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”
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
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