Physician Assistant Program

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Physician Assistant Program

  1. 1. Physician Assistant Program Guidelines and Policies Class of 2010 2008 – 2010 REVISED 8/2008 All information found in this handbook is subject to change. Please contact the Physician Assistant Program at (208)282-4726 with any questions or concerns. 1
  2. 2. Table of Contents Introduction 5 ISU PA Program Overview 6 The Mission 8 Curriculum 9 Didactic Curriculum 9 Clinical Curriculum 10 General Policies and Guidelines 11 ISU Policies and Guidelines 11 Family Educational Rights and Privacy Act 11 Americans With Disabilities 11 ADA and Disabilities Resource Center 12 ISU Policy and HIPAA 12 1. Academic Standing and Grades 12 Progression through PA Curriculum 12 Transfer of Credits 12 Time Limits 12 Final Program of Study 12 Application for a Degree 12 Graduation Requirements 13 Academic Progression/Dismissal 13 Academic Affairs Committee 13 Repeated Courses and Auditing Courses in the PA curriculum 13 Professional Behavior 14 2. Withdrawal or Dismissal 16 3. Appeals of Grade or Dismissal 17 4. Academic Dishonesty 21 5. Employment Policy 22 Didactic Year Policies and Guidelines 23 6. Didactic Year Attendance 23 7. Evaluation of Student Performance 23 8. Learning Objectives 25 9. Tutoring 25 10. Didactic Year Clinical Experiences 26 11. Entrance into Clinical Year 26 Background Checks 26 Capstone Experience 27 12. Capstone Experience, Masters Project in PA Studies course description 27 Comprehensive Examination 27 Case Presentation 27 Advisors and Committee 27 Conflict of Interest of Graduate Faculty 27 Written Report 28 2
  3. 3. Oral Defense 27 Portfolio 28 Failure of portion of capstone event 31 Continuing Registration for Graduate Students 31 Introduction to the Clinical Year 33 Maximizing your clinical experience 33 Clinical Year Policies and Guidelines 34 13. Clinical Rotation Information 34 ISU Catalog Descriptions 34 Clinical Rotations I-VIII Overview 34 End of Semester Meetings 34 Rotation Change Policy 34 Out-of-area site policy 34 Personally arranged sites 35 Preceptorship Policies 35 Rotation Selection 35 14. Travel Funds 36 15. Clinical Year Attendance 36 16. Academic Standards 37 Grading Criteria 37 Good Academic Standing 38 End-of-Rotation Exams 38 Makeup Examination 38 Student Name Tag 38 Professional Appearance 39 Supervision 40 Incident Reports 40 17. Progression from Clinical Year to Graduation 41 18. Information for Preceptors 42 19. Clinical Year Objectives 47 Part I - PA Program Outcome Objectives 48 Part II - General Clinical Year Objectives 49 Part III - Specific Clinical Rotation Objectives Primary Care Rotations 54 Outpatient and Inpatient 54 Obstetrics and Gynecology 66 Pediatrics 71 Part III - Specific Clinical Rotation Objectives Specialty Care Rotations 76 Surgery 76 Psychiatry 82 Emergency Medicine 87 Part III - Specific Clinical Rotation Objectives Elective Rotations 90 Cardiology 90 3
  4. 4. Dermatology 94 ENT 99 Orthopedics 103 20. Clinical Year Evaluations Policies 108 21. Clinical Evaluation Forms 109 Preceptor Forms Mid-Rotation Preceptor Evaluation Form 110 Final Preceptor Evaluation Form 111 Faculty Forms: Mid-Rotation Site Visit Form 116 Evaluation of Case Presentation 117 Student Forms: Site Evaluation 120 22. Appendices 124 Appendix A: Guidelines for Ethical Conduct 124 Appendix B: Needle Stick/Bloodborne Pathogen Exposure Policy 134 Appendix C: Medicare Reimbursement Guidelines for Students 135 Appendix D: Competencies for the Physician Assistant Profession 140 4
  5. 5. Introduction There are numerous components to the concept of professionalism. Not all of them can be enumerated in this guide. However, the Program faculty has identified areas of behavior and activity which it deems essential for student compliance. Expectations are identified which address academic and professional criteria for successful completion of the physician assistant course of study. As a PA student, you are expected to be completely cognizant of such expectations and will be evaluated on the basis of your compliance with them. The information contained in these Policies and Guidelines is consistent with the Idaho State University Graduate Catalog, the Accreditation Review Commission on Education for the Physician Assistant, Inc. (ARC-PA) Standards and the National Commission on Certification of Physician Assistants (NCCPA). 5
  6. 6. ISU PA Program Overview Definition of A Physician Assistant (PA) Physician assistants are health professionals licensed to practice medicine with physician supervision. Physician assistants are qualified by graduation from an accredited physician assistant educational program and/or certification by the National Commission on Certification of Physician Assistants. Within the physician/PA relationship, physician assistants exercise autonomy in medical decision- making and provide a broad range of diagnostic and therapeutic services. The clinical role of physician assistants includes primary and specialty care in medical and surgical practice settings in rural and urban areas. Physician assistant practice is centered on patient care and may include educational, research and administrative activities. Services performed by physician assistants include, but are not limited to: - Evaluation - Eliciting a detailed medical history, performing an appropriate physical examination, delineating problems, and recording information in the medical record. - Monitoring - Assisting the physician in developing and implementing patient management plans, recording progress notes in office-based and patient health care settings. - Diagnostics - Performing and interpreting (at least to the point of recognizing deviations from the norm) common laboratory, radiologic, cardiographic, and other routine diagnostic procedures used to identify pathophysiologic processes. - Therapeutics - Performing routine procedures such as injections, immunizations, suturing and wound care, managing simple conditions produced by infection or trauma, participating in the management of more complex illness and injury, and taking initiative in performing evaluation and therapeutic procedures in response to life-threatening situations. - Counseling - Instructing and counseling patients regarding compliance with prescribed therapeutic regimens, normal growth and development, family planning, situational adjustment reactions and health maintenance. - Referral - Facilitating the referral of patients to the community’s health and social service agencies when appropriate. The extent of the involvement by physician assistants in the assessment and treatment of patients depends largely on the complexity and acuity of the patient’s condition as well as their training, experience, and preparation as assessed by the supervising physician. The Profession 6
  7. 7. Physician Assistants (PAs) are academically and clinically prepared to provide healthcare services, including the diagnosis and treatment of disease, with the direction and responsible supervision of a doctor of medicine or osteopathy. The physician-PA team relationship is fundamental to the PA profession and enhances the delivery of high quality health care. PAs make clinical decisions and provide a broad range of diagnostic, therapeutic, preventive, and health maintenance services. The clinical role of PAs includes primary and specialty care in all medical and surgical practice settings. PA practice is centered on patient care and may include educational, research and administrative activities. Nationwide, the starting salary for PA graduates ranges from approximately $55,000 - $101,000 per year. The role of the PA demands intelligence, sound judgment, intellectual honesty, appropriate interpersonal skills, and the capacity to react to emergencies in a calm and reasoned manner. An attitude of respect for self and others, adherence to the concepts of privilege and confidentiality in communicating with patients, and a commitment to the patient’s welfare are essential attributes of the graduate PA. The Program The Physician Assistant (PA) Program at Idaho State University awards the Master of Physician Assistant Studies (MPAS) degree and a PA certificate upon successful completion of its 24 month graduate curriculum. A class of 50 students is enrolled each fall semester. Application to the Program is through the Central Application Service for Physician Assistants (CASPA). The Program is fully accredited by the Accreditation Review Commission on the Education of Physician Assistants, Inc., ARC-PA. Graduates of this Program are eligible to take the NCCPA’s Physician Assistant National Certifying Exam (PANCE). 7
  8. 8. The Mission The mission of the Idaho State University Physician Assistant Program is to: Curriculum: Provide a quality graduate medical education that emphasizes critical thinking and problem solving, is technologically enhanced, research oriented, and evidence-based, with strength in both the basic and clinical medical sciences. Students: Seek a culturally, ethnically, and socially diverse student body which will demonstrate the finest attributes of professional health care practitioners, including intellectual curiosity, insight, maturity, ethical behavior, critical thinking, empathy, strong interpersonal skills, a service orientation, and a commitment to evidence-based practice, research and lifelong learning. Faculty: Employ, develop and maintain outstanding faculty who are appropriate in expertise and number to the needs of the Program, represent the diversity of the nation, are student-centered and committed to the educational needs of the students as well as excellence in teaching, scholarly research, service, and continuing clinical competence. Affiliations: Establish and maintain, for the educational benefit of program students, clinical, educational, and other relationships with the medical community and other individuals and organizations that seek to enhance health care to rural and other medically underserved populations of the State, region, and beyond. Service: Nurture in students sensitivity to the needs of others and a desire and willingness to provide service of the highest quality, in the most caring manner, to all people, especially to those individuals and groups that are medically underserved, regardless of biological, social, political, economic, religious, or other status. 8
  9. 9. Curriculum The ISU PA Program graduate curriculum is twenty-four (24) months in length, divided into twelve (12) months of didactic and twelve (12) months of supervised clinical education. Each class progresses through the curriculum as a cadre. There is no part-time option. The fall semester of the didactic curriculum is comprised of foundation courses, followed by modules in the spring semester and summer session that provide an immersion experience in the diagnosis and treatment of diseases commonly encountered in primary care medicine. DIDACTIC CURRICULUM Fall Semester: BIOS 529 Regional Anatomy and Histology PAS 601 Intro to Physician Assistant BIOS 564 Lectures in Human Physiology PAS 602 Research Methods BIOS 563 Human Pathophysiology PAS 603 Clinical Assessment PAS 604 Pharmacology Spring Semester: PAS 630 Allergy/Immunology Module PAS 637 Gastroenterology Module PAS 631 Infectious Disease Module PAS 638 ENT Module PAS 632 Hematology/Oncology Module PAS 640 Rheumatology Module PAS 633 Endocrinology Module PAS 641 Orthopedics Module PAS 634 Renal Module PAS 642 Psychiatry Module PAS 635 Pulmonology Module PAS 645 Ophthalmology Module PAS 636 Cardiology Module Summer Semester: PAS 639 Dermatology Module PAS 652 Geriatrics Module PAS 646 Neurology Module PAS 653 Surgery Module PAS 647 Human Sexuality Module PAS 654 Emergency Medicine Module PAS 648 Women’s Health Module PAS 656 Alternative/Occupational PAS 649 Men’s Health/Urology Module Medicine Module PAS 650 Obstetrics/Perinatology Module PAS 657 Comprehensive Evaluation PAS 651 Pediatrics Module 9
  10. 10. CLINICAL CURRICULUM Fall Semester: PAS 660 Clinical Rotation I: Supervised clinical practicum in primary care and/or specialty care in medical practice settings. PAS 661 Clinical Rotation II: Supervised clinical practicum in primary care and/or specialty care in medical practice settings. PAS 662 Clinical Rotation III: Supervised clinical practicum in primary care and/or specialty care in medical practice settings. PAS 669 End of Semester Meeting I: Students will participate in a 2-day meeting. Lectures and other content in primary care, specialty care and professional development content will be delivered. Cumulative end of semester assessments will be given. Spring Semester: PAS 663 Masters Project in Physician Assistant Studies: An evidence-based medical case study, completed under the direction of the program faculty. A written report and oral explication of the case study is required. PAS 664 Clinical Rotation IV: Supervised clinical practicum in primary care and/or specialty care in medical practice settings. PAS 665 Clinical Rotation V: Supervised clinical practicum in primary care and/or specialty care in medical practice settings. PAS 666 Clinical Rotation VI: Supervised clinical practicum in primary care and/or specialty care in medical practice settings. PAS 670 End of Semester Meeting II: Students will participate in a 2-day meeting. Lectures and other content in primary care, specialty care and professional development content will be delivered. Cumulative end of semester assessments will be given. Summer Semester: PAS 667 Clinical Rotation VII: Supervised clinical practicum in primary care and/or specialty care in medical practice settings. PAS 668 Clinical Rotation VIII: Supervised clinical practicum in primary care and/or specialty care in medical practice settings. 10
  11. 11. General Program Policies and Guidelines ISU POLICIES AND GUIDELINES Federal Family Educational Rights and Privacy Act of 1974 Idaho State University in compliance with the Family Educational Rights and Privacy Act (FERPA), is responsible for maintaining educational records and monitoring the release of information of those records. Staff and faculty with access to student educational records are legally responsible for protecting the privacy of the student by using information only for legitimate educational reasons to instruct, advise, or otherwise assist students. Only those records defined as "directory information" may be released without the express written permission of the student. Directory information includes the student's name, address listings, telephone listings, e-mail addresses, full-time/part-time status, class level, college, major field of study, degree types and dates, enrollment status, club and athletic participation records, and dates of attendance including whether or not currently enrolled. No other information contained in a student's educational records may be released to any outside party without the written consent of the student. A student may restrict release of all directory information by filing a Declaration of Non-disclosure of Educational Record Information form in the Office of Registration and Records. Student may choose to restrict release of their address and telephone listings only. This may be done through their MyISU portal by accessing the Student Address Change Request form under Student Records information. This restriction will apply to the students' address and telephone listings only; all other directory listings will continue to be available for release. Students must request complete directory information restriction or address/phone listing restrictions during the first week of fall term to prevent their information from being published in the Student Directory. Any restriction is permanent and remains in place even after the student has stopped attending or has graduated from the University unless the student requests, in writing, that it be removed. Additional FERPA information may be found on the web at: http://www.isu.edu/areg/ferpafacts.shtml Americans with Disabilities Statement on Compliance and Services The Americans With Disabilities Act (ADA) is the civil rights guarantee for persons with disabilities in the United States. It provides protection from discrimination for individuals on the basis of disability. The ADA extends civil rights protection to people with disabilities in matters which include transportation, public accommodations, accessibility, services provided by state and local government, telecommunication relay services, and employment in the private sector. Idaho State University, in the spirit and letter of the law, will make every effort to comply with “reasonable accommodations”, according to section 504 of the Rehabilitation Act of 1973 and the Americans With Disabilities Act. Idaho State University will not discriminate in the recruitment, admission, or treatment of students or employees with disabilities. Students and employees who need auxiliary aids 11
  12. 12. or other accommodations should contact the ADA & Disabilities Resource Center, Campus Box 8121, (208) 282-3599. ADA and Disabilities Resource Center Students with disabilities who wish to have accommodations provided by the University must self identify in order to have accommodations provided. Information and applications for accommodations are available in the Center and may be picked up in person or requested by telephone or TDD by calling (208) 282-3599. In order for the Center to arrange accommodations for those who need assistance, they request notification as early as possible so that timely arrangements can be made. ISU Policy and HIPAA “The Health Insurance Portability and Accountability Act (HIPAA) was passed in 1999. ISU is committed to protecting the confidentiality of protected health information and in complying with Federal and State regulations regarding protected health information.” 1. ACADEMIC STANDING AND GRADES A. Progression through PA Curriculum: i. The Physician Assistant curriculum is a progressive immersion experience and each class of students is expected to move through the curriculum as a cohort. B. Transfer of Credits: i. Transfer of credits from other programs is not permitted. C. Time Limits: i. The field of medicine is continually advancing, therefore all requirements for an MPAS degree must be completed within 4 (four) years. D. Final Program of Study: i. A final Program of Study must be submitted to and be approved by the Graduate School during the semester immediately preceding the semester in which the student intends to graduate (typically during the Spring semester). ii. The Program will initiate the required forms for the Program of Study. iii. The final Program of Study form will list all requirements that must be completed in order to receive the degree or certificate. E. Application For a Degree: i. Within the first two weeks of the fall or spring semester in which the student expects to complete work for the degree, or the last day of spring semester for graduation during summer session, an application for graduation must be filed with the Graduate School. ii. An application and diploma fee must be paid at this time in the Office of Registration and Records. Check the Graduate Catalog for the fee amount (http://www.isu.edu/catalogs.shtml) iii. If the student does not complete requirements during this semester or summer session, an updated application must be submitted for the subsequent semester 12
  13. 13. and a reprocessing fee paid to the Graduate School. Check the Graduate Catalog for the reprocessing fee amount (http://www.isu.edu/catalogs.shtml). iv. Applications for degrees will not be approved without the prior approval of a final Program of Study form. F. Graduation Requirements: i. In order to graduate from the PA Program, a. Students must successfully complete all program requirements for the didactic and clinical years. b. Students must meet all requirements of the Graduate School. c. Throughout the Program, students must possess a cumulative grade point average (GPA) of 3.0 for all course work undertaken as part of the Physician Assistant Program. G. Academic Progression/Dismissal: i. Any student who receives a grade of C+ or below for any one course in any given semester must petition the PA Program Academic Affairs Committee (AAC) in order to continue in the Program. ii. If a student receives a grade of C+ or below in more than two courses/modules in the Program, the student will be academically dismissed from the Program, regardless of GPA. iii. Grades will be reviewed by the Academic and Clinical Coordinators at the end of each semester. a. Students whose cumulative grade point average falls below 3.0 may be placed on academic probation for the following semester. b. If the student fails to achieve an overall cumulative average of 3.0 after one semester of probation, the student may be academically dismissed from the Program. iv. Deviations from these standards must be approved by the PA Program Academic Affairs Committee (AAC) through formal petition by the student. H. Academic Affairs Committee (AAC): i. The AAC shall be convened in order to deliberate student appeals in those cases where a student falls out of good standing, either academic or behavioral, as per this manual. ii. The purpose of the AAC is to provide a recommendation to the Program Director based on the student’s files, petition to continue, facts and information presented, and demonstrated potential to successfully complete the Program. iii. The AAC will be comprised of a minimum of three faculty appointed by the Program Director. This Committee will meet as soon as possible in order not to impede the academic progress of students who may continue in the Program. I. Repeated Courses and Auditing Courses in the PA curriculum: i. The curriculum is an immersion experience, and all students are expected to move through the Program as a cohort. ii. Students who have previously taken courses that are part of the Program curriculum may petition the AAC to audit the class(es). a. Students who are auditing a class are expected to attend lectures and otherwise meet all course objectives. b. Audits are not allowed if content, labs, or small groups/discussions vary from that required by the program’s objectives. 13
  14. 14. J. Professional Behavior: In addition to meeting minimum grade requirements, students must adhere to standards of professional behavior which include, but are not limited to the following Professional Behavior Performance Criteria: i. Successful completion of the program is dependent upon compliance with professional behavior criteria as well as academic performance. These criteria include, but are not limited to, consistent demonstration of: a. Mature demeanor, manner, conduct, behavior, character, deportment, and performance. b. Evidence of respect shown for patients, preceptors, staff, instructors and fellow students; c. Personal integrity and honesty; d. Sensitivity to patients and respect for their rights to competent, confidential service. ii. Examples of unprofessional behavior include, but are not limited to, the following: a. Failure to comply with Program regulations and rules; b. Failure to participate fully in all aspects of the curriculum. 1) If a student believes that full participation in this professional curriculum is not possible, it is the student’s responsibility to notify the program faculty immediately or as soon as the student is aware that there is a limitation. 2) Failure to participate fully in all aspects of the curriculum or failure to notify program faculty in a timely manner of the inability to fully participate may result in disciplinary action, including dismissal. c. Failure to accept and act upon constructive criticism; d. Attendance problems: including failure to notify the instructor, the clinical site, and/or the program; chronic absences; leaving early; etc. 1) Absences will be recorded. 2) Students are required to attend and participate in all scheduled activities. 3) Classes and/or clinical experiences may include involvement on any day of the week, weekends, evenings, holidays, as well as being on-call. 4) Anticipated absences must be requested on-line, and discussion with the appropriate faculty member must take place before the absence. 5) Voice mail messages are not adequate notice of an anticipated absence. Students must always talk personally with a faculty member and preceptor (for clinical rotations) if a student is going to be absent. (Refer to 6A.-D. for Didactic Year, and 15A.-D. for Clinical Year) 6) Not showing up for class, without prior approval, will be an absence. 7) Leaving the classroom during class will be counted as an absence. 14
  15. 15. e. Lateness/tardiness: including failure to immediately notify the instructor, clinical site, and/or the program; 1) Tardiness will be recorded. 2) Tardiness (late entering the classroom and taking your seat) will be recorded as an absence. f. Failure to follow protocol or directions of supervising preceptor or Program faculty; g. Performing unauthorized procedures or administering services which are not permitted by the program, supervisor or facility; h. Lack of cooperation with faculty, preceptors, lecturers, and fellow students; i. Electronic Device Use: Laptop use during class must be solely for academic purposes, not for email, games, or other on-line activities unrelated to the class. EXCEPTION: To email or message Brian, Jerry, or Chad regarding technical problems during the lecture, e.g., “The volume is too high/low,” “The picture is out of focus,” etc. 1) Access to pornography using the University internet connection, while in an academic or clinical setting, or while on University property is a violation of professional standards and may result in dismissal from the program. 2) Your use of your computer or other electronic devices must not be a distraction to other students during lecture. 3) Cell phones must be OFF (not even vibrate) during lectures. Emergency calls must come through the program phones during a lecture. 4) Cell phones can be used during breaks, between lectures. Leaving a lecture to make or take a cell phone call is considered unprofessional. j. Hostile, disruptive and passive-aggressive attitudes and behaviors; k. Quizzes and Tests: 1) MUST be taken in the classroom unless determined otherwise by appropriate faculty. 2) You may only have one piece of paper and a pen, no other windows may be open on your computer, and all books/back packs must be outside of the classroom. 3) Absolute silence must be maintained in the classroom during examinations. 4) Copying exams or quizzes, by any methodology, is forbidden and will be treated as Academic Dishonesty as defined by the University. l. Evaluations of Program and Courses: 1) Must be professional in criticism. 2) Unprofessional comments and language will be deleted. m. Violating patient confidentiality; n. Not respecting the rights of patients; 15
  16. 16. o. Avoiding, or failing to perform, or only partially performing, assigned tasks and responsibilities; p. Leaving the clinical setting without informing the supervising preceptor or program representative; q. Performing any activity which is beyond the scope of the role of a student or beyond a student’s clinical ability; r. Failure to properly identify yourself as a physician assistant student; s. Failure to inform a patient who refers to you as “doctor” of your identity as a physician assistant student; t. Failure to report all observed unethical conduct by other members of the health profession and/or fellow students to Program faculty; u. Associating professionally with those who violate ethical practices; v. Endangering the health and welfare of any patient. iii. Violations of professional behavior policy and possible outcomes: a. Based upon the nature and degree of the precipitating events, students who fail to maintain appropriate behavior, will, as previously described above, be subject to the following disciplinary actions: 1) If a violation of the professional behavioral policy is deemed to have occurred, the Program faculty will meet with the student and issue a verbal warning regarding the behavior with written documentation to the student’s file. 2) THREE (3) WARNINGS ON ANY OF THESE BEHAVIORAL MATTERS WILL RESULT IN THE STUDENT BEING REFERRED TO THE PROGRAM’S ACADEMIC AFFAIRS COMMITTEE. Possible results from the review may include the following: a) No action taken; b) A written warning being given the student and the student being placed on academic probation with written documentation to the student’s file. c) Dismissal of the student from the program. 2. WITHDRAWAL OR DISMISSAL A. PA Program students may not withdraw from a required course without permission from the Program Director. i. Withdrawal from a required course without permission may, at the discretion of the AAC, necessitate dismissal from the Program. B. Students may voluntarily withdraw from graduate courses until the official drop date listed in the Academic Calendar at the front of the Graduate School Catalog. In such cases, the student must provide written request for the withdrawal by use of the appropriate withdrawal forms. Students wishing to withdraw from graduate courses or from a graduate program after the official drop date must obtain approval of the Dean of Graduate Studies. Withdrawal from courses must occur prior to final examination week. Voluntary withdrawal from a graduate program during an appeal of dismissal automatically terminates the appeals process. 16
  17. 17. C. Students receiving letters of dismissal will automatically be dropped from all graduate courses, regardless of whether they choose to appeal, and fees will be refunded in accordance with University policy. i. A "W" grade will then be entered on the transcript for all graduate courses not completed. ii. Students receiving dismissal letters after the 10th day of classes may petition the Dean of Graduate Studies for permission to complete the graduate courses in which they are enrolled. iii. Students who appeal the dismissal will be blocked from registration for further graduate courses during the appeals process itself. iv. See also the Graduate School Catalog section entitled “Appeal of Dismissal”. D. A graduate student may be dismissed from a graduate program by a department/college according to the policy described in the Appeal of Dismissal section of the Graduate School Catalog. 3. APPEALS OF GRADE OR DISMISSAL A. Appeal of a Grade i. Midterm grades are not official and may not be formally appealed. Students who wish redress for midterm grades should discuss the grade with the instructor of the course in order to determine a course of action leading up to the final grade. Graduate students who wish to appeal final grades must use the following procedural format. Appeal of a grade must be made within one semester following the posting of the grade. Grades earned in the spring semester that are to be appealed need not be appealed during the summer, but the appeals process must be initiated in the following fall semester. Faculty members who are overruled in the appeals process are entitled to the same sequence of appeal as the graduate student. Documentation of the appeal must be sent to the Graduate School to be placed in the student's file. The Graduate School encourages resolution of appeals at the lowest possible level. When a grade appeal involves plagiarism, cheating, or other academic dishonesty, please also refer to the "Academic Dishonesty" section of the Graduate Catalog. ii. Procedures for the Appeal of a Grade a. Step 1: The Instructor of the Course When a student receives a grade that is judged by that student to be unjustifiably low, the first step in the appeals process is to discuss the matter with the instructor of the course. This may be done informally, but if the student plans to proceed up the line of appeal, a formal statement must be prepared in accordance with the format presented in the "Protocol for Appealing a Grade," which is described below. If the instructor agrees that the student was erroneously graded, the grade is changed using standard procedures. If the instructor stands by the original decision, the case may be taken to the department chairperson. In such an instance, the instructor must prepare a statement explaining the reasons for the grade. 17
  18. 18. b. Step 2: The Department Chairperson The chairperson of the department in which the appealed grade was received is to review the student’s written statement and the instructor’s written rationale for the grade. The chairperson should interview the student and the instructor and may conduct whatever additional investigation is deemed appropriate to help in the decision-making process. The chairperson must render a decision within two weeks of receipt of the appeal. If the chairperson sustains the decision of the instructor, the appeal may be taken to the dean of the college. If the department chairperson chooses to overrule the instructor, the grade must be adjusted and the chairperson may adjust the grade. It is possible to negotiate the adjusted grade. If the student remains dissatisfied with the adjustment, the appeal may still be taken to the dean of the college. Regardless of the decision, the chairperson must prepare a statement, in writing, that explains the reason for the decision. If the appeal is taken to the dean, the chairperson’s statement must accompany the student’s appeal and the instructor’s statement. c. Step 3: The Dean of the College The dean of the college is next to be contacted in the appeals process. The dean is to appoint an impartial committee of faculty members who will review all written documentation pertaining to the case. This appeals committee should interview both the student and the instructor and may conduct any other investigation deemed necessary. The appeals committee, which is advisory to the dean, must submit a written statement of its decision. The dean’s decision is also to be tendered in writing. The committee’s deliberation and the dean’s decision must be completed within three weeks of receipt of the appeal in the dean’s office. If the student is not satisfied with the decision of the committee, the appeal may be taken to the Graduate Council. d. Step 4: The Graduate Council via the Dean of the Graduate School At the request of the student, the Graduate Council will review all prior documentation and render a decision within three weeks of receipt of the appeal. The Dean of the Graduate School and/or the Graduate Council may interview the student and instructor or carry out any other investigation deemed necessary to assist in the decision-making process. Once the decision is made, it is final and will be implemented by the Dean of the Graduate School. B. Protocol for Appealing a Grade i. Protocol for appeal of a grade must include the student’s name, department/college, date of the appeal, course title and number, instructor’s name, and grade received in the course. Also included must be the student’s rationale for appeal of the grade. The student should state as succinctly as possible the reasons for making the appeal. The student must also state the remedy he/she is seeking. C. Dismissals i. Dismissal Policy: A graduate student may be dismissed from a graduate program by a department/college according to the following criteria: 18
  19. 19. a. If the student receives two or more grades of C+ or below, or b. If the student fails to meet the continuation standards of the department (including conditions stated on the Approval for Admission form), or c. If it is the academic judgment of two-thirds of the graduate faculty in the department that the student is not making satisfactory progress in the program, and such judgment is recorded by formal vote. In all cases the student must be notified in writing by certified mail, return receipt requested, that he/she is dismissed and must be told in the document that he/she has the right of appeal according to the ISU Graduate Catalog. The student should be given a copy of the Graduate Catalog or notified that the Catalog is available online or in the Graduate School. Students receiving letters of dismissal will automatically be dropped from all graduate courses in the program from which they are being dismissed, regardless of whether they choose to appeal; fees will be refunded in accordance with university policy. A "W" grade will then be entered on the transcript for all graduate courses not completed. Students receiving dismissal letters after the 10th day of classes may petition the Dean of the Graduate School for permission to complete the graduate courses in which they are enrolled. Students who appeal the dismissal will be blocked from registration for additional graduate courses during the appeals process. See "Procedures for the Appeal of Dismissal from a Graduate Program," below. The initiation of the appeal must occur within 15 working days of the notification of the dismissal, unless the student is appealing dismissal due to receiving two or more grades of C+ or below. In that case, the student may wish to appeal one or more grades before beginning appeal of dismissal (see "Appeal of a Grade" section). If the grade is upheld, and the student now wishes to appeal the dismissal, the student must begin the appeal of dismissal within 15 working days of the notification of the decision of the grade appeal. If the grade is changed to a B- or above, and the student no longer has two or more grades of C+ or below, the dismissal will be cancelled by the department/college. However, if the dismissal is also based on items b or c, above, the dismissal proceedings may continue. Documentation of the appeal must be sent to the Graduate School to be placed in the student's file. The Graduate School encourages resolution of appeals at the lowest possible level. When a dismissal involves plagiarism, cheating, or other academic dishonesty, please also refer to the "Academic Dishonesty" section of the Graduate Catalog. D. Procedures for the Appeal of Dismissal from a Graduate Program i. Step 1: The Departmental Level a. The student must request reconsideration in writing using the "Protocol for Appealing Dismissal from a Graduate Program," which is described below. b. A majority of the graduate faculty of the department must meet within 15 working days of the filed appeal and must decide by a 2/3 vote of those present to sustain the dismissal, or the dismissal is revoked. If necessary, the meeting of the graduate 19
  20. 20. faculty may include those participating by telephone or video conference. Should it prove impossible during the summer to convene a majority of the graduate faculty, the department is required to assemble them in the first week they are on contract in the fall semester. In such instance, if the student chooses to appeal the department’s graduate faculty decision, the dean of the college and the Graduate Council will attempt to expedite the procedure described below. c. Either decision (revoke or sustain) is to be explained in writing to the student. Copies of this decision and explanation should be sent to the Dean of the Graduate School. d. If the department upholds the dismissal, the student may appeal the decision to the dean of the college. The student must appeal to the dean of the college within 15 working days of the notification of the department’s decision. e. If the dismissal is revoked, the department chairperson shall notify in writing the student and the Dean of the Graduate School, and the student shall be reinstated. ii. Step 2: The Dean of the College a. If the student appeals to the dean of the college, then the dean must do the following: 1) Read the student’s written statement. 2) Read the written decision and explanation of the graduate faculty of the department. 3) The dean may interview the student or the graduate faculty in the department or conduct any other appropriate investigation that may aid in the decision- making process. 4) The dean must consider the appeal within 15 working days of the student’s filed appeal and must decide to either revoke or sustain the dismissal. b. Dean Overrules Dismissal. If the dismissal is revoked, the dean must state in writing the reasons for the overrule and notify the student, the department, and the Dean of the Graduate School, and the student shall be reinstated. The graduate faculty of the department may appeal the dean’s decision to the Graduate Council. c. Dean Sustains Dismissal. If the dean sustains the decision to dismiss, he/she must notify in writing the student, the department, and the Dean of the Graduate School. iii. Step 3: The Graduate Council via the Dean of the Graduate School a. The student may appeal to the Graduate Council if the dean of the college sustains the dismissal. The student must appeal to the Graduate Council within 15 working days of the notification of the dean’s decision. This appeal must be in writing. b. The Graduate Council must consider the appeal within 15 working days of the student’s notification of appeal. This 20
  21. 21. review should include copies of documents prepared in Step 1 and Step 2 of the appeal process. c. The Dean of the Graduate School and/or the Graduate Council may interview the student, graduate faculty, or college dean to secure whatever information might be deemed necessary to aid in the review. d. The Council’s decision to revoke or sustain the dismissal is final. e. The Council’s decision is to be pre pared in writing, and, with all other documentation, kept in the student’s file in the Graduate School. f. The Dean of the Graduate School must notify in writing the student, department, and college dean of the decision. g. If the decision is to revoke the dismissal, the Dean of the Graduate School must reinstate the student in the program. E. Protocol for Appealing Dismissal from a Graduate Program Protocol for appeal of dismissal from a graduate program must include the student’s name, department/college, and date of the appeal. Also included must be the rationale for appeal of the dismissal. The student should state as succinctly as possible the reason for making the appeal. The student must also state the remedy he/she is seeking. 4. ACADEMIC DISHONESTY A. Academic dishonesty includes, but is not limited to, cheating and plagiarism. Copying, electronic copying, distribution and reproduction of academic material without proper written consent will also be considered academic dishonesty. (Examples of academic material include, but are not limited to, testing and quiz content, course material, presentation files, etc.) Academic dishonesty at the graduate level is considered a serious offense and may result in dismissal from a graduate program. B. Whenever a faculty member suspects a graduate student of academic dishonesty, the instructor should present the evidence to the student and consider the student's response. C. If the instructor concludes after consultation with the student that academic dishonesty has indeed occurred, the instructor should write a letter to the chairperson of the department in which the student is seeking a graduate degree, describing the incident. D. The instructor should include with the letter any evidence used to draw the conclusion that academic dishonesty has occurred (e.g., copies of the student's written assignment, copies of documents thought to have been plagiarized, etc.), and should state clearly the penalty imposed within the course itself. E. The penalty should be in proportion to the severity of the offense. i. If the penalty is to be a failing grade, the instructor should first consult with the chairperson of the department, and the chairperson should meet jointly with the student and faculty member to review the incident. F. The student may appeal the penalty by following the procedures in the Graduate Catalog entitled "Appeal of a Grade." 21
  22. 22. G. A copy of the instructor's letter reporting the offense, along with any evidence submitted to the chairperson, should be sent to the student, to the dean of the college in which the student is seeking a graduate degree, and to the Dean of Graduate Studies. i. A copy of the letter is to be placed in the student's permanent file in the department and in the Office of Graduate Studies. ii. If the student is exonerated during the appeals process, however, the letter and all other records of the accusation of academic dishonesty are to be deleted from the student's files. H. The department chairperson may, in accordance with the policy and procedures of the department, impose the penalty of dismissal from the program. i. A student may appeal the dismissal by following the procedures in the Graduate Catalog entitled "Appeal of Dismissal from a Graduate Program." 5. EMPLOYMENT POLICY A. Employment in the didactic portion of the program is discouraged. B. Employment in the clinical portion of the program is not permitted. 22
  23. 23. Didactic Year Policies and Guidelines 6. DIDACTIC YEAR ATTENDANCE A. As stated in the Program Policies & Guidelines (Sections 1.J.ii.d.2) and 1.J.ii.e.), students are required to attend and participate in all classroom activities. B. Classes and/or clinical experiences may include involvement on any day of the week, weekends, evenings and holidays. C. Students are required to submit an online “Absence Report Form” for all absences. The form can be found in the Moodle “PA Didactic Year Commons”. i. Anticipated absences: a. Students must submit an Absence Report Form at least two business days in advance of the absence. b In addition to the Absence Report Form, students must verbally notify a faculty member at least 24 hours in advance of an anticipated absence. Voice mail messages are not an acceptable form of notification. ii. Unanticipated absences: a. An Absence Report Form must be submitted for an unanticipated absence as soon as is reasonably possible. b. Students must verbally notify a faculty member as close to the time of the unanticipated absence as is reasonably possible. D. Absences in excess of 16 hours per semester or more than 50% of a module are considered excessive and in violation of the Program’s professional behavior standards. The student may be subject to disciplinary action as outlined in Section 1.J.iii. of these General Program Policies and Guidelines. 7. EVALUATION OF STUDENT PERFORMANCE A. Behavioral performance evaluation: i. Student behavioral performance will be evaluated based upon the behavioral objectives and expectations listed in Section 1.J. of this document. B. Course performance evaluation: i. Non-modular courses (Didactic Year fall semester courses) will be evaluated based on criteria established by the faculty member in charge of the course. ii. Module course (Didactic Year spring and summer semester courses) performance evaluation: a. Each student’s performance in a module will be evaluated by the following criteria 1) Objective written examination: A) Minimal passing score: 70% or as outlined on the course syllabus. B) Failure to obtain a minimal passing score: If a student fails to obtain a minimal passing score on the module examination, one (1) repeat examination will be permitted. 23
  24. 24. i) The repeat examination will typically be taken within 5 days of the initial examination, but depending on circumstances, the timing may be shortened or lengthened by the faculty. ii) The retake exam may be a repeat of the same exam, a new exam, an essay type exam, a verbal/practical exam, or any variation of the above, as determined by faculty. iii) If the repeat examination is passed, the student will receive a score of 70% for the module examination, even if the score on the repeat examination is higher than 70%. iv) A student may not take more than one makeup examination for the same course. v) Makeup examinations must be taken as scheduled by the PA Program. If a makeup examination is not taken as scheduled, the originally earned grade will prevail. vi) If the student fails the repeat examination the Academic faculty will determine what action will be taken. Available actions include: a) No action b) Remediation c) Referral to the Academic Affairs Committee. Actions of the committee may include: I. Dismissal from the program II. Probation III. Other actions as appropriate to the situation. vii) In the event a student fails more than two written exams in a semester the Academic faculty will determine what action will be taken. Available actions include those previously mentioned in this section. 2) Practical examinations A) Practical examination will be used to evaluate minimal student competence in the following areas: i) Clinical assessment ii) Clinical procedures iii) Other competencies that may be assessed by practical performance or demonstration of a skill B) Practical examinations will be graded on a point system with 70% being the minimal passing standard or a pass – fail system as determined by the faculty member in charge of the course. 24
  25. 25. C) Same principles apply to practice as written exams, see 7.B.ii.a.1)B) i) - vii) above 3) Objective exam and practical exams A) The objective exams must be completed at a 70% level or greater (or as stated on the course/module syllabus) and the practical examinations must be completed at a 70% level or greater (or as stated on the course/module syllabus) in order to pass the module. 4) Case presentations A) Case presentations will be evaluated based upon criteria determined by the faculty making the assignment and as listed on the course/module syllabus. 5) Written assignments A) Written assignments will be evaluated based upon criteria determined by the faculty making the assignment and as listed on the course/module syllabus. 6) Grades: All didactic PAS courses will be graded according to the following scale. (This is a recommended scale; an instructor may deviate at his/her discretion; see individual course syllabuses). A 94-100 C 63-65.9 A- 88-93.9 C- 60-62.9 B+ 81-87.9 D+ 57-59.9 B 75-80.9 D 55-56.9 B- 70-74.9 D- 53-54.9 C+ 66-69.9 F 53 and below 8. LEARNING OBJECTIVES A. The most current learning objectives can be found within the syllabus for each module located in the Syllabus Directory of Moodle. http://elearning.isu.edu/moodleisu/mod/book/view.php?id=30036 9. TUTORING A. The didactic year academic load is very heavy and may tax even very well prepared students. Some students may desire tutoring. Academic tutoring can be arranged through the Academic Coordinator. B. In some instances, the PA Program faculty may require a student to obtain tutoring. Tutoring for non PA courses can be arranged through the academic skills office at 282-3662 25
  26. 26. 10. DIDACTIC YEAR CLINICAL EXPERIENCES A. Each semester clinical experiences in diverse settings may be arranged by faculty. i. Attendance may be voluntary or may be appointed and required, as deemed appropriate by the faculty. ii. Professional attire is mandatory. Program logo shirts or other professional attire and name badges provided by the program must be worn during these clinical experiences. B. All didactic year clinical experiences require the supervision of at least one Program faculty member. For liability purposes, unassigned (personally arranged) clinical experiences are not covered and are not permitted. 11. ENTRANCE INTO CLINICAL YEAR A. In order to enter the clinical year of the program, each student must meet the following criteria: i. Successfully complete all didactic year classes as outlined in this document a. Achieve an overall cumulative average of 3.0 1) If the cumulative GPA at the end of the didactic phase of the Program is below 3.0 the student may, at the discretion of the AAC, be prohibited from progressing to the clinical year, remediated, or dismissed from the Program b. Have current immunizations, titers, and/or tests as required by ISU and the clinical sites. These include, but are not limited to, MMR, Rubella and Rubeola titers, Tetanus, Hepatitis B immunization, Varicella, Tuberculosis. c. Complete the PACKRAT examination. d. Demonstrate competent physical examination and clinical reasoning skills as determined by clinical skills problems via mock patient, objective examinations, or other simulations, administered by the Program faculty. e. Demonstrate compliance with the PA code of ethics. f. Conform to professional behavior guidelines in this document. g. Read the clinical guidelines and policies section of this handbook, and agree to abide thereby by signing the accompanying statement. B. Background Checks: Clinical sites may require a background check be done by an organization that the site contracts with or may require the student to submit a completed check. Students are responsible for the cost of the background check(s). ISU Public Safety will provide background checks for a fee. 26
  27. 27. Capstone Experience 12. CAPSTONE EXPERIENCE Masters Project in PA Studies (PAS 663): The capstone experience will be consistent with the nature of this professional curriculum and will include a comprehensive objective examination, an oral case presentation, and submission of a portfolio. These components have been chosen so that each graduating student has the opportunity to demonstrate competencies in the medical sciences, research, written and oral communication, and the integration of prior learning into evidence-based patient care. A. Comprehensive Examination: A comprehensive written objective examination will be utilized to assure that all students have acquired a minimal level of factual data in the medical sciences. This examination is also designed to help prepare graduating students for the national certification examination that is required for certification in the profession. B. Case Presentation: The case presentation will be an oral, in-depth, critical analysis of the evaluation and care of an actual patient encountered by the student in the clinical year of the program. This oral presentation will require the application of research skills, critical analysis of the literature, evidence-based medicine, as well as depth and breadth of knowledge in primary care medicine. The oral presentation will be given by the student to his/her examining committee. A schedule of deadlines for all materials will be provided at the Fall End of Semester Meeting. i. Advisors & Examining Committees: Examining Committees: The oral presentation committees will consist of three University graduate faculty. One is a designated Graduate Faculty Representative (GFR), who may be chosen by the student, and then recommended by the department to the Graduate School. A list of GFRs is available in the Graduate School catalog. The two remaining committee positions will be occupied be Physician Assistant Program faculty members; one of which will be designated as the committee chair. If the student elects, he/she may have one professional guest attend their oral case presentation. The Dean of Graduate Studies and the student’s committee must approve the guest prior to the oral case presentation. ii. Conflict of Interest of Graduate Faculty: Faculty are expected to exclude themselves from evaluation of graduate students with regard to whom impartiality may be jeopardized by considerations that are not academic. Such considerations may include, but are not limited to, membership in the same household or close familial relationships. iii. Written Report: A brief written report must be handed in to the chair of the student’s examining committee a minimum of two weeks prior to the oral presentation date. The report will be used as a guide for the detailed oral presentation. The report should conform to the American Medical Association’s (AMA) Manual of Style. iv. Oral Defense: The oral defense will consist of an in-depth patient case presentation to the student’s committee and is open to the public. 27
  28. 28. a. The student will be examined in detail over all aspects of the case. In order to determine a student’s fund of knowledge, students will be asked questions about the specific aspects of the case presented and will be asked questions about aspects relating to the case. b. Students are free to use supportive materials such as Microsoft PowerPoint, overheads, slides, imaging, etc. during their presentation. 1) Note: Students must request any equipment needed a minimum of two weeks prior to the oral presentation date. Students may not have written materials, PDAs, charts or other aids during the oral examination. C. Portfolio: The portfolio will be developed over the course of the clinical year, and will consist of collections of medical writings authored by the student. This portfolio will allow the faculty to evaluate the student’s ability to communicate complex medical concepts in writing. The student can also use the contents of the portfolio when seeking employment. The portfolio must be professionally bound and include 1 of each of the following: i. Cover page with student name. ii. Table of contents listing each document in the portfolio. iii. Complete Adult History & Physical: a. Identifying Data (excluding patient name) b. Chief Complaint c. History of Present Illness d. Past Medical History e. Family History f. Social History g. Review of System h. Physical Examination i. Laboratory Findings and Diagnostic Studies j. Assessment and Plan iv. SOAP Note: a. Chief Complaint b. Subjective c. Objective d. Assessment and Plan v. Procedure Note: a. Procedure b. Indications c. Permit d. Physicians e. Description of Procedure f. Complications g. EBL (estimated blood loss) h. Specimens/Findings Obtained i. Disposition vi. Inpatient Progress Note: a. Date of Admission b. Admitting Diagnosis 28
  29. 29. c. Procedures (with results) to Date d. Hospital Course to Date (briefly summarized) e. Brief Physical Examination (pertinent to patient’s problem) f. Pertinent Lab Data g. Problem List h. Assessment and Plan vii. Inpatient Discharge Summary: a. Date of Admission b. Date of Discharge c. Admitting Diagnosis d. Discharge Diagnosis e. Attending Physician and Service Caring for Patient f. Referring Physician g. Procedures h. Brief History & Physical and Laboratory Data i. Hospital Course j. Condition at Discharge k. Disposition l. Discharge Medications m. Discharge Instructions and Follow-up n. Problem List viii. Psychiatric Note: a. Psychiatric History: 1) chief complaint 2) history of present illness 3) psychiatric history 4) past medical history 5) family history 6) social history 7) developmental psychiatric history 8) review of systems b. Mental Status Examination (MSE): 1) general aspects 2) mood and affect (emotions) 3) speech 4) perception 5) thought 6) cognitive and intellectual functions (Mini-Mental Status Examination [MMSE]) c. Diagnostic Workup d. Assessment and Plan ix. Preoperative Note: a. Preoperative Diagnosis b. Procedure c. Laboratory d. CXR (note results) e. ECG (note results) 29
  30. 30. f. Blood g. History and Physical h. Orders i. Permit x. Operative Note: a. Preoperative Diagnosis b. Postoperative Diagnosis c. Procedure d. Surgeons e. Findings f. Anesthesia g. Fluids h. EBL (estimated blood loss) i. Drains j. Specimens k. Complications l. Condition xi. Postoperative Note: a. Procedure b. Level of Consciousness c. Vital Signs d. I&O e. Physical Examination f. Laboratory g. Assessment and Plan xii. Complete Pediatric History & Physical: a. Identifying Data (excluding patient name) b. Chief Complaint c. History of Present Illness d. Past Medical History e. Family History f. Social History g. Review of Systems h. Physical Examination i. Laboratory Findings and Diagnostic Studies j. Assessment and Plan: 1) birth history 2) feeding history 3) growth and development (Denver Development or other scale) 4) immunizations and screening procedures 5) childhood illnesses 6) social development xiii. Delivery Note: A delivery note should follow this format: ___ year old (married or single) G ___ now para ___ AB ___, clinic (note if patient received prenatal clinic care) patient with EDC ___, and a prenatal course (uncomplicated or describe any problems). Any comments concerning 30
  31. 31. labor (eg, Pitocin-induced, premature rupture) and draped in the usual sterile fashion. Under controlled conditions delivered a ___ lb ___ oz (___ g) viable male or female infant under ___ (general, spinal, pudendal, none) anesthesia. Delivery was via SVD with midline episiotomy (or forceps or cesarean section). Apgars were ___ at 1 minute and ___ 5 minutes. State delivery date and time. Cord blood sent to lab and placenta expressed intact with trailing membranes. Lacerations of the ___ degree repaired by standard method with good hemostasis and restoration of normal anatomy. a. EBL b. MBT (maternal blood type) c. HCT (predelivery and postdelivery) d. RT (rubella titer) e. VDRL test (venereal disease research laboratory) f. Condition of mother D. Failure of one or more of the components of the Master’s Capstone Project, (End of Clinical Year Exam, Oral Defense of Case Presentation, Portfolio): i. The course instructor will record a grade of IP for the course. ii. The course instructor will notify the student in writing of the areas requiring improvement. iii. The instructor will also submit a Course Completion Contract along with the grade report for the course. The Course Completion Contract must be signed by the student and the instructor stipulating the work and timeline required for completing the course. A copy of the Contract is to be given to the student, a copy retained by the instructor, and the original copy sent to the Registrar’s Office. iv. Only one repeat of the Case Presentation will be allowed. E. Continuing Registration for Graduate Students: i. Graduate students who have registered for one or more credits of master's project, master's paper, master's thesis, or doctoral thesis or dissertation (usually, courses numbered 650, 651, 699, 750, or 850) must be registered for at least one graduate credit during each subsequent semester, including each summer session, until they have completed their degrees ii. Students who for compelling reasons wish to interrupt their work on projects, theses, or dissertations may petition the Graduate School for a leave of absence. iii. Graduate students who fail to meet this continuing registration requirement will be judged to have dropped out of their programs and will no longer enjoy access to university resources, including the library and computer facilities. In order to regain access to university resources, they will be required to reapply to the Graduate School and be readmitted. iv. A corollary of this requirement is that a graduate student must be registered for at least one graduate credit in order to take a final oral examination or be processed for graduation. v. Any student who registers for the required credit and then subsequently drop the credit, will be considered in violation of this policy. 31
  32. 32. vi. Incomplete work must be completed within a maximum of (1) calendar year from the date such grade is given. A change of grade form must be submitted by the faculty member or the Incomplete will become permanent. vii. To receive credit for a course in which an Incomplete grade has become a permanent grade, the entire course must be repeated. viii. Petitions to deviate from this policy will not be allowed. 32
  33. 33. Introduction to the Clinical Year During the clinical year you will have the opportunity to demonstrate and augment the knowledge and skills which you acquired during the first year of the Physician Assistant Program. You will be assigned to clinical settings which will promote the development of a greater understanding of the health care environment and patient management. The responsibility entrusted to you as a clinical PA student is significant. Therefore, commitment to a high level of professionalism and clinical skill is an integral part of your obligations to the patients, clinical facilities, PA profession and yourself. Maximizing your clinical experience You should be aware that clinical learning experiences and flexibility vary from site to site. • At some sites you may be permitted a full range of participation in patient care activities; • Other sites may impose restrictions relative to chart documentation, certain clinical procedures, administration of medication, on-call, etc. • Restrictions are usually based on institutionally mandated protocols but in some cases preceptors will restrict your activity if they have reservations about your ability or professional conduct. It is your professional obligation to augment clinical experiences with a daily review of the medical literature. By developing a disciplined approach to reading you will build upon your foundation of medical knowledge. This will not only enhance your personal development but will serve as preparation for end of semester written examinations and the national certification examination. Keep in mind that at no other time during your professional career as physician assistants are you likely to be exposed to the variety of medical experiences available to you this year. It is up to you to make the most of this opportunity. 33
  34. 34. Clinical Year Policies and Guidelines 13. CLINICAL ROTATION INFORMATION The clinical year consists of 3 semesters of clinical rotations courses and a Master’s project course: a. ISU catalog descriptions: Course Credit Course Titles Description Numbers Hours Clinical 4 Supervised Practicum in medical practice PAS Rotation I, II, credits settings. 660-662 III each Master’s Project An evidence-based medical case study, in Physician completed under the direction of Program PAS 663 2 Assistant faculty. A written report and oral explanation of Studies the case study are required. Graded: S/U Clinical 4 Supervised Practicum in medical practice PAS Rotation IV, V, credits settings. 664-668 VI, VII, VIII each Students will participate in a 2 day meeting. End of 1 Lectures and other content in primary care, PAS Semester credit specialty care, and professional development 669, 670 Meeting I, II each content will be delivered. Cumulative end of semester assignments will be given. b. Clinical Rotations I - VIII Overview: During the clinical year students will complete rotations in: Inpatient Medicine, Outpatient Medicine, Obstetrics & Gynecology, and Pediatrics, Emergency Medicine, Psychiatry, Surgery and an elective area. These focus areas can be completed at one site or multiple sites. c. End of Semester Meetings: Students will return to campus for 2-day meetings at the end of each Fall and Spring semester. d. Rotation change policy: Up until a rotation is confirmed the Clinical Coordinator has the authority to change a rotation. To request a rotation be changed, the student must submit a Rotation Request Form located in Moodle. It is the policy of the Program that once a rotation is confirmed, a student must ask permission of the general faculty in order to change the rotation site or preceptor. e. Out-of-area clinical site policy: i. The Clinical Coordinator will set up the rotation sites for students in Idaho and at established ISU clinical training sites outside of Idaho. ii. If a student desires rotations outside of Idaho or at sites that are not established with the Program, it is the student’s responsibility to make initial contact with the site. The Clinical Coordinator will then facilitate the development and confirmation of that site. iii. The Clinical Coordinator reserves the right to not approve a clinical site if the site doesn’t meet minimum standards or program mission/objectives. 34
  35. 35. iv. A student may be given deadlines by the Clinical Coordinator by which site identification must be completed. If a deadline cannot be met, the student must perform the rotation at an affiliated site in Idaho. f. Personally arranged sites: For liability purposes, unassigned (personally arranged) clinical experiences are not covered by student malpractice insurance. g. Preceptorship Policies: Preceptorships are graded educational experiences with potential employment as a possible outcome. 1. It is the Program’s responsibility to provide rotations and preceptorships; however, preceptorships may be arranged by the student or by the Program. 2. Preceptorships may be selected from publicly listed potential employers or potential employers discovered through the efforts of the individual student. 1. Publicly listed employment sites are open to all students on a first come first serve basis. a. The Program will attempt to arrange one preceptorship at a time per student (i.e., multiple simultaneous requests by one student will not be pursued). 2. An employment site developed by an individual student shall be arranged as a preceptorship only for that student. a. The Program will treat this situation as an employment contract negotiation between the individual student and the potential employer, and refrain from interfering in that process beyond qualifying the site and arranging the preceptorship. b. The program will not open or offer the site to any other student without the prior agreement, or the graduation, of the student who developed the site. c. Preceptorship assignment/arrangement issues between student and potential employer must be resolved by those parties. If issues are not resolved by one week prior to the beginning of the preceptorship, the site will not be used and the student will be reassigned. 3. If a student is unable to secure a preceptorship on his/her own by six weeks before the start of the rotation, the Clinical Coordinator will assign the student to a primary care site. 4. Ideally, the student should inform the Clinical Coordinator of an in-state preceptorship site eight weeks prior to the beginning of the preceptorship and should inform the Clinical Coordinator of an out-of-state preceptorship site twelve weeks prior to the beginning of the preceptorship. This will allow adequate time for credentialing of the PA student at the clinical facility and for approval of the legally required Affiliation agreement between ISU and the site. 5. Faculty will not compete for job openings that result from the private efforts of an individual student seeking a preceptorship or employment. h. Rotation selection: Latitude is given to students to select clinical experiences that maximize their interest and needs. Students may choose to do a clinical rotation at one site for an entire semester (15 weeks) or break the rotation up into 10 week or 5 week blocks. Throughout the course of the year students should see diverse patient populations in a variety of clinical settings, therefore seven focus areas have been mandated. The areas are: inpatient, outpatient, pediatric, obstetrics and gynecology, emergency, surgery, and psychiatry. The focus area is 35
  36. 36. patient specific, not specialty specific (i.e., students may see an obstetric patient in the family practice setting). 14. TRAVEL FUNDS a. It is the student’s responsibility to pay all travel costs related to Program requirements, including clinical assignments b. Limited travel funds may be available to reimburse students for Program related travel. Availability of travel reimbursement funds is contingent upon grant funding, and cannot be guaranteed. c. Travel Reimbursement/Stipend Policy (Assuming the availability of grant funds): To facilitate students attending rotations in rural and underserved areas funds are available to reimburse travel (to and from clinical sites) and housing. The criteria are: i. Site must be considered one of the following: HPSA, MUAs, MUCs, rural/frontier medical practices, practice serving culturally diverse populations, geriatric practices, or HIV/AIDs clinical training sites. ii. Clinical site must be at least 50 miles from student’s home base. 1. If the above criteria are met, each student may apply for reimbursement. 2. Students may apply for funds by sending an email to the Clinical Year Administrative Assistant. Check with the Administrative Assistant at 208-282-3226 for the current email address. Please include name, social security number, current address for receiving mail, the name and location of the clinical site, and how it meets the above criteria. 3. Reimbursement may be taxable or affect financial aid amounts. 15. CLINICAL YEAR ATTENDANCE a. Clinical Rotation Attendance i. Attendance at clinical rotations is mandatory. If you are unable to report to report to your assigned site for any reason you must: 1. Call your clinical preceptor before your scheduled reporting time. 2. You must call the Physician Assistant Program at (208) 282-4726 by 10:00 a.m. and speak with the Clinical Coordinator or other faculty person. You may not leave a message with non-faculty staff unless you can leave a number where the Clinical Coordinator may reach you. ii. If you are absent from a site and do not call both the preceptor and the PA Program, or if your absence is unexcused or unauthorized, you will be required to make up two days for each day lost. You may also be subject to disciplinary review by the Academic Affairs Committee (AAC). b. End-of-Semester Meeting Attendance i. There will be a mandatory face-to-face meeting at the end of each semester. c. Students are permitted three authorized absences over the entire clinical year. i. An authorized absence is one in which a legitimate and unavoidable cause such as illness or a death in the family prevents the student from attending the rotation or end of semester activities. ii. In cases where there is no authorized absence, the time lost will have to be made up as defined in section XIII. a. ii. 36

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