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  1. 1. Physician Assistant Studies STUDENT HANDBOOK ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 1
  2. 2. PHYSICIAN ASSISTANT PROGRAM Class of 2010 This student handbook is designed to supplement the information presented in the Salus University Student Handbook and the PA Program Academic Policy document. Please bear in mind that information provided in this book is subject to change. Changes in structure and policy regarding the didactic and clinical year may occur. Every attempt will be made to provide you with updated information, as it is available. If you find that some additional information would have been particularly helpful to you, please let us know. Physician Assistant Program Faculty and Staff Salus University College of Health Sciences ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 2
  4. 4. I. GENERAL INFORMATION GENERAL POLICY STATEMENT All students accepted into the Physician Assistant (PA) program obligate themselves to the rules and regulations of the University, the Program, and all clinical institutions in which they practice. As explained in the Salus University Student Handbook, this Physician Assistant program Student Handbook and the PA program Academic Policy document, students in the Physician Assistant program must comply with standards governing, among other issues, attendance, dress and appearance and professional conduct. Rules of professional conduct have been carefully established to safeguard the privacy, right and comfort of the patient and to protect the image of the profession and the University. Violations of these regulations are subject to disciplinary action and may result in dismissal from the Physician Assistant program. By signing the “evidence of understanding” (in Appendix), students acknowledge their responsibility to understand and adhere to the rules, regulations and procedures for the PA program and the University. The policies and procedures of the Salus University Physician Assistant program, as published in this document or otherwise, may be modified or amended at any time. Every attempt will be made to notify all those affected. HISTORY OF THE PROFESSION In the mid-sixties in the United States there was a call at both the national and local level for more available, accessible, and affordable health care services. One response to that call occurred in 1965 at the Duke University Medical Center in Durham, North Carolina. Dr. Eugene Stead, chairman of the Department of Medicine at Duke, established a two-year program to formally educate “physician assistants”. The education model proposed by Dr. Stead was based in part on his experience of fast- track training of doctors during World War II and on his work developing a new curriculum for undergraduate medical education. The model focused on the training of ex-military corpsmen. In the fall of 1965, four ex-Navy corpsmen began their education at Duke under Dr. Stead’s direction. The concept gained momentum when, also in 1965, Dr. Henry Silver, at the University of Colorado, began a four-month program designed to train pediatric nurse practitioners from baccalaureate nurses. Popularity of the physician assistant concept continued to grow and a wide variety of programs ranging in length from four months to five years emerged. In 1969, Dr. Silver inaugurated the Child Health Associate Program, which offered a baccalaureate degree to graduates. The Child Health Associate Program later gained attention when, in 1974, it was the first program to offer a master’s degree to qualified students. At the University of Washington, Dr. Richard Smith instituted the fifteen-month MEDEX program specifically designed to train and place ex-medical corpsmen in rural, underserved areas. Another model that emerged was the two-year specialty program, including Pathologist’s Assistant, Surgeon Assistant, Urologic Assistant, Radiologic Assistant, and Orthopedic Assistant. ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 4
  5. 5. Today, PA educational programs offer a choice of models. In addition, current programs offer a variety of credentials upon completion including a certificate of completion and/or an academic degree ranging from associate’s to master’s. In addition, there are post-graduate specialty programs offering training in a variety of specialties, such as occupational medicine, emergency medicine, surgery, rural primary care, and pediatrics. Information regarding the history of the PA Profession is available at: PROFESSIONAL ROLE The American Academy of Physician Assistants (AAPA), in describing the role of physician assistants, states, “PAs practice medicine with supervision by licensed physicians. As members of the health care team, PAs provide a broad range of medical services that would otherwise be provided by physicians.” The AAPA further notes that, “Within the physician/PA relationship, physician assistants exercise autonomy in medical decision making.” The American Medical Association defines the PA as one who is “academically and clinically prepared to provide health care services with the direction and responsible supervision of a doctor of medicine or osteopathy who is responsible for the performance of that assistant… The role of the PA demands intelligence, sound judgment, intellectual honesty, and the ability to relate with people and the capacity to react to emergencies in a calm reasoned manner.” Physician assistants are educated using the medical model. The intensive didactic curriculum focuses on the basic and clinical sciences. This is complemented by a period of clinical rotations in all major clinical disciplines. Within that framework, PA students learn to elicit detailed medical histories, perform comprehensive physical examinations, request and interpret numerous laboratory and diagnostic procedures, prepare and deliver both oral and written case summaries, and provide patient and family counseling regarding therapeutic plans and health promotion/disease prevention. They are prepared to evaluate and treat common acute and chronic disease processes. They become familiar with the special health needs of infants, children and adolescents, young and middle-aged adults, and geriatric patients. PA students learn to provide such patient services as cast application, suturing of wounds, and monitoring of critically ill patients. They are prepared to function in all settings, including the office, clinic, long-term care facility and hospital, as well as home care. PROGRAM ACCREDITATION Standards for PA programs were first established in 1971 with the publication of The Essentials and Guidelines of an Approved Educational Program for the Assistant to the Primary Care Physician. The Essentials were adopted by the Joint Review Committee of the AMA-sponsored Committee on Allied Health Education and Accreditation (CAHEA), which was the precursor to the Committee on Accreditation of Allied Health Education Programs. The Accreditation Review Commission on Education for the Physician Assistant (ARC-PA) has recently replaced CAAHEP as the accrediting body for the PA profession. ARC-PA is an independent accrediting body overseen by a Board composed of representative of five physician organizations as well as Commissioners from the AAPA and the Association of PA Programs (APAP). The Essentials are now known as Standards, which are now established by ARC-PA. ARC-PA evaluates PA programs and awards accreditation based on compliance with guidelines in the Standards. ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 5
  6. 6. Our Physician Assistant program was granted accreditation status in March 2007 by the ARC-PA. Our status is defined as “provisional”, the only status a new PA program may acquire. Our next ARC-PA site visit will be in November 2009 and our accreditation status will be next determined at the March 2010 ARC-PA general meeting. Our graduates are eligible to sit for the National Certification Examination for Physician Assistants, a credential required for state licensure. For more accreditation information go to www. Graduation from a PA program with accreditation status is a requirement for students who take the Physician Assistant National Certification Examination (PANCE). All fees will be returned to students if the PA program is not granted accreditation status. The website for the ARC-PA is Final approval from the Pennsylvania Department of Education (PDE) authorizing the University to award the degree of Master of Medical Science (M.M.S.) was granted in May 2007. NATIONAL CERTIFICATION AND CONTINUED COMPETENCY The National Commission on Certification of Physician Assistants (NCCPA) is the organization that administers both the PA National Certifying Examination (PANCE), administered at the time a PA student graduates, as well as the Physician Assistant National Re-certifying Examination (PANRE). The Board of the NCCPA is responsible for determining eligibility for the exam and evaluating the results. Currently, satisfactory completion of the PANCE is required for eligibility to practice in most states. To ensure continued competency, all certified PAs must document 100 hours of continuing medical education (CME) every two years in order to retain certification. Re-certification is required every six years and involves successful completion of the PANRE as well as documentation of appropriate CME hours. The website for the NCCPA is PROFESSIONAL ORGANIZATIONS American Academy of Physician Assistants In 1968, the American Academy of Physician Assistants (AAPA) was founded by a small group of PA students at Duke University. The AAPA was established to promote the education of both lay and professional people regarding the physician assistant concept and to provide continuing medical education for the membership. Today, the Academy has 57 chartered constituent chapters representing the interests of PAs in 50 states, the District of Columbia, the Army, Navy, Air Force, Public Health Service/Coast Guard, Veteran’s Affairs and Guam. In addition the AAPA, as the only national voice of the profession, serves as the umbrella organization for the specialty PA organizations that have been established as well as caucuses representing specific interests of PAs. The website for the AAPA is AAPA House of Delegates The AAPA House of Delegates meets annually to adopt legislation and policy proposed by standing committees and councils, constituent organizations, the Board of Directors, the Student Academy, and the Association of PA Programs. The Board of Directors implements the policy ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 6
  7. 7. direction of the House. The daily affairs of the Academy are managed by a Chief Executive Officer/Executive Vice President and staff with national offices in Alexandria, Virginia. Physician Assistant Education Association or PAEA (formerly, Association of Physician Assistant Programs APAP) The Association of Physician Assistant Programs (APAP) was formed in 1972 to provide a forum for physician assistant programs to share ideas, research, and curriculum design and evaluation methodologies. The Association conducts activities and develops policy to improve PA education, including faculty development. In 2006, APAP became the Physician Assistant Education Association (PAEA). The website for the PAEA is Physician Assistant Foundation The Physician Assistant Foundation (PAF) was formed in 1977 by the AAPA to provide student financial assistance and funding for research. With its new motto of “advancing health care through philanthropy,” the PA Foundation also funds projects in local communities that improve health and human conditions. Information regarding the PA Foundation is available at: Pennsylvania Society of Physician Assistants (PSPA) The Pennsylvania Society of Physician Assistants was established in 1976. As a young but steadily growing non-profit organization, the PSPA strives to be representative of all physician assistants within the Commonwealth of Pennsylvania. The goals and objectives of the Society are to enhance quality medical care to the people of Pennsylvania through a process of continuing medical education, both to the membership and to the public; to provide loyal and honest service to the public and to the medical profession; to promote professionalism among its membership; and to promote understanding of the PA profession. The PSPA is a constituent chapter of the American Academy of Physician Assistants (AAPA). The Society sends delegates to the AAPA House of Delegates, which meets annually to perform policy- making activities under the Academy's bylaws. The elected Board of Directors of the Society includes the president, president-elect, secretary, treasurer, and six Board members. Two of the six Board members are student members. There are standing committees in the Society that perform its' many functions. Each committee has a Board approved chairperson and is comprised of interested members from the various regions in the state. The Society encourages the membership to become involved by volunteering some time and energy to one of these important committees. The website for the PSPA is HISTORY OF SALUS UNIVERSITY Salus University (SU) is a private, specialized academic institution holding IRS status as a 501(c) (3) non-profit charitable organization. The University was originally chartered as the Pennsylvania State ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 7
  8. 8. University of Optometry (PSCO) in 1919. The University changed its name to Pennsylvania College of Optometry (PCO) in 1964. The University was originally located at 1809 Spring Garden Street in center city Philadelphia, but later moved to 1200 West Godfrey Avenue onto the Oak Lane Campus (OLC) in 1933. The University remained at this campus for 65 years, significantly expanding its facilities over the years to include a new academic building in 1969 and two housing facilities in 1966 and 1972. For 55 years, the Pennsylvania College of Optometry remained a single purpose educational institution producing excellent clinical optometrists. In the mid 1970's, the College recognized the need to diversify its programs in order to maintain both financial viability and academic excellence. Through a continuous strategic planning process, the College expanded its mission and chartered a new vision, which included new degree and non-degree programs, as well as a significant commitment to research and scholarly pursuits. In 1978, PCO opened The Eye Institute (TEI), a clinical facility providing comprehensive interdisciplinary eye and vision care to resident of the Delaware Valley and beyond. In 1996 the College purchased the former Breyer Office Park in Elkins Park, Pennsylvania. In 1998, after a major renovation of this facility, most of the academic and administrative functions of the University were moved to the new Elkins Park Campus (EPC), which is about three miles north of the Oak Lane Campus in Montgomery County, PA. The Eye Institute, a critically important component of Salus University academic and clinical programs, remained at its location in Oak Lane. In January 2005, the Board of Trustees formally called for a comprehensive feasibility study of the requirements for continued program expansion and for achieving university status. After considerable internal planning and critical evaluation of the feasibility results, the Board of Trustees at its May 22, 2006 meeting authorized the President to submit an application to the Pennsylvania Department of Education to request consideration for university status. The Pennsylvania College of Optometry officially became Salus University on July 1, 2008, taking its name from a Latin word meaning health and well-being. The University is comprised of four colleges: the Pennsylvania College of Optometry, the George S. Osborne College of Audiology, the College of Education and Rehabilitation, and the College of Health Sciences, which offers the Physician Assistant program. Currently, the University is led by its fifth president, Thomas L. Lewis, O.D.’70, Ph.D., and a Board of Trustees that is broadly representative of the University’s professional, institutional and community stakeholders. The University currently has 243 employees, including 55 full-time and 20 part-time faculty members. Accredited by all the relevant professional and regional accreditation bodies, most recently the University received formal commendation for its 2005 Periodic Review Report (PRR) submitted to the Middle State Commission on Higher Education (MSCHE). The University’s administrative offices are located at 8360 Old York Road, Elkins Park, Pennsylvania 19027. Our website is Today, Salus University provides professional and graduate degree programs, both on a full and part- time basis, to approximately 1,500 students from around the world. The University awards nine earned degrees. The Doctor of Optometry (O.D.) and Doctor of Audiology (Au.D.) degrees are awarded to all students who have successfully completed the professional curriculum. Bachelor of Science (B.S.) or Master of Science in Clinical Optometry degrees are awarded to international ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 8
  9. 9. ophthalmic practitioners who have successfully completed a specialized bridge program currently offered by PCO in 16 countries. The University offers three Master of Science (M.S.) degrees, including a Master of Science in Low Vision Rehabilitation, one in Orientation and Mobility Therapy, and one in Vision Rehabilitation Therapy; as well as a Master of Education degree in professional preparation programs for Teachers of Teachers of Children with Visual and Multiple Impairments. These programs are also available at the Certificate level. The University will grant its first Master of Medical Science (MMS) degree to the first graduation class of Physician Assistant students in 2009. The University confers honorary degrees of Doctor of Science, Doctor of Laws, and Doctor of Humane Letters upon individuals selected for their distinguished service. ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 9
  10. 10. II. PHYSICIAN ASSISTANT PROGRAM INFORMATION HISTORY OF THE PA PROGRAM AT SALUS UNIVERSITY The development of the Physician Assistant program stems from the vision of the College’s President, Thomas L. Lewis, O.D. ’70, Ph.D., to transform PCO into a broadly based health sciences institution. The 2004-2009 Salus University Strategic Plan includes an objective that reads: “(T)o explore, and if appropriate, develop new academic programs to significantly enhance the quality of student education…” Consistent with this goal, a preliminary study on the feasibility of adding a PA program at the University was conducted. In order to gain a better understanding of the resources required to establish a Physician Assistant (PA) program, Dr. Lewis and Dr. Anthony F. Di Stefano, Vice President and Dean of Academic Affairs, met with the provost of Barry University, a health professions university that had recently established a physician assistant program. Utilizing an educational consultant, a preliminary study and follow-up study on the feasibility of adding a PA program at the College were undertaken. Phase I of the study was completed in the spring of 2005. Immediately following, Phase II of the feasibility study was launched and completed in the fall of 2005. The results indicated that there was sufficient need for additional (PA) programs and that ample clinical training sites were available to educate students. As a result, a PA Planning Committee was appointed in the fall of 2005 to develop an implementation plan for a PA program at the College. This planning committee was chaired by the College’s Vice President and Dean for Academic Affairs along with College faculty and administration, academic and practicing PAs and an educational consultant. The Committee as a whole and two sub-committees comprised of members from the Committee met over the ensuing months. One sub-committee addressed curriculum development and the other was responsible for interfacing with both internal and external constituents and stakeholders. The information developed by the Planning Committee was assembled into a detailed plan outlining the implementation of a Physician Assistant Degree Program. The study was reviewed by the PA Planning Committee and subsequently formally presented to the College’s Educational Policy and Curriculum Committee (EPCC). This committee functions within the guidelines of the Faculty Organization of the Pennsylvania College of Optometry (FOPCO), and includes both faculty and students. All new academic programs and any substantive changes in existing programs must be approved by this committee. The EPCC approved the proposed PA program and sent its recommendation to the Institutional Policy and Curriculum Committee (IPCC) of the Board of Trustees, which also endorsed the proposal. In January 2006, the College’s Board of Trustees authorized the Executive Committee of the Board to act on its behalf with regard to furthering the Physician Assistant Program. On March 8, 2006, the Executive Committee unanimously authorized the President to submit formal application to the Pennsylvania Department of Education to grant approval for the implementation of a Master of Medical Science program (MMS) in Physician Assistant Studies, to begin in the 2007 academic year. On May 22, 2006 the Board of Trustees unanimously supported the recommendation of the Executive Committee. The PA Program has thus received all the necessary institutional approvals and reflects the outcome of a methodical and critical assessment of the program’s feasibility, programmatically and fiscally. ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 10
  11. 11. After a national search, George S. Bottomley, D.V.M., PA-C, joined the College on July 1, 2006 as Program Director. Michael Huber, M.M.S., PA-C, joined the program on October 16, 2006 as the Academic Coordinator. Kem Yenal, MD and Jane Arenas, MS, PA-C joined in 2007 as Medical Director and Clinical Coordinator, respectively. Associate Professors Joseph Spanier, MPAS, PA-C, and Susan Dubendorfer, MPAS, PA-C, joined in August 2008. In September 2006, the PA Planning Committee was transformed into a permanent PA Program Advisory Board. The membership has been adjusted to reflect the ongoing needs of the program. The role of the Board will continue to provide guidance and input into the planning and implementation of the program. (The first meeting of this new PA Program Advisory Board was held on September 7, 2006 with all in attendance.) On September 18, 2006 an application allowing PCO to award an MMS to Physician Assistant program graduates was submitted to the Pennsylvania Department of Education (PDE). A site visit in March 2007 by the PDE was successful and resulted in our being granted provisional accreditation authorizing PCO the ability to award this degree. This final approval from the Pennsylvania Department of Education (PDE) authorizing the University to award the degree of Master of Medical Science (M.M.S.) was granted in May 2007. An application and self-study for provisional accreditation were submitted in November 2006 to the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). A successful site visit in December 2006 resulted in our being granted provisional accreditation in March 2007. Provisional accreditation is the standard time-limited designation for all new PA programs recognized to be in compliance with required accreditation standards. Continuing accreditation status is achieved only after a successful review of additional application and a follow up ARC-PA site visit. The Salus University PA program is scheduled for this review in March 2010. In August 2007 our inaugural class of 20 students (9 men and 11 women) started the program. ADMINISTRATION AND FACULTY Organizationally, the Physician Assistant Program is part of the planned Department of Physician Assistant Studies. This tentatively titled Department is part of the College of Health Sciences of Salus University. At the writing of this handbook, the PA Program falls under the authority of Anthony F. Di Stefano, O.D., M.P.H. Dr. Di Stefano is the Vice President of Academic Affairs for the University and Associate Professor of Public Health. CORE FACULTY The core faculty of the Physician Assistant Program includes the following positions: • Interim Program Director: Pierrette Dayhaw-Barker, Ph.D. • Academic Coordinator: Michael Huber, MMS, PA-C • Clinical Coordinator: Jane Arenas, MS, PA-C • Faculty: Joseph Spanier, MPAS, PA-C • Medical Director: Kem Yenal, MD ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 11
  12. 12. The core faculty is responsible for: a) developing the mission statement for the program. b) selecting applicants for admission to the PA program. c) providing student instruction. d) evaluating PA student performance. e) academic counseling of PA students. f) assuring the availability of remedial instruction. g) designing, implementing, coordinating, and evaluating curriculum. h) administering and evaluating the program. The Salus University PA program is fortunate to have the services of a number of highly qualified part-time or adjunct faculty members, who add their expertise to the student’s education. While each member of the faculty has major areas of responsibility, the planning and execution of the program is a highly collaborative effort. PROFESSIONAL AND ADMINISTRATIVE STAFF • Administrative Assistant, Mrs. June Battista • Educational Program Assistant, Mrs. Elizabeth LaTorre ADJUNCT FACULTY: COURSE DIRECTORS, FACULTY LIAISONS AND COURSE CO-DIRECTORS In an effort to allow students a way to direct any course questions on content, examinations, and evaluation, the following is a list of responsibilities that are expected of all. COURSE DIRECTORS can be PA program faculty, SALUS UNIVERSITY faculty, or adjunct faculty from outside the University. These individuals are responsible for the following: • Development and updating of course syllabus • Course syllabus to include course and lecture objectives written in behavioral format, in accordance to required course textbook(s) • Development of examinations and other course evaluative tools referenced to course and lecture objectives • Proctoring of lab examinations • Submitting to Program course A/V, handouts and supply needs within appropriate time requirements • Maintenance of student grades; submission of grades within designated time to PA Department Chair or faculty liaison • Scheduling of lecturers for topics not covered by course director • Completion of all payroll paperwork to PA departmental secretary in compliance with the College and department requirements for course director and other adjunct faculty providing lectures • Schedule student conferences when needed • Address examination challenge questions submitted by students • Attendance to program curriculum and accreditation meetings ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 12
  13. 13. FACULTY LIAISONS are core PA Faculty members that assist Course Directors from outside of the PA Program with their responsibilities, with special attention to the following: • Administration of course exams, handouts and various course material, notification of special audiovisual needs. • Submission of grades to the Department Chair. • Assist in submission of all payroll paperwork to PA departmental secretary in compliance with the University and department requirements for course director and other adjunct faculty providing lectures • Communication with department administrative assistant to ensure correspondence with adjunct faculty to include confirmation letters and directions prior to their lecture date, confirmation phone call one week prior to lecture date, certificate eligibility, as well as follow-up thank-you letters. • Address examination challenge questions submitted by students with Course Director and question content writers COURSE CO-DIRECTORS Assist Course Directors with their responsibilities as needed SALUS UNIVERSITY MISSION AND GOALS The mission of Salus University is to educate health care professionals and educators, conduct research and provide patient care and rehabilitative services that advance the welfare of the public worldwide. It is the objective of the University to foster in students those attributes of intellectual curiosity, integrity, professionalism and caring for people. The University is committed to excellence in the pursuit of all its endeavors and to providing an environment that encourages learning and professional development through an open exchange of ideas. All segments of the University community join together on a continuing basis to identify the aims of the institution, specifically in terms of the needs of the near future. PHYSICIAN ASSISTANT PROGRAM MISSION STATEMENT, GOALS, AND EDUCATIONAL OBJECTIVES To graduate collaborative clinicians who will serve the healthcare needs of a worldwide community with intelligence, compassion and integrity. PROGRAM GOALS: These goals are based on Salus University Institutional Goals and on the knowledge, skills, and attitudes expected by the physician assistant profession as outlined in the document, “Physician Assistant Competencies” developed through a collaborative effort of the AAPA (American Academy of Physician Assistants), ARC-PA (Accreditation Review Commission on Education for the Physician Assistant), NCCPA (National Commission on Certification of Physician Assistants), and the PAEA (Physician Assistant Educator’s Association) which can be found at: ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 13
  14. 14. on.pdf • Recruit a diverse and intellectually curious student body and develop in them the strong basic science and clinical medical knowledge necessary to deliver the highest quality patient- centered healthcare in a variety of clinical settings worldwide. • Foster analytic thinking skills such that graduates will be able to gather and evaluate patient history, physical findings, laboratory data, and other pertinent information to appropriately care for and consul patients of any age or background. • Nurture a sensitivity and respect for the cultural and personal beliefs of all patients and an understanding of how social, economic, and other system forces can impact health and healthcare… and how these impact patient morbidity and mortality. • Encourage graduates to be responsive to the needs of patients and society and advocate for quality patient care regardless of patient population. • Graduate practitioners who will have the information technology and research skills necessary to access and interpret the medical literature and support their ongoing professional development. • Expect graduates to practice collaboratively, professionally, legally, ethically, and with integrity as a part of and representative for the Pennsylvania University of Optometry and the physician assistant profession. • Develop tomorrow’s leaders in clinical medicine, research, and education such that the goals of the Physician Assistant Program and University can be attained. PHYSICIAN ASSISTANT PROGRAM EDUCATIONAL OBJECTIVES/ EXPECTED COMPETENCIES Salus University PA program Educational Objective/Expected Competencies are the “Physician Assistant Competencies” as mentioned above. They are listed below in detail. The PA profession defines the specific knowledge, skills, and attitudes required, and provides educational experiences as needed in order to physician assistants to acquire and demonstrate these competencies. 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 assistant are expected to demonstrate an investigatory and analytic thinking approach to clinical situations. Physician assistants are expected to: • understand etiologies, risk factors, underlying pathologic process, and epidemiology for medical conditions • identify signs and symptoms of medical conditions • select and interpret appropriate diagnostic or 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 ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 14
  15. 15. cases and those requiring referral or admission • identify appropriate interventions for prevention of conditions • identify the appropriate methods to detect conditions in an asymptomatic individual • differentiate between the normal and the abnormal in anatomic, physiological, laboratory findings and other diagnostic data • appropriately use history and physical findings and diagnostic studies to formulate a differential diagnosis • provide appropriate care to patients with chronic conditions Interpersonal & Communication Skills Interpersonal and communication skills encompass verbal, nonverbal and written 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 the messages to the context of the individual patient interaction • work effectively with physicians and other health care professionals as a member or leader of a health care team or other professional group • apply an understanding of human behavior • demonstrate emotional resilience and stability, adaptability, flexibility and tolerance of ambiguity and anxiety • accurately and adequately document and record information regarding the care process for medical, legal, quality and financial purposes Patient Care Patient care includes age-appropriate assessment, evaluation and management. Physician assistants must demonstrate care that is effective, patient-centered, timely, efficient and equitable for the treatment of health problems and the promotion of wellness. Physician assistants are expected to: • work effectively with physicians and other health care professionals to provide patient- centered care • demonstrate caring and respectful behaviors when interacting with patients and their families • gather essential and accurate information about their patients • make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment • develop and carry out patient management plans • counsel and educate patients and their families • competently perform medical and surgical procedures considered essential in the area of practice • provide health care services and education aimed at preventing health problems or maintaining health ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 15
  16. 16. 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 on-going professional development • commitment to ethical principles pertaining to provision or withholding of clinical care, confidentiality of patient information, informed consent, and business practices • sensitivity and responsiveness to patients’ culture, age, gender, and disabilities • self-reflection, critical curiosity and initiative Practice-Based Learning and Improvement Practice-based learning and improvement includes the processes through which clinicians engage in critical analysis of their own practice experience, medical literature and other information resources for the purpose of self-improvement. Physician assistants must be able to assess, evaluate and improve their patient care practices. Physician assistants are expected to: • analyze practice experience and perform practice-based improvement activities using a systematic methodology in concert with other members of the health care delivery team • locate, appraise, and integrate evidence from scientific studies related to their patients; health problems • obtain and apply information about their own population of patients and the larger population from which their patients are drawn • apply knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness • apply information technology to manage information, access on-line medical information, and support their own education • facilitate the learning of student 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 ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 16
  17. 17. 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-bases factors that negatively impact patient care • apply medical information and clinical data systems to provide more effective, efficient patient care • use the systems responsible for the appropriate payment of service ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 17
  18. 18. III. THE PHYSICIAN ASSISTANT PROGRAM CURRICULUM THE DIDACTIC YEAR CURRICULUM Overview The 25-month, 146 credit PA program curriculum is divided into a 12-month didactic year, a 12- month clinical year, and a one-month advanced didactic phase. In the three-term, 75-credit didactic year, the foundation biomedical and clinical sciences courses are Physiology and Pathophysiology I, II, and III, Clinical Medicine I, II, and III, and Pharmacology and Clinical Therapeutics I, II, and III. The didactic curriculum is progressive and integrated. In these foundation courses, basic science modules in cell biology, pathology, genetics, immunology, and pharmacokinetics are “front-loaded” in the first semester. Medical Microbiology similarly begins with an overview of infectious disease. During the three terms, these courses sequentially educate the student in general medicine topics in all body systems and special populations of patients (pediatric, geriatric, women’s medicine, etc.). The normal physiology and pathophysiology of diseases of a specific body system are first discussed in Physiology and Pathophysiology I, II, and III. The patient presentation, history and physical examination findings, diagnostic tests, differential diagnosis, and care plan for these diseases are developed in Clinical Medicine I, II, and III. Treatment modalities for these diseases are presented in Pharmacology and Clinical Therapeutics I, II, and III. All body systems, beginning with HEENT in the first term and ending with focused populations and focused courses (pediatrics, geriatrics, women’s medicine, emergency medicine, surgery) in the third term are presented. The anatomy and history and physical examination courses in the first term (Anatomy, Clinical Assessment I) are integrated. Didactic lectures and cadaver-based laboratories comprise the anatomy course in the first term. This course introduces students to the topographical and internal anatomic structures such that they will be familiar with the anatomy of a body system just prior to learning the history and physical examination skills specific to that body system in the Clinical Assessment I course. Students will be introduced to normal radiographic and imaged anatomy in the anatomy course. In the Clinical Assessment I and II courses, students will first learn how to perform the complete adult history and physical examination. They will meet weekly and work in small groups with faculty instructors and visit long-term care facilities to work with residents to develop these skills. They will learn to write a complete “H and P” and “SOAP” note. The Clinical Assessment II course will develop skills in “focused” H and Ps and in specialty exams for pregnant women, geriatric, and other patient populations. We store our cadavers for student’s self- directed study during the didactic and clinical years. For example, as part of Advanced Clinical Skills I and II in the spring and summer terms, students will be able to return to their cadavers in the anatomy lab to review clinical anatomic correlates important in understanding the clinical procedures/skills pertinent to that body system (pelvic exam, prostate exam, placing central lines, etc.). Just prior to studying a new body system in Clinical Medicine I, II, and III, students will be able to review clinical anatomic correlates important in understanding the disease process pertinent to that body system. ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 18
  19. 19. Behavioral Science I will introduce students to common primary care psychosocial and behavioral issues and the communication/counseling skills required to care for patients (with sensitivity to their gender, age, race, culture, disability, and socioeconomic status). Behavior Science II will present topics in psychiatry that are critical to the practice of medicine. Health Care I and II will start with an overview of health care systems. Topics will include the historical underpinnings of today’s health care policy, managed care, the insurance and pharmaceutical industries, health care settings, quality assurance and risk management, medical education, and other contemporary health care issues and how providers and patients fit into this system. Health Care II will be specific to the PA profession. It will discuss PA history and the professional organizations, responsibilities, legalities, and issues important to a practicing PA. Students apply skills gained during the Evidence Based Medicine (EBM) course in the first term to the Clinical Problem Solving (CPS) course sequence that extends throughout the first year. The fall term CPS content prepares students for their pre-clinical experiences that begin in the spring term. The spring term is when the small group problem-based learning methodology commences. In small groups with faculty facilitators, the spring and summer courses specifically allow students to apply the clinical decision-making skills gained in the EBM course. It is the integrative course that applies the basic and biomedical science knowledge, clinical assessment skills, biopsychosocial understanding, communication techniques, and health care system knowledge developed in other parts of the curriculum to the diagnosis and management of patient cases. Again, case topics parallel the body system being taught in Clinical Medicine. Small-group instruction is used to develop critical-thinking, communication (oral and written), and other clinical assessment and diagnostic skills. Starting in the spring term, part of CPS is a required weekly clinical “pre-clinical” experience. Students are placed in a primary care outpatient setting for a minimum of four hours per week to initially observe and slowly and according to their skills and with preceptor supervision, sequentially apply the knowledge, skills, and professional attributes they are learning in the classroom. These primary care pre-clinical experiences are designed for students to: 1. develop confidence in approaching patients 2. observe experienced clinicians in the medical setting 3. gain experience in the art of obtaining a medical history and performing physical examinations and selected technical skills 4. reinforce classroom learning through clinical application of knowledge and skills 5. demonstrate professional behavior 6. become familiar with the PA student role in clinical practice 7. be familiar with data gathering and documentation skills This will be their introduction to practice-based medicine. In the fall CPS course to prepare them for their “pre-clinical” experience, students will be given an overview of billing, coding, reimbursement, and other practice- based essentials including HIPPA and OSHA/ Bloodborne Pathogens essentials. They will be introduced to PAST™ - Physician Assistant Student Tracking System, patient-encounter tracking software that is loaded onto their palm pilots so that they can begin to collect patient information (gender, age, ICD-9 and CPT codes, etc.). ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 19
  20. 20. CPS will be a structure in which faculty can evaluate and reinforce evidence-based and health promotion concepts, counseling skills, cross-cultural sensitivities, and professional behavior. This experiential learning will be discussed in the weekly CPS meetings. It will serve as a way to introduce students to the health care system and discuss the application of didactic material to the “real world” care of patients. It will allow faculty to evaluate strengths and weaknesses on an individual student basis. As part of a weeklong Salus University orientation process prior to the start of classes, students will have received information in areas of professional behavior and cross-cultural competency. The use of required laptop computers during the didactic year for dissemination of course materials and evaluations via Blackboard and access to evidence-based and other databases will insure that students enter the clinical year and clinical practice with the required technology skills. THE CLINICAL-YEAR CURRICULUM Overview The clinical year consists of three terms (fall, spring and summer) over a twelve-month period. The goal of the clinical year is for the student to learn to apply the knowledge gained from didactic course work in medicine, surgery and the basic and behavioral sciences in the clinical arena, which will result in the ability to successfully manage patients in a thorough and comprehensive manner. The clinical phase exposes the student to a wide spectrum of clinical environments so as to facilitate reinforcement of the didactic material in clinic, hospital, long- term care facilities and private practice settings. Student placements are based on educational needs of the students and the resources and needs of the clinical facilities and preceptors. Academic instruction during this year will be directed toward patient care skills and clinical case assessment. Sequencing of rotations is at the discretion of the Clinical Coordinator. Appropriate professional behavior as demonstrated by clinical preceptors is expected of our students. During this time, students complete nine required clinical rotations. These include eight, four- week rotations in the required/core primary care areas and one “Floating Block” at the writing of this handbook to be an additional Family Practice/ Primary Care rotation. Required rotations are in Emergency Medicine, Family Medicine/Primary Care, Internal Medicine, General Surgery, Geriatric Medicine, Pediatric Medicine, Women’s Health/Prenatal Care, and Psychiatry/ Behavioral Medicine. The remaining twelve-week period is comprised of three, four-week electives in areas of the student’s choosing (primary care; areas of specialty practice, such as hospitalist medicine, nephrology, interventional radiology, etc.). Due to academic, professional or other individual student issues, rather then being allowed to experience an elective rotation(s), the faculty may determine that a student should be required to repeat one or more of the core rotations. During this phase of the program, all students participate in supervised clinical practice in a variety of outpatient, emergency, inpatient, and long-term care settings. In these rotations, ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 20
  21. 21. physicians, physician assistants, and other members of the health care team provide the clinical education. During the clinical year, students will be required to return to campus at the end of rotations for one full or half-day. These are termed “Call Back Days”. Call Backs are devoted to end-of- rotation testing, class meetings, announcements, Grand Rounds presentations, and enrichment lectures. Students will receive a separate Clinical Year Handbook outlining this in more detail. ADVANCED DIDACTIC PHASE The clinical year will be followed by a one-month, 7-credit, “Advanced Didactic Phase” emphasizing the transition into the health care system as a practitioner. “Transition to Practice” will discuss matters specific to the PA as he/ she graduates and enters practice. The PANCE, PANRE, CME, credentialing, licensure, and liability insurance will be addressed. During the student’s last clinical rotation, the PACKRAT will again be given. Results will determine class strengths and weaknesses in certain areas. Faculty will develop a list of topics in which the class, as a whole, did not perform well. Senior Seminar will consist of student presentations in these areas in preparation for PANCE. Students will bring their clinical year and other experiences to Legal and Ethical Aspects of Medicine. These experiences will allow for reality-based discussions of ethical dilemmas encountered in primary care in such areas as genetic testing and counseling, end-of-life issues, and the patient-provider relationship. CAPSTONE PROJECT Serving as an independent study project linked to Clinical Problem Solving IV in the Advanced Didactic Phase, the “Capstone Project” for the Salus University Physician Assistant Program is a formal Grand Rounds presentation to the Salus University Community along with the submission of a referenced review article and a written case summary. The Grand Rounds Presentation is an in-depth presentation of a medical patient case that the student encountered during his/her clinical rotations. It will demonstrate the evidence-based process that led to the final diagnosis, treatment plan, prognosis and patient counseling. The preventive medicine aspects of the disease will also be addressed. The referenced review article and case summary will be submitted prior to the formal presentation and will allow the faculty to generate questions regarding the case. • It is a summative evaluation tool we will use to measure cognitive, motor, and affective domains at a point near the completion of the program. • It is a mechanism through which we measure a student’s ability to meet the PA Program’s published Educational Objectives. • It is a way to promote interdisciplinary education and practice. We will invite the various Salus University disciplines (optometry, audiology, graduate studies in vision impairment, basic sciences, and research) to this presentation for interdisciplinary student and faculty development. A semester-by-semester course listing with credits is included in the Appendix. PACKRAT (Physician Assistant Clinical Knowledge Rating and Assessment Tool) ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 21
  22. 22. Students will take the online ePACKRAT examination at the end of the didactic year and again prior to graduation. This is a statistically referenced examination and should be used by students for self-assessment purposes. This examination is being offered to you via the auspices of the Physician Assistant Education Association (PAEA). All expenses are paid for by the program. ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 22
  23. 23. BASIC LIFE SUPPORT (BLS) FOR THE PROVIDER CERTIFICATION The Physician Assistant Program requires that all students be certified in Basic Life Support for the Provider at the time they are admitted to the PA Program. All students are required to provide the Office of Admissions with a copy of the BLS for the provider card prior to starting the PA Program as this is a prerequisite for the ACLS Certificate that students will earn and receive during the Advanced Clinical Skills I course in the spring term. Recertification compliance must be maintained during the complete course of the program and is required for the clinical year. This BLS certification is the financial responsibility of the student. PA PROGRAM SUMMATIVE EVALUATION The PA Program Summative Evaluation (PAPSE) consists of the student having successfully completed the following tasks (“success” is defined by achieving a grade of “pass” in all pass/ fail courses/rotations and evaluations, a grade of “C” or better in all graded courses and a cumulative GPA of 3.0 or better on a 4.0 scale): • Successful completion of each didactic course defined by a grade of “C” or better and an average cumulative GPA of 3.0 or greater on a 4.0 scale. • Successful Grand Rounds presentation, review paper, and case write- up (Capstone Experience”) • Successful completion of OSCE (Objective Structured Clinical Examination) near the end of the clinical year • Demonstration of acceptable professional behavior throughout the didactic and clinical years, both in and out of the classroom/ clinical setting. Faculty and preceptor evaluations of the student during the didactic phase and clinical rotations will be methods of determining this requirement. Following each summative evaluation, the PA Core Faculty Committee presents its recommendations for progression and graduation to the University-wide committee responsible for allowing progression and graduation, called the Class Faculty. This process is outlined in the Academic Policy Handbook for the Physician Assistant Program (see Appendix) REQUIREMENTS FOR GRADUATION Overview The PA Program Core Faculty Committee (PAPCFC) conducts two evaluations of each student: one at the conclusion of the didactic phase and one just before graduation. • The first review occurs at the end of the didactic phase, prior to clinical rotations. The student must successfully complete all courses in the didactic phase, with a cumulative grade point average of 3.00 on a 4.00 scale in order to progress to the clinical phase. In addition, a student may not receive a grade less than “C” in any individual course. The student must also have demonstrated appropriate professional and ethical behavior throughout the didactic year. The second review occurs toward the end of the clinical phase, before the student’s projected graduation date. This is the PA Program Summative Evaluation (PAPSE). ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 23
  24. 24. • The second review occurs toward the end of the clinical phase, before the student’s projected graduation date. This is the PA Program Summative Evaluation (PAPSE). ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 24
  25. 25. IV. PHYSICIAN ASSISTANT PROGRAM POLICIES STUDENT HEALTH AND SAFETY REQUIREMENTS All Physician Assistant students are required to have health insurance while enrolled in the program. Medical Providers It is the student’s responsibility to acquire and have in place appropriate and adequate health insurance prior to the first day of the didactic year. If you do not have medical coverage, the University is pleased to provide you with the opportunity to enroll in a Student Injury and Sickness Insurance plan designed by Mega Life and Health Insurance Company especially for students at Salus University. Details are found in the Salus University Student Handbook. Prior to entering the program and as a condition of acceptance, students are required to have: • documentation of their current health status by way of a health exam prior to entering the program (students need to notify FileMDe, Inc. of any changes in their medical condition and update their records). • proof of up-to-date immunizations and/or titers in accordance with CDC recommendations for health professionals It is a requirement of the University that all students have proof of immunity to measles, mumps, rubella, varicella, and Hepatitis B by laboratory evidence prior to starting any experiential learning or clinical rotation. The (TB) Mantoux test, including chest x-ray and counseling, when applicable is required prior to starting the PA Program and it is to be repeated before entering their senior year and clinical rotations. TB testing may be required more frequently according to clinical site requirements. A copy of the student’s immunization records will be provided to the student prior to starting his/her clinical rotations. These records are to be taken by the student on his/her rotations and copies provided to the clinical sites as needed. Note: The Hepatitis B immunization series takes a minimum of 5 months to complete and sometimes longer in some individuals to achieve appropriate titers. • national criminal background checks and drug screen (see following explanation) ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 25
  26. 26. Many sites, especially hospitals, will require this documentation before granting clinical privileges. Occasionally, some hospitals will have additional requirements (child abuse check, fingerprint check, etc.). Some clinical sites may require documentation of latex allergy testing or statement that the student is not allergic to latex products. These additional requirements will be paid for by the student. Note: Student health care cannot be provided by PA Program core faculty, nor can program faculty or staff have access to student’s health care records (except for tuberculosis and immunization screening results which may be maintained and released with written permission of the student). NATIONAL CRIMINAL BACKGROUND CHECKS AND DRUG SCREENS Criminal background checks and drug screening are becoming mandatory at medical institutions as a requirement of JCAHO. These are also requirements of most future employers of our PA graduates. A PA Program graduate’s background is also considered by many state boards as they evaluate graduates for licensure. So that any negative issues arising from this data collection can be identified and evaluated proactively (i.e., negative results can effect one’s ability to be placed in clinical sites while a PA student and a graduate’s ability to practice after graduation, etc.), passing a national criminal background check and drug screen are now conditional requirements of matriculation into the PA Program. Once accepted into the PA Program, students will be required to pay for and submit results of these requirements to the PA Program for evaluation. A negative criminal background check, negative drug screen and other items are required as a condition of matriculation. If any is/ are positive, the matter will be brought before the PA Program Admissions Committee for review. The student’s acceptance could be reversed and the student not allowed to matriculate. Neither Salus University nor the PA Program will be held liable for a student’s dismissal, failure to graduate, obtain a state license or ability to practice/ work because of a positive criminal background check or any other negative medical, ethical or legal finding. Repeated criminal background checks, drug screens and/ or other requirements may be necessary as determined by the PA Program. I.D. CARDS AND INTRODUCTIONS Students must introduce themselves to every patient using their name, and the term “physician assistant student”. Students must never present themselves to patients as a physician, resident, medical student, or graduate physician assistant. While in the Program, students may not use previously earned titles (i.e. RN, MD, DO, PhD, etc.) for identification purposes. The Salus University ID/SECURITY card is issued during first-year orientation. This card will permit you to enter the University via select doorways. ID cards are also needed to access the Student Center. These photo ID cards identifying each student as a PA Student must be worn during any and all experiential learning sessions/ clinical rotations. Student must also wear their Salus University badge identifying them as a PA student on their white lab/ clinic coats. The ID/SECURITY card may be useful in check cashing, student discounts and security at student functions. There is a charge of $20.00 to replace any lost or damaged ID card. The ID should be worn at all times on campus. It is important that security is notified ASAP of a lost ID card. ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 26
  27. 27. ACCIDENTAL EXPOSURE POLICY OVERVIEW The Physician Assistant Program recognizes that as students begin to interact with patients as part of their clinical training, they will encounter the risk of exposure to infectious diseases. Recognizing that there is no way to totally eliminate this risk and continue to provide a meaningful and quality medical education, the Program and the University accepts their responsibility to provide all students appropriate training in universal precautions and other risk reduction behaviors before entering the patient care environment. Training The PA program will provide students with training on universal precautions regarding the appropriate handling of blood and body fluids during training in accordance with OSHA guidelines. Additionally, students will receive written handouts for future reference. Documentation of training will be maintained by the program and provided to clinical sites upon request. Accidental Exposure to Contagious Diseases There are several steps students should take in the event of Accidental Exposure. Those steps include but may not be limited to the following: • Remove soiled clothing and administer immediate self aid including (wash skin, flush eyes 10-15 minutes, etc.) remove contact lenses if eyes are exposed. • Notify your preceptor immediately. DO NOT DELAY. GET ASSISTANCE IMMEDIATELY. • Obtain name, medical record number, and number of the patient source. • Immediately, report to the designated person/location at your clinical site to receive information and counseling regarding proper treatment. Depending on the type of exposure the student may be advised to receive one or more drugs that may reduce the risk of contracting a disease. Reminder, all Salus University students are required to carry health insurance for the duration of the program. Incident Reporting If a student is involved in a situation that meets the criteria for an incident report at the clinical site during a student-related activity (i.e. needle stick/splash, TB exposure), the student should report such an incident immediately to his/her preceptor and receive appropriate medical care. If this incident happens while on rotation at a hospital, the student should follow the police of that institution by going to their Employee Health Department, Occupational Health Services Department, or ER for immediate care. This care might include wound care, lab work and post exposure prophylaxis. Every incident must be reported to the Physician Assistant Program Clinical Coordinator. The student should then send copies of all paperwork relating to the incident and its ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 27
  28. 28. treatment (e.g. Physician’s or other provider’s note, EHD/ED report, and incident report) to the PA Program Clinical Coordinator. This approach provides documentation for the student’s insurance coverage and safety. SALUS UNIVERSITY FACULTY AND STUDENT LIABILITY INSURANCE POLICY It is the policy of Salus University to maintain for the University and for each Student and to maintain for or cause each Faculty to maintain professional liability insurance for liability arising out of the rendering of or our failure to render professional services during the policy period with claims made coverage in the amount of at least $1,000,000.00 per medical incident involving death or injury to persons and at least $3,000,000,00 in the aggregate for all medical incidents during the policy year involving death or injury to persons. The University also maintains for itself and for each Student and Faculty general comprehensive public liability insurance providing coverage in the amount of at least $1,000,000.00 and for any one occurrence of death or injury and at least $3,000,000.00 in the aggregate during the policy year. A current Certificate of Insurance evidencing such coverage may be furnished on request. ATTENDANCE POLICY Attendance is expected and required at all PA Program lectures, labs, clinical problem solving sessions, experiential learning sites, clinical rotations, seminars, grand rounds presentations, and other didactic and clinical related sessions scheduled by the PA Program. Attendance policy is addressed in detail in the PA Program Academic Policy Handbook and outlined in general here. While students receive a class schedule for the semester that includes weekly schedules and course schedules, the program cannot always adhere strictly to the days and times listed. The majority of the part-time faculty is composed of practicing physicians, physician assistants and others whose schedules can fluctuate. When an emergency or conflict arises and classes must be rescheduled, every effort is made to do so within regularly scheduled class times. Classes may have to be scheduled on an off time, including evenings and weekends (Saturdays and/ or Sundays) to accommodate faculty schedules. The PA Program reserves the right to add additional hours to previously scheduled class hours as determined by the faculty. Advanced Cardiac Life Support (ACLS), for example, is typically given to students on a weekend day or days. Exams are frequently scheduled during times other than regular class times. Students are expected to be in the classroom, ready to begin classes at the stated times. STUDENT PROFESSIONAL CONDUCT POLICY Students in the Physician Assistant Program are participants in a professional, graduate level training program whose graduates assume significant levels of responsibility as health care providers. Therefore, students are evaluated not only on academic progress and clinical skills but also in the area of professionalism (interpersonal and team skills, reliability, professional demeanor, and appearance). Problems in any of these areas will be brought to the student’s attention and may result in disciplinary action. ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 28
  29. 29. Salus University and the Physician Assistant Program expect each student to exhibit integrity, honesty, good moral character, and professionalism. Instances of dishonesty will be handled in accordance with University policy as outlined in the Salus University Handbook. DRESS POLICY Students are expected to maintain a neat, clean, and professional appearance. Students must not wear the ¾ or full-length white lab coat and must wear the short white lab coat complete with the school name tag clearly identifying you as a Physician Assistant Student. The wearing of scrubs is restricted to areas in which the risk of exposure to blood and other bodily fluid exposure is relatively high i.e., Surgery, OB, and ER. Scrubs are NOT to be worn during routine clinic hours unless it is the dress expected by the clinical preceptor. TECHNOLOGY REQUIREMENTS The PA Program requires all students have laptop computers and PDA’s that meet certain technical standards and that students have service contracts to support such items. This technology requirement is included in the financial aid package. These devices are to ensure each student’s ability to access required educational websites/ databases/ software during the didactic and clinical year. For example, students will need laptops to access evidence-based websites for Clinical Problem Solving courses in the didactic year and Blackboard for taking examinations and accessing course materials during the didactic and clinical year. Students will need PDA’s loaded with Typhon software (read below) so that they may enter patient encounter data; this data is then “synced” to the Typhon website on their laptop computer. PA PATIENT TRACKING SYSTEM The clinical patient tracking system (available through Typhon) provides an electronic method to simplify collection of each student's patient encounter logs. Program directors, clinical site coordinators, faculty and students can have instant online access to view tallies and charts of cumulative clinical experiences. Custom searches also provide us with further case details based on filters and subsets. Students can quickly and easily enter all patient encounter information from one page, including demographics, clinical information, and diagnosis and procedure codes including demographics, clinical information, diagnosis and procedure codes, medications, and clinical notes. In addition, students learn how to document their work using ICD-9 and CPT codes. Administrators can customize various areas including rotation types, clinical locations, medication details, expiration dates, time logs and optional data fields; students can set defaults for commonly used fields. There are a variety of pre-built reports, including cumulative tallies, individual case logs, and time log totals. Reports can be run by date, rotation, clinical site or preceptor. Evaluation tools are also distributed and collected using this technology. Students will be given instruction by the program in the use of this system. OUTSIDE ACTIVITIES AND WORK POLICIES The Physician Assistant curriculum has been designed to be a full-time activity for the student. It ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 29
  30. 30. consists of a very demanding course load with a great deal of time spent in class and in clinical experiences. There are also many special seminars, films and guest lecturers that may be available to students on relatively short notice. We encourage you to seek outside sources of support (scholarships, loans, etc.) and devote as much time as possible to your professional education. Your primary effort at this point in your life needs to be on the educational process. Employment is STRONGLY DISCOURAGED. Physician assistant students may not perform service work within the Physician Assistant Program and will not be substituted for regular staff. Students are prohibited from substituting for clerical and/or clinical personnel during first year clinical experiences and clinical rotations. While enrolled in the University, no student may serve as a formal instructor to other enrolled students. STUDENT RECORDS In accordance with University Policy and the Family Educational Rights and Privacy Act of 1974, the University and the Physician Assistant Program provide students access to their records. Student Access to Records is discussed in the PA Program Academic Policy document. GRADING POLICY Beginning with didactic year Class of 2010 and clinical year Class of 2009, quiz, exam and other grades whenever appropriate will be recorded to 2 decimal points. Grades submitted to the Registrar for midterm and final grades will be recorded and reported to the nearest whole number. Specifically, regarding the determination of the midterm and final grade, when the two decimal number is equal to or greater then .50 (e.g., 87.50, 87.51, etc.), the midterm and final grade will be will be rounded to the next highest whole number (e.g., 88). A midterm or final numerical grade that is equal to or .49 (e.g., 87.49, 87.48, etc.) or less will be rounded to the lower whole number (e.g., 87). EVALUATION INSTRUMENT (EXAM/ QUIZ) REVIEW AND ITEM CHALLENGE POLICY Review of an evaluation instrument is a privilege granted by the faculty. It is designed for students to discuss/ debate instrument items (questions) and learn from the process. It is a privilege that may be withdrawn at any time. Once an evaluation instrument (exam, quiz) is completed, the Course Director or his/ her designee corrects the instrument. This person will evaluate the individual items on the instrument according to procedures similar to the evaluation of the PANCE (biserial analysis, etc.). If an item demonstrates questionable validity, the Course Director/ designee may contact the lecturer of the material/ author of the item to discuss validity. Once this process is complete, the Course Director/ designee will post the instrument’s results. This process is variable and depends on the lecturer’s/writer’s availability and the current workload of the Course Director/ designee. The instrument is then available for review by the class. The instrument (with the correct answers identified) is posted in an e-folder by the Course Director/ designee and made available to the President on the Shared Drive at a time mutually acceptable to the Course Director/ designee and President. The President scrolls slowly through the instrument asking the class if the item needs ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 30
  31. 31. discussion. Students who choose to attend who correctly answered the question should explain to those who question the item their rationale for the answer. If there is concern regarding the item’s validity, the item(s) should be presented to the Course Director/ designee with the rationale for invalidity and references from the required text and/ or power point presentation substantiating the “challenge” Any challenge to an item must be submitted within 48 working hours of the completion of the test review. The item’s validity will be reviewed by the Course Director/ designee and the President and/ or class will be notified of the outcome. Once this occurs, there is no further challenge. The exam is closed for discussion. POLICY ON EVALUATIONS OF COURSE, LAB, LECTURER, ETC. The evaluation of courses, lecturers, clinical rotations, preceptors, clinical sites and other curricular and University related offerings is an ARC-PA requirement for accreditation. The PA Program has submitted to the ARC-PA a detailed process of self-assessment and evaluation. You play an important part in this process. For the Didactic Year and Advanced Didactic Phase, evaluations should be posted on Blackboard 1 week after final exams are given and any test reviews have been completed. Students are expected to complete all appropriate evaluations. Dates for completion of these evaluations will be posted with the evaluations. CAPSTONE PROJECT CONTENT POLICY Beginning with the Class of 2010, PA students cannot use for their capstone project topic a disease either they or a relative has/ has had. In order to “step out of their comfort zone”, students will be required to select a disease that is new to them so as not to give any one student an unfair advantage over the other students. FACULTY MEETING POLICY To insure and respect individual faculty member’s privacy and maintain the confidentiality of matters faculty may be discussing in their offices or conference room, students should not go directly to any faculty member’s office and should not wait outside of a faculty member’s office to meet. A student wishing to meet with a faculty member for any reason must first either: 1. E-mail the faculty member to arrange a time, or 2. Stop at the Program Office and have an administrative staff representative ask the faculty member if he/she can meet with the student at that time or arrange a meeting. When the student arrives for the appointment, he/she should not proceed to the faculty member’s office but first ask the administrative staff representative to let the faculty member know the student is there for their appointment. TECHNICAL STANDARDS The technical standards for admission set forth by the Physician Assistant Program establish the essential qualities that are considered necessary for students admitted to this program to achieve the knowledge, skills and levels of competency stipulated for graduation by the faculty and expected of the professional program by its accrediting agency (ARC-PA, Inc.). All students admitted to this ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 31
  32. 32. program are expected to demonstrate the attributes and meet the expectations listed below. These Technical Standards are required for admission and also must be maintained throughout a student's progress through the Physician Assistant Program. In the event that, during training, a student is unable to fulfill these technical standards, with or without reasonable accommodations, then the student may be asked to leave the program. Candidates for admission to the Physician Assistant Program must possess the following Technical Standards: Observation Students must be able to observe demonstrations, exercises, patients accurately at a distance and close at hand, and note non-verbal as well as verbal signals. Communication Students should be able to speak intelligibly, hear sufficiently, elicit and transmit patient information in oral and written English to members of the healthcare team, describe changes in mood, activity and posture, and communicate effectively and sensitively with patients. They must possess demonstrated reading skills at a level sufficient to accomplish curricular requirements and provide clinical care for patients. They must be capable of completing appropriate medical records and documents and plans according to protocol in a thorough and timely manner. Sensory and Motor Coordination and Function Students must possess motor skills sufficient to directly perform palpation, percussion, auscultation, and other basic diagnostic procedures. They must be able to execute motor movements reasonably required to provide basic medical care, such as airway management, placement of catheters, suturing, phlebotomy, application of sufficient pressure to control bleeding, simple obstetrical maneuvers, etc. Such actions require coordination of gross and fine muscular movements, equilibrium, and functional use of the senses of touch and vision. Intellectual-Conceptual, Integrative and Quantitative Abilities Problem solving, the critical skill demanded of PAs, requires that students have the ability to measure, calculate reason, analyze, and synthesize. Students must be able to independently access and interpret medical histories or files; identify significant findings from history, physical examination, and laboratory data; provide a reasoned explanation for likely diagnoses and prescribed medications and therapy; and recall and retain information in an efficient and timely manner. The ability to incorporate new information from peers, teachers, and the medical literature in formulating diagnoses and plans is essential. Good judgment in patient assessment and diagnostic and therapeutic planning is essential. Behavioral and Social Attributes Students must possess the ability to use their intellectual capacity, exercise good judgment, and promptly complete all responsibilities attendant to the diagnosis under potentially stressful and/or emergency circumstances. They must also be able to develop empathic, sensitive, and effective relationships with patients. They must be able to adapt to changing environments and to learn in the face of uncertainties inherent in the practice of medicine. Compassion, integrity, ethical standards, concern for others, interpersonal skills, interest, and motivation are all personal qualities that will be assessed during the admissions and educational process. The students must be able to use supervision ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 32
  33. 33. appropriately and act independently, when indicated. Candidates for admission to the Salus University Physician Assistant Program who are accepted for admission will be required to verify that they understand and meet these technical standards. Admission decisions are made on the assumption that each candidate can meet the technical standards without consideration of disability. Letters of admission will be offered contingent on either a signed statement from the applicant that she/he can meet the program's technical standards without accommodation, or a signed statement from the applicant that she/he believes she/he can meet the technical standards if reasonable accommodation is provided. If an applicant states she/he can meet the technical standards with accommodation, then the University will determine whether it agrees that the student can meet the technical standards with reasonable accommodation; this includes a review of whether the accommodations requested are reasonable, taking into account whether the accommodation would jeopardize patient safety, or the educational process of the student or the institution, including all coursework and internships deemed essential to graduation. The Center for Personal and Professional Development and the Physician Assistant Program will jointly decide what accommodations are suitable or possible in terms of reasonable accommodation, and will render the person capable of performing all essential functions established by the program. POLICIES ON ACADEMIC STANDING AND STUDENT PROGRESS Policies on grading, student progression, academic standing, academic retention/ reenrollment, etc. are found in the Salus University Student Handbook and the PA Program Academic Policy document. TESTING POLICIES Please refer to the Salus University Student Handbook for these additional policies. PART-TIME ATTENDANCE Part-time attendance will be considered on an individual student basis only. CONFIDENTIALITY Students are expected to comply with the HIPPA Privacy Rules in effect as of April, 2003. All records and communications regarding a patient’s care are protected by Federal and State courts as confidential and are only to be disclosed to other members of the health care team who have a need to know. Even with appropriate personnel, the student is to use discretion when discussing patient information. Such communication is not to take place in hallways, elevators, cafeterias or areas where other employees, students, patients or visitors may overhear information. Information overheard or viewed by the student inadvertently is subject to the same respect for patients’ confidentiality as firsthand knowledge. Unauthorized release of confidential information, in ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 33
  34. 34. any form, may subject the medical institution, health care providers and staff to civil and criminal liability or professional disciplinary actions. Therefore, a breach of confidential information pertaining to a patient’s medical, mental, personal or financial conditions is considered adequate justification for dismissal of the student from the next experiential learning session/ clinical rotation and all subsequent patient care experiences scheduled with the involved institution. The student is then liable for disciplinary action and/or dismissal from the Program. HIPPA Salus University PA Program Health Insurance Portability and Accountability Act (HIPAA) Guidelines Summary Students in the Salus University Physician Assistant Program must adhere to the following guidelines with regards to the Health Insurance Portability and Accountability Act regulations: • Patient information should not be discussed where others can overhear the conversation such as hallways, elevators, water coolers, at home or at social events. • Dictation of patient information should occur in places where others cannot hear the dictation. • Confidential papers, reports or computer printout should be kept in a safe and secure place. • Confidential papers should be picked up ASAP from copiers, mailboxes or faxes. • Confidential papers should be appropriately disposed of by being shredded or torn up. • Accessing any information other than what is required to do you job is a violation of confidentiality policies. • It is the provider’s duty and responsibility to keep health care information totally confidential. • Computer “passwords” must not be written down or shared with anyone else. • You cannot use someone else’s “password” to access an institution’s or practice’s computer system. Students will receive HIPPA training in the fall semester. Each student is expected to be fully acquainted and comply with all published policies, rules and regulations, of the University and the PA Program as outlined in this document, the PA Program Academic Policy document, and the Salus University Student Handbook. Serious violations of these policies, rules and regulations during the didactic and/ or clinical year may result in failed course grades and/or with the advice and consent of the Program Director, the Class Faculty, the Committee on Academic Promotions (CAP), Office of Student Affairs, and/ or the Office of Academic Affairs dismissal from the program. ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 34
  35. 35. V. PA SUPPORT SERVICES AND COMMITTEES ACADEMIC ADVISING BY PA FACULTY All student advisement is done by PA Program faculty who will make themselves available for student consultation. Students must meet with their advisor at least once each semester, and more often as needed. If a student encounters academic difficulties, the student should meet with the course instructor, then their advisor and finally with the Program Director. Prior to these meetings, the student should do a personal self-assessment focusing on the source of the difficulty and identifying possible plans for improvement. The role of the faculty advisor: • to be available during office hours or by appointment to meet with students to discuss academic problems which have not been resolved at the instructor level and to suggest possible remedies • to acquaint the student with available institutional resources and student services and, where appropriate, make referral to such services • to monitor academic and clinical progress and to be available for consultation where the student’s progress is in jeopardy • to share the benefit of his/her professional expertise in the area of professional development and career opportunities related to the PA profession The role of the student advisee: • to be familiar with all Program policies and procedures • to be familiar with all University requirements • to provide contributory information in a clear, concise manner to facilitate the advising process • to demonstrate insight about their academic performance and any deficiencies that may exist • to be familiar with their grades and current performance, in any course • to act on any academic recommendations and suggestions made by their advisor and/or the program director and • to be responsible for the successful completion of all course work and practical experience throughout the didactic and clinical components of PA training PHYSICIAN ASSISTANT PROGRAM COMMITTEES There are three committees specific to the PA Program: The PA Program Core Faculty Committee, the PA Program Curriculum Committee, and the PA Program Admissions Committee. THE PHYSICIAN ASSISTANT PROGRAM CORE FACULTY COMMITTEE The core faculty meets weekly, chaired by the program director, as a committee of the whole to discuss issues of day-to-day program operation. Curricular issues and/ or issues that require analysis ____________________________________________________________________________ Physician Assistant Student Handbook – Class of 2010 35