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PROCEDURES
UNITONE
Introduction to Medical Assisting
1 Competency-Based Education and the Medical Assistant Student, 1
2 The Health Record, 15
PROCEDURE 2-1 Create a Patient's Health Record: Register a New Patient in the Practice Management Software, 20
PROCEDURE2-2 Organize a Patient's Health Record: Upload Documents to the Electronic Health Record, 27
PROCEDURE2-3 Create and Organize a Patient's Paper Health Record, 38
PROCEDURE2-4 File Patient Health Records, 39
3 Infection Control, 45
PROCEDURE 3-1 Participate in Bloodborne Pathogen Training: Use Standard Precautions to Remove Contaminated Gloves and Discard Biohazardous Material, 54
PROCEDURE 3-2 Demonstrate the Proper Use of Eye Wash Equipment: Perform an Emergency Eye Wash, 56
PROCEDURE 3-3 Participate in Bloodborne Pathogen Training and a Mock Environmental Exposure Event with Documentation of Steps, 59
PROCEDURE 3-4 Participate in Bloodborne Pathogen Training: Perform Medical Aseptic Hand Washing, 62
PROCEDURE 3-5 Select Appropriate Barrier/Personal Protective Equipment and Demonstrate Proper Disposal of Biohazardous Material: Use Standard Precautions for Sanitizing Instruments and Discarding Biohazardous Material, 64
PROCEDURE3-6 Perform Compliance Reporting Based on Public Health Statutes, 67
4 Patient Assessment, 69
PROCEDURE4-1 Demonstrate Therapeutic Communication Feedback Techniques to Obtain Patient Information and Document Patient Care Accurately in the Medical Record, 74
PROCEDURE 4-2 Respond to Nonverbal Communication, 79
PROCEDURE 4-3 Use Medical Terminology Correctly and Pronounce Accurately to Communicate Information to Providers and Patients, 90
5 Patient Education, 97
PROCEDURE 5-1 Develop a List of Community Resources for Patients' Healthcare Needs; also, Facilitate Referrals in the Role of Patient Navigator, 104
PROCEDURE5-2 Coach Patients in Health Maintenance, Disease Prevention, and Following the Treatment Plan, 107
6 Nutrition and Health Promotion, 111
PROCEDURE 6-1 Instruct a Patient According to the Patient's Dietary Needs: Coach the Patient on the Basics of the Glycemic Index, 132
PROCEDURE 6-2 Coach a Patient About How to Understand Food Labels, 134
7 Vital Signs, 141
PROCEDURE7-1 Obtain Vital Signs: Obtain an Oral Temperature Using a Digital Thermometer, 145
PROCEDURE7-2 Obtain Vital Signs: Obtain an Aural Temperature Using the Tympanic Thermometer, 147
PROCEDURE7-3 Obtain Vital Signs: Obtain a Temporal Artery Temperature, 148
PROCEDURE 7-4 Obtain Vital Signs: Obtain an Axillary Temperature, 150
PROCEDURE 7-5 Obtain Vital Signs: Obtain an Apical Pulse, 152
PROCEDURE 7-6 Obtain Vital Signs: Assess the Patient's Radial Pulse and Respiratory Rate, 156
PROCEDURE7-8 Obtain Vital Signs: Measure a Patient's Weight and Height, 165
8 Assisting with the Primary Physical Examination, 171
PROCEDURE8-1 Use Proper Body Mechanics, 180
PROCEDURE 8-2 Assist Provider with a Patient Exam: Fowler's and Semi-Fowler's Positions, 182
PROCEDURE 8-3 Assist Provider with a Patient Exam: Horizontal Recumbent and Dorsal Recumbent Positions, 183
PROCEDURE 8-4 Assist Provider with a Patient Exam: Lithotomy Position, 184
PROCEDURE 8-5 Assist Provider with a Patient Exam: Sims Position, 185
PROCEDURE 8-6 Assist Provider with a Patient Exam: Prone Position, 186
PROCEDURE 8-7 Assist Provider with a Patient Exam: Knee-Chest Position, 187
PROCEDURE 8-8 Assist Provider with a Patient Exam, 191
UNITTWO
AssistingwithMedications
9 Principles of Pharmacology, 196
PROCEDURE 9-1 Prepare a Prescription for the Provider's Signature, 206
10 Pharmacology Math, 226
PROCEDURE 10-1 Demonstrate Knowledge of Basic Math Computations, 235
PROCEDURE10-2 Calculate Proper Dosages of Medication for Administration: Convert Among Measurement Systems, 236
PROCEDURE10-3 Calculate Proper Dosages of Medication for Administration: Calculate the Correct Pediatric Dosage Using Body Weight, 237
11 Administering Medications, 241
PROCEDURE 11-1 Administer Oral Medications, 248
PROCEDURE 11-2 Fill a Syringe from an Ampule, 251
PROCEDURE 11-3 Fill a Syringe from a Vial, 252
PROCEDURE 11-4 Reconstitute a Powdered Drug for Administration, 259
PROCEDURE 11-5 Administer Parenteral (Excluding IV) Medications: Give an lntradermal Injection, 260
PROCEDURE 11-6 Select the Proper Sites for Administering a Parenteral Medication: Administer a Subcutaneous Injection, 264
PROCEDURE 11-7 Mix Two Different Types of Insulin in One Syringe, 266
PROCEDURE 11-8 Administer Parenteral (Excluding IV) Medications: Administer an Intramuscular Injection into the Deltoid Muscle, 270
PROCEDURE 11-9 Select the Proper Sites for Administering a Parenteral Medication: Administer a Pediatric Intramuscular Vastus Lateralis Injection, 272
PROCEDURE 11-10 Administer Parenteral (Excluding IV)
Medications: Give a Z-Track Intramuscular Injection into the Dorsogluteal Site, 275
PROCEDURE 11-11 Complete an Incident Report Related to an Error in Patient Care, 278
UNITTHREE
Assisting with Medical Specialties
12 Safety and Emergency Practices, 282
PROCEDURE 12-1 Evaluate the Work Environment to Identify Unsafe Working Conditions and Comply With Safety Signs and Symbols, 285
PROCEDURE 12-2 Manage a Difficult Patient, 286
PROCEDURE 12-3 Demonstrate the Proper Use of a Fire Extinguisher, 287
PROCEDURE 12-4 Participate in a Mock Environmental Exposure Event: Evacuate a Provider's Office, 288
PROCEDURE12-5 Maintain an Up-to-Date List of Community Resources for Emergency Preparedness, 291
PROCEDURE12-6 Maintain Provider/ProfessionalLevel CPR Certification: Use an Automated External Defibrillator (AED), 294
PROCEDURE12-7 Perform Patient Screening Using Established Protocols: Telephone Screening and Appropriate Documentation, 295
PROCEDURE 12-8 Maintain Provider/Professional-Level CPR Certification: Perform Adult Rescue Breathing and One-Rescuer CPR; Perform Pediatric and Infant CPR,298
PROCEDURE 12-9 Perform First Aid Procedures: Administer Oxygen, 301
PROCEDURE 12-10 Perform First Aid Procedures: Respond to an Airway Obstruction in an Adult, 302
PROCEDURE12-11 Perform First Aid Procedures: Care for a Patient Who Has Fainted or Is in Shock, 305
PROCEDURE12-12 Perform First Aid Procedures: Care for a Patient With Seizure Activity, 309
PROCEDURE12-13 Perform First Aid Procedures: Care for a Patient With a Suspected Fracture of the Wrist by Applying a Splint, 310
PROCEDURE 12-14 Perform First Aid Procedures: Control Bleeding, 312
PROCEDURE12-15 Perform First Aid Procedures: Care for a Patient With a Diabetic Emergency, 314
13 Assisting in Ophthalmology and Otolaryngology, 319
PROCEDURE13-1 Perform Patient Screening Using Established Protocols: Measure Distance Visual Acuity with the Snellen Chart, 328
PROCEDURE13-2 Instruct and Prepare a Patient for a Procedure: Assess Color Acuity Using the Ishihara Test, 330
PROCEDURE13-3 Instruct and Prepare a Patient for a Procedure or Treatment: Irrigate a Patient's Eyes, 332
PROCEDURE13-4 Instruct and Prepare a Patient for a Procedure or Treatment: Instill an Eye Medication, 333
PROCEDURE13-5 Perform Patient Screening Using Established Protocols: Measure Hearing Acuity with an Audiometer, 341
PROCEDURE 13-6 Instruct and Prepare a Patient for a Procedure or Treatment: Irrigate a Patient's Ear, 342
PROCEDURE 13-7 Instruct and Prepare a Patient for a Procedure or Treatment: Instill Medicated Ear Drops, 344
PROCEDURE 13-8 Perform Patient Screening Using Established Protocols: Collect a Specimen for a Throat Culture, 346
14 Assisting in Dermatology, 350
15 Assisting in Gastroenterology, 368
PROCEDURE 15-1 Perform Patient Screening Using Established Protocols: Telephone Screening of a Patient with a Gastrointestinal Complaint, 373
PROCEDURE 15-2 Assist the Provider with a Patient Examination: Assist with an Endoscopic Examination of the Colon, 386
PROCEDURE 15-3 Instruct and Prepare a Patient for a Procedure: Instruct Patients in the Collection of a Fecal Specimen, 387
PROCEDURES
16 Assisting in Urology and Male Reproduction, 391
PROCEDURE 16-1 Coach Patients in Health Maintenance: Teach Testicular Self-Examination, 406
17 Assisting in Obstetrics and Gynecology, 414
PROCEDURE 17-1 Instruct and Prepare a Patient for Procedures and/or Treatments: Assist with the Examination of a Female Patient and Obtain a Smear for a Pap Test, 426
PROCEDURE17-2 Instruct and Prepare a Patient for Procedures and/or Treatments: Prepare the Patient for a LEEP, 429
PROCEDURE17-3 Coach Patients in Health Maintenance and Disease Prevention: Teach the Patient Breast SelfExamination, 432
PROCEDURE17-4 Instruct and Prepare a Patient for Procedures and/or Treatments: Assist with a Prenatal Examination, 439
18 Assisting in Pediatrics, 446
PROCEDURE 18-1 Verify the Rules of Medication Administration: Document Immunizations, 466
PROCEDURE 18-2 Maintain Growth Charts: Measure the Circumference of an Infant's Head, 472
PROCEDURE 18-3 Maintain Growth Charts: Measure an Infant's Length and Weight, 473
PROCEDURE 18-4 Measure and Record Vital Signs: Obtain Pediatric Vital Signs and Perform Vision Screening, 476
PROCEDURE 18-5 Assist Provider With a Patient Exam: Applying a Urinary Collection Device, 479
19 Assisting in Orthopedic Medicine, 484
PROCEDURE 19-1 Assist the Provider with Patient Care: Assist with Cold Application, 505
PROCEDURE 19-2 Assist the Provider with Patient Care: Assist with Moist Heat Application, 506
PROCEDURE19-3 Coach Patients in the Treatment Plan: Teach the Patient Crutch Walking and the SwingThrough Gait, 509
PROCEDURE19-4 Assist the Provider with Patient Care: Assist with Application of a Cast, 511
PROCEDURE19-5 Assist the Provider with Patient Care: Assist with Cast Removal, 513
20 Assisting in Neurology and Mental Health, 517
PROCEDURE 20-1 Assist the Provider with Patient Care: Assist with the Neurologic Examination, 535
PROCEDURE 20-2 Explain the Rationale for Performance of a Procedure: Prepare the Patient for an Electroencephalogram, 536
PROCEDURE 20-3 Assist the Provider with Patient Care: Prepare the Patient for and Assist with a Lumbar Puncture, 538
21 Assisting in Endocrinology, 542
PROCEDURE 21-1 Assist the Provider with Patient Care: Perform a Blood Glucose TRUEresult Test, 550
PROCEDURE 21-2 Assist the Provider with Patient Care: Perform a Monofilament Foot Exam, 555
22 Assisting in Pulmonary Medicine, 560
PROCEDURE22-1 Instruct Patients According to Their Needs: Teach a Patient to Use a Peak Flow Meter, 569
PROCEDURE22-2 Assist the Provider with Patient Care: Administer a Nebulizer Treatment, 571
PROCEDURE 22-3 Assist the Provider with Patient Care: Perform Volume Capacity Spirometry Testing, 576
PROCEDURE22-4 Perform Patient Screening Using Established Protocols: Perform Pulse Oximetry, 577
PROCEDURE22-5 Obtain Specimens for Microbiologic Testing: Obtain a Sputum Sample for Culture, 578
23 Assisting in Cardiology, 582
24 Assisting in Geriatrics, 601
PROCEDURE24-1 Demonstrate Empathy: Understand the Sensorimotor Changes of Aging, 603
UNITFOUR
DiagnosticProcedures
25 Principles of Electrocardiography, 620
PROCEDURE25-1 Perform Electrocardiography: Obtain a 12-Lead ECG, 629
PROCEDURE25-2 Instruct and Prepare a Patient for a Procedure or Treatment: Fit a Patient With a Holter Monitor, 640
26 Assisting with Diagnostic Imaging, 645
27 Assisting in the Clinical Laboratory, 675
PROCEDURE 27-1 Perform a Quality Control Measure on a Glucometer and Record the Results on a Flow Sheet, 683
PROCEDURE 27-2 Use the Microscope and Perform Routine Maintenance on Clinical Equipment, 694
28 Assisting in the Analysis of Urine, 699
PROCEDURE28-1 Instruct and Prepare a Patient for a Procedure or Treatment: Instruct a Patient in the Collection of a 24-Hour Urine Specimen, 702
PROCEDURE28-2 Instruct and Prepare a Patient for a Procedure or Treatment: Collect a Clean-Catch Midstream Urine Specimen, 704
PROCEDURE 28-3 Assess Urine for Color and Turbidity: Physical Test, 707
PROCEDURE 28-4 Perform Quality Control Measures: Differentiate Between Normal and Abnormal Test Results while Determining the Reliability of Chemical Reagent Strips, 713
PROCEDURE 28-5 Obtain a Specimen and Perform a CUAWaived Urinalysis: Test Urine with Chemical Reagent Strips, 713
PROCEDURE 28-6 Prepare a Urine Specimen for Microscopic Examination, 715
PROCEDURE 28-7 Obtain a Specimen and Perform a CUAWaived Urinalysis: Test Urine for Glucose Using the Clinitest Method, 723
PROCEDURE28-8 Obtain a Specimen and Perform a CUA-Waived Urinalysis: Perform a Pregnancy Test, 725
PROCEDURE 28-9 Obtain a Specimen and Perform a CUA-Waived Urinalysis: Perform a Multidrug Screening Test on Urine, 727
PROCEDURE 28-1 OAssess a Urine Specimen for Adulteration before Drug Testing, 729
29 Assisting in Blood Collection, 733
PROCEDURE 29-1 Instruct and Prepare a Patient for a Procedure and Perform Venipuncture: Collect a Venous Blood Sample Using the Vacuum Tube Method, 744
PROCEDURE 29-2 Perform Venipuncture: Collect a Venous Blood Sample Using the Syringe Method, 747
PROCEDURE 29-3 Perform Venipuncture: Obtain a Venous Sample with a Safety Winged Butterfly Needle, 751
PROCEDURE29-4 Instruct and Prepare a Patient for a Procedure and Perform Capillary Puncture: Obtain a Capillary Blood Sample by Fingertip Puncture, 758
30 Assisting in the Analysis of Blood, 765
PROCEDURE30-1 Perform Routine Maintenance of Clinical Equipment: Perform Preventive Maintenance for the Microhematocrit Centrifuge, 769
PROCEDURE 30-2 Obtain Specimens and Perform CUAWaived Hematology Testing: Perform a Microhematocrit Test, 770
PROCEDURE30-3 Perform CUA-Waived Hematology Testing: Perform a Hemoglobin Test, 772
PROCEDURE30-4 Obtain a Specimen and Perform CUA-Waived Hematology Testing: Determine the Erythrocyte Sedimentation Rate Using a Modified Westergren Method, 774
PROCEDURE30-5 Obtain a Specimen and Perform a CUA-Waived Protime/lNR Test, 777
PROCEDURE30-6 Perform a CUA-Waived Chemistry Test: Determine the Cholesterol Level or Lipid Profile Using a Cholestech Analyzer, 788
31 Assisting in Microbiology and Immunology, 797
PROCEDURE31-1 Instruct and Prepare a Patient for a Procedure: Instruct Patients in the Collection of Fecal Specimens to Be Tested for Ova and Parasites, 806
PROCEDURE31-2 Obtain a Specimen and Perform a CUA-Waived Microbiology Test: Perform a Rapid Strep Test, 813
PROCEDURE31-3 Obtain a Specimen and Perform a CUA-Waived Immunology Test: Perform the QuickVue+ Infectious Mononucleosis Test, 816
UNITFIVE
AssistingwithSurgeries
32 Surgical Supplies and Instruments, 825
PROCEDURE 32-1 Identify Surgical Instruments, 828
33 Surgical Asepsis and Assisting With Surgical Procedures, 842
PROCEDURE 33-1 Prepare Items for Autoclaving: Wrap Instruments and Supplies for Sterilization in an Autoclave, 846
PROCEDURE33-2 Perform Sterilization Procedures: Operate the Autoclave, 849
PROCEDURE33-3 Perform Skin Prep for Surgery, 853
PROCEDURE33-4 Perform Handwashing: Perform a Surgical Hand Scrub, 855
PROCEDURE33-5 Prepare a Sterile Field, 858
PROCEDURE 33-6 Perform Within a Sterile Field: Use Transfer Forceps, 859
PROCEDURE33-7 Perform Within a Sterile Field: Pour a Sterile Solution into a Sterile Field, 860
PROCEDURE33-8 Perform Within a Sterile Field: Put on Sterile Gloves, 860
PROCEDURE 33-9 Perform Within a Sterile Field: Assist with Minor Surgery, 864
PROCEDURE 33-10 Perform Wound Care: Assist With Suturing, 867
PROCEDURE33-11 Perform Wound Care and a Dressing Change: Apply or Change a Sterile Dressing, 868
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Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary.
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With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions.
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PREFACE
Medical assisting as a profession has changed dramatically since 1he Office Assistant in Medical and Dental Practice, by Portia Frederick and Carol Towner, was first published in 1956. Each subsequent edition of this textbook has reflected the age in which it was published. Now, Kinn's 1he Medical Assistant: An Applied Learning Approach, thirteenth edition, in its 60th year of publication, continues to represent a long-standing commitment to high-quality medical assisting education with its engaging, straightforward writing style and demonstrated positive outcomes. Hundreds of instructors in classrooms across the country have used this text to teach thousands of students over the years. Many of these students have gone on to teach students of their own with this very same trusted resource. To continue the use and growth of this text and its features, the thirteenth edition continues to offer the most comprehensive, up-to-date, and innovative approach to teaching this subject today.
This textbook has endured throughout the years because it has been able to keep pace with an ever-changing profession while producing students who are well trained and qualified to enter medical practices across the country. This dependability is the reason the market continues to rely on this text, edition after edition. Underlying this dependability is a foundation of pedagogic features that has stood the test of time and that has been expanded and improved upon yet again in this latest edition. Such features include the following:
• An easy-to-read, highly interactive writing style that engages students through practical applications of medical assistant competencies.
• An emphasis on skill development, with procedural steps outlining each skill, supported by rationales that provide meaning to each step.
• A pedagogic framework based on the use of learning objectives, vocabulary terms, and supportive student supplements.
• A package of supportive materials to accommodate a wide variety of student learning types and instructor teaching styles.
NEWTOTHISEDITION
• Updated Art Program. The artwork throughout has been updated and modernized, providing a more attractive textbook for student use. Many new photographs and line drawings throughout support the revised content more effectively and are more relevant to the actual healthcare setting. New images show up-to-date equipment, provide more disease examples, and better illustrate key procedural steps.
• New chapter on Competency-Based Education for Medical Assisting. The emphasis of competency mastery is high to meet accreditation standards. This chapter helps set the stage for medical assisting students to understand their programming and how the road to mastery will affect their ability to attain a job.
• New Chapter on The Health Record. The manner in which the medical record is maintained in a medical office has changed dramatically with the move to the EHR. This chapter reviews how the medical assistant maintains and interacts with the medical record.
• Learning Objectives are listed in the same order as the flow of content. The learning objectives are tied to curriculum competencies. This feature makes it easy to see where the learning objectives are covered to aid in review of the material and measurement of competency coverage.
• Procedures are integrated into the TOC. Provides a quick reference to where the procedures will be covered and in what order.
• Professional Behaviors boxes. The medical assistant must develop the ability to interact professionally with patients, families, co-workers, and other members of the healthcare team. These boxes provide tips on professional behavior that are specific to each chapter's content.
EVOLVE
The Evolve site features a variety of student resources, including Chapter Review Quizzes, new Procedure Videos, Medical Terminology Audio Glossary, practice CMA and RMA exams, and much more! The instructors' Evolve Resources site consists of TEACH Instructor Resources, including Lesson Plans, PowerPoint Presentations, Answer Keys for Chapter Review Quizzes, and a retooled Test Bank with more than 3000 questions.
STUDYGUIDEANDPROCEDURE CHECKLISTMANUAL
The Study Guide provides students with the opportunity to review and build on information they have learned in the text through vocabulary reviews, case studies, workplace applications, and more. The updated Procedure Checklists include CAAHEP and ABHES competencies that can be traced to the online correlation grid.
fEAlURES
Scenmio is p1esented ot the beginning o\ eoch chopte1 so the student con envision o ieo\-wo1\d situotion when 1eoding the chop· te1 content.
Eoch choptet contoins ovocobulmv \is\ with de\initions so students con \i!st \omi\imize themselves with theimportant te1ms ossoci· oted with eoch chopte1.
Scenmio questions p1ovide owov fot stu· dents to opplv the concepts thev me \eom· ing ond think obout decisions thev would moke in 1eol situations.
leoming Ob\ectives emphasize the cognitive and peno1monce ob\ectives p1esentedin the chopte1.
l VOCABULARY age ofmajo
NTRODUCTION TO MEDICAL ASSISTING
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UNITONE
Critical Thinking Application boxes prompt students to apply what they have learned as they read and study the chapter.
Safety Alert boxes alert students to important safety information and reinforce the importance of safety in the profession.
148 UNITONE INTRODUCTION TO MEDICAL ASSISTING
7. ~esslhebultj lheprobeasdirected.Thetemperaturellillappear oo lhe displays een in 1ta25'<anrls.
8. Remove lhe pr , note lhe rooding, and disaml lhe probe cave, inlCJ a biohazordw~ containerwithouttouchingit. fl!RE!!SE: Th probe caver is coolomiooted and must be di~arded in a biohozardw cOfltainer.
9. Scmitize yo bends and disinlect lhe equiprn<nt I indicoted. See lhe mon~actur rs monual lor clooning lhe probe tip. Many recommend cleonirrg •probe lens wilh okohal llipes. ~ oensure infection control.
The tern ral artery scanner uses an infrared beam to assess the tempera re of the blood flowing through the temporal anery of the late forehead, where the artery lies about l mm below the skin (F re 7-3). Because: the anery is so close to the skin, it provides d surfucc heat conduction, allowing the thermometer to obtai a fut, accurate, and noninvasive measurement ofbody tempcrat re. To perform the procedure, place the probe in the center of forehead, halfway between the eyebrows and the hairline. Ban should be pushed back off the forehead {this method cannot be ed if bandages cover the area). Depress the button on the ner and gently stroke: the probe across the forehead toward the h line (at the temples), keeping the probe fiat on the patient's k. the 60Ulncr moves across the forehead, repeated temperare measurements arc taken and the highest measurement is orded; keeping the button dcprcs.sc:d., lift the scanner from the emporal area and lightly place the probe behind the earlobe. Release the button and remove the probe. Recording an accurate temperature takes about 3 seconds (Proccclure 7-3). Depending on
10. Record lhetemperolure results (e.g., T-98.6° Fmlin lhepotienfsheallh record. fl!RE!!SE: Pmcedureslhatare not recorded are considered not done. 3/30/20-2:20 "' T·101.1°F m. C. Rkci, CMA WIMl the facility's infection control procedures disposable covers can be used on the scanner or it can be cleaned between patients with an alcohol wipe.
Goal: Ta acrurotelt r/etennine am! recrm/apaffenfs temparature using otemparo/ ar/ery scanner.
1, Sanitize your bends. fl!RE!!SE:Toensureinfectioocontral.
2. Golher lhe necesso~ equipment and supplies.
3, Introduce yoorselt, identify your potiern, and ex~aio lhe procedure. fl!RE!!SE: ldentificotionaflhe petientprevenlsenoo,arnl explanations me omoons of goining implied consellt ond patient cooperation.
~: To ensure infection control.
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5. Push lhe potienfs hairup off lhe forehead loexpose lhe site. Genllyplace lfre probe an lhe polienfs forehead, halfway belween lhe edg, of lhe eyebrows om! the hoiriine.
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112UNITTWO
REVIEWERS
Brenda G. Abplanalp, RN, BSN, MSEd Director
Pennsylvania College of Technology Williamsport, Pennsylvania
Pam Alt, RN, MSN, RMA
Medical Assistant Program Director Mid-State Technical College Marshfield, Wisconsin
Deborah A. Balentine, MEd, RH/A, CCS, CCS-P, CHTS-TR
Adjunct Instructor-Adult Education City Colleges of Chicago Chicago, Illinois
Janet K. Baumann, BS, CMA (AAMA), EMT-8
Medical Assistant Program Director Northcentral Technical College Wausau, Wisconsin
Cynthia A. Bloss, AA, RMA, BMO Instructor, Clinical Liaison Southeastern College Clearwater, Florida
Marquitta Breeding, CMA (AAMA)
Wallace State Community College Hanceville, Alabama
Leon Deutsch, RMA, BS, MEd Dean of Teaching & Learning Grayson College Denison, Texas
Jennifer Dietz, BS, CMA (AAMA), PBT (ASCP) CM Assistant Professor
Cuyahoga Community College-Metropolitan Campus Cleveland, Ohio
Tracie Fuqua, BS, CMA (AAMA)
Medical Assistant Program Director Wallace State Community College Hanceville, Alabama
Deborah S. Gilbert, RH/A, MBA, CMA
Assistant Professor of School of Allied Health Dalton State College Dalton, Georgia
Kimberly Annette Head, DC, BS, BA Director of CE Healthcare Programs Collin College Plano, Texas
Judith K. Kline, RMA, NCMA, CCMA, CMAA, AHi, NCET, NC/CS, NCPT Professor
Miami Lakes Educational Center & Technical College Miami Lakes, Florida
Jennifer K. Lester, BA, NHA, AMT
Medical Administrative Instructor
Charleston Job Corps Center & Bridge Valley Community & Technical College Workforce Program Charleston, West Virginia
Michelle C. Maus, MBA, BS, PhD, ABD
Department Chair/Assistant Professor Tiffin University Tiffin, Ohio
Tammy Mcclish, MEd, CMA (AAMA), RTARRT
Allied Health Instructor
The University of Akron Akron, Ohio
Brigitte Niedzwiecki, RN, MSN, RMA
Medical Assistant Program Director & Instructor Chippewa Valley Technical College Eau Claire, Wisconsin
Cynthia 8. Orlando, GAHi, OBT, NRCMA Instructor
Eastern College of Health Vocations New Orleans, Louisiana
Julie Pepper, BS, CMA (AAMA)
Medical Assistant Instructor Chippewa Valley Technical College Eau Claire, Wisconsin
8AssistingwiththePrimaryPhysicalExamination,171 Anatomy and Physiology, 172 Primary Care Provider, 173 Physical Examination, 175 Principles of Body Mechanics, 177
Procedure8-1:UseProperBodyMechanics,180 Assisting with the Physical Examination, 181
You Got the Job!, 903 Life Skills, 905 Closing Comments, 907 Glossary,91O Index,927
COMPETENCY-BASED EDUCATION AND THE MEDICAL ASSISTANT STUDENT 1
1-i#iffi#t•i
Shawna Long isa newlyadmittedstudentin a medical assistant (MA) program at your school. Shawna is anxious about starting classes and very concerned that she may not be a successful student. She had trouble with some of her
• What is competency-based education and how can it help Shawna learn and achieve skills?
• Why is it important for Shawna to understand how she learns best?
• Time management is a crucial part of being a successful student and a successful medical assistant. What are some methods Shawna can implement to help her manage her time as effectively as possible?
LEARNING OBJECTIVES
1. Define, spell, and pronounce the terms listed in the vocabulary.
2. Discuss competency-based education and adult learners.
3. Summarize the importance of student porrlolios in proving academic success and skill competency.
4. Examine your learning preferences and interpret how your learning style affects your success as a student.
5. Differentiate between adaptive and nonadaptive coping mechanisms.
6. Apply time management strategies to make the most of your learning opportunities.
7. Integrate effective study skills into you daily activities.
classesinhighschool andmustcontinue towork parttimewhiletakingmedical assistant classes. Based onwhatyoudiscover about the learning processin this chapter, see whether you can help Shawna take steps toward success.
• Shawna will face many problems and challenges while working through the MA program. How can sbe '-elop workable strategies for dealing with these issues?
• What is the role of gssegiveness in effective professional communications? V
• Studying may be a cnallenge for Shawna. What skills can she use to help her learn new material and prepare for examinations?
8. Design test-taking strategies that help you take charge of your success.
9. Incorporate critical thinking and reflection to help you make mental connections as you learn material.
10. Analyze healthcare results as reported in graphs and tables.
11. Apply problem-solving techniques to manage conflict and overcome barriers to your success.
12. Relate assertiveness, aggressiveness, and passive behaviors to professional communication and discuss the role of assertiveness in effective communication.
For many years the curriculum for medical assistant programs has been based on student achievement of specific competencies . According to the Medical Assisting Education Review Board (MAERB):
Medical assistants graduating from programs accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) will demonstrate critical thinking based on knowledge of academic subject matter required for competence in the profession. They will incorporate the cognitive knowledge in performance of the psychomotor and affective domains in their practice as medical assistants in providing patient care.
The Accrediting Bureau of Health Education Schools (ABHES) also bases its recommended curriculum on student achievement of identified competencies:
The depth and breadth of the program's curriculum enables graduates to acquire the knowledge and competencies necessary to become an entry-level professional in the medical assisting field. Competencies required for successful completion of the program are delineated, and the curriculum ensures achievement of these entry-level competencies through mastery of coursework and skill achievement. Focus is placed on credentialing requirements and opportunities to obtain employment and to increase employability.
National curriculum standards for the education of medical assistants are based on recognized competencies that employers expect entry-level medical assistants to have. The 2015 Core Curriculum for Medical Assistants established by the MAERB must be followed for programs accredited by CAAHEP. Those completing a CAAHEPaccredited program must demonstrate core entry-level competencies in knowledge of subject matter, be able to perform the psychomotor skills needed in an ambulatory care center, and have appropriate behavioral competencies to respond professionally and with empathy toward patients and their families. The 12 academic subjects in a CMHEP-approved curriculum are as follows:
I. Anatomy and Physiology
II. Applied Mathematics
III. Infection Control
IV Nutrition
V Concepts of Effective Communication
VI. Administrative Functions
VII. Basic Practice Finances
VIII. Third Party Reimbursement
IX. Procedural and Diagnostic Coding
X. Legal Implications
XI. Ethical Considerations
XII. Protective Practices
ABHES also offers accreditation for medical assisting programs. The organization focuses its curriculum requirements on student competency achievement with 11 required areas of study:
1. General Orientation [to the field of medical assisting]
2. Anatomy and Physiology
3. Medical Terminology
4. Medical Law and Ethics
5. Psychology of Human Relations
6. Pharmacology
7. Records Management
8. Administrative Procedures
9. Clinical Procedures
10. Medical Laboratory Procedures
11. Career Development
What does this mean for you, the medical assistant student? To meet national standards, your MA program must comply with competency-based learning in multiple areas. The most important characteristic of competency-based education is that it measures learning and skill achievement over time. Students progress through the program by demonstrating their competence, which means they prove they have mastered the knowledge, skills, and professional behaviors required to achieve competency in a particular task. For example, one of the basic skills you must achieve as a medical assistant student is taking an accurate blood pressure. Some students will have more difficulty consistently achieving this goal than others, but each student must be able to take a blood pressure accurately before he or she can move on in the curriculum.
ADULTLEARNERSAND COMPETENCY-BASEDEDUCATION
Competency-based learning is ideal for adult learners who are attempting to understand new information and achieve new skills. Educators recognize that adult learners come to the classroom with different work-related experiences and educational backgrounds. Therefore, adult students have a wide range of understanding about the knowledge and skills that must be achieved in the program. Adult students also learn material at different rates. Competencybased education recognizes these qualities of adult learners and takes advantage of them. Let's go back to the blood pressure example. Perhaps you took a healthcare lab in high school, in which you learned to take blood pressures; another student may have worked in a long-term care facility, where he was responsible for monitoring vital signs throughout the day. You both may need just a review of the anatomy and physiology aspects of a patient's blood pressure. However, other students in the class will not know anything about this skill. With competency-based education, your instructor can design laboratory activities that meet all students' needs, including your own.
CRITICALTHINKING APPLICATION 1-1
Can you think of any examples of how competency-based education might help you succeed as a medical assistant student? Come up with two possibilities and share them with your classmates.
PORTFOLIOS
Have you taken a class in the past that required you to develop a portfolio? Portfolios are frequently used in an Art or English class to demonstrate student skills and learning achievements. Generally, a portfolio is a collection of student materials that demonstrates learning. An advantage of developing a portfolio for a medical assistant program is that you can decide which pieces of your work best demonstrate your learning and skill achievement over time. Why would this be beneficial to you?
In a competency-based program, you must achieve a series of skills, not only to complete the program, but also to prove to future
