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Doctoral Dissertation Defense
Submitted to the Graduate Faculty of
Argosy University, Phoenix
Graduate School of Business and Management
In Partial Fulfillment of the Requirements for the Degree of
Doctor of Education
Organizational Leadership
By
Vincent Bridges
December XX, 2016
 John Opinski, Ph.D, Committee Chair
Graduate School of Business & Management
 David Blake, Ph.D, Committee Member
Graduate School of Business & Management
 Dale Mancini, Ph.D, Department Chair
Graduate School of Business & Management
 Problem Background
 Purpose and Importance of the Study
 Problem Statements
 Themes and Concepts
 Research Questions
 Review of Literature
 Methodology and Study Design
 Results and Findings
 Findings Summary
 Conclusions and Recommendations
 Future Research and Summary
 Increasing number of jobs and
future projection. (U.S. Bureau of
Labor Statistics, 2012)
 Education and Preparedness
Training of Medical Assistants
 Changing role of the Medical
Assistant
 Shortage of Primary Care
Physicians and Nurse Practitioners
(Bodenheimer, Willard-Grace &
Ghorob, 2014)
 Medical Assistant Expanded
Responsibilities (American
Association of Medical Assistants,
2015)
 Ascertain the effectiveness of the medical assistant program outcomes for
three Midwestern United States schools.
 Ensuring Quality Patient Care through quality education and training.
 Allow educational institutions to align educational delivery with
stakeholder needs.
 Continuous effort to ensure competent and confident graduates
 Medical assistant graduates are encountering job responsibilities that
are traditionally not a part of their formal didactic education and
training, due to the changing medical environment and the requirements
of the medical assistants to perform expanded job duties to help ensure
quality patient care.
 Some medical assistant graduates are not considered strong enough
candidates as those who have had additional skill set training as it
relates to the expanded job duties and functions.
 Patient Centered Medical Home Teams vs Traditional Disease Management
 Health Coaching vs Traditional Patient Motivation and Education
 Panel Management vs Traditional Quality of Care and Patient Care Outcome
Management
 Medical Scribing vs Traditional Documentation Process and Patient
Interaction
 How do the program outcome for the medical assisting program at three
Midwestern United States schools meet the needs of its stakeholders?
 What program decisions or changes can be made by educational leaders of
three Midwestern United States schools, as a result of these study results, to
enhance or better meet stakeholder needs that may be identified?
 The Role of the Medical Assistant
 Traditional
 Expanded
Medical Assistants and Healthcare Quality
 Diabetes Study – UNITE Health Center
 Hypertension, Hyperlipidemia & Uncontrolled Type 2 Diabetes Study
 Colon Rectal Cancer (CRC) Screening Study
Scope of Practice
 Varies by State
 Not addressed by some states
 Delegation of Duties
Delegation of Duties
 Exclusions
 Definition of the M.A’s Scope of Practice (McCarty, 2012)
 As of 2012 , 11 states passed laws recognizing clinical scope of practice
(McCarty, 2012)
Medical Assistants and Meaningful Use of Electronic Medical Records
 Centers for Medicare and Medicaid Services Initiative
 Electronic Health Records and Computerized Physician Order Entry
 Study Methodology: Qualitative Study
 Study Design: Descriptive Design
 Data Collection Tool & Design Method: A two page survey with seventeen
open and closed-ended questions.
 Data Collection Method: Online - Preferred, Email, and Mail
 Sampling Method: Purposive Sampling to identify appropriate professionals
that have experience hiring medical assistants and understand their job
responsibilities, and/or managing their day-to-day administrative and clinical
responsibilities.
 The study participants must meet the following criteria to participate:
 Work(ed) for a medical organization, physician practice, healthcare institution or urgent care;
and,
 Hire(d) Medical Assistants and understand their job duties and requirements; or,
Manage(d) day-to-day clinical and administrative responsibilities of medical assistants
(Present or Recent Past); and,
 Reside in one of the Midwestern United States, including Oklahoma; and,
 At least 18 years of age.
 The study will seek 20-25 healthcare professionals that meet the study
participation requirements to complete the online survey.
Informed Consent and Confidentiality
Consent Documentation and Process
Information and Participant Confidentiality and Security
 Organization Affiliation
 EMR/EHR Usage/Type
 EHR Modules (CPOE)
 PCMH Team Models
 Medical Scribing Practices
 Administrative Functions
 Clinical Function
 Simulation Training
 Laboratory Analysis Skills
 Microbiology Proficiency
 Survey Participants Demographics
 Total Number of Participants - 25
 Gender Make-Up - Female – 64% and Male 36%
 Participant Educational Level
Some College – 4%, 1 Participant
Associate Degree - 28%, 7 Participants
Bachelor’s Degree – 40%, 10 Participants
Master’s Degree – 16%, 4 Participants
Doctorate Degree – 12%, 3 Participants
 Participant Organizational Affiliation
 Physician Practice – 36%, 9 Participants
 Hospital or Free-Standing Clinic – 24%, 6 Participants
 Urgent Care – 20%, 5 Participants
 Other – 20%, 5 Participants
 Chiropractic Medicine, Dialysis, Medical Employment
Partners, and Practice Management Leadership
Consultants
 First Coding Cycle
 Two Elemental Methods Used:
 In-Vivo Coding – Use of words or short phrases from the actual
language. These codes are identified by “xxxx”.
 Descriptive Coding – Summarizing in a word or short phrase the basic
topic of a passage of qualitative data.
 Second Coding Cycle
 Pattern Coding – Pulls together a lot of material into a more
meaningful unit of analysis.
 Frequency – How often or seldom a word or short phrase happens.
(Saldana, 2016)
Four-Step Process
 Step 1: Identify what was taught by each institution.
(Institution Catalog & Course Description)
 Step 2: Identify what the stakeholders considered important.
(Participant Survey)
 Step 3: Apply a frequency pattern to the stakeholder information and
feedback. (Frequency Tables)
 Step 4: Compare the data in step three to data in step one.
(Review & Analysis)
What was identified from the data:
 10 Category
 17 Sub-Category
 152 Codes
Symbol Grading System
✓ Needs Met
× Needs Not Met
✶ Needs Partially Met
≠ Unable to Determine
The Areas of Review and Recommendation were
discussed under the previous slide
“Codes Affecting All Institutions”
“No Additional Findings”
Institution “A” – Eight (8) Significant Findings
Institution “B” – Ten (10) Significant Findings
Institution “C” – Nine (9) Significant Findings
RQ1 - How do the program outcome for the medical assisting program at three
Midwestern United States schools meet the needs of its stakeholders?
 Overall – All institutions are for the most part meeting the expected stakeholder needs,
many of the findings were related to some of the expanded duties and enhancement of
some of the traditional functions already being taught and are addressed under RQ2.
 RQ2 - What program decisions or changes can be made by educational
leaders of three Midwestern United States schools, as a result of the
evaluation results, to enhance or better meet stakeholder needs that may be
identified?
 Enhance Critical Thinking (Exams and Didactic Courses)
 Incorporate learning and Instruction related to PCMH teams
 Incorporate learning and Instruction related to CPOE
 Add Complex Medication Management
 Add Legal Course Related to Pharmacology & Medication Delivery
 Introduce Complex Medical or Clinical Scenarios to Promote Critical Thinking and
Decision-Making within the Scope of Practice
 Phlebotomy Practice
 Consider incorporating “live sticks” – using student-student practice
 Microbiology (Infection Control)
 Include Laboratory Component
 Inoculate Agar
 Microscopic Microbe Analysis
 Incorporate Chain of Infection Model
 Include Morphology of Bacteria
 Teach Various Methods to Break Chain of Infection
 Laboratory Test
 Urinalysis
 Glucose
 Hematocrit
 Patient Education
 Disease Management Goals
 Patient Out-Reach
 Survey Larger Population and Sample
 Add Additional States – Incorporate M.A. Legislation for Specific States and
analyze impact related to current functions and expanded duties.
 Research Oversight and Regulation Concerns
 Sample – Physicians Regarding Auspice and Oversight and include feedback
from various boards such as the Board of Medical Examiners, Board of
Osteopathic Examiners, and the various Nursing Boards.
American Association of Medical Assistants. (2015). What is a medical assistant.
Retrieved 06 17, 215, from American Association of Medical Assistants:
http://www.aama-ntl.org/medical-assisting/what-is-a-medical-assistant
Bodenheimer, T., Willard-Grace, R., & Ghorob, A. (2014, 07). Expanding the roles of
medical assistants: Who does what in primary care? Journal of the American
Medical Association, 174(7), 1025-1026.doi:10.1001/jamaintemmed.2014.1319
McCarty, M. (2012). The lawful scope of practice of medical assistants: 2012
update. Retrieved from American MedTech:
http://www.americanmedtech.org/portals/0/pdf/news/scopeofpracticearticle_june%2020
12.pdf
Saldana, J. (2016). Coding manual for qualitative researchers. Los Angeles: Sage
Publishing
U.S. Bureau of Labor Statistics. (2012). Occupational outlook handbook: Medical
assistants. Retrieved 06 17, 2015, from U.S. Bureau of Labor Statistics:
http://www.bls.gov/ooh/healthcare/medical-assistants.htm
Questions?

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Example Final Defense Power Point Slide

  • 1. Doctoral Dissertation Defense Submitted to the Graduate Faculty of Argosy University, Phoenix Graduate School of Business and Management In Partial Fulfillment of the Requirements for the Degree of Doctor of Education Organizational Leadership By Vincent Bridges December XX, 2016
  • 2.  John Opinski, Ph.D, Committee Chair Graduate School of Business & Management  David Blake, Ph.D, Committee Member Graduate School of Business & Management  Dale Mancini, Ph.D, Department Chair Graduate School of Business & Management
  • 3.  Problem Background  Purpose and Importance of the Study  Problem Statements  Themes and Concepts  Research Questions  Review of Literature  Methodology and Study Design  Results and Findings  Findings Summary  Conclusions and Recommendations  Future Research and Summary
  • 4.  Increasing number of jobs and future projection. (U.S. Bureau of Labor Statistics, 2012)  Education and Preparedness Training of Medical Assistants  Changing role of the Medical Assistant  Shortage of Primary Care Physicians and Nurse Practitioners (Bodenheimer, Willard-Grace & Ghorob, 2014)  Medical Assistant Expanded Responsibilities (American Association of Medical Assistants, 2015)
  • 5.  Ascertain the effectiveness of the medical assistant program outcomes for three Midwestern United States schools.  Ensuring Quality Patient Care through quality education and training.  Allow educational institutions to align educational delivery with stakeholder needs.  Continuous effort to ensure competent and confident graduates
  • 6.  Medical assistant graduates are encountering job responsibilities that are traditionally not a part of their formal didactic education and training, due to the changing medical environment and the requirements of the medical assistants to perform expanded job duties to help ensure quality patient care.  Some medical assistant graduates are not considered strong enough candidates as those who have had additional skill set training as it relates to the expanded job duties and functions.
  • 7.  Patient Centered Medical Home Teams vs Traditional Disease Management  Health Coaching vs Traditional Patient Motivation and Education  Panel Management vs Traditional Quality of Care and Patient Care Outcome Management  Medical Scribing vs Traditional Documentation Process and Patient Interaction
  • 8.  How do the program outcome for the medical assisting program at three Midwestern United States schools meet the needs of its stakeholders?  What program decisions or changes can be made by educational leaders of three Midwestern United States schools, as a result of these study results, to enhance or better meet stakeholder needs that may be identified?
  • 9.  The Role of the Medical Assistant  Traditional  Expanded Medical Assistants and Healthcare Quality  Diabetes Study – UNITE Health Center  Hypertension, Hyperlipidemia & Uncontrolled Type 2 Diabetes Study  Colon Rectal Cancer (CRC) Screening Study
  • 10. Scope of Practice  Varies by State  Not addressed by some states  Delegation of Duties Delegation of Duties  Exclusions  Definition of the M.A’s Scope of Practice (McCarty, 2012)  As of 2012 , 11 states passed laws recognizing clinical scope of practice (McCarty, 2012)
  • 11. Medical Assistants and Meaningful Use of Electronic Medical Records  Centers for Medicare and Medicaid Services Initiative  Electronic Health Records and Computerized Physician Order Entry
  • 12.  Study Methodology: Qualitative Study  Study Design: Descriptive Design  Data Collection Tool & Design Method: A two page survey with seventeen open and closed-ended questions.  Data Collection Method: Online - Preferred, Email, and Mail  Sampling Method: Purposive Sampling to identify appropriate professionals that have experience hiring medical assistants and understand their job responsibilities, and/or managing their day-to-day administrative and clinical responsibilities.
  • 13.  The study participants must meet the following criteria to participate:  Work(ed) for a medical organization, physician practice, healthcare institution or urgent care; and,  Hire(d) Medical Assistants and understand their job duties and requirements; or, Manage(d) day-to-day clinical and administrative responsibilities of medical assistants (Present or Recent Past); and,  Reside in one of the Midwestern United States, including Oklahoma; and,  At least 18 years of age.  The study will seek 20-25 healthcare professionals that meet the study participation requirements to complete the online survey.
  • 14. Informed Consent and Confidentiality Consent Documentation and Process Information and Participant Confidentiality and Security
  • 15.  Organization Affiliation  EMR/EHR Usage/Type  EHR Modules (CPOE)  PCMH Team Models  Medical Scribing Practices  Administrative Functions  Clinical Function  Simulation Training  Laboratory Analysis Skills  Microbiology Proficiency  Survey Participants Demographics
  • 16.  Total Number of Participants - 25  Gender Make-Up - Female – 64% and Male 36%  Participant Educational Level Some College – 4%, 1 Participant Associate Degree - 28%, 7 Participants Bachelor’s Degree – 40%, 10 Participants Master’s Degree – 16%, 4 Participants Doctorate Degree – 12%, 3 Participants
  • 17.  Participant Organizational Affiliation  Physician Practice – 36%, 9 Participants  Hospital or Free-Standing Clinic – 24%, 6 Participants  Urgent Care – 20%, 5 Participants  Other – 20%, 5 Participants  Chiropractic Medicine, Dialysis, Medical Employment Partners, and Practice Management Leadership Consultants
  • 18.  First Coding Cycle  Two Elemental Methods Used:  In-Vivo Coding – Use of words or short phrases from the actual language. These codes are identified by “xxxx”.  Descriptive Coding – Summarizing in a word or short phrase the basic topic of a passage of qualitative data.  Second Coding Cycle  Pattern Coding – Pulls together a lot of material into a more meaningful unit of analysis.  Frequency – How often or seldom a word or short phrase happens.
  • 20. Four-Step Process  Step 1: Identify what was taught by each institution. (Institution Catalog & Course Description)  Step 2: Identify what the stakeholders considered important. (Participant Survey)  Step 3: Apply a frequency pattern to the stakeholder information and feedback. (Frequency Tables)  Step 4: Compare the data in step three to data in step one. (Review & Analysis)
  • 21.
  • 22. What was identified from the data:  10 Category  17 Sub-Category  152 Codes
  • 23.
  • 24.
  • 25.
  • 26. Symbol Grading System ✓ Needs Met × Needs Not Met ✶ Needs Partially Met ≠ Unable to Determine
  • 27.
  • 28. The Areas of Review and Recommendation were discussed under the previous slide “Codes Affecting All Institutions” “No Additional Findings”
  • 29.
  • 30.
  • 31. Institution “A” – Eight (8) Significant Findings Institution “B” – Ten (10) Significant Findings Institution “C” – Nine (9) Significant Findings
  • 32. RQ1 - How do the program outcome for the medical assisting program at three Midwestern United States schools meet the needs of its stakeholders?  Overall – All institutions are for the most part meeting the expected stakeholder needs, many of the findings were related to some of the expanded duties and enhancement of some of the traditional functions already being taught and are addressed under RQ2.
  • 33.  RQ2 - What program decisions or changes can be made by educational leaders of three Midwestern United States schools, as a result of the evaluation results, to enhance or better meet stakeholder needs that may be identified?  Enhance Critical Thinking (Exams and Didactic Courses)  Incorporate learning and Instruction related to PCMH teams  Incorporate learning and Instruction related to CPOE  Add Complex Medication Management  Add Legal Course Related to Pharmacology & Medication Delivery  Introduce Complex Medical or Clinical Scenarios to Promote Critical Thinking and Decision-Making within the Scope of Practice  Phlebotomy Practice  Consider incorporating “live sticks” – using student-student practice
  • 34.  Microbiology (Infection Control)  Include Laboratory Component  Inoculate Agar  Microscopic Microbe Analysis  Incorporate Chain of Infection Model  Include Morphology of Bacteria  Teach Various Methods to Break Chain of Infection
  • 35.  Laboratory Test  Urinalysis  Glucose  Hematocrit  Patient Education  Disease Management Goals  Patient Out-Reach
  • 36.  Survey Larger Population and Sample  Add Additional States – Incorporate M.A. Legislation for Specific States and analyze impact related to current functions and expanded duties.  Research Oversight and Regulation Concerns  Sample – Physicians Regarding Auspice and Oversight and include feedback from various boards such as the Board of Medical Examiners, Board of Osteopathic Examiners, and the various Nursing Boards.
  • 37. American Association of Medical Assistants. (2015). What is a medical assistant. Retrieved 06 17, 215, from American Association of Medical Assistants: http://www.aama-ntl.org/medical-assisting/what-is-a-medical-assistant Bodenheimer, T., Willard-Grace, R., & Ghorob, A. (2014, 07). Expanding the roles of medical assistants: Who does what in primary care? Journal of the American Medical Association, 174(7), 1025-1026.doi:10.1001/jamaintemmed.2014.1319 McCarty, M. (2012). The lawful scope of practice of medical assistants: 2012 update. Retrieved from American MedTech: http://www.americanmedtech.org/portals/0/pdf/news/scopeofpracticearticle_june%2020 12.pdf
  • 38. Saldana, J. (2016). Coding manual for qualitative researchers. Los Angeles: Sage Publishing U.S. Bureau of Labor Statistics. (2012). Occupational outlook handbook: Medical assistants. Retrieved 06 17, 2015, from U.S. Bureau of Labor Statistics: http://www.bls.gov/ooh/healthcare/medical-assistants.htm

Editor's Notes

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