NOVA SOUTHEASTERN UNIVERSITY
                  
                      PHYSICIAN ASSISTANT PROGRAM
                        ...
4/8/2009
                                                                                     PAC 5000
                   ...
4/8/2009
                                                                                  PAC 5000
                      ...
4/8/2009
                                                                                      PAC 5000
                  ...
4/8/2009
                                                                                      PAC 5000
                  ...
4/8/2009
                                                                                      PAC 5000
                  ...
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PAC 5000 Physical Diagnosis I Syllabus

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PAC 5000 Physical Diagnosis I Syllabus

  1. 1. NOVA SOUTHEASTERN UNIVERSITY    PHYSICIAN ASSISTANT PROGRAM Ft Lauderdale Course Syllabus I. Course Title: PAC 5000 Physical Diagnosis I II. Course Director: Steven J. Sager, MPAS, PA-C Terry Building, 2nd Floor, Room 1283 Office: 954-262-1236 ssager@nsu.nova.edu III. Meeting Times: Please refer to the online WebEvent calendar IV. Instructor’s Office Hours: By appointment. V. Course Description: The Physical Diagnosis course is an introduction to clinical medicine. Students will acquire the knowledge and skills essential to obtain a comprehensive medical history and perform a complete head-to-toe physical examination. Emphasis is placed on normal physical findings. The course emphasizes patient interviewing, acquiring a medical data base, and performing a comprehensive physical examination. A combination of lectures, discussions, case studies, and performance skills labs will be used to present and practice the necessary concepts and skills. Lab sessions are used to optimize teaching of concepts. The student will be required to demonstrate Competency Based Learning during the performance of the required procedures and skills. VI. Course Goals: This course will teach students the skills necessary to obtain and document a comprehensive medical history and to perform and document a complete head-to-toe physical examination. Students will also develop the necessary skills to proficiently and comfortably handle medical equipment and instruments. In addition, students will: 1. Develop skills in medical interviewing that allow for establishing rapport and gathering accurate and complete information while maintaining patient comfort and dignity. 2. Acquire and hone the knowledge and skills to perform a complete physical examination, including a beginning appreciation for distinguishing normal from abnormal. 3. Learn to present an organized, thorough case history in both written and oral form. VII: Course Objectives: At the end of this course the student will be able to: 1. Obtain a comprehensive patient history. 2. Perform a thorough head-to-toe examination. 3. Correctly document medical information in a different formats
  2. 2. 4/8/2009 PAC 5000 04/08/09 VIII: Learning Objectives: Given an adult patient and the necessary equipment, without assistance or reference, obtain a comprehensive medical history and perform a complete head-to-toe physical examination utilizing a logical, systematic sequence of steps. Each section will include the following: Medical Interview Define the primary goal of the patient interview Identify the method by which the tone of the interview is established Compare and contrast techniques for gathering information from the patient Identify techniques to elicit the patient’s perspective Define the purpose and content of the “Chief Complaint” Construct the method for eliciting the “history of present illness.” Compare and contrast “pertinent positives” and “pertinent negatives” Define the differences between “disease and illness” Describe the purpose and content of the past medical history, social history and family history Define the purpose and content of the “review of systems” Define the techniques used to close the patient interview Define documentation guidelines as established by the Center for Medicare/ Medicaid Services (formerly HCFA) Obtain a complete patient history Document a complete medical history including a patient genogram Physical Examination List the components of the vital signs assessment Describe the techniques used to evaluate each vital sign Properly obtain vital signs on a classmate Identify the elements of the General Survey Identify the anatomical structures/landmarks of the skin Identify the anatomical structures/landmarks of the head and neck Describe and demonstrate the proper techniques of examination of the head and neck Identify the anatomical structures/landmarks of the eye Describe and demonstrate the proper techniques of examination of the eye Identify the anatomical structures/landmarks of the ear, nasal cavity, and oral cavity Describe and demonstrate the proper techniques for the examination of the ear, nasal cavity, and oral cavity Identify thoracic and pulmonary anatomy and landmarks Identify and demonstrate the proper techniques for inspection, palpation, percussion and auscultation of the lungs, thorax, and heart Describe and demonstrate the steps of the cardiac examination, including: o the proper positions of the patient and examiner o the important precordial areas for inspection, palpation, and auscultation o the proper use of the diaphragm and bell in cardiac auscultation o the method for timing the cardiac cycle using two senses o the normal cardiac sounds 2
  3. 3. 4/8/2009 PAC 5000 04/08/09 Identify peripheral vascular landmarks in upper and lower extremities including areas of palpation for pulses and auscultation for bruits Describe and demonstrate the steps of the peripheral vascular examination, including determination of the arterial blood pressure by palpation and auscultation, inspection of the external jugular vein, and measurement of jugular venous pressure Identify the anatomical structures/landmarks of the abdomen and the relationship of the abdominal organs to each other Discuss the anatomy of the abdomen as it relates to the physical examination of the abdomen Describe and demonstrate the proper techniques of examination of the abdomen Identify the anatomical structures/landmarks of the musculoskeletal system Discuss the physiology of movement as it pertains to the musculoskeletal system Measure the range of motion of selected joints and compare your results to the normal range of motion Describe and demonstrate the proper techniques of examination of specific joints Describe the anatomy of the nervous system Identify the motor and sensory pathways Describe the pathways involved in the spinal reflex Define and demonstrate the proper techniques of the Mental Status examination List or identify the functions of the cranial nerves Describe and demonstrate the proper techniques of examination of the cranial nerves Describe and demonstrate the proper techniques of examination of the motor component of the nervous system Identify or list the innervations of the muscles Describe and demonstrate the proper techniques of examination of the sensory component of the nervous system Identify the dermatomes Identify and demonstrate the proper techniques of examination of the deep tendon and abdominal reflexes Identify and demonstrate the proper techniques of examination of cerebellar function Properly perform a complete head-to-toe physical examination in the allotted time IX. Texts: Required: 1) Seidel HM, Ball JW, Dains JE, Benedict GW. Mosby’s Guide to Physical Examination. 6th ed. St. Louis, MO: Mosby; 2006. (ISBN 13: 978-0-3230-2888-2) 2) Coulehan JL, Block MR. The Medical Interview: Mastering Skills for Clinical Practice. 5th ed. F.A. Davis; 2006 (ISBN 13: 978-0-8036-1246-4) Recommended: 1) Seidel HM, Ball JW, Dains JE, Benedict GW. Student Laboratory Manual for Mosby’s Guide to Physical Examination. 6th ed. St. Louis, MO: Mosby; 2006. (ISBN 13: 978-0-3230-3573-6) 2) LeBlond RF, DeGowin RL, Brown DD. DeGowin’s Diagnostic Examination. McGraw- Hill; 2008 (ISBN 13: 978-0-0714-7898-4) 3
  4. 4. 4/8/2009 PAC 5000 04/08/09 X. Evaluation Procedures: Quizzes – will be administered using audience response devices (“clickers”) and will be given prior to each lecture for each system discussed. Advanced reading of the material prior to the lecture is required. (Responding to questions asked during the lectures will be counted as part of the class participation grade.) Written examinations for PAC 5000 will be held at the times designated on the WebEvent calendar. The comprehensive midterm written examination will cover lecture material from the first half of the course. The comprehensive final written examination will cover lecture material presented in the second half of the course. A minimum score of 75% (C) must be achieved to pass each written exam. Failure of a written exam requires retesting or mandatory participation in a remedial exercise (tutorial). Practical Examinations – Faculty will use standardized checklists to evaluate each student’s physical examination skills. A minimum score of 80% (B-) must be achieved to pass each practical exam. Failure of a practical exam requires mandatory attendance and participation in a remedial exercise (tutorial), which consists of practicing the failed material under direct faculty supervision. Although the remedial exercise is mandatory, your original grade will not change after the exercise is complete. Classroom and laboratory preparation and performance will be evaluated based on student’s attendance and participation. This includes: punctuality preparation and successful completion of assignments classroom responses using the audience response device (“clicker”) proper lab attire functional diagnostic equipment familiarity with material The final course grade will be calculated based on the following distribution: Quizzes 15% Classroom & laboratory preparation and performance 15% Midterm written exam 15% Final written exam 15% Practical exams 20% Final skills demonstration (head-to-toe physical exam) 20% In order to pass this course, all students must achieve a cumulative average of 75% (C) or greater on the written exams, a cumulative average of 80% (B-) or better on the practical examinations, and a score of 80% (B-) or better on the final skills demonstration. NOTE: all evaluation components of this course must be passed to pass the course. The student will be offered one remedial exam for each component that is not passed. Failure to pass any of the remedial exams will result in course failure without the option of additional remediation and the student will be referred to the Committee on Student Progress. 4
  5. 5. 4/8/2009 PAC 5000 04/08/09 This course is a prerequisite for PAC 5100 Physical Diagnosis II. Failure to pass the course may result in dismissal, prohibition from enrolling in PAC 5100 Physical Diagnosis II, or may extend the student’s course of study. XI. COURSE POLICIES: Student attendance at all lectures, labs, and exams is mandatory and essential to achieve the course objectives! It is expected that all students will engage in critical thinking and problem solving during this course. Reading assignments must be completed prior to the lecture. All written assignments must be in MS Word document format and they must be submitted electronically as an e-mail attachment. All written assignments must also be formatted using the following parameters: Margins: 1” on all sides Font: Times New Roman 12-pitch Spacing: single-space Title: LastnameFirstinitial_Assignment (SmithA_SOAP1) Participation is essential insure learning of interviewing and physical examination techniques and is expected of every student throughout the course. While in the classroom or lab, students will be selected at random to answer questions concerning the reading material. Mandatory lab attire and equipment: If a student is not properly attired or does not have their diagnostic equipment, they will be asked to leave, which will be counted as an unexcused absence. Only tennis shoes or crocs-like footwear is authorized. Slippers, sandals, and flip-flops are not acceptable. Men: program T-shirt and program exercise shorts Women: sports top (bra), program T-shirt, and program exercise shorts All: student lab coat with PA program logo Students should bring their textbook to all lecture and lab sessions throughout the semester. Assigned readings must be completed prior to lectures and laboratory practicums. Students will be randomly called upon to answer questions and will be expected to critique their own and other students' thinking. The required textbooks will serve as the authoritative answer to a clinical problem if not addressed in lecture or written handout. Please refer to the Academic Year Handbook on the policies and procedure for missed exams and the procedure for documenting and reporting all absences. Immediately notify the course director via phone call of any missed lectures, exams, or labs. 5
  6. 6. 4/8/2009 PAC 5000 04/08/09 Tardiness will not be tolerated. Tardy students will not be permitted to enter the classroom. However, if the student is denied entry into the lecture because of tardiness, he/she will be permitted to enter the classroom during the next class break. XII. Classroom Behavior and Conduct Professional behavior and decorum is a requirement for successful completion of this course. This will be evaluated in the classroom, labs, and all associated encounters with the instructor and/or staff. Failure to adhere to this standard, regardless of academic achievement in the course, will subject the individual to referral to the Committee on Student Progress for possible disciplinary action and/or dismissal. THE COURSE DIRECTOR RESERVES THE RIGHT TO MAKE REVISIONS TO THIS SYLLABUS AT ANY TIME. 6

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