephone: (718)708-5650 By Train: Take Subway #5 towards Eastchester - Dyre Avenue (about 57 mins - 24 stops). Then get off on Gun Hill Road.Walk to 2426 Eastchester Road. (About 13 mins) Hospital for Joint Diseases Orthopedic Institute 301 E. 17th Street New York, NY 10003 (212) 598-6000 See directions for Beth Israel Medical Center. The Hospital for Joint Disease is located across the street from it. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 67 of 206 DIRECTIONS TO CLINICAL AFFILIATIONS/SITES 2014 - 2015 Kingsbrook Jewish Medical Center 585 Schenectady Avenue Brooklyn, NY 11203 By Train & Bus Take the #4 to Crown Heights/Utica Avenue. It is the last stop on the #4 line. Take the number 46 bus south to Rutland Road. Walk one block west to Schenectady Avenue. Long Island Jewish Medical Center 400 Lakeville Road New Hyde Park, NY 11042 (718) 470-7000 By Car: From "South Brooklyn" take the Belt Parkway east to the Cross Island Parkway North. Exit off the Cross Island to the Grand Central Parkway East. (This turns into the Northern State Pkwy.) Take the Grand Central Parkway to Exit 25, Lakeville Road. At stoplight, (Marcus Ave.) make a right, go to the next light (Lakeville Road) make a left. Continue to second light (past Medical Society) and make a right turn. From "North Brooklyn" take the Brooklyn-Queens Expressway east to the Grand Central Parkway East. Continue as above. By Train&Bus: Take "E" or "F" train to Union Turnpike/Kew Gardens. Leave via 78th St. exit. Take the Q46 bus to the last stop – 271st Street. Walk north 2 blocks to the 76th Ave. / Hospital Entrance. Lutheran Medical Center 150 55th Street Brooklyn, NY 11220 (718) 630-7000 By Car: Take the Brooklyn-Queens Expressway (I-278W). Take the 39th Street exit (Exit 23). Turn left on 2nd Avenue. Turn right on 53rd Street to 1st Avenue. Turn left on 1st Avenue to 55th Street for the main entrance and parking lot. Alternate parking is available on 56th Street. By Train: Take N or R train to 53rd Street. Walk 1-1/2 blocks south along 4th Avenue to 55th Street. Right on 55th Street toward 1st Avenue. Enter through the main entrance on 55th Street, halfway down the block between 1st and 2nd Avenues. By Bus B37: Take the bus to 3rd Avenue and 56th Street. Walk 1-1/2 blocks west along 56th Street toward the waterfront (2nd Avenue). B11: Take the bus to 55th Street and 2nd Avenue. B63: Take the 5th Avenue Bus to 56th Street. Walk one block north to 55th Street. Turn left on 55th Street and walk toward the waterfront (2nd Avenue). B9: Take the 60th Street bus to 3rd Avenue. Walk five blocks north to 55th Street. Turn left on 55th Street and walk toward the waterfront (2nd Avenue). LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 68 of 206 DIRECTIONS TO CLINICAL AFFILIATIONS/SITES 2014 - 2015 Maimonides Medical Center 4802 Tenth Avenue Brooklyn, NY 11219 (718 ) 283-6000 Main Hospital By Train: Walk to DeKalb Ave station and take the R train towards Bay Ridge – 95th Street and get off at Atlantic Ave - Barclays Center (3 min - 1 stop). From there, take the D train towards Coney Island - Stillwell Ave and get off at Fort Hamilton Pkwy station (12 min - 3 stops). Walk to 4802 10th Ave (About 6 min , 0.3 mi). Manhattan VA Hospital 423 E. 23rd Street (Between First Avenue & 23rd Street) New York, NY 10010 (212) 686-7500 - x7548 By Train: From Brooklyn take #4 or #5 to 14 Street and switch to #6 for one stop to 23rd Street. Walk east to First Avenue. From other boroughs, take any train to 23rd Street and walk (or take 23rd Street cross-town bus) east to First Avenue. New York – Presbyterian /Lower Manhattan Hospital 170 William Street New York, NY 10038 (212) 312-5000 By Train: Take R train to City Hall. Walk across Park to Pace University. Hospital is across from Pace (Gold Street). IRT Lexington Avenue line (#4 or #5) to Brooklyn Bridge stop. Hospital is two blocks from train stop. By Car: Brooklyn Bridge to first exit off bridge, stay to right, at bottom of exit ramp and (from Brooklyn) make a right turn. New York Downtown Hospital is one block after right turn. Office of Chief Medical Examiner Brooklyn Office 520 First Ave New York, NY 10016-6499 By Train: Walk to DeKalb Avenue. Take the Q train towards Astoria - Ditmars Blvd and get off at 14th St - Union Square (12 min - 2 stops). From there, take #6 train towards Pelham Bay Park and get off at 28th Street’s stop (3 min - 2 stops). Walk to 520 1st Ave. About (12 min - 0.6 mi). LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 69 of 206 DIRECTIONS TO CLINICAL AFFILIATIONS/SITES 2014 - 2015 Office of Chief Medical Examiner (Continued) Queens Office 1600 Pelham Parkway South Bronx, NY 10461-1119 By Train&Bus: Walk to Nevins Street and take the #2 train towards Wakefield - 241 St (57 min – 28 stops). Get off on Pelham Pkwy and from there walk to Pelham Pkwy/White Plains Rd to take the Bx12 bus towards Orchard Beach. Get off at Pelham Pkwy/Stillwell Av (10 min – 7 stops). Then, walk to 1600 Pelham Pkwy South. Parker Jewish Institute for Health Care & Rehabilitation 271-11 76th Avenue New Hyde Park, NY 11040 (718) 289-2100 By Car: From "South Brooklyn" take the Belt Parkway east to the Cross Island Parkway North. Exit off the Cross Island to the Grand Central Parkway East. (This turns into the Northern State Pkwy.) Take the Grand Central Parkway to Exit 25, Lakeville Road. At stoplight, (Marcus Avenue) make a right, go to the next light (Lakeville Road) make a left. Continue to second light (past Medical Society) and make a right turn. From "North Brooklyn" take the Brooklyn-Queens Expressway east to the Grand Central Parkway East. Continue as above. Paid parking lot is available. By Train&Bus: See directions to Long Island Jewish Medical Center. Parking: Free parking on the other side of Lakeville Road. Preferred Health Partners Location #1: Bedford Williamsburg Center (Dr. Bassoul) 233 Nostrand Avenue Brooklyn, NY 11205 (718) 826 - 5900 By Train: Walk to Hoyt - Schermerhorn Street (about 9 mins). Take G subway from Hoyt Schermerhorn Street towards Long Island City - Court Sq. (about 6 mins, 4 stops). Get off on Bedford - Nostrand Avenue and walk to 233 Nostrand Avenue (about 3 mins). Location #2: Flatbush Center (Dr. Rajpar) 1000 Church Avenue Brooklyn, NY 11218 (718) 826-4000 By Train: Take Q express or local train to Church Avenue and use the Church Avenue exit or take F train to Church Avenue. By Bus: Take B35 or B68 bus to corner of Coney Island Avenue and Church Avenue. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 70 of 206 DIRECTIONS TO CLINICAL AFFILIATIONS/SITES 2014 - 2015 Schiowitz, Emanuel, M.D. 1701 59th Street Brooklyn, NY 11204 (718) 259-0222 By Train: OR Take the F train to 18th Avenue. Transfer for the B11 bus to 17th Avenue and 60th Street (library on the corner). Get off the bus and make a right onto 17 th Avenue. Walk 1 block. Take N or R train to 18th Avenue. Get out at 17th Avenue exit and walk 6 blocks to 59th Street or get off at 63rd Street and walk 4 blocks. St. Luke’s-Roosevelt Hospital Center 1000 10th Avenue New York, NY 10019 (212) 523-4000 St. Luke’s Hospital 1111 Amsterdam Avenue, New York, NY 10025 By Train/Bus: Take the #1 train to West 110th Street and Broadway-Cathedral Parkway. Walk one block east to Amsterdam Avenue and four blocks north to West 114th Street. Take #2 or 3 trains to West 110th Street-Lenox Avenue-Cathedral Parkway. Walk or take M4 west to Amsterdam Avenue and then walk four blocks north to West 114 th St. Take #6 train to 110th Street and Lexington Avenue, then take M4 west to Amsterdam Avenue and walk four blocks north to West 114th Street. Take M104 bus (Broadway) to West 114th Street, and then walk east to Amsterdam Ave Take the M11 bus (Amsterdam Avenue) to West 114th Street. Take M4 bus to Amsterdam Ave. and 110th St, and then walk north to West 114th St. Roosevelt Hospital 1000 10th Ave. & 58th St., New York, NY 10019 By Train/Bus: Take A, B, C, D or #1 train to 59th Street-Columbus Circle. Walk west to 10th Avenue \ and one block south to West 58th Street. Take Q train to West 57th Street and 7th Avenue. Take M57 bus west to 10th Avenue or walk west to 10th Avenue. Walk one block north to West 58th Street. Take M7, M11 or M104 bus (Broadway) to West 58th St, and then walk west to 10th Ave. Weiner, Robert, M.D. 2352 Ralph Avenue Brooklyn, NY 11234 By Train&Bus: Take the #2 or #5 to Flatbush Avenue/Brooklyn College Station. Then take the B47 or B41 bus. The office is on Ralph Avenue between Avenues M and N. Bay car: There is parking available – call ahead for directions. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 71 of 206 Appendix E: CLINICAL YEAR GRIEVANCE PROCEDURE Students at the Brooklyn Campus may expect a scrupulous regard for their rights as students and individuals and should expect to be treated fairly and with courtesy by all members of the academic community. In any matter in which students feel that their rights have been violated, or in matters of serious dispute with members of the administration or faculty, students may avail themselves of the following formal grievance procedure: 1. The student will notify the Director of Clinical Education in person or via electronic mail within ten (10) days of the event, and will include a written statement that clearly describes the event and grievance. 2. The student will receive a response from the Director of Clinical Education within a reasonable amount of time. This will include a time and date during which the Director of Clinical Education will meet with the student. Following this meeting, the Director of Clinical Education will render a decision regarding the event within a reasonable amount of time via electronic mail and via overnight courier (Federal Express, UPS or similar courier). 3. In the event that the Director of Clinical Education is on vacation or is otherwise on leave from the University, the student will be aware of the faculty member’s absence or will be notified by electronic mail that the Director of Clinical Education is unavailable. In this case, the student will notify the Division Director of the event and grievance via electronic mail. 4. If the student is not satisfied with the response received from the Director of Clinical Education, the student may appeal the decision to the Division Director. The student will notify the Division Director in person or via electronic mail within ten (10) days of the meeting with the Director of Clinical Education, and will include a written statement that clearly describes the event and grievance. 5. The student will receive a response from the Division Director within a reasonable amount of time. This will include a time and date during which the Division Director will meet with the student. Following this meeting, the Division Director will render a decision regarding the event within a reasonable amount of time via electronic mail and via overnight courier (Federal Express, UPS or similar courier). 6. If the student is not satisfied with the response received from the Division Director, the student may appeal the decision to the Appeals Committee of the Division of Physician Assistant Studies. This committee is made up of available faculty within the Division, including Professors Kiefer, Verity, Compte, and Eckert. 6. In the event that the student has exhausted all opportunities to appeal to the faculty of the Division, the student may appeal through the Associate Dean of the School of Health Professions. The Associate Dean will review the matter and will follow the following procedure: Dean’s Office Appeal Process - School of Health Professions The following process will be used for all appeals that students choose to bring to the Dean as part of the University appeal process. This process will not supersede program or Division procedures and will only be followed after appeals at the Division level are exhausted. 1. The student MUST have first followed departmental appeal processes including but not limited to the appeal to the instructor and to the Division director. 2. Appeals to the Dean must be submitted in writing and must be submitted within 10 business days of receipt of the decision letter from the Division. This written appeal will be transmitted to the Appeal Board for review and will be a factor in the final LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 72 of 206 3. 4. 5. 6. 7. decision made by the Dean. The appeal must be accompanied by a completed Appeal Checklist. If deemed necessary by the Dean, the Associate Dean will serve as a hearing officer and will appoint an ad hoc Appeal Board. The Appeal Board will consist of three faculty members from the School of Health Professions, who may be tenure track, non-tenure track, or have administrative roles. One of these faculty members will be from the program from which the appeal has originated. The Dean will be present at the hearing, but will not contribute to the discussion. The hearing will be scheduled as expeditiously as possible. At the hearing (with all parties present): a. The hearing may be recorded for future reference. b. The student will present his/her appeal including justifications, circumstances and anything else s/he wishes the Board to consider. The maximum time allowed is 30 minutes. c. The course instructor, or other appropriate faculty member, will present the circumstances and evidence leading to the decision being appealed. The maximum time allowed is 30 minutes. d. Student and faculty will not engage in debate of the circumstances with each other but will answer questions posed by the Board for the purpose of clarification. e. Upon completion of the presentations and any questioning by the Board, the student and faculty will be excused. f. The Board will discuss the facts of the appeal and reach consensus, or vote, on a recommendation to the Dean. If a vote is taken, the Associate Dean will not vote. Within 24 hours of the hearing, the Associate Dean will prepare a written report that contains: a. A summary of the information presented by both sides at the hearing; b. A summary of the discussion of the Board after the parties were dismissed; c. A recommendation for action by the Dean. The Dean will then reach a decision based upon the report from the Board, the written appeal submitted by the student and any other information relevant to the case, and will notify the student by certified mail. This decision will normally be made within 48 hours unless further investigation is necessary or the Dean is unavailable within that time frame. If the decision will be delayed longer than 48 hours, the student will be notified by the Dean’s office of that delay. The foregoing procedure shall be a formal grievance procedure for the resolution of all student grievances, including those alleging actions prohibited by legislation. The following form must be submitted to the Dean’s office with the written appeal. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 73 of 206 School of Health Professions Long Island University - Brooklyn STUDENT APPEAL CHECKLIST Student: __________________________________________________________ Program/Division: __________________________________________________________ Course or Action: ___________________________________________________________ 1. Appeal to the Professor Date: _______________ Faculty: ____________________________________________________________ Signature Print Name 2. Appeal to the Director / Chair Date: _______________ Director: ____________________________________________________________ Signature Print Name 3. Appeal to the Division / Department / Program Committee Date: _______________ Committee Chair: _____________________________________________________ Signature Print Name 4. Appeal to the Dean Date Written Appeal Received: _______________ By: _______________________________________________________________ Signature Print Name LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 74 of 206 Appendix F: DIVISION OF PHYSICIAN ASSISTANT STUDIES 1 University Plaza ● Brooklyn, NY 11201 ● Phone: 718 488 1505 ● Fax: 718 246 6364 YEAR 2014 - 2015 SAMPLE CLINICAL EVALUATION FORM Student’s Name: Rotation #: Site: Start Date: Preceptor: End Date: Please evaluate the student’s performance for each component of clinical competence. Check the rating on the next page which best describes the student’s skills and abilities: 5= (A) Outstanding: Student’s performance is consistently superior and far exceeds the expected standards; demonstrates ability, knowledge, skills in the particular category which only a few students can be expected to attain. 4.3 = (B) Above Average: Student’s performance is consistently good and regularly surpasses the expected standard; student can work with minimal supervision; performance is better than that of most other students. 3.8 = (C) Average: Student consistently meets the established standard of performance; work is consistently acceptable and student demonstrates effort to achieve the standard; amount of supervision required is appropriate to the clinical situation. 3= (D) Unsatisfactory: Student occasionally meets the standard but has difficulty in doing so consistently; needs more supervision, guidance than would normally be expected for the situation. (THE CLINICAL EVALUATION FORM IS SUBJECT TO CHANGE) LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 75 of 206 ATTRIBUTE OF STUDENT, with descriptors Fund of Knowledge Extensive and well-applied knowledge; knows mechanisms of disease and clinical signs and symptoms associated with diseases; able to integrate information into clinical diagnosis Data Acquisition: History Skills & Physical Exam Gathers data in a logical, thorough, reliable manner. Establishes a broad base of information about the patient. Complete, accurate, directed toward patient's problems, properly sequenced. Elicits both obvious and subtle findings Data Interpretation (Problem-Solving): Differential Diagnosis Identifies patient's problems in order of importance. Relates clinical findings to altered physiology. Establishes a complete, prioritized differential diagnosis Development of Diagnostic and Treatment Plans Provides appropriate sequence of testing and therapeutic recommendations, considering patient's age, gender, lifestyle, genetics, and co-morbidities. Involves patient and family in planning Patient Care and Follow Up Seeks results of tests; communicates results in chart notes, to clinical care team, and to patient and family. Re-evaluates patient's clinical condition, including additional history and physical examination, as needed Relationships with Patients Always shows integrity, respect, compassion and empathy to patients. Establishes trust. Maintains credibility, excellent rapport with patients and families; respects patients' needs for information and personal preferences Relationships with Clinical Team Participates actively in discussions and work with clinical team at all levels. Excellent rapport with peers; shows respect for peers, teachers, staff. Friendly, trustworthy, interested in welfare of team Reliability Punctual for all clinical activities, teaching sessions. Prepares material for presentation in a timely fashion. Readily takes on additional assignments, stays late as needed Effort to Learn Self-motivated to acquire knowledge about all aspects of medicine, not just specific cases. Excellent use of resources including texts and online searches. Aware of own strengths and weaknesses; directs own learning agenda; able to think and work independently Professionalism and Integrity Is responsible, reliable, committed; is respectful and honest in professional situations; maintains highest standards for self and others; establishes trust. Always demonstrates respect, compassion for individuals; readily accepts non-judgmentally all rights of others. Demonstrates ethical behavior and cultural competence. Respects privacy and trust of patients (D) is considered a failing grade. A B C D 5 4.3 3.8 3.0 Inadequate, limited knowledge base, poorly organized or applied information 5 4.3 3.8 3.0 History Skills: Often incomplete, superficial, and not directed to patient’s problems. Physical Exam :Often incomplete, inaccurate, cursory, non-directed, insensitive, or awkward 5 4.3 3.8 3.0 Superficial diagnostic ability. Unable to organize data into a problem list. Unable to establish priorities 5 4.3 3.8 3.0 Over-reliance on tests and procedures. Does not consider patient’s concerns, opinions, limitations, and lifestyle. Treats problems rather than patients 5 4.3 3.8 3.0 Loses interest in patient after initial encounter. Does not follow through to ascertain and communicate test results. Does not follow patient’s condition over time 5 4.3 3.8 3.0 5 4.3 3.8 3.0 5 4.3 3.8 3.0 5 4.3 3.8 3.0 5 4.3 3.8 3.0 Lacks appropriate integrity, respect, empathy and compassion. Does not appreciate patient’s perceptions of illness, procedures, health care environment. Does not consider patient’s preferences. Poor rapport with patients and families Uninvolved, uncommunicative, removed from team activities and communication. Self-centered, competitive, antagonistic or argumentative; untrustworthy, arrogant or aggressive Not consistently present for ward rounds, clinic sessions, preceptor sessions, seminars; late or unprepared. Difficult to locate. Does not complete clinical assignments; does not report information about patients to clinical team Does minimum reading; uses abbreviated sources of information. Does not participate in discussions on rounds, in seminars; does not ask questions. Poor use of resources. Depends on others for direction; unaware of strengths and weaknesses Is unreliable or irresponsible; uncommitted to the medical profession; dishonest in professional relationships; is deceptive or abuses trust. Lacks appropriate respect, compassion, empathy. Displays insensitivity and intolerance for patients' differences. Does not respect patients' privacy. SETTING(S) OF OBSERVATION: ___________________________________ HOURS OF OBSERVATION: ___________ ROTATION #: ______ EVALUATOR’S NAME AND SIGNATURE: ________________________________________________________________ DATE: ____________ STUDENT’S NAME AND SIGNATURE: ___________________________________________________________________ DATE: ____________ LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 76 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES CLINICAL EVALUATION FORM COMMENTS (OPTIONAL): Please amplify the ratings given by providing more detailed descriptions of this student. In doing so, you may consider the prior categories listed and/or others that you feel pertain to the student's achievement of the rotation's goals. 1. Provide specific comments about this student's outstanding positive qualities, attributes which distinguish student from others: 2. Describe any qualities of this student that hinder his/her effectiveness as a clinician: 3. Recommendations for specific commendation, areas that need improvement, or specific remediation: Days absent on this rotation: ________ I would consider this student for employment with my organization: (check one) EVALUATOR’S NAME AND SIGNATURE: ________________________________________________ DATE: ________________ STUDENT’S NAME AND SIGNATURE: ____________________________________________________ DATE: ________________ LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 77 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MID-ROTATION EVALUATION FORM 2014 - 2015 ROTATION # ______________ STUDENT: DATE: _____________________ ______________________________________ ROTATION SITE: __________________________________ THIS FORM SHOULD BE COMPLETED DURING THE THIRD WEEK OF THE CLINICAL ROTATION. At this point, how is the student performing on the clinical rotation? The student’s performance is satisfactory. The student’s performance is NOT satisfactory. Preceptor’s Name (Please print or stamp): _________________________ Preceptor’s Signature: _____________________ PLEASE FAX THIS FORM TO Marion Masterson, PA-C, MPAS Director of Clinical Education Division of Physician Assistant Studies Telephone: (718) 488-1505 ● Fax: (718) 246-6364 LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 78 of 206 Appendix: G DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 601 INTERNAL MEDICINE CLERKSHIP SYLLABUS Director of Clinical Education: Marion F. Masterson, PA-C, MPAS Course Directors: Marion F. Masterson, PA-C, MPAS Sharon Verity, PA-C, MPAS Required Texts: - Bickley, LS et al., Bates Guide to Physical Examination and History Taking, 10th edition. Philadelphia: Lippincott Williams and Wilkins, 2008. - Costanzo, LS., Physiology, 4th edition with Student Consult Online Access. Philadelphia: Elsevier, 2009. - Goldman, LS et al., Cecil’s Medicine: Expert Consult Premium Edition: Enhanced online features and print, 24th edition. Philadelphia: Elsevier, 2011. - Gomella, LG et al., Clinician’s Pocket Reference, 11th edition. New York: McGraw-Hill, 2006. - Katzung, B., Basic and Clinical Pharmacology, 12th edition. New York: McGraw-Hill, 2011. - Kumar, V et al., Basic pathology, 9th edition. Philadelphia: Saunders, 2012. - McPhee, SJ et al., Current Medical Diagnosis and Treatment, 51st edition. McGraw-Hill, 2011. - Moore, K et al., Clinically Oriented Anatomy, 6th edition. Philadelphia: Lippincott Williams and Wilkins, 2009. - Venes, D., Taber’s Cyclopedic Medical Dictionary, 21st edition. Philadelphia: FA Davis, 2009. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 79 of 206 Course Description: This clinical course is a clinical clerkship in internal medicine. All clinical clerkships are five (5) weeks in length. Each student is assigned a clinical site and preceptor at the inception of the clinical year. Prerequisites: Successful completion of the didactic year of the Physician Assistant Studies curriculum. 2 (two) credits. Format: This course is comprised of an internal medicine clerkship that is conducted in a hospital. The student is assigned to a preceptor and is charged with the care of patients as delegated by the preceptor. Teaching and Learning Strategies: This course includes supervised clinical work, teaching at the bedside by the preceptor and/or the attending physician; conferences and other lectures at the facility; End-of-Rotation lectures and Board Review lectures. Course Times and Dates: Specific times and dates are variable according to clinical clerkship site and preceptor. Estimate of Time Spent in this Course: The Accreditation Review Commission on Education of the Physician Assistant, Inc. (ARC-PA) requires that all clinical year students spend a minimum of 35 hours per week at the clinical site. However, there is no maximum number of hours that may be required. Course Goals: At the end of this course, the student will: 1. Have a deeper understanding and knowledge of the major diagnoses seen in internal medicine with particular emphasis on cardiovascular and pulmonary processes 2. Be at a developing level in procedures used frequently in internal medicine 3. Have increased understanding and knowledge of pharmacologic entities unique to internal medicine 4. Have developed additional skills in working with a team 5. Have developed additional skills in case presentations 6. Have developed additional skills in writing Admission and SOAP notes, discharge summaries and other documentation required in internal medicine Expected Learning Outcomes: At the end of this course, the student will (be): 1. Proficient at performing a history and physical exam specific to the internal medicine patient 2. At a developing or proficient level of formulating an assessment and plan for internal medicine patients 3. Adept at working with a team 4. Comfortable with and respectful of patients from other cultures and backgrounds from the student 5. Proficient at formulating a differential diagnosis of common complaints seen in internal medicine. 6. Proficient at formulating appropriate workup and treatment of common internal medicine complaints. 7. Developing or proficient at counseling patients appropriately concerning common internal medicine complaints. Student Learning Objectives: Please see the Clinical Year Educational Objectives, which are to be found at the end of this book (Appendix I). LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 80 of 206 Attendance: Attendance is mandatory. Five (5) days may be used as sick days during the entire clinical year. After these five days have been exhausted, all excused absences must be made up. For more information on policies on attendance and unexcused absences, please see Attendance Issues (Chapter II). Professionalism: Students are expected to act professionally at all times when interacting with fellow classmates, preceptors, patients, other members of the health care team, and faculty members. Please refer to Academic and Professional Guidelines and Policies (Chapter III) concerning the policies on professionalism. COURSE REQUIREMENTS AND METHODS OF EVALUATION: Pharmacology Independent Study / Drug Card Completion: In order to successfully complete the course, all students must complete and turn in 10 drug cards to faculty at the end of rotation meeting. The drug cards must be hand written. The drugs they are chosen must be relevant to the patients that students’ cared for/were exposed to during their rotation. Each drug card must be labeled and include: • • • • • • • • • • Brand/generic drug name Class Indications Mechanism of action Adult indication and dosage Children indication and dosage (if drugs are contraindicated in children, you must note that.) Contraindications Warnings/precautions Interactions Side effects/adverse reactions The cards will be collected at End-of-Rotation meetings and placed in each student’s file for faculty review. The cards will be graded on a pass/fail basis. At the end of the 10 rotations, the cards will be returned to the student to assist the student in their PANCE preparation. Failure to submit 10 drug cards at End of Rotation will result in a deduction of 10 points from the final rotation average. Physician Assistant Student Tracking (PAST): In order to ensure that students have access to a variety of clinical experiences during the clinical year, the Division of Physician Assistant Studies subscribes to the Typhon Group’s Physician Assistant Student Tracking (PAST) system. This system allows students to submit data regarding patient encounters, diagnoses, procedures completed, technical skills obtained, and other information in a secure, paperless system. Students must enter data within 7 days of the date that the patient was seen/procedure completed. If students do not do so, they will be locked out and will forfeit entry of these data. The Typhon Group system is monitored by the Division faculty and staff. Submissions will be graded on a pass/fail basis. Students who do not enter patient data on this system will lose 10 points from their final course average. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 81 of 206 Histories and Physicals Admission Notes / SOAP Notes: The requisite number of these notes must be entered on Typhon by your last day on rotation. The number and type of required notes is specified in the learning objectives of your Clinical Year Handbook. The student must submit notes on a computer. In accordance with HIPAA, patient names and medical record numbers must not appear anywhere on H&Ps, SOAP notes, or other documentation submitted to the Division of Physician Assistant Studies. The H&Ps and SOAP notes will be graded on a pass/fail basis. Failure to submit the required number of notes or comply with HIPAA will result in a deduction of 10 points from the final rotation average. Course Grades and Policies: The final course grade is calculated on the basis of two (2) components. These two components include the clinical evaluation form and the End-ofRotation Examination. The Clinical Course Evaluation completed by the preceptor, and available for student review in the Clinical Year Handbook, is worth 50% of the final clerkship course grade. The End-of-Rotation Examination, based on student learning objectives, is worth 50% of the final clerkship course grade. If the student fails the End-of-Rotation Examination with a score of less than 74, the student must take a remedial examination. If a student fails either the remedial exam OR if the student fails the course with a final average of less than 74, the student will receive a grade of F for the course and must repeat the clinical clerkship including the examination. Please refer to the Division’s Clinical Year Handbook for more information regarding this policy. The minimum passing grade for this course is a 74. All physician assistant students are graded on the following scale: Letter Grade Numerical Grade A AB+ B BC+ C F > = 93% 90 - 92.99 87 - 89.99 83 - 86.99 80 - 82.99 77 - 79.99 74 - 76.99 < 74 Graduate GPA Policy: All LIU graduate students must maintain a minimum overall GPA of 3.0 on a 4.0 scale in order to remain in good academic standing. THIS SYLLABUS IS SUBJECT TO CHANGE. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 82 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 602 GENERAL SURGERY CLERKSHIP SYLLABUS Director of Clinical Education: Marion F. Masterson, PA-C, MPAS Course Director: James Eckert, PA-C, M.A. Required Texts: - Bickley, LS et al., Bates Guide to Physical Examination and History Taking, 10th edition. Philadelphia: Lippincott Williams and Wilkins, 2008. - Costanzo, LS., Physiology, 4th edition with Student Consult Online Access. Philadelphia: Elsevier, 2009. - Doherty, GM et al., Current Surgical Diagnosis and Treatment, 13th edition. New York: Lange Medical Books / McGraw-Hill, 2009. - Gomella, LG et al. Clinician’s Pocket Reference, 11th edition. New York: McGraw-Hill, 2006. - Katzung, B., Basic and Clinical Pharmacology, 12th edition. New York: McGraw-Hill, 2011. - Kumar, V et al., Basic pathology, 9th edition. Philadelphia: Saunders, 2012. Recommended Textbooks: - Lawrence, P.F., Essentials of General Surgery, 4th edition. Philadelphia: Lippincott Williams & Wilkins, 2006. - Lawrence, P.F., Essentials of Surgical Specialties, 3rd edition. Philadelphia: Lippincott Williams & Wilkins, 2006. - Skinner, H.B. (Ed), Current Orthopedics Diagnosis and Treatment, 4th edition. New York: Lange Medical Books / McGraw-Hill, 2006. - Klingensmith, M.E. et al. (Eds), The Washington Manuel of Surgery, 6th edition. Philadelphia: Lippincott Williams & Wilkins, 2012. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 83 of 206 Course Description: This clinical course is a clinical clerkship in general surgery. All clinical clerkships are five (5) weeks in length. Each student is assigned a clinical site and preceptor at the inception of the clinical year. Prerequisites: Successful completion of the didactic year of the Physician Assistant Studies curriculum. 2 (two) credits. Format: This course is comprised of a general surgery clerkship that is conducted in a hospital. The student is assigned to a preceptor and is charged with the care of patients as delegated by the preceptor. Teaching and Learning Strategies: This course includes supervised clinical work, teaching at the bedside by the preceptor and/or the attending physician; conferences and other lectures at the facility; End-of-Rotation lectures and Board Review lectures. Course Times and Dates: Specific times and dates are variable according to clinical clerkship site and preceptor. Estimate of Time Spent in this Course: The Accreditation Review Commission on Education of the Physician Assistant, Inc. (ARC-PA) requires that all clinical year students spend a minimum of 35 hours per week at the clinical site. However, there is no maximum number of hours that may be required. Course Goals: At the end of this course, the student will: 1. Have a deeper understanding and knowledge of the major diagnoses seen in general surgery 2. Be at a developing level in procedures used frequently in general surgery, such as aseptic technique, gowning and gloving, and assisting in O.R. 3. Have increased understanding and knowledge of pharmacologic entities unique to general surgery 4. Have developed additional skills in working with a team 5. Have developed additional skills in case presentations 6. Have developed additional skills in writing Admission and SOAP notes, discharge summaries and other documentation required in general surgery. Expected Learning Outcomes: At the end of this course, the student will (be): 1. Proficient at performing a history and physical exam specific to the surgical patient 2. At a developing or proficient level of formulating an assessment and plan for surgical patients 3. Adept at working with a team 4. Comfortable with and respectful of patients from other cultures and backgrounds from the student 5. Proficient at formulating a differential diagnosis of common complaints seen in general surgery 6. Proficient at formulating appropriate workup and treatment of common surgical complaints 7. Developing or proficient at counseling patients appropriately concerning common surgical complaints. Student Learning Objectives: Please see the Clinical Year Educational Objectives, which are to be found at the end of this book (Appendix I). LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 84 of 206 Attendance: Attendance is mandatory. Five (5) days may be used as sick days during the entire clinical year. After these five days have been exhausted, all excused absences must be made up. For more information on policies on attendance and unexcused absences, please see Attendance Issues (Chapter II). Professionalism: Students are expected to act professionally at all times when interacting with fellow classmates, preceptors, patients, other members of the health care team, and faculty members. Please refer to Academic and Professional Guidelines and Policies (Chapter III) concerning the policies on professionalism. COURSE REQUIREMENTS AND METHODS OF EVALUATION: Pharmacology Independent Study / Drug Card Completion: In order to successfully complete the course, all students must complete and turn in 10 drug cards to faculty at the end of rotation meeting. The drug cards must be hand written. The drugs they are chosen must be relevant to the patients that students’ cared for/were exposed to during their rotation. Each drug card must be labeled and include: • • • • • • • • • • Brand/generic drug name Class Indications Mechanism of action Adult indication and dosage Children indication and dosage (if drugs are contraindicated in children, you must note that.) Contraindications Warnings/precautions Interactions Side effects/adverse reactions The cards will be collected at End-of-Rotation meetings and placed in each student’s file for faculty review. The cards will be graded on a pass/fail basis. At the end of the 10 rotations, the cards will be returned to the student to assist the student in their PANCE preparation. Failure to submit 10 drug cards at End of Rotation will result in a deduction of 10 points from the final rotation average. Physician Assistant Student Tracking (PAST): In order to ensure that students have access to a variety of clinical experiences during the clinical year, the Division of Physician Assistant Studies subscribes to the Typhon Group’s Physician Assistant Student Tracking (PAST) system. This system allows students to submit data regarding patient encounters, diagnoses, procedures completed, technical skills obtained, and other information in a secure, paperless system. Students must enter data within 7 days of the date that the patient was seen/procedure completed. If students do not do so, they will be locked out and will forfeit entry of these data. The Typhon Group system is monitored by the Division faculty and staff. Submissions will be graded on a pass/fail basis. Students who do not enter patient data on this system will lose 10 points from their final course average. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 85 of 206 Histories and Physicals Admission Notes / SOAP Notes: The requisite number of these notes must be entered on Typhon by your last day on rotation. The number and type of required notes is specified in the learning objectives of your Clinical Year Handbook. The student must submit notes on a computer. In accordance with HIPAA, patient names and medical record numbers must not appear anywhere on H&Ps, SOAP notes, or other documentation submitted to the Division of Physician Assistant Studies. The H&Ps and SOAP notes will be graded on a pass/fail basis. Failure to submit the required number of notes or comply with HIPAA will result in a deduction of 10 points from the final rotation average. Course Grades and Policies: The final course grade is calculated on the basis of two (2) components. These two components include the clinical evaluation form and the End-ofRotation Examination. The Clinical Course Evaluation completed by the preceptor, and available for student review in the Clinical Year Handbook, is worth 50% of the final clerkship course grade. The End-of-Rotation Examination, based on student learning objectives, is worth 50% of the final clerkship course grade. If the student fails the End-of-Rotation Examination with a score of less than 74, the student must take a remedial examination. If a student fails either the remedial exam OR if the student fails the course with a final average of less than 74, the student will receive a grade of F for the course and must repeat the clinical clerkship including the examination. Please refer to the Division’s Clinical Year Handbook for more information regarding this policy. The minimum passing grade for this course is a 74. All physician assistant students are graded on the following scale: Letter Grade Numerical Grade A AB+ B BC+ C F > = 93% 90 - 92.99 87 - 89.99 83 - 86.99 80 - 82.99 77 - 79.99 74 - 76.99 < 74 Graduate GPA Policy: All LIU graduate students must maintain a minimum overall GPA of 3.0 on a 4.0 scale in order to remain in good academic standing. THIS SYLLABUS IS SUBJECT TO CHANGE. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 86 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 603 PEDIATRIC CLERKSHIP SYLLABUS Director of Clinical Education: Marion F. Masterson, PA-C, MPAS Course Director: Marion F. Masterson, PA-C, MPAS Required Texts: - Bickley, LS et al., Bates Guide to Physical Examination and History Taking, 10th edition. Philadelphia: Lippincott Williams and Wilkins, 2008. - Costanzo, LS., Physiology, 4th edition with Student Consult Online Access. Philadelphia: Elsevier, 2009. - Gomella, LG et al., Clinician’s Pocket Reference, 11th edition. New York: McGraw-Hill, 2006. - Marcdante, K. et al., Nelson Essentials of Pediatrics, 7th edition. Philadelphia: Saunders, 2013. - Katzung, B., Basic and Clinical Pharmacology, 12th edition. New York: McGraw-Hill, 2011. - Kumar, V et al., Basic Pathology, 9th edition. Philadelphia: Saunders, 2012. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 87 of 206 Course Description: This clinical course is a clinical clerkship in pediatrics. All clinical clerkships are five (5) weeks in length. Each student is assigned a clinical site and preceptor at the inception of the clinical year. Prerequisites: Successful completion of the didactic year of the Physician Assistant Studies curriculum. 2 (two) credits. Format: This course is comprised of a pediatrics clerkship that is conducted in a hospital. The student is assigned to a preceptor and is charged with the care of patients as delegated by the preceptor. Teaching and Learning Strategies: This course includes supervised clinical work, teaching at the bedside by the preceptor and/or the attending physician; conferences and other lectures at the facility; End-of-Rotation lectures and Board Review lectures. Course Times and Dates: Specific times and dates are variable according to clinical clerkship site and preceptor. Estimate of Time Spent in this Course: The Accreditation Review Commission on Education of the Physician Assistant, Inc. (ARC-PA) requires that all clinical year students spend a minimum of 35 hours per week at the clinical site. However, there is no maximum number of hours that may be required. Course Goals: At the end of this course, the student will: 1. Have a deeper understanding and knowledge of the major diagnoses seen in pediatrics 2. At a developing level in procedures used frequently in pediatrics 3. Have increased understanding and knowledge of pharmacologic entities unique to pediatrics, with particular emphasis on dosage 4. Have developed additional skills in working with a team 5. Have developed additional skills in case presentations 6. Have developed additional skills in writing Admission and SOAP notes, discharge summaries and other documentation required in pediatrics Expected Learning Outcomes: At the end of this course, the student will be: 1. Proficient at performing a history and physical exam specific to the pediatric patient 2. At a developing or proficient level of formulating an assessment and plan for pediatric patients 3. Adept at working with a team 4. Comfortable with and respectful of patients from other cultures and backgrounds from the student 5. Proficient at formulating a differential diagnosis of common complaints seen in pediatrics 6. Proficient at formulating appropriate workup and treatment of common pediatric complaints. 7. Developing or proficient at counseling patients appropriately concerning common pediatric complaints. Student Learning Objectives: Please see the Clinical Year Educational Objectives, which are to be found at the end of this book (Appendix I). LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 88 of 206 Attendance: Attendance is mandatory. Five (5) days may be used as sick days during the entire clinical year. After these five days have been exhausted, all excused absences must be made up. For more information on policies on attendance and unexcused absences, please see Attendance Issues (Chapter II). Professionalism: Students are expected to act professionally at all times when interacting with fellow classmates, preceptors, patients, other members of the health care team, and faculty members. Please refer to Academic and Professional Guidelines and Policies (Chapter III) concerning the policies on professionalism. COURSE REQUIREMENTS AND METHODS OF EVALUATION: Pharmacology Independent Study / Drug Card Completion: In order to successfully complete the course, all students must complete and turn in 10 drug cards to faculty at the end of rotation meeting. The drug cards must be hand written. The drugs they are chosen must be relevant to the patients that students’ cared for/were exposed to during their rotation. Each drug card must be labeled and include: • • • • • • • • • • Brand/generic drug name Class Indications Mechanism of action Adult indication and dosage Children indication and dosage (if drugs are contraindicated in children, you must note that.) Contraindications Warnings/precautions Interactions Side effects/adverse reactions The cards will be collected at End-of-Rotation meetings and placed in each student’s file for faculty review. The cards will be graded on a pass/fail basis. At the end of the 10 rotations, the cards will be returned to the student to assist the student in their PANCE preparation. Failure to submit 10 drug cards at End of Rotation will result in a deduction of 10 points from the final rotation average. Physician Assistant Student Tracking (PAST): In order to ensure that students have access to a variety of clinical experiences during the clinical year, the Division of Physician Assistant Studies subscribes to the Typhon Group’s Physician Assistant Student Tracking (PAST) system. This system allows students to submit data regarding patient encounters, diagnoses, procedures completed, technical skills obtained, and other information in a secure, paperless system. Students must enter data within 7 days of the date that the patient was seen/procedure completed. If students do not do so, they will be locked out and will forfeit entry of these data. The Typhon Group system is monitored by the Division faculty and staff. Submissions will be graded on a pass/fail basis. Students who do not enter patient data on this system will lose 10 points from their final course average. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 89 of 206 Histories and Physicals Admission Notes / SOAP Notes: The requisite number of these notes must be entered on Typhon by your last day on rotation. The number and type of required notes is specified in the learning objectives of your Clinical Year Handbook. The student must submit notes on a computer. In accordance with HIPAA, patient names and medical record numbers must not appear anywhere on H&Ps, SOAP notes, or other documentation submitted to the Division of Physician Assistant Studies. The H&Ps and SOAP notes will be graded on a pass/fail basis. Failure to submit the required number of notes or comply with HIPAA will result in a deduction of 10 points from the final rotation average. Course Grades and Policies: The final course grade is calculated on the basis of two (2) components. These two components include the clinical evaluation form and the End-ofRotation Examination. The Clinical Course Evaluation completed by the preceptor, and available for student review in the Clinical Year Handbook, is worth 50% of the final clerkship course grade. The End-of-Rotation Examination, based on student learning objectives, is worth 50% of the final clerkship course grade. If the student fails the End-of-Rotation Examination with a score of less than 74, the student must take a remedial examination. If a student fails either the remedial exam OR if the student fails the course with a final average of less than 74, the student will receive a grade of F for the course and must repeat the clinical clerkship including the examination. Please refer to the Division’s Clinical Year Handbook for more information regarding this policy. The minimum passing grade for this course is a 74. All physician assistant students are graded on the following scale: Letter Grade Numerical Grade A AB+ B BC+ C F > = 93% 90 - 92.99 87 - 89.99 83 - 86.99 80 - 82.99 77 - 79.99 74 - 76.99 < 74 Graduate GPA Policy: All LIU graduate students must maintain a minimum overall GPA of 3.0 on a 4.0 scale in order to remain in good academic standing. THIS SYLLABUS IS SUBJECT TO CHANGE. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 90 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 604 FAMILY MEDICINE CLERKSHIP SYLLABUS Director of Clinical Education: Marion F. Masterson, PA-C, MPAS Course Director: Maria E. Compte, M.D., MPH & TM, C-Trop. Med. Required Texts: - Beckmann, CRB et. al., Obstetrics and Gynecology, 7th edition. Philadelphia: Lippincott Williams and Wilkins, 2013. - Bickley, LS et al., Bates Guide to Physical Examination and History Taking, 10th edition. Philadelphia: Lippincott Williams and Wilkins, 2008. - Costanzo, LS., Physiology, 4th edition with Student Consult Online Access. Philadelphia: Elsevier, 2009. - Goldman, LS et al., Cecil’s Medicine: Expert Consult Premium Edition: Enhanced online features and print, 24th edition. Philadelphia: Elsevier, 2011. - Gomella, LG et al., Clinician’s Pocket Reference, 11th edition. New York: McGraw-Hill, 2006. - Katzung, B., Basic and Clinical Pharmacology, 12th edition. New York: McGraw-Hill, 2011. - Kumar, V et al., Basic Pathology, 9th edition. Philadelphia: Saunders, 2012. - Marcdante, K. et al., Nelson Essentials of Pediatrics, 7th edition. Philadelphia: Saunders, 2013. - McPhee, SJ et al., Current Medical Diagnosis and Treatment, 51st edition. McGraw-Hill, 2011. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 91 of 206 Course Description: This clinical course is a clinical clerkship in family medicine. All clinical clerkships are five (5) weeks in length. Each student is assigned a clinical site and preceptor at the inception of the clinical year. Prerequisites: Successful completion of the didactic year of the Physician Assistant Studies curriculum. 2 (two) credits. Format: This course is comprised of a family medicine clerkship that is conducted in a hospital. The student is assigned to a preceptor and is charged with the care of patients as delegated by the preceptor. Teaching and Learning Strategies: This course includes supervised clinical work, teaching at the bedside by the preceptor and/or the attending physician; conferences and other lectures at the facility; End-of-Rotation lectures and Board Review lectures. Course Times and Dates: Specific times and dates are variable according to clinical clerkship site and preceptor. Estimate of Time Spent in this Course: The Accreditation Review Commission on Education of the Physician Assistant, Inc. (ARC-PA) requires that all clinical year students spend a minimum of 35 hours per week at the clinical site. However, there is no maximum number of hours that may be required. Course Goals: At the end of this course, the student will: 1. Have a deeper understanding and knowledge of the major diagnoses seen in family medicine (including pediatrics, adult medicine, prenatal care and gynecology, and geriatrics) with particular emphasis on care throughout the life span and for the family unit 2. Be at a developing level in procedures used frequently in family medicine 3. Have increased understanding and knowledge of pharmacologic entities unique to family medicine 4. Have developed additional skills in working with a team 5. Have developed additional skills in case presentations 6. Have developed additional skills in writing Admission and SOAP notes, discharge summaries and other documentation required in family medicine Expected Learning Outcomes: At the end of this course, the student will (be): 1. Proficient at performing a history and physical exam specific to the family medicine patient 2. At a developing or proficient level of formulating an assessment and plan for family medicine patients 3. Adept at working with a team 4. Comfortable with and respectful of patients from other cultures and backgrounds from the student 5. Proficient at formulating a differential diagnosis of common complaints seen in family medicine 6. Proficient at formulating appropriate workup and treatment of common family medicine complaints. 7. Developing or proficient at counseling patients appropriately concerning common family medicine complaints. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 92 of 206 Student Learning Objectives: Please see the Clinical Year Educational Objectives that are to be found at the end of this book (Appendix I). Attendance: Attendance is mandatory. Five (5) days may be used as sick days during the entire clinical year. After these five days have been exhausted, all excused absences must be made up. For more information on policies on attendance and unexcused absences, please see Attendance Issues (Chapter II). Professionalism: Students are expected to act professionally at all times when interacting with fellow classmates, preceptors, patients, other members of the health care team, and faculty members. Please refer to Academic and Professional Guidelines and Policies (Chapter III) concerning the policies on professionalism. COURSE REQUIREMENTS AND METHODS OF EVALUATION: Pharmacology Independent Study / Drug Card Completion: In order to successfully complete the course, all students must complete and turn in 10 drug cards to faculty at the end of rotation meeting. The drug cards must be hand written. The drugs they are chosen must be relevant to the patients that students’ cared for/were exposed to during their rotation. Each drug card must be labeled and include: • • • • • • • • • • Brand/generic drug name Class Indications Mechanism of action Adult indication and dosage Children indication and dosage (if drugs are contraindicated in children, you must note that.) Contraindications Warnings/precautions Interactions Side effects/adverse reactions The cards will be collected at End-of-Rotation meetings and placed in each student’s file for faculty review. The cards will be graded on a pass/fail basis. At the end of the 10 rotations, the cards will be returned to the student to assist the student in their PANCE preparation. Failure to submit 10 drug cards at End of Rotation will result in a deduction of 10 points from the final rotation average. Physician Assistant Student Tracking (PAST): In order to ensure that students have access to a variety of clinical experiences during the clinical year, the Division of Physician Assistant Studies subscribes to the Typhon Group’s Physician Assistant Student Tracking (PAST) system. This system allows students to submit data regarding patient encounters, diagnoses, procedures completed, technical skills obtained, and other information in a secure, paperless system. Students must enter data within 7 days of the date that the patient was seen/procedure completed. If students do not do so, they will be locked out and will forfeit entry of these data. The Typhon Group system is monitored by the Division faculty and staff. Submissions will be graded on a pass/fail basis. Students who do not enter patient data on this system will lose 10 points from their final course average. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 93 of 206 Histories and Physicals Admission Notes / SOAP Notes: The requisite number of these notes must be entered on Typhon by your last day on rotation. The number and type of required notes is specified in the learning objectives of your Clinical Year Handbook. The student must submit notes on a computer. In accordance with HIPAA, patient names and medical record numbers must not appear anywhere on H&Ps, SOAP notes, or other documentation submitted to the Division of Physician Assistant Studies. The H&Ps and SOAP notes will be graded on a pass/fail basis. Failure to submit the required number of notes or comply with HIPAA will result in a deduction of 10 points from the final rotation average. Course Grades and Policies: The final course grade is calculated on the basis of two (2) components. These two components include the clinical evaluation form and the End-ofRotation Examination. The Clinical Course Evaluation completed by the preceptor, and available for student review in the Clinical Year Handbook, is worth 50% of the final clerkship course grade. The End-of-Rotation Examination, based on student learning objectives, is worth 50% of the final clerkship course grade. If the student fails the End-of-Rotation Examination with a score of less than 74, the student must take a remedial examination. If a student fails either the remedial exam OR if the student fails the course with a final average of less than 74, the student will receive a grade of F for the course and must repeat the clinical clerkship including the examination. Please refer to the Division’s Clinical Year Handbook for more information regarding this policy. The minimum passing grade for this course is a 74. All physician assistant students are graded on the following scale: Letter Grade Numerical Grade A AB+ B BC+ C F > = 93% 90 - 92.99 87 - 89.99 83 - 86.99 80 - 82.99 77 - 79.99 74 - 76.99 < 74 Graduate GPA Policy: All LIU graduate students must maintain a minimum overall GPA of 3.0 on a 4.0 scale in order to remain in good academic standing. THIS SYLLABUS IS SUBJECT TO CHANGE. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 94 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 605 EMERGENCY MEDICINE CLERKSHIP SYLLABUS Director of Clinical Education: Marion F. Masterson, PA-C, MPAS Course Director: Maria E. Compte, M.D., MPH & TM, C-Trop. Med. Required Texts: - Bickley, LS et al., Bates Guide to Physical Examination and History Taking, 10th edition. Philadelphia: Lippincott Williams and Wilkins, 2008. - Costanzo, LS., Physiology, 4th edition with Student Consult Online Access. Philadelphia: Elsevier, 2009. - Goldman, LS et al., Cecil’s Medicine: Expert Consult Premium Edition: Enhanced online features and print, 24th edition. Philadelphia: Elsevier, 2011. - Gomella, LG et al., Clinician’s Pocket Reference, 11th edition. New York: McGraw-Hill, 2006. - Katzung, B., Basic and Clinical Pharmacology, 12th edition. New York: McGraw-Hill, 2011. - Kumar, V et al., Basic Pathology, 9th edition. Philadelphia: Saunders, 2012 - McPhee, SJ et al., Current Medical Diagnosis and Treatment, 51st edition. McGraw-Hill, 2011. - Stone, K., Current Diagnosis & Treatment Emergency Medicine, 7th edition. New York: McGraw-Hill, 2011. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 95 of 206 Course Description: This clinical course is a clinical clerkship in emergency medicine. All clinical clerkships are five (5) weeks in length. Each student is assigned a clinical site and preceptor at the inception of the clinical year. Prerequisites: Successful completion of the didactic year of the Physician Assistant Studies curriculum. 2 (two) credits. Format: This course is comprised of an emergency medicine clerkship that is conducted in a hospital. The student is assigned to a preceptor and is charged with the care of patients as delegated by the preceptor. Teaching and Learning Strategies: This course includes supervised clinical work, teaching at the bedside by the preceptor and/or the attending physician; conferences and other lectures at the facility; End-of-Rotation lectures and Board Review lectures. Course Times and Dates: Specific times and dates are variable according to clinical clerkship site and preceptor. Estimate of Time Spent in this Course: The Accreditation Review Commission on Education of the Physician Assistant, Inc. (ARC-PA) requires that all clinical year students spend a minimum of 35 hours per week at the clinical site. However, there is no maximum number of hours that may be required. Course Goals: At the end of this course, the student will: 1. Have a deeper understanding and knowledge of the major diagnoses seen in emergency medicine 2. At a developing level in procedures used frequently in emergency medicine 3. Have increased understanding and knowledge of pharmacologic entities unique to emergency medicine 4. Have developed additional skills in working with a team 5. Have developed additional skills in case presentations 6. Have developed additional skills in writing Admission and SOAP notes, discharge summaries and other documentation required in emergency medicine Expected Learning Outcomes: At the end of this course, the student will be: 1. Proficient at performing a history and physical exam specific to the emergency medicine patient 2. At a developing or proficient level of formulating an assessment and plan for emergency medicine patients 3. Adept at working with a team 4. Comfortable with and respectful of patients from other cultures and backgrounds from the student 5. Proficient at formulating a differential diagnosis of common complaints seen in emergency medicine. 6. Proficient at formulating appropriate workup and treatment of common emergency medicine complaints. 7. Developing or proficient at counseling patients appropriately concerning common emergency medicine complaints. Student Learning Objectives: Please see the Clinical Year Educational Objectives that are to be found at the end of this book (Appendix I). LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 96 of 206 Attendance: Attendance is mandatory. Five (5) days may be used as sick days during the entire clinical year. After these five days have been exhausted, all excused absences must be made up. For more information on policies on attendance and unexcused absences, please see Attendance Issues (Chapter II). Professionalism: Students are expected to act professionally at all times when interacting with fellow classmates, preceptors, patients, other members of the health care team, and faculty members. Please refer to Academic and Professional Guidelines and Policies (Chapter III) concerning the policies on professionalism. . COURSE REQUIREMENTS AND METHODS OF EVALUATION: Pharmacology Independent Study / Drug Card Completion: In order to successfully complete the course, all students must complete and turn in 10 drug cards to faculty at the end of rotation meeting. The drug cards must be hand written. The drugs they are chosen must be relevant to the patients that students’ cared for/were exposed to during their rotation. Each drug card must be labeled and include: • • • • • • • • • • Brand/generic drug name Class Indications Mechanism of action Adult indication and dosage Children indication and dosage (if drugs are contraindicated in children, you must note that.) Contraindications Warnings/precautions Interactions Side effects/adverse reactions The cards will be collected at End-of-Rotation meetings and placed in each student’s file for faculty review. The cards will be graded on a pass/fail basis. At the end of the 10 rotations, the cards will be returned to the student to assist the student in their PANCE preparation. Failure to submit 10 drug cards at End of Rotation will result in a deduction of 10 points from the final rotation average. Physician Assistant Student Tracking (PAST): In order to ensure that students have access to a variety of clinical experiences during the clinical year, the Division of Physician Assistant Studies subscribes to the Typhon Group’s Physician Assistant Student Tracking (PAST) system. This system allows students to submit data regarding patient encounters, diagnoses, procedures completed, technical skills obtained, and other information in a secure, paperless system. Students must enter data within 7 days of the date that the patient was seen/procedure completed. If students do not do so, they will be locked out and will forfeit entry of these data. The Typhon Group system is monitored by the Division faculty and staff. Submissions will be graded on a pass/fail basis. Students who do not enter patient data on this system will lose 10 points from their final course average. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 97 of 206 Histories and Physicals Admission Notes / SOAP Notes: The requisite number of these notes must be entered on Typhon by your last day on rotation. The number and type of required notes is specified in the learning objectives of your Clinical Year Handbook. The student must submit notes on a computer. In accordance with HIPAA, patient names and medical record numbers must not appear anywhere on H&Ps, SOAP notes, or other documentation submitted to the Division of Physician Assistant Studies. The H&Ps and SOAP notes will be graded on a pass/fail basis. Failure to submit the required number of notes or comply with HIPAA will result in a deduction of 10 points from the final rotation average. Course Grades and Policies: The final course grade is calculated on the basis of two (2) components. These two components include the clinical evaluation form and the End-ofRotation Examination. The Clinical Course Evaluation completed by the preceptor, and available for student review in the Clinical Year Handbook, is worth 50% of the final clerkship course grade. The End-of-Rotation Examination, based on student learning objectives, is worth 50% of the final clerkship course grade. If the student fails the End-of-Rotation Examination with a score of less than 74, the student must take a remedial examination. If a student fails either the remedial exam OR if the student fails the course with a final average of less than 74, the student will receive a grade of F for the course and must repeat the clinical clerkship including the examination. Please refer to the Division’s Clinical Year Handbook for more information regarding this policy. The minimum passing grade for this course is a 74. All physician assistant students are graded on the following scale: Letter Grade Numerical Grade A AB+ B BC+ C F > = 93% 90 - 92.99 87 - 89.99 83 - 86.99 80 - 82.99 77 - 79.99 74 - 76.99 < 74 vb Graduate GPA Policy: All LIU graduate students must maintain a minimum overall GPA of 3.0 on a 4.0 scale in order to remain in good academic standing. THIS SYLLABUS IS SUBJECT TO CHANGE. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 98 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 606 OBSTETRICS AND GYNECOLOGY CLERKSHIP SYLLABUS Director of Clinical Education: Marion F. Masterson, PA-C, MPAS Course Director: James Eckert, PA-C, M.A. Required Texts: - Beckmann, CRB et al., Obstetrics and Gynecology, 7th edition. Philadelphia: Lippincott Williams and Wilkins, 2013. - Bickley, LS et al., Bates Guide to Physical Examination and History Taking, 10th Edition. Philadelphia: Lippincott Williams and Wilkins, 2008. - Costanzo, LS., Physiology, 4th edition with Student Consult Online Access. Philadelphia: Elsevier, 2009. - Goldman, LS et al., Cecil’s Medicine: Expert Consult Premium Edition: Enhanced online features and print, 24th edition. Philadelphia: Elsevier, 2011. - Gomella, LG et al., Clinician’s Pocket Reference, 11th edition. New York: McGraw-Hill, 2006. - Katzung, B., Basic and Clinical Pharmacology, 12th edition. New York: McGraw-Hill, 2011. - Kumar, V et al., Basic Pathology, 9th edition. Philadelphia: Saunders, 2012. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 99 of 206 Course Description: This clinical course is a clinical clerkship in obstetrics and gynecology. All clinical clerkships are five (5) weeks in length. Each student is assigned a clinical site and preceptor at the inception of the clinical year. Prerequisites: Successful completion of the didactic year of the Physician Assistant Studies curriculum. 2 (two) credits. Format: This course is comprised of an obstetrics and gynecology clerkship that is conducted in a hospital. The student is assigned to a preceptor and is charged with the care of patients as delegated by the preceptor. Teaching and Learning Strategies: This course includes supervised clinical work, teaching at the bedside by the preceptor and/or the attending physician; conferences and other lectures at the facility; End-of-Rotation lectures and Board Review lectures. Course Times and Dates: Specific times and dates are variable according to clinical clerkship site and preceptor. Estimate of Time Spent in this Course: The Accreditation Review Commission on Education of the Physician Assistant, Inc. (ARC-PA) requires that all clinical year students spend a minimum of 35 hours per week at the clinical site. However, there is no maximum number of hours that may be required. Course Goals: At the end of this course, the student will: 1. Have a deeper understanding and knowledge of the major diagnoses seen in obstetrics and gynecology 2. Be at a developing level in procedures used frequently in obstetrics and gynecology 3. Have increased understanding and knowledge of pharmacologic entities unique to obstetrics and gynecology with particular emphasis on agents safe or deleterious for use in pregnant or lactating patients 4. Have developed additional skills in working with a team 5. Have developed additional skills in case presentations 6. Have developed additional skills in writing Admission and SOAP notes, discharge summaries and other documentation required in obstetrics and gynecology Expected Learning Outcomes: At the end of this course, the student will (be): 1. Proficient at performing a history and physical exam specific to the obstetric and gynecologic patient 2. At a developing or proficient level of formulating an assessment and plan for obstetric and gynecologic patients 3. Adept at working with a team 4. Comfortable with and respectful of patients from other cultures and backgrounds from the student 5. Proficient at formulating a differential diagnosis of common complaints seen in obstetrics and gynecology 6. Proficient at formulating appropriate workup and treatment of common obstetric and gynecologic complaints 7. Developing or proficient at counseling patients appropriately concerning common obstetric and gynecologic complaints. Student Learning Objectives: Please see the Clinical Year Educational Objectives, which are to be found at the end of this book (Appendix I). LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 100 of 206 Attendance: Attendance is mandatory. Five (5) days may be used as sick days during the entire clinical year. After these five days have been exhausted, all excused absences must be made up. For more information on policies on attendance and unexcused absences, please see Attendance Issues (Chapter II). Professionalism: Students are expected to act professionally at all times when interacting with fellow classmates, preceptors, patients, other members of the health care team, and faculty members. Please refer to Academic and Professional Guidelines and Policies (Chapter III) concerning the policies on professionalism. COURSE REQUIREMENTS AND METHODS OF EVALUATION: Pharmacology Independent Study / Drug Card Completion: In order to successfully complete the course, all students must complete and turn in 10 drug cards to faculty at the end of rotation meeting. The drug cards must be hand written. The drugs they are chosen must be relevant to the patients that students’ cared for/were exposed to during their rotation. Each drug card must be labeled and include: • • • • • • • • • • Brand/generic drug name Class Indications Mechanism of action Adult indication and dosage Children indication and dosage (if drugs are contraindicated in children, you must note that.) Contraindications Warnings/precautions Interactions Side effects/adverse reactions The cards will be collected at End-of-Rotation meetings and placed in each student’s file for faculty review. The cards will be graded on a pass/fail basis. At the end of the 10 rotations, the cards will be returned to the student to assist the student in their PANCE preparation. Failure to submit 10 drug cards at End of Rotation will result in a deduction of 10 points from the final rotation average. Physician Assistant Student Tracking (PAST): In order to ensure that students have access to a variety of clinical experiences during the clinical year, the Division of Physician Assistant Studies subscribes to the Typhon Group’s Physician Assistant Student Tracking (PAST) system. This system allows students to submit data regarding patient encounters, diagnoses, procedures completed, technical skills obtained, and other information in a secure, paperless system. Students must enter data within 7 days of the date that the patient was seen/procedure completed. If students do not do so, they will be locked out and will forfeit entry of these data. The Typhon Group system is monitored by the Division faculty and staff. Submissions will be graded on a pass/fail basis. Students who do not enter patient data on this system will lose 10 points from their final course average. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 101 of 206 Histories and Physicals Admission Notes / SOAP Notes: The requisite number of these notes must be entered on Typhon by your last day on rotation. The number and type of required notes is specified in the learning objectives of your Clinical Year Handbook. The student must submit notes on a computer. In accordance with HIPAA, patient names and medical record numbers must not appear anywhere on H&Ps, SOAP notes, or other documentation submitted to the Division of Physician Assistant Studies. The H&Ps and SOAP notes will be graded on a pass/fail basis. Failure to submit the required number of notes or comply with HIPAA will result in a deduction of 10 points from the final rotation average. Course Grades and Policies: The final course grade is calculated on the basis of two (2) components. These two components include the clinical evaluation form and the End-ofRotation Examination. The Clinical Course Evaluation completed by the preceptor, and available for student review in the Clinical Year Handbook, is worth 50% of the final clerkship course grade. The End-of-Rotation Examination, based on student learning objectives, is worth 50% of the final clerkship course grade. If the student fails the End-of-Rotation Examination with a score of less than 74, the student must take a remedial examination. If a student fails either the remedial exam OR if the student fails the course with a final average of less than 74, the student will receive a grade of F for the course and must repeat the clinical clerkship including the examination. Please refer to the Division’s Clinical Year Handbook for more information regarding this policy. The minimum passing grade for this course is a 74. All physician assistant students are graded on the following scale: Letter Grade Numerical Grade A AB+ B BC+ C F > = 93% 90 - 92.99 87 - 89.99 83 - 86.99 80 - 82.99 77 - 79.99 74 - 76.99 < 74 Graduate GPA Policy: All LIU graduate students must maintain a minimum overall GPA of 3.0 on a 4.0 scale in order to remain in good academic standing. THIS SYLLABUS IS SUBJECT TO CHANGE. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 102 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 607 BEHAVIORAL MEDICINE CLERKSHIP SYLLABUS Director of Clinical Education: Marion F. Masterson, PA-C, MPAS Course Directors: Sharon Verity, PA-C, MPAS Required Texts: - Bickley, LS et al., Bates Guide to Physical Examination and History Taking, 10th edition. Philadelphia: Lippincott Williams and Wilkins, 2008. - Costanzo, LS., Physiology, 4th edition with Student Consult Online Access. Philadelphia: Elsevier, 2009. - Goldman, LS et al., Cecil’s Medicine: Expert Consult Premium Edition: Enhanced online features and print, 24th edition. Philadelphia: Elsevier, 2011. - Gomella, LG et al., Clinician’s Pocket Reference, 11th edition. New York: McGraw-Hill, 2006. - Katzung, B., Basic and Clinical Pharmacology, 12th edition. New York: McGraw-Hill, 2011. - Kumar, V et al., Basic Pathology, 9th edition. Philadelphia: Saunders, 2012. - McPhee, SJ et al., Current Medical Diagnosis and Treatment, 51st Edition. McGraw-Hill, 2011. - Sadock, BJ et al., Kaplan and Sadock’s Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry, 11th edition. Philadelphia: Lippincott Williams and Wilkins, 2014. - Venes D. Taber’s Cyclopedic Medical Dictionary, 21st Edition. Philadelphia: FA Davis, 2009. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 103 of 206 Course Description: This clinical course is a clinical clerkship in behavioral medicine. All clinical clerkships are five (5) weeks in length. Each student is assigned a clinical site and preceptor at the inception of the clinical year. Prerequisites: Successful completion of the didactic year of the Physician Assistant Studies curriculum. 2 (two) credits. Format: This course is comprised of an behavioral medicine clerkship that is conducted in a hospital. The student is assigned to a preceptor and is charged with the care of patients as delegated by the preceptor. Teaching and Learning Strategies: This course includes supervised clinical work, teaching at the bedside by the preceptor and/or the attending physician; conferences and other lectures at the facility; End-of-Rotation lectures and Board Review lectures. Course Times and Dates: Specific times and dates are variable according to clinical clerkship site and preceptor. Estimate of Time Spent in this Course: The Accreditation Review Commission on Education of the Physician Assistant, Inc. (ARC-PA) requires that all clinical year students spend a minimum of 35 hours per week at the clinical site. However, there is no maximum number of hours that may be required. Course Goals: At the end of this course, the student will: 1. Have a deeper understanding and knowledge of the major diagnoses seen in behavioral medicine 2. At a developing level in procedures used frequently in behavioral medicine 3. Have increased understanding and knowledge of pharmacologic entities unique to behavioral medicine 4. Have developed additional skills in working with a team 5. Have developed additional skills in case presentations 6. Have developed additional skills in writing Admission and SOAP notes, discharge summaries and other documentation required in behavioral medicine Expected Learning Outcomes: At the end of this course, the student will be: 1. Proficient at performing a history and physical exam specific to the behavioral medicine patient 2. At a developing or proficient level of formulating an assessment and plan for behavioral medicine patients 3. Adept at working with a team 4. Comfortable with and respectful of patients from other cultures and backgrounds from the student 5. Proficient at formulating a differential diagnosis of common complaints seen in behavioral medicine 6. Proficient at formulating appropriate workup and treatment of common behavioral medicine complaints 7. Developing or proficient at counseling patients appropriately concerning common behavioral medicine complaints. Student Learning Objectives: Please see the Clinical Year Educational Objectives, which are to be found at the end of this book (Appendix I). LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 104 of 206 Attendance: Attendance is mandatory. Five (5) days may be used as sick days during the entire clinical year. After these five days have been exhausted, all excused absences must be made up. For more information on policies on attendance and unexcused absences, please see Attendance Issues. Professionalism: Students are expected to act professionally at all times when interacting with fellow classmates, preceptors, patients, other members of the health care team, and faculty members. Please refer to Academic and Professional Guidelines and Policies concerning the policies on professionalism. COURSE REQUIREMENTS AND METHODS OF EVALUATION: Pharmacology Independent Study / Drug Card Completion: In order to successfully complete the course, all students must complete and turn in 10 drug cards to faculty at the end of rotation meeting. The drug cards must be hand written. The drugs they are chosen must be relevant to the patients that students’ cared for/were exposed to during their rotation. Each drug card must be labeled and include: • • • • • • • • • • Brand/generic drug name Class Indications Mechanism of action Adult indication and dosage Children indication and dosage (if drugs are contraindicated in children, you must note that.) Contraindications Warnings/precautions Interactions Side effects/adverse reactions The cards will be collected at End-of-Rotation meetings and placed in each student’s file for faculty review. The cards will be graded on a pass/fail basis. At the end of the 10 rotations, the cards will be returned to the student to assist the student in their PANCE preparation. Failure to submit 10 drug cards at End of Rotation will result in a deduction of 10 points from the final rotation average. Physician Assistant Student Tracking (PAST): In order to ensure that students have access to a variety of clinical experiences during the clinical year, the Division of Physician Assistant Studies subscribes to the Typhon Group’s Physician Assistant Student Tracking (PAST) system. This system allows students to submit data regarding patient encounters, diagnoses, procedures completed, technical skills obtained, and other information in a secure, paperless system. Students must enter data within 7 days of the date that the patient was seen/procedure completed. If students do not do so, they will be locked out and will forfeit entry of these data. The Typhon Group system is monitored by the Division faculty and staff. Submissions will be graded on a pass/fail basis. Students who do not enter patient data on this system will lose 10 points from their final course average. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 105 of 206 Histories and Physicals Admission Notes / SOAP Notes: The requisite number of these notes must be entered on Typhon by your last day on rotation. The number and type of required notes is specified in the learning objectives of your Clinical Year Handbook. The student must submit notes on a computer. In accordance with HIPAA, patient names and medical record numbers must not appear anywhere on H&Ps, SOAP notes, or other documentation submitted to the Division of Physician Assistant Studies. The H&Ps and SOAP notes will be graded on a pass/fail basis. Failure to submit the required number of notes or comply with HIPAA will result in a deduction of 10 points from the final rotation average. Course Grades and Policies: The final course grade is calculated on the basis of two (2) components. These two components include the clinical evaluation form and the End-ofRotation Examination. The Clinical Course Evaluation completed by the preceptor, and available for student review in the Clinical Year Handbook, is worth 50% of the final clerkship course grade. The End-of-Rotation Examination, based on student learning objectives, is worth 50% of the final clerkship course grade. If the student fails the End-of-Rotation Examination with a score of less than 74, the student must take a remedial examination. If a student fails either the remedial exam OR if the student fails the course with a final average of less than 74, the student will receive a grade of F for the course and must repeat the clinical clerkship including the examination. Please refer to the Division’s Clinical Year Handbook for more information regarding this policy. The minimum passing grade for this course is a 74. All physician assistant students are graded on the following scale: Letter Grade Numerical Grade A AB+ B BC+ C F > = 93% 90 - 92.99 87 - 89.99 83 - 86.99 80 - 82.99 77 - 79.99 74 - 76.99 < 74 Graduate GPA Policy: All LIU graduate students must maintain a minimum overall GPA of 3.0 on a 4.0 scale in order to remain in good academic standing. THIS SYLLABUS IS SUBJECT TO CHANGE. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 106 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 608 INTERNAL MEDICINE ELECTIVE CLERKSHIP SYLLABUS Director of Clinical Education: Marion F. Masterson, PA-C, MPAS Course Director: James Eckert, PA-C, M.A. Required Texts: - Bickley, LS et al., Bates Guide to Physical Examination and History Taking, 10th edition. Philadelphia: Lippincott Williams and Wilkins, 2008. - Costanzo, LS., Physiology, 4th edition with Student Consult Online Access. Philadelphia: Elsevier, 2009. - Goldman, LS et al., Cecil’s Medicine: Expert Consult Premium Edition: Enhanced online features and print, 24th edition. Philadelphia: Elsevier, 2011. - Gomella, LG et al., Clinician’s Pocket Reference, 11th edition. New York: McGraw-Hill, 2006. - Katzung, B., Basic and Clinical Pharmacology, 12th edition. New York: McGraw-Hill, 2011. - Kumar, V et al., Basic pathology, 9th edition. Philadelphia: Saunders, 2012. - McPhee, SJ et al., Current Medical Diagnosis and Treatment, 51st edition. McGraw-Hill, 2011. - Moore, K et al., Clinically Oriented Anatomy, 6th edition. Philadelphia: Lippincott Williams and Wilkins, 2009. - Sadock, BJ et al., Kaplan and Sadock’s Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry, 11th edition. Philadelphia: Lippincott Williams and Wilkins, 2014. - Venes, D., Taber’s Cyclopedic Medical Dictionary, 21st edition. Philadelphia: FA Davis, 2009. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 107 of 206 Course Description: This clinical course is a clinical clerkship in a particular discipline of internal medicine. All clinical clerkships are five (5) weeks in length. Each student is assigned a clinical site and preceptor after discussion with Professor Masterson and after any required paperwork is completed (application for an external site placement; completion of a new clinical contract) during the clinical year. The elective may also be conducted at an existing clinical site. Prerequisites: Successful completion of the didactic year of the Physician Assistant Studies curriculum. 2 (two) credits. Format: This course is comprised of an internal medicine clerkship that is conducted in a hospital. The student is assigned to a preceptor and is charged with the care of patients as delegated by the preceptor. Teaching and Learning Strategies: This course includes supervised clinical work, teaching at the bedside by the preceptor and/or the attending physician; conferences and other lectures at the facility; End-of-Rotation lectures and Board Review lectures. Course Times and Dates: Specific times and dates are variable according to clinical clerkship site and preceptor. Estimate of Time Spent in this Course: The Accreditation Review Commission on Education of the Physician Assistant, Inc. (ARC-PA) requires that all clinical year students spend a minimum of 35 hours per week at the clinical site. However, there is no maximum number of hours that may be required. Course Goals: At the end of this course, the student will: 1. Have a deeper understanding and knowledge of the major diagnoses seen in internal medicine with particular emphasis on the specialty or subspecialty chosen by the student for the elective 2. Be at a developing level in procedures used frequently in internal medicine with particular emphasis on the specialty or subspecialty chosen by the student for the elective 3. Have increased understanding and knowledge of pharmacologic entities unique to internal medicine with particular emphasis on the specialty or subspecialty chosen by the student for the elective 4. Have developed additional skills in working with a team 5. Have developed additional skills in case presentations 6. Have developed additional skills in writing Admission and SOAP notes, discharge summaries and other documentation required in internal medicine Expected Learning Outcomes: At the end of this course, the student will be: 1. Proficient at performing a history and physical exam specific to the discipline chosen for the elective by the student 2. At a developing or proficient level of formulating an assessment and plan for internal medicine patients with particular emphasis on the specialty or subspecialty chosen by the student for the elective 3. Adept at working with a team 4. Comfortable with and respectful of patients from other cultures and backgrounds from the student 5. Proficient at formulating a differential diagnosis of common complaints seen in internal medicine. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 108 of 206 6. Proficient at formulating appropriate workup and treatment of common internal medicine complaints with particular emphasis on the specialty or subspecialty chosen by the student for the elective 7. Developing or proficient at counseling patients appropriately concerning common internal medicine complaints with particular emphasis on the specialty or subspecialty chosen by the student for the elective. Student Learning Objectives: Please see the Clinical Year Educational Objectives that are to be found at the end of this book (Appendix I). Attendance: Attendance is mandatory. Five (5) days may be used as sick days during the entire clinical year. After these five days have been exhausted, all excused absences must be made up. For more information on policies on attendance and unexcused absences, please see Attendance Issues (Chapter II). Professionalism: Students are expected to act professionally at all times when interacting with fellow classmates, preceptors, patients, other members of the health care team, and faculty members. Please refer to Academic and Professional Guidelines and Policies (Chapter III) concerning the policies on professionalism. COURSE REQUIREMENTS AND METHODS OF EVALUATION: Pharmacology Independent Study / Drug Card Completion: In order to successfully complete the course, all students must complete and turn in 10 drug cards to faculty at the end of rotation meeting. The drug cards must be hand written. The drugs they are chosen must be relevant to the patients that students’ cared for/were exposed to during their rotation. Each drug card must be labeled and include: • • • • • • • • • • Brand/generic drug name Class Indications Mechanism of action Adult indication and dosage Children indication and dosage (if drugs are contraindicated in children, you must note that.) Contraindications Warnings/precautions Interactions Side effects/adverse reactions The cards will be collected at End-of-Rotation meetings and placed in each student’s file for faculty review. The cards will be graded on a pass/fail basis. At the end of the 10 rotations, the cards will be returned to the student to assist the student in their PANCE preparation. Failure to submit 10 drug cards at End of Rotation will result in a deduction of 10 points from the final rotation average. Physician Assistant Student Tracking (PAST): In order to ensure that students have access to a variety of clinical experiences during the clinical year, the Division of Physician Assistant Studies subscribes to the Typhon Group’s Physician Assistant Student Tracking (PAST) system. This system allows students to submit data regarding patient encounters, LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 109 of 206 diagnoses, procedures completed, technical skills obtained, and other information in a secure, paperless system. Students must enter data within 7 days of the date that the patient was seen/procedure completed. If students do not do so, they will be locked out and will forfeit entry of these data. The Typhon Group system is monitored by the Division faculty and staff. Submissions will be graded on a pass/fail basis. Students who do not enter patient data on this system will lose 10 points from their final course average. Histories and Physicals Admission Notes / SOAP Notes: The requisite number of these notes must be entered on Typhon by your last day on rotation. The number and type of required notes is specified in the learning objectives of your Clinical Year Handbook. The student must submit notes on a computer. In accordance with HIPAA, patient names and medical record numbers must not appear anywhere on H&Ps, SOAP notes, or other documentation submitted to the Division of Physician Assistant Studies. The H&Ps and SOAP notes will be graded on a pass/fail basis. Failure to submit the required number of notes or comply with HIPAA will result in a deduction of 10 points from the final rotation average. Course Grades and Policies: The final course grade is calculated on the basis of two (2) components. These two components include the clinical evaluation form and the End-ofRotation Examination. The Clinical Course Evaluation completed by the preceptor, and available for student review in the Clinical Year Handbook, is worth 50% of the final clerkship course grade. The End-of-Rotation Examination, based on student learning objectives, is worth 50% of the final clerkship course grade. If the student fails the End-of-Rotation Examination with a score of less than 74, the student must take a remedial examination. If a student fails either the remedial exam OR if the student fails the course with a final average of less than 74, the student will receive a grade of F for the course and must repeat the clinical clerkship including the examination. Please refer to the Division’s Clinical Year Handbook for more information regarding this policy. The minimum passing grade for this course is a 74. All physician assistant students are graded on the following scale: Letter Grade Numerical Grade A AB+ B BC+ C F > = 93% 90 - 92.99 87 - 89.99 83 - 86.99 80 - 82.99 77 - 79.99 74 - 76.99 < 74 Graduate GPA Policy: All LIU graduate students must maintain a minimum overall GPA of 3.0 on a 4.0 scale in order to remain in good academic standing. THIS SYLLABUS IS SUBJECT TO CHANGE. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 110 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 609 SURGICAL ELECTIVE CLERKSHIP SYLLABUS Director of Clinical Education: Marion F. Masterson, PA-C, MPAS Course Director: James Eckert, PA-C, M.A. Required Texts: - Bickley, LS et al., Bates Guide to Physical Examination and History Taking, 10th edition. Philadelphia: Lippincott Williams and Wilkins, 2008. - Costanzo, LS., Physiology, 4th edition with Student Consult Online Access. Philadelphia: Elsevier, 2009. - Doherty, GM et al., Current Surgical Diagnosis and Treatment, 13th edition. New York: Lange Medical Books / McGraw-Hill, 2009. - Gomella, LG et al. Clinician’s Pocket Reference, 11th edition. New York: McGraw-Hill, 2006. - Katzung, B., Basic and Clinical Pharmacology, 12th edition. New York: McGraw-Hill, 2011. - Kumar, V et al., Basic pathology, 9th edition. Philadelphia: Saunders, 2012. Recommended Textbooks: - Lawrence, P.F., Essentials of General Surgery, 4th edition. Philadelphia: Lippincott Williams & Wilkins, 2006. - Lawrence, P.F., Essentials of Surgical Specialties, 3rd edition. Philadelphia: Lippincott Williams & Wilkins, 2006. - Skinner, H.B. (Ed), Current Orthopedics Diagnosis and Treatment, 4th edition. New York: Lange Medical Books / McGraw-Hill, 2006. - Klingensmith, M.E. et al. (Eds), The Washington Manuel of Surgery, 6th edition. Philadelphia: Lippincott Williams & Wilkins, 2012. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 111 of 206 Course Description: This clinical course is a clinical clerkship in a particular discipline of surgery of the student’s choice. All clinical clerkships are five (5) weeks in length. Each student is assigned a clinical site and preceptor after discussion with Professor Masterson and after any required paperwork is completed (application for an external site placement; completion of a new clinical contract) during the clinical year. The elective may also be conducted at an existing clinical site. Prerequisites: Successful completion of the didactic year of the Physician Assistant Studies curriculum. 2 (two) credits. Format: This course is comprised of a surgery clerkship that is conducted in a hospital. The student is assigned to a preceptor and is charged with the care of patients as delegated by the preceptor. Teaching and Learning Strategies: This course includes supervised clinical work, teaching at the bedside by the preceptor and/or the attending physician; conferences and other lectures at the facility; End-of-Rotation lectures and Board Review lectures. Course Times and Dates: Specific times and dates are variable according to clinical clerkship site and preceptor. Estimate of Time Spent in this Course: The Accreditation Review Commission on Education of the Physician Assistant, Inc. (ARC-PA) requires that all clinical year students spend a minimum of 35 hours per week at the clinical site. However, there is no maximum number of hours that may be required. Course Goals: At the end of this course, the student will: 1. Have a deeper understanding and knowledge of the major diagnoses seen in surgery with particular emphasis on the specialty or subspecialty chosen by the student for the elective 2. Be at a developing level in procedures used frequently in surgery with particular emphasis on the specialty or subspecialty chosen by the student for the elective 3. Have increased understanding and knowledge of pharmacologic entities unique to surgery with particular emphasis on the specialty or subspecialty chosen by the student for the elective 4. Have developed additional skills in working with a team 5. Have developed additional skills in case presentations 6. Have developed additional skills in writing Admission and SOAP notes, discharge summaries and other documentation required in surgery Expected Learning Outcomes: At the end of this course, the student will (be): 1. Proficient at performing a history and physical exam specific to the discipline chosen for the elective by the student 2. At a developing or proficient level of formulating an assessment and plan for surgical patients with particular emphasis on the specialty or subspecialty chosen by the student for the elective 3. Adept at working with a team 4. Comfortable with and respectful of patients from other cultures and backgrounds from the student 5. Proficient at formulating a differential diagnosis of common complaints seen in surgery LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 112 of 206 6. Proficient at formulating appropriate workup and treatment of common surgical complaints with particular emphasis on the specialty or subspecialty chosen by the student for the elective 7. Developing or proficient at counseling patients appropriately concerning common surgical complaints with particular emphasis on the specialty or subspecialty chosen by the student for the elective. Student Learning Objectives: Please see the Clinical Year Educational Objectives that are to be found at the end of this book (Appendix I). Attendance: Attendance is mandatory. Five (5) days may be used as sick days during the entire clinical year. After these five days have been exhausted, all excused absences must be made up. For more information on policies on attendance and unexcused absences, please see Attendance Issues. Professionalism: Students are expected to act professionally at all times when interacting with fellow classmates, preceptors, patients, other members of the health care team, and faculty members. Please refer to Academic and Professional Guidelines and Policies concerning the policies on professionalism. COURSE REQUIREMENTS AND METHODS OF EVALUATION: Pharmacology Independent Study / Drug Card Completion: In order to successfully complete the course, all students must complete and turn in 10 drug cards to faculty at the end of rotation meeting. The drug cards must be hand written. The drugs they are chosen must be relevant to the patients that students’ cared for/were exposed to during their rotation. Each drug card must be labeled and include: • • • • • • • • • • Brand/generic drug name Class Indications Mechanism of action Adult indication and dosage Children indication and dosage (if drugs are contraindicated in children, you must note that.) Contraindications Warnings/precautions Interactions Side effects/adverse reactions The cards will be collected at End-of-Rotation meetings and placed in each student’s file for faculty review. The cards will be graded on a pass/fail basis. At the end of the 10 rotations, the cards will be returned to the student to assist the student in their PANCE preparation. Failure to submit 10 drug cards at End of Rotation will result in a deduction of 10 points from the final rotation average. Physician Assistant Student Tracking (PAST): In order to ensure that students have access to a variety of clinical experiences during the clinical year, the Division of Physician Assistant Studies subscribes to the Typhon Group’s Physician Assistant Student Tracking (PAST) system. This system allows students to submit data regarding patient encounters, LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 113 of 206 diagnoses, procedures completed, technical skills obtained, and other information in a secure, paperless system. Students must enter data within 7 days of the date that the patient was seen/procedure completed. If students do not do so, they will be locked out and will forfeit entry of these data. The Typhon Group system is monitored by the Division faculty and staff. Submissions will be graded on a pass/fail basis. Students who do not enter patient data on this system will lose 10 points from their final course average. Histories and Physicals Admission Notes / SOAP Notes: The requisite number of these notes must be entered on Typhon by your last day on rotation. The number and type of required notes is specified in the learning objectives of your Clinical Year Handbook. The student must submit notes on a computer. In accordance with HIPAA, patient names and medical record numbers must not appear anywhere on H&Ps, SOAP notes, or other documentation submitted to the Division of Physician Assistant Studies. The H&Ps and SOAP notes will be graded on a pass/fail basis. Failure to submit the required number of notes or comply with HIPAA will result in a deduction of 10 points from the final rotation average. Course Grades and Policies: The final course grade is calculated on the basis of two (2) components. These two components include the clinical evaluation form and the End-ofRotation Examination. The Clinical Course Evaluation completed by the preceptor, and available for student review in the Clinical Year Handbook, is worth 50% of the final clerkship course grade. The End-of-Rotation Examination, based on student learning objectives, is worth 50% of the final clerkship course grade. If the student fails the End-of-Rotation Examination with a score of less than 74, the student must take a remedial examination. If a student fails either the remedial exam OR if the student fails the course with a final average of less than 74, the student will receive a grade of F for the course and must repeat the clinical clerkship including the examination. Please refer to the Division’s Clinical Year Handbook for more information regarding this policy. The minimum passing grade for this course is a 74. All physician assistant students are graded on the following scale: Letter Grade Numerical Grade A AB+ B BC+ C F > = 93% 90 - 92.99 87 - 89.99 83 - 86.99 80 - 82.99 77 - 79.99 74 - 76.99 < 74 Graduate GPA Policy: All LIU graduate students must maintain a minimum overall GPA of 3.0 on a 4.0 scale in order to remain in good academic standing. THIS SYLLABUS IS SUBJECT TO CHANGE. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 114 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 610 CLINICAL ELECTIVE CLERKSHIP SYLLABUS Director of Clinical Education: Marion F. Masterson, PA-C, MPAS Course Director: James Eckert, PA-C, M.A. Required Texts: - Bickley, LS et al., Bates Guide to Physical Examination and History Taking, 10th edition. Philadelphia: Lippincott Williams and Wilkins, 2008. - Costanzo, LS., Physiology, 4th edition with Student Consult Online Access. Philadelphia: Elsevier, 2009. - Goldman, LS et al., Cecil’s Medicine: Expert Consult Premium Edition: Enhanced online features and print, 24th edition. Philadelphia: Elsevier, 2011. - Gomella, LG et al., Clinician’s Pocket Reference, 11th edition. New York: McGraw-Hill, 2006. - Katzung, B., Basic and Clinical Pharmacology, 12th edition. New York: McGraw-Hill, 2011. - Kumar, V et al., Basic pathology, 9th edition. Philadelphia: Saunders, 2012. - McPhee, SJ et al., Current Medical Diagnosis and Treatment, 51st edition. McGraw-Hill, 2011. - Moore, K et al., Clinically Oriented Anatomy, 6th edition. Philadelphia: Lippincott Williams and Wilkins, 2009. - Sadock, BJ et al., Kaplan and Sadock’s Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry, 11th edition. Philadelphia: Lippincott Williams and Wilkins, 2014. - Venes, D., Taber’s Cyclopedic Medical Dictionary, 21st edition. Philadelphia: FA Davis, 2009. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 115 of 206 Course Description: The elective clinical clerkship is a clinical clerkship in a particular discipline of medicine or surgery of the student’s choice. All clinical clerkships are five (5) weeks in length. Each student is assigned a clinical site and preceptor after discussion with Professor Masterson and after any required paperwork is completed (application for an external site placement; completion of a new clinical contract) during the clinical year. The elective may also be conducted at an existing clinical site. Prerequisites: Successful completion of the didactic year of the Physician Assistant Studies curriculum. 2 (two) credits. Format: This clinical course is comprised of a particular discipline of medicine or surgery clerkship that is conducted in a hospital. The student is assigned to a preceptor and is charged with the care of patients as delegated by the preceptor. Teaching and Learning Strategies: This course includes supervised clinical work, teaching at the bedside by the preceptor and/or the attending physician; conferences and other lectures at the facility; End-of-Rotation lectures and Board Review lectures. Course Times and Dates: Specific times and dates are variable according to clinical clerkship site and preceptor. Estimate of Time Spent in this Course: The Accreditation Review Commission on Education of the Physician Assistant, Inc. (ARC-PA) requires that all clinical year students spend a minimum of 35 hours per week at the clinical site. However, there is no maximum number of hours that may be required. Course Goals: At the end of this course, the student will: 1. Have a deeper understanding and knowledge of the major diagnoses seen in the specialty or subspecialty chosen by the student for the elective 2. Be at a developing level in procedures used frequently in the specialty or subspecialty chosen by the student for the elective 3. Have increased understanding and knowledge of pharmacologic entities unique to the specialty or subspecialty chosen by the student for the elective 4. Have developed additional skills in working with a team 5. Have developed additional skills in case presentations 6. Have developed additional skills in writing Admission and SOAP notes, discharge summaries and other documentation required in specialty or subspecialty chosen by the student for the elective Expected Learning Outcomes: At the end of this course, the student will (be): 1. Proficient at performing a history and physical exam specific to the discipline chosen for the elective by the student 2. At a developing or proficient level of formulating an assessment and plan for patients with diagnosis specific to the specialty or subspecialty chosen by the student for the elective 3. Adept at working with a team LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 116 of 206 4. Comfortable with and respectful of patients from other cultures and backgrounds from the student 5. Proficient at formulating a differential diagnosis of common complaints seen in discipline chosen for the elective by the student 6. Proficient at formulating appropriate workup and treatment of common complaints seen in the specialty or subspecialty chosen by the student for the elective 7. Developing or proficient at counseling patients appropriately concerning common complaints with particular emphasis on the specialty or subspecialty chosen by the student for the elective. Student Learning Objectives: Please see the Clinical Year Educational Objectives, which are to be found at the end of this book (Appendix I). Attendance: Attendance is mandatory. Five (5) days may be used as sick days during the entire clinical year. After these five days have been exhausted, all excused absences must be made up. For more information on policies on attendance and unexcused absences, please see Attendance Issues (Chapter II). Professionalism: Students are expected to act professionally at all times when interacting with fellow classmates, preceptors, patients, other members of the health care team, and faculty members. Please refer to Academic and Professional Guidelines and Policies (Chapter III) concerning the policies on professionalism. COURSE REQUIREMENTS AND METHODS OF EVALUATION: Pharmacology Independent Study / Drug Card Completion: In order to successfully complete the course, all students must complete and turn in 10 drug cards to faculty at the end of rotation meeting. The drug cards must be hand written. The drugs they are chosen must be relevant to the patients that students’ cared for/were exposed to during their rotation. Each drug card must be labeled and include: • • • • • • • • • • Brand/generic drug name Class Indications Mechanism of action Adult indication and dosage Children indication and dosage (if drugs are contraindicated in children, you must note that.) Contraindications Warnings/precautions Interactions Side effects/adverse reactions The cards will be collected at End-of-Rotation meetings and placed in each student’s file for faculty review. The cards will be graded on a pass/fail basis. At the end of the 10 rotations, the cards will be returned to the student to assist the student in their PANCE preparation. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 117 of 206 Failure to submit 10 drug cards at End of Rotation will result in a deduction of 10 points from the final rotation average. Physician Assistant Student Tracking (PAST): In order to ensure that students have access to a variety of clinical experiences during the clinical year, the Division of Physician Assistant Studies subscribes to the Typhon Group’s Physician Assistant Student Tracking (PAST) system. This system allows students to submit data regarding patient encounters, diagnoses, procedures completed, technical skills obtained, and other information in a secure, paperless system. Students must enter data within 7 days of the date that the patient was seen/procedure completed. If students do not do so, they will be locked out and will forfeit entry of these data. The Typhon Group system is monitored by the Division faculty and staff. Submissions will be graded on a pass/fail basis. Students who do not enter patient data on this system will lose 10 points from their final course average. Histories and Physicals Admission Notes / SOAP Notes: The requisite number of these notes must be entered on Typhon by your last day on rotation. The number and type of required notes is specified in the learning objectives of your Clinical Year Handbook. The student must submit notes on a computer. In accordance with HIPAA, patient names and medical record numbers must not appear anywhere on H&Ps, SOAP notes, or other documentation submitted to the Division of Physician Assistant Studies. The H&Ps and SOAP notes will be graded on a pass/fail basis. Failure to submit the required number of notes or comply with HIPAA will result in a deduction of 10 points from the final rotation average. Course Grades and Policies: The final course grade is calculated on the basis of two (2) components. These two components include the clinical evaluation form and the research paper. The clinical course evaluation completed by the preceptor is worth 50% of the final clerkship course grade and the research paper is worth 50% of the final clerkship course grade. The research paper is written on a clinical topic of particular interest to the student and that is germane to the medical or surgical specialty or subspecialty of the clinical elective. The paper is not to be a review of the literature regarding a particular topic. The student should also discuss the proposed topic with the clinical preceptor. Research papers are due on the first day of the End-of-Rotation meeting. Students who are unsure how to research the chosen topic may consult the Course Director, the Director of Clinical Education, or a reference librarian of the Long Island University Library. The research paper must be at least six (6) double spaced pages. There is no maximum length. Margins must be set at 1”inch in a font equal to or less than 12 point. At least ten (10) references are required which must be dated within the past ten (10) years. References must be from peer-reviewed medical journal articles or from standard medical textbooks. Footnotes and bibliographic citations should follow American Medical Association (AMA) guidelines. These guidelines are available in: Iverson C et al. American Medical Association manual of style: a guide for authors and editors, 10th edition. New York: Oxford University Press, 2007. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 118 of 206 Using the rubric that is attached to this syllabus the faculty grade the research paper. The rubric includes the following components: Paper topic; Epidemiology; Pathophysiology; Signs and symptoms; Physical examination findings; Diagnostic studies and results; Management; Clarity of writing and grammar; References. All research papers are screened by the faculty for evidence of plagiarism using search engines such as Google. All physician assistant students are graded on the following scale: Letter Grade Numerical Grade A AB+ B BC+ C F > = 93% 90 - 92.99 87 - 89.99 83 - 86.99 80 - 82.99 77 - 79.99 74 - 76.99 < 74 Graduate GPA Policy: All LIU graduate students must maintain a minimum overall GPA of 3.0 on a 4.0 scale in order to remain in good academic standing. THIS SYLLABUS IS SUBJECT TO CHANGE LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 119 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 610 - CLINICAL ELECTIVE RESEARCH PAPER EVALUATION RUBRIC Student’s Name: ______________________________ Faculty Member: ___________________ Date of Evaluation: ______________________________ Final Numerical Grade: ______________ % Google Search: Negative for Plagiarism Positive for Plagiarism (Automatic Failure) COMPONENT Paper Topic (11%) COMPONENT GRADE Exemplary (10-11 points) Proficient (8-9 points) Marginal (7 points) The topic that is completely appropriate to the clinical elective discipline. The topic is completely appropriate for the scope of the paper. The topic that is very appropriate to the clinical elective discipline. The topic is slightly too broad or too specific for the scope of the paper. The topic that is related to the clinical elective discipline. The topic is too broad or too specific for the scope of the paper. Proficient (8-9 points) Marginal (7 points) Contains significant epidemiologic data regarding the clinical entity, including population(s) affected and risk factors. Contains some epidemiologic data regarding the clinical entity, including population(s) affected and risk factors. Epidemiology (11%) Exemplary (10-11 points) Pathophysiology (11%) Exemplary (10-11 points) Contains thorough epidemiologic data regarding the clinical entity, including population(s) affected and risk factors. Contains a thorough, accurate explanation of the disease process. Marginal (7 points) Proficient (8-9 points) Explanation of the disease process is mostly complete and mostly accurate. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Contains some correct details of the disease process; OR description is incomplete or only partially accurate. Page 120 of 206 Unacceptable (5-6 points) The topic that is unrelated to the clinical elective discipline. The topic is completely inappropriate for the scope of the paper. Unacceptable (5-6 points) Contains little or no epidemiologic data regarding the clinical entity, including population(s) affected and risk factors. Unacceptable (5-6 points) Contains little or no explanation of the disease process; OR description is completely inaccurate. COMPONENT Signs & Symptoms (11%) Physical Exam Findings (11%) COMPONENT GRADE Exemplary (10-11 points) Contains a thorough and accurate description of signs and symptoms of clinical entity. Exemplary (10-11 points) Contains a thorough and accurate description of physical exam findings of clinical entity. Diagnostic Studies & Results (11%) Exemplary (10-11 points) Management (11%) Exemplary (10-11 points) Clarity of Writing; Grammar; Spelling (12%) Exemplary (10-12 points) References (11%) Contains a thorough and accurate description of laboratory, radiologic and other study findings appropriate to clinical entity. Contains a thorough and accurate description of the management appropriate to clinical entity. Grammar and spelling are free of errors. The paper is written in a very clear and concise manner. The paper is of the quality expected of a peer-reviewed journal submission. Proficient (8-9 points) Marginal (7 points) Contains a largely thorough and largely accurate description of signs and symptoms of clinical entity. The description of signs and symptoms of the clinical entity is present but contains errors or significant omissions of material. Proficient (8-9 points) Marginal (7 points) Contains a largely thorough and largely accurate description of physical exam findings of clinical entity. The description of physical exam findings of the clinical entity is present but contains errors or significant omissions of material. Marginal (7 points) Proficient (8-9 points) Contains a largely thorough and largely accurate description of laboratory, radiologic and other study findings appropriate to clinical entity. Marginal (7 points) Proficient (8-9 points) Contains a largely thorough and largely accurate description of the management appropriate to clinical entity. Proficient (8-9 points) There are only a few errors of grammar and spelling. The paper is written in a generally clear and concise manner. The paper is nearly of the quality expected of a peer-reviewed journal submission. The references follow only the American Medical Association (AMA) format. There are no errors. All references are less than ten (10) years old. All journal article references are from peer-reviewed journals. The references generally follow only the American Medical Association (AMA) format. There are errors in no more than 10% of the references. Almost all references (>90%) are less than ten (10) years old. Almost all journal article references (>90%) are from peer-reviewed journals. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 The description of the management appropriate to clinical entity is present but contains errors or significant omissions of material. Marginal (7-8 points) There are many errors of grammar and spelling. The paper is written in an unnecessarily verbose style OR the paper is unclear. Marginal (7.5 points) Proficient (8.5 points) Exemplary (10-11 points) The description of laboratory, radiologic and other study findings appropriate to clinical entity is present but contains errors or significant omissions of material. The references do not follow only the American Medical Association (AMA) format. Other formats (e.g., American Psychological Association) are used. There are numerous errors. Many references (>20%) are more than ten (10) years old. Only some (>50%) journal article references are from peer-reviewed journals. Page 121 of 206 Unacceptable (5-6 points) The description of signs and symptoms of the clinical entity is absent OR contains grave errors. Unacceptable (5-6 points) The description of physical exam findings of the clinical entity is absent OR contains grave errors. Unacceptable (5-6 points) The description of laboratory, radiologic and other study findings appropriate to clinical entity is absent OR contains grave errors. Unacceptable (5-6 points) The description of the management appropriate to clinical entity is absent OR contains grave errors. Unacceptable (5-7 points) More than 25% of the paper is affected by errors of spelling and grammar. The paper is very poorly written. It is difficult to understand the intent of the writer. Unacceptable (5 points) The references do not follow the American Medical Association (AMA) format at all. There are many errors. A large number (>40%) of references are more than ten (10) years old. Almost no (<30%) journal article references are from peerreviewed journals. DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 611 CLINICAL SEMINAR I SYLLABUS Director of Clinical Education: Marion F. Masterson, PA-C, MPAS Course Director: James Eckert, PA-C, M.A. Required Texts: - Bickley, LS et al., Bates Guide to Physical Examination and History Taking, 10th edition. Philadelphia: Lippincott Williams and Wilkins, 2008. - Costanzo, LS., Physiology, 4th edition with Student Consult Online Access. Philadelphia: Elsevier, 2009. - Goldman, LS et al., Cecil’s Medicine: Expert Consult Premium Edition: Enhanced online features and print, 24th edition. Philadelphia: Elsevier, 2011. - Gomella, LG et al., Clinician’s Pocket Reference, 11th edition. New York: McGraw-Hill, 2006. - Katzung, B., Basic and Clinical Pharmacology, 12th edition. New York: McGraw-Hill, 2011. - Kumar, V et al., Basic pathology, 9th edition. Philadelphia: Saunders, 2012. - McPhee, SJ et al., Current Medical Diagnosis and Treatment, 51st edition. McGraw-Hill, 2011. - Moore, K et al., Clinically Oriented Anatomy, 6th edition. Philadelphia: Lippincott Williams and Wilkins, 2009. - Venes, D., Taber’s Cyclopedic Medical Dictionary, 21st edition. Philadelphia: FA Davis, 2009. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 122 of 206 Course Description: Clinical Seminar I. In this seminar, students will draw on their clinical clerkship(s) in Internal Medicine and/or the Internal Medicine elective as well as all material previously learned in the entire PA Studies curriculum to produce and deliver a detailed patient case presentation from Internal Medicine or an Internal Medicine elective before a group of clinical year PA students and faculty member(s). Prerequisites: successful completion of the didactic year of the Physician Assistant Studies curriculum. 1 (one) credit. Format: Clinical seminar I is a seminar that takes place in the clinical year both in the clinical clerkship and during an End-of-Rotation meeting. It culminates in the presentation made by the student before a group of other students and a faculty member. Teaching and Learning Strategies: This course includes supervised clinical work, teaching at the bedside by the preceptor and/or the attending physician; use of medical databases and journals; review and interpretation of the medical literature; formulation of a written case presentation; production of a PowerPoint presentation; and public speaking. Course Times and Dates: Variable by clinical clerkship, site, and preceptor, and End-ofRotation meeting dates and times. Estimate of Time Spent in this Course: The Accreditation Review Commission on Education of the Physician Assistant, Inc. (ARC-PA) requires that all clinical year students spend a minimum of 35 hours per week at the clinical site. However, there is no maximum number of hours that may be required. It is estimated that the student will spend a minimum of fifteen (15) hours on this case from its inception to its completion. Course Goals: At the end of this course, the student will: 1. Be proficient at taking a medical history and performing a physical examination in internal medicine 2. Be proficient at gathering pertinent positive and negative clues in formulating a differential diagnosis, assessment and plan in internal medicine 3. Be proficient at interpreting ancillary studies in internal medicine 4. Be at a developing or proficient level in creating a PowerPoint presentation for a case in internal medicine 5. Be at a developing or proficient level in public speaking Expected Learning Outcomes: At the end of this course, the student will be: 1. Proficient at formulating a differential diagnosis of common complaints seen in the discipline chosen for the elective by the student 2. Proficient at formulating appropriate workup and treatment of complaints commonly seen in the specialty or subspecialty chosen by the student for the elective 3. Developing or proficient at counseling patients appropriately concerning common complaints unique to the specialty or subspecialty chosen by the student for the elective LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 123 of 206 Student Learning Objectives: Please see the Clinical Year Educational Objectives that are to be found at the end of this book (Appendix I). Attendance: Attendance is mandatory. For more information on policies on attendance and unexcused absences, please see Attendance Issues (Chapter II). Professionalism: Students are expected to act professionally at all times when interacting with fellow classmates, preceptors, patients, other members of the health care team, and faculty members. Please refer to Academic and Professional Guidelines and Policies (Chapter III) concerning the policies on professionalism. Methods of Evaluation: The grade is calculated on the basis of a rubric (see attached) used to evaluate the student’s presentation. The student must also present a peer-reviewed article that is germane to the case diagnosis and that has been published no more than ten (10) years ago. The student must discuss the findings of the article and how it relates to the case. Course Grades and Policies: The final course grade is calculated based on the case presentation made by the student before a group of other students and a faculty member. Using the rubric for case presentation, the faculty grade the case presentation of the student. The rubric is worth 100% of the clinical seminar grade. The student who receives less than a 74 on the case presentation will receive a grade of F for the course and must repeat the clinical seminar. Please refer to the Division’s Clinical Year Handbook for more information regarding this policy. Students are required to submit a copy of the case presentation and a journal article to the designated faculty member at end-of-rotation. Students should be prepared to send the case presentation and the journal article to a faculty member, if requested, up to one week before the end-of-rotation. All physician assistant students are graded on the following scale: Letter Grade Numerical Grade A AB+ B BC+ C F > = 93% 90 - 92.99 87 - 89.99 83 - 86.99 80 - 82.99 77 - 79.99 74 - 76.99 < 74 Graduate GPA Policy: All LIU graduate students must maintain a minimum overall GPA of 3.0 on a 4.0 scale in order to remain in good academic standing. THIS SYLLABUS IS SUBJECT TO CHANGE LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 124 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 611 – CLINICAL SEMINAR I CASE PRESENTATION EVALUATION RUBRIC Student’s Name: ___________________________ Date of Evaluation: ___________________________ COMPONENT Faculty Member: ________________________ Final Numerical Grade: ____________% COMPONENT GRADE History of Present Illness GRADE: ________ Exemplary (9-10 points) Proficient (8-9 points) Contains all elements of a thorough history of present illness. Medical History GRADE: ________ Physical Exam Findings GRADE: ________ Ancillary Test Results GRADE: ________ Marginal (7-8 points) Unacceptable (0-7 points) Contains most elements of a thorough history of present illness. Contains some elements of a thorough history of present illness. Contains only a few elements of a thorough history of present illness. Exemplary (9-10 points) Proficient (8-9 points) Marginal (7-8 points) Unacceptable (0-7 points) Contains all elements of a thorough medical history. Contains most elements of a thorough medical history. Contains some elements of a thorough medical history. Contains only a few elements of a thorough medical history. Exemplary (9-10 points) Proficient (8-9 points) Marginal (7-8 points) Unacceptable (0-7 points) Contains all elements of a thorough physical exam. Contains most elements of a thorough physical exam. Contains some elements of a thorough physical exam. Contains only a few elements of a thorough physical exam. Proficient (8-9 points) Marginal (7-8 points) Unacceptable (0-7 points) Contains a largely thorough and mostly accurate explanation of lab, radiologic and other results for the patient. Contains some explanation of lab, radiologic and other results for the patient. Numerous inaccuracies are noted. Contains little or no explanation of lab, radiologic and other results for the patient, OR the explanation is almost entirely inaccurate. Exemplary (9-10 points) Contains a thorough, accurate explanation of lab, radiologic and other results for the patient. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 125 of 206 COMPONENT COMPONENT GRADE Marginal (7.5 points) Proficient (8-9 points) Differential Diagnosis GRADE: ________ Exemplary (9-10 points) Contains a thorough and accurate differential diagnosis. Contains a largely thorough and largely accurate differential diagnosis. Assessment GRADE: ________ Exemplary (9-10 points) Proficient (8-9 points) Contains a thorough and accurate assessment. Contains a largely thorough and largely accurate assessment. Treatment Plan GRADE: ________ Exemplary (9-10 points) Proficient (8-9 points) Contains a thorough and accurate description of the treatment plan. Contains a largely thorough treatment plan. Hospital Course of Patient GRADE: ________ Exemplary (9-10 points) Proficient (8-9 points) Contains a thorough and accurate description of the hospital course. Contains a largely thorough and largely accurate description of the hospital course. Exemplary (9-10 points) Proficient (8-9 points) Refers to a peer-reviewed journal article published <10 years ago. Has full understanding of the article and comments on it. Refers to a peer-reviewed journal article published <10 years ago. Has good understanding of the article and comments on it. Refers to a non-peer reviewed medical journal article published at any time. Has some understanding of the article and comments on it. Proficient (8-9 points) Marginal (7.5 points) The quality is that of a good student presentation. Generally speaks well. Uses mostly appropriate medical terminology. Does not read from PowerPoint slides more than occasionally. Makes eye contact with audience. Answers questions relatively easily and accurately. The quality is that of a fledgling student presentation. Is difficult to hear at times. Uses appropriate medical terminology occasionally. Reads frequently from PowerPoint slides. Does not make eye contact with audience. Answers questions with difficulty. Reference Article GRADE: ________ Exemplary (9-10 points) Presentation Skills GRADE: ________ The quality is that of a professional presentation. Speaks well. Uses only appropriate medical terminology. Does not read from PowerPoint slides. Makes eye contact with audience. Answers questions easily and accurately. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 The differential diagnosis is present but contains numerous errors or significant omissions of material. Marginal (7.5 points) The assessment is present but contains numerous errors or significant omissions of material. Marginal (7.5 points) The treatment plan is present but contains numerous errors, OR significant omissions of material. Unacceptable (0-7 points) The differential diagnosis is absent OR contains grave errors. Unacceptable (0-7 points) The assessment is absent, OR contains grave errors. Unacceptable (0-7 points) The treatment plan is absent OR contains grave errors. Marginal (7.5 points) The description of the hospital course is present but contains numerous errors or significant omissions of material. Unacceptable (0-7 points) The description of the hospital course is absent OR contains grave errors. Marginal (7.5 points) Page 126 of 206 Unacceptable (0-7 points) Does not refer to a journal article, OR has little to no understanding of the article, or cannot comment on it. Unacceptable (0-7 points) The quality is very poor. Does not speak well. Uses no medical terminology. Reads directly from PowerPoint slides. Makes no eye contact with audience. Cannot answer questions. DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 612 CLINICAL SEMINAR II SYLLABUS Director of Clinical Education: Marion F. Masterson, PA-C, MPAS Course Director: James Eckert, PA-C, M.A. Required Texts: - Bickley, LS et al., Bates Guide to Physical Examination and History Taking, 10th edition. Philadelphia: Lippincott Williams and Wilkins, 2008. - Costanzo, LS., Physiology, 4th edition with Student Consult Online Access. Philadelphia: Elsevier, 2009. - Doherty, GM et al., Current Surgical Diagnosis and Treatment, 13th edition. New York: Lange Medical Books / McGraw-Hill, 2009. - Gomella, LG et al. Clinician’s Pocket Reference, 11th edition. New York: McGraw-Hill, 2006. - Katzung, B., Basic and Clinical Pharmacology, 12th edition. New York: McGraw-Hill, 2011. - Kumar, V et al., Basic Pathology, 9th edition. Philadelphia: Saunders, 2012. Recommended Textbooks: - Lawrence, P.F., Essentials of General Surgery, 4th edition. Philadelphia: Lippincott Williams & Wilkins, 2006. - Lawrence, P.F., Essentials of Surgical Specialties, 3rd edition. Philadelphia: Lippincott Williams & Wilkins, 2006. - Skinner, H.B. (Ed), Current Orthopedics Diagnosis and Treatment, 4th edition. New York: Lange Medical Books / McGraw-Hill, 2006. - Klingensmith, M.E. et al. (Eds), The Washington Manuel of Surgery, 6th edition. Philadelphia: Lippincott Williams & Wilkins, 2012. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 127 of 206 Course Description: Clinical Seminar II. In this seminar, students will draw on their clinical clerkship(s) in General Surgery and/or the surgical elective as well as all material previously learned in the entire PA Studies curriculum to produce and deliver a detailed patient case presentation from General Surgery or the surgical elective before a group of clinical year PA students and faculty member(s). Prerequisites: successful completion of the didactic year of the Physician Assistant Studies curriculum. 1 (one) credit. Format: Clinical seminar II is a seminar that takes place in the clinical year both in the clinical clerkship and during an End-of-Rotation meeting. It culminates in the presentation made by the student before a group of other students and a faculty member. Teaching and Learning Strategies: This course includes supervised clinical work, teaching at the bedside by the preceptor and/or the attending physician; use of medical databases and journals; review and interpretation of the medical literature; formulation of a written case presentation; production of a PowerPoint presentation; and public speaking. Course Times and Dates: Variable by clinical clerkship, site, and preceptor, and End-ofRotation meeting dates and times. Estimate of Time Spent in this Course: The Accreditation Review Commission on Education of the Physician Assistant, Inc. (ARC-PA) requires that all clinical year students spend a minimum of 35 hours per week at the clinical site. However, there is no maximum number of hours that may be required. It is estimated that the student will spend a minimum of fifteen (15) hours on this case from its inception to its completion. Course Goals: At the end of this course, the student will: 1. Be proficient at taking a medical history and performing a physical examination in surgery 2. Be proficient at gathering pertinent positive and negative clues in formulating a differential diagnosis, assessment and plan in surgery 3. Be proficient at interpreting ancillary studies in surgery 4. Be at a developing or proficient level in creating a PowerPoint presentation for a case in surgery 5. Be at a developing or proficient level in public speaking Expected Learning Outcomes: At the end of this course, the student will be: 1. Proficient at formulating a differential diagnosis of common complaints seen in surgery 2. Proficient at formulating appropriate workup and treatment of complaints commonly seen in surgery 3. Developing or proficient at counseling patients appropriately concerning common surgical complaints LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 128 of 206 Student Learning Objectives: Please see the Clinical Year Educational Objectives that are to be found at the end of this book (Appendix I). Attendance: Attendance is mandatory. For more information on policies on attendance and unexcused absences, please see Attendance Issues (Chapter II). Professionalism: Students are expected to act professionally at all times when interacting with fellow classmates, preceptors, patients, other members of the health care team, and faculty members. Please refer to Academic and Professional Guidelines and Policies (Chapter III) concerning the policies on professionalism. Methods of Evaluation: The grade is calculated on the basis of a rubric (see attached) used to evaluate the student’s presentation. The student must also present a peer-reviewed article that is germane to the case diagnosis and that has been published no more than ten (10) years ago. The student must discuss the findings of the article and how it relates to the case. Course Grades and Policies: The final course grade is calculated based on the case presentation made by the student before a group of other students and a faculty member. Using the rubric for case presentation, the faculty grade the case presentation of the student. The rubric is worth 100% of the clinical seminar grade. The student who receives less than a 74 on the case presentation will receive a grade of F for the course and must repeat the clinical seminar. Please refer to the Division’s Clinical Year Handbook for more information regarding this policy. Students are required to submit a copy of the case presentation and a journal article to the designated faculty member at end-of-rotation. Students should be prepared to send the case presentation and the journal article to a faculty member, if requested, up to one week before the end-of-rotation. All physician assistant students are graded on the following scale: Letter Grade Numerical Grade A AB+ B BC+ C F > = 93% 90 - 92.99 87 - 89.99 83 - 86.99 80 - 82.99 77 - 79.99 74 - 76.99 < 74 Graduate GPA Policy: All LIU graduate students must maintain a minimum overall GPA of 3.0 on a 4.0 scale in order to remain in good academic standing. THIS SYLLABUS IS SUBJECT TO CHANGE LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 129 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 612 – CLINICAL SEMINAR II CASE PRESENTATION EVALUATION RUBRIC Student’s Name: _______________________________ Date of Evaluation: _______________________________ COMPONENT Faculty Member: ________________________ Final Numerical Grade: ____________% COMPONENT GRADE Marginal (7-8 points) History of Present Illness GRADE: ________ Exemplary (9-10 points) Proficient (8-9 points) Contains all elements of a thorough history of present illness. Contains most elements of a thorough history of present illness. Contains some elements of a thorough history of present illness. Medical History GRADE: ________ Exemplary (9-10 points) Proficient (8-9 points) Marginal (7-8 points) Unacceptable (0-7 points) Contains all elements of a thorough medical history. Contains most elements of a thorough medical history. Contains some elements of a thorough medical history. Contains only a few elements of a thorough medical history. Physical Exam Findings GRADE: ________ Exemplary (9-10 points) Proficient (8-9 points) Marginal (7-8 points) Unacceptable (0-7 points) Contains all elements of a thorough physical exam. Contains most elements of a thorough physical exam. Contains some elements of a thorough physical exam. Contains only a few elements of a thorough physical exam. Proficient (8-9 points) Marginal (7-8 points) Unacceptable (0-7 points) Contains a largely thorough and mostly accurate explanation of lab, radiologic and other results for the patient. Contains some explanation of lab, radiologic and other results for the patient. Numerous inaccuracies are noted. Contains little or no explanation of lab, radiologic and other results for the patient, OR the explanation is almost entirely inaccurate. Ancillary Test Results GRADE: ________ Exemplary (9-10 points) Contains a thorough, accurate explanation of lab, radiologic and other results for the patient. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 130 of 206 Unacceptable (0-7 points) Contains only a few elements of a thorough history of present illness. COMPONENT COMPONENT GRADE Marginal (7.5 points) Proficient (8-9 points) Differential Diagnosis GRADE: ________ Exemplary (9-10 points) Contains a thorough and accurate differential diagnosis. Contains a largely thorough and largely accurate differential diagnosis. Assessment GRADE: ________ Exemplary (9-10 points) Proficient (8-9 points) Contains a thorough and accurate assessment. Contains a largely thorough and largely accurate assessment. Treatment Plan GRADE: ________ Exemplary (9-10 points) Proficient (8-9 points) Contains a thorough and accurate description of the treatment plan. Contains a largely thorough treatment plan. Exemplary (9-10 points) Proficient (8-9 points) Contains a thorough and accurate description of the hospital course. Contains a largely thorough and largely accurate description of the hospital course. Exemplary (9-10 points) Proficient (8-9 points) Refers to a peer-reviewed journal article published <10 years ago. Has full understanding of the article and comments on it. Refers to a peer-reviewed journal article published <10 years ago. Has good understanding of the article and comments on it. Hospital Course of Patient GRADE: ________ Reference Article GRADE: ________ Exemplary (9-10 points) Presentation Skills GRADE: ________ The quality is that of a professional presentation. Speaks well. Uses only appropriate medical terminology. Does not read from PowerPoint slides. Makes eye contact with audience. Answers questions easily and accurately. Marginal (7.5 points) The assessment is present but contains numerous errors or significant omissions of material. Marginal (7.5 points) The treatment plan is present but contains numerous errors, OR significant omissions of material. Unacceptable (0-7 points) The differential diagnosis is absent OR contains grave errors. Unacceptable (0-7 points) The assessment is absent, OR contains grave errors. Unacceptable (0-7 points) The treatment plan is absent OR contains grave errors. Marginal (7.5 points) The description of the hospital course is present but contains numerous errors or significant omissions of material. Unacceptable (0-7 points) The description of the hospital course is absent OR contains grave errors. Marginal (7.5 points) Proficient (8-9 points) The quality is that of a good student presentation. Generally speaks well. Uses mostly appropriate medical terminology. Does not read from PowerPoint slides more than occasionally. Makes eye contact with audience. Answers questions relatively easily and accurately. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 The differential diagnosis is present but contains numerous errors or significant omissions of material. Refers to a non-peer reviewed medical journal article published at any time. Has some understanding of the article and comments on it. Unacceptable (0-7 points) Does not refer to a journal article, OR has little to no understanding of the article, or cannot comment on it. Marginal (7.5 points) The quality is that of a fledgling student presentation. Is difficult to hear at times. Uses appropriate medical terminology occasionally. Reads frequently from PowerPoint slides. Does not make eye contact with audience. Answers questions with difficulty. Page 131 of 206 Unacceptable (0-7 points) The quality is very poor. Does not speak well. Uses no medical terminology. Reads directly from PowerPoint slides. Makes no eye contact with audience. Cannot answer questions. DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 613 CLINICAL SEMINAR III PANCE PREPARATION COURSE SYLLABUS Director of Clinical Education: Marion F. Masterson, PA-C, MPAS Course Director: Maria E. Compte, M.D., MPH & TM, C-Trop Med Required Texts: - Beckmann, CRB et.al., Obstetrics and Gynecology, 7th edition. Philadelphia: Lippincott Williams and Wilkins, 2013. - Bickley, LS et al., Bates Guide to Physical Examination and History Taking, 10th edition. Philadelphia: Lippincott Williams and Wilkins, 2008. - Costanzo, LS., Physiology, 4th edition with Student Consult Online Access. Philadelphia: Elsevier, 2009. - Doherty, GM et al., Current Surgical Diagnosis and Treatment, 13th edition. New York: Lange Medical Books / McGraw-Hill, 2009. - Fishbach, Francis, A Manual of Laboratory and Diagnostic Tests, 9th edition. Philadelphia: Lippincott Williams and Wilkins, 2014. - Goldman, LS et al., Cecil’s Medicine: Expert Consult Premium Edition: Enhanced online features and print, 24th edition. Philadelphia: Elsevier, 2011. - Gomella, LG et al., Clinician’s Pocket Reference, 11th edition. New York: McGraw-Hill, 2006. - Katzung, B., Basic and Clinical Pharmacology, 12th edition. New York: McGraw-Hill, 2011. - Kumar, V et al., Basic Pathology, 9th edition. Philadelphia: Saunders, 2012. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 132 of 206 - Marcdante, K. et al., Nelson Essentials of Pediatrics, 7th edition. Philadelphia: Saunders, 2013. - McPhee, SJ et al., Current Medical Diagnosis and Treatment, 51st edition. McGraw-Hill, 2011. - Moore, K et al., Clinically Oriented Anatomy, 6th edition. Philadelphia: Lippincott Williams and Wilkins, 2009. - Sadock, BJ et al., Kaplan and Sadock’s Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry, 11th edition. Philadelphia: Lippincott Williams and Wilkins, 2014. - Stone, K., Current Diagnosis &Treatment Emergency Medicine, 7th edition. New York: McGraw-Hill, 2011. - Venes, D., Taber’s Cyclopedic Medical Dictionary, 21st edition. Philadelphia: FA Davis, 2009. Course Description: In this seminar, students practice the techniques that will lead to successful completion of the Physician Assistant National Certifying Examination. The students will be offered board review lectures, as well as simulated examinations. Prerequisites: successful completion of the didactic year of the Physician Assistant Studies curriculum. 1 (one) credit. Format: Clinical seminar III is a seminar that takes place in the clinical year following completion of all clinical rotations. The preparation will be based on board review lectures presented via video and in person. Teaching and Learning Strategies: This course includes Board review lectures and frequent examinations given in order to prepare the student for the PANCE. Course Times and Dates: To be determined by the Division of Physician Assistant Studies and by the registrar office. Estimate of Time Spent in this Course: It is estimated that the student will spend a minimum of fifteen (15) hours in lecture and at least thirty (30) hours preparing at home by reading and studying for examinations. Course Goals: At the end of this course, the student will: 1. Be proficient at taking and passing written examinations in medicine and surgery 2. Understand use of the PANCE Blueprint for PANCE preparation 3. Understand and employ test-taking strategies specific to the PANCE LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 133 of 206 Expected Learning Outcomes: At the end of this course, the student will be: 1. Proficient at testing in all concepts of medicine and surgery covered on the PANCE Student Learning Objectives: Please see the Clinical Year Educational Objectives that are to be found at the end of this book (Appendix I). Attendance: Attendance is mandatory. For more information on policies on attendance and unexcused absences, please see Attendance Issues (Chapter II). Professionalism: Students are expected to act professionally at all times when interacting with fellow classmates and faculty members. Course Grades and Policies: The grade is calculated on the basis of several examinations given in order to prepare the student for the PANCE (These examinations do NOT include PACKRAT or other commercially prepared examinations). The student who receives less than a 74% average will receive a grade of F for the course and must repeat the clinical seminar but will not need to repeat clinical clerkships. The examinations comprise 100% of the clinical seminar grade. All physician assistant students are graded on the following scale: Letter Grade Numerical Grade A AB+ B BC+ C F > = 93% 90 - 92.99 87 - 89.99 83 - 86.99 80 - 82.99 77 - 79.99 74 - 76.99 < 74 Graduate GPA Policy: All LIU graduate students must maintain a minimum overall GPA of 3.0 on a 4.0 scale in order to remain in good academic standing. THIS SYLLABUS IS SUBJECT TO CHANGE LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 134 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 614 SUMMATIVE EVALUATION SYLLABUS Director of Clinical Education: Marion F. Masterson, PA-C, MPAS Course Director: Marion F. Masterson, PA-C, MPAS Required Texts: - Beckmann, CRB et.al., Obstetrics and Gynecology, 7th edition. Philadelphia: Lippincott Williams and Wilkins, 2013. - Bickley, LS et al., Bates Guide to Physical Examination and History Taking, 10th edition. Philadelphia: Lippincott Williams and Wilkins, 2008. - Costanzo, LS., Physiology, 4th edition with Student Consult Online Access. Philadelphia: Elsevier, 2009. - Doherty, GM et al., Current Surgical Diagnosis and Treatment, 13th edition. New York: Lange Medical Books / McGraw-Hill, 2009. - Fishbach, Francis, A Manual of Laboratory and Diagnostic Tests, 9th edition. Philadelphia: Lippincott Williams and Wilkins, 2014. - Goldman, LS et al., Cecil’s Medicine: Expert Consult Premium Edition: Enhanced online features and print, 24th edition. Philadelphia: Elsevier, 2011. - Gomella, LG et al., Clinician’s Pocket Reference, 11th edition. New York: McGraw-Hill, 2006. - Katzung, B., Basic and Clinical Pharmacology, 12th edition. New York: McGraw-Hill, 2011. - Kumar, V et al., Basic Pathology, 9th edition. Philadelphia: Saunders, 2012. - Marcdante, K. et al., Nelson Essentials of Pediatrics, 7th edition. Philadelphia: Saunders, 2013. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 135 of 206 - McPhee, SJ et al., Current Medical Diagnosis and Treatment, 51st edition. McGraw-Hill, 2011. - Moore, K et al., Clinically Oriented Anatomy, 6th edition. Philadelphia: Lippincott Williams and Wilkins, 2009. - Sadock, BJ et al., Kaplan and Sadock’s Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry, 11th edition. Philadelphia: Lippincott Williams and Wilkins, 2014. - Stone, K., Current Diagnosis &Treatment Emergency Medicine, 7th edition. New York: McGraw-Hill, 2011. - Venes, D., Taber’s Cyclopedic Medical Dictionary, 21st edition. Philadelphia: FA Davis, 2009. Course Description: In this course, students will draw on all material previously learned in the entire PA Studies curriculum to complete a summative evaluation, which includes a clinically oriented exercise and a written examination. Part of this evaluation will take place in the Division’s Simulation Laboratory. The student will demonstrate his or her ability to evaluate, stabilize, examine, diagnose, perform relevant clinical procedures, and treat the simulated patient (Sim-Man 3G). The student will also demonstrate the ability to work well with other members of the health care team and to provide culturally competent care. Prerequisites: successful completion of the didactic year of the Physician Assistant Studies curriculum. 1 (one) credit. Format: The summative evaluation is conducted in two formats: a written examination and practical clinical scenario(s) that occur in the last four months of the program. Teaching and Learning Strategies: This seminar includes work done by the student in order to prepare for the clinical scenario and the written examination. . Course Times and Dates: To be determined by the Division of Physician Assistant Studies and by the registrar office. Estimate of Time Spent in this Course: It is estimated that the student will spend a minimum of thirty (30) hours in the classroom/laboratory and hundred (100) hours at home in the preparing or this summative evaluation. Course Goals: At the end of this course, the student will: 1. Demonstrate the ability to examine, assess, diagnose and treat a patient 2. Demonstrate the ability to work well with other members of the health care team 3. Demonstrate the ability to be compassionate 4. Demonstrate the ability to be culturally competent 5. Demonstrate professionalism 6. Demonstrate knowledge of medicine and surgery LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 136 of 206 7. Demonstrate that s/he is capable of performing the tasks of a graduate physician assistant. Expected Learning Outcomes: At the end of this course, the student will be: 1. Able to function as a professional, compassionate, culturally competent and skilled PA. 2. Able to perform well on a written examination encompassing all aspects of medicine and surgery as outlined on the NCCPA Blueprint. Student Learning Objectives: Please see the Clinical Year Educational Objectives that are to be found at the end of this book (Appendix I). Attendance: Attendance is mandatory. For more information on policies on attendance and unexcused absences, please see Attendance Issues (Chapter II). Professionalism: Students are expected to act professionally at all times when interacting with fellow classmates and faculty members. Course Grades and Policies: The grade is calculated on the basis of two separate examinations: a written examination based on all material taught in the entire physician assistant curriculum, and the clinical scenario, in which the student must demonstrate the ability to assess, diagnose and treat a patient; to be compassionate; to be culturally competent; to be professional; and to demonstrate the ability to function at the level of a graduate PA. The clinical scenario is evaluated through use of a rubric that is attached to this syllabus. The student who receives less than a 74% average will receive a grade of F for the course and must repeat the clinical seminar. All physician assistant students are graded on the following scale: Letter Grade Numerical Grade A AB+ B BC+ C F > = 93% 90 - 92.99 87 - 89.99 83 - 86.99 80 - 82.99 77 - 79.99 74 - 76.99 < 74 Graduate GPA Policy: All LIU graduate students must maintain a minimum overall GPA of 3.0 on a 4.0 scale in order to remain in good academic standing. THIS SYLLABUS IS SUBJECT TO CHANGE LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 137 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 614 – SUMMATIVE EVALUATION SUMMATIVE EVALUATION RUBRIC Student’s Name: _______________________________ Date of Evaluation: _______________________________ COMPONENT Medical Knowledge GRADE: ________ Interpersonal Skills GRADE: _________ Faculty Member: _________________________ Final Numerical Grade: ____________% COMPONENT GRADE Outstanding (23 points) Superb performance. Demonstrates phenomenal understanding of medicine. Practices at the level one would expect of an experienced PA. Acts on subtle and major findings. Considers differential diagnoses. Demonstrates care that also incorporates cost-effectiveness and risk/benefit ratios. Proficient (20-22 points) Very good performance. Demonstrates very good understanding of medicine. Practices at the level one would expect of a graduate PA. Acts on major findings. Considers some differential diagnoses. Demonstrates care with reasonable concern for cost-effectiveness and risk/benefit ratio. Acceptable (18-19 points) Adequate performance. Demonstrates good understanding of medicine. Practices at the level one would expect of a clinical year PA student. Acts on most major findings. Considers at least a few differential diagnoses. Demonstrates care with at least some concern for cost effectiveness and riskbenefit ratio. Needs Improvement (16-18 points) Substandard performance. Demonstrates some understanding of medicine, but at a level below which one would expect of a clinical year PA student. Acts on few findings. Considers only a few differential diagnoses. Demonstrates minimal concern for cost effectiveness and risk-benefit ratio. Unacceptable (<16 points) Unacceptable performance. Demonstrates virtually no understanding of medicine. Practices at a level well below what one would expect of a clinical year PA student. Considers no differential diagnoses. Demonstrates no concern for cost effectiveness or for risk-benefit ratio. Outstanding (23 points) Works extremely well with other team members. Demonstrates excellent leadership. Collaborates well with others. An outstanding supervisor. Gives clear instructions and consistently solicits ideas from other team members. Proficient (20-22 points) Works very well with other team members. Demonstrates very good leadership. Collaborates well with others. An excellent supervisor. Gives generally clear instructions and frequently solicits ideas from other team members. Acceptable (18-19 points) Works well with other team members. Demonstrates good leadership. Collaborates with others. A good supervisor. Gives clear instructions most of the time and occasionally solicits ideas from other team members. Needs Improvement (16-18 points) Occasionally works well with other team members. Demonstrates leadership occasionally. Is not an effective supervisor. Gives clear instructions at least some of the time. Usually does not solicit ideas from other team members. Unacceptable (<16 points) Does not work well with other team members. Does not demonstrate any leadership. Ignores or is abusive to team members. Consistently gives unclear or confusing instructions. Does not involve team members at all in patient care or in decision making. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 138 of 206 COMPONENT Patient Care Skills GRADE: _________ Professionalism GRADE:_______ Intangibles GRADE:_______ COMPONENT GRADE Outstanding (23 points) Performs tasks with exceptional skill (including history, physical exam, and clinical procedures). Demonstrates comprehensive understanding of components of procedure(s). Proficient (20-22 points) Performs tasks very skillfully (including history, physical exam, and clinical procedures). Demonstrates very good understanding of components of procedure(s). Acceptable (18-19 points) Performs tasks skillfully (including history, physical exam, and clinical procedures). Demonstrates good understanding of components of procedure(s). Needs Improvement (16-18 points) Performs some but not all tasks with some skill (including history, physical exam, and clinical procedures). Does not complete all tasks. Does not demonstrate understanding of all components of procedure(s). Unacceptable (<16 points) Performs few, if any, tasks with some skill (including history, physical exam, and clinical procedures). Completes only a few tasks, if any. Demonstrates almost no understanding of any procedures. Treats patient and family with little to no respect. Outstanding (23 points) Treats patient and family with utmost respect. Demonstrates great understanding of the role and scope of practice of the PA. Interacts extremely well with other members of the team. Proficient (20-22 points) Treats patient and family with great respect. Demonstrates very good understanding of the role and scope of practice of the PA. Interacts very well with other members of the team. Acceptable (18-19 points) Treats patient and family very respectfully. Demonstrates good understanding of the role and scope of practice of the PA. Interacts well with other members of the team. Needs Improvement (16-18 points) Does not consistently treat patient and family with respect. Demonstrates at least some understanding of the role and scope of practice of the PA. Interacts adequately at times with some other members of the team. Unacceptable (<16 points) Treats patient and family with little to no respect. Rarely demonstrates understanding of the role and scope of practice of the PA. Interacts poorly with some members of the team. Outstanding (7-8 points) Calm and collected. Phenomenal bedside manner. A consummate professional. Proficient (6-7 points) Initially nervous but relaxed with time. Very good bedside manner. Acceptable (5-6 points) Remained nervous throughout scenario but was able to care for patient. Good bedside manner. Needs Improvement (4-5 points) Very anxious throughout scenario. Distracted. Was not focused on patient. Unacceptable (<4 points) Unable to focus on case. Distracted or inattentive. Had little to no interest in patient. COMMENTS: LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 139 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 615 CAPSTONE PROJECT SYLLABUS Director of Clinical Education: Marion F. Masterson, PA-C, MPAS Course Director: Maria E. Compte, M.D., MPH & TM, C-Trop. Med. Required Texts: - Beckmann, CRB et al., Obstetrics and Gynecology, 7th edition. Philadelphia: Lippincott Williams and Wilkins, 2013. - Bickley, LS et al., Bates Guide to Physical Examination and History Taking, 10th edition. Philadelphia: Lippincott Williams and Wilkins, 2008. - Costanzo, LS., Physiology, 4th edition with Student Consult Online Access. Philadelphia: Elsevier, 2009. - Doherty, GM et al., Current Surgical Diagnosis and Treatment, 13th edition. New York: Lange Medical Books / McGraw-Hill, 2009. - Fishbach, Francis, A Manual of Laboratory and Diagnostic Tests, 9th edition. Philadelphia: Lippincott Williams and Wilkins, 2014. - Goldman, LS et al., Cecil’s Medicine: Expert Consult Premium Edition: Enhanced online features and print, 24th edition. Philadelphia: Elsevier, 2011. - Gomella, LG et al., Clinician’s Pocket Reference, 11th edition. New York: McGraw-Hill, 2006. - Katzung, B., Basic and Clinical Pharmacology, 12th edition. New York: McGraw-Hill, 2011. - Kumar, V et al., Basic Pathology, 9th edition. Philadelphia: Saunders, 2012. - Marcdante, K. et al., Nelson Essentials of Pediatrics, 7th edition. Philadelphia: Saunders, 2013. - McPhee, SJ et al., Current Medical Diagnosis and Treatment, 51st edition. McGraw-Hill, 2011. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 140 of 206 - Moore, K et al., Clinically Oriented Anatomy, 6th edition. Philadelphia: Lippincott Williams and Wilkins, 2009. - Sadock, BJ et al., Kaplan and Sadock’s Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry, 11th edition. Philadelphia: Lippincott Williams and Wilkins, 2014. - Stone, K., Current Diagnosis &Treatment Emergency Medicine, 7th edition. New York: McGraw-Hill, 2011 - Venes, D., Taber’s Cyclopedic Medical Dictionary, 21st edition. Philadelphia: FA Davis, 2009. Course Description: Students will draw on all material previously learned in the entire PA Studies curriculum to complete a capstone project in partial fulfillment of the requirements of the Master’s degree. The student will formulate a research paper based on a clinical issue of interest to the student from one of the student’s clinical clerkships. The student will also use techniques learned in Research Methods I and II and in Introduction to Medical Literature in the didactic year. Prerequisites: successful completion of the didactic year of the Physician Assistant Studies curriculum. 2 (two) credits. Format: The capstone project is a research project that draws on didactic and clinical education and that is researched and written in the last semester of the clinical year. Students will be assigned a faculty advisor for the capstone project. Original research is not required for this project. The student identifies a topic of interest to him or her that has arisen in the course of the student’s clinical rotations and uses clinical inquiry, appropriate use of medical databases, understanding of research methodology and critical analysis to analyze the current medical literature on this topic. Teaching and Learning Strategies: Students will choose a project theme based on clinical practice at patient bedside. Students will spend time in lecture and will meet with faculty advisors individually in the preparation of and completion of the capstone project. Course Times and Dates: To be determined by the Division of Physician Assistant Studies and by the registrar office. Estimate of Time Spent in this Course: It is estimated that the student will spend a minimum of sixty (60) hours preparing at the clinical sites, thirty (30) hours with faculty advisers and hundred (100) hours at home to complete the capstone project. Course Goals: At the end of this course, the student will: 1. Demonstrate proficiency at researching an appropriate topic; 2. Demonstrate developing to proficient level skills in using medical databases; 3. Demonstrate proficiency in written English; 4. Demonstrate proficiency in using AMA format for references; 5. Demonstrate the ability to assess critically medical literature. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 141 of 206 Expected Learning Outcomes: At the end of this course, the student will be: 1. Able to analyze critically the medical literature; 2. Able to write a research paper while maintaining principles of academic honesty and integrity; 3. Able to identify, formulate, research, and write about a clinical topic of interest to the student. Student Learning Objectives: Please see the Clinical Year Educational Objectives that are to be found at the end of this book (Appendix I). Attendance: Attendance in lecture and at advisory meetings is mandatory. Professionalism: Students are expected to act professionally at all times when interacting with fellow classmates and faculty members. Course Grades and Policies: The grade is calculated on the basis of a rubric (see attached). The rubric assesses the depth and breadth of the research topic; the critical assessment of the medical literature assessed; the depth and breadth of the articles and other sources evaluated by the student; the ability of the student to use correct form of AMA format for references; and the ability of the student to write in correct English (based on grammar, spelling and punctuation). All papers should contain a minimum of twenty (20) references from peer-reviewed medical journals, all of which must be no more than ten (10) years old. All papers must be no less than 30 pages in length (double-spaced, 12 point font, with no more than a 1” margin on all sides). All papers will be assessed via Blackboard for potential plagiarism. The student who receives less than a 74% will receive a grade of F for the course and must repeat the clinical seminar. Please refer to the Division’s Clinical Year Handbook for more information regarding this policy. The capstone project comprises 100% of the clinical seminar grade. All physician assistant students are graded on the following scale: Letter Grade Numerical Grade A AB+ B BC+ C F > = 93% 90 - 92.99 87 - 89.99 83 - 86.99 80 - 82.99 77 - 79.99 74 - 76.99 < 74 Graduate GPA Policy: All LIU graduate students must maintain a minimum overall GPA of 3.0 on a 4.0 scale in order to remain in good academic standing. THIS SYLLABUS IS SUBJECT TO CHANGE LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 142 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 615 – CAPSTONE PROJECT RESEARCH PAPER EVALUATION RUBRIC Student Name: _________________________________ Type of Submission: ☐Draft ☐Final Faculty Name: _________________________________ Date of Review: ________________________ Plagiarism Screen: ☐Negative ☐Positive* Grade: _________% *RESULTS IN AUTOMATIC FAILURE OF PAPER AND COURSE Components Title 2 points Abstract 5 points Introduction 8 points Proficient Is descriptive of the research question and type of study work performed. (1.5-2 points) States clearly the research question being asked, Is written in one paragraph of about 100 words or less, Highlights most important findings with enough information to understand the work, States major findings and conclusions, Is a concise summary of question and findings. (4.5-5 points) Provides the reader with the necessary information to understand the present study, Arises the reader’s interest and stresses the importance of the research question, Gives appropriate information to previous studies that are relevant to the student’s current study, Does not contain superfluous information and/or is not wordy, Gives a description of the specific purpose of the study, a description of the hypothesis being tested and a brief summary of the strategy being used at the end of the introduction, Gives a description of the study system utilized (either narrative or systematic review of the medical literature). (7-8 points) Developing Needs Improvement Unacceptable Gives a general description of question and work performed. (0.5-1.5 points) Is present but incomplete or confusing. (0.5 points) Abstract is not well organized or concise, Is missing one component of good abstract (see first column). (2-4.5 points) Abstract does not give an overview that leads directly to the reader being able to state the major findings of the study, Is missing two components of a good abstract (see first column), (1-2 points) Is not written in a professional style, Is missing three or more components of a good abstract (see first column), Includes references in the abstract. (0-1 point) Contains some superfluous information, Does not arise the interest of the reader, Is missing some needed background information, Gives too much information--more like a summary, Has all the components of a good introduction but some parts may be difficult to understand, Gives a description of the study system with some comment on its appropriate use. (5-7 points) Is missing one or two components of a good introduction, Contains significant superfluous information, Gives a description of the study system. (1-5 points) Is missing needed information to understand the present study, OR: Is missing a description of the specific purpose of the study, a description of the hypothesis being tested and a brief summary of the strategy being used at the end of the introduction, Contains no information about the study system. (0-1 point) LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 143 of 206 Not present. (0 points) Components Proficient Developing Needs Improvement Unacceptable Methods 6 points Is written in paragraph form, Clearly describes the research steps undertaken, and the major characteristics of the medical articles reviewed, including: -main type of studies reviewed, -PICOS, -if longitudinal studies, length of follow up, -outcome measures of the studies reviewed (RR, OR, etc.), -biases and confounding, -main limitations of the studies reviewed. (5.5-6 points) Is written in paragraph form, Clearly describes most of the steps undertaken and at least 4 important characteristics of the medical articles reviewed (see first column). (3-5.5 points) Is written in paragraph form, Describes in basic manner the steps undertaken and at least 3 4 important characteristics of the medical articles reviewed (see first column), But the Methods section lacks detail or is confusing. (1-3 points) Is lacking several critical details so that it is impossible to understand the steps undertaken, There is no description of and the major characteristics of the medical articles reviewed (see first column). (0-1 points) Results 8 points All pertinent processed data from the main relevant articles is described, Raw unprocessed data is absent, Data is presented in a logical manner to enable the reader to draw conclusions, Important data is highlighted, No conclusions are included in this section, If present, all tables and figures have appropriate legends, If present, all tables and figures are described in the narrative text, If tables or figures are present, they are provided an appendix and correctly referenced in the body of the paper, Any appendix tables, graphs or figures ARE NOT counted as part of the 30 page minimum requirement for the paper. (7-8 points) All pertinent processed data from the main relevant articles data is described, Raw unprocessed data is absent, Most data presented in a logical manner to enable the reader to draw conclusions, Most important data is highlighted, If present, all tables and figures have appropriate legends, If present, all tables and figures are described in the narrative text, If tables or figures are present, they are provided an appendix and correctly referenced in the body of the paper, Any appendix tables, graphs or figures ARE NOT counted as part of the 30 page minimum requirement for the paper. (5-7 points) Most pertinent processed data from the main relevant articles is described, Raw unprocessed data is absent Most results presented as both narrative text and in figures and tables, Most data are presented in a logical manner to enable the reader to draw conclusions, Most important data is highlighted, Of present, most of the tables and figures have appropriate legends, If present, most tables and figures are described in the narrative text, If tables or figures are present, they are provided an appendix and correctly referenced in the body of the paper, Any appendix tables, graphs or figures ARE NOT counted as part of the 30 page minimum requirement for the paper. (1-5 points) Only raw, unprocessed data from the reviewed articles is present, Few results are presented as both narrative text and /or in figures and tables, Data are not clearly presented, Important data are not highlighted, If present, data in tables or figures are not described in narrative form and/or not correctly referenced or labeled, If tables or figures are present, they are provided in the body of the paper and/ or counted as part of the 30 page minimum requirement for the paper. (0-1 points) Discussion/ Conclusions 8 points Research question and hypothesis are restated, Conclusions are stated clearly with explicit reference to the data that support a conclusion, Argument for conclusions well organized, Importance of conclusions discussed, Conclusions related to other studies and put into a context of current knowledge, Clear differentiation between speculations and conclusions, Final paragraph states the major finding of the review study, Makes suggestions for future research or follow up investigations. (7-8 points) Conclusions are stated clearly with explicit reference to the data that support a conclusion, Argument for conclusions is generally well organized, Importance of conclusions discussed, Conclusions related to other studies and put into a context of current knowledge, Final paragraph states the major finding of the study. (5-7 points) Conclusions are stated clearly with reference to the data that support a conclusion, Argument for the conclusions can be understood but difficult to follow, Final paragraph states the major finding of the study. (1-5 points) Conclusions are stated but without sufficient reference to the findings that support it, Lacking several of the characters of a good discussion (see first column). (0-1 points) LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 144 of 206 Components Proficient Needs Improvement Unacceptable All cited sources present In required AMA format Minimum of 20 references Minimum 15 recent (2003-to present) References relevant and appropriate (2-4.5 points) Most cited sources present Generally in required format 14-19 total references and/or less than 15 recent (within 10 years) References relevant and appropriate (1-2 points) Many sources absent Inappropriate format References not most relevant/appropriate to study Less than 14 total, and/or less than 10 recent (within 10 years) (0.5-1 point) Bibliography 5 points Grammar and style 4 points Paragraphs well organized Sections with logical organization of paragraphs (especially introduction, results and conclusions) Few grammatical errors, typos and misspellings Appropriate word selection Correct use of medical/ scientific terms (3.5-4 points) Most paragraphs well organized Sections with logical organization of paragraphs (especially introduction, results and conclusions) Several grammatical errors, typos, and misspelling may be present Some misappropriate word usage errors (e.g. effect vs. affect) Some misuse of medical/scientific terms (2-3.5 points) Many paragraphs well organized Several grammatical errors, typos, and misspelling may be present. Frequent use of lay terminology in place of medical/scientific terms. (1-2 points) Paper lacks well organized paragraphs Sections do not contain information presented in a logical order Many grammatical errors Many misappropriate word usage errors (e.g., effect vs. affect) Mostly usage of lay term and/or misuse of medical/scientific terminology. (0-1 point) Paper Format and submission 4 points All components of the paper are in the appropriate format: - 30 pages minimum narratives -standard (Times NR, Calibri) 12 pt. font -double spacing -1 inch margins Author name and date is displayed Hard copy in black ink, stapled* Submitted by due date. Most components of the required format followed (see first column) Author name and date displayed Hard copy in black ink, stapled* Submitted by due date. An attempt made to follow required format Author name and date displayed Hard copy in black ink, stapled* Submitted by due date. No evidence of required format or Author name (and/or date) missing Hard copy printed in colored ink, and/or not stapled, and/or submitted electronically. * All cited sources present No references not cited in the body present In the required AMA format Minimum of 20 references Minimum 15 recent (within 10 years) References all highly relevant (4.5-5 points) Developing *(Unless electronic submission authorized by advisor) (2-3.5 points) *(Unless electronic submission authorized by advisor) (1-2 points) *(Unless electronic submission authorized by advisor) (3.5-4 points) Basic Overall Evaluation 45 - 50 points 40 - 44 points 35 - 39 points Course grades: A >93 A90-92.99 B+ 87-89.99 B 83-86.99 B80-82.99 C+ 77-79.99 C 74-76.99 F <74.00 LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 145 of 206 *(Unless electronic submission authorized by advisor) (0-1 point) 0 - 34 points APPENDIX I: DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 601 INTERNAL MEDICINE CLERKSHIP OBJECTIVES DESCRIPTION: This is a required five-week rotation, which takes place in a hospital setting. Students are required to attend conferences, lectures and may take call. Emphasis is placed on the hospitalized, acute, non-surgical adult patient. Students are also responsible for assigned readings and case presentations. At the end of the rotation, students will report to the Physician Assistant Program for administrative tasks and an examination. These are the required learning objectives for the Inpatient Medicine rotation. Students are responsible for meeting these objectives whether or not clinical examples are seen during the rotation experience. These objectives form the basis for the end of rotation examination. STUDENT RESPONSIBILITIES: The student is responsible for performing the admitting history and physical examination; daily monitoring of patients; diagnostic procedures and medical management (under supervision) of patients. Students are required to enter in TYPHON 4 complete histories and physicals (including impression, plan and follow-up) as well as 4 SOAP notes on other medical patients on the team. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 146 of 206 MS 601 Student Objectives Learning/Teaching Method Level of Competence Expected Evaluation Method Graduation Competency A. Clinical Knowledge of Common Medical Problems C, T K C, E PC, K The student will be able to describe and discuss the appropriate historical questions needed to be asked, and necessary portions of the physical exam to be performed in order to formulate a differential diagnosis for the following problems: Rationale: Physician assistants must understand and be familiar with common medical problems encountered in the inpatient environment. a. b. c. d. e. f. g. h. i. abdominal pain arthralgia bowel incontinence chest pain colicky pain constipation diarrhea difficulty breathing fatigue j. fever k. headache l. hematuria m. hemoptysis n. intermittent claudication o. jaundice p. JVD r. melena s. muscle wasting t. night sweats u. paresthesia v. pedal edema w. productive cough x. seizure y. shortness of breath z. syncope aa. tremor ab. urinary incontinence __________________________________________________________________________ Learning/Teaching Method: Level of Competence Expected: Evaluation Method: Graduation Competency: C– K– C– PC – Clinical Setting Knows Clinical Evaluation Patient Care LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 T– DEK- Textbook Does Examination Knowledge Page 147 of 206 ac. ad. ae. af. urinary retention vertigo vomiting weight loss MS 601 Student Objectives Learning/Teach ing Method Level of Competence Evaluation Expected Method Graduation Competency B. Diagnosis and Treatment of Common Medical Problems C, T K PC, K C, E The student will be able to demonstrate a working knowledge of the signs, symptoms, etiology, diagnosis, related lab values and management of patients with the following problems: Pulmonary Rationale: Physician assistants must understand and be familiar with methods of diagnosis and treatment of common medical conditions encountered in the inpatient setting. Cardiovascular Gastrointestinal Hematopoetic Pneumonia Tuberculosis Carcinoma Atelectasis Pneumothorax Hemothorax MI Hypertension CHF Aneurysm Angina Varicosities Duodenal ulcer Gastric ulcer Granulomatous disease Ulcerative colitis Parasites Obstruction Pulmonary embolism Endocarditis/pericarditis Pancreatitis Anemia Sickle cell anemia Hemophilia Hodgkin‘s disease Leukemia Multiple myeloma Hypercoagulable state COPD Asthma Pleural effusion Cardiac arrhythmias Rheumatic heart disease Cardiomyopathies Genitourinary Neurological UTI Pyelonephritis PID CVA/TIA Multiple sclerosis Alcoholism Altered mental status/states of consciousness Meningitis Seizure disorder Acute drug overdose Hepatitis Cholecystitis Cirrhosis Portal hypertension Musculoskeletal / Rheumatologic Hernated disc Rheumatoid arthritis Osteoarthritis Systemic lupus erythematosus Gout Fibromyalgia Vasculitis Endocrine Thyroid disease Diabetes mellitus Adrenal disorders Pituitary disorders Hyperlipidemia Renal failure BPH Renal calculi Prostate CA Infectious Disease HIV/AIDS and related opportunistic infections Sexually transmitted diseases Epstein-Barr virus Lyme disease Rabies Malaria LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 148 of 206 Electrolyte Imbalances Hyponatremia Hypernatremia Hypokalemia Hyperkalemia Hypocalcemia Hypercalcemia MS 601 Student Objectives Learning/Teaching Method Level of Competence Expected Evaluation Method Graduation Competency C. Pharmaceutical Knowledge C, T K C, E PC, K The student will be familiar with drug therapy, including but not limited to the following drug classifications: Rationale: Physician assistants must understand and be familiar with commonly used pharmaceutical agents encountered in the inpatient setting. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Analgesics Antacids Anxiolytics Antibiotics Antihypertensives Antidepressants Antiarrhythmics Bronchodilators Antifungals Antivirals LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 149 of 206 MS 601 Student Objectives Learning/Teaching Method Level of Competence Expected Evaluation Method Graduation Competency D. Skills Used in the Management of Common Medical Problems C, T K C, E PC, K A. The student will be able to perform the following technical skills used in inpatient medicine: 1. Lumbar puncture 2. Insertion of nasogastric tube 3. IV cannulization 4. Performance of EKG 5. Performing CPR 6. Administration of parenteral medication 7. Gastric lavage 8. Arterial blood gas sampling 9. Venipuncture/phlebotomy 10. Foley catheter insertion Rationale: Physician assistants must understand and be familiar with medical instrumentation skills commonly used in the inpatient environment. B. The student will be able to interpret test results including, but not limited to the following: 1. PA/lateral chest x-ray 2. Extremity films 3. Flat and upright abdominal x-rays 4. CBC with differential 5. SMA-20 6. Culture and sensitivity 7. PT/PTT/INR 8. Pulmonary function tests 9. EKGs 10. CD4 counts/viral loads 11. Serology 12. Urinalysis with microscopic C. The student will maintain appropriate medical records to include the following: 1. Complete physical examination 2. Complete medical history 3. SOAP progress notes 4. Admission orders 5. Discharge summaries LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 150 of 206 MS 601 Student Objectives E. Professional Skills Used in the Ambulatory Medicine Setting Learning/Teaching Method Level of Competence Expected Evaluation Method Graduation Competency C, T K C, E PC, K The student will be able to: Rationale: Physician assistants must demonstrate professional behavior in their relationships with patients and colleagues. 1. Demonstrate sensitivity and understanding in relating to the emotional and social background of the patient; 2. Relate and perform professionally in a working environment with other medical professionals; 3. Demonstrate a willingness to ask for help when appropriate from others; 4. Demonstrate the recognition of limits by using resource referrals and consultation with preceptor; 5. Demonstrate willingness to accept constructive criticism; 6. Show a general concern for patients as demonstrated in thoroughness of monitoring patients and attitudes toward record-keeping; 7. Demonstrate evidence of having read medical texts regarding medical conditions encountered on clinical rotation; 8. Demonstrate a constructively self-critical manner; 9. Perform duties with professional attitude with regard to: attendance, dress code, and general demeanor. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 151 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 602 GENERAL SURGERY CLERKSHIP OBJECTIVES DESCRIPTION: This is a required five-week rotation, which takes place on the surgical service in a hospital setting. Students are required to attend conferences, lectures and may take call. Students are also responsible for assigned readings and case presentations. At the end of the rotation, students will report to the Physician Assistant Program for administrative tasks and an examination. These are the required learning objectives for the Surgery rotation. Students are responsible for meeting these objectives whether or not clinical examples are seen during the rotation experience. These objectives form the basis for the end of rotation examination. STUDENT RESPONSIBILITIES: The student is responsible for performing the admitting history and physical examination for elective and emergency surgical patients; daily monitoring of patients; diagnostic procedures and surgical management (under supervision) of patients; pre- and post-operative management; and assisting in the operating room. Students are required to enter in TYPHON 4 complete histories and physicals (including impression, plan and follow-up) as well as 4 SOAP notes on other surgical patients on the team. These may include pre-op and post-op notes. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 152 of 206 MS 602 Student Objectives Learning/Teaching Method Level of Competence Expected Evaluation Method Graduation Competency A. Clinical Knowledge of Common Medical Problems C, T K C, E PC, K Rationale: Physician assistants must understand and be familiar with common medical problems encountered in the inpatient environment. The student will be able to describe and discuss the appropriate historical questions and pertinent physical examination needed to formulate a differential diagnosis for the following problems: 1. abdominal pain /distention 12. incontinence 2. back pain 13. jaundice 3. breast mass 14. nausea / vomiting, diarrhea/constipation 4. chest pain 15. neck mass 5. constipation 16. paresthesia 6. edema 17. peripheral ischemia 7. flank pain 18. rectal bleeding 8. foot drop 19. retention 9. hematemesis 20. scrotal mass 10. hematuria 21. shortness of breath 11. hemoptysis 22. varicose vein Demonstrate a working knowledge of the signs, symptoms, etiology, diagnosis, related lab values and management of patients with the following problems: 1. breast mass 31. volvulus 2. breast carcinoma 32. intussuception 3. goiter 33. colon cancer 4. carotid ASHD 34. hemorrhoids 5. carcinoma of the lung 35. anal fissure/anal polyps 6. pulmonary embolism 36. perirectal abscess 7. pneumothorax 37. thrombophlebitis 8. hemothorax 38. herniated disc 9. Mallory-Weiss syndrome 39. hernia (hiatal/abdominal/inguinal) 10. esophageal varices / carcinoma 40. arteriosclerotic occlusive disease / portal hypertension 11. gastritis 41. renal calculi 12. gastric carcinoma 42. shock 13. pancreatic carcinoma 43. aortic aneurysm 14. pancreatitis 44. burns 15. cholecystitis/lithiasis 45. acute abdomen 16. intestinal obstruction 46. testicular torsion LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 153 of 206 17. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. Meckel’s diverticulum appendicitis mesenteric adenitis Crohn’s disease ulcerative colitis empyema cholangitis prostate carcinoma BPH peritonitis blunt trauma pheochromocytoma DIC 47. 48. 49. 50. 51. 52. 53. 54. 55. Varicocele / spermatocele obstructive uropathies polycystic kidney disease electrolyte imbalance peptic ulcer / duodenal fractures pseudocolitis compartment syndrome lacerations The student should be able to recognize (through appropriate use of historical and physical examination skills) and know the management of the following post-operative complications: 1. fever 8. renal failure 2. wound infection/dehiscence 9. evisceration 3. pulmonary embolism 10. adhesions 4. pneumonia 11. atelectasis 5. urinary retention 12. arrhythmias 6. ileus 13. tetany 7. constipation In addition, the student will have a working knowledge of wound care. __________________________________________________________________________ Learning/Teaching Method: Level of Competence Expected: Evaluation Method: Graduation Competency: C– K– C– PC – Clinical Setting Knows Clinical Evaluation Patient Care LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 T– DEK- Textbook Does Examination Knowledge Page 154 of 206 MS 602 Student Objectives Learning/Teaching Method Level of Competence Evaluation Expected Method Graduation Competency B. Skills C, T K PC, K C, E 1. The student will be able to perform the following technical skills: a. appropriate surgical admission history b. appropriate surgical admission physical examination c. write appropriate operative and procedural notes d. perform necessary observations to record SOAP progress notes e. write discharge summaries Rationale: Physician assistants must understand, be familiar with the principles of, and have proficiency in general surgical skills 2. The student will be able to perform the following technical skills: a. arterial / venous blood collection b. starting review of etiology of surgical fever (5 W’s) c. taking EKG d. foley catheter placement e. NG tube placement f. placement and removal of sutures and surgical staples g. maintain aseptic technique: I. OR assisting II. wound debridement III. dressing changes h. interpret laboratory tests including but not limited to: I. CBC with differential II. electrolytes III. arterial blood gas IV. urinalysis and microscopic i. Interpret radiological findings reported by the radiologist for the following: I. flat and upright of the abdomen II. upper GI series III. barium anemia IV. extremity films j. distinguish normal from abnormal chest PA and lateral films LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 155 of 206 MS 602 Student Objectives Learning/Teaching Method Level of Competence Evaluation Expected Method Graduation Competency C. Pharmaceutical Knowledge C, T K PC, K Rationale: Physician assistants must understand and be familiar with commonly used pharmaceutical agents encountered in the inpatient setting. The student will be familiar with the indications, actions and adverse reactions of the following drug classifications. Student will know several of the agents commonly associated with the management of surgical patients in each class: 1. analgesics 2. antibiotics 3. anticoagulants 4. anesthetics. MS 602 Student Objectives D. Professional Skills Used in the Ambulatory Medicine Setting Rationale: Physician assistants must demonstrate professional behavior in their relationships with patients and colleagues. C, E Learning/Teaching Method Level of Competence Evaluation Expected Method Graduation Competency C, T K PC, K C, E The student will be able to: 1. Demonstrate sensitivity and understanding in relating to the emotional and social background of the patient; 2. Relate and perform professionally in a working environment with other medical professionals; 3. Demonstrate a willingness to ask for help when appropriate from others; 4. Demonstrate the recognition of limits by using resource referrals and consultation with preceptor; 5. Demonstrate willingness to accept constructive criticism; 6. Show a general concern for patients as demonstrated in thoroughness of monitoring patients and attitudes toward record-keeping; 7. Demonstrate evidence of having read medical texts regarding medical conditions encountered on clinical rotation; 8. Demonstrate a constructively self-critical manner; 9. Perform duties with professional attitude with regard to: attendance, dress code, and general demeanor. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 156 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 603 PEDIATRICS CLERKSHIP OBJECTIVES DESCRIPTION: This is a required five-week rotation, which takes place in a hospital, clinic or private office setting. Students are required to attend conferences, read suggested literature and may take call. At the end of rotation, students must report to the Physician Assistant Program for administrative tasks and an examination. These are the required learning objectives for the Pediatric rotation. Students are responsible for these objectives whether or not clinical examples are seen during the rotation experience. These objectives form the basis of the end of rotation examination. STUDENT RESPONSIBILITIES: The student will be responsible for obtaining histories from patients or caregivers, performing physical examinations, diagnostic procedures and medical management (under supervision) of patients. Students are required to enter in TYPHON 4 complete histories and physicals (including impression and plan) and 4 additional SOAP notes on other pediatric patients when at a hospital (inpatient) facility or 8 SOAP notes if scheduled at an outpatient facility. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 157 of 206 MS 603 Student Objectives Learning/Teaching Method Level of Competence Evaluation Expected Method Graduation Competency A. Clinical Knowledge of Common Medical Problems C, T D PC, K C, E The student will be able to describe and discuss the appropriate historical questions and physical examination to perform in order to formulate a differential diagnosis for the following problems: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Rationale: Physician assistants must understand and be familiar with common medical problems encountered in the pediatric environment. Poor weight gain Joint pain Sore throat Fever Abdominal pain Earache Rash Cough/wheezing Anemia Dehydration 11. Headache 12. Trauma: blunt/penetrating 13. Drug/toxic ingestion 14. Seizure 15. Nuchal rigidity 16. Colic 17. Diarrhea 18. Vomiting 19. GI bleeding 20. Lethargy __________________________________________________________________________ Learning/Teaching Method: Level of Competence Expected: Evaluation Method: Graduation Competency: C– K– C– PC – Clinical Setting Knows Clinical Evaluation Patient Care LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 T– DEK- Textbook Does Examination Knowledge Page 158 of 206 MS 603 Student Objectives Learning/Teaching Method Level of Competence Evaluation Expected Method Graduation Competency B. Diagnosis and Treatment of Common Medical Problems C, T D PC, K C, E The student will be able to identify signs, symptoms, etiology, diagnosis, related lab values and management of patients with the following conditions: Rationale: Physician assistants must understand and be familiar with methods of diagnosis and management of pediatric medical conditions. Infections: 1. Impetigo 2. Varicella/mumps/measles 3. External otitis 4. Acute/serous otitis media 5. Tonsilitis 6. Strep throat 7. Sinusitis 8. Conjunctivitis 9. Gastroenteritis 10. Influenza 11. URI 12. Pneumonia Congenital: 1. Syphilis 2. Hip dislocation 3. HIV infection 4. Pyloric stenosis 5. Undescended testicle 6. Umbilical hernia 7. Inguinal hernia 8. Cardiac anomalies 9. GI anomalies 10. GU anomalies 11. Extremity anomalies LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 13. Bronchitis 14. Epiglottitis 15. Mononucleosis 16. Infectious Meningitis 17. Appendicitis 18. Herpes simplex stomatitis/genitalis 19. UTI 20. Tinea pedis/corporis/etc 21. Scarlet fever 22. Rheumatic feer 23. Periorbital cellulitis 24. Roseola/fifth’s disease 25. Croup Inherited: 1. Down syndrome 2. Sickle cell disease 3. Bleeding dyscrasias 4. Chromosomal abnormalities Neontal: 1. Apnea 2. SIDS 3. Hyperbilirubinemia 4. APGAR determination 5. Rh sensitization Page 159 of 206 Dermatology: 1. Eczema 2. Urticaria 3. Monilia 4. Wart 5. Pyoderma 6. Hemangioma 7. Petechiae 8. Purpura 9. Seborrhea Scabies 10. Molluscum cantagiosun 11. Alopecia Other: 1. Nephrotic syndrome 2. Glomerulonephritis 3. Leukemia 4. Asthma 5. Pediatric HIV 6. Rheumatoid arthritis 7. Kawasaki’s disease 8. Meckel’s diverticulum 9. Intussusception 10. Volvulus 11. Hirschsprung’s disease 12. Cystic fibrosis 13. Wilm’s tumor 14. ADHD 15. Puberty 16. STD’s 17. Hand-foot-mouth disease LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Nutrition: 1. Failure to thrive 2. Iron deficiency anemia 3. Obesity 4. Anorexia nervosa/bulimia 5. Vitamin deficiency Social: 1. Child abuse; physical, sexual, emotional 2. Under stimulation 3. Patient/parent compliance Metabolic: 1. Juvenile diabetes mellitus 2. Lead poisoning 3. Phenylketonuria 4. G6PD deficiency Neurologic: Seizure Disorder Page 160 of 206 MS 603 Student Objectives Learning/Teaching Method Level of Competence Evaluation Expected Method Graduation Competency C. Counseling and Patient Education of Common Medical Problems C, T D PC, K C, E The student will be able to provide patient education concerning the treatment, disease process and preventative aspects of care to the patient/parents/guardians for the above listed disease processes. Rationale: Physician assistants must understand and be familiar with methods of counseling and of educating patients concerning common medical conditions encountered in the pediatric setting. Students will be able to give parents advice and education concerning: 1. 2. 3. 4. 5. 6. Nutrition Developmental norms Anticipatory guidance Immunizations Child care needs Safety: - car seats - poison control - household child proofing measures - water safety LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 161 of 206 MS 603 Student Objectives D. Skills Learning/Teaching Method C, T Level of Competence Evaluation Expected Method D C, E Graduation Competency PC, K 1. The student will be able to make assessments and/or provide counseling for the: a. need and frequency of well-baby visits b. need and frequency of follow up visits c. need for consultations and referrals 2. The student will be able to describe the appropriate immunization schedule for the pediatric population and understand the indication, contraindications and adverse reactions of the current immunizations available; 3. The student will be able to describe the development norm/milestones commonly assessed in the pediatric population and be able to make the appropriate referrals for evaluations of delays; 4. The students will know community resources available to the patient and their family; Rationale: Physician assistants must understand and be familiar with frequent skills needed to treat common medical problems encountered in the pediatric environment. 5. The student will consider the cost in relation to patient recommendation regarding treatment, foods, toys, etc.; 6. The student will be familiar with the medications commonly used in the pediatric population including indications, dosage and side effects; 7. The student will be able to perform the following technical skills: a. complete physical examination on pediatric patient, b. elicit a complete third party history, c. evaluate growth and development through the use of: growth charts and periodic examination, d. certain clinical skill including but not limited to: i. venipuncture, ii. arterial blood gas, iii. immunization administration, iv. obtain culture specimens: throat, urine, blood, v. allergic desensitizations, vi. lumbar puncture, vii. ppd placement. e. interpret the following test results: i. chest x-rays, ii. laboratory data: a. CBC with differential and retic, d. Urinanalysis and microscopic,. b. Electrolytes, e. Arterial blood gases, c. Lead screening tests, f. Bilirubin g. PKU screening LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 162 of 206 MS 603 Student Objectives Learning/Teaching Level of Competence Method Expected Evaluation Method Graduation Competency E. Professional Skills Used in the Pediatric Setting C, T C, E PC, K Rationale: Physician assistants must demonstrate professional behavior in their relationships with patients and colleagues. D The student will be able to: 1. Demonstrate sensitivity and understanding in relating to the emotional and social background of patients. 2. Relate and perform professionally in a working situation with other members of the health care team. 3. Demonstrate a willingness to ask for help when appropriate from other people and resources for patient care. 4. Demonstrate an openness to recognize limitations by using resource referrals and consultations with supervising preceptor when appropriate. 5. Demonstrate an openness to receive constructive criticism. 6. Show a general concern for patients as demonstrated in thoroughness of monitoring patients and attitudes toward record keeping. 7. Demonstrate having done independent outside reading concerning problems seen. 8. Demonstrates a constructively self-critical manner, and perform duties with professional attitude comprising such areas as attendance, dress code and general demeanor. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 163 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 604 FAMILY MEDICINE CLERKSHIP OBJECTIVES DESCRIPTION: This is a required five-week rotation, which takes place in an ambulatory/outpatient setting. Students are required to attend conferences, lectures and may take call. Students are also responsible for assigned readings and case presentations. At the end of the rotation, students will report to the Physician Assistant Program for administrative tasks and an examination. These are the required learning objectives for the outpatient medicine rotation. Students are responsible for meeting these objectives whether or not clinical examples are seen during the rotation experience. These objectives form the basis for the end of rotation examination. STUDENT RESPONSIBILITIES: The student is responsible for performing history and physical examinations, patient assessments, diagnostic procedures and followup care for a minimum of 5 patients per day under appropriate supervision. Students must submit 8 SOAP on TYPHON. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 164 of 206 MS 604 Student Objectives Learning/Teaching Level of Competence Method Expected Evaluation Method Graduation Competency A. Clinical Knowledge of Common Medical Problems C, T C, E PC, K Rationale: Physician assistants must understand and be familiar with common medical problems encountered in the outpatient environment. D The student will be able to describe and discuss the appropriate historical questions and physical examination to perform in order to formulate a differential diagnosis for the following problems: 1. Skin conditions 20. Polyuria/nocturia 2. Rashes 21. Penile discharge 3. Facial pain 22. Hematuria 4. Headaches 23. Genital lesions 5. Conjunctivitis 24. Menorrhagia 6. Dizziness/vertigo 25. Back pain 7. Visual disturbances 26. Strains/sprains 8. Epistaxis 27. Bone/joint pain 9. Obesity/weight change 28. Substance abuse 10. Fatigue 29. Depression 11. Breast mass 30. Anxiety reaction 12. Lymphadenopathy 31. Vaginal bleeding 13. Fever 32. Rectal bleeding 14. Cough 33. Constipation 15. Hemoptysis 34. Diarrhea 16. Chest pain (pleuritic, coronary) 35. Hematemesis 17. Palpitations 36. Vomiting 18. Shortness of breath 37. Dyspepsia 19. Abdominal pain 38. Jaundice 39. Vision loss ________________________________________________________________________ Learning/Teaching Method: Level of Competence Expected: Evaluation Method: Graduation Competency: C– K– C– PC – Clinical Setting Knows Clinical Evaluation Patient Care LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 T– DEK- Textbook Does Examination Knowledge Page 165 of 206 MS 604 Student Objectives Learning/Teaching Method Level of Competence Evaluation Expected Method Graduation Competency B. Diagnosis and Treatment of Common Medical Problems C, T D PC, K Rationale: Physician assistants must understand and be familiar with methods of diagnosis and treatment of common medical conditions encountered in the outpatient setting. C, E The student will be able to demonstrate a working knowledge of the signs, symptoms, etiology, diagnosis, related lab values and management of patients with the following problems: 1. Scabies 27. Esophagitis 2. Herpes zoster 28. GERD/Peptic ulcer disease 3. Syncope 29. Cholecystitis 4. Anemia 30. Hepatitis 5. “Red eye” 31. Pancreatitis 6. Headache 32. Gastroenteritis 7. Otitis externa 33. Hemorrhoids 8. Otitis media 34. Ectopic pregnancy 9. Sinusitis 35. Appendicitis 10. Hypo-/hyperthyroidism 36. Sexually transmitted diseases 11. Diabetes mellitus 37. Tinea pedis, versicolor, corporis, cruris, etc. 12. URI 38. Urinary retention 13. Asthma 39. Prostatitis 14. Pneumonia 40. Impotence 15. COPD 41. Low back pain 16. CHF 42. Renal calculi 17. Heart block 43. UTI 18. Arrhythmias 44. Muscle spasm 19. TIA 45. Gout 20. CVA 46. Phlebitis 21. Osteoarthritis 47. HIV 22. Rheumatoid arthritis 48. Contact dermatitis, acne, eczema 23. Hypertension 49. Pityriasis rosea 24. Benign prostatic hypertrophy 50. Psoriasis 25. Abnormal uterine bleeding 51. Esophageal tumor 26. Breast mass LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 166 of 206 MS 604 Student Objectives Learning/Teaching Method Level of Competence Expected Evaluation Method Graduation Competency C. Counseling and Patient Education of Common Medical Problems C, T D C, E PC, K The student will be able to demonstrate proficiency in counseling and educating patients in the following areas: Rationale: Physician assistants must understand and be familiar with methods of counseling and of educating patients concerning common medical conditions encountered in the outpatient setting. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Contraception Nutrition Heart disease High blood pressure HIV Sexually transmitted diseases Pregnancy Stress reduction Exercise Lifestyle changes Cancer Risk reduction LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 167 of 206 MS 604 Student Objectives Learning/Teaching Level of Competence Method Expected Evaluation Method Graduation Competency D. Pharmacologic Agents Used in the Treatment of Common Medical Problems C, T C, E PC, K Rationale: Physician assistants must understand and be familiar with pharmacologic agents used to treat common medical problems encountered in the outpatient environment. D The student will be familiar with the following classes of pharmacologic agents used to treat various conditions encountered in ambulatory medicine: 1. Analgesics 2. Antacids/5-HT blockers/proton pump inhibitors 3. Anxiolytics 4. Antiarrhythmics 5. Antidepressants 6. Antihypertensives 7. Diuretics 8. Antibiotics 9. Bronchodilators 10. NSAIDs/analgesics 11. Hypoglycemic agents 12. Anticonvulsants 13. Contraceptives 14. Antidepressants 15. Thyroid preparations 16. Hormones LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 168 of 206 MS 604 Student Objectives Learning/Teaching Method Level of Competence Evaluation Expected Method Graduation Competency E. Skills Used in the Management of Common Medical Problems C, T D PC, K Rationale: Physician assistants must understand and be familiar with medical instrumentation skills commonly used in the outpatient environment. C, E A. The student will be familiar with the following clinical skills used in ambulatory medicine: 1. Complete medical history and physical examination 2. Interim history and physical examination 3. Directed history and physical examination 4. Venipuncture 5. Electrocardiogram 6. Urinalysis 7. Dressing changes 8. Cast/splint application 9. Suturing/suture removal; stapling/staple removal 10. IM/subcutaneous/intradermal injections B. The student will be able to interpret test results including, but not limited to the following: 1. PA/lateral chest x-ray 2. Extremity films 3. CBC with differential 4. SMA-20 5. Serology 6. Urinalysis with microscopic 7. EKG LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 169 of 206 MS 604 Student Objectives Learning/Teaching Method Level of Competence Expected Evaluation Method Graduation Competency F. Professional Skills Used in the Ambulatory Medicine Setting C, T D C, E PC, K The student will be able to: Rationale: Physician assistants must demonstrate professional behavior in their relationships with patients and colleagues. 1. Demonstrate sensitivity and understanding in relating to the emotional and social background of the patient; 2. Relate and perform professionally in a working environment with other medical professionals; 3. Demonstrate a willingness to ask for help when appropriate from others; 4. Demonstrate the recognition of limits by using resource referrals and consultation with preceptor; 5. Demonstrate willingness to accept constructive criticism; 6. Show a general concern for patients as demonstrated in thoroughness of monitoring patients and attitudes toward record-keeping; 7. Demonstrate evidence of having read medical texts regarding medical conditions encountered on clinical rotation; 8. Demonstrate a constructively self-critical manner; 9. Perform duties with professional attitude with regard to: attendance, dress code, and general demeanor. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 170 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 605 EMERGENCY MEDICINE CLERKSHIP OBJECTIVES DESCRIPTION: This is a required five-week rotation, which takes place in the Emergency Department of a hospital. Students may be assigned to rotating shifts and report as scheduled. Students must also attend conferences, lectures and are responsible for assigned readings. Students must report to the Physician Assistant Program at the end of the rotation for administrative tasks and an examination. These are required learning objectives for the Emergency Medicine rotation. Students are responsible for meeting these objectives even if certain clinical examples are not seen during the rotation experience. These objectives form the basis of the end of rotation examination. STUDENT RESPONSIBILITIES: The student will be responsible for performing directed histories and physicals; diagnostic procedures and medical management (under supervision) of patients. Additionally, the student must submit on TYPHON 8 SOAP. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 171 of 206 MS 605 Student Objectives Learning/Teaching Method Level of Competence Evaluation Expected Method Graduation Competency A. Clinical Knowledge of Emergency Medical Problems C, T D PC, K C, E The student will be able to describe and discuss the appropriate historical questions and physical examination to perform in order to formulate a differential diagnosis for the following problems: 1. Abdominal pain 2. Altered states of consciousness 3. Burns 4. Chest pain 5. Difficulty breathing 6. Extremity features 7. Hemorrhage 8. Seizures 9. Shock 10. Trauma to include; head, thorax, abdomen and extremities 11. Anaphylaxis Rationale: Physician assistants must understand and be familiar with common medical problems encountered in the Emergency Department. __________________________________________________________________________ Learning/Teaching Method: Level of Competence Expected: Evaluation Method: Graduation Competency: C– K– C– PC – Clinical Setting Knows Clinical Evaluation Patient Care LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 T– DEK- Textbook Does Examination Knowledge Page 172 of 206 MS 605 Student Objectives Learning/Teaching Level of Competence Method Expected Evaluation Method Graduation Competency B. Diagnosis and Treatment of Acute Medical Problems C, T C, E PC, K D The student will be able to describe and discuss the appropriate historical questions and portions of the physical examination necessary to formulate a differential diagnosis for the following acute problems: Rationale: Physician assistants must understand and be familiar with methods of diagnosis and treatment of common medical conditions encountered in the emergency room setting. 1. 2. 3. 4. 5. 6. 7. 8. Allergic reaction Back pain Bursitis Diarrhea Dysuria Fever Flank pain Headache LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 9. 10. 11. 12. 13. 14. 15. 16. Laceration Nausea and vomiting Rectal bleeding Sprains/strains Sore Throat Urethral discharge Eye injuries DKA Page 173 of 206 MS 605 Student Objectives Learning/Teaching Method Level of Competence Expected Evaluation Method Graduation Competency C. Understanding Diagnosis and Management of Common Medical Problems in the Emergency Room Setting C, T D C, E PC, K Rationale: Physician assistants must understand and have a working knowledge of the conditions encountered in the Emergency Department. The student will identify signs, symptoms, etiology, diagnosis and lab values of the following problems: 1. Hemoptysis 25. PID 2. Pulmonary embolus 26. STD’s 3. Pulmonary edema 27. NGU 4. Acute epiglottitis 28. Fractures 5. Bronchial 29. Dislocations 6. Pneumonia 30. Septic joints 7. Pneumothorax 31. Sprain/strains 8. GI bleeding 32. Angina 9. Peptic ulcer disease asthma 33. Myocardial infarction 10. Appendicitis 34. Cardiac arrhythmias 11. Cholecystitis 35. Cardiac tamponade 12. Pancreatitis 36. Malignant hypertension 13. Abd aortic aneurysm 37. Drug abuse 14. CVA 38. ETOH abuse 15. Meningitis 39. Overdose 16. Coma 40. Anxiety disorders 17. Epidural hematoma 41. Acute psychotic 18. Subdural hematoma 42. Suicidal ideations 19. Seizure disorder 43. Shock 20. Subarachnoid bleed 44. Vasovagal syncope 21. Hematuria 45. Heat stroke/ exhaustion 22. UTI/ pyelonephritis 46. Frostbite 23. Renal colic 47. Herpes zoster 24. Ectopic pregnancy 48. Epistaxis LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 174 of 206 MS 605 Student Objectives Learning/Teaching Method Level of Competence Expected Evaluation Method Graduation Competency D. Patient Education C, T D C, E PC, K 1. The student will be able to provide patient education concerning treatment, disease process and preventative aspects of care to the patient and family members. 2. The student will be able to provide appropriate parameters for expectant follow up patients discharged from the emergency department. 3. The student will be able to make appropriate arrangements for follow up care. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 175 of 206 MS 605 Student Objectives Level of Learning/Teaching Competence Method Expected Evaluation Method Graduation Competency E. Skills C, T C, E PC, K D The student will be able to perform the following skills: 1. History taking and physical examination 2. Venipuncture/arterial blood gas collection 3. Tube insertion: IV lines, NG tubes, urinary catheters, chest tubes 4. I&D of superficial infections 5. Splint and cast application 6. EKG 7. Suture placement and removal 8. Lumbar puncture under direct supervision 9. Cardiopulmonary resuscitation at a minimum of BLS level of performance 10. Interpretation of the following: A. Imaging Studies: PA and lateral chest Flat and upright abdomen Skull series C-spine Lumbar spine Extremity films to rule out fracture CAT scans / MRI’s Sonography. B. Laboratory results: CBC with differential Electrolytes Arterial blood gases Urinanalysis and microscopic CSF fluid. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 176 of 206 MS 605 Student Objectives Learning/Teaching Method F. Professional Skills Used in C, T the Emergency Room Setting Rationale: Physician assistants must demonstrate professional behavior in their relationships with patients and colleagues. Level of Competence Expected Evaluation Method Graduation Competency D C, E PC, K The student will be able to: 1. Demonstrate sensitivity and understanding in relating to the emotional and social background of patients. 2. Relate and perform professionally in a working situation with other members of the health care team. 3. Demonstrate a willingness to ask for help when appropriate from other people and resources for patient care. 4. Demonstrate an openness to recognize limitations by using resource referrals and consultations with supervising preceptor when appropriate. 5. Demonstrate an openness to receive constructive criticism. 6. Show a general concern for patients as demonstrated in thoroughness of monitoring patients and attitudes toward record keeping. 7. Demonstrate having done independent outside reading concerning problems seen. 8. Demonstrates a constructively self-critical manner, and perform duties with professional attitude comprising such areas as attendance, dress code and general demeanor. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 177 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 606 OBSTETRICS AND GYNECOLOGY CLERKSHIP OBJECTIVES DESCRIPTION: This is a required five-week rotation, which takes place in a hospital, clinic or private practice setting. Students must attend conferences, lectures and may take call. Students are also responsible for assigned readings and case presentations. During the end of the rotation, students must report to the Physician Assistant Program for administrative tasks and an examination. The objectives for this rotation are divided into two categories: Obstetrics and Gynecology. Students are responsible for these objectives whether or not clinical examples are seen during the rotation experience. These objectives form the basis for the end of rotation examination. STUDENT RESPONSIBILITIES: The student will be responsible for performing histories and physical examinations: diagnostic procedures; monitoring of patients and medical management (under supervision) of obstetrical and gynecological patients. Additionally, students may assist in the delivery and operating rooms as directed by their clinical preceptor. Students must submit 4 complete histories and physicals (including impression and plan) and 4 SOAP progress notes for OB/GYN patients on TYPHON by the last day of rotation. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 178 of 206 MS 606 Student Objectives Learning/Teaching Method Level of Competence Evaluation Expected Method Graduation Competency A. Clinical Knowledge of Common Medical Problems C, T K PC, K C, E A. The student will know and be able to discuss the following: 1. 2. 3. 4. Rationale: Physician assistants must understand and be familiar with common medical problems encountered in the inpatient environment. How to make the presumptive diagnosis of pregnancy based on physical findings, history and laboratory confirmation (test reliability and timing). The cardiovascular, hematologic, gastrointestinal and other physiologic changes occurring in pregnancy during each trimester. How to obtain an Apgar score and discuss its significance. The meaning and significance of common obstetrical terms, including but not limited to the following: a. episiotomy b. cesarean section c. multiparity d. nulliparous e. extroverted/retroflexed/anteverted/ anteflexed uterus f. ectopic pregnancy g. amnioocentesis h. sonography i. gravidity j. biophysical profile (BPP) 5. 6. The stages of labor and its associated terms, i.e. effacement, staging, etc. Provide patient education regarding signs of labor, childbirth, maternal nutrition, hygiene and activity. 7. Estimate fetal age by dates and examination, using Leopold’s maneuvers. 8. Recognize the abnormalities of labor including prematurity, ineffective labor, cephalo-pelvic disproportion and fetal distress. 9. Monitor the fetus by various modalities including non-stress testing and scalp pH. 10. Recognize and describe the appropriate procedures and monitoring that occur during labor and delivery for both vaginal and cesarean births. 11. Provide patient education regarding the post-partum period including breast care and breastfeeding, episiotomy care, C-section wound care, activity and physiologic and hormonal changes, etc. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 179 of 206 12. Provide and utilize institution and community resources for patient with sub- optimal pregnancy outcomes. B. The student will know the implications, diagnosis and primary management and referral (if necessary) of the following common obstetrical problems/diagnosis and be able to identify these entities through history and physical examination skills: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. hyperemesis gravidarum hemorrhoids heartburn low back pain anemia urinary tract infection Braxton-Hicks contractions fatigue DM/gestational diabetes Rh incompatibility abruptio placentae / placenta previa premature rupture of membranes (PROM) Varicosities thrombophlebitis pre-eclampsia/leclampsia trimester specific bleeding placenta previa vaginal infections UTIs/pyelonephritis postpartum fever postpartum hemorrhage oligohydramnios/polyhydramnios spontaneous abortion threatened abortion LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 180 of 206 GYNECOLOGY Clinical Knowledge: The student will be able to: A. Understand normal reproductive anatomy, the menstrual cycle and explain the physiology and hormonal patterns associated with menarche, normal menstrual cycle and birth control pills. B. Diagnose and identify the common etiologies of: 1. menorrhagia 2. menopause 3. menarche 4. metrorrhagaia 5. premenstrual syndrome 6. amenorrhea 7. oligomeorrhea 8. menometrorrhagia 9. Dysfunctional uterine bleeding (DUB) C. Describe the signs and symptoms associated with vaginal discharge and infections including: 1. trichomoniasis vaginalis 2. chlamydial infection 3. pelvic inflammatory disease 4. candida albicans 5. bacterial vaginosis 6. gonorrhea 7. herpes simplex II 8. syphilis D. Identify and know the treatment for the following conditions: 1. condylomata acuminato 2. Leiomyomas (fibroids) 3. Bartholin’s cyst 4. ovarian cyst 5. pediculosis pubis 6. polyps (cervical/cndometrial) 7. Nabothian cyst E. List the diagnostic techniques, signs and symptoms, epidemiology, prognosis and management for carcinoma of the vagina, cervix, endometrium and ovary. F. Recognize other common gynecological problems such as endometriosis, urinary stress incontinence, rectal/uterine prolapse; and know at least one possible treatment modality for each. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 181 of 206 G. Provide patient education and counseling regarding issues common to the female patient including, but not limited to: 1. proper diet and exercise 2. stress reduction 3. annual physical examination 4. HIV testing and follow up 5. Papanicolaou smear 6. mammography 7. menopause 8. lifestyle and risk reduction H. Provide patient education regarding family planning and contraception and know indications, contraindications and mode of action for: 1. Hormonal contraception 2. intrauterine device 3. diaphragm 4. Termination of pregnancy 5. foam 6. condom (male and female) 7. Emergency contraception 8. Sterilization I. Be familiar with: 1. risk factors associated with birth defects 2. common genetic disorders and incidence 3. indications for amniocentesis, CVS and their associated risks J. Provide counseling and support for sexual assault victims and perform the appropriate physical examination and obtain the necessary samples and information for the police report. __________________________________________________________________________ Learning/Teaching Method: Level of Competence Expected: Evaluation Method: Graduation Competency: C– K– C– PC – Clinical Setting Knows Clinical Evaluation Patient Care LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 T– DEK- Textbook Does Examination Knowledge Page 182 of 206 MS 606 Student Objectives Learning/Teaching Method Level of Competence Expected Evaluation Method Graduation Competency B. Skills C, T K C, E PC, K The student will be able to perform: A. A complete obstetrical and gynecological history B. A complete physical examination including: breasts, abdominal, pelvic, rectal and bimanual examination Rationale: Physician assistants must understand, be familiar with the principles of, and have proficiency in general surgical skills C. An interim obstetrical exam including determination of fetal growth and position and assessment of clinical pelvimetry D. A Papanicolaou smear E. Obtain and evaluate a wet mount F. Venipuncture and insertion and discontinuance of IV therapy G. Aseptic technique H. Preparation of a sterile field using aseptic technique I. Assist in obstetrical/gynecological surgical procedures and deliveries LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 183 of 206 MS 606 Student Objectives Learning/Teaching Level of Competence Method Expected C. Pharmaceutical Knowledge C, T K Evaluation Method Graduation Competency C, E PC, K The student will be familiar with the indications, actions, dosages and side effects of the medications commonly used in the obstetrical/gynecological population, including but not limited to: Rationale: Physician assistants must understand and be familiar with commonly used pharmaceutical agents encountered in the inpatient setting. 1. Hormonal contraception 2. Tocolytics 3. Prostaglandins 4. Oxytocin 5. Methergine 6. Progesterones 7. Estrogens 8. Alpha-adrenergic agents 9. Selective serotonin reuptake inhibitors 10. Analgesics 11. Local anesthetics 12. Antibiotics LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 184 of 206 MS 606 Student Objectives Learning/Teaching Level of Competence Method Expected Evaluation Method Graduation Competency D. Professional Skills Used in the Ambulatory Medicine Setting C, T C, E PC, K K The student will be able to: A. demonstrate sensitivity and understanding in relating to the emotional and social background of patients; B. relate and perform professionally in a working situation with other members of the health care team; C. demonstrate a willingness to ask for help when appropriate from other people and resources for patient care; Rationale: Physician assistants must demonstrate professional behavior in their relationships with patients and colleagues. D. demonstrate an openness to recognize limitations by using resource referrals and consultation with supervising preceptor when appropriate; E. demonstrate an openness to receive constructive criticism; F. show a general concern for patients as demonstrated in thoroughness of monitoring patients and attitudes toward record keeping; G. demonstrate having done independent outside reading concerning problems seen; H. demonstrate a constructively self-critical manner; and I. perform duties with professional attitude comprising such areas as attendance, dress code and general demeanor. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 185 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 607 BEHAVIORAL MEDICINE CLERKSHIP OBJECTIVES DESCRIPTION: This is a required five-week rotation in Psychiatry, which takes place in a hospital, clinic or private practice setting. Students must attend conferences, lectures and may take call. Students are also responsible for assigned readings and case presentations. During the end of the rotation, students must report to the Physician Assistant Program for administrative tasks and an examination. Additionally, the student is responsible for performing a satisfactory physical diagnosis practical as outlined in the Senior Year Guidelines and Policies. Students are responsible for these objectives whether or not clinical examples are seen during the rotation experience. These objectives form the basis for the end of rotation examination. STUDENT RESPONSIBILITIES: The student will be responsible for performing histories and mental status examinations: diagnostic procedures; monitoring of patients and medical management (under supervision) of psychiatric patients. Additionally, students may assist in therapeutic community and/or group activities as directed by their clinical preceptor. Students must enter in TYPHON 4 complete histories and physicals (including impression and plan) and 4 SOAP progress notes or 8 SOAP notes if at an outpatient facility. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 186 of 206 MS 607 Student Objectives Learning/Teaching Method Level of Competence Evaluation Expected Method Graduation Competency A. Clinical Knowledge of Psychiatric Illness C, T D PC, K C, E The student will demonstrate a working knowledge of the etiology, clinical symptoms, course of the disorder, differential diagnosis and treatment modalities of the following: 1. Schizophrenia 2. Bipolar disorders 3. Major depression 4. Cyclothymia 5. Dysthymia 6. Personality disorders 7. Anxiety disorders 8. Organic mental syndromes 9. Substance abuse disorders 10. Incest 11. Dementia 12. Delirium 13. Eating disrders 14. Suicidal ideations 15. Homicidal ideations 16. Pathologic grief 17. Obsessive compulsive disorder Rationale: Physician assistants must understand and be familiar with common medical problems encountered in the Psychiatric setting. __________________________________________________________________________ Learning/Teaching Method: Level of Competence Expected: Evaluation Method: Graduation Competency: C– K– C– PC – Clinical Setting Knows Clinical Evaluation Patient Care LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 T– DEK- Textbook Does Examination Knowledge Page 187 of 206 MS 607 Student Objectives Learning/Teaching Level of Competence Method Expected Evaluation Method Graduation Competency B. Skills C, T C, E PC, K D The student will be able to: Rationale: Physician assistants must understand and be familiar with frequent skills encountered in the psychiatric setting. 1. 2. 3. 4. 5. Perform an intake psychiatric history Perform the Mental Status examination Perform a complete neurological examination of the psychiatric patient Perform oral case presentations to preceptors Observe patients for changes in behavior LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 188 of 206 MS 607 Student Objectives Learning/Teaching Level of Competence Method Expected Evaluation Method Graduation Competency C. Understanding Psychiatric Pharmacology C, T C, E PC, K D The student will know the indications, actions, adverse reactions and side effects for the following psychiatric therapeutics including but not limited to: Rationale: Physician assistants must understand and have a working knowledge psychiatric therapeutics. Major Tranquilizers: 1. Chlorpromazine (Thorazine) 2. Chioridazine (Mellaril) 3. Mesoridazine (Serentil) 4. Lithium carbonate 5. Haloperidol (Hladol) 6. Thiothixine (Navane) MAO Inhibitors: 1. Phenelzine (Nardil) 2. Tranylcpromine (Parnate) Anxiolytic Agents: 1. Alprazolam (Xanax) 2. Chlordiazepoxide (Librium) 3. Diazepam (Valium) 4.Lorazepam (Ativan) SSRI’s: 1. Paroxetine (Paxil) 2. Sertraline (Zoloft) 3. Fluoxetine (Prozac) Antidepressants: 1. Amitriptyline (Elavil) 2. Desipramine (Norpramin) 3. Doxepin (Sinequan) 4. Maprotiline (Ludiomil) 5. Nortriptyline (Pamelor) 6. Imipramine (Tofranil) 7. Bupropion (Wellbutyrin) LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 189 of 206 MS 607 Student Objectives Learning/Teaching Level of Competence Method Expected Evaluation Method Graduation Competency D. Modalities of Therapy C, T C, E PC, K D The student will know the different modalities of therapy and be able to define: 1. 2. 3. 4. 5. 6. Group therapy Counseling Supportive care ECT Therapeutic community Intervention MS 607 Student Objectives Learning/Teaching Level of Competence Method Expected Evaluation Method Graduation Competency E. Skills C, T C, E PC, K D The student will know the community resources available in discharge planning for psychiatric patients. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 190 of 206 MS 607 Student Objectives Learning/Teaching Method Level of Competence Expected Evaluation Method Graduation Competency E. Professional Skills Used in the Psychiatric Setting C, T D C, E PC, K The student will be able to: Rationale: Physician assistants must demonstrate professional behavior in their relationships with patients and colleagues. 1. Demonstrate sensitivity and understanding in relating to the emotional and social background of patients. 2. Relate and perform professionally in a working situation with other members of the health care team. 3. Demonstrate a willingness to ask for help when appropriate from other people and resources for patient care. 4. Demonstrate an openness to recognize limitations by using resource referrals and consultations with supervising preceptor when appropriate. 5. Demonstrate an openness to receive constructive criticism. 6. Show a general concern for patients as demonstrated in thoroughness of monitoring patients and attitudes toward record keeping. 7. Demonstrate having done independent outside reading concerning problems seen. 8. Demonstrates a constructively self-critical manner, and perform duties with professional attitude comprising such areas as attendance, dress code and general demeanor. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 191 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 608 INTERNAL MEDICINE ELECTIVE CLERKSHIP OBJECTIVES DESCRIPTION: The objectives for the Internal Medicine Elective are based on the subject matter of the elective, which must be internal medicine; or a specialty or subspecialty of internal medicine. Examples include cardiology, gastroenterology, pulmonary medicine, hematology, etc. Please refer to the MS 601 objectives for an overview of internal medicine objectives. Moreover, the professional skills used throughout the clinical year are also expected of the student on the clinical elective. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 192 of 206 MS 608 Student Objectives Level of Learning/Teaching Competence Method Expected Evaluation Method Graduation Competency A. Professional Skills used C, T C, E K, PC, IC, P, SBP, LL, PBL Rationale: Rationale: Physician assistants must demonstrate professional behavior in their relationships with patients and colleagues. D The student will be able to: 1. Demonstrate sensitivity and understanding in relating to the emotional and social background of patients. 2. Relate and perform professionally in a working situation with other members of the health care team. 3. Demonstrate a willingness to ask for help when appropriate from other people and resources for patient care. 4. Demonstrate an openness to recognize limitations by using resource referrals and consultations with supervising preceptor when appropriate. 5. Demonstrate an openness to receive constructive criticism. 6. Show a general concern for patients as demonstrated in thoroughness of monitoring patients and attitudes toward record keeping. 7. Demonstrate having done independent outside reading concerning problems seen. 8. Demonstrates a constructively self-critical manner, and perform duties with professional attitude comprising such areas as attendance, dress code and general demeanor. __________________________________________________________________________ Learning/Teaching Method: Level of Competence Expected: Evaluation Method: Graduation Competency: C– K– C– PC – Clinical Setting Knows Clinical Evaluation Patient Care LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 T– DEK- Textbook Does Examination Knowledge Page 193 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 609 SURGICAL ELECTIVE CLERKSHIP OBJECTIVES DESCRIPTION: The objectives for the Surgical Elective are based on the subject matter of the elective, which must be a subspecialty of surgery. Examples include orthopedic surgery, urology, cardiothoracic surgery, surgical critical care, etc. Please refer to the MS 602 objectives for an overview of surgical objectives. Moreover, the professional skills used throughout the clinical year are expected of the student on the clinical elective. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 194 of 206 MS 609 Student Objectives Level of Learning/Teaching Evaluation Graduation Competence Method Method Competency Expected A. Professional Skills used C, T Rationale: Rationale: Physician assistants must demonstrate professional behavior in their relationships with patients and colleagues. D C, E K, PC, IC, P, SBP, LL, PBL The student will be able to: 1. Demonstrate sensitivity and understanding in relating to the emotional and social background of patients. 2. Relate and perform professionally in a working situation with other members of the health care team. 3. Demonstrate a willingness to ask for help when appropriate from other people and resources for patient care. 4. Demonstrate an openness to recognize limitations by using resource referrals and consultations with supervising preceptor when appropriate. 5. Demonstrate an openness to receive constructive criticism. 6. Show a general concern for patients as demonstrated in thoroughness of monitoring patients and attitudes toward record keeping. 7. Demonstrate having done independent outside reading concerning problems seen. 8. Demonstrates a constructively self-critical manner, and perform duties with professional attitude comprising such areas as attendance, dress code and general demeanor. __________________________________________________________________________ Learning/Teaching Method: Level of Competence Expected: Evaluation Method: Graduation Competency: C– K– C– PC – Clinical Setting Knows Clinical Evaluation Patient Care LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 T– DEK- Textbook Does Examination Knowledge Page 195 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 610 CLINICAL ELECTIVE CLERKSHIP OBJECTIVES DESCRIPTION: This is a required five-week rotation, which may take place in an inpatient or outpatient setting of the student’s choice with approval from the Director of Clinical Education. Students are required to attend conferences, lectures and may take call. Students are also responsible for assigned readings and case presentations. At the end of the rotation, students will report to the Physician Assistant Program for administrative tasks and an examination. The objectives for the Clinical Elective are based on the subject matter of the elective. However, the professional skills used throughout the clinical year are expected of the student on the clinical elective. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 196 of 206 MS 610 Student Objectives Level of Learning/Teaching Competence Method Expected Evaluation Method Graduation Competency A. Professional Skills used C, T C, E PC, K Rationale: Rationale: Physician assistants must demonstrate professional behavior in their relationships with patients and colleagues. D The student will be able to: 1. Demonstrate sensitivity and understanding in relating to the emotional and social background of patients. 2. Relate and perform professionally in a working situation with other members of the health care team. 3. Demonstrate a willingness to ask for help when appropriate from other people and resources for patient care. 4. Demonstrate an openness to recognize limitations by using resource referrals and consultations with supervising preceptor when appropriate. 5. Demonstrate an openness to receive constructive criticism. 6. Show a general concern for patients as demonstrated in thoroughness of monitoring patients and attitudes toward record keeping. 7. Demonstrate having done independent outside reading concerning problems seen. 8. Demonstrates a constructively self-critical manner, and perform duties with professional attitude comprising such areas as attendance, dress code and general demeanor. __________________________________________________________________________ Learning/Teaching Method: Level of Competence Expected: Evaluation Method: Graduation Competency: C– K– C– PC – Clinical Setting Knows Clinical Evaluation Patient Care LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 T– DEK- Textbook Does Examination Knowledge Page 197 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 611 CLINICAL SEMINAR I: INTERNAL MEDICINE CASE PRESENTATION OBJECTIVES MS 611 Student Objectives Learning/Teaching Level of Competence Method Expected Evaluation Method Graduation Competency A. Presentation Skills C, LE, T C, P K, IC, P, SBP, LL, PBL Rationale: Rationale: Physician assistants must be able to give patient case presentations to supervising physicians, colleagues, and other members of the health care team. D The student will be able to: 1. Report concisely to a group of other students and a faculty member the following components of a presentation in internal medicine: a. The chief complaint; b. The history of present illness; c. The patient’s past medical and surgical history, family history, psychosocial history, medications, and allergies; d. The review of systems as it relates to the history of present illness; e. The physical examination; f. Ancillary tests performed, the rationale for such testing, and the results; g. Initial diagnosis made; h. Treatment; i. Hospital course of the patient. 2. Demonstrate having performed a literature search on the patient’s final diagnosis. LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 198 of 206 3. Summarize the findings of a recent peer-reviewed article about the patient’s final diagnosis. 4. Demonstrate the ability to answer questions about the patient’s case and hospital course. 5. Demonstrate an openness to receive constructive criticism. 6. Demonstrates a constructively self-critical manner, and perform duties with professional attitude and general demeanor. __________________________________________________________________________ Learning/Teaching Method: Level of Competence Expected: Evaluation Method: Graduation Competency: C– K– C– PC – Clinical Setting Knows Clinical Evaluation Patient Care LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 T– DEK- Textbook Does Examination Knowledge Page 199 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 612 CLINICAL SEMINAR II: SURGICAL CASE PRESENTATION OBJECTIVES MS 612 Student Objectives Learning/Teaching Method Level of Competence Expected Evaluation Method Graduation competency A. Presentation Skills C, LE, T D C, P K, IC, P, SBP, LL, PBL Rationale: Rationale: Physician assistants must be able to give patient case presentations to supervising physicians, colleagues, and other members of the health care team. The student will be able to: 1. Report concisely to a group of other students and a faculty member the following components of a presentation in general surgery or in a surgical subspecialty: j. The chief complaint; k. The history of present illness; l. The patient’s past medical and surgical history, family history, psychosocial history, medications, and allergies; m. The review of systems as it relates to the history of present illness; n. The physical examination; o. Ancillary tests performed, the rationale for such testing, and the results; p. Initial diagnosis made; q. Surgical procedure or procedures performed in the course of formulating the diagnosis or in the course of treating the patient’s condition; r. Other methods of treatment; LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 200 of 206 2. 3. 4. 5. 6. s. Results of pathological studies; t. Hospital course of the patient. Demonstrate having performed a literature search on the patient’s final diagnosis. Summarize the findings of a recent peer-reviewed article about the patient’s final diagnosis. Demonstrate the ability to answer questions about the patient’s case and hospital course. Demonstrate an openness to receive constructive criticism. Demonstrates a constructively self-critical manner, and perform duties with professional attitude and general demeanor. __________________________________________________________________________ Learning/Teaching Method: Level of Competence Expected: Evaluation Method: Graduation Competency: C– K– C– PC – Clinical Setting Knows Clinical Evaluation Patient Care LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 T– DEK- Textbook Does Examination Knowledge Page 201 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 613 CLINICAL SEMINAR III: PANCE PREPARATION OBJECTIVES MS 613 Student Objectives Learning/Teaching Level of Competence Method Expected Evaluation Method Graduation Competency A. PANCE Preparation C, LE, LA, T E K, PC, SBP, LL, PBL Rationale: Rationale: Physician assistants must be able to complete successfully the Physician Assistant National Certifying Examination (PANCE) in order to obtain a state license to practice as a physician assistant. K, D The student will be able to: 1. Achieve a passing score on a series of simulated Board examinations including but not limited to the following areas: a. Cardiology; b. Pulmonology; c. Otorhinolaryngology; d. Ophthalmology; e. Endocrinology; f. Dermatology; g. Gastroenterology; h. Hematology; i. Oncology; j. Radiology; k. Renal medicine; l. Rheumatology; m. Neurology; n. Psychiatry; LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 202 of 206 o. Infectious diseases; p. HIV medicine; q. Allergy and immunology; r. Anatomy; s. Physiology; t. Pathology; u. Family medicine; v. Emergency medicine; w. Pediatrics; x. Geriatrics; y. Obstetrics; z. Gynecology; aa. General surgery; bb. Orthopaedics; cc. Epidemiology; dd. Medical ethics; ee. Role socialization; ff. Human sexuality; gg. Substance abuse; hh. Cultural competency; ii. End of life care; jj. Urology; kk. Pharmacology; ll. Physical diagnosis; mm. History taking; nn. Formulation of a diagnosis; oo. Laboratory interpretation; pp. Therapeutics; qq. Patient counseling; rr. Scientific concepts. __________________________________________________________________________ Learning/Teaching Method: Level of Competence Expected: Evaluation Method: Graduation Competency: C– K– C– PC – Clinical Setting Knows Clinical Evaluation Patient Care LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 T– DEK- Textbook Does Examination Knowledge Page 203 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 614 SUMMATIVE EVALUATION OBJECTIVES MS 614 Student Objectives Learning/Teaching Level of Competence Method Expected Evaluation Method Graduation Competency Summative Evaluation LA, RP P PC, IC, P, SBP, PBL Rationale: Physician assistant students must demonstrate the ability to perform at the level of a physician assistant in clinical practice before completing the curriculum. The student will be able to: 1. demonstrate a fund of knowledge equivalent to that of a graduate physician assistant, including but not limited to the following based on an objective structured clinical examination (OSCE): a. perform initial assessment of a simulated patient b. stabilize the patient, if necessary c. perform the relevant physical examination d. order appropriate laboratory tests e. order appropriate radiologic studies f. order appropriate diagnostic studies or procedures g. make an initial diagnosis h. order appropriate therapeutics i. demonstrate an understanding of pharmacotherapeutics related to the simulation j. perform relevant procedures or examinations k. Demonstrate a fund of knowledge equivalent to that of a graduate physician assistant based on a written examination of all material included in the PA curriculum D LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 Page 204 of 206 2. demonstrate clinical skills related to the simulation, including but not limited to: a. cardiopulmonary resuscitation b. defibrillation c. cardio version d. injections e. administration of oxygen f. endotracheal intubation g. arterial blood gas sampling h. intravenous cannulization i. nasogastric intubation j. urinary catheterization k. insertion of chest tube l. decompression of tension pneumothorax 3. Demonstrate compassion toward the patient and his/her loved ones 4. Demonstrate culturally competent care 5. Demonstrate professional behavior toward colleagues and other members of the health care team 6. Utilize the clinical team and direct colleagues appropriately in a professional manner 7. Assist the team leader and act appropriately as a team member 8. Demonstrate a calm approach to the patient, the patient’s loved ones, and the other staff members involved in the simulation __________________________________________________________________________ Learning/Teaching Method: Level of Competence Expected: Evaluation Method: Graduation Competency: C– K– C– PC – Clinical Setting Knows Clinical Evaluation Patient Care LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 T– DEK- Textbook Does Examination Knowledge Page 205 of 206 DIVISION OF PHYSICIAN ASSISTANT STUDIES MS 615 CAPSTONE PROJECT OBJECTIVES MS 615 Student Objectives Learning/Teaching Method Level of Competence Expected Evaluation Method Graduation Competency Capstone Project C D E K, LL Rationale: Physician assistant students must demonstrate the ability to write a cogent research paper on a topic of clinical interest. The student will be able to: 1. Write a research paper that would be appropriate for publication in a peer-reviewed physician assistant journal 2. Conceive a clinically based topic derived from one of the clinical electives 3. Demonstrate a well-conceived thesis statement 4. Perform thorough research to support the thesis statement 5. Demonstrate the ability to synthesize material gleaned from research and apply it 6. Demonstrate the ability to interpret the medical literature critically 7. Write clearly, with correct grammar and spelling, free of plagiarism 8. Document references according to American Medical Association format __________________________________________________________________________ Learning/Teaching Method: Level of Competence Expected: Evaluation Method: Graduation Competency: C– K– C– PC – Clinical Setting Knows Clinical Evaluation Patient Care LIU – Division of Physician Studies Clinical Year Handbook 2014 – 2015 T– DEK- Textbook Does Examination Knowledge Page 206 of 206