CO 2025 Clinical Year Handbook | March 10, 2025 by Hofstra University

CLINICAL YEAR HANDBOOK

Fall 2024

FACULTY AND STAFF CONTACT INFORMATION

Chair and Program Director / Assistant Professor

J. Scott Gould, DMSc, PA-C (516) 463-4411

Scott.Gould@hofstra.edu

Gallon Wing, room 243B

Associate Director / Assistant Professor

Mark L’Eplattenier, MPAS, PA-C (516) 463-1353

Mark.S.Leplattenier@hofstra.edu

Gallon Wing, room 243C

Academic Coordinator / Assistant Professor

Amy Roberts, MS, PA-C (516) 463-7728

Amy.Roberts@hofstra.edu

Gallon Wing, room 130

Dual-Degree Coordinator / Assistant Professor

Mary Banahan, MS, PA-C (516) 463-4161

Mary.K.Banahan@hofstra.edu

Gallon Wing, room 244

Academic Faculty/ Assistant Professor

William Heuser, Pharm D, MS, EMT-P (516) 463-7008

William.Heuser@hofstra.edu

Gallon Wing, room 139

Academic Faculty/Assistant Professor

Gina Pontrelli, DHSc, PA-C (516) 463-4381

Gina.L.Pontrelli@hofstra.edu

Gallon Wing, room 131

Assistant Professor/Clinical Coordinator

Janet Tutuyan, MPH, PA-C (516) 463-6841

Janet.Tutuyan@hofstra.edu

Gallon Wing, room 236

Academic Faculty / Assistant Professor

Carina Loscalzo, MS, PA-C (516) 463-4412

Carina.Loscalzo@hofstra.edu

Gallon Wing, room 243A

Medical Director

Samuel Sandowski, MD (516) 463-4074

ssandowski@snch.org

Gallon Wing, room 132

Academic Coordinator/ Assistant Professor/ Assistant Chair

Christine Zammit, MS, PA-C (516) 463-4380

Christine.Zammit@hofstra.edu

Gallon Wing, room 137

Director of Clinical Education /Assistant Professor

Shannan Ricoy, MS, PA-C (516) 463-4233 (516) 509-6470 (Program cellular phone)

Shannan.Ricoy@hofstra.edu

Gallon Wing, room 237

Senior Assistant-Full Time

Marie Sorrentino (516) 463-4074

Marie.Sorrentino@hofstra.edu

Gallon Wing, room 132

Clinical Secretary/Secretary - Part Time

Karen Forman/Sharon Poulson (516) 463-4074

Karen.S.Forman@hofstra.edu

Sharon.Poulson@hofstra.edu

Gallon Wing, room 132

Academic Administrator/Advisement Coordinator

Gia Raponi (516) 463-4043

Gia.R.Raponi@hofstra.edu

Gallon Wing, room 245

Department Main Office

Phone: (516) 463-4074

Fax: (516) 463-5177

Hofstra University

Physician Assistant Studies

Gallon Wing, room 132

Hempstead, New York 11549-1270

Rotation 1 Fall Semester

Rotation 2 Fall Semester

Rotation 3, Part #1 Fall Semester

2024-2025 Clinical Year Schedule

8/26/2024 – 10/3/2024

Students off 9/2/2024

10/07/2024 – 11/14/2024

Students off 10/14/2024

11/18/2024 - 12/19/2024

Students off 11/28/2024 - 12/1/2024

Call Back Day (one day): 10/4/2024

Location: Gallon 240

Call Back Day (one day): 11/15/2024

Location: Gallon 240

Call Back Day (one day): 1/3/2025

Location: Gallon 240 Winter Break- 12/23/2024– 12/29/2024

Rotation 3, Part #2 Fall Semester

Rotation 4 Spring Semester

Rotation 5 Spring Semester

Rotation 6 Spring Semester

Rotation 7 Summer I

12/30/2024 - 1/2/2025

Students off 1/1/2024

1/6/2025 – 2/12/2025

Call Back Day 1: 2/13/2025

Location: Gallon 240

Call Back Day 2: 2/14/2025

Location: SIC

2/18/2025 – 3/26/2025

Students off 2/17/2025

Call Back Day 1: 3/27/2025

Location: Gallon 240

Call Back Day 2: 3/28/2025

Location: SIC Spring Break- 3/31/2025 – 4/6/2025

4/7/2025 – 5/15/2025

5/19/2025 – 6/25/2025

Students off 5/26/2025

Rotation 8 Summer II

6/30/2025 – 8/6/2025

Students off 7/4/2025

Call Back Day (one day): 5/16/2025

Location: Gallon 240

Call Back Day 1: 6/26/2025

Location: Gallon 240

Call Back Day 2: 6/27/2025

Location: SIC

Call Back Day 1: 8/7/2025

Location: Gallon 240

Call Back Day 2: 8/8/2025

Location: SIC

Introduction

Congratulations on progressing to the clinical year! It is an accomplishment to complete the didactic phase of training and to advance to the clinical portion of the curriculum. The goal of the clinical year is to provide the skills necessary for graduation and ultimately for practice as a physician assistant. This handbook is designed to provide the information necessary to complete the requirements for each clerkship (also referred to as a “rotation”). The clinical handbook will be useful throughout the clinical year; keep it in an accessible place. It is also posted on Exxat in the student packet section.

The clinical coordinators will be the primary faculty you will interact with this year. However, the entire faculty and staff are available to support and guide you through this year. Please feel free to contact any faculty or staff member with questions or concerns.

Making the Transition to Clinical Practice

The clinical year differs from the academic year in many ways. A chief difference is that the security found in the company of fellow students will be absent in many cases. The familiar routine of the classroom will similarly be absent. Self-reliance and self-motivation will play a more important role in succeeding in the clinical year. A key feature of the experience this year will be the ability to integrate and apply core knowledge with practical experience. This does not occur automatically and will depend on the ability to continue to study physiology, pharmacology, and clinical medicine when not on-site.

While each clerkship will provide the opportunity to meet each objective, with some effort you will find additional opportunities that will yield added enrichment. Take advantage of these opportunities.

Making the most of the clinical year depends on the amount of effort, work, and dedication you are willing to expend. Some clerkships will be more enjoyable than others. While some clerkships may not meet all your expectations, remember that learning to navigate the clinical world in all circumstances is important to success in the clinical year. Learning to find the resources and individuals to help meet the objectives will optimize your clinical experiences.

Structure of the Clinical Year

The clinical year is made up of seven core clerkships and one elective clerkship, totaling approximately 2,000 hours of clinical training. The core clerkships include family medicine, internal medicine, surgery, behavioral and mental health care, woman’s health, emergency medicine, and pediatrics. The elective clerkship provides experience to work within a sub-specialty of medicine or surgery, or the chance to repeat a rotation of personal interest in another setting. At the conclusion of each clerkship, students are required to participate in ‘call back’ session(s) on campus, the Center for Learning and Innovation (CLI), or the Science Innovation Center (SIC).

The objectives for each clerkship are found in the back of this handbook. Students are responsible for the objectives regardless of the types of patient care experiences they encounter.

All students are responsible to contact the site for their upcoming clinical rotations according to the site’s requirements and timeline. Some sites require the completion of an orientation session, online modules, and the submission of time-sensitive, site-specific documents before attending the rotation. All students will have access to the clinical year software program, Exxat. Exxat contains all the information for the clinical year. Failure to check Exxat for clinical site-related information may result in the student losing rotation and not graduating on time.

Preparation for Clerkships

There are several factors to consider before beginning each clerkship. They include:

• Identification of Gaps in Knowledge: The ability to identify areas of weakness and finding ways to address them is a lifelong process that begins in the clinical year. Before presenting to the clinical site for the first time, review the learning objectives for that discipline (found at the end of the Handbook). Some areas of weakness will be apparent before beginning the clerkship; others may present during the rotation. Early identification allows for timely remediation.

• Communication with Preceptor: Meet with the preceptor on the first day of each rotation and discuss the objectives with him/her. Reviewing the objectives with the preceptor will help plan how best to use the weeks allotted for the clerkship. Afterward, the preceptor must sign the “Student-Preceptor Review of Instructional Objectives and Learner Outcomes” form.

• Personal Preparation: Students are required to be at the site at all times designated by the preceptor. In some cases, this will require staying at the site late into the evening or overnight, arriving very early in the morning, or working on weekends/holidays. Anticipate long, irregular hours and prepare by engaging babysitters, family, dog-walkers, or helpers in the care of others who rely on you. Students may not be excused from any scheduled hours without contacting the program and obtaining permission from the clinical team (see clinical attendance).

• Transportation: A car in good working order is required to travel to most rotation sites. Many rotations will require a drive of many miles. It is not acceptable to miss time from a rotation because of car trouble. A back-up plan must be developed for reaching a clinical site without a car. While it is possible to complete the clinical year without a car, this will increase travelling time and require familiarity with the public transportation system. For rotations at sites that are far away or inaccessible via public transport, it may be necessary to find short-term living accommodations. As outlined in the

list of tuition and fees upon entrance to the PA Program, students are responsible for all expenses related to the clinical rotations. These include, but are not limited to, parking, tolls, gasoline, and car maintenance.

• Smart phones or iPads: Owners of smart phones or iPads should download pertinent information such as textbooks, PDRs, EKG, and radiology references. In addition to its use as a reference, these devices can be used to take notes, keep study lists or to log patients. Should the purchase of a device not be possible, determine how to quickly access information, to keeptrack of patients, and take notes. It is not appropriate to be talking, texting, or taking pictures with your electronic device cell phone in patient care areas while on clinical rotations.

• Oral Presentations: Clinical rotations require students to present patient cases to preceptors, fellow students, and other health care team members. Practice of the presentation beforehand will aid in the appearance of confidence and being well informed. Discomfort with public speaking can be remedied with practice in front of a mirror, to friends, and to classmates.

• Emotions: When beginning the clinical year, many students feel inadequate when considering the responsibility associated with patient care. Acknowledgment of this feeling may prevent becoming crippled by it. Most preceptors and staff are sympathetic to student nervousness, and do not expect a student to know everything. It is important to ask questions, listen, and learn. Reading and preparing throughout the clerkship may help in feeling confident.

• Getting Help: Students may experience personal problems during the clinical year or interpersonal conflicts may arise on a clinical site. The clinical coordinators, faculty, and program director are available for advice and support. Call them as soon as a problem arises. Do not wait until the situation spirals.

• Involvement in Clinical Training: The amount of learning in and enjoyment of the clerkship is directly proportional to the effort extended. Reading about disease states encountered each day is essential. Students are expected to volunteer for presentations and to spend as much time as possible at the site. Many find that the best teaching is “after hours.” Others find that helping with “scut” work may make the preceptor more inclined to teach and mentor.

• First Impressions Count: Preceptors often form opinions of students early in the rotation. It is important, therefore, to be punctual, maintain a good physical appearance, and demonstrate initiative from the first day of the clerkship. Learning the layout of the facility, important phone numbers, and procedures for ordering labs, diagnostic studies, and consults early will aid in making a good first impression.

• Interpersonal Communication: One key to a successful clerkship experience is the ability to get along with patients, preceptors, and other medical staff at the site. Being respectful and courteous includes self-awareness of tone of voice, body language and attitude. Yet, the clerkship experience is not designed for any student to be taken advantage of or excluded from important learning experiences. It may be necessary to be assertive at times. Striking a balance between being courteous and a responsible learner may prove challenging. Program facultycan help negotiate this balance and should be called upon if needed.

• Seek Out Teachers: In addition to the preceptor, other members of the health care team such as social workers and nurses may be willing to teach. It is especially important to attend all teaching rounds

that are offered at the site. If medical students rotate at the site, seek an invitation to participate in their teaching rounds. Being polite and respectful may result in opportunities that might otherwise be missed.

• Be Assertive: Some sites will have many students rotating at the same time, either from other PA programs or from other schools. All these students will compete for the attention of preceptors, for the opportunity to perform procedures, or for the privilege to present cases on rounds. This will necessitate the ability to assert oneself to gain access to important learning opportunities. While this may be difficult, it is essential to maximize the clerkship experience.

• Expect Frustrations: As with other phases of PA education, there are aspects of the clinical year that are frustrating. Remaining flexible will help in minimizing the negative aspects of a clerkship experience. It is also important to keep in mind that patients can be the source of frustration. Patients can be angry, fearful, manipulative, or duplicitous. This may be due to a number of factors, some not directly related to the student. A discussion with the preceptor may help determine if factors can be modified in the provider-patient interaction.

Clerkship Assignment Policy

Students are not required to provide or solicit clinical sites or preceptors. Students are assigned to clerkship sites by the clinical coordinators. Clerkship site assignments are not negotiable. The clinical schedule may change due to situations beyond the program’s control. It is necessary that students remain flexible when these situations arise.

While personal considerations are respected, when possible, the primary focus of clerkship assignments is to give each student a well-rounded clinical experience. Therefore, students are required to rotate to each clerkship site as assigned. To ensure the best possible clinical year experience, students will be assigned clerkships that will require travel. As outlined in the tuition and fees list upon acceptance into the PA Program, the cost of possible temporary housing, meals, transportation, and medical care is the student's responsibility. All clerkship schedule decisions rest with the clinical coordinators.

Cultural Humility

The range of clinical experiences will include working with patients of varied racial, ethnic, economic, geographic, and cultural backgrounds. Students will be assigned to sites in various geographical areas or work with patient populations with which they may be unfamiliar. Providing care to all populations is a central part of the mission of the PA profession. Students are expected to rotate to all sites to which they are assigned, regardless of geography or patient population.

Registration for Clinical Courses

Students must register each semester for their clinical rotations. Since the clinical year does not follow the academic calendar, students must take responsibility for registering each semester. Students must register using the following schedule:

Fall Semester

Rotations 1-3 and PHA CLRK 01*

Spring Semester: Rotations 4-6

Summer I

Summer II

Rotation 7

Rotation 8

* One-time clinical clerkship fee attached to CLRK 01 course in the Fall only. This is not clinical rotation.

Clerkships are considered courses. The codes for the clerkships are:

Family Medicine

Internal Medicine

Women’s Health

Surgery

Emergency Med

Pediatrics

Behavioral and Mental Health Care

Elective

PHA 250

PHA 255

PHA 260

PHA 265

PHA 270

PHA 280

PHA 285

PHA 290

Register for each clerkship in the order in which it is taken. The designation “R” before the course number refers to the sequence of the clerkship. For example, each student will register for the first rotation under “R-1”; the second “R-2” etc. Grades cannot be entered unless the correct clerkships appear in Banner in the proper semester and in the proper order. It is the responsibility of the student to update their registrations should a change occur in their clinical year schedule.

Course Coordinators

A clinical coordinator has been assigned to each course. The course coordinator is responsible for all aspects of the course. All questions relating to a specific course should be directed to the respective course coordinator listed below, however, please carbon copy (cc) the rest of the clinical team on your email.

Discipline

Family Medicine

Internal Medicine

Women’s Health

Surgery

Emergency Medicine

Pediatrics

Behavioral and Mental Health Care

Elective

Course Number

PHA 250

PHA 255

Course Coordinator

Professor Ricoy

PHA 260 Professor Tutuyan

PHA 265 Professor Tutuyan

PHA 270 Professor Ricoy

PHA 280

PHA 285

PHA 290

Policies Regarding Clinical Rotations

Security and Personal Safety

Professor Ricoy

Professor Tutuyan

Clinical year clerkship sites are evaluated by the clinical coordinators and deemed secure and safe for all students. Students should familiarize themselves with the location and telephone number of their clinical site’s security department. If a clinical year student feels their personal safety is being compromised, they should contact the on-site security department, the program, and alert their preceptor. If the site does not have a security department, the student is unable to reach a faculty

member at the program, and the preceptor is unavailable, the student is to call 911. If a clinical year student has questions or concerns regarding site security or safety, they may contact the program main office at 516-463-4074 or call the emergency clinical coordinator program mobile at 516-509-6470 after office hours. All students are required to complete the learning module “Promoting a Culture of Workplace Safety” and download the “Hofstra SAFE” app from the following website: https://www.hofstra.edu/public-safety/ before the start of the clinical year. Once the learning module is completed, upload your certificate to Exxat under required documents.

Exxat

Exxat is a software program that helps optimize clinical education during the clinical year. Exxat will contain preceptor and site contact information, orientation information, clinical forms, site required documents, clinical site forms, patient and procedure logging, clinical year evaluations and any other materials needed by students during the clinical year. All students are required to be familiar with the information in Exxat. As this information is continuously in flux, the student is responsible for the most current information. Each student is responsible for checking Exxat daily for important site updates. Students can log into Exxat at: https://apps.exxat.com.

Exxat Profile

All students will have an Exxat portfolio set-up before the start of the clinical year which will contain your student profile. This student profile will be sent to all clinical sites and preceptors. Each student profile will house personal demographics, various certifications, and health documents. Exxat currently does not have the capability to send emails directly to clinical sites and preceptors. Students will need to send their profile link through their own Hofstra email account via the following pathway:

Dashboard • My profile • Send Profile Link • Enter your Hofstra email address into the recipient box and hit send to obtain your Exxat profile link (Link will appear in your Hofstra inbox)

The student must copy and paste this link into the body of the email going to the clinical site. Only one email is necessary unless otherwise indicated. This email must be sent to all required site contacts and/or preceptors as indicated in the site requirements. To prevent any discrepancies, the clinical team recommends using the copy-and-paste feature when entering the recipient’s email addresses. Attach all completed site-required forms to your initial email unless otherwise specified on Exxat. The email being sent to your clinical site should state the following:

Subject: Hofstra PA Student, (Include rotation number and discipline), Rotation Dates: XX to XX

Dear Contact Person/Clinical Preceptor-

My name is ____________________. I am a Hofstra University PA student and scheduled to rotate through your ____________ department from _________ to __________.

Below is a link to my personal profile. My profile houses learning modules, health documents, various certifications, and completed site specific documents. Thank you.

Copy and Paste Profile Link Here

Thank you,

Student Name, PA-S

Clerkship Time Sheets

All students are required to complete a weekly timesheet on Exxat for their clerkship. Timesheets can be completed week by week or once for the entire rotation. Students are required to submit their timesheet no later than Friday of the first week, and every Monday thereafter if submitting weekly (when submitting timesheets students must click “submit” not “save”), it is strongly recommended that students strive to be at their clinical site for a minimum of forty hours per week to get the best possible clinical experience. Time sheets can be found on the Exxat dashboard underplacements • by session • time sheet. Time sheets will be utilized in determining when to schedule a site visit or place a call to a student. It will also assure the student and the program that the clinical site will average enough hours per week of clinical experience.

Your time sheet must be updated if your schedule changes for any reason. Any planned absence, lateness, or religious observance requests (including clinical year activity or required orientation for an upcoming clerkship) must be submitted via Exxat a minimum of 1 week prior and approved by the clinical coordinators. Your request is not approved until the clinical coordinators have reviewed your submission and sent you approval via Exxat. It is the student’s responsibility to check Exxat regarding your submission status. To submit or review your absence or lateness request via Exxat, students must locate the “my leave” section. The “my leave” section can be found on the Exxat dashboard underplacements • by session • my leave. The time used to make up absences must be similarly documented on Exxat in the “my leave” section. Failure to submit a clerkship timesheet for the entire six weeks of your clerkship or my leave request will result in a grade of “incomplete” until your submission is received.

Clinical Attendance

Clinical year students are required to follow the schedule set by their preceptor. Students should arrive at the facility before their scheduled shift and remain at the site until excused. Students are expected to take call as designated by the preceptor. Students are expected to work weekends, holidays, and overnight. University holidays and snow days do not pertain to the clinical year. If a student is unable to get to their clerkship due to adverse weather conditions, or told by the site to not come in, all students must still report the absence as outlined below. Students may not take vacations apart from those designated by the clinical year schedule. Should a student be physically present on a site but away from the team, they will be considered absent. It is not acceptable to go to the library to study or to be away from the team without the preceptor’s knowledge and permission.

If a student is unexpectedly unable to report to or will be late to a clinical activity for any reason, they are required to:

1. Call the course coordinator’s office phone ONLY (cell phone calls are reserved for emergencies) and e-mail the course coordinator. All emails require a cc to the clinical team before the start of your activity or shift.

2. Call and e-mail the clinical preceptor before the start of your scheduled shift.

3. Log your lateness or absence on Exxat in “my leave” and be specific on how many days or hours you will not be at their clinical site.

4. Update your “my leave” request with the dates/times of when you will be making up the missed time/shift once confirmed with your clinical site and preceptor.

If a student is feeling ill, they should NOT report to their clerkship and should follow the above clinical attendance protocol.

It is unacceptable to leave a message with the program administrative assistant. It is unacceptable for a student to call or email on behalf of another student.

If an absence due to an illness occurs the day before, the day after a holiday or for longer than 2 days, the student must provide the clinical coordinators with a note from a medical provider verifying the student was seen and uploaded onto Exxat under the “my leave” section. Any absence not related to a clinical year activity or required orientation for an upcoming clerkship, must be made up at the clinical site. There are no “personal days.”

Failure to report an absence and obtain approval from the clinical coordinators will result in an unexcused absence. An unexcused absence, a pattern of multiple excused absences, extended absences, or chronic lateness are subject to disciplinary action, including appearance before the Academic Standing Committee as outlined in the Student Handbook provided to students last year.

Additional information regarding attendance is found under “Clinical Year Examination Policy” and “Clinical Site Evaluation.”

Remote Learning

There may be times where synchronous and asynchronous online learning may occur. Below are policies related to online learning:

Video/Audio

Faculty and staff commonly use Zoom and Collaborate. Please install Zoom on all personal devices. Should additional software need to be downloaded, faculty and staff will provide instruction. Faculty strive to increase interaction with students regardless of the setting. Further, faculty feel strongly that it is important students are present and engaged during instructional sessions. As part of that initiative, faculty requires that video cameras remain on during online platform sessions, such as Zoom or Collaborate. If you are uncomfortable having others visualize what is behind you while participating, you may select a virtual background, set up the computer in front of a blank wall, or hang a drape. When you enter an online session, please ensure that your microphone is muted. If technical difficulties installing products or any other issue are encountered, please call the University Help Desk at 516-463-7777. Should you encounter technical difficulties during an instructional session, please email the Clinical team and then call the Help Desk. If technical difficulties arise on your main device which prevent you from being at the lecture, please log onto Zoom with an alternative device (e.g., cell phone, tablet, iPad)

Netiquette

While remote clinical activities may seem "relaxed", it is important to be cognizant of the comments you post in the chat, name displayed on your account and the background included in your video. Remote learning and platforms give you the option of using a virtual background if needed. Your attire should be professional, and your background should be respectful (do not lay down in your bed, drive around in your car, travel, etc.). This information and advice are especially important when participating in activities delivered by outside adjuncts and content experts, as these professionals may end up being your preceptor or be present in a future job interview. It is very easy for someone to misinterpret your communication and behavior during these remote activities. We need to ensure that we are representing the physician assistant profession and our program professionally.

Copyright Infringement

All students should be aware that unauthorized distribution of copyrighted material, including unauthorized peer-to-peer file sharing, may subject them to civil and criminal liability. Copyright infringement is the act of exercising, without permission or legal authority, one or more of the exclusive rights granted to the copyright owner under section 106 of the Copyright Act (Title 17 of the United States Code). These rights include the right to reproduce or distribute copyrighted work. In the file-sharing context, downloading or uploading substantial parts of a copyrighted work without authority constitutes an infringement. Penalties for copyright infringement include civil and criminal penalties. In general, anyone found liable for civil copyright infringement may be ordered to pay either actual damages or "statutory" damages affixed at not less than $750 and not more than $30,000 per work infringed. For "willful" infringement, a court may award up to $150,000 per work infringed. A court can, in its discretion, also assess costs and attorneys' fees. For details, see Title 17, United States Code, Sections 504, 505. Willful copyright infringement can also result in criminal penalties, including imprisonment of up to five years and fines of up to $250,000 per offense.

For more information, please see the website of the U.S. Copyright Office at www.copyright.gov, especially the FAQ at www.copyright.gov/help/faq. Students who engage in illegal downloading or unauthorized distribution of copyrighted material may also be charged with failure to comply with the Acceptable Use Guidelines in accordance with the procedures outlined in the Code of Community Standards and may be subject to loss of Hofstra University computing privileges, disconnection from the Hofstra network, and additional University sanctions as outlined in the Code of Community Standards.

University Policy Related to Absences for Religious Observance

For the clinical year, class time as detailed below is equated to clinical clerkships and all related clinical year activities. Students should report absences as described under the clinical year attendance policy.

Hofstra University recognizes that students and/or faculty may sometimes miss class due to religious observances. Students who anticipate missing class for this reason must notify faculty members and their current preceptor in advance. Likewise, faculty members who anticipate missing class for religious observance will notify students in their classes with as much notice as possible.

As per Faculty Policy Series 12 (B):

“No student shall be expelled or refused admission to Hofstra University because he or she is unable to participate in any examination, study, or work requirement because of his or her religious obligations and practices. However, all students are expected to complete all assignments and examinations. It is understood that no adverse or prejudicial effects shall result to any student who avails him or herself of religious observances. The University, faculty, and student shall work together to achieve a reasonable accommodation concerning any conflicts between educational and religious obligations.”

Faculty will publish notice of this policy in their syllabi and announce it during the first week of each semester and will further make reasonable efforts to avoid scheduling exams and/or due dates of assignments that would otherwise interfere with religious observances of students.

Additionally, in accordance with New York State Law, each student who is absent from school because of his or her religious beliefs will be given an equivalent opportunity to register for classes or

make up any examination, study, or work requirements which they may have missed because of that absence on any particular day or days.

Student & Preceptor Review of Instructional Objectives and Learner Outcomes

At the beginning of each clerkship, students must review the instructional objectives and learner outcomes with their preceptor. Instructional objectives and learner outcomes are in each syllabus. Once reviewed, the student and preceptor review of instructional objectives and learner outcomes form must be uploaded onto Exxat by the Friday of the first week of each clerkship. This form can be found on the Exxat dashboard underplacements • by session • to do list • session required documents. Failure to submit this form will result in a three (3) point deduction from the rotation grade (see appendix).

Preceptor Review and Countersignature

Students must ensure that each patient seen is evaluated by the supervising preceptor. The supervising preceptor must review and countersign all notes written by the student in a clinical setting. The student must sign each note with “PA-student” and not “PA-S” to prevent confusion. The supervising preceptor must countersign the note immediately.

The student is not authorized to initiate any orders for a patient without the consultation and the signature of the supervising preceptor. Students are not permitted to sign prescriptions or create eprescriptions. Failure to adhere to these policies will result in a disciplinary hearing before the Academic Standing Committee.

Clinical Year Stamps

All students must purchase a self-inking stamp to be used underneath their signature on all clinical documents during the clinical year. Stamps should include the following information:

Student’s Name PA Student Hofstra University

Elective Surgical Rotations

Students who chose surgical electives may work with preceptors who practice in specialty areas. These preceptors may have operating room privileges in hospitals or other facilities such as surgical centers which are not affiliated with the Program. These students will not be able to accompany the preceptor into the operating room in these circumstances. In some cases, the preceptor operates in an affiliated hospital, but additional paperwork or scrub class may need to be submitted before accompanying the preceptor in surgery. The clinical coordinators will assist you through this process. Students should consider the limits to operating room access before beginning a surgical elective rotation.

Blood Borne Pathogen Exposure Control Plan Policy

An exposure incident is defined as a specific eye, mouth, other mucous membrane, or non-intact skin contact with any potentially infectious material. Students should be aware that an infectious or environmental hazard exposure can adversely affect their overall health as well as performance in the Program.

1. Immediately wash the exposed skin area with soap and water. If your eyes are exposed, immediately flush with water. For mouth or other mucous membrane exposures, rinse with copious amounts of water.

2. If the exposure occurs on a clinical clerkship, the student shall IMMEDIATELY REPORT the incident to the Preceptor or clinician student is working with. The student will follow the institutional infectious and environmental hazard policy, including completing all necessary documentation as required, and proceed to step 5. The student must report the incident via telephone and email to one of the clinical coordinators as soon as possible but no later than 24 hours after.

3. If exposure occurs on the Hofstra University campus, the student shall IMMEDIATELY REPORT the incident to the course instructor. The course instructor should call Public Safety to report the incident. The number to call from a cell phone is: 516-463-6606 or from a campus landline phone: x36606. If the source individual is another student or faculty member, they will be instructed to call Student Health Services at 516-463-6745 prior before reporting to Wellness and Campus Living Center for determination of infectious disease status and proceed to step 6.

4. If exposure occurs at the Northwell Bioskills lab, the student shall IMMEDIATELY REPORT the incident to the course instructor. The course instructor will ensure the student irrigates and cleans the affected area. The course instructor will notify Northwell staff. The course instructor will ask Northwell staff for a copy of the Anatomy Gifts Registry specimen data sheet. The student must call Student Health Services at 516-463-6745 before reporting to Wellness and Campus Living Center and proceed to step 6.

5. The student must go to the nearest Hospital Emergency Department immediately after the incident to receive counseling, a physical examination, blood testing, and post-exposure prophylaxis if deemed appropriate by the health care provider. If possible, arrangements should be made to determine infectious disease state of the source person. This is generally done through established institutional protocols that are initiated by the health care provider evaluating student post exposure. Although this is recommended, this is not a requirement and should not delay post exposure management. In the absence of known source person status, risk assessment of the severity of exposure and HIV status of the source person should be completed by healthcare provider to determine post exposure management.

6. The Exposure Incident Investigation Form should first be filled out by the student as much as possible, ensuring details are included as well as recommendations for avoiding repetition, and then reviewed and signed by an Academic Coordinator if the incident occurred on campus or at the Northwell Bioskills lab, or a Clinical Coordinator if occurred on a clinical clerkship. This form must be completed and signed in person or virtually by the appropriate faculty member within 24-48 hours of exposure. The form is available in all program handbooks, including electronically on Exxat and at http://www.hofstra.edu/academics/colleges/nursing-physician-assistant/physicianassistant/physician-assistant-handbooks.html

7. A copy of the Exposure Incident Investigation Form, Post-Exposure Evaluation and Follow-up Checklist, and Emergency Department Discharge Papers (if applicable) should be brought to Hofstra University Student Health Services Center within 24-48 hours of exposure. In response to precautionary changes on campus associated with COVID-19, Student Health Services has implemented a phone triage system and requires all students to call first at 516-463-6745. When appropriate, clinicians may recommend an in-person evaluation. Hofstra University Student Health Services Center will complete the Post-Exposure Evaluation and Follow-Up Checklist. Follow-up is

confidential. The Student Health Services Center hours of operation, services, and personnel information can be found at: http://www.hofstra.edu/StudentAffairs/StudentServices/welctr/index.html

8. The Academic Coordinator or Clinical Coordinator will review all pertinent documents and place a copy of the Exposure Incident Investigation Form into the student’s file and provide a copy to the PA Program Director as soon as possible.

Dress Requirements

Dress requirements as outlined below, and each clinical sites policies and procedures must be strictly adhered to during the clinical year. One reason is safety – dress can increase or decrease the potential for injury. The second is that clinical year students represent both the physician assistant profession and Hofstra University. Therefore, students must look professional while interacting with patients and health professionals at clinical sites and related facilities.

Students should wear business attire while on clinical clerkships and at related facilities. Button-down shirts with ties, dress pants, professional tops or blouses, appropriate length skirts and dresses should be worn. Closed-toed shoes with socks or stockings as well as a short white uniform jacket must always be worn. Each student should wear a watch with a second hand. Bracelets are not permitted on clinical clerkships or at program-related facilities. Students should avoid wearing insignia, buttons, or decals of a political nature while on clinical clerkships or at program-related facilities. ID badges must be worn daily and should be easily visible.

Unacceptable clothing includes:

• Revealing clothing

• Open-toed shoes

• Tight pants, leggings, or shorts

• T-shirts, sweatshirts, or sweatpants

• Any clothing made of denim

• Clothing that exposes the mid-abdomen

• Clothing that is soiled, in poor repair, or not well maintained.

Students may wear scrubs only while in the operating room, emergency room or in the delivery room. Students may wear sneakers only while wearing scrubs as listed above. Students may not wear scrubs while outside the hospital, or while traveling to or from the hospital. All students are required to follow the designated scrub policy for each hospital or facility.

Hair must be pulled back away from the face if it is longer than shoulder length. Fingernails must be less than ¼ inch long. Nail polish should not be worn while on rotations that requires the student to scrub. No artificial nails, wraps, multi-colored or designer nail polish or nail paintings are permitted.

Some patients may be sensitive to fragrances, particularly when ill. Students should be sensitive to the needs of patients and avoid wearing fragrances while in the health care setting. Only post earrings are permitted. Consider removing body piercings.

Sexual Misconduct and Other Unlawful Harassment

Sexual relations between a PA student and a patient are unethical, regardless of who initiated the relationship. Sexual relations between a PA student and clinical staff at a site are similarly unacceptable. As a result, no PA student shall engage in sexual relationships or conduct that may reasonably be perceived as inviting or encouraging a sexual relationship, with a patient or with clinical staff at a site. Violation of this policy by a PA student will result in dismissal from the program.

Sexual harassment of a physician assistant student by a preceptor or other rotation site employee is a serious matter. Hofstra University has a Harassment Policy, found at www.hofstra.edu/harassment prohibiting sexual harassment and prohibiting harassment based on any characteristic protected by law.

Any PA student who experiences sexual harassment, or any form of unlawful harassment, must report it immediately to the Hofstra clinical coordinators and/or to the University’s Equal Rights and Opportunity Officer. Hofstra University policies, procedures, and resources for those who believe they have experienced sexual or other unlawful harassment may be found in Hofstra University’s Nondiscrimination Policy at www.hofstra.edu/eoe Retaliation against anyone who makes a report of sexual or other unlawful harassment is prohibited.

Call Back Day

Students will return to campus, the Center for Learning and Innovation (CLI) and/or the Science and Innovation Center (SIC) at the end of each clerkship for one or two days for clinical year activities. At times call back may involve a remote clinical year activity via zoom. This is up to the clinical team's discretion, and students will be notified in advance. Call back day dates and locations can be found at the beginning of the handbook and on Exxat in the “student packet” section. Call back day activities can include lectures, case presentations, clinical skills workshops, and simulated patient encounters. All callback day activities are mandatory. Activities will vary throughout the year, however every student, except those on their elective rotations will take a Physician Assistant Education Association (PAEA) end of rotation exam on call back day. Should an absence be unavoidable, the clinical coordinator must be contacted PRIOR to the date to discuss the legitimacy of the absence. A student leaving an on-site or remote call back day early, without notifying the clinical coordinator will result in a 5-point deduction from the overall clerkship grade. Any unexcused absence from call back day will result in a 10-point deduction from the overall clerkship grade and an incomplete will be submitted for the course until all assignments have been completed successfully.

Call Back Day Structure

Call back day activities for rotations 1, 2, 3 and 6 will be one day in length and held on campus or remotely, if decided by the clinical team. All students on core rotations will take their PAEA end of rotation examination. Students on their elective rotation (rotation 6 only) must present their interesting case to their assigned group. A guest lecture/workshop activity will be scheduled for rotations 1, 2, and 3.

Call back day activities for rotations 4, 5, 7 and 8 will be two days in length. Day one of call back day will be on campus or remote and require all students on core rotations to take their PAEA end of rotation examination. Students on their elective rotation must present their interesting case to their

assigned group. A guest lecture/workshop activity may also be scheduled. Day two of call back day will be at SIC or remote and include a longitudinal patient care experience.

Students are required to fill out a Call Back Day Lecturer Evaluation on Exxat within one week of the call back day for any scheduled lecturers. This evaluation can be found from the dashboard • placements • by session • to do list • eval summary • call back day lecturer evaluation. Failure to do so will result in a three-point deduction from the overall rotation grade.

Clinical Year Examination Policy

Almost all multiple-choice examinations are administered utilizing an online format in a computer lab or with a laptop. At the end of each clerkship, except for the elective clerkship, students will be required to take a PAEA End of Rotation exam. If a student arrives late, no additional time will be granted to take the exam. Arriving more than fifteen minutes late for an exam will result in a five (5) point deduction in the exam grade. Should an unexcused absence occur for an exam, the student will need to meet with the Academic Standing Committee (ASC). If the opportunity to take the exam at a later time is granted by the ASC, the highest possible grade the student would receive would be 65%, regardless of the score. Any student with an excused absence on the day of the examination may result in a five (5) point deduction from the examination grade.

No student can take the day off before an end-of-rotation exam to study or complete assignments. If this type of unexcused absence occurs, the student will receive ten points off the final grade for the clerkship and must meet with the Academic Standing Committee

Student Success and Focused Remediation

The program faculty continuously monitors student performance throughout the didactic, clinical, and research phases of the program. Students identified to fall below program-defined academic and professional benchmarks will be given additional guidance and tools as soon as possible and entered a structured or focused remediation program. The intent of these processes is to ensure students are able to successfully complete the program and ultimately pass the PANCE examination. The process is not intended to be punitive.

The process is as follows:

1. Program faculty monitor examination scores throughout all phases of the program. Students falling 2 standard deviations below the class average on more than one clinical medicine examination, failure of one or more end of rotation exam and program competency examinations will be identified as falling below the program benchmark and holistically evaluated for possible remediation assistance or exclusion at the end of each semester.

2. The Remediation coordinator will notify faculty advisors of any student who meets criteria outlined above (see item 1), and an individualized remediation plan will be developed based on deficiency.

*Clinical students who maintain a z score of minus >.09 (-.09) on 3 or more exams will be holistically evaluated and possibly removed from focused remediation. Faculty will continue to monitor performance throughout the remainder of the program.

PAEA Examination Grade & Review Policy

Within 24 hours of submitting the exam, each student will receive an email from PAEA containing the raw score and feedback on incorrectly answered exam questions. This feedback should be saved and used for remediation and studying for the PANCE. Within 72-hours after receiving your PAEA raw score the clinical coordinators will convert your raw score to a numerical grade and post on Exxat. Your grade can be found from the Exxat dashboard under- my current placement • evaluations • PAEA End of Rotation Examination Grade.

To calculate your PAEA EOC Exam grade please utilize the below process:

and less (failure of PAEA exam)

3.1 - 3.5

3.51 or greater

** z score less than minus 1.86 is considered a PAEA exam failure

End-of-Rotation Examination Failure

A passing grade for end-of-rotation examinations is 65%. Should a student fail the end-of-rotation exam, the student will be given the opportunity to take a make-up PAEA exam. A grade of 65% or better must be achieved on the PAEA make-up exam to pass the clerkship. A grade of 65% will be entered for this portion of the final grade, regardless of the passing grade earned for the make-up exam. A failure of the make-up examination will result in failure of the clerkship.

Students are permitted to take no more than two (2) make-up exams for the entire clinical year. Any student who fails two end-of-rotation exams will be called before the Academic Standing Committee

and placed on academic probation. Failing a third end-of-rotation exam will result in an appearance before the Academic Standing Committee and dismissal from the Program.

Clinical Site Evaluation of the Student

Each student will have one (1) site evaluation during the clinical year. The student will be visited in person by one of the clinical coordinators at their clinical site, or remotely via zoom, within the last two weeks of the clerkship. The site visit schedule for each rotation will be posted in the “Student Packet” section of Exxat. The site evaluation assesses student command of clinical knowledge of the discipline practiced at the site. Notification for a visit can vary from five weeks to 24 hours beforehand. In the unlikely event that a student is unable to be present for the site visit, the clinical coordinators must be notified at least 24 hours prior to the visit. If a student is scheduled for a remote site visit, the clinical coordinator assigned to the site visit will send you a zoom link with the date and time of your visit. All students should be prepared to present the course assignment (i.e., Health Promotion, H & P/SOAP, or Interesting Case) outlined in the syllabus at the time of the site visit. Students should review the grading evaluation forms in the appendix section of the handbook or in the “student packet” section on Exxat under “Grading Forms for Clinical Assignments.” Students should be prepared to present on all required components of the grading rubric.

Students are responsible to have the below documentation uploaded onto Exxat in the “Session Required Documents” section designated for that rotation prior to their in-person or remote site visit:

1) Depending upon the clerkship syllabus, presentation* of one H&P or SOAP note, if applicable.

2) Presentation of three (3) pharmaceutical agents (called “drug cards”). Students will be asked questions by the clinical coordinator during the site visit. Students will not be able to read from their drug cards. Students are responsible for knowing all information on their drug cards.

3) Depending upon the clerkship syllabus, if applicable, presentation* of one of the following:

• Interesting Patient Case Assignment

• Health Promotion Project

An unexcused absence will result in a failure of this component of the clerkship grade. If the student is not prepared for the clinical coordinator at the time of the site visit, thestudent will receive a zero for any missing component of the site visit grade.

*Presentation can be done via Microsoft Word or PowerPoint

Clerkship Grades

Each clinical clerkship must be passed to graduate from the program. A course grade below 70% will result in failure of the course.

Clinical Clerkship Failure

A student will fail a clinical clerkship if:

1. A failing grade at any point in the clerkship is submitted by a preceptor on the Preceptor Evaluation Form.

2. A failing grade is earned on the PAEA end-of-rotation examination. Failure is defined as less than 65% on both the initial and the make-up PAEA exam.

3. The total clerkship grade is less than 70%.

Should a student fail a clerkship, the rotation will be repeated at the end of the research semester, thereby extending the length of the curriculum. Graduation will be delayed. The student will be responsible for all associated costs of repeating the failed clerkship. A failed rotation will result in the student appearing before the Academic Standing Committee and placement of the student on academic probation for the duration of study in the Hofstra University Program in Physician Assistant Studies.

Two failed clerkships will result in reappearance before the Academic Standing Committee. All extenuating circumstances will be considered. Dismissal from the program will be considered at that time.

Mid-Clerkship Evaluation

The mid-clerkship evaluation forms are completed and submitted on Exxat by the end of the third week of each clerkship (See appendix). Once the deadline has passed, the evaluation will be locked on Exxat. This evaluation instrument is designed for students to facilitate a conversation with their preceptor to determine their strengths and weaknesses early so that the opportunity to identify and address deficiencies is possible in a timely manner. This tool also provides the program with feedback regarding clerkship quality. Lastly, it allows the course coordinator to identify problems with a clinical site and/or an issue with an individual student, allowing the course coordinator to follow-up with the student in a timely manner regarding the identified deficiency. If the midclerkship evaluation is not submitted on time, three (3) points will be deducted from the final grade for the rotation. Additionally, students who miss the deadline must email the clinical secretary to unlock the evaluation.

The procedure for submitting the mid-clerkship evaluation form on Exxat is as follows:

• Start from dashboard

• Then go to my current placement

• Click on the rotation number

• Click “Evaluation Summary” under the “To Do” list

• Select mid-clerkship evaluation form

• Fill out the evaluation by clicking the green pencil icon

• Submit evaluation

Student Clinical Site & Preceptor Evaluation

The Student Clinical Site & Preceptor Evaluation form is to be completed and submitted on Exxat (see appendix). Student feedback and comments are vital to the growth and continued improvement of the program. Students must submit their evaluation of each clerkship on Exxat prior to the start of call back day. Once the deadline has passed the evaluation will be locked on Exxat. Three (3) points will be deducted from the FINAL GRADE for the course if the student evaluation is submitted late. Additionally, students who miss the deadline must email the clinical secretary to unlock the evaluation.

The procedure for submitting the student clinical site & preceptor evaluation form on Exxat is as follows:

• Start from dashboard.

• Then go to my current placement.

• Click on the rotation number.

• Click “Evaluation Summary” under the “To Do” list.

• Select student clinical site & preceptor evaluation form.

• Fill out the evaluation by clicking on the green pencil icon.

• Submit the evaluation.

Submitting Call Back Day Materials

All materials must be completed and uploaded on Exxat prior to the start of call back day. Students should upload all call back materials to the “Session Required Documents” section in the “To Do List” on your Exxat dashboard. Once the deadline has passed, this section will be locked on Exxat. Failure to do this will result in a three (3) point deduction from the final rotation grade. The following materials must be uploaded or completed on Exxat:

• Clinical Documentation (only if an H&P or SOAP is listed in the syllabus)

• Preceptor End of Rotation Evaluation

• Student Clinical Site & Preceptor Evaluation

• Signed and stamped Exxat log specific to your rotation

• Interesting Patient Case Assignment (if listed in the syllabus)

• Health Promotion Project (if listed in the syllabus)

• Peer reviewed journal article relating to your interesting patient case assignment (if listed in the syllabus).

• Elective Interesting Case Presentation (if listed in the syllabus). Please note that if your presentation is too large to upload to Exxat, please email the PowerPoint to the clinical team prior to your presentation.

• Three (3) Pharmaceutical “Drug Cards” (may be typed)

Clerkship Grades

The grading for each rotation takes five – six weeks from the previous call back day. Students can find their grades in the evaluation summary section on Exxat. From the dashboard • My placements or To Do List • Evaluation Summary.

Clinical Year

Syllabi

PHA 250 FAMILY

MEDICINE

COURSE COORDINATOR (B1.03c)

CLERKSHIP 3 s.h. (B1.03a, B3.04c, B3.07a)

Shannan Ricoy, M.S., PA-C; Email: Shannan.Ricoy@hofstra.edu Office: 516-463-4233

COURSE DESCRIPTION (B1.03b)

This course is a supervised clinical experience where students function under the supervision of family medicine preceptors who enable students to meet learning outcomes for conditions encountered in a family medicine setting. All students will complete this clerkship in an outpatient setting (B3.04c) The student will participate in the evaluation and monitoring, addressing preventative care, and helping manage patients needing family medicine management. Emphasis is placed on evaluation, management, health promotion, and preventive medicine.

COURSE GOAL (B1.03d)

This clerkship’s goal is to enhance students’ knowledge of the general principles of family medicine and to expose them to patients with a variety of family medicine-related conditions. The students will have the opportunity to participate in the care of patients with multiple medical complaints. The student will assess common problems by taking a medical history, performing a physical examination, ordering and interpreting diagnostic studies, and formulating management plans for patients requiring preventative, acute, and chronic care.

INSTRUCTIONAL OBJECTIVES, COURSE LEARNING OUTCOMES, AND ASSESSMENT TOOLS, SPECIFIC TO FAMILY MEDICINE

The instructional objectives listed below are used to guide the students in achieving the course learning outcomes. The instructional objectives and thus, the course learning outcomes are measured by the assessment tool listed in the appropriate column. The instructional objectives and course learning outcomes, as measured by the assessment tool, guide students toward the acquisition of the program competencies. The following represents instructional objectives, course learning outcomes, and assessment tools specific to the Family Medicine clerkship.

Instructional Objectives

By the conclusion of the Family Medicine clerkship, students will demonstrate competency in the following: (B1.01d, B1.03e, B3.07a)

Course Learning Outcomes

Upon successful completion of this clerkship, students will attain the following knowledge, interpersonal, clinical/technical skills, professional behaviors, clinical reasoning, and problem-solving abilities: (B1.01d, B1.03e, B3.07a)

Assessment Tools Utilized

Program Competencies

Competency of instructional objectives and learner outcomes are measured by successful completion of the following assessment tools: (B1.03e, B1.03g, B4.01a)

The instructional objectives, learning outcomes, and successful completion of course assessments guide students toward the acquisition of the following Program

Competencies: (B1.01b, B1.03e, B4.01a)

• Elicits a detailed history of patients with a family medicine condition. (B3.07a)

• Perform an appropriate physical examination on patients with a family medicine condition. (B3.07a)

When presented with a patient with a family medicine condition, the student will use effective interviewing skills to perform a comprehensive evaluation that includes a detailed history and physical examination (B3.07a)

• Preceptor evaluation

• Clerkship specific patient encounter requirements

• Elicit a detailed medical history, perform appropriate physical examination, and accurately record all pertinent data. (MK5)

• Use effective interviewing skills to elicit a detailed history. (IC1)

• Selects appropriate diagnostic studies to order for patients with a family medicine condition. (B3.07a)

• Interpret diagnostic studies for patients with a family medicine condition. (B3.07a)

When presented with a patient with a family medicine condition, the student can appropriately use diagnostic studies to aid in the diagnosis. (B3.07a)

• Formulate a differential diagnosis for patients with a family medicine condition. (B3.07a)

• Appropriately diagnose patients with a family medicine condition. (B3.07a)

When presented with a patient with a family medicine condition, the student will be able to develop a differential diagnosis and determine the most likely diagnosis. (B3.07a)

• Preceptor evaluation

• Clerkship specific patient encounter requirements

• Virtual Patient Case Assignment

• EOC Exam

• Preceptor evaluation

• Virtual Patient Case Assignment

• Clerkship specific patient encounter requirements

• EOC Exam

• Select and interpret appropriate screening and diagnostic studies. (MK7)

• Identify and formulate an appropriate assessment and management plan (MK6)

• Formulates a management plan that uses consultations appropriately for patients with a family medicine condition. (B3.07a)

• Provides information regarding health promotion when caring for family medicine patients. (B3.03b, B3.07a)

• Provides information regarding disease prevention when caring for family medicine patients. (B3.03b, B3.07a)

• Creates a pharmacological plan for patients with a family medicine condition. (B3.07a)

• Formulates a plan that includes nonpharmacological management for patients with a family medicine condition. (B3.07a)

• Formulates a plan inclusive of appropriate referrals for patients with a family medicine condition. (B3.07a)

• Formulates a plan that includes follow up for patients with a family medicine condition. (B3.07a)

• Provides effective patient education to patients with a family medicine condition. (B3.07a)

• Emphasizes shared decision making for patients with a family medicine condition. (B3.07a)

• Applies the evidence from scientific studies to family medicine patient cases. (B3.07a)

• Performs effective oral presentations for patients with a family medicine condition. (B3.07a)

When presented with a patient with a family medicine condition, focusing on shared decision making, the student will be able to formulate a management plan including the use of appropriate consults, pharmacologic plan, non-pharmacologic care, referral, follow up and patient education. (B3.07a)

• Preceptor evaluation

• Drug cards

• Health Promotion Project

• Virtual Patient Case Assignment

• Clerkship specific patient encounter requirements

• EOC Exam

• Identify and formulate an appropriate assessment and management plan (MK6).

• Provides appropriate referrals (IC4).

• Use effective basic counseling and patient education skills that enable shared decision making (IC6).

• Locate, appraise, and apply evidence from scientific studies to enhance patient care. (CRPSA3)

• Understand the principles of preventative medicine and how they apply to clinical practice. (SPH5)

When presented with a patient with a family medicine condition, the student will effectively orally present patients. (B3.07a)

• Preceptor Evaluation

• Effectively complete oral presentations (IC3)

• Accurately documents patient data for patients with a family medicine condition. (B3.07a)

When presented with a patient with a family medicine condition, the student will accurately record all data. (B3.07a)

• Clerkship specific patient encounter requirements

• Preceptor Evaluation

• Clerkship specific patient encounter requirements

• Accurately provides preventive care to family medicine patients. (B3.03a, B3.07a)

• Accurately evaluates patients with acute conditions associated with family medicine. (B3.03a, B3.07a)

• Accurately evaluates patients with chronic conditions associated with family medicine. (B3.03a, B3.07a)

• Accurately evaluates adult patients (1864 yo) with family medicine conditions. (B3.03b, B3.07a)

• Accurately evaluates elderly patients (65 and older) with family medicine conditions. (B3.03b, B3.07a)

When presented with a patient with a family medicine condition, students will be able complete a history, perform a physical examination, formulate an assessment, and create a management plan for the following categories of patient encounters:

• for preventative, acute, and chronic patient encounters. (B3.03a, B3.07a)

• across the life span, to include adults, and the elderly. (B3.03b, B3.07a)

• Preceptor Evaluation

• Clerkship specific patient encounter requirements

• Elicit a detailed medical history, perform appropriate physical examination, and accurately record all pertinent data. (MK5)

• Accurately document medical information (IC2)

• Discern among acute, chronic, and emerging disease states. (MK2)

• Elicit a detailed medical history, perform appropriate physical examination, and accurately record all pertinent data. (MK5)

• Identify and formulate an appropriate assessment and management plan. (MK6)

• Understand the principles of preventative medicine and how they apply to clinical practice. (SPH5)

• accurately evaluate patients for hypertension. (B3.07a)

• Accurately evaluates patients with congestive hyperlipidemia. (B3.07a)

• Accurately evaluate patients with diabetes. (B3.07a)

When in a family medicine setting, the student can appropriately evaluate patients with common conditions such as hypertension, hyperlipidemia, and diabetes. (B3.07a)

• Preceptor Evaluation

• Elicit a detailed medical history, perform appropriate physical examination, and accurately record all pertinent data. (MK5)

• Identify and formulate an appropriate assessment and management plan (MK6).

INSTRUCTIONAL OBJECTIVES, COURSE LEARNING OUTCOMES, AND ASSESSMENT TOOLS COMMON TO ALL CLERKSHIPS

Instructional Objectives

By the conclusion of the Family Medicine clerkship, students will demonstrate competency in the following: (B1.01d, B1.03e, B3.07a)

Course Learning Outcomes

(B1.01d, B1.03e, B3.07a)

Assessment

Tools Utilized

Competency of instructional objectives and learner outcomes are measured by successful completion of the following assessment tools:

(B1.03e, B1.03g, B4.01a)

Program Competencies

The instructional objectives, learning outcomes, and successful completion of course assessments guide students toward the acquisition of the following Program Competencies: (B1.01b, B1.03e, B4.01a)

• Effectively communicates with patients. (B3.07a)

• Effectively communicates with families. (B3.07a)

• Effectively communicates with members of the health care team. (B3.07a)

When presented with a patient with a family medicine condition, the student will develop relationships that result in effective communication with patients, their families, and members of the interprofessional team. (B3.07a)

• Preceptor evaluation

• Demonstrates empathy. (B3.07a)

• Demonstrates respect. (B3.07a)

• Demonstrates ethical behavior. (B3.07a)

When presented with a patient with a family medicine condition, the student demonstrates empathy, respect, and appropriate ethical behavior. (B3.07a)

• Preceptor evaluation

• Use effective interviewing skills to elicit a detailed history. (IC1)

• Understands the importance of effective communication with patients, families, physicians, and other members of the care team. (IC7)

• Demonstrate empathetic and respectful behaviors. (PB1)

• Demonstrates and identifies appropriate ethical behavior. (PB4)

• Demonstrates reliability. (B3.07a)

• Demonstrates accountability. (B3.07a)

• Demonstrates dependability. (B3.07a)

• Exhibits a positive approach to learning. (B3.07a)

• Demonstrate an understanding of diverse health care needs. (B3.07a)

When presented with a patient with a family medicine condition, the student exhibits reliability, dependability, and is accountable. (B3.07a)

• Preceptor evaluation • Exhibit reliability, accountability, and dependability. (PB2)

• Demonstrates accountability to patients, society, and the profession (PB6).

When presented with a patient with a family medicine condition, the student can understand the diverse needs of patients.

(B3.07a)

• Utilize appropriate clinical reasoning and problem-solving abilities. (B3.07a)

• Analyze clinical data correctly.

(B3.07a)

• Demonstrate care that is effective. (B3.07a)

• Demonstrate care that is safe. (B3.07a)

• Demonstrate care that is equitable. (B3.07a)

• Demonstrate care that is of high quality. (B3.07a)

When presented with a patient with a family medicine condition, the student will be able to utilize the clinical reasoning and problem-solving abilities, inclusive of synthesizing and analyzing clinical data, to appropriately evaluate the patient. (B3.07a)

• Preceptor evaluation Demonstrates an understanding of diverse health care needs (IC8).

When presented with a patient with a family medicine condition, the student will provide effective, safe, equitable, and high-quality care. (B3.07a)

• Preceptor evaluation • Utilize appropriate clinical reasoning and problemsolving abilities to identify and manage medical conditions (CRPSA1).

• Synthesize and analyze clinical data correctly (CRPSA2).

• Preceptor evaluation Demonstrate care that is effective, safe, equitable, and high quality (CRPSA4).

OUTLINE OF TOPICS COVERED IN THIS COURSE (B1.03f)

Family medicine topics covered in this course are outlined below. They are derived from the PAEA Family medicine topic list found here: https://paeaonline.org/assessment/end-of-rotation/content. Success requires an understating of the definition, etiology, risk factors, pathophysiology, clinical presentation, diagnostic work-up and management of patients with these conditions.

CARDIOVASCULAR

Angina, Arrhythmias, Chest pain, Congestive heart failure, Coronary artery disease, Endocarditis, Hyperlipidemia, Hypertension, Hypertriglyceridemia, Peripheral vascular disease, valvular disease

PULMONOLOGY

Asthma, Bronchitis, Chronic obstructive pulmonary disease, Lung cancer, Pneumonia, Sleep disorders, Tobacco use/dependence, Tuberculosis

GASTROINTESTINAL/NUTRITIONAL

Anal fissure, Appendicitis, Bowel obstruction, Cholecystitis/cholelithiasis, Cirrhosis, Colorectal cancer/colonic polyps, Diarrhea/constipation, Esophagitis, Gastritis, Gastroenteritis, Gastroesophageal reflux disease, Gastrointestinal bleeding, Giardiasis and other parasitic infections, Hemorrhoids, Hiatal hernia, Inflammatory bowel disease, Irritable bowel syndrome, Jaundice, Pancreatitis, Peptic ulcer disease, Viral hepatitis

ENOT/OPHTHALMOLOGY

Acute/chronic sinusitis, Allergic rhinitis, Aphthous ulcers, Blepharitis, Cholesteatoma, Conjunctivitis, Corneal abrasion, Corneal ulcer, Dacryocystitis, Ectropion, Entropion, Epistaxis, Glaucoma, Hordeolum, Hyphemia, Labyrinthitis, Laryngitis, Macular degeneration, Meniere disease, Nasal polyps, Otitis externa, Otitis media, Papilledema, Parotitis, Peritonsillar abscess, Pharyngitis/tonsillitis, Pterygium, Retinal detachment, Retinal vascular occlusion, Retinopathy, Sialadenitis, Tinnitus, Tympanic membrane perforation

OBSTETRICS/GYNECOLOGY

Breast cancer, Breast mass, Cervical cancer, Contraception, Cystocele, Dysfunctional uterine bleeding, Dysmenorrhea, Intrauterine pregnancy, Menopause, Pelvic inflammatory disease, Rectocele, Spontaneous abortion, Vaginitis

ORTHOPEDICS/RHEUMATOLOGY

Acute and chronic lower back pain, Bursitis/tendonitis, Costochondritis, Fibromyalgia, Ganglion cysts, Gout, Osteoarthritis, Osteoporosis, Overuse syndrome, Plantar fasciitis, Reactive arthritis, Rheumatoid arthritis, Sprains/strains, Systemic lupus erythematosus

NEUROLOGY

Alzheimer disease, Bell palsy, Cerebral vascular accident, Delirium, Dementia, Dizziness, Essential tremor, Headaches (cluster, migraine, tension), Parkinson disease, Seizure disorders, Syncope, Transient ischemic attack, Vertigo

DERMATOLOGY

Acanthosis nigricans, Acne vulgaris, Actinic keratosis, Alopecia, Basal cell carcinoma, Bullous pemphigoid, Cellulitis, Condyloma acuminatum, Dermatitis (eczema, seborrhea), Drug eruptions, Dyshidrosis, Erysipelas, Erythema multiforme, Exanthems, Folliculitis, Hidradenitis suppurativa, Impetigo, Kaposi sarcoma, Lice, Lichen planus, Lichen simplex chronicus, Lipomas/epithelial inclusion cysts, Melanoma, Melasma, Molluscum contagiosum, Nummular eczema, Onychomycosis, Paronychia, Pilonidal disease, Pityriasis rosea, Pressure ulcers, Psoriasis, Rosacea, Scabies, Seborrheic keratosis, Spider bites, Stevens-Johnson syndrome, Tinea infections, Tinea versicolor, Toxic epidermal necrolysis, Urticaria, Verrucae, Vitiligo

ENDOCRINOLOGY

Adrenal insufficiency, Cushing disease, Diabetes mellitus, Hyperthyroidism, Hypothyroidism

PSYCHIATRY/BEHAVIORAL MEDICINE

Anorexia nervosa, Anxiety disorders, Bipolar disorders, Bulimia nervosa, Insomnia disorder, Major depressive disorder, Panic disorder, Posttraumatic stress disorder, Specific phobia, Spouse or partner neglect/violence, Substance use disorders, Suicide

UROLOGY/RENAL

Balanitis, Benign prostatic hyperplasia, Chlamydia, Cystitis, Epididymitis, Glomerulonephritis, Gonorrhea, Hernias, Nephrolithiasis, Orchitis, Prostatitis, Pyelonephritis, Testicular cancer, Urethritis

HEMATOLOGY

Anemia, Clotting disorders, Leukemia, Lymphomas, Polycythemia, Thrombocytopenia

INFECTIOUS DISEASES

Human immunodeficiency virus, Influenza, Lyme disease, Meningitis, Mononucleosis, Salmonellosis, Shigellosis

URGENT CARE

Acute abdomen, Allergic reaction/anaphylaxis, Bites/stings, Burns, Cardiac failure/arrest, deteriorating mental status/unconscious patient, foreign body aspiration, Fractures/dislocations, Hypertensive crisis, Ingesting harmful substances (poisonings), Myocardial infarction, Orbital cellulitis, Pneumothorax, Pulmonary embolus, Respiratory failure/arrest, Sprains/strains, Third trimester bleeding

ARC-PA STANDARDS

B3.03 Supervised clinical practice experiences musts enable all students to meet the program’s learning outcomes: a) for preventative, emergent, acute, and chronic patient encounters,

b) across the life span, to include infants, children, adolescents, adults, and the elderly, c) for women’s health (to include prenatal and gynecologic care), d) for conditions requiring surgical management, including pre-operative, intra-operative care, post-operative care and e) for behavioral and mental health conditions.

B3.04 Supervised clinical practice experiences must occur in the following settings:

a) emergency department, b) inpatient, c) outpatient, and d) operating room.

B3.07 Supervised clinical practice experiences must occur with preceptors who enable students to meet program defined learning outcomes for:

a) family medicine, b) emergency medicine, c) internal medicine, d) surgery, e) pediatrics,

f) women’s health including prenatal and gynecological care, g) behavioral and mental health care.

STUDENT ASSESSMENT/EVALUATION (B1.03g)

Clerkship Specific Assessments

The grade for the Family Medicine clerkship is based on the following components:

Promotion Project

Evaluation

Clerkship Specific Patient Encounter Requirements

Virtual Patient Case Assignment

GRADING PLAN (B1.03h)

Passage of the clerkship course requires an overall average grade of 70% or greater.

Grade Calculations

Each grade entered into the gradebook is rounded to the 100th (i.e., 92.60). The final calculation for the course is rounded to the whole number (i.e., 93) and then converted to the letter grade (i.e., A).

CLERKSHIP SPECIFIC ASSESSMENTS

HEALTH PROMOTION PROJECT

An important element of the family medicine clerkship is to provide patient centered care by promoting healthy lifestyles, identifying risky behavior, and preventing complications from chronic illness. Therefore, during the family medicine rotation, students will be required to complete a health promotion project. This project's objective is to explore ways to enable patients to increase control over risk factors, thereby improving health outcomes. This project provides a vehicle for students to counsel, teach and support patients about preventive measures for their disease states and to evaluate the effectiveness of their efforts.

The student will choose a patient with chronic illness or lifestyle risk factors and provide counseling. Afterward, the student completes the questionnaire found in the appendix. Question number 4 requires that the student follow-up with the patient. This can be accomplished via a follow-up visit or by telephone conversation. Should a telephone conversation be chosen, permission must be obtained from the patient, and the site preceptor. Question 5 requires that the student read and submit an academic article, no more than five years old, that discusses the health promotion issues related to the patient. A one-paged, typed, double-spaced paper summarizing the article and discussing how to implement the recommendations is submitted and/or presented during the site visit or on call back day should a site visit not occur. Failure to submit this project on Exxat will result in a grade of zero for this portion of the clerkship grade.

If a passing grade is not achieved, the student must remediate by completing another interesting case assignment until a passing grade of 70% or higher is achieved. Once competency is demonstrated, 70% will be entered into Exxat for the interesting case assignment.

DRUG CARDS

not be able to read their cards. Students who do not have a site visit should upload them onto Exxat under “Session Required Documents” prior to the start of call back day. Student name, date and number must be listed on each drug card. Drug cards may be typed and submitted in word format. Should a student fail to produce these cards on a site visit or upload onto Exxat prior to the start of call back day, they will receive an incomplete for this clerkship. An incomplete remains until the student completes the requirement. If a passing grade is not achieved, the student must remediate the assignment as directed by the clinical coordinator until competency is achieved.

PRECEPTOR EVALUATION

Clerkship specific preceptor evaluations are used to evaluate student performance. The preceptor evaluations are based on the instructional objectives provided above and assist students with meeting the course learning outcomes. Students should review the instructional objectives and course learning outcomes above in preparation for clerkship and should review the preceptor evaluation. Copies of the clerkship specific preceptor evaluation can be found at the back of your clinical handbook and is posted on Exxat in the “Student Packet” section under “Generalized Documents.”

The preceptor evaluation will be sent to the preceptor via email from Exxat towards the end of each clerkship. Students are encouraged to discuss the evaluation with their preceptor. Students are responsible for ensuring that an evaluation is completed for each clinical clerkship. Students must make every reasonable effort to follow-up with the site to ensure that the evaluation is completed in a timely fashion. A grade less than 60 on the preceptor evaluation constitutes a failure. A failing preceptor evaluation during the clerkship will result in clerkship failure. Please see the clinical handbook for additional policies.

END OF CLERKSHIP EXAMINATION (EOC Exam)

To assess the student’s comprehensive knowledge in Family Medicine, a 120-question multiple-choice examination is given at the end of the clerkship. This end of rotation examination is offered by the Physician Assistant Education Association (PAEA) and is developed by PA educators for use during the clinical year. It is a peer-reviewed exam that incorporates current, relevant test items that follow the NCCPA tasks and blueprints and corresponding PAEA blueprints and topic lists.

To assist with preparation for the examination and assure you are meeting the course objectives and learning outcomes, students must use the following Core Tasks and Objectives https://paeaonline.org/assessment/core-tasks-and-objectives/ and apply information to the TOPIC LIST provided here: https://paeaonline.org/assessment/end-of-rotation/content. Student should also review blueprint of the exam which can be found through the following link: https://paeaonline.org/assessment/end-of-rotation/content. The EOC examinations have a similar format to the Physician Assistant National Certifying Examination (PANCE).

To pass the examinations, a student must receive a grade of no less than 65%. Should a student fail the EOC exam, they will be given the opportunity to take a PAEA make-up exam. A grade of 65% or better must be achieved on the make-up exam to pass the clerkship. A grade of 65% will be entered for this portion of the final grade, regardless of the passing grade earned for the make-up exam. Only one makeup examination will be offered in any clerkship. A failure of the make-up examination will result in failure of the clerkship.

CLERKSHIP SPECIFIC PATIENT ENCOUNTER REQUIREMENTS (Patient Logs)

Clerkship logs help the Program track student clinical experiences, identify and address student deficiencies promptly, and assure competencies are achieved. Filling out logs thoroughly and accurately will help the program to ensure students are receiving a quality clinical education. Students are required to log each patient encounter into Exxat daily. All submissions are reviewed by the program each Monday at 9am. Weekly logs during the final week of the clerkship must be logged by 9am of the call back day. Students must log their patient experiences prior to this time. More than one failure to log minimum weekly patient encounters on time will result in a three (3) point deduction from the OVERALL ROTATION GRADE. Each additional failure to log will result in a one (1) point deduction from the overall rotation grade. Students are contacted if the weekly review identifies deficiencies in patient care experiences. A clinical coordinator will discuss methods of assuring requirements are achieved and maximizing clinical opportunities for the remaining time in the clerkship.

The minimum Family Medicine clerkship requirements for the clinical year are presented in the table below. Please do not stop logging once the minimum requirement is completed, as clinical encounters will increase in complexity and level of participation as students’ progress in each clerkship and throughout the clinical phase of the program. Students should print out a copy of their patient encounter log in “graph” format and have their preceptor sign off on the following specific patient encounters. The preceptor signature not only confirms exposure, but competence in these areas of care. Once signed, your log should be uploaded onto session required documents on Exxat. Should a student not meet these competencies during their Family Medicine clerkship, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required for course completion and graduation and a grade of “I” incomplete will be given until all patient encounter requirements are completed.

Family Medicine

90 encounters during the Family Medicine clerkship (approximately 15 per week)

Preventive 10 encounters during the Family Medicine clerkship

Acute 10 encounters during the Family Medicine clerkship

Chronic 10 encounters during the Family Medicine clerkship

Adults- 18-64 yo 10 encounters during the Family Medicine clerkship

Elderly- 65 and older 10 encounters during the Family Medicine clerkship

Preventive: Routine health care that includes screenings, check-ups, and patient counseling to prevent illness, disease, or other health problems.

Acute: Related to a medical condition with a rapid onset and short course.

Chronic: Related to a medical condition that persists and is long lasting.

Emergent: Related to a medical condition requiring immediate intervention.

VIRTUAL PATIENT CASE ASSIGNMENT

assignment will result in an incomplete grade for this clerkship. An incomplete remains until the student completes the requirement. If a passing grade is not achieved, the student must remediate the assignment as directed by the clinical coordinator until competency is achieved.

CLINICAL YEAR REQUIRMENTS for GRADUATION

The following are requirements completed during the clinical year needed to graduate.

Clinical Year Patient Encounter Requirements

Clinical Year Procedure Logging Requirements

Quality Assurance/Performance Improvement Assignment

Developmental Disabilities Logging Requirement and Reflective Journaling P/F

Longitudinal Patient Case with Medical Documentation Submission

CLINICAL YEAR PATIENT ENCOUNTER REQUIREMENTS (Patient logs)

Although students must log specific Family Medicine encounters during this clerkship, the below clinical year encounters are required to be completed by the end of the clinical year, not by the end of the Family medicine clerkship. These requirements may be met on any of the eight clerkships. Preceptors must sign off on the following specific patient encounters. The preceptor signature not only confirms exposure, but competence in these areas of care. The process ensures student deficiencies are identified and addressed in a timely manner. Should a student be at risk of not meeting these competencies during the clinical year, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required for clinical year completion and graduation. Please follow the same process for logging patients as described under the section titled “Clerkship Specific Patient Encounter Requirements.”

Types of Clinical Encounters

Preventative

Acute

Chronic

Emergent

20 encounters during clinical year

Preventative: Routine health care that includes screenings, check-ups, and patient counseling to prevent illness, disease, or other health problems.

Acute: Related to a medical condition with a rapid onset and short course.

Chronic: Related to a medical condition that persists and is long lasting.

Emergent: Related to a medical condition requiring immediate intervention.

Medical Care Across the Life Span Encounters

Infants- less than 1 years of age 15 encounters during the clinical year

Children- 1-11 y/o 30 encounters during the clinical year

Adolescents- 12-17 y/o 30 encounters during the clinical year

Adults- 18-64 y/o 100 encounters during the clinical year

Elderly - 65 and older 100 encounters during the clinical year

CLINICAL YEAR PROCEDURE LOGGING REQUIREMENTS

Clinical year procedures logs are designed to help the Program track student clinical experiences, identify and address student deficiencies promptly, and assure competencies are achieved. Students must perform and log several procedures. Students must print out their “procedure list” for each rotation and have preceptors sign off on the procedure list. The preceptor signature not only confirms exposure, but competence in performing the procedure.

Procedures are tracked through the Exxat System. Please make sure to perform, rather than observe or assist as many procedures as possible, as credit is given only for those logged as “performed”. Once your log is signed, please upload it to Exxat in “session required documents”. During the Family Medicine clerkship, it is recommended that you focus on procedures such as IM/SC/ID injections, venipuncture, and wound care. Students should seek out opportunities to meet procedural requirements, however, not all the requirements listed below need to be completed during the student’s Family Medicine clerkship. The clinical coordinator reviews procedure logs every three months. The process ensures student deficiencies are identified and addressed in a timely manner. Should a student be at risk of not meeting these competencies during the clinical year, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required for clinical year completion and graduation.

REQUIRED CLINICAL YEAR PROCEDURES/EXAMINATIONS

QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT ASSIGNMENT

The quality assurance project is designed to enhance student understanding and appreciation of quality improvement initiatives and how they impact patient care. This activity requires students to view the videos and participate in 3 group discussions posted in the Medicine III Canvas shell. This material is from the Patient Safety Institute. Students must post at least twice in each scenario as indicated in the instructions. One original post and one reply to another student or professor’s post is the minimum requirement. Student posts should be thoughtful and substantial but need not be overly long. This assignment is not designed to take up a tremendous amount of time but to simply enhance student learning in quality assurance. This is pass/fail and must be completed before the end of the eight clinical clerkships. If a student fails to complete this activity, before the completion of the eighth clinical clerkship, they will be required to submit a separate document answering all the discussion boards with at least 500 words, and 2 references for each post.

Completion is required by the end of the clinical year and for graduation. Failure of students to participate satisfactorily in this project by the end of the last clinical rotation will result in an "Incomplete" for the final clinical rotation. An incomplete remains until the student completes the requirement.

Summary:

1. Go to Canvas

2. Go to course PHA 227

3. Click on “discussion board” on left side

4. Click on “Patient Safety Institute CO 2025”

5. Click on course modules on left side and review “IHI Videos.”

6. Follow instructions for the discussion board

DEVELOPMENTAL DISABILITIES LOGGING REQUIREMENT AND REFLECTIVE JOURNALING

Logging requirement:

Although students must log specific Family Medicine encounters during this clerkship, the below developmental disabilities logging requirement are required to be completed by the end of the clinical year, not by the end of the Family medicine clerkship. Throughout the clinical year, 15 patients with a history of developmental disabilities must be logged in the Exxat system. Please be sure you click on the “developmental disability” box to capture your patients in the system. These requirements may be met on any of the eight clerkships. Preceptors must sign off on the following specific patient encounters. The preceptor signature not only confirms exposure, but competence in these areas of care. The process ensures student deficiencies are identified and addressed in a timely manner. Should a student be at risk of not meeting these competencies during the clinical year, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required by the end of the clinical year and for graduation. Please follow the same process for logging patients as described under the section titled “Clerkship Specific Patient Encounter Requirements”.

Developmental Disabilities

Reflective Journal:

Types of Clinical Encounters

15 encounters during clinical year

Choose five clinical encounters with a patient with developmental disabilities, reflect on your experiences and write them in a journal. Entries should focus on self-critique of the interaction, communication with individuals and their families and personal reactions to situations. Commenting on internal struggles or feelings, comfortability with providing care to individuals with developmental disabilities and their families/caregivers and ways of improving care are also encouraged. All students must submit at least five reflective journal entries by call back day eight (8). Journal entries should be 1 page in length, double-spaced. Students can submit their reflective journal on Exxat. From the dashboard • placements • by session • to do list • session required documents • developmental disability reflective journaling. Title each journal entry adhering to the following format: “Clinical Encounter Number X”. Submissions will be reviewed by the program at the end of the 6th clerkship and the 8th clerkship. When submitting documents, ONLY submit at the end of these two clerkships and ensure that all journal entries are submitted as one “running” document. For example, if you submit journal entries 1, 2 and 3 at the end of rotation 6, when you submit at the end of rotation 8, you will submit one “running document” with journal entries 1 -3 and 4 & 5. This process ensures student deficiencies are identified and addressed in a timely manner. Should a student be at risk of not completing this assignment during the clinical year, students must formulate a plan with one of the clinical coordinators to assure completion. Completion is required by the end of the clinical year and for graduation. Failure of students to participate satisfactorily in this project by the end of the last clinical rotation will result in an "Incomplete" for the final clinical rotation. An incomplete remains until the student completes the requirement.

LONGITUDINAL PATIENT CASE with MEDICAL DOCUMENTATION SUBMISSION

The longitudinal patient case is completed over the course of the clinical year. It is designed to allow students to simulate care for a patient over a prolonged period. Thus, the student begins with an initial visit with the simulated patient and then evaluates the “same patient” over the course of the clinical year. At each visit, the patient’s health care needs may change, simulating care of a patient longitudinally. Students must obtain the necessary history, perform a physical examination, order and interpret diagnostic studies, formulate an assessment, and formulate a plan in a simulated environment. After the clinical encounter, a debrief session led by faculty will focus on communication skills, clinical skills, history taking, physical exam skills, assessment and plan formulation.

After each longitudinal patient encounter, students must submit a SOAP note documenting the encounter. The SOAP note must be submitted to Exxat within 72 hours of call back day. Students can submit their SOAP note on Exxat. From the dashboard • placements • by session • to do list • session required documents • longitudinal patient case SOAP note. Please make sure to upload under the correct rotation.

After each longitudinal patient encounter, students will be required to view their encounter remotely (on Hofstra or Northwell network) and complete a video self-reflection assessing their performance. The video self-reflection should focus on student communication skills, level of empathy, non-verbal skills, methods of improving interactions, ways of improving comfortability, and overall patient interaction. The video self-reflection is due 2 weeks after the callback day. Students can submit their longitudinal patient reflection on Exxat. From the

dashboard • placements • by session • to do list • session required documents • longitudinal patient reflection. Please make sure to upload under your current rotation.

If a student misses a patient encounter or does not complete either the SOAP note or video self-reflection, they will receive an incomplete in the clerkship they are just finished. An incomplete remains until the student completes the requirement.

CLERKSHIP BIBLIOGRAPHY

During the clinical year and in practice, there is no set textbook or resource that will address the learner's specific needs or the clerkship experience. Course textbooks and resources should be tailored to student needs. Didactic textbooks can be utilized for the clinical year; however, faculty encourage students to utilize more advanced resources during their clinical year such as those found through your access medicine and Up-to-Date accounts.

Please refer to the Student and Clinical Year Handbooks for additional policies related to clinical clerkships.

PHA 255 INTERNAL MEDICINE CLERKSHIP 3 s.h.

(B1.03a, B3.04b, B3.07c)

COURSE COORDINATOR (B1.03c)

Shannan Ricoy, M.S., PA-C; Email: Shannan.Ricoy@hofstra.edu

Office: 516-463-4233

COURSE DESCRIPTION (B1.03b)

This course is a supervised clinical experience where students function under the supervision of internal medicine preceptors who enable students to meet learning outcomes for conditions encountered in an internal medicine setting. All students will complete this clerkship in an inpatient setting (B3.04b). The student will actively participate in the evaluation and monitoring, perform diagnostic procedures, and assist with the management of patients requiring internal medicine management.

COURSE GOAL (B1.03d)

The goal of this clerkship is to enhance the students’ knowledge of the general principles of internal medicine and to expose students to patients with a variety of internal medicine related conditions. The students will have the opportunity to participate in the care of patients with multiple medical complaints. The student will assess common problems by taking a medical history, performing a physical examination, ordering and interpreting diagnostic studies, and formulating management plans for patients requiring acute and chronic care.

INSTRUCTIONAL OBJECTIVES, COURSE LEARNING OUTCOMES, AND ASSESSMENT TOOLS, SPECIFIC TO INTERNAL MEDICINE

Instructional Objectives

By the conclusion of the Internal medicine clerkship, students will demonstrate competency in the following: (B1.01d, B1.03e, B3.07c)

Course Learning Outcomes

Assessment Tools Utilized

Competency of instructional objectives and learner outcomes are measured by successful completion of the following assessment tools: (B1.03e, B1.03g, B4.01a)

Program Competencies

The instructional objectives, learning outcomes, and successful completion of course assessments guide students toward the acquisition of the following Program Competencies: (B1.01b, B1.03e, B4.01a)

• Elicits a detailed history of patients with an internal medicine condition. (B3.07c)

• Perform an appropriate physical examination on patients with an internal medicine condition. (B3.07c)

When presented with a patient with an internal medicine condition, the student will use effective interviewing skills to perform a comprehensive evaluation that includes a detailed history and physical examination (B3.07c)

• Preceptor evaluation

• Clerkship specific patient encounter requirements

• Elicit a detailed medical history, perform appropriate physical examination, and accurately record all pertinent data. (MK5)

• Use effective interviewing skills to elicit a detailed history. (IC1)

• Selects appropriate diagnostic studies to order for patients with an internal medicine condition. (B3.07c)

• Interpret diagnostic studies for patients with an internal medicine condition. (B3.07c)

When presented with a patient with an internal medicine condition, the student will be able to appropriately use diagnostic studies to aid in the diagnosis. (B3.07c)

• Preceptor evaluation

• Clerkship specific patient encounter requirements

• Virtual Patient Case Assignment

• EOC Exam

• Select and interpret appropriate screening and diagnostic studies. (MK7)

• Formulate a differential diagnosis for patients with an internal medicine condition. (B3.07c)

• Appropriately diagnose patients with an internal medicine condition. (B3.07c)

When presented with a patient with an internal medicine condition, the student will develop a differential diagnosis and determine the most likely diagnosis. (B3.07c)

• Preceptor evaluation

• Clerkship specific patient encounter requirements

• Virtual Patient Case Assignment

• EOC Exam

• Identify and formulate an appropriate assessment and management plan (MK6)

• Formulates a management plan that uses consults appropriately for patients with an internal medicine condition. (B3.07c)

• Creates a pharmacological plan for patients with an internal medicine condition. (B3.07c)

• Formulates a plan that includes nonpharmacological management for patients with an internal medicine condition. (B3.07c)

• Formulates a plan using appropriate referrals for patients with an internal medicine condition. (B3.07c)

• Formulates a plan that includes follow-up for patients with an internal medicine condition. (B3.07c)

• Provides effective patient education to patients with an internal medicine condition. (B3.07c)

• Emphasizes shared decision making for patients with an internal medicine condition. (B3.07c)

• Applies the evidence from scientific studies to internal medicine patient cases. (B3.07c)

• Performs effective oral presentations for patients with an internal medicine condition. (B3.07c)

When presented with a patient with an internal medicine condition, focusing on shared decision making, the student will be able to formulate a management plan including the use of appropriate consults, pharmacologic plan, non-pharmacologic care, referral, follow up and patient education. (B3.07c)

• Preceptor evaluation

• Drug cards

• Clerkship specific patient encounter requirements

• Virtual Patient Case Assignment

• EOC Exam

• Identify and formulate an appropriate assessment and management plan (MK6).

• Provides appropriate referrals (IC4).

• Use effective basic counseling and patient education skills that enable shared decision making (IC6).

• Locate, appraise, and apply evidence from scientific studies to enhance patient care. (CRPSA3)

When presented with a patient with an internal medicine condition, the student will effectively orally present patients. (B3.07c)

• Accurately documents patient data for patients with an internal medicine condition. (B3.07c)

When presented with a patient with an internal medicine condition, the student will accurately record all data. (B3.07c)

• Preceptor Evaluation

• Clerkship specific patient encounter requirements

• Preceptor Evaluation

• Effectively complete oral presentations (IC3)

• Elicit a detailed medical history, perform appropriate physical examination, and accurately record all pertinent data. (MK5)

• Accurately evaluates patients with acute conditions associated with internal medicine. (B3.03a, B3.07c)

• Accurately evaluates patients with chronic conditions associated with internal medicine. (B3.03a, B3.07c)

• Accurately evaluates adult patients (1864 yo) with internal medicine conditions. (B3.03b, B3.07c)

• Accurately evaluates elderly patents (65 and older) with internal medicine conditions. (B3.03b, B3.07c)

• accurately evaluates patients for hypertension. (B3.07c)

• Accurately evaluate patients with congestive heart failure. (B3.07c)

• Accurately evaluates patients with pneumonia. (B3.07c)

When presented with a patient with an internal medicine condition, students will be able complete a history, perform a physical examination, formulate an assessment, and create a management plan for the following categories of patient encounters:

• for acute and chronic patient encounters. (B3.03a, B3.07c)

• across the life span, to include adults, and the elderly. (B3.03b, B3.07c)

• Clinical documentation assignment

• Clerkship specific patient encounter requirements

• Preceptor Evaluation

• Clerkship specific patient encounter requirements

• Accurately document medical information (IC2)

When in an internal medicine setting, the student can appropriately evaluate patients with common conditions such as hypertension, congestive heart failure, and pneumonia. (B3.07c)

• Preceptor Evaluation

• Discern among acute, chronic, and emerging disease states. (MK2)

• Elicit a detailed medical history, perform appropriate physical examination, and accurately record all pertinent data. (MK5)

• Identify and formulate an appropriate assessment and management plan. (MK6)

• Elicit a detailed medical history, perform appropriate physical examination, and accurately record all pertinent data. (MK5)

• Identify and formulate an appropriate assessment and management plan (MK6).

INSTRUCTIONAL OBJECTIVES, COURSE LEARNING OUTCOMES, AND ASSESSMENT TOOLS COMMON TO ALL CLERKSHIPS

Instructional Objectives

By the conclusion of the Internal Medicine clerkship, students will demonstrate competency in the following: (B1.01d, B1.03e, B3.07c)

Course Learning Outcomes

(B1.01d, B1.03e, B3.07c)

Assessment

Tools Utilized

Competency of instructional objectives and learner outcomes are measured by successful completion of the following assessment tools:

(B1.03e, B1.03g, B4.01a)

Program

Competencies

The instructional objectives, learning outcomes, and successful completion of course assessments guide students toward the acquisition of the following Program Competencies: (B1.01b, B1.03e, B4.01a)

• Effectively communicates with patients. (B3.07c)

• Effectively communicates with families. (B3.07c)

• Effectively communicates with members of the health care team. (B3.07c)

When presented with a patient with an internal medicine condition, the student will develop relationships that result in effective communication with patients, their families, and members of the interprofessional team. (B3.07c)

• Preceptor evaluation

• Demonstrates empathy. (B3.07c)

• Demonstrates respect. (B3.07c)

• Demonstrates ethical behavior. (B3.07c)

When presented with a patient with an internal medicine condition, the student demonstrates empathy, respect, and appropriate ethical behavior. (B3.07c)

• Preceptor evaluation

• Use effective interviewing skills to elicit a detailed history. (IC1)

• Understands the importance of effective communication with patients, families, physicians, and other members of the care team. (IC7)

• Demonstrate empathetic and respectful behaviors. (PB1)

• Demonstrates and identifies appropriate ethical behavior. (PB4)

• Demonstrates reliability. (B3.07c)

• Demonstrates accountability. (B3.07c)

• Demonstrates dependability. (B3.07c)

• Exhibits a positive approach to learning. (B3.07c)

• Demonstrates an understanding of diverse health care needs. (B3.07c)

When presented with a patient with an internal medicine condition, the student exhibits reliability, dependability, and is accountable. (B3.07c)

• Preceptor evaluation • Exhibit reliability, accountability, and dependability. (PB2)

• Demonstrates accountability to patients, society, and the profession. (PB6)

• Utilize appropriate clinical reasoning and problem-solving abilities to identify and manage medical conditions. (B3.07c)

• Analyze clinical data correctly. (B3.07c)

When presented with a patient with an internal medicine condition, the student demonstrates the ability to understand the diverse needs of patients. (B3.07c)

When presented with a patient with an internal medicine condition, the student will be able to utilize the clinical reasoning and problem-solving abilities, inclusive of synthesizing and analyzing clinical data, to appropriately evaluate the patient. (B3.07c)

• Preceptor evaluation Demonstrates an understanding of diverse health care needs (IC8).

• Preceptor evaluation • Utilize appropriate clinical reasoning and problemsolving abilities to identify and manage medical conditions (CRPSA1).

• Synthesize and analyze clinical data correctly (CRPSA2).

• Demonstrate care that is effective. (B3.07c)

• Demonstrate care that is safe. (B3.07c)

• Demonstrate care that is equitable. (B3.07c)

• Demonstrate care that is of high quality. (B3.07c)

When presented with a patient with an internal medicine condition, the student will provide effective, safe, equitable, and highquality care. (B3.07c)

OUTLINE OF TOPICS COVERED IN THIS COURSE (B1.03f)

• Preceptor evaluation Demonstrate care that is effective, safe, equitable, and high quality (CRPSA4).

Internal medicine topics covered in this course are outlined below. They are derived from the PAEA Internal medicine topic list found here: https://paeaonline.org/assessment/end-of-rotation/content. Success requires an understating of the definition, etiology, risk factors, pathophysiology, clinical presentation, diagnostic work-up and management of patients with these conditions.

CARDIOVASCULAR

Angina pectoris, Cardiac arrhythmias/conduction disorders, Cardiomyopathy, Congestive heart failure, Coronary vascular disease, Endocarditis, Heart murmurs, Hyperlipidemia, Hypertension, Myocardial infarction, Myocarditis, Pericarditis, Peripheral vascular disease, Rheumatic fever, Rheumatic heart disease, Valvular heart disease, vascular disease

PULMONOLOGY

Acute/chronic bronchitis, Asthma Bronchiectasis, Carcinoid tumor, Chronic obstructive pulmonary disease, Cor pulmonale, Hypoventilation syndrome, Idiopathic pulmonary fibrosis, Pneumoconiosis, Pneumonia (viral, bacterial, fungal, human immunodeficiency virus-related), Pulmonary hypertension, Pulmonary neoplasm, Sarcoidosis, Solitary pulmonary nodule

GASTROINTESTINAL/NUTRITIONAL

Acute and chronic hepatitis, Acute/chronic pancreatitis, Anal fissure/fistula, Cancer of rectum, colon, esophagus, stomach, Celiac disease, Cholangitis, Cholecystitis, Cholelithiasis, Cirrhosis, Crohn disease, Diverticular disease, Esophageal strictures, Esophageal varices, Esophagitis, Gastritis, Gastroenteritis, Gastroesophageal reflux disease, Hemorrhoid, Hepatic cancer, Hiatal hernia, Irritable bowel syndrome, Mallory-Weiss tear, Peptic ulcer disease, Ulcerative colitis

ORTHOPEDICS/RHEUMATOLOGY

Fibromyalgia, Gout/pseudogout, Polyarteritis nodosa, Polymyalgia rheumatica, Polymyositis, Reactive arthritis, Rheumatoid arthritis, Sjogren syndrome, Systemic lupus erythematosus, Systemic sclerosis (scleroderma)

ENDOCRINOLOGY

Acromegaly, Addison’s disease, Cushing disease, Diabetes insipidus, Diabetes mellitus (type I & type II), Hypercalcemia, Hypernatremia, Hyperparathyroidism, Hyperthyroidism/thyroiditis, Hypocalcemia, Hyponatremia, Hypoparathyroidism, Hypothyroidism, Paget disease of the bone, Pheochromocytoma, Pituitary adenoma, Thyroid cancer

NEUROLOGY

Bell palsy, Cerebral aneurysm, Huntington disease, Intracranial tumors, Cerebral vascular accident, Cluster headaches, Coma, Complex regional pain syndrome, Concussion, Delirium, Dementia, Encephalitis, Essential tremor, Giant cell arteritis, Guillain-Barré syndrome, Meningitis, Migraine headaches, Multiple sclerosis, Myasthenia gravis, Parkinson disease, Peripheral neuropathies, Seizure disorders, Syncope, Tension headaches, Transient ischemic attacks

UROLOGY/RENAL

Acid base disturbances, Acute and chronic renal failure, Acute interstitial nephritis, Benign prostatic hyperplasia, Bladder cancer, Epididymitis, Erectile dysfunction, Glomerulonephritis, Hydrocele, Hydronephrosis, Hypervolemia, Hypovolemia, Nephritic syndrome, Nephritis, Polycystic kidney disease, Prostate cancer, Prostatitis, Pyelonephritis, Renal calculi, Renal cell carcinoma, Renal vascular disease, Testicular torsion, Urinary tract infection, Varicocele

CRITICAL CARE

Acute abdomen, Acute adrenal insufficiency, Acute gastrointestinal bleed, Acute glaucoma, Acute respiratory distress/failure, Angina pectoris, Cardiac arrest, Cardiac arrhythmias and blocks, Cardiac failure, Cardiac tamponade, Coma, Diabetic ketoacidosis/acute hypoglycemia, Hypertensive crisis, Myocardial infarction, Pericardial effusion, Pneumothorax, Pulmonary embolism, Seizures, Shock, Status epilepticus, Thyroid storm

HEMATOLOGY

Acute/chronic leukemia, Anemia of chronic disease, Clotting factor disorders, G6PD deficiency anemia, Hypercoagulable state, Idiopathic thrombocytopenic purpura, Iron deficiency anemia, Lymphoma, Multiple myeloma, Sickle cell anemia, Thalassemia, Thrombotic thrombocytopenic purpura, Vitamin B12 and folic acid deficiency anemia

INFECTIOUS DISEASE

Botulism, Candidiasis, Chlamydia, Cholera, Cryptococcus, Cytomegalovirus, Diphtheria, Epstein-Barr infection, Gonococcal infections, Herpes simplex infection, Histoplasmosis, Human immunodeficiency virus infection, Influenza, Lyme disease, Parasitic infections, Pertussis, Pneumocystis, Rabies, Rocky Mountain spotted fever, Salmonellosis, Shigellosis, Syphilis, Tetanus, Toxoplasmosis, Tuberculosis, Varicella zoster

ARC-PA STANDARDS

To assist with assuring students, complete the supervised clinical experiences with preceptors that enable all students to meet program defined learning outcomes, the program clearly outlines specific areas of the ARC-PA Standards this course assist with addressing underlined and bolded below. Throughout the program, students will meet learning outcomes in all areas of the standard listed below.

B3.03 Supervised clinical practice experiences musts enable all students to meet the program’s learning outcomes:

d) for conditions requiring surgical management, including pre-operative, intra-operative care, post-operative care and e) for behavioral and mental health conditions.

B3.04 Supervised clinical practice experiences must occur in the following settings:

a) emergency department, b) inpatient,

c) outpatient, and d) operating room.

B3.07 Supervised clinical practice experiences must occur with preceptors who enable students to meet program defined learning outcomes for:

a) family medicine,

b) emergency medicine,

c) internal medicine,

d) surgery,

e) pediatrics,

f) women’s health including prenatal and gynecological care,

g) behavioral and mental health care.

STUDENT ASSESSMENT/EVALUATION (B1.03g)

Clerkship Specific Assessments

The grade for the Internal medicine clerkship is based on the following components:

Documentation Assignment: H & P

of Clerkship Examination (EOC Exam)

Clerkship Specific Patient Encounter Requirements

Virtual Patient Case Assignment

GRADING PLAN (B1.03h)

Passage of the clerkship course requires an overall average grade of 70% or greater.

Grade Calculations

CLERKSHIP SPECIFIC ASSESSMENTS

CLINICAL DOCUMENTATION ASSIGNMENT

Each student must submit one full history and physical note by the completion of the Internal Medicine clerkship. All notes must be submitted to Exxat in “session required documents” prior to the start of call back day (see submitting call back day materials). Please use the grading rubric in the back of the handbook for additional guidance on completing this assignment.

Please note:

• H&P notes are to be a maximum of five (5) pages in length.

• H&P notes are not acceptable on hospital forms.

• No identifying information may appear on any notes as this violates HIPAA (Health Insurance Portability and Accountability) regulations. Notes submitted with identifying information will earn a grade of zero for that note.

For each day the note is late, five (5)-points will be deduction from the Clinical Documentation grade.

If a passing grade is not achieved, the clinical coordinator will formulate a remediation plan and may include daily or additional note submission on the next clerkship. Once the student has been deemed competent, a grade of 70% will be placed in the gradebook for this assignment. A final grade of incomplete will be used until the student is remediated.

DRUG CARDS

Students are required to research three (3) pharmaceutical agents used during this clerkship and create flash cards demonstrating their knowledge of the class, mechanism of action, indications, contraindications, side effects, dosing, and cost of medication. The student is required to present these cards on the day of a site visit and be prepared to answer questions regarding the drugs selected. Students will not be able to read their cards. Students who do not have a site visit should upload them onto Exxat under “Session Required Documents” prior to the start of call back day. Student name, date and number must be listed on each drug card. Drug cards may be typed and submitted in word format. Should a student fail to produce these cards on a site visit or upload onto Exxat prior to the start of call back day, they will receive an incomplete for this clerkship. An incomplete remains until the student completes the requirement. If a passing grade is not achieved, the student must remediate the assignment as directed by the clinical coordinator until competency is achieved.

PRECEPTOR EVALUATION

END OF CLERKSHIP EXAMINATION (EOC Exam)

To assess the student’s comprehensive knowledge in Internal Medicine, a 120-question multiple-choice examination is given at the end of the clerkship. This end of rotation examination is offered by the Physician Assistant Education Association (PAEA) and is developed by PA educators for use during the clinical year. It is a peer-reviewed exam that incorporates current, relevant test items that follow the NCCPA tasks and blueprints and corresponding PAEA blueprints and topic lists.

To assist with preparation for the examination and assure you are meeting the course objectives and learning outcomes, students must use the following Core Tasks and Objectives https://paeaonline.org/assessment/core-tasks-and-objectives/ and apply information to the TOPIC LIST provided here: https://paeaonline.org/assessment/end-of-rotation/content. Student should also review blueprint of the exam which can be found through the following link: https://paeaonline.org/assessment/end-of-rotation/content. The EOC examinations have a similar format as the Physician Assistant National Certifying Examination (PANCE).

CLERKSHIP SPECIFIC PATIENT ENCOUNTER REQUIREMENTS (Patient Logs)

overall rotation grade. Students are contacted if the weekly review identifies deficiencies in patient care experiences. A clinical coordinator will discuss methods of assuring requirements are achieved and maximizing clinical opportunities for the remaining time in the clerkship.

The minimum Internal Medicine clerkship requirements for the clinical year are presented in the table below. Please do not stop logging once the minimum requirement is completed, as clinical encounters will increase in complexity and level of participation as students’ progress in each clerkship and throughout the clinical phase of the program. Students should print out a copy of their patient encounter log in “graph” format and have their preceptor sign off on the following specific patient encounters. The preceptor signature not only confirms exposure, but competence in these areas of care. Once signed, your log should be uploaded onto session required documents on Exxat. Should a student not meet these competencies during their Internal medicine clerkship, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required for course completion and graduation and a grade of “I” incomplete will be given until all patient encounter requirements are completed.

Internal Medicine

60 encounters during the Internal medicine clerkship (approximately 10 per week)

Acute 10 encounters during the Internal medicine clerkship

Chronic 10 encounters during the Internal medicine clerkship

Adults- 18-64 yo 10 encounters during the Internal medicine clerkship

Elderly- 65 and older 10 encounters during the Internal medicine clerkship

Preventive: Routine health care that includes screenings, check-ups, and patient counseling to prevent illness, disease, or other health problems.

Acute: Related to a medical condition with a rapid onset and short course.

Chronic: Related to a medical condition that persists and is long lasting. Emergent: Related to a medical condition requiring immediate intervention.

VIRTUAL PATIENT CASE ASSIGNMENT

Virtual Patient Case Assignments are internet-based virtual patient programs addressing the core clerkship learning objectives. Each student will be assigned two (2) cases within the first two weeks of the clerkship. Both assigned cases need to be completed by the designated due date and proof of completion uploaded to the “session required documents” section of Exxat. Failure to complete this assignment will result in an incomplete grade for this clerkship. An incomplete remains until the student completes the requirement. If a passing grade is not achieved, the student must remediate the assignment as directed by the clinical coordinator until competency is achieved.

CLINICAL YEAR REQUIRMENTS for GRADUATION

The following are requirements completed during the clinical year needed to graduate.

Clinical Year Patient Encounter Requirements P/F

Clinical Year Procedure Logging Requirements P/F

Quality Assurance/Performance Improvement Assignment P/F

Developmental Disabilities Logging Requirement and Reflective Journaling P/F

Longitudinal Patient Case with Medical Documentation Submission

CLINICAL YEAR PATIENT ENCOUNTER REQUIREMENTS (Patient logs)

Although students must log specific Internal Medicine encounters during this clerkship, the below clinical year encounters are required to be completed by the end of the clinical year, not by the end of the Internal Medicine clerkship. These requirements may be met on any of the eight clerkships. Preceptors must sign off on the following specific patient encounters. The preceptor signature not only confirms exposure, but competence in these areas of care. The process ensures student deficiencies are identified and addressed in a timely manner. Should a student be at risk of not meeting these competencies during the clinical year, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required for clinical year completion and graduation. Please follow the same process for logging patients as described under the section titled “Clerkship Specific Patient Encounter Requirements”.

Types of Clinical Encounters

Preventative

Acute

Chronic

Emergent

20 encounters during clinical year

Preventative: Routine health care that includes screenings, check-ups, and patient counseling to prevent illness, disease, or other health problems.

Acute: Related to a medical condition with a rapid onset and short course.

Chronic: Related to a medical condition that persists and is long lasting.

Emergent: Related to a medical condition requiring immediate intervention.

Medical Care Across the Life Span Encounters

Infants- less than 1 years of age 15 encounters during the clinical year

Children- 1-11 y/o 30 encounters during the clinical year

Adolescents- 12-17 y/o 30 encounters during the clinical year

Adults- 18-64 y/o 100 encounters during the clinical year

Elderly 65 and older 100 encounters during the clinical year

CLINICAL YEAR PROCEDURE LOGGING REQUIREMENTS

Procedures are tracked through the Exxat System. Please make sure to perform, rather than observe or assist as many procedures as possible, as credit is given only for those logged as “performed”. Once your log is signed, please upload it to Exxat in “session required documents”. During the Internal Medicine clerkship, it is recommended that you focus on procedures such as ABG, blood cultures, IM/SC/ID injections, venipuncture, IV placement, Foley catheter placement, NG tube placement, and wound care. Students should seek out opportunities to meet procedural requirements, however, not all the requirements listed below need to be completed during the student’s Internal Medicine clerkship. The clinical coordinator reviews procedure logs every three months. The process ensures student deficiencies are identified and addressed in a timely manner. Should a student be at risk of not meeting these competencies during the clinical year, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required for clinical year completion and graduation.

REQUIRED CLINICAL YEAR PROCEDURES/EXAMINATIONS

QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT ASSIGNMENT

Summary:

1. Go to Canvas

2. Go to course PHA 227

3. Click on “discussion board” on left side

4. Click on “Patient Safety Institute CO 2025”

5. Click on course modules on left side and review “IHI Videos.”

6. Follow instructions for the discussion board

DEVELOPMENTAL DISABILITIES LOGGING REQUIREMENT AND REFLECTIVE JOURNALING

Logging requirement:

Although students must log specific Internal medicine encounters during this clerkship, the below developmental disabilities logging requirement are required to be completed by the end of the clinical year, not by the end of the Internal Medicine clerkship. Throughout the clinical year, 15 patients with a history of developmental disabilities must be logged in the Exxat system. Please be sure you click on the “developmental disability” box to capture your patients in the system. These requirements may be met on any of the eight clerkships. Preceptors must sign off on the following specific patient encounters. The preceptor signature not only confirms exposure, but competence in these areas of care. The process ensures student deficiencies are identified and addressed in a timely manner. Should a student be at risk of not meeting these competencies during the clinical year, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required by the end of the clinical year and for graduation. Please follow the same process for logging patients as described under the section titled “Clerkship Specific Patient Encounter Requirements”.

Types of Clinical Encounters

Developmental Disabilities 15 encounters during clinical year

these two clerkships and ensure that all journal entries are submitted as one “running” document. For example, if you submit journal entries 1, 2 and 3 at the end of rotation 6, when you submit at the end of rotation 8, you will submit one “running document” with journal entries 1 -3 and 4 & 5. This process ensures student deficiencies are identified and addressed in a timely manner. Should a student be at risk of not completing this assignment during the clinical year, students must formulate a plan with one of the clinical coordinators to assure completion. Completion is required by the end of the clinical year and for graduation. Failure of students to participate satisfactorily in this project by the end of the last clinical rotation will result in an "Incomplete" for the final clinical rotation. An incomplete remains until the student completes the requirement.

LONGITUDINAL PATIENT CASE with MEDICAL DOCUMENTATION SUBMISSION

The longitudinal patient case is completed over the clinical year. It is designed to allow students to simulate care for a patient over a prolonged period. Thus, the student begins with an initial visit with the simulated patient and then evaluates the “same patient” over the course of the clinical year. At each visit, the patient’s health care needs may change, simulating care of a patient longitudinally. Students must obtain the necessary history, perform a physical examination, order and interpret diagnostic studies, formulate an assessment, and formulate a plan in a simulated environment. After the clinical encounter, a debrief session led by faculty will focus on communication skills, clinical skills, history taking, physical exam skills, assessment and plan formulation.

CLERKSHIP BIBLIOGRAPHY

Please refer to the Student and Clinical Year Handbooks for additional policies related to clinical clerkships.

PHA 260 WOMEN’S HEALTH CLERKSHIP 3 s.h. (B1.03a,

B3.03c, B3.07f)

COURSE COORDINATOR (B1.03c)

Janet Tutuyan, MPH, PA-C; Email: Janet.Tutuyan@hofstra.edu Office: 516-463-6841

COURSE DESCRIPTION (B1.03b)

This course is a supervised clinical experience where students function under the supervision of Women’s health preceptors who enable students to meet learning outcomes for Women’s Health conditions. The Women's Health supervised clerkship is designed to provide PA students with comprehensive exposure to the specialized field of women's health. During clinical experiences students work with preceptors to evaluate patients with women’s health related concerns, including prenatal and gynecologic care. The rotation involves hands-on experience, clinical application, and patient interaction under the supervision of preceptors. The student will also become involved with preventive women’s health care and common gynecologic disorders.

COURSE GOAL (B1.03d)

The goal of this clerkship is to enhance the students’ knowledge of the general principles of Women’s Health and to expose students to patients with a variety of prenatal and gynecologic conditions. The student will assess common medical problems by taking a medical history, performing a physical examination, ordering and interpreting diagnostic studies, and formulating management plans for patients with women’s health needs. The student will evaluate patients with common gynecological problems, as well as deliver prenatal care to pregnant females including prenatal screening and counseling.

INSTRUCTIONAL OBJECTIVES, COURSE LEARNING OUTCOMES, AND ASSESSMENT TOOLS, SPECIFIC TO WOMEN’S HEALTH

Instructional Objectives

By the conclusion of the Women’s Health clerkship, students will demonstrate competency in the following: (B1.01d, B1.03e, B3.03c, B3.07f)

Course Learning Outcomes

Assessment

Tools Utilized

Competency of instructional objectives and learner outcomes are measured by successful completion of the following assessment tools: (B1.03e, B1.03g, B4.01a)

Program Competencies

The instructional objectives, learning outcomes, and successful completion of course assessments guide students toward the acquisition of the following Program Competencies:

(B1.01b, B1.03e, B4.01a)

• Elicits a detailed history for patients presenting women’s health concerns.

(B3.03c, B4.07f)

• Obtains a prenatal history on a pregnant patient. (B3.03c, B4.07f)

• Perform an appropriate physical examination on patients with a women’s health concern. (B3.03c, B4.07f)

• Perform a prenatal examination on pregnant patients. (B3.03c, B4.07f)

• Perform pelvic examinations on patients with a women’s health concern. (B3.03c, B4.07f)

• Perform breast examinations on patients with women’s health concern. (B3.03c, B4.07f)

• Selects appropriate diagnostic tests to order for patients with women’s health concerns. (B3.03c, B4.07f)

When presented with a patient with a women’s health concern, the student will use effective interviewing skills to perform a comprehensive evaluation that includes a detailed history and physical examination (B3.03c, B4.07f)

• Preceptor evaluation

• Clerkship specific patient encounter requirements

• Elicit a detailed medical history, perform appropriate physical examination, and accurately record all pertinent data. (MK5)

• Use effective interviewing skills to elicit a detailed history. (IC1)

When presented with a patient with a patient with a women’s health concern, the student will be able to appropriately use diagnostic studies to aid in the diagnosis. (B3.03c, B4.07f)

• Preceptor evaluation

• Clerkship specific patient encounter requirements

• Select and interpret appropriate screening and diagnostic studies. (MK7)

• Interpret diagnostic studies for patients with women’s health concerns. (B3.03c, B4.07f)

• Formulate a differential diagnosis for patients with women’s health concerns.

(B3.03c, B4.07f)

• Appropriately diagnose patients with women’s health concerns. (B3.03c, B4.07f)

• Formulates a management plan that uses consultations appropriately for patients with women’s health concerns. (B3.03c, B4.07f)

• Creates a pharmacological plan for patients with women’s health concerns.

(B3.03c, B4.07f)

• Formulates a plan that includes nonpharmacological management for patients with women’s health concerns.

(B3.03c, B4.07f)

• Formulates a plan inclusive of appropriate referrals for patients with a women’s health concern. (B3.03c, B4.07f)

• Formulates a plan that includes follow-up for patients with a women’s health concern. (B3.03c, B4.07f)

• Provides effective patient education to patients with a women’s health concern. (B3.03c, B4.07f)

• Provides effective prenatal counseling for patients with a women’s health concern.

(B3.03c, B4.07f)

• Emphasizes shared decision making for patients with a women’s health concern.

(B3.03c, B4.07f)

When presented with a patient with a women’s health concern, the student will be able to develop a differential diagnosis and determine the most likely diagnosis.

(B3.03c, B4.07f)

When presented with a patient with a women’s health concern, focusing on shared decision making, the student will be able to formulate a management plan including the use of appropriate consults, pharmacologic plan, non-pharmacologic care, referral, follow up and patient education. (B3.03c, B4.07f)

• EOC Exam

• Preceptor evaluation

• Clerkship specific patient encounter requirements

• EOC Exam

• Preceptor evaluation

• Drug cards

• Clerkship specific patient encounter requirements

• EOC Exam

• Identify and formulate an appropriate assessment and management plan (MK6)

• Identify and formulate an appropriate assessment and management plan (MK6).

• Provides appropriate referrals (IC4).

• Use effective basic counseling and patient education skills that enable shared decision making (IC6).

• Locate, appraise, and apply evidence from scientific studies to enhance patient care. (CRPSA3)

• Provides patient education related to family planning to patients with women’s health concerns. (B3.03c, B4.07f)

• Applies the evidence from scientific studies to women’s health patient cases. (B3.03c, B4.07f)

• Performs effective oral presentations for patients with a women’s health concern. (B3.03c, B4.07f)

When presented with a patient with a women’s health concern, the student will effectively orally present patients. (B3.03c)

• Accurately documents patient data for patients with a women’s health concern. (B3.03c, B4.07f)

When presented with a patient with a women’s health concern, the student will accurately record all data. (B3.03c)

• Preceptor Evaluation

• Clerkship specific patient encounter requirements

• Preceptor evaluation

• Clinical Documentation Assignment

• Clerkship specific patient encounter requirements

• Effectively complete oral presentations (IC3)

• Accurately provides preventive care to patients with women’s health concerns.

• Accurately evaluates patients with emergent conditions associated with women’s health care. (B3.03a, B3.07f)

• Accurately evaluates patients with acute conditions associated with women’s health care. (B3.03a, B3.07f)

• Accurately evaluates patients with chronic conditions associated with women’s health care. (B3.03a, B3.07f)

• Accurately evaluates adult patients (1864 yo) with conditions associated with women’s health care (B3.03b, B3.07f)

When presented with a patient with a women’s health concern, students will be able complete a history, perform a physical examination, formulate an assessment, and create a management plan for the following categories of patient encounters:

• for preventive, emergent, acute, and chronic patient encounters. (B3.03a)

• across the life span, to include adults, and the elderly. (B3.03b)

• for prenatal patient encounters. (B3.03c, B3.07f)

• for gynecologic patient encounters. (B3.03c, B3.07f)

• Preceptor evaluation

• Clerkship specific patient encounter requirements

• Elicit a detailed medical history, perform appropriate physical examination, and accurately record all pertinent data. (MK5)

• Accurately document medical information (IC2)

• Discern among acute, chronic, and emerging disease states. (MK2)

• Elicit a detailed medical history, perform appropriate physical examination, and accurately record all pertinent data. (MK5)

• Understand the principles of preventative medicine and how they apply to clinical practice. (SPH5)

• Accurately evaluates elderly patents (65 and older) with conditions associated with women’s health care (B3.03b, B3.07f)

• Accurately evaluates prenatal patients (B3.03c, B3.07f)

• Accurately evaluates patients requiring gynecologic care (B3.03c, B3.07f)

• Accurately evaluate patients with vaginal bleeding. (B3.03c, B3.07f)

• Accurately evaluates patients with a pelvic infection. (B3.03c, B3.07f)

• Accurately evaluates patients with complications associated with pregnancy. (B3.03c, B3.07f)

When in a women’s health setting, the student can appropriately evaluate patients with common conditions such as vaginal bleeding, pelvic infections, and pregnancy complications. (B3.03c, B3.07f)

• Identify and formulate an appropriate assessment and management plan. (MK6)

Preceptor Evaluation • Elicit a detailed medical history, perform appropriate physical examination, and accurately record all pertinent data. (MK5)

• Identify and formulate an appropriate assessment and management plan (MK6).

INSTRUCTIONAL OBJECTIVES, COURSE LEARNING OUTCOMES, AND ASSESSMENT TOOLS COMMON TO ALL CLERKSHIPS

Instructional Objectives

By the conclusion of the Women’s Health clerkship, students will demonstrate competency in the following: (B1.01d, B1.03e, B3.03c, B3.07f)

Course Learning Outcomes

Assessment Tools Utilized

Competency of instructional objectives and learner outcomes are measured by successful completion of the following assessment tools: (B1.03e, B1.03g, B4.01a)

Program Competencies

The instructional objectives, learning outcomes, and successful completion of course assessments guide students toward the acquisition of the following Program Competencies: (B1.01b, B1.03e, B4.01a)

• Effectively communicates with patients. (B3.03c, B3.07f)

• Effectively communicates with families. (B3.03c, B3.07f)

• Effectively communicates with members of the health care team. (B3.03c, B3.07f)

When presented with a patient with a women’s health concern, the student will develop relationships that result in effective communication with patients, their families, and members of the interprofessional team.

(B3.03c, B3.07f)

• Demonstrates empathy. (B3.03c, B3.07f)

• Demonstrates respect. (B3.03c, B3.07f)

• Demonstrates ethical behavior. (B3.03c, B3.07f)

When presented with a patient with a women’s health concern, the student demonstrates empathy, respect, and appropriate ethical behavior. (B3.03c, B3.07f)

Preceptor evaluation • Use effective interviewing skills to elicit a detailed history. (IC1)

• Understands the importance of effective communication with patients, families, physicians, and other members of the care team. (IC7)

Preceptor evaluation • Demonstrate empathetic and respectful behaviors. (PB1)

• Demonstrates and identifies appropriate ethical behavior. (PB4)

• Demonstrates reliability. (B3.03c, B3.07f)

• Demonstrates accountability. (B3.03c, B3.07f)

• Demonstrates dependability. (B3.03c, B3.07f)

• Exhibits a positive approach to learning. (B3.03c, B3.07f)

• Demonstrate an understanding of diverse health care needs. (B3.03c, B3.07f)

When presented with a patient with a women’s health concern, the student exhibits reliability, dependability, and is accountable. (B3.03c, B3.07f)

Preceptor evaluation

When presented with a patient with a women’s health concern, the student demonstrates the ability to understand the diverse needs of patients. (B3.03c, B3.07f)

• Exhibit reliability, accountability, and dependability. (PB2)

• Demonstrates accountability to patients, society, and the profession (PB6).

Preceptor evaluation Demonstrates an understanding of diverse health care needs (IC8).

• Utilize appropriate clinical reasoning and problem-solving abilities. (B3.03c, B3.07f)

• Analyze clinical data correctly. (B3.03c, B3.07f)

When presented with a patient with a women’s health concern, the student will be able to utilize the clinical reasoning and problem-solving abilities, inclusive of synthesizing and analyzing clinical data, to appropriately evaluate the patient. (B3.03c, B3.07f)

Preceptor evaluation Utilize appropriate clinical reasoning and problem- solving abilities to identify and manage medical conditions (CRPSA1).

Synthesize and analyze clinical data correctly (CRPSA2).

• Demonstrate care that is effective. (B3.03c, B3.07f)

• Demonstrate care that is safe. (B3.03c, B3.07f)

• Demonstrate care that is equitable. (B3.03c, B3.07f)

• Demonstrate care that is of high quality. (B3.03c, B3.07f)

When presented with a patient with a women’s health concern, the student will be able to provide effective, safe, equitable, and high-quality care. (B3.03c, B3.07f)

Preceptor evaluation Demonstrate care that is effective, safe, equitable, and high quality (CRPSA4).

OUTLINE OF TOPICS COVERED IN THIS COURSE (B1.03f)

Women’s Health Care topics covered in this course are outlined below. They are derived from the PAEA Women’s Health topic list found here: https://paeaonline.org/assessment/end-of-rotation/content. Success requires an understating of the definition, etiology, risk factors, pathophysiology, clinical presentation, diagnostic work-up and management of patients with these conditions.

MENSTRUATION

Amenorrhea, Dysfunctional uterine bleeding, Dysmenorrhea, Menopause, Normal physiology, Premenstrual dysphoric disorder, Premenstrual syndrome

INFECTIONS

Cervicitis (gonorrhea, chlamydia, herpes simplex, human papilloma virus), Chancroid, Lymphogranuloma venereum, Pelvic Inflammatory disease, Syphilis, Vaginitis (trichomoniasis, bacterial vaginosis, atrophic vaginitis, candidiasis)

NEOPLASMS

Breast cancer, Cervical carcinoma, Cervical dysplasia, Endometrial cancer, Ovarian neoplasms, Vaginal/vulvar neoplasms

DISORDERS OF THE BREAST

Breast abscess, Breast fibroadenoma, Fibrocystic disease, Mastitis

STRUCTURAL ABNORMALITIES

Cystocele, Ovarian torsion, Rectocele, Uterine prolapse

OTHER

Contraceptive methods, Endometriosis, Infertility, Leiomyoma, Ovarian cyst, Sexual assault, Spouse or partner neglect/violence, Urinary incontinence

PRENATAL CARE/NORMAL PREGNANCY

Apgar score, Fetal position, Multiple gestation, Normal labor and delivery (stages, duration, mechanism of delivery, monitoring), Physiology of pregnancy, Prenatal diagnosis/care

PREGNANCY COMPLICATIONS

Abortion, Ectopic pregnancy, Gestational diabetes, Gestational trophoblastic disease (molar pregnancy, choriocarcinoma), Incompetent cervix, Placenta abruption, Placenta previa, Preeclampsia/eclampsia, Pregnancy induced hypertension, Rh incompatibility

LABOR AND DELIVERY COMPLICATIONS

Breech presentation, Dystocia, Fetal distress, Premature rupture of membranes, Preterm labor, Prolapsed umbilical cord

POSTPARTUM CARE

Endometritis, Normal physiology changes of puerperium, Perineal laceration/episiotomy care, Postpartum hemorrhage

ARC-PA STANDARDS

To assist with assuring students complete the supervised clinical experiences with preceptors that enable all students to meet programdefined learning outcomes, the program clearly outlines specific areas of the ARC-PA Standards this course assist with addressing underlined and bolded below to assist with assuring students, complete the supervised clinical experiences with preceptors that enable all students to meet program-defined learning outcomes; the program clearly outlines specific areas of the ARC-PA Standards this course assists with addressing underlined and bolded below. Throughout the program, students will meet learning outcomes in all areas of the standard listed below.

B3.03 Supervised clinical practice experiences musts enable all students to meet the program’s learning outcomes:

a) for preventative, emergent, acute, and chronic patient encounters,

b) across the life span, to include infants, children, adolescents, adults, and the elderly, c) for women’s health (to include prenatal and gynecologic care),

d) for conditions requiring surgical management, including pre-operative, intra-operative care, post-operative care and e) for behavioral and mental health conditions.

B3.07 Supervised clinical practice experiences must occur with preceptors who enable students to meet program defined learning outcomes for a) family medicine, b) emergency medicine, c) internal medicine, d) surgery, e) pediatrics, f) women’s health including prenatal and gynecological care, g) behavioral and mental health care.

STUDENT ASSESSMENT/EVALUATION (B1.03g)

Clerkship Specific Assessments

The grade for the Women’s Health Care clerkship is based on the following components:

Specific Patient Encounter Requirements

GRADING PLAN

(B1.03h)

Passage of the clerkship course requires an overall average grade of 70% or greater.

Grade Calculations

CLERKSHIP SPECIFIC ASSESSMENTS

CLINICAL DOCUMENTATION ASSIGNMENT

Each student must submit one full history and physical note by the completion of the Women’s Health clerkship. All notes must be submitted to Exxat in “session required documents” prior to the start of call back day (see submitting call back day materials). Please use the grading rubric in the back of the handbook for additional guidance on completing this assignment.

Please note:

• H&P notes are to be a maximum of five (5) pages in length.

• H&P notes are not acceptable on hospital forms.

• No identifying information may appear on any notes as this violates HIPAA regulations. Notes submitted with identifying information will earn a grade of zero for that note.

For each day the note is late, five (5)-points will be deduction from the Clinical Documentation grade.

DRUG CARDS

PRECEPTOR EVALUATION

preceptor evaluation can be found at the back of your clinical handbook and is posted on Exxat in the “Student Packet” section under “Generalized Documents.”

END OF CLERKSHIP EXAMINATION (EOC Exam)

To assess comprehensive knowledge of the discipline of Women’s Health Care, a 120-question multiple-choice examination is given at the end of the clerkship. This end of rotation examination is offered by the Physician Assistant Education Association (PAEA) and is developed by PA educators for use during the clinical year. It is a peer-reviewed exam that incorporates current, relevant test items that follow the NCCPA tasks and blueprints and corresponding PAEA blueprints and topic lists.

To assist with preparation for the examination and assure you are meeting the course objectives and learning outcomes, students must use the following Core Tasks and Objectives https://paeaonline.org/assessment/core-tasks-and-objectives/ and apply information to the TOPIC LIST provided here: https://paeaonline.org/assessment/end-of-rotation/content. Student should also review blueprint of the exam which can be found through the following link: https://paeaonline.org/assessment/end-of-rotation/content. The EOC examinations have a similar format as the Physician Assistant National Certifying Examination (PANCE).

To pass the examinations, a student must receive a grade of no less than 65%. Should a student fail the EOC exam, they will be given the opportunity to take a PAEA make-up exam. A grade of 65% or better must be achieved on the make-up exam to pass the clerkship. A grade of 65% will be entered for this portion of the final grade, regardless of the passing grade earned for the make-up exam. Only one make up examination will be offered in any clerkship. A failure of the make-up examination will result in failure of the clerkship.

CLERKSHIP SPECIFIC PATIENT ENCOUNTER REQUIREMENTS (Patient Logs)

The minimum Women’s Health requirements for the clinical year are presented in the table below. Please do not stop logging once the minimum requirement is completed, as clinical encounters will increase in complexity and level of participation as students’ progress in

each clerkship and throughout the clinical phase of the program. Students should print out a copy of their patient encounter log in “graph” format and have their preceptor sign off on the following specific patient encounters. The preceptor signature not only confirms exposure, but competence in these areas of care. Once signed, your log should be uploaded onto session required documents on Exxat. Should a student not meet these competencies during their Women’s Health clerkship, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required for course completion and graduation and a grade of “I” incomplete will be given until all patient encounter requirements are completed.

Women’s Health

Prenatal Care

Gynecologic Care

Preventive

60 encounters during the Women’s Health clerkship (approximately 10 per week)

15 encounters during the Women’s Health clerkship

5 encounters during the Women’s Health clerkship

Acute 5 encounters during the Women’s Health clerkship

Chronic 5 encounters during the Women’s Health clerkship

Emergent 2 encounters during the Women’s Health clerkship

Adults- 18-64 yo 10 encounters during the Women’s Health clerkship

Elderly - 65 and older 10 encounters during the Women’s Health clerkship

Preventive: Routine health care that includes screenings, check-ups, and patient counseling to prevent illness, disease, or other health problems.

Acute: Related to a medical condition with a rapid onset and short course.

Chronic: Related to a medical condition that persists and is long lasting.

Emergent: Related to a medical condition requiring immediate intervention.

CLINICAL YEAR REQUIRMENTS for GRADUATION

The following are requirements completed during the clinical year needed to graduate.

Clinical Year Patient Encounter Requirements

Clinical Year Procedure Logging Requirements

Quality Assurance/Performance Improvement Assignment

Developmental Disabilities Logging Requirement and Reflective Journaling

Longitudinal Patient Case with Medical Documentation Submission

CLINICAL YEAR PATIENT ENCOUNTER REQUIREMENTS (Patient logs)

Although students must log specific Women’s Health encounters during this clerkship, the below clinical year encounters are required to be completed by the end of the clinical year, not by the end of the Women’s Health clerkship. These requirements may be met on any of the eight clerkships. Preceptors must sign off on the following specific patient encounters. The preceptor signature not only confirms exposure, but competence in these areas of care. The process ensures student deficiencies are identified and addressed in a timely manner.

Should a student be at risk of not meeting these competencies during the clinical year, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required for clinical year completion and graduation. Please follow the same process for logging patients as described under the section titled “Clerkship Specific Patient Encounter Requirements”.

Types of Clinical Encounters

Preventative

Acute

Chronic

Emergent

20 encounters during clinical year

Preventative: Routine health care that includes screenings, check-ups, and patient counseling to prevent illness, disease, or other health problems.

Acute: Related to a medical condition with a rapid onset and short course.

Chronic: Related to a medical condition that persists and is long lasting.

Emergent: Related to a medical condition requiring immediate intervention.

Medical Care Across the Life Span Encounters

Infants- less than 1 years of age 15 encounters during the clinical year

Children- 1-11 y/o

Adolescents- 12-17 y/o

Adults- 18-64 y/o

Elderly- 65 and older

30 encounters during the clinical year

100 encounters during the clinical year

CLINICAL YEAR PROCEDURE LOGGING REQUIREMENTS

Procedures are tracked through the Exxat System. Please make sure to perform, rather than observe or assist as many procedures as possible, as credit is given only for those logged as “performed”. Once your log is signed, please upload it to Exxat in “session required documents”. During the Women’s Health clerkship, it is recommended that you focus on procedures such as IM/SC/ID injections, venipuncture, IV placement, Foley catheter placement, suturing, breast examinations and pelvic examinations. Students should seek out opportunities to meet procedural requirements, however, not all the requirements listed below need to be completed during the student’s Women’s Health Care clerkship. The clinical coordinator reviews procedure logs every three months. The process ensures student deficiencies are identified and addressed in a timely manner. Should a student be at risk of not meeting these competencies during the clinical year, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required for clinical year completion and graduation.

REQUIRED CLINICAL YEAR PROCEDURES/EXAMINATIONS

QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT ASSIGNMENT

Summary:

1. Go to Canvas

2. Go to course PHA 227

3. Click on “discussion board” on left side

4. Click on “Patient Safety Institute CO 2025”

5. Click on course modules on left side and review “IHI Videos.”

6. Follow instructions for the discussion board

DEVELOPMENTAL DISABILITIES LOGGING REQUIREMENT AND REFLECTIVE JOURNALING

Logging requirement:

Although students must log specific Women’s Health encounters during this clerkship, the below developmental disabilities logging requirement is required to be completed by the end of the clinical year, not by the end of the Women’s Health clerkship. Throughout the clinical year, 15 patients with a history of developmental disabilities must be logged in the Exxat system. Please be sure you click on the “developmental disability” box to capture your patients in the system. These requirements may be met on any of the eight clerkships. Preceptors must sign off on the following specific patient encounters. The preceptor signature not only confirms exposure, but competence in these areas of care. The process ensures student deficiencies are identified and addressed in a timely manner. Should a student be at risk of not meeting these competencies during the clinical year, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required by the end of the clinical year and for graduation. Please follow the same process for logging patients as described under the section titled “Clerkship Specific Patient Encounter Requirements”.

Types of Clinical Encounters

Developmental Disabilities 15 encounters during clinical year

Reflective Journal: Choose five clinical encounters with a patient with developmental disabilities, reflect on your experiences and write them in a journal. Entries should focus on self-critique of the interaction, communication with individuals and their families and personal reactions to situations. Commenting on internal struggles or feelings, comfortability with providing care to individuals with developmental disabilities and their families/caregivers and ways of improving care are also encouraged. All students must submit at least five reflective journal entries by call back day eight (8). Journal entries should be 1 page in length, double-spaced. Students can submit their reflective journal on Exxat. From the dashboard • placements • by session • to do list • session required documents • developmental disability reflective journaling. Title each journal entry adhering to the following format: “Clinical Encounter Number X”. Submissions will be reviewed by the program at the end of the 6th clerkship and the 8th clerkship. When submitting documents, ONLY submit at the end of these two clerkships and ensure that all journal entries are submitted as one “running” document. For example, if you submit journal entries 1, 2 and 3 at the end of rotation 6, when you submit at the end of rotation 8, you will submit one “running document” with journal entries 1 -3 and 4 & 5. This process ensures student deficiencies are identified and addressed in a timely manner. Should a student be at risk of not completing this assignment during the clinical year, students must formulate a plan with one of the clinical coordinators to assure completion. Completion is required by the end of the clinical year and for graduation. Failure of students to participate satisfactorily in this project by the end of the last clinical rotation will result in an "Incomplete" for the final clinical rotation. An incomplete remains until the student completes the requirement.

LONGITUDINAL PATIENT CASE with MEDICAL DOCUMENTATION SUBMISSION

course of the clinical year. At each visit, the patient’s health care needs may change, simulating care of a patient longitudinally. Students must obtain the necessary history, perform a physical examination, order and interpret diagnostic studies, formulate an assessment, and formulate a plan in a simulated environment. After the clinical encounter, a debrief session led by faculty will focus on communication skills, clinical skills, history taking, physical exam skills, assessment and plan formulation.

CLERKSHIP BIBLIOGRAPHY

Please refer to the Student and Clinical Year Handbooks for additional policies related to clinical clerkships.

PHA 266 SURGERY CLERKSHIP 3 s.h. (B1.03a, B3.03d, B3.04b, B3.04d, B3.07d)

COURSE COORDINATOR (B1.03c)

Janet Tutuyan, MPH, PA-C; Email: Janet.Tutuyan@hofstra.edu

Office: 516-463-6841

COURSE DESCRIPTION (B1.03b)

This course is a supervised clinical experience where students function under the supervision of surgical preceptors who enable students to meet learning outcomes for conditions requiring surgical management. The student will participate in the evaluation and monitoring, perform diagnostic procedures, and help manage patients needing surgical management. Students will be working in the inpatient setting, including the operating room (B3.04d). The student will work as a member of the surgical team and be involved in all aspects of surgical care, including pre-operative, intra-operative, and postoperative care.

COURSE GOAL (B1.03d)

This clerkship’s goal is to enhance students’ knowledge of the general principles of surgery and to expose them to patients with a variety of surgical conditions. The student will assess common problems by taking a medical history, performing a physical examination, ordering and interpreting diagnostic studies, and formulating management plans for patients with surgical needs.

INSTRUCTIONAL OBJECTIVES, COURSE LEARNING OUTCOMES, AND ASSESSMENT TOOLS, SPECIFIC TO SURGERY

Instructional Objectives

By the conclusion of the Surgery clerkship, students will demonstrate competency in the following: (B1.01d, B1.03e, B3.03d, B3.07d)

Course Learning Outcomes

Assessment Tools Utilized

Program Competencies

Competency of instructional objectives and learner outcomes are measured by successful completion of the following assessment tools: (B1.03e, B1.03g, B4.01a)

The instructional objectives, learning outcomes, and successful completion of course assessments guide students toward the acquisition of the following Program Competencies: (B1.01b, B1.03e, B4.01a)

• Elicits a detailed history of patients with a surgical condition. (B3.03d, B3.07d)

• Perform an appropriate physical examination on patients with a surgical condition. (B3.03d, B3.07d)

When presented with a patient with a surgical condition, the student will use effective interviewing skills to perform a comprehensive evaluation that includes a detailed history and physical examination (B3.03d, B3.07d)

• Preceptor evaluation

• Clerkship specific patient encounter requirements

• Elicit a detailed medical history, perform appropriate physical examination, and accurately record all pertinent data. (MK5)

• Use effective interviewing skills to elicit a detailed history. (IC1)

• Selects appropriate diagnostic tests to order for patients with a surgical condition. (B3.03d, B3.07d)

• Interpret diagnostic studies for patients with a surgical condition. (B3.03d, B3.07d)

• Formulates a management plan for patients with surgical conditions. (B3.03d, B3.07d)

• Appropriately diagnose patients with a surgical condition. (B3.03d, B3.07d)

When presented with a patient with a surgical condition, the student can appropriately use diagnostic studies to aid in the diagnosis. (B3.03d, B3.07d)

When presented with a patient with a surgical condition, the student will be able to develop a differential diagnosis and determine the most likely diagnosis. (B3.03d, B3.07d)

• Preceptor evaluation

• Clerkship specific patient encounter requirements

• EOC Exam

• Preceptor evaluation

• Clerkship specific patient encounter requirements

• EOC Exam

• Select and interpret appropriate screening and diagnostic studies. (MK7)

• Identify and formulate an appropriate assessment and management plan (MK6)

• Formulates a management plan that uses consultations appropriately for patients with a surgical condition. (B3.03d, B3.07d)

• Creates a pharmacological plan for patients with a surgical condition. (B3.03d, B3.07d)

• Formulates a plan that includes nonpharmacological management for patients with surgical conditions. (B3.03d, B3.07d)

• Formulates a plan inclusive of appropriate referrals for patients with a surgical condition. (B3.03d, B3.07d)

• Formulates a plan that includes appropriate follow up for patients with a surgical condition. (B3.03d, B3.07d)

• Provides effective patient education to patients with surgical conditions. (B3.03d, B3.07d)

• Emphasizes shared decision making for patients with a surgical condition. (B3.03d, B3.07d)

• Applies the evidence from scientific studies to surgical patient cases. (B3.03d, B3.07d)

• Performs effective oral presentations for patients with a surgical condition. (B3.03d, B3.07d)

When presented with a patient with a surgical condition, focusing on shared decision making, the student will be able to formulate a management plan including the use of appropriate consults, pharmacologic plan, non-pharmacologic care, referral, follow up and patient education. (B3.03d, B3.07d)

• Preceptor evaluation

• Drug cards

• Clerkship specific patient encounter requirements

• EOC Exam

• Identify and formulate an appropriate assessment and management plan (MK6).

• Provides appropriate referrals (IC4).

• Use effective basic counseling and patient education skills that enable shared decision making (IC6).

• Locate, appraise, and apply evidence from scientific studies to enhance patient care. (CRPSA3)

When presented with a patient with a surgical condition, the student will effectively orally present patients. (B3.03d, B3.07d)

• Accurately documents patient data for patients with a surgical condition. (B3.03d, B3.07d)

When presented with a patient with a surgical condition, the student will accurately record all data. (B3.03d, B3.07d)

• Preceptor Evaluation

• Clerkship specific patient encounter requirements

• Preceptor Evaluation

• Effectively complete oral presentations (IC3)

• Elicit a detailed medical history, perform appropriate physical examination, and accurately record all pertinent data. (MK5)

• Accurately evaluates patients with emergent conditions associated with surgical care. (B3.03a, B3.07d)

• Accurately evaluates patients with acute conditions associated with surgical care. (B3.03a, B3.07d)

• Accurately evaluates patients with chronic conditions associated with surgical care. (B3.03a, B3.07d)

• Accurately evaluates adult patients (1864 yo) with surgical conditions (B3.03b, B3.07d)

• Accurately evaluates elderly patents (65 and older) with surgical conditions (B3.03b, B3.07d)

• Accurately evaluates pre-operative patients requiring surgical management (B3.03d, B3.07d)

• Accurately evaluates post-operative patients requiring surgical management (B3.03d, B3.07d)

• Accurately assists with the care of patients requiring surgical management in the intra-operative setting. (B3.03d, B3.04d, B3.07d)

When presented with a patient with a surgical condition, students will be able to complete a history, perform a physical examination, formulate an assessment, and create a management plan for the following categories of patient encounters:

• for emergent, acute, and chronic patient encounters. (B3.03a, B3.07d)

• across the life span, to include adults, and the elderly. (B3.03b, B3.07d)

• pre-operative and post-operative care. (B3.03d, B3.07d)

• Clinical Documentation Assignment

• Clerkship specific patient encounter requirements

• Preceptor Evaluation

• Clerkship specific patient encounter requirements

• Accurately document medical information (IC2)

• Accurately evaluates patients for postoperative infection. (B3.03d, B3.07d)

When caring for a patient with a surgical condition in the operating room, students can assist with patient care during the intraoperative procedure. (B3.03d, B3.04d, b3.07d)

• Preceptor Evaluation

• Clerkship specific patient encounter requirements

• Discern among acute, chronic, and emerging disease states. (MK2)

• Elicit a detailed medical history, perform appropriate physical examination, and accurately record all pertinent data. (MK5)

• Identify and formulate an appropriate assessment and management plan. (MK6)

When in a Surgery setting, the student will be able to appropriately evaluate patients with common conditions such as cholecystitis, intestinal obstruction, and

• Preceptor Evaluation

• Utilize appropriate clinical reasoning and problemsolving abilities to identify and manage medical conditions. (CRPSA1)

• Elicit a detailed medical history, perform appropriate physical examination, and

• Accurately evaluates patients with cholecystitis. (B3.03d, B3.07d)

• Accurately evaluates patients with intestinal obstruction. (B3.03d, B3.07d)

evaluates for post- operative infection.

(B3.03d, B3.07d) accurately record all pertinent data. (MK5)

• Identify and formulate an appropriate assessment and management plan (MK6)

INSTRUCTIONAL OBJECTIVES, COURSE LEARNING OUTCOMES, AND ASSESSMENT TOOLS COMMON TO ALL CLERKSHIPS

Instructional Objectives

By the conclusion of the Surgery clerkship, students will demonstrate competency in the following: (B1.01d, B1.03e, B3.03d, B3.07d)

Course Learning Outcomes

(B1.01d, B1.03e, B3.03d, B3.07d

Assessment Tools Utilized

Competency of instructional objectives and learner outcomes are measured by successful completion of the following assessment tools:

(B1.03e, B1.03g, B4.01a)

Program Competencies

The instructional objectives, learning outcomes, and successful completion of course assessments guide students toward the acquisition of the following Program Competencies: (B1.01b, B1.03e, B4.01a)

• Effectively communicates with patients.

(B3.03d, B3.07d)

• Effectively communicates with families. (B3.03d, B3.07d)

• Effectively communicates with members of the health care team. (B3.03d, B3.07d)

When presented with a patient with a Surgical condition, the student will develop relationships that result in effective communication with patients, their families, and members of the interprofessional team.

(B3.03d, B3.07d)

• Preceptor evaluation • Use effective interviewing skills to elicit a detailed history. (IC1)

• Understands the importance of effective communication with patients, families, physicians, and other members of the care team. (IC7)

• Demonstrates empathy. (B3.03d, B3.07d)

• Demonstrates respect. (B3.03d, B3.07d)

• Demonstrates ethical behavior. (B3.03d, B3.07d)

• Demonstrates reliability. (B3.03d, B3.07d)

• Demonstrates accountability. (B3.03d, B3.07d)

• Demonstrates dependability. (B3.03d, B3.07d)

• Exhibits a positive approach to learning. (B3.03d, B3.07d)

When presented with a patient with a Surgical condition, the student demonstrates empathy, respect, and appropriate ethical behavior. (B3.03d, B3.07d)

• Preceptor evaluation

• Demonstrate an understanding of diverse health care needs. (B3.03d, B3.07d)

When presented with a patient with a Surgical condition, the student exhibits reliability, dependability, and is accountable. (B3.03d, B3.07d)

• Utilize appropriate clinical reasoning and problem-solving abilities. (B3.03d, B3.07d)

• Analyze clinical data correctly. (B3.03d, B3.07d)

When presented with a patient with a Surgical condition, the student demonstrates the ability to understand the diverse needs of patients. (B3.03d, B3.07d)

When presented with a patient with a Surgical condition, the student will be able to utilize clinical reasoning and problemsolving abilities, inclusive of synthesizing and analyzing clinical data, to appropriately evaluate the patient. (B3.03d, B3.07d)

• Demonstrate empathetic and respectful behaviors. (PB1)

• Demonstrates and identifies appropriate ethical behavior. (PB4)

• Preceptor evaluation • Exhibit reliability, accountability, and dependability. (PB2)

• Demonstrates accountability to patients, society, and the profession (PB6).

• Preceptor evaluation Demonstrates an understanding of diverse health care needs (IC8).

• Preceptor evaluation • Utilize appropriate clinical reasoning and problemsolving abilities to identify and manage medical conditions (CRPSA1).

• Synthesize and analyze clinical data correctly (CRPSA2).

• Demonstrate care that is effective. (B3.03d, B3.07d)

• Demonstrate care that is safe. (B3.03d, B3.07d)

• Demonstrate care that is equitable. (B3.03d, B3.07d)

• Demonstrate care that is of high quality. (B3.03d, B3.07d)

When presented with a patient with a Surgical condition, the student will be able to provide effective, safe, equitable, and high-quality care. (B3.03d, B3.07d)

• Preceptor evaluation Demonstrate care that is effective, safe, equitable, and high quality (CRPSA4).

OUTLINE OF TOPICS COVERED IN THIS COURSE (B1.03f)

Surgery topics covered in this course are outlined below. They are derived from the PAEA Surgery topic list found here: https://paeaonline.org/assessment/end-of-rotation/content. Success requires an understating of the definition, etiology, risk factors, pathophysiology, clinical presentation, diagnostic work-up and management of patients with these conditions.

GASTROINTESTINAL/NUTRITIONAL

Anal disorders, Appendicitis, Bowel obstruction, Cholecystitis/cholelithiasis, Diverticulitis, Gastrointestinal bleeding, Hiatal hernia, Ileus, Inflammatory bowel disease, Malignancy of the gastrointestinal tract, Obesity, Pancreatitis, Peritonitis, Toxic megacolon, Perioperative gastrointestinal/nutritional risk assessment and complications.

Gastrointestinal/nutritional procedures: Abdominal drains, Colonoscopy, Endoscopic retrograde cholangiopancreatography, Endoscopy Ileostomy, Nasogastric tubes, Parenteral nutrition, Percutaneous endoscopic gastronomy tube

CARDIOVASCULAR/VASCULAR

Acute arterial occlusion, Aortic aneurysm, Aortic dissection, Chronic arterial insufficiency, Chronic venous insufficiency, Compartment syndrome, Coronary artery disease, Carotid artery stenosis, Intestinal ischemia, Renal vascular disease, Valvular heart disease, Varicose veins, Perioperative cardiovascular/vascular risk assessment and complications.

Cardiovascular/vascular procedures: Advanced cardiac life support, Arteriovenous fistula placement, Central line placement, Permcath/port placement, Vascular access

PULMONARY/THORACIC SURGERY

Chylothorax, Empyema, Hemothorax, Lung malignancy, Mediastinal disorders, Pleural effusion, Pneumothorax, Pulmonary nodule, Perioperative pulmonary/thoracic surgery risk assessment and complications.

Pulmonary/thoracic surgery procedures: Chest tube, Thoracentesis

BREAST SURGERY

Breast abscess, Benign breast disease, Carcinoma of the female breast, Carcinoma of the male breast, Disorders of the augmented breast, Fat necrosis, Mastitis, Phyllodes tumor, Perioperative breast surgery risk assessment and complications.

Breast surgery procedures: Biopsy

DERMATOLOGY

Burns, Cellulitis, Dermatologic neoplasms, Epidermal inclusion cyst, Hidradenitis suppurativa, Lipoma, Pressure ulcer, Perioperative dermatology risk assessment and complications.

Dermatology procedures: Aspiration of seroma/hematoma, Incision and drainage of abscess, Skin biopsy, Skin graft, and flap Suturing

UROLOGY/RENAL

Benign prostatic hyperplasia, Nephrolithiasis, Paraphimosis/phimosis, Testicular torsion, Urethral stricture, Urologic/renal neoplasms, Perioperative urology/renal risk assessment and complications.

Urology/renal procedures: Lithotripsy, Urinary catheterization, Vasectomy

TRAUMA/ACUTE CARE

Acute abdomen, Alteration in consciousness, Compound fractures, Shock, Perioperative trauma/acute care risk assessment and complications.

Trauma/acute care procedures: Transfusion

NEUROLOGY/NEUROSURGERY

Carpal tunnel syndrome, Epidural hematoma, Neurologic neoplasms, Subarachnoid hemorrhage, Perioperative neurology/neurosurgery risk assessment and complications.

Neurology/neurosurgery procedures: Lumbar puncture

PAIN MEDICINE/ANESTHESIA

Acute pain, Chronic pain, Substance use disorder, Perioperative pain medicine/anesthesia risk assessment and complications.

Pain medicine/anesthesia procedures: Endotracheal intubation, Intravenous line placement, Local and regional anesthesia

ENDOCRINOLOGY

Adrenal disorders, Endocrine neoplasms, Parathyroid disorders, Pituitary disorders, Thyroid disorders, Perioperative endocrinology risk assessment and complications.

Endocrinology procedures: Fine needle biopsy

ARC-PA STANDARDS

B3.03 Supervised clinical practice experiences musts enable all students to meet the program’s learning outcomes:

a) for preventative, emergent, acute, and chronic patient encounters,

b) across the life span, to include infants, children, adolescents, adults, and the elderly,

c) for women’s health (to include prenatal and gynecologic care),

d) for conditions requiring surgical management, including pre-operative, intra-operative care, post-operative care and

e) for behavioral and mental health conditions.

B3.04 Supervised clinical practice experiences must occur in the following settings:

a) emergency department,

b) inpatient,

c) outpatient, and

d) operating room.

B3.07 Supervised clinical practice experiences must occur with preceptors who enable students to meet program defined learning outcomes for:

a) family medicine,

b) emergency medicine,

c) internal medicine, d) surgery,

e) pediatrics,

f) women’s health including prenatal and gynecological care,

g) behavioral and mental health care.

STUDENT ASSESSMENT/EVALUATION (B1.03g)

Clerkship Specific Assessments

The grade for the Surgery clerkship is based on the following components:

Clinical Documentation Assignment: SOAP Note

Cards

Preceptor Evaluation

End of Clerkship Examination (EOC Exam)

Clerkship Specific Patient Encounter Requirements P/F

GRADING PLAN (B1.03h)

Passage of the clerkship course requires an overall average grade of 70% or greater.

Grade Calculations

CLERKSHIP SPECIFIC ASSESSMENTS

CLINICAL DOCUMENTATION ASSIGNMENT

Each student will submit one typed SOAP note by the surgery clerkship's completion. All notes must be submitted to Exxat in “session required documents” prior to the start of call back day (see submitting call back day materials). Please use the grading rubric in the back of the handbook for additional guidance on completing this assignment.

Please note:

• SOAP notes are not the same as progress notes. Progress notes will not fulfill this requirement.

• SOAP notes are to be a maximum of one (1) page in length.

• SOAP notes must contain pertinent patient history, physical examination findings, assessment, and management plan. They should also include health care maintenance and patient education.

• Photocopies are not acceptable.

• SOAP notes are not acceptable on hospital forms.

• No identifying information may appear on any notes as this violates HIPAA regulations. Notes submitted with identifying information will earn a grade of zero for that note.

For each day the note is late, five (5)-points will be deducted from the Clinical Documentation grade.

DRUG CARDS

Students are required to research three (3) pharmaceutical agents used during this clerkship and create flash cards demonstrating their knowledge of the class, mechanism of action, indications, contraindications, side effects, dosing, and cost of medication. The student is required to present these cards on the day of a site visit and be prepared to answer questions regarding the drugs selected. Students will not be able to read their cards. Students who do not have a site visit should upload them onto Exxat under “Session Required Documents” prior to the start of call back day. Student name, date, and number must be listed on each drug card. Drug cards may be typed and submitted in word format. Should a student fail to produce these cards on a site visit or upload onto Exxat prior to the start of call back day, they will receive an incomplete for this clerkship. An incomplete remains until the student completes the requirement. If a passing grade is not achieved, the student must remediate the assignment as directed by the clinical coordinator until competency is achieved.

PRECEPTOR EVALUATION

END OF CLERKSHIP EXAMINATION (EOC Exam)

To assess the student’s comprehensive knowledge in surgery, a 120-question multiple-choice examination is given at the end of the clerkship. This end of rotation examination is offered by the Physician Assistant Education Association (PAEA) and is developed by PA educators for use during the clinical year. It is a peer-reviewed exam that incorporates current, relevant test items that follow the NCCPA tasks and blueprints and corresponding PAEA blueprints and topic lists.

To assist with preparation for the examination and assure you are meeting the course objectives and learning outcomes, students must use the following Core Tasks and Objectives https://paeaonline.org/assessment/core-tasks-and-objectives/ and apply information to the TOPIC LIST provided here: https://paeaonline.org/assessment/end-of-rotation/content. Student should also review blueprint of the exam which can be found through the following link: https://paeaonline.org/assessment/end-of-rotation/content. The EOC examinations have a similar format as the Physician Assistant National Certifying Examination (PANCE).

CLERKSHIP SPECIFIC PATIENT ENCOUNTER REQUIREMENTS (Patient Logs)

The minimum Surgery clerkship requirements for the clinical year are presented in the table below. Please do not stop logging once the minimum requirement is completed, as clinical encounters will increase in complexity and level of participation as students’ progress in each clerkship and throughout the clinical phase of the program. Students should print out a copy of their patient encounter log in “graph” format and have their preceptor sign off on the following specific patient encounters. The preceptor signature not only confirms exposure, but competence in these areas of care. Once signed, your log should be uploaded onto session required documents on Exxat. Should a student not meet these competencies during their surgery clerkship, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required for course completion and graduation and a grade of “I” incomplete will be given until all patient encounter requirements are completed.

Surgery

Pre-operative

Intra-operative

Post-operative

Acute

Chronic

Emergent

Adults- 18-64 yo

Elderly - 65 and older

60 encounters during the Surgery clerkship (approximately 10 per week)

10 encounters during the Surgery clerkship

5 encounters during the Surgery clerkship

2 encounters during the Surgery clerkship

10 encounters during the Surgery clerkship

Preventive: Routine health care that includes screenings, check-ups, and patient counseling to prevent illness, disease, or other health problems.

Acute: Related to a medical condition with a rapid onset and short course.

Chronic: Related to a medical condition that persists and is long lasting.

Emergent: Related to a medical condition requiring immediate intervention.

CLINICAL YEAR REQUIRMENTS for GRADUATION

The following are requirements completed during the clinical year needed to graduate.

Clinical Year Patient Encounter Requirements

Clinical Year Procedure Logging Requirements

Quality Assurance/Performance Improvement Assignment

Developmental Disabilities Logging Requirement and Reflective Journaling

Longitudinal Patient Case with Medical Documentation Submission P/F

CLINICAL YEAR PATIENT ENCOUNTER REQUIREMENTS (Patient logs)

Although students must log specific Surgery encounters during this clerkship, the below clinical year encounters are required to be completed by the end of the clinical year, not by the end of the Surgery clerkship. These requirements may be met on any of the eight clerkships. Preceptors must sign off on the following specific patient encounters. The preceptor signature not only confirms exposure, but competence in these areas of care. The process ensures student deficiencies are identified and addressed in a timely manner. Should a student be at risk of not meeting these competencies during the clinical year, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required for clinical year completion and graduation. Please follow the same process for logging patients as described under the section titled “Clerkship Specific Patient Encounter Requirements”.

Types of Clinical Encounters

Preventative

20 encounters during clinical year

Acute 20 encounters during clinical year

Chronic 20 encounters during clinical year

Emergent 20 encounters during clinical year

Preventative: Routine health care that includes screenings, check-ups, and patient counseling to prevent illness, disease, or other health problems.

Acute: Related to a medical condition with a rapid onset and short course.

Chronic: Related to a medical condition that persists and is long lasting.

Emergent: Related to a medical condition requiring immediate intervention.

Medical Care Across the Life Span Encounters

Infants- less than 1 years of age 15 encounters during the clinical year

Children- 1-11 y/o 30 encounters during the clinical year

Adolescents- 12-17 y/o 30 encounters during the clinical year

Adults- 18-64 y/o 100 encounters during the clinical year

Elderly - 65 and older 100 encounters during the clinical year

CLINICAL YEAR PROCEDURE LOGGING REQUIREMENTS

Procedures are tracked through the Exxat System. Please make sure to perform, rather than observe or assist as many procedures as possible, as credit is given only for those logged as “performed”. Once your log is signed, please upload it to Exxat in “session required documents”. During the Surgery clerkship, it is recommended that you focus on procedures such as IM/SC/ID injections, venipuncture, IV placement, Foley catheter placement, NG tube placement, wound care, suturing, and rectal examinations. Students should seek out opportunities to meet procedural requirements, however, not all the requirements listed below need to be completed during the student’s Surgery clerkship. The clinical coordinator reviews procedure logs every three months. The process ensures student deficiencies are identified and addressed in a timely manner. Should a student be at risk of not meeting these competencies during the clinical year, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required for clinical year completion and graduation.

QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT ASSIGNMENT

Summary:

1. Go to Canvas

2. Go to course PHA 227

3. Click on “discussion board” on left side

4. Click on “Patient Safety Institute CO 2025”

5. Click on course modules on left side and review “IHI Videos.”

6. Follow instructions for the discussion board

DEVELOPMENTAL DISABILITIES LOGGING REQUIREMENT AND REFLECTIVE JOURNALING

Logging requirement:

Although students must log specific Surgery encounters during this clerkship, the below developmental disabilities logging requirement is required to be completed by the end of the clinical year, not by the end of the Surgery clerkship. Throughout the clinical year, 15 patients with a history of developmental disabilities must be logged in the Exxat system. Please be sure you click on the “developmental disability” box to capture your patients in the system. These requirements may be met on any of the eight clerkships. Preceptors must sign off on the following specific patient encounters. The preceptor signature not only confirms exposure, but competence in these areas of care. The process ensures student deficiencies are identified and addressed in a timely manner. Should a student be at risk of not meeting these competencies during the clinical year, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required by the end of the clinical year and for graduation. Please follow the same process for logging patients as described under the section titled “Clerkship Specific Patient Encounter Requirements”.

Types of Clinical Encounters

Developmental Disabilities 15 encounters during clinical year

LONGITUDINAL PATIENT CASE with MEDICAL DOCUMENTATION SUBMISSION

formulate a plan in a simulated environment. After the clinical encounter, a debriefing session led by faculty will focus on communication skills, clinical skills, history taking, physical exam skills, assessment and plan formulation.

After each longitudinal patient encounter, students will be required to view their encounter remotely (on Hofstra or Northwell network) and complete a video self-reflection assessing their performance. The video self-reflection should focus on student communication skills, level of empathy, non-verbal skills, methods of improving interactions, ways of improving comfortability, and overall patient interaction.The video self-reflection is due 2 weeks after the callback day. Students can submit their longitudinal patient reflection on Exxat. From the dashboard • placements • by session • to do list • session required documents • longitudinal patient reflection. Please make sure to upload under your current rotation.

CLERKSHIP BIBLIOGRAPHY

Please refer to the Student and Clinical Year Handbooks for additional policies related to clinical clerkships.

COURSE COORDINATOR (B1.03c)

Shannan Ricoy, M.S., PA-C; Email: Shannan.Ricoy@hofstra.edu

Office: 516-463-4233

COURSE DESCRIPTION (B1.03b)

This course is a supervised clinical experience where students function under the supervision of emergency medicine preceptors who enable students to meet learning outcomes for conditions encountered in an emergency department. All students will complete this clerkship in an emergency department. The student will actively participate in the evaluation of patients, perform procedures, and assist with the management of patients requiring emergency management.

COURSE GOAL (B1.03d)

This clerkship’s goal is to enhance students’ knowledge of the general principles of emergency medicine and to expose them to patients with a variety of emergency medicine-related conditions. The student will assess common problems by taking a medical history, performing a physical examination, ordering and interpreting diagnostic studies, and formulating management plans for patients requiring emergent care.

INSTRUCTIONAL OBJECTIVES, COURSE LEARNING OUTCOMES, AND ASSESSMENT TOOLS, SPECIFIC TO EMERGENCY MEDICINE

Instructional Objectives

By the conclusion of the Emergency Medicine clerkship, students will demonstrate competency in the following: (B1.01d, B1.03e, B3.04a, B3.07b)

Course Learning Outcomes

(B1.01d, B1.03e, B3.04a, B3.07b)

Assessment Tools Utilized

Competency of instructional objectives and learner outcomes are measured by successful completion of the following assessment tools:

(B1.03e, B1.03g, B4.01a)

Program Competencies

The instructional objectives, learning outcomes, and successful completion of course assessments guide students toward the acquisition of the following Program Competencies:

(B1.01b, B1.03e, B4.01a)

• Elicits a detailed history of patients with an emergency medicine condition. (B3.04a, B3.07b)

• Perform an appropriate physical examination on patients with an emergency medicine condition. (B3.04a, B3.07b)

When presented with a patient with an emergency medicine condition, the student will use effective interviewing skills to perform a comprehensive evaluation that includes a detailed history and physical examination (B3.04a, B3.07b)

• Preceptor evaluation

• Interesting patient case

• Simulation Experience

• Clerkship specific patient encounter requirements

• Elicit a detailed medical history, perform appropriate physical examination, and accurately record all pertinent data. (MK5)

• Use effective interviewing skills to elicit a detailed history. (IC1)

• Selects appropriate diagnostic studies to order for patients with an emergency medicine condition. (B3.04a, B3.07b)

• Interpret diagnostic studies for patients with an emergency medicine condition.

(B3.04a, B3.07b)

When presented with a patient with an emergency medicine condition, the student will be able to appropriately use diagnostic studies to aid in the diagnosis.

(B3.04a, B3.07b)

• Preceptor evaluation

• Interesting patient case

• Simulation Experience

• Clerkship specific patient encounter requirements

• EOC Exam

• Select and interpret appropriate screening and diagnostic studies. (MK7)

• Formulate a differential diagnosis for patients with an emergency medicine condition. (B3.04a, B3.07b)

• Appropriately diagnose patients with an emergency medicine condition. (B3.04a, B3.07b)

When presented with a patient with an emergency medicine condition, the student will be able to develop a differential diagnosis and determine the most likely diagnosis. (B3.04a, B3.07b)

• Preceptor evaluation

• Interesting patient case

• Simulation Experience

• Clerkship specific patient encounter requirements

• EOC Exam

• Identify and formulate an appropriate assessment and management plan (MK6)

• Formulates a management plan that uses consultations appropriately for patients with an emergency medicine condition. (B3.04a, B3.07b)

• Creates a pharmacological plan for patients with an emergency medicine condition. (B3.04a, B3.07b)

• Formulates a plan that includes nonpharmacological management for patients with an emergency medicine condition. (B3.04a, B3.07b)

• Formulates a plan using appropriate referrals for patients with an emergency medicine condition. (B3.04a, B3.07b)

• Formulates a plan that includes appropriate follow-up for patients with an emergency medicine condition. (B3.04a, B3.07b)

• Provides effective patient education to patients with emergency medicine conditions. (B3.04a, B3.07b)

• Emphasizes shared decision making for patients with an emergency medicine condition. (B3.04a, B3.07b)

When presented with a patient with an emergency medicine condition, focusing on shared decision making, the student will be able to formulate a management plan including the use of appropriate consults, pharmacologic plan, nonpharmacologic care, referral, follow up and patient education. (B3.04a, B3.07b)

• Preceptor evaluation

• Interesting patient case

• Simulation Experience

• Drug cards

• Clerkship specific patient encounter requirements

• EOC Exam

• Identify and formulate an appropriate assessment and management plan (MK6).

• Provides appropriate referrals (IC4).

• Use effective basic counseling and patient education skills that enable shared decision making (IC6).

• Locate, appraise, and apply evidence from scientific studies to enhance patient care. (CRPSA3)

• Applies the evidence from scientific studies to emergency medicine patient cases. (B3.04a, B3.07b)

• Performs effective oral presentations for patients with an emergency medicine condition. (B3.04a, B3.07b)

When presented with a patient with an emergency medicine condition, the student will effectively orally present patients. (B3.04a, B3.07b)

• Accurately documents patient data for patients with an emergency medicine condition. (B3.04a, B3.07b)

• Accurately evaluates patients with emergent conditions. (B3.03a, B3.07b)

• Accurately evaluates patients with acute conditions. (B3.03a, B3.07b)

• Accurately evaluates adult patients (1864 yo) with emergency medicine conditions (B3.03b, B3.07b)

• Accurately evaluates elderly patents (65 and older) with emergency medicine conditions (B3.03b, B3.07b)

When presented with a patient with an emergency medicine condition, the student will accurately record all data. (B3.04a, B3.07b)

• Preceptor Evaluation

• Clerkship specific patient encounter requirements

• Preceptor Evaluation

• Clerkship specific patient encounter requirements

• Effectively complete oral presentations (IC3)

• Accurately evaluates patients with chest pain. (B3.04a, B3.07b)

When presented with a patient with an emergency medicine condition, students will be able complete a history, perform a physical examination, formulate an assessment, and create a management plan for the following categories of patient encounters:

• for emergency and acute patient encounters. (B3.03a, B3.07b)

• across the life span, to include adults, and the elderly. (B3.03b, B3.07b)

• Accurately evaluates patients with abdominal pain. (B3.04a, B3.07b) When in an Emergency Department setting, the student can appropriately evaluate patients with common complaints such as chest pain, abdominal

• Preceptor Evaluation

• Clerkship specific patient encounter requirements

• Elicit a detailed medical history, perform appropriate physical examination, and accurately record all pertinent data. (MK5)

• Accurately document medical information (IC2)

• Discern among acute, chronic, and emerging disease states. (MK2)

• Elicit a detailed medical history, perform appropriate physical examination, and accurately record all pertinent data. (MK5)

• Identify and formulate an appropriate assessment and management plan. (MK6)

• Preceptor Evaluation

• Elicit a detailed medical history, perform appropriate physical examination, and

• Accurately evaluates patients with shortness of breath. (B3.04a, B3.07b)

pain, and shortness of breath. (B3.04a, B3.07b) accurately record all pertinent data. (MK5)

• Identify and formulate an appropriate assessment and management plan (MK6).

INSTRUCTIONAL OBJECTIVES, COURSE LEARNING OUTCOMES, AND ASSESSMENT TOOLS COMMON TO ALL CLERKSHIPS

Instructional Objectives

By the conclusion of the Emergency Medicine clerkship, students will demonstrate competency in the following:

(B1.01d, B1.03e, B3.04a, B3.07b)

Course Learning Outcomes

(B1.01d, B1.03e, B3.04a, B3.07b)

Assessment Tools Utilized

Competency of instructional objectives and learner outcomes are measured by successful completion of the following assessment tools:

(B1.03e, B1.03g, B4.01a)

Program Competencies

The instructional objectives, learning outcomes, and successful completion of course assessments guide students toward the acquisition of the following Program Competencies: (B1.01b, B1.03e, B4.01a)

• Effectively communicates with patients.

(B3.04a, B3.07b)

• Effectively communicates with families.

(B3.04a, B3.07b)

• Effectively communicates with members of the health care team. (B3.04a, B3.07b)

When presented with a patient with an emergency medicine condition, the student will develop relationships that result in effective communication with patients, their families, and members of the interprofessional team. (B3.04a, B3.07b)

• Preceptor evaluation

• Use effective interviewing skills to elicit a detailed history. (IC1)

• Understands the importance of effective communication with patients, families, physicians, and other members of the care team. (IC7)

• Demonstrates empathy. (B3.04a, B3.07b)

• Demonstrates respect. (B3.04a, B3.07b)

• Demonstrates ethical behavior. (B3.04a, B3.07b)

When presented with a patient with an emergency medicine condition, the student demonstrates empathy, respect, and ethical behavior. (B3.04a, B3.07b)

• Demonstrates reliability. (B3.04a, B3.07b)

• Demonstrates accountability. (B3.04a, B3.07b)

• Demonstrates dependability. (B3.04a, B3.07b)

• Exhibits a positive approach to learning. (B3.04a, B3.07b)

• Demonstrate an understanding of diverse health care needs. (B3.04a, B3.07b)

When presented with a patient with an emergency medicine condition, the student exhibits reliability, dependability, and is accountable. (B3.04a, B3.07b)

• Preceptor evaluation

• Utilize appropriate clinical reasoning and problem-solving abilities to identify and manage medical conditions. (B3.04a, B3.07b)

• Analyze clinical data correctly. (B3.04a, B3.07b)

When presented with a patient with an emergency medicine condition, the student demonstrates the ability to understand the diverse needs of patients. (B3.04a, B3.07b)

When presented with a patient with an emergency medicine condition, the student will be able to utilize the clinical reasoning and problem-solving abilities, inclusive of synthesizing and analyzing clinical data, to appropriately evaluate the patient. (B3.04a, B3.07b)

• Demonstrate empathetic and respectful behaviors. (PB1)

• Demonstrates and identifies appropriate ethical behavior. (PB4)

• Preceptor evaluation • Exhibit reliability, accountability, and dependability. (PB2)

• Demonstrates accountability to patients, society, and the profession (PB6).

• Preceptor evaluation Demonstrates an understanding of diverse health care needs (IC8).

• Preceptor evaluation • Utilize appropriate clinical reasoning and problemsolving abilities to identify and manage medical conditions (CRPSA1).

• Synthesize and analyze clinical data correctly (CRPSA2).

• Demonstrate care that is effective. (B3.04a, B3.07b)

• Demonstrate care that is safe. (B3.04a, B3.07b)

• Demonstrate care that is equitable. (B3.04a, B3.07b)

• Demonstrate care that is high quality. (B3.04a, B3.07b)

When presented with a patient with an emergency medicine condition, the student will provide effective, safe, equitable, and high-quality care. (B3.04a, B3.07b)

• Preceptor evaluation Demonstrate care that is effective, safe, equitable, and high quality (CRPSA4).

OUTLINE OF TOPICS COVERED IN THIS COURSE

(B1.03f)

Emergency Medicine topics covered in this course are outlined below. They are derived from the PAEA Emergency Medicine topic list found here: https://paeaonline.org/assessment/end-of-rotation/content. Success requires an understating of the definition, etiology, risk factors, pathophysiology, clinical presentation, diagnostic work-up and management of patients with these conditions.

CARDIOVASCULAR

Acute/subacute bacterial endocarditis, Angina, Arrhythmias, Cardiac tamponade, Chest pain, Conduction disorders (atrial fibrillation/flutter, supraventricular tachycardia, bundle branch block, ventricular tachycardia/fibrillation, premature beats), Coronary heart disease (non-ST acute myocardial infarction, ST segment elevation acute myocardial infarction, angina pectoris, unstable angina, Prinz metal/variant angina), Dyspnea on exertion, Edema, Heart failure, Hypertensive emergencies, Hypotension (cardiogenic shock, orthostatic hypotension) Orthopnea, Palpitations, Pericardial effusion, Peripheral vascular disease, Syncope, Valvular disease (aortic stenosis, aortic regurgitation, mitral stenosis, mitral regurgitation), Vascular disease (aortic aneurysm/dissection, arterial occlusion/thrombosis, phlebitis)

ORTHOPEDICS/RHEUMATOLOGY

Back strain/sprain, Bursitis/tendonitis, Cauda equina, Costochondritis, Ecchymosis/erythema, Fractures/dislocations (shoulder, forearm/wrist/hand, hip, knee, ankle/foot), Gout, Herniated disk, Low back pain, Osteomyelitis, Pain, Septic arthritis, soft tissue injuries, Sprains/strains Swelling/deformity

GASTROINTESTINAL/NUTRITIONAL

Abdominal pain, Acute appendicitis, Acute cholecystitis, Acute hepatitis, Acute pancreatitis, Anal fissure/fistula/abscess, Anorexia, Change in bowel habits/diarrhea/constipation, Cholangitis, Cirrhosis, Diarrhea/constipation, Diverticular disease, Esophagitis, Gastritis, Gastroenteritis, Gastrointestinal bleeding, Giardiasis and other parasitic infections, Heartburn, Hematemesis, Hemorrhoids (thrombosed), Hernia (incarcerated/strangulated), Infectious diarrhea, Inflammatory bowel disease/toxic megacolon, Ischemic bowel disease, Jaundice, Mallory-Weiss tear, Melena; bleeding per rectum, Nausea/vomiting, Obstruction (small bowel, large bowel, volvulus), Peptic ulcer disease

PULMONOLOGY

Acute bronchiolitis, Acute bronchitis, Acute epiglottitis, Acute respiratory distress syndrome, Asthma, Croup, Foreign body aspiration, Hemoptysis, Influenza, Lung cancer, Pertussis, Pleural effusion, Pleuritic chest pain, Pneumonia (bacterial, viral, fungal, human immunodeficiency virus-related), Pneumothorax, Pulmonary embolism, Respiratory syncytial virus, Shortness of breath, Tuberculosis, Wheezing

NEUROLOGY

Altered level of consciousness/coma, Bell palsy, Encephalitis, Epidural/subdural hematoma, Guillain-Barré syndrome, Head trauma/concussion/contusion, Headache (migraine, cluster, tension), Intracerebral hemorrhage, Loss of consciousness/change in mental status, Loss of coordination/ataxia, Loss of memory, Meningitis, Numbness/paresthesia, Seizure (symptom), Seizure disorders, Spinal cord injury, Status epilepticus, Stroke, Subarachnoid hemorrhage/cerebral aneurysm, Syncope, Transient ischemic attack, Vertigo, Weakness/paralysis

ENT/OPHTHALMOLOGY

Acute laryngitis, Acute otitis media, Acute pharyngitis (viral, bacterial), Acute sinusitis, Allergic rhinitis, Barotrauma, Blepharitis, Blowout fracture, Conjunctivitis, Corneal abrasion/ulcer, Dacryoadenitis, Dental abscess, Ear pain, Epiglottitis, Epistaxis, Foreign body (eye, ear, nose), Glaucoma (acute angle closure), Hyphemia, Labyrinthitis, Macular degeneration (wet), Mastoiditis, Nasal congestion, Optic neuritis, Orbital cellulitis, Otitis externa, Papilledema, Peritonsillar abscess, Retinal detachment, Retinal vein occlusion, Sore throat, Trauma/hematoma (external ear), Tympanic membrane perforation, Vertigo, Vision loss

UROLOGY/RENAL

Acid/base disorders, Acute renal failure, Incontinence, Nephrolithiasis, Cystitis, Dysuria, Epididymitis, Fluid and electrolyte disorders, Glomerulonephritis, Hematuria, Hernias, Orchitis, Prostatitis, Pyelonephritis, Suprapubic/flank pain, Testicular torsion, Urethritis

DERMATOLOGY

Bullous pemphigoid, Burns, Cellulitis, Dermatitis (eczema, contact), Discharge, Drug eruptions, Erysipelas, Herpes zoster, Impetigo, Itching, Lice, Pilonidal disease, Pressure sores, Rash, Scabies, Spider bites, Stevens-Johnson syndrome, Toxic epidermal necrolysis, Urticaria, Viral exanthems

ENDOCRINOLOGY

Adrenal insufficiency, Cushing disease, Diabetes insipidus, Diabetes mellitus, Diabetic ketoacidosis, Heat/cold intolerance, Hyperparathyroidism, Hyperthyroidism, Hypothyroidism, Nonketotic hyperglycemia, Palpitations, Thyroiditis, Tremors

OBSTETRICS/GYNECOLOGY

Amenorrhea, Pelvic inflammatory disease, Dysfunctional uterine bleeding, Pelvic pain/dysmenorrhea, Ectopic pregnancy, Placenta abruption, Endometriosis, Placenta previa, Fetal distress, Premature rupture of membranes, Intrauterine pregnancy, Spontaneous abortion, Mastitis/breast abscess, Vaginal discharge, Ovarian cysts, Vaginitis

PSYCHIATRY/BEHAVIORAL MEDICINE

Anxiety disorders, Bipolar and related disorders, Depressive disorders, Neurocognitive disorders, Panic disorder, Posttraumatic stress disorder, Schizophrenia, spectrum and other psychotic disorders, Spouse or partner neglect/violence, Substance use disorders, Suicide

HEMATOLOGY

Acute leukemia, Anemia, Aplastic anemia, Clotting factor disorders, Easy bruising, Fatigue, Hemolytic anemia, Hypercoagulable states, Lymphomas, Polycythemia, Sickle cell anemia/crisis, Thrombocytopenia

ARC-PA STANDARDS

B3.03 Supervised clinical practice experiences musts enable all students to meet the program’s learning outcomes:

a) for preventative, emergent, acute, and chronic patient encounters, b) across the life span, to include infants, children, adolescents, adults, and the elderly, c) for women’s health (to include prenatal and gynecologic care), d) for conditions requiring surgical management, including pre-operative, intra-operative care, post-operative care and e) for behavioral and mental health conditions.

B3.04 Supervised clinical practice experiences must occur in the following settings: a) emergency department, b) inpatient, c) outpatient, and d) operating room.

STUDENT ASSESSMENT/EVALUATION (B1.03g)

Clerkship Specific Assessments

The grade for the Emergency Medicine clerkship is based on the following components:

Interesting Patient Case

Drug Cards P/F

Preceptor Evaluation 50%

End of Clerkship Examination (EOC Exam) 35%

Clerkship Specific Patient Encounter Requirements P/F

Simulation Experience P/F

GRADING PLAN (B1.03h)

Passage of the clerkship course requires an overall average grade of 70% or greater.

Grade Calculations

CLERKSHIP SPECIFIC ASSESSMENTS

INTERESTING PATIENT CASE ASSIGNMENT

An interesting patient case assignment is a requirement during the Emergency Medicine clerkship. The interesting case will either be presented on a site visit or uploaded onto Exxat prior to the start of call back day. All interesting patient case assignments should include all elements of a focused H&P, a written summary of the pathophysiology of the disease state, and one related journal article review utilizing the “Evaluating a Peer Reviewed Scientific Article” form. Journal articles should be related to the chosen interesting case, current, less than 5

years old, and come from an academic, peer-reviewed medical publication. Students that present an interesting case on a site visit should be prepared to lead a discussion with their fellow classmates and a faculty member.

The interesting case assignment format can be submitted as either a word document or Power Point presentation in the same format as a focused H&P note. Students required to present their case may use an outline or notes for guidance, but reading verbatim is not permitted. Failure to submit this project will result in a grade of zero for this portion of the clerkship grade.

DRUG CARDS

PRECEPTOR EVALUATION

END OF CLERKSHIP EXAMINATION (EOC Exam)

To assess the student’s comprehensive knowledge in Emergency Medicine, a 120-question multiple-choice examination is given at the end of the clerkship. This end of rotation examination is offered by the Physician Assistant Education Association (PAEA) and is developed by

PA educators for use during the clinical year. It is a peer-reviewed exam that incorporates current, relevant test items that follow the NCCPA tasks and blueprints and corresponding PAEA blueprints and topic lists.

CLERKSHIP SPECIFIC PATIENT ENCOUNTER REQUIREMENTS (Patient Logs)

The minimum Emergency Medicine clerkship requirements for the clinical year are presented in the table below. Please do not stop logging once the minimum requirement is completed, as clinical encounters will increase in complexity and level of participation as students’ progress in each clerkship and throughout the clinical phase of the program. Students should print out a copy of their patient encounter log in “graph” format and have their preceptor sign off on the following specific patient encounters. The preceptor signature not only confirms exposure, but competence in these areas of care. Once signed, your log should be uploaded onto session required documents on Exxat. Should a student not meet these competencies during their Emergency Medicine clerkship, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required for course completion and graduation and a grade of “I” incomplete will be given until all patient encounter requirements are completed.

Emergency Medicine

Emergent

Acute

Adults- 18-64 y/o

Elderly - 65 and older

90 encounters during the Emergency Medicine clerkship (approximately 15 per week)

2 encounters during the Emergency Medicine clerkship

10 encounters during the Emergency Medicine clerkship

Preventive: Routine health care that includes screenings, check-ups, and patient counseling to prevent illness, disease, or other health problems.

Acute: Related to a medical condition with a rapid onset and short course.

Chronic: Related to a medical condition that persists and is long lasting.

Emergent: Related to a medical condition requiring immediate intervention.

SIMULATION EXPERIENCE

SimMan are computer-operated simulators that are used to create a variety of clinical education scenarios based on the core clerkship learning objectives. Students will attend a simulation session at the Center for Learning and Innovation (CLI) or at the Science and Innovation Center (SIC) while on their emergency medicine clerkship. Students will receive an email from the clinical coordinators with the date and time of your simulation session within the first two weeks of the clerkship. If CLI/SIC should be closed for any reason, a makeup simulation or similar experience will be assigned later. Failure to attend and participate in the clinical scenarios at CLI/SIC will result in an incomplete grade for this clerkship. An incomplete remains until the student completes the requirement. If a passing grade is not achieved, the student must remediate the assignment as directed by the clinical coordinator until competency is achieved.

CLINICAL YEAR REQUIRMENTS for GRADUATION

The following are requirements completed during the clinical year needed to graduate.

Clinical Year Patient Encounter Requirements

Clinical Year Procedure Logging Requirements

Quality Assurance/Performance Improvement Assignment

Developmental Disabilities Logging Requirement and Reflective Journaling

Longitudinal Patient Case with Medical Documentation Submission

CLINICAL YEAR PATIENT ENCOUNTER REQUIREMENTS (Patient logs)

Although students must log specific Emergency Medicine encounters during this clerkship, the below clinical year encounters are required to be completed by the end of the clinical year, not by the end of the Emergency Medicine clerkship. These requirements may be met on any of the eight clerkships. Preceptors must sign off on the following specific patient encounters. The preceptor signature not only confirms exposure, but competence in these areas of care. The process ensures student deficiencies are identified and addressed in a timely manner. Should a student be at risk of not meeting these competencies during the clinical year, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required for clinical year completion and graduation. Please follow the same process for logging patients as described under the section titled “Clerkship Specific Patient Encounter Requirements”.

Types of Clinical Encounters

Preventative

Acute

20 encounters during clinical year

Chronic 20 encounters during clinical year

Emergent 20 encounters during clinical year

Preventative: Routine health care that includes screenings, check-ups, and patient counseling to prevent illness, disease, or other health problems.

Acute: Related to a medical condition with a rapid onset and short course.

Chronic: Related to a medical condition that persists and is long lasting.

Emergent: Related to a medical condition requiring immediate intervention.

Medical Care Across the Life Span Encounters

Infants- less than 1 years of age 15 encounters during the clinical year

Children- 1-11 y/o 30 encounters during the clinical year

Adolescents- 12-17 y/o 30 encounters during the clinical year

Adults- 18-64 y/o 100 encounters during the clinical year

Elderly- 65 and older 100 encounters during the clinical year

CLINICAL YEAR PROCEDURE LOGGING REQUIREMENTS

Procedures are tracked through the Exxat System. Please make sure to perform, rather than observe or assist as many procedures as possible, as credit is given only for those logged as “performed”. Once your log is signed, please upload it to Exxat in “session required documents”. During the Emergency Medicine clerkship, it is recommended that you focus on procedures such as ABG, abscess incision & drainage, blood cultures, IM/SC/ID injections, venipuncture, IV placement, Foley catheter placement, NG tube placement, wound care, suturing, breast examination, pelvic examinations, and rectal examinations. Students should seek out opportunities to meet procedural requirements, however, not all the requirements listed below need to be completed during the student’s Emergency Medicine clerkship. The clinical coordinator reviews procedure logs every three months. The process ensures student deficiencies are identified and addressed in a timely manner. Should a student be at risk of not meeting these competencies during the clinical year, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required for clinical year completion and graduation.

QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT ASSIGNMENT

Summary:

1. Go to Canvas

2. Go to course PHA 227

3. Click on “discussion board” on left side

4. Click on “Patient Safety Institute CO 2025”

5. Click on course modules on left side and review “IHI Videos.”

6. Follow instructions for the discussion board

DEVELOPMENTAL DISABILITIES LOGGING REQUIREMENT AND REFLECTIVE JOURNALING

Logging requirement:

Although students must log specific Emergency Medicine encounters during this clerkship, the below developmental disabilities logging requirement are required to be completed by the end of the clinical year, not by the end of the Emergency Medicine clerkship. Throughout the clinical year, 15 patients with a history of developmental disabilities must be logged in the Exxat system. Please be sure you click on the “developmental disability” box to capture your patients in the system. These requirements may be met on any of the eight clerkships. Preceptors must sign off on the following specific patient encounters. The preceptor signature not only confirms exposure, but competence in these areas of care. The process ensures student deficiencies are identified and addressed in a timely manner. Should a student be at risk of not meeting these competencies during the clinical year, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required by the end of the clinical year and for graduation. Please follow the same process for logging patients as described under the section titled “Clerkship Specific Patient Encounter Requirements”.

Types of Clinical Encounters

Developmental Disabilities 15 encounters during clinical year

LONGITUDINAL PATIENT CASE with MEDICAL DOCUMENTATION SUBMISSION

course of the clinical year. At each visit, the patient’s health care needs may change, simulating care of a patient longitudinally. Students must obtain the necessary history, perform a physical examination, order and interpret diagnostic studies, formulate an assessment, and formulate a plan in a simulated environment. After the clinical encounter, a debriefing session led by faculty will focus on communication skills, clinical skills, history taking, physical exam skills, assessment and plan formulation.

If a student misses a patient encounter or does not complete either the SOAP note or video self-reflection, they will receive an incomplete in the clerkship they just finished. An incomplete remains until the student completes the requirement.

CLERKSHIP BIBLIOGRAPHY

Please refer to the Student and Clinical Year Handbooks for additional policies related to clinical clerkships.

PHA 280 PEDIATRICS CLERKSHIP 3 s.h. (B1.03a, B3.03b, B3.07e)

COURSE COORDINATOR (B1.03c)

Shannan Ricoy, M.S., PA-C; Email: Shannan.Ricoy@hofstra.edu Office: 516-463-4233

COURSE DESCRIPTION (B1.03b)

This course is a supervised clinical experience where students function under the supervision of pediatric preceptors who enable students to meet learning outcomes and gain proficiency in the care of pediatric patients. Students will focus on recognizing and managing common childhood illnesses, well childcare, management of chronic conditions, assessment of growth and development, and the practice of preventive health care in this specific population.

COURSE GOAL (B1.03d)

The goal of this clerkship is to provide students with general knowledge of the principles of pediatric medicine and to allow students the opportunity to participate in the care of pediatric patients, including infants, children, and adolescents. The student will assess common medical problems by taking a medical history, performing a physical examination, ordering and interpreting diagnostic studies, and formulating management plans for infants, children, and adolescent patients.

INSTRUCTIONAL OBJECTIVES, COURSE LEARNING OUTCOMES, AND ASSESSMENT TOOLS, SPECIFIC TO PEDIATRICS

Instructional Objectives

By the conclusion of the Pediatric clerkship, students will demonstrate competency in the following: (B1.01d, B1.03e, B3.03b, B3.07e)

• Elicits a detailed history of pediatric patients. (B3.03b, B3.07e)

• Perform an appropriate physical examination on pediatric patients. (B3.03b, B3.07e)

• Evaluates patients for pediatric growth and development. (B3.03b, B3.07e)

Course Learning Outcomes

(B1.01d, B1.03e, B3.03b, B3.07e)

Assessment Tools Utilized

Competency of instructional objectives and learner outcomes are measured by successful completion of the following assessment tools:

(B1.03e, B1.03g, B4.01a)

Program Competencies

The instructional objectives, learning outcomes, and successful completion of course assessments guide students toward the acquisition of the following Program Competencies:

(B1.01b, B1.03e, B4.01a)

• Selects appropriate diagnostic studies to order for pediatric patients. (B3.03b, B3.07e)

• Interpret diagnostic studies for pediatric patients. (B3.03b, B3.07e)

When presented with a pediatric patient, the student will use effective interviewing skills to perform a comprehensive evaluation that includes a detailed history and physical examination. (B3.03b, B3.07e)

• Preceptor evaluation

• Clerkship specific patient encounter requirements

• Elicit a detailed medical history, perform appropriate physical examination, and accurately record all pertinent data. (MK5)

• Use effective interviewing skills to elicit a detailed history. (IC1)

• Formulate a differential diagnosis for pediatric patients. (B3.03b, B3.07e)

• Appropriately diagnose pediatric patients. (B3.03b, B3.07e)

When presented with a pediatric patient, the student can appropriately use diagnostic studies to aid in the diagnosis.

(B3.03b, B3.07e)

When presented with a pediatric patient, the student will develop a differential diagnosis and determine the most likely diagnosis. (B3.03b, B3.07e)

• Preceptor evaluation

• Clerkship specific patient encounter requirements

• EOC Exam

• Preceptor evaluation

• Clerkship specific patient encounter requirements

• EOC Exam

• Select and interpret appropriate screening and diagnostic studies. (MK7)

• Identify and formulate an appropriate assessment and management plan (MK6)

• Formulates a management plan that uses consultations appropriately for pediatric patients. (B3.03b, B3.07e)

• Provides information regarding health promotion when caring for pediatric patients. (B3.03b, B3.07e)

• Provides information regarding injury prevention when caring for pediatric patients. (B3.03b, B3.07e)

• Creates a pharmacological plan for pediatric patients. (B3.03b, B3.07e)

• Formulates a plan that includes nonpharmacological management for pediatric patients. (B3.03b, B3.07e)

• Formulates a plan using appropriate referrals for pediatric patients. (B3.03b, B3.07e)

• Formulates a plan that includes appropriate follow-up for pediatric patients. (B3.03b, B3.07e)

• Provides effective patient education to patients and their families for pediatric patients. (B3.03b, B3.07e)

• Emphasizes shared decision making for pediatric patients. (B3.03b, B3.07e)

• Applies the evidence from scientific studies to pediatric patient cases. (B3.03b, B3.07e)

• Performs effective oral presentations for pediatric patients (B3.03b, B3.07e)

When presented with a pediatric patient, focusing on shared decision making, the student will formulate a management plan including the use of appropriate consultations, pharmacologic plan, nonpharmacologic care, referral, follow up and patient education. (B3.03b, B3.07e)

• Preceptor evaluation

• Drug cards

• Clerkship specific patient encounter requirements

• EOC Exam

• Identify and formulate an appropriate assessment and management plan (MK6).

• Provides appropriate referrals (IC4).

• Use effective basic counseling and patient education skills that enable shared decision making (IC6).

• Locate, appraise, and apply evidence from scientific studies to enhance patient care. (CRPSA3)

• Understand the principles of preventative medicine and how they apply to clinical practice. (SPH5)

When presented with a pediatric patient, the student will effectively orally present patients. (B3.03b, B3.07e)

• Preceptor Evaluation

• Clerkship specific patient encounter requirements

• Effectively complete oral presentations (IC3)

• Accurately documents patient data for pediatric patients. (B3.03b, B3.07e)

• Accurately provides preventive care to pediatric patients. (B3.03a, B3.07e)

• Accurately evaluates pediatric patients with acute conditions. (B3.03a, B3.07e)

• Accurately evaluates pediatric patients with chronic conditions. (B3.03a, B3.07e)

• Accurately evaluates infants (less than 1) (B3.03b, B3.07e)

• Accurately evaluates children (1-11 years old) (B3.03b, B3.07e)

• Accurately evaluates adolescents (12-17 years old) (B3.03b, B3.07e)

When presented with a pediatric patient, the student will accurately record all data. (B3.03b, B3.07e)

When presented with a pediatric patient, students will be able complete a history, perform a physical examination, formulate an assessment, and create a management plan for the following categories of patient encounters:

• for preventive, acute, and chronic patient encounters. (B3.03a, B3.07e)

• across the life span, to include infants, children, and adolescents. (B3.03b, B3.07e)

• Preceptor Evaluation

• Clinical Documentation Assignment

• Clerkship specific patient encounter requirements

• Preceptor Evaluation

• Clerkship specific patient encounter requirements

• Elicit a detailed medical history, perform appropriate physical examination, and accurately record all pertinent data. (MK5)

• Accurately document medical information (IC2)

• Accurately evaluates pediatric patients with a cough. (B3.03b, B3.07e)

• Accurately evaluates pediatric patients with a fever. (B3.03b, B3.07e)

• Accurately evaluates patients requiring a routine health assessment. (B3.03b, B3.07e)

The student will be able to appropriately evaluate pediatric patients with common complaints such as cough, fever, and patients requiring a routine health assessment. (B3.03b, B3.07e)

Preceptor Evaluation

• Discern among acute, chronic, and emerging disease states. (MK2)

• Elicit a detailed medical history, perform appropriate physical examination, and accurately record all pertinent data. (MK5)

• Identify and formulate an appropriate assessment and management plan. (MK6)

• Understand the principles of preventative medicine and how they apply to clinical practice. (SPH5)

• Elicit a detailed medical history, perform appropriate physical examination, and accurately record all pertinent data. (MK5)

• Identify and formulate an appropriate assessment and management plan (MK6).

INSTRUCTIONAL OBJECTIVES, COURSE LEARNING OUTCOMES, AND ASSESSMENT TOOLS COMMON TO ALL CLERKSHIPS

Instructional Objectives

By the conclusion of the Pediatric clerkship, students will demonstrate competency in the following: (B1.01d, B1.03e, B3.03b, B3.07e)

Course Learning Outcomes

(B1.01d, B1.03e, B3.03b, B3.07e)

Assessment

Tools Utilized

Competency of instructional objectives and learner outcomes are measured by successful completion of the following assessment tools:

(B1.03e, B1.03g, B4.01a)

Program

Competencies

The instructional objectives, learning outcomes, and successful completion of course assessments guide students toward the acquisition of the following Program Competencies: (B1.01b, B1.03e, B4.01a)

• Effectively communicates with patients.

(B3.03b, B3.07e)

• Effectively communicates with families. (B3.03b, B3.07e)

• Effectively communicates with members of the health care team. (B3.03b, B3.07e)

When presented with a pediatric patient, the student will develop relationships that result in effective communication with patients, their families, and members of the interprofessional team. (B3.03b, B3.07e)

Preceptor evaluation

• Demonstrates empathy. (B3.03b, B3.07e)

• Demonstrates respect. (B3.03b, B3.07e)

• Demonstrates ethical behavior. (B3.03b, B3.07e)

When presented with a pediatric patient, the student demonstrates empathy, respect, and ethical behavior. (B3.03b, B3.07e)

Preceptor evaluation

• Use effective interviewing skills to elicit a detailed history. (IC1)

• Understands the importance of effective communication with patients, families, physicians, and other members of the care team. (IC7)

• Demonstrate empathetic and respectful behaviors. (PB1)

• Demonstrates and identifies appropriate ethical behavior. (PB4)

• Demonstrates reliability. (B3.03b, B3.07e)

• Demonstrates accountability. (B3.03b, B3.07e)

• Demonstrates dependability. (B3.03b, B3.07e)

• Exhibits a positive approach to learning. (B3.03b, B3.07e)

• Demonstrate an understanding of diverse health care needs. (B3.03b, B3.07e)

When presented with a pediatric patient, the student exhibits reliability, dependability, and is accountable. (B3.03b, B3.07e)

Preceptor evaluation • Exhibit reliability, accountability, and dependability. (PB2)

• Demonstrates accountability to patients, society, and the profession (PB6).

• Utilize appropriate clinical reasoning and problem-solving abilities. (B3.03b, B3.07e)

• Analyze clinical data correctly. (B3.03b, B3.07e)

When presented with a pediatric patient, the student can understand the diverse needs of patients. (B3.03b, B3.07e)

Preceptor evaluation Demonstrates an understanding of diverse health care needs (IC8).

When presented with a pediatric patient, the student will be able to utilize the clinical reasoning and problem-solving abilities, inclusive of synthesizing and analyzing clinical data, to appropriately evaluate the patient. (B3.03b, B3.07e)

Preceptor evaluation • Utilize appropriate clinical reasoning and problemsolving abilities to identify and manage medical conditions (CRPSA1).

• Synthesize and analyze clinical data correctly (CRPSA2).

• Demonstrate care that is effective. (B3.03b, B3.07e)

• Demonstrate care that is safe. (B3.03b, B3.07e)

• Demonstrate care that is equitable. (B3.03b, B3.07e)

• Demonstrate care that is of high quality. (B3.03b, B3.07e)

When presented with a pediatric patient, the student will provide effective, safe, equitable, and high-quality care. (B3.03b, B3.07e)

Preceptor evaluation Demonstrate care that is effective, safe, equitable, and high quality (CRPSA4).

OUTLINE OF TOPICS COVERED IN THIS COURSE (B1.03f)

Pediatric topics covered in this course are outlined below. They are derived from the PAEA Pediatric topic list found here: https://paeaonline.org/assessment/end-of-rotation/content. Success requires an understating of the definition, etiology, risk factors, pathophysiology, clinical presentation, diagnostic work-up and management of patients with these conditions.

DERMATOLOGY

Acne vulgaris, Androgenetic alopecia, Atopic dermatitis, Burns, Contact dermatitis, Dermatitis (diaper, perioral), Drug eruptions, Erythema multiforme, Exanthems, Impetigo, Lice, Lichen planus, Pityriasis rosea, Scabies, Stevens-Johnson syndrome, Tinea, Toxic epidermal necrolysis, Urticaria, Verrucae

ENT/OPHTHALMOLOGY

Acute otitis media, Acute pharyngotonsillitis, Allergic rhinitis, Conjunctivitis, Epiglottitis, Epistaxis, Hearing impairment, Mastoiditis, Oral candidiasis, Orbital cellulitis, Otitis externa, Peritonsillar abscess, Strabismus, Tympanic membrane perforation

INFECTIOUS DISEASE

Atypical mycobacterial disease, Epstein-Barr disease, Erythema infectiosum, Hand-foot-and-mouth disease, Herpes simplex, Influenza, Measles, Mumps, Pertussis, Pinworms, Roseola, Rubella, Varicella infection

PULMONOLOGY

Acute bronchiolitis, foreign body, Asthma, Croup, Cystic fibrosis, Hyaline membrane disease, Pneumonia (bacterial, viral), Respiratory syncytial virus

CARDIOVASCULAR

Acute rheumatic fever, Atrial septal defect, Coarctation of the aorta, Hypertrophic cardiomyopathy, Kawasaki disease, Patent ductus arteriosus, Syncope, Tetralogy of Fallot, Ventricular septal defect

GASTROINTESTINAL/NUTRIONAL SYSTEM

Appendicitis, Colic, Constipation, Dehydration, Duodenal atresia, Encopresis, Foreign body, Gastroenteritis, Gastroesophageal reflux disease, Hepatitis, Hirschsprung disease, Inguinal hernia, Intussusception, Jaundice, Lactose intolerance, Niacin deficiencies, Pyloric stenosis, Umbilical hernia, Vitamin A deficiency, Vitamin C deficiency, Vitamin D deficiency

NEUROLOGY/DEVELOPMENTAL Anticipatory guidance, Down syndrome, Febrile seizure, Immunization guidelines, Meningitis, Normal growth and development, Seizure disorders, Teething, Turner syndrome

PSYCHIATRY/BEHAVIORAL MEDICINE

Anxiety disorders, Attention-deficit/hyperactivity disorder, Autism spectrum disorder, Child abuse and neglect, Disruptive, impulsecontrol, and conduct disorders, Feeding or eating disorders, Suicide, Depressive disorders

ORTHOPEDICS/RHEUMATOLOGY

Avascular necrosis of the proximal femur, Congenital hip dysplasia, Juvenile rheumatoid arthritis, Neoplasia of the musculoskeletal system, Nursemaid elbow, Osgood-Schlatter disease, Scoliosis, Slipped capital femoral epiphysis

ENDOCRINOLOGY

Diabetes mellitus, Hypercalcemia, Hyperthyroidism, Hypothyroidism, Obesity, Short stature

HEMATOLOGY

Anemia, Bleeding disorders, Brain tumors, Hemophilia, Lead poisoning, Leukemia, Lymphoma, Neutropenia

UROLOGY/RENAL

Cryptorchidism, Cystitis, Enuresis, Glomerulonephritis, Hydrocele, Hypospadias, Paraphimosis, Phimosis, Testicular torsion, Vesicourethral reflux

ARC-PA STANDARDS

To assist with assuring student’s, complete the supervised clinical experiences with preceptors that enable all students to meet program defined learning outcomes, the program clearly outlines specific areas of the ARC-PA Standards this course assist with addressing underlined and bolded below. Throughout the program, students will meet learning outcomes in all areas of the standard listed below.

B3.03 Supervised clinical practice experiences musts enable all students to meet the program’s learning outcomes:

B3.07 Supervised clinical practice experiences must occur with preceptors who enable students to meet program defined learning outcomes for:

(a) family medicine, (b) emergency medicine, (c) internal medicine, (d) surgery, (e) pediatrics, (f) women’s health including prenatal and gynecological care, (g) behavioral and mental health care.

STUDENT ASSESSMENT/EVALUATION (B1.03g)

Clerkship Specific Assessments

The grade for the Pediatric clerkship is based on the following components:

Clinical Documentation Assignment: H&P 15%

Drug Cards P/F

Preceptor Evaluation 50%

End of Clerkship Examination (EOC Exam) 35%

Clerkship Specific Patient Encounter Requirements P/F

GRADING PLAN (B1.03h)

Passage of the clerkship course requires an overall average grade of 70% or greater.

Grade Calculations

CLERKSHIP SPECIFIC ASSESSMENTS

CLINICAL DOCUMENTATION ASSIGNMENT

Each student must submit one full history and physical note by the completion of the Pediatric clerkship using Microsoft Word. All notes must be submitted to Exxat in “session required documents” prior to the start of call back day (see submitting call back day materials). Please use the grading rubric in the back of the handbook for additional guidance on completing this assignment.

Please note:

• H&P notes are to be a maximum of five (5) pages in length.

• H&P notes are not acceptable on hospital forms.

• No identifying information may appear on any notes as this violates HIPAA regulations. Notes submitted with identifying information will earn a grade of zero for that note.

For each day the note is late, five (5)-points will be deduction from the Clinical Documentation grade.

DRUG CARDS

PRECEPTOR EVALUATION

Clerkship specific preceptor evaluations are used to evaluate student performance. The preceptor evaluations are based on the instructional objectives provided above and assist students with meeting the course learning outcomes. Students should review the instructional objectives and course learning outcomes above in preparation for the clerkship and the preceptor evaluation. Copies of the clerkship specific preceptor evaluation can be found at the back of your clinical handbook and is posted on Exxat in the “Student Packet” section under “Generalized Documents.”

END OF CLERKSHIP EXAMINATION (EOC Exam)

To assess the student’s comprehensive knowledge in pediatrics, a 120-question multiple-choice examination is given at the end of the clerkship. This end of rotation examination is offered by the Physician Assistant Education Association (PAEA) and is developed by PA educators for use during the clinical year. It is a peer-reviewed exam that incorporates current, relevant test items that follow the NCCPA tasks and blueprints and corresponding PAEA blueprints and topic lists.

CLERKSHIP SPECIFIC PATIENT ENCOUNTER REQUIREMENTS (Patient Logs)

The minimum Pediatric clerkship requirements for the clinical year are presented in the table below. Please do not stop logging once the minimum requirement is completed, as clinical encounters will increase in complexity and level of participation as students’ progress in each clerkship and throughout the clinical phase of the program. Students should print out a copy of their patient encounter log in “graph” format and have their preceptor sign off on the following specific patient encounters. The preceptor signature not only confirms exposure, but competence in these areas of care. Once signed, your log should be uploaded onto session required documents on Exxat. Should a student not meet these competencies during their pediatric clerkship, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required for course completion and graduation and a grade of “I” incomplete will be given until all patient encounter requirements are completed.

Pediatric

60 encounters during the Pediatric clerkship (approximately 10 per week)

Preventive 10 encounters during the Pediatric clerkship

Acute 5 encounters during the Pediatric clerkship

Chronic 5 encounters during the Pediatric clerkship

Infants- less than 1 years of age 15 encounters during the Pediatric clerkship

Children- 1-11 y/o 30 encounters during the Pediatric clerkship

Adolescents- 12-17 y/o 30 encounters during the Pediatric clerkship

Preventive: Routine health care that includes screenings, check-ups, and patient counseling to prevent illness, disease, or other health problems.

Acute: Related to a medical condition with a rapid onset and short course.

Chronic: Related to a medical condition that persists and is long lasting.

Emergent: Related to a medical condition requiring immediate intervention.

CLINICAL YEAR REQUIRMENTS for GRADUATION

The following are requirements completed during the clinical year needed to graduate.

Clinical Year Patient Encounter Requirements P/F

Clinical Year Procedure Logging Requirements P/F

Quality Assurance/Performance Improvement Assignment P/F

Developmental Disabilities Logging Requirement and Reflective Journaling P/F

Longitudinal Patient Case with Medical Documentation Submission P/F

CLINICAL YEAR PATIENT ENCOUNTER REQUIREMENTS (Patient logs)

Although students must log specific encounters during the Pediatric clerkship, the below clinical year encounters are required to be completed by the end of the clinical year, not by the end of the Pediatric clerkship. These requirements may be met on any of the eight clerkships. Preceptors must sign off on the following specific patient encounters. The preceptor signature not only confirms exposure, but competence in these areas of care. The process ensures student deficiencies are identified and addressed in a timely manner. Should a student be at risk of not meeting these competencies during the clinical year, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required for clinical year completion and graduation. Please follow the same process for logging patients as described under the section titled “Clerkship Specific Patient Encounter Requirements”.

Types of Clinical Encounters

Preventative

20 encounters during clinical year

Acute 20 encounters during clinical year

Chronic 20 encounters during clinical year

Emergent 20 encounters during clinical year

Preventative: Routine health care that includes screenings, check-ups, and patient counseling to prevent illness, disease, or other health problems.

Acute: Related to a medical condition with a rapid onset and short course.

Chronic: Related to a medical condition that persists and is long lasting.

Emergent: Related to a medical condition requiring immediate intervention.

Medical Care Across the Life Span Encounters

Infants- less than 1 years of age 15 encounters during the clinical year

Children- 1-11 y/o 30 encounters during the clinical year

Adolescents- 12-17 y/o 30 encounters during the clinical year

Adults- 18-64 y/o 100 encounters during the clinical year

Elderly - 65 and older 100 encounters during the clinical year

CLINICAL YEAR PROCEDURE LOGGING REQUIREMENTS

Procedures are tracked through the Exxat System. Please make sure to perform, rather than observe or assist as many procedures as possible, as credit is given only for those logged as “performed”. Once your log is signed, please upload it to Exxat in “session required documents”. During the Pediatric clerkship, it is recommended that you focus on procedures such as IM/SC/ID injections, venipuncture, and IV placement. Students should seek out opportunities to meet procedural requirements, however, not all the requirements listed below need to be completed during the student’s Pediatric clerkship. The clinical coordinator reviews procedure logs every three months. The process ensures student deficiencies are identified and addressed in a timely manner. Should a student be at risk of not meeting these competencies during the clinical year, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required for clinical year completion and graduation. REQUIRED

QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT ASSIGNMENT

Summary:

1. Go to Canvas

2. Go to course PHA 227

3. Click on “discussion board” on left side

4. Click on “Patient Safety Institute CO 2025”

5. Click on course modules on left side and review “IHI Videos.”

6. Follow instructions for the discussion board

DEVELOPMENTAL DISABILITIES LOGGING REQUIREMENT AND REFLECTIVE JOURNALING

Logging requirement:

Although students must log specific pediatric encounters during the pediatric clerkship, the below developmental disabilities logging requirement is required to be completed by the end of the clinical year, not by the end of the pediatric clerkship. However, the Pediatric

rotation offers a good opportunity to meet this requirement. Throughout the clinical year, 15 patients with a history of developmental disabilities must be logged in the Exxat system. Please be sure you click on the “developmental disability” box to capture your patients in the system. These requirements may be met on any of the eight clerkships. Preceptors must sign off on the following specific patient encounters. The preceptor signature not only confirms exposure, but competence in these areas of care. The process ensures student deficiencies are identified and addressed in a timely manner. Should a student be at risk of not meeting these competencies during the clinical year, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required by the end of the clinical year and for graduation. Please follow the same process for logging patients as described under the section titled “Clerkship Specific Patient Encounter Requirements”.

Types of Clinical Encounters

Developmental Disabilities 15 encounters during clinical year

LONGITUDINAL PATIENT CASE with MEDICAL DOCUMENTATION SUBMISSION

• by session • to do list • session required documents • longitudinal patient case SOAP note. Please make sure to upload under the correct rotation.

CLERKSHIP BIBLIOGRAPHY

Please refer to the Student and Clinical Year Handbooks for additional policies related to clinical clerkships.

PHA 285 BEHAVIORAL AND MENTAL HEALTH CARE CLERKSHIP 3 s.h. (B1.03a, B3.03e, B3.07g)

COURSE COORDINATOR (B1.03c)

Shannan Ricoy, M.S., PA-C; Email: Shannan.Ricoy@hofstra.edu

Office: 516-463-4233

COURSE DESCRIPTION (B1.03b)

This is a supervised clinical experience where students function under the supervision of preceptors who enable them to meet learning outcomes for behavioral and mental health conditions. The student will actively participate in evaluating and managing patients with behavioral and mental health conditions.

COURSE GOAL (B1.03d)

This clerkship’s goal is to enhance students’ knowledge of the general principles of Behavioral and Mental Health Care and to expose them to patients with a variety of behavioral and mental conditions. Students will develop their psychiatric history taking skills, mental status examination skills, and learn appropriate use of psychoactive pharmaceuticals.

INSTRUCTIONAL OBJECTIVES, COURSE LEARNING OUTCOMES, AND ASSESSMENT TOOLS, SPECIFIC TO BEHAVIORAL AND MENTAL HEALTH CARE

Instructional Objectives

By the conclusion of the Behavioral and Mental Health Care clerkship, students will demonstrate competency in the following:

(B1.01d, B1.03e, B3.03e, B3.07g)

Course Learning Outcomes

Assessment

Tools Utilized

Competency of instructional objectives and learner outcomes are measured by successful completion of the following assessment tools: (B1.03e, B1.03g, B4.01a)

Program Competencies

The instructional objectives, learning outcomes, and successful completion of course assessments guide students toward the acquisition of the following Program Competencies: (B1.01b, B1.03e, B4.01a)

• Elicits a detailed history of patients with behavioral and mental health conditions.

(B3.03e, B3.07g)

• Evaluate the mental status of patients with behavioral and mental health conditions using a MMSE. (B3.03e, B3.07g)

• Selects appropriate diagnostic studies to order for patients with behavioral and mental health conditions. (B3.03e, B3.07g)

• Interpret diagnostic studies for patients with behavioral and mental health conditions. (B3.03e, B3.07g)

When presented with a patient with a behavioral and mental health condition, the student will use effective interviewing skills to perform a comprehensive evaluation that includes a detailed history and mental status examination. (B3.03e, B3.07g)

• Preceptor evaluation

• Interesting patient case

• Clerkship specific patient encounter requirements

• Elicit a detailed medical history, perform appropriate physical examination, and accurately record all pertinent data. (MK5)

• Use effective interviewing skills to elicit a detailed history. (IC1)

When presented with a patient with a behavioral and mental health condition, the student will be able to appropriately use diagnostic studies to aid in the diagnosis of patients with a behavioral and mental health condition. (B3.03e, B3.07g)

• Preceptor evaluation

• Interesting patient case

• Clerkship specific patient encounter requirements

• EOC Exam

• Select and interpret appropriate screening and diagnostic studies. (MK7)

• Formulate a differential diagnosis for patients with behavioral and mental health conditions. (B3.03e, B3.07g)

• Appropriately use the DSM V in diagnosis of patients with behavioral and mental health conditions. (B3.03e, B3.07g)

When presented with a patient with a behavioral and mental health condition, the student will develop a differential diagnosis and determine the most likely diagnosis. (B3.03e, B3.07g)

• Preceptor evaluation

• Interesting patient case

• Clerkship specific patient encounter requirements

• Identify and formulate an appropriate assessment and management plan (MK6).

• Formulates a management plan that uses consultations appropriately for patients with behavioral and mental health conditions. (B3.03e, B3.07g)

• Creates a pharmacological plan for patients with a behavioral and mental health condition. (B3.03e, B3.07g)

• Formulates a plan that includes nonpharmacological management for patients with a behavioral and mental health condition. (B3.03e, B3.07g)

• Formulates a plan inclusive of appropriate referrals for patients with a behavioral and mental health condition. (B3.03e, B3.07g)

• Formulates a plan that includes follow up for patients with behavioral and mental health condition. (B3.03e, B3.07g)

• Provides effective patient education to patients and their families for patients with behavioral and mental health conditions. (B3.03e, B3.07g)

• Emphasizes shared decision making for patients with behavioral and mental health conditions. (B3.03e, B3.07g)

• Applies the evidence from scientific studies to behavioral and mental health patient cases. (B3.03e, B3.07g)

• Performs effective oral presentations for patients with behavioral and mental health condition. (B3.03e, B3.07g)

When presented with a patient with a behavioral and mental health condition, focusing on shared decision making, the student will be formulating a management plan including the use of appropriate consults, pharmacologic plan, nonpharmacologic care, referral, follow up and patient education. (B3.03e, B3.07g)

• EOC Exam

When presented with a patient with a behavioral and mental health condition, the student will effectively orally present patients. (B3.03e, B3.07g)

• Preceptor evaluation

• Interesting patient case

• Drug cards

• Clerkship specific patient encounter requirements

• EOC Exam

• Identify and formulate an appropriate assessment and management plan (MK6).

• Provides appropriate referrals (IC4).

• Use effective basic counseling and patient education skills that enable shared decision making (IC6).

• Locate, appraise, and apply evidence from scientific studies to enhance patient care. (CRPSA3)

• Preceptor Evaluation

• Effectively complete oral presentations (IC3)

Accurately documents patient data for patients with behavioral and mental health condition. (B3.03e, B3.07g)

When presented with a patient with a behavioral and mental health condition, the student will accurately record all data.

(B3.03e, B3.07g)

• Accurately evaluates patients with acute behavioral and mental health conditions. (B3.03a, B307g)

• Accurately evaluates patients with chronic behavioral and mental health conditions. (B3.03a, B3.07g)

• Accurately evaluates adult patients (1864 yo) with behavioral and mental health conditions. (B3.03b, B3.07g)

• Accurately evaluates elderly patients (65 and older) with behavioral and mental health conditions. (B3.03b, B3.07g)

• Accurately evaluates patients with depression. (B3.03e, B3.07g)

• Accurately evaluates patients with an anxiety disorder. (B3.03e, B3.07g)

• Accurately evaluates patients with bipolar disorder. (B3.03e, B3.07g)

• Accurately evaluates patients with schizophrenia. (B3.03e, B3.07g)

• Accurately evaluates patients with substance-related disorders. (B3.03e, B3.07g)

When presented with a patient with a behavioral and mental health condition, students will be able complete a history, perform a mental status examination, formulate an assessment, and create a management plan for the following categories of patient encounters:

• for acute and chronic patient encounters. (B3.03a, B3.07g)

• across the life span, to include adults, and the elderly. (B3.03b, B3.07g)

When in a behavioral health setting, the student will be able to appropriately evaluate patients with common conditions such as depression, anxiety, bipolar disorder, schizophrenia, and substance related disorders. (B3.03e, B3.07g)

• Clerkship specific patient encounter requirements

• Preceptor Evaluation

• Clerkship specific patient encounter requirements

• Preceptor Evaluation

• Clerkship specific patient encounter requirements

• Elicit a detailed medical history, perform appropriate physical examination, and accurately record all pertinent data. (MK5)

• Accurately document medical information (IC2)

• Discern among acute, chronic, and emerging disease states. (MK2)

• Elicit a detailed medical history, perform appropriate physical examination, and accurately record all pertinent data. (MK5)

• Identify and formulate an appropriate assessment and management plan. (MK6)

• Preceptor Evaluation

• Elicit a detailed medical history, perform appropriate physical examination, and accurately record all pertinent data. (MK5)

• Identify and formulate an appropriate assessment and management plan (MK6).

INSTRUCTIONAL OBJECTIVES, COURSE LEARNING OUTCOMES, AND ASSESSMENT TOOLS COMMON TO ALL CLERKSHIPS

Instructional Objectives

By the conclusion of the Behavioral and Mental Health Care clerkship, students will demonstrate competency in the following: (B1.01d, B1.03e, B3.03e, B3.07g)

Course Learning Outcomes

Assessment Tools

Utilized

Competency of instructional objectives and learner outcomes are measured by successful completion of the following assessment tools: (B1.03e, B1.03g, B4.01a)

Program Competencies

The instructional objectives, learning outcomes, and successful completion of course assessments guide students toward the acquisition of the following Program

Competencies: (B1.01b, B1.03e, B4.01a)

• Effectively communicates with patients. (B3.03e, B3.07g)

• Effectively communicates with families. (B3.03e, B3.07g)

• Effectively communicates with members of the health care team. ((B3.03e, B3.07g)

When presented with a patient with a behavioral and mental health condition, the student will develop relationships that result in effective communication with patients, their families, and members of the interprofessional team. (B3.03e, B3.07g)

• Preceptor evaluation

• Demonstrates empathy. (B3.03e)

• Demonstrates respect. (B3.03e)

• Demonstrates ethical behavior. (B3.03e)

When presented with a patient with a behavioral and mental health condition, the student demonstrates empathy, respect, and appropriate ethical behavior. (B3.03e)

• Preceptor evaluation

• Use effective interviewing skills to elicit a detailed history. (IC1)

• Understands the importance of effective communication with patients, families, physicians, and other members of the care team. (IC7)

• Demonstrate empathetic and respectful behaviors. (PB1)

• Demonstrates and identifies appropriate ethical behavior. (PB4)

• Demonstrates reliability. (B3.03e)

• Demonstrates accountability. (B3.03e)

• Demonstrates dependability. (B3.03e)

• Exhibits a positive approach to learning. (B3.03e)

When presented with a patient with a behavioral and mental health condition, the student exhibits reliability, dependability, and is accountable. (B3.03e)

• Preceptor evaluation • Exhibit reliability, accountability, and dependability. (PB2)

• Demonstrates accountability to patients, society, and the profession (PB6).

• Demonstrate an understanding of diverse health care needs. (B3.03e)

• Utilize appropriate clinical reasoning and problem-solving abilities to identify conditions. (B3.03e)

• Analyze clinical data correctly. (B3.03e)

When presented with a patient with a behavioral and mental health condition, the student demonstrates the ability to understand the diverse needs of patients. (B3.03e)

When presented with a patient with a behavioral and mental health condition, the student will be able to utilize the clinical reasoning and problem-solving abilities, inclusive of synthesizing and analyzing clinical data, to appropriately evaluate the patient. (B3.03e)

• Preceptor evaluation Demonstrates an understanding of diverse health care needs (IC8).

• Demonstrate care that is effective. (B3.03e)

• Demonstrate care that is safe. (B3.03e)

• Demonstrate care that is equitable. (B3.03e)

• Demonstrate care that is of high quality. (B3.03e)

When presented with a patient with a behavioral and mental health condition, the student will provide effective, safe, equitable, and high-quality care. (B3.03e)

• Preceptor evaluation • Utilize appropriate clinical reasoning and problemsolving abilities to identify and manage medical conditions (CRPSA1). Synthesize and analyze clinical data correctly (CRPSA2).

• Preceptor evaluation Demonstrate care that is effective, safe, equitable, and high quality (CRPSA4).

OUTLINE OF TOPICS COVERED IN THIS COURSE (B1.03f)

Behavioral and Mental Health Care topics covered in this course are outlined below. They are derived from the PAEA Behavioral and Mental Health Care and Behavioral Health topic list found here: https://paeaonline.org/assessment/end-of-rotation/content. Success requires an understating of the definition, etiology, risk factors, pathophysiology, clinical presentation, diagnostic work-up and management of patients with these conditions.

DEPRESSIVE DISORDERS: BIPOLAR AND RELATED DISORDERS

Bipolar I disorder, Bipolar II disorder, Cyclothymic disorder, Major depressive disorder, Persistent depressive disorder (dysthymia)

ANXIETY DISORDERS; TRAUMA- AND STRESS-RELATED DISORDERS

Generalized anxiety disorder, Panic disorder, Phobic disorders, post-traumatic stress disorder, Specific phobias

SUBSTANCE-RELATED DISORDERS

Alcohol-related disorders, Cannabis-related disorders, Hallucinogen-related disorders, Inhalant-related disorders, Opioid-related disorders, Sedative-, hypnotic-, or anxiolytic-related disorders, Stimulant-related disorders, Tobacco-related disorders

SCHIZOPHRENIA SPECTRUM AND OTHER PSYCHOTIC DISORDERS

Delusional disorder, Schizoaffective disorder, Schizophrenia, Schizophreniform disorder

DISRUPTIVE, IMPULSE-CONTROL AND CONDUCT DISORDERS; NEURODEVELOPMENTAL DISORDERS

Attention-deficit/hyperactivity disorder, Autism spectrum disorder, Conduct disorder, Oppositional defiant disorder

PERSONALITY DISORDERS; OBSESSIVE-COMPULSIVE AND RELATED DISORDERS

Antisocial personality disorder, Narcissistic personality disorder, Avoidant personality disorder, Body dysmorphic disorder, Borderline personality disorder, Dependent personality disorder, Histrionic personality disorder, Obsessive-compulsive disorder, Obsessivecompulsive personality disorder, Paranoid personality disorder, Schizoid personality disorder, Schizotypal personality disorder

SOMATIC SYMPTOM AND RELATED DISORDERS; NONADHERENCE TO MEDICAL TREAMENT

Factitious disorder, Illness anxiety disorder, Somatic symptom disorder

FEEDING OR EATING DISORDERS

Anorexia nervosa, Bulimia nervosa

PARAPHILIC DISORDERS; SEXUAL DYSFUNCTIONS Exhibitionistic disorder, Female sexual interest/arousal disorder, Fetishistic disorder, Male hypoactive sexual desire disorder, Pedophilic disorder, Sexual masochism disorder, Voyeuristic disorder

ARC-PA STANDARDS

B3.03 Supervised clinical practice experiences musts enable all students to meet the program’s learning outcomes: a) for preventative, emergent, acute, and chronic patient encounters, b) across the life span, to include infants, children, adolescents, adults, and the elderly, c) for women’s health (to include prenatal and gynecologic care), d) for conditions requiring surgical management, including pre-operative, intra-operative care, post-operative care and e) for behavioral and mental health conditions.

STUDENT ASSESSMENT/EVALUATION (B1.03g)

Clerkship Specific Assessments

The grade for the Behavioral and Mental Health Care clerkship is based on the following components: Interesting Patient Case Assignment 15% Drug Cards P/F

Preceptor Evaluation 50% End of Clerkship Examination (EOC Exam) 35%

Clerkship Specific Patient Encounter Requirements P/F

GRADING PLAN (B1.03h)

Passage of the clerkship course requires an overall average grade of 70% or greater.

Grade Calculations

CLERKSHIP SPECIFIC ASSESSMENTS

INTERESTING PATIENT CASE ASSIGNMENT

The interesting patient case assignment is a requirement during the Behavioral and Mental Health Care clerkship. The interesting case will either be presented on a site visit or uploaded onto Exxat prior to the start of call back day. All interesting patient case assignments should include all elements of a focused H&P, a written summary of the pathophysiology of the disease state, and one related journal article review utilizing the “Evaluating a Peer Reviewed Scientific Article” form. Journal articles should be related to the chosen interesting case, current, less than 5 years old, and come from an academic, peer-reviewed medical publication. Students that present an interesting case on a site visit should be prepared to lead a discussion with their fellow classmates and a faculty member.

DRUG CARDS

they will receive an incomplete for this clerkship. An incomplete remains until the student completes the requirement. If a passing grade is not achieved, the student must remediate the assignment as directed by the clinical coordinator until competency is achieved.

PRECEPTOR EVALUATION

END OF CLERKSHIP EXAMINATION (EOC Exam)

To assess comprehensive knowledge of the discipline of Behavioral and Mental Health Care, a 120-question multiple-choice examination is given at the end of the clerkship. This end of rotation examination is offered by the Physician Assistant Education Association (PAEA) and is developed by PA educators for use during the clinical year. It is a peer-reviewed exam that incorporates current, relevant test items that follow the NCCPA tasks and blueprints and corresponding PAEA blueprints and topic lists.

To assist with preparation for the examination and ensure you are meeting the course objectives and learning outcomes, students must use the following Core Tasks and Objectives https://paeaonline.org/assessment/core-tasks-and-objectives/ and apply information to the TOPIC LIST provided here: https://paeaonline.org/assessment/end-of-rotation/content. Student should also review blueprint of the exam which can be found through the following link: https://paeaonline.org/assessment/end-of-rotation/content. The EOC examinations have a similar format as the Physician Assistant National Certifying Examination (PANCE).

CLERKSHIP SPECIFIC PATIENT ENCOUNTER REQUIREMENTS (Patient Logs)

patient experiences prior to this time. More than one failure to log minimum weekly patient encounters on time will result in a three (3) point deduction from the OVERALL ROTATION GRADE. Each additional failure to log will result in a one (1) point deduction from the overall rotation grade. Students are contacted if the weekly review identifies deficiencies in patient care experiences. A clinical coordinator will discuss methods of assuring requirements are achieved and maximizing clinical opportunities for the remaining time in the clerkship.

The minimum Behavioral and Mental Health Care requirements for the clinical year are presented in the table below. Please do not stop logging once the minimum requirement is completed, as clinical encounters will increase in complexity and level of participation as students’ progress in each clerkship and throughout the clinical phase of the program. Students should print out a copy of their patient encounter log in “graph” format and have their preceptor sign off on the following specific patient encounters. The preceptor signature not only confirms exposure, but competence in these areas of care. Once signed, your log should be uploaded onto session required documents on Exxat. Should a student not meet these competencies during their Behavioral and Mental Health Care clerkship, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required for course completion and graduation and a grade of “I” incomplete will be given until all patient encounter requirements are completed.

Behavioral and Mental Health Care 60 encounters during the Behavioral and Mental Health Care clerkship (approximately 10 per week)

Acute 5 encounters during the Behavioral and Mental Health Care clerkship

Chronic 5 encounters during the Behavioral and Mental Health Care clerkship

Adults- 18-64 y/o 10 encounters during the Behavioral and Mental Health Care clerkship

Elderly- 65 and older 10 encounters during the Behavioral and Mental Health Care clerkship

Acute: Related to a medical condition with a rapid onset and short course.

Chronic: Related to a medical condition that persists and is long lasting.

Emergent: Related to a medical condition requiring immediate intervention.

CLINICAL YEAR REQUIRMENTS for GRADUATION

The following are requirements completed during the clinical year needed to graduate.

Clinical Year Patient Encounter Requirements P/F

Clinical Year Procedure Logging Requirements P/F

Quality Assurance/Performance Improvement Assignment P/F

Developmental Disabilities Logging Requirement and Reflective Journaling P/F

Longitudinal Patient Case with Medical Documentation Submission P/F

CLINICAL YEAR PATIENT ENCOUNTER REQUIREMENTS (Patient logs)

Although students must log specific encounters during the Behavioral and Mental Health Care clerkship, the below clinical year encounters are required to be completed by the end of the clinical year, not by the end of the Behavioral and Mental Health Care clerkship. These

requirements may be met on any of the eight clerkships. Preceptors must sign off on the following specific patient encounters. The preceptor signature not only confirms exposure, but competence in these areas of care. The process ensures student deficiencies are identified and addressed in a timely manner. Should a student be at risk of not meeting these competencies during the clinical year, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required for clinical year completion and graduation. Please follow the same process for logging patients as described under the section titled “Clerkship Specific Patient Encounter Requirements”.

Types of Clinical Encounters

Preventative 20 encounters during clinical year

Acute 20 encounters during clinical year

Chronic 20 encounters during clinical year

Emergent 20 encounters during clinical year

Preventative: Routine health care that includes screenings, check-ups, and patient counseling to prevent illness, disease, or other health problems.

Acute: Related to a medical condition with a rapid onset and short course.

Chronic: Related to a medical condition that persists and is long lasting.

Emergent: Related to a medical condition requiring immediate intervention.

Medical Care Across the Life Span Encounters

Infants- less than 1 years of age 15 encounters during the clinical year

Children- 1-11 y/o 30 encounters during the clinical year

Adolescents- 12-17 y/o 30 encounters during the clinical year

Adults- 18-64 y/o

Elderly- 65 and older

100 encounters during the clinical year

CLINICAL YEAR PROCEDURE LOGGING REQUIREMENTS

the student’s Behavioral and Mental Health Care clerkship. The clinical coordinator reviews procedure logs every three months. The process ensures student deficiencies are identified and addressed in a timely manner. Should a student be at risk of not meeting these competencies during the clinical year, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required for clinical year completion and graduation.

REQUIRED CLINICAL YEAR PROCEDURES/EXAMINATIONS

QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT ASSIGNMENT

Summary:

1. Go to Canvas

2. Go to course PHA 227

3. Click on “discussion board” on left side

4. Click on “Patient Safety Institute CO 2025”

5. Click on course modules on left side and review “IHI Videos.”

6. Follow instructions for the discussion board

DEVELOPMENTAL DISABILITIES LOGGING REQUIREMENT AND REFLECTIVE JOURNALING

Logging requirement:

Although students must log specific encounters during the Behavioral and Mental Health Care clerkship, the below developmental disabilities logging requirement are required to be completed by the end of the clinical year, not by the end of the Behavioral and Mental Health Care clerkship. Throughout the clinical year, 15 patients with a history of developmental disabilities must be logged in the Exxat system. Please be sure you click on the “developmental disability” box to capture your patients in the system. These requirements may be met on any of the eight clerkships. Preceptors must sign off on the following specific patient encounters. The preceptor signature not only confirms exposure, but competence in these areas of care. The process ensures student deficiencies are identified and addressed in a timely manner. Should a student be at risk of not meeting these competencies during the clinical year, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required by the end of the clinical year and for graduation. Please follow the same process for logging patients as described under the section titled “Clerkship Specific Patient Encounter Requirements”.

Types of Clinical Encounters

Developmental Disabilities

15 encounters during clinical year

student be at risk of not completing this assignment during the clinical year, students must formulate a plan with one of the clinical coordinators to assure completion. Completion is required by the end of the clinical year and for graduation. Failure of students to participate satisfactorily in this project by the end of the last clinical rotation will result in an "Incomplete" for the final clinical rotation. An incomplete remains until the student completes the requirement.

LONGITUDINAL PATIENT CASE with MEDICAL DOCUMENTATION SUBMISSION

The longitudinal patient case is completed over the clinical year. It is designed to allow students to simulate care for a patient over a prolonged period. Thus, the student begins with an initial visit with the simulated patient and then evaluates the “same patient” over the course of the clinical year. At each visit, the patient’s health care needs may change, simulating care of a patient longitudinally. Students must obtain the necessary history, perform a physical examination, order and interpret diagnostic studies, formulate an assessment, and formulate a plan in a simulated environment. After the clinical encounter, a debriefing session led by faculty will focus on communication skills, clinical skills, history taking, physical exam skills, assessment and plan formulation.

CLERKSHIP BIBLIOGRAPHY

Please refer to the Student and Clinical Year Handbooks for additional policies related to clinical clerkships.

PHA 290 ELECTIVE CLERKSHIP 3 s.h. (B1.03a)

COURSE COORDINATOR (B1.03c)

Janet Tutuyan, MPH, PA-C; Email: Janet.Tutuyan@hofstra.edu

Office: 516-463-6841

COURSE DESCRIPTION (B1.03b)

This course is a supervised clinical experience where students function under the supervision of preceptors who enable students to meet learning outcomes for elective clerkship. The elective supervised clerkship is designed to provide PA students with comprehensive exposure to a field of health care they are interested in exploring. Options include medical sub-specialties, surgical sub-specialties, or to gain further experience in one of the core disciplines. The rotation involves hands-on experience, clinical application, and patient interaction under the supervision of preceptors.

COURSE GOAL (B1.03d)

The goal of this clerkship is to enhance the students’ knowledge of the general principles and to expose students to patients with a variety of conditions. The student will assess common medical problems by taking a medical history, performing a physical examination, ordering and interpreting diagnostic studies, and formulating management plans for patients.

INSTRUCTIONAL OBJECTIVES, COURSE LEARNING OUTCOMES, AND ASSESSMENT TOOLS, SPECIFIC TO THE ELECTIVE

Instructional Objectives

By the conclusion of the Elective clerkship, students will demonstrate competency in the following: (B1.01d, B1.03e)

Course Learning Outcomes

Assessment Tools

Utilized

Competency of instructional objectives and learner outcomes are measured by successful completion of the following assessment tools: (B1.03e, B1.03g, B4.01a)

Program Competencies

The instructional objectives, learning outcomes, and successful completion of course assessments guide students toward the acquisition of the following Program Competencies:

(B1.01b, B1.03e, B4.01a)

• Elicits a detailed history for patients specific to this elective.

• Perform an appropriate physical examination on patients specific to this elective.

When presented with a patient on the elective clerkship, the student will use effective interviewing skills to perform a comprehensive evaluation that includes a detailed history and physical examination

• Preceptor evaluation

• Interesting patient case

• Clerkship specific patient encounter requirements

• Elicit a detailed medical history, perform appropriate physical examination, and accurately record all pertinent data. (MK5)

• Use effective interviewing skills to elicit a detailed history. (IC1)

• Selects appropriate diagnostic tests to order for patients specific to this elective.

• Interpret diagnostic studies for patients specific to this elective.

• Formulate a differential diagnosis for patients specific to this elective.

• Appropriately diagnose patients for patients specific to this elective.

When presented with a patient on an elective clerkship, the student can appropriately use diagnostic studies to aid in the diagnosis.

When presented with a patient on an elective clerkship, the student will be able to develop a differential diagnosis and determine the most likely diagnosis.

• Preceptor evaluation

• Interesting patient case

• Clerkship specific patient encounter requirements

• Preceptor evaluation

• Interesting patient case

• Clerkship specific patient encounter requirements

• Select and interpret appropriate screening and diagnostic studies. (MK7)

• Identify and formulate an appropriate assessment and management plan (MK6)

• Formulates a management plan that uses consultations appropriately for patients specific to this elective.

• Creates a pharmacological plan for patients specific to this elective.

• Formulates a plan that includes non-pharmacological management for patients specific to this elective.

• Formulates a plan inclusive of appropriate referrals for patients specific to this elective.

• Formulates a plan that includes follow-up for patients specific to this elective.

• Provides effective patient education to patients specific to this elective.

• Emphasizes shared decision making for patients specific to this elective.

• Applies the evidence from scientific studies for patients specific to this elective.

• Performs effective oral presentations for patients specific to this elective.

When presented with a patient on an elective clerkship, focusing on shared decision making, the student will be able to formulate a management plan including the use of appropriate consults, pharmacologic plan, nonpharmacologic care, referral, follow up and patient education.

• Preceptor evaluation

• Interesting patient case

• Drug cards

• Clerkship specific patient encounter requirements

• Identify and formulate an appropriate assessment and management plan (MK6).

• Provides appropriate referrals (IC4).

• Use effective basic counseling and patient education skills that enable shared decision making (IC6).

• Locate, appraise, and apply evidence from scientific studies to enhance patient care. (CRPSA3)

When presented with a patient on an elective clerkship, the student will effectively orally present patients.

• Accurately documents patient data for patients specific to this elective.

When presented with a patient on an elective clerkship, the student will accurately record all data.

• Preceptor Evaluation

• Clerkship specific patient encounter requirements

• Preceptor evaluation

• Clinical Documentation Assignment

• Effectively complete oral presentations (IC3)

• Elicit a detailed medical history, perform appropriate physical examination, and accurately record all pertinent data. (MK5)

• Clerkship specific patient encounter requirements

• Accurately document medical information (IC2)

INSTRUCTIONAL OBJECTIVES, COURSE LEARNING OUTCOMES, AND ASSESSMENT TOOLS COMMON TO ALL CLERKSHIPS

Instructional Objectives

By the conclusion of the Elective clerkship, students will demonstrate competency in the following: (B1.01d, B1.03e)

Course Learning Outcomes

(B1.01d, B1.03e)

Assessment Tools Utilized

Competency of instructional objectives and learner outcomes are measured by successful completion of the following assessment tools:

(B1.03e, B1.03g, B4.01a)

Program Competencies

The instructional objectives, learning outcomes, and successful completion of course assessments guide students toward the acquisition of the following Program Competencies: (B1.01b, B1.03e, B4.01a)

• Effectively communicates with patients.

• Effectively communicates with families.

• Effectively communicates with members of the health care team.

When presented with a patient on an elective clerkship, the student will develop relationships that result in effective communication with patients, their families, and members of the interprofessional team.

Preceptor evaluation

• Use effective interviewing skills to elicit a detailed history. (IC1)

• Understands the importance of effective communication with patients, families, physicians, and other members of the care team. (IC7)

• Demonstrates empathy.

• Demonstrates respect.

• Demonstrates ethical behavior.

When presented with a patient on an elective clerkship, the student demonstrates empathy, respect, and appropriate ethical behaviors.

Preceptor evaluation • Demonstrate empathetic and respectful behaviors. (PB1)

• Demonstrates and identifies appropriate ethical behavior. (PB4)

• Demonstrates reliability.

• Demonstrates accountability.

• Demonstrates dependability.

• Exhibits a positive approach to learning.

• Demonstrate an understanding of diverse health care needs.

When presented with a patient with an elective clerkship, the student exhibits reliability, dependability, and is accountable.

Preceptor evaluation • Exhibit reliability, accountability, and dependability. (PB2)

• Demonstrates accountability to patients, society, and the profession (PB6).

• Utilize appropriate clinical reasoning and problem-solving abilities.

• Analyze clinical data correctly.

When presented with a patient on an elective clerkship, the student demonstrates the ability to understand the diverse needs of patients.

When presented with a patient on an elective clerkship, the student will be able to utilize the clinical reasoning and problemsolving abilities, inclusive of synthesizing and analyzing clinical data, to appropriately evaluate the patient.

Preceptor evaluation Demonstrates an understanding of diverse health care needs (IC8).

Preceptor evaluation Utilize appropriate clinical reasoning and problem- solving abilities to identify and manage medical conditions (CRPSA1).

Synthesize and analyze clinical data correctly (CRPSA2).

• Demonstrate care that is effective.

• Demonstrate care that is safe.

• Demonstrate care that is equitable.

• Demonstrate care that is high quality.

When presented with a patient on an elective clerkship, the student will provide effective, safe, equitable, and high-quality care.

Preceptor evaluation Demonstrate care that is effective, safe, equitable, and high quality (CRPSA4).

OUTLINE OF TOPICS COVERED IN THIS COURSE (B1.03f)

The elective clerkship is designed to supplement the other seven mandatory clerkships which cover all necessary topics, including meeting ARC-PA standards related to clinical setting, care across the life span, types of patient encounters (ie preventive, emergent, acute etc.), and clerkship discipline (ie surgery, EM, IM etc.) Therefore, this clerkship focuses on student interests, rather than mandatory competencies. Thus, there are no set topics addressed in the elective clerkship.

STUDENT ASSESSMENT/EVALUATION (B1.03g)

Clerkship Specific Assessments

The grade for the Elective Care clerkship is based on the following components:

Interesting Patient Case 50%

Preceptor Evaluation 50%

Clerkship Specific Patient Encounter Requirements P/F

GRADING PLAN (B1.03h)

Passage of the clerkship course requires an overall average grade of 70% or greater.

Grade Calculations

CLERKSHIP SPECIFIC ASSESSMENTS

INTERESTING PATIENT CASE ASSIGNMENT

The interesting patient case assignment is a requirement during the elective clerkship. The interesting case will be presented on call back day. All interesting patient case presentations should be in a PowerPoint format and include a focused H&P, a summary of the pathophysiology of the disease state. In addition to this, students must create a unique plan to educate their patients on this topic. Examples include a poster, pamphlet, or lesson plan. Students should be prepared to lead a discussion with their fellow classmates and the clinical coordinator. This presentation can be no longer than twenty minutes in length and submitted to Exxat in session required documents prior to the start of call back day. If your file is too large to submit on Exxat, please send it to the clinical team via email. All topics are to be submitted to the clinical coordinators a minimum of two weeks prior to call back day for approval. Students should have a grade sheet and copy of their elective presentation for the instructor.

Students required to present their case may use an outline or notes for guidance, but reading verbatim is not permitted. Failure to submit this project will result in a grade of zero for this portion of the clerkship grade.

PRECEPTOR EVALUATION

CLERKSHIP SPECIFIC PATIENT ENCOUNTER REQUIREMENTS (Patient Logs)

The minimum Elective requirements for the clinical year are presented in the table below. Please do not stop logging once the minimum requirement is completed, as clinical encounters will increase in complexity and level of participation as students' progress in each clerkship and throughout the clinical phase of the program. Students should print out a copy of their patient encounter log in “graph” format and have their preceptor sign off on the following specific patient encounters. The preceptor signature not only confirms exposure, but competence in these areas of care. Once signed, your log should be uploaded onto session required documents on Exxat. Should a student not meet these competencies during their Elective clerkship, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required for course completion and graduation and a grade of “I” incomplete will be given until all patient encounter requirements are complete.

Elective 30 encounters during the Elective clerkship (approximately 5 per week)

CLINICAL YEAR REQUIRMENTS for GRADUATION

The following are requirements completed during the clinical year needed to graduate.

Clinical Year Patient Encounter Requirements

Clinical Year Procedure Logging Requirements

Quality Assurance/Performance Improvement Assignment

Developmental Disabilities Logging Requirement and Reflective Journaling

Longitudinal Patient Case with Medical Documentation Submission

CLINICAL YEAR PATIENT ENCOUNTER REQUIREMENTS (Patient logs)

P/F

Although students must log specific Elective encounters during this clerkship, the below clinical year encounters are required to be completed by the end of the clinical year, not by the end of the Elective clerkship. These requirements may be met on any of the eight clerkships. Preceptors must sign off on the following specific patient encounters. The preceptor signature not only confirms exposure, but competence in these areas of care. The process ensures student deficiencies are identified and addressed in a timely manner. Should a student be at risk of not meeting these competencies during the clinical year, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required for clinical year completion and graduation. Please follow the same process for logging patients as described under the section titled “Clerkship Specific Patient Encounter Requirements”.

Types of Clinical Encounters

Preventative

Acute

20 encounters during clinical year

Chronic 20 encounters during clinical year

Emergent 20 encounters during clinical year

Preventative: Routine health care that includes screenings, check-ups, and patient counseling to prevent illness, disease, or other health problems.

Acute: Related to a medical condition with a rapid onset and short course.

Chronic: Related to a medical condition that persists and is long lasting.

Emergent: Related to a medical condition requiring immediate intervention.

Medical Care Across the Life Span Encounters

Infants- less than 1 years of age 15 encounters during the clinical year

Children- 1-11 y/o 30 encounters during the clinical year

Adolescents- 12-17 y/o 30 encounters during the clinical year

Adults- 18-64 y/o 100 encounters during the clinical year

Elderly- 65 and older 100 encounters during the clinical year

CLINICAL YEAR PROCEDURE LOGGING REQUIREMENTS

Procedures are tracked through the Exxat System. Please make sure to perform, rather than observe or assist as many procedures as possible, as credit is given only for those logged as “performed”. Once your log is signed, please upload it to Exxat in “session required documents”. Students should seek out opportunities to meet procedural requirements, however, not all the requirements listed below need to be completed during the student’s Elective Care clerkship. The clinical coordinator reviews procedure logs every three months. The process ensures student deficiencies are identified and addressed in a timely manner. Should a student be at risk of not meeting these competencies during the clinical year, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required for clinical year completion and graduation. REQUIRED

QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT ASSIGNMENT

Summary:

1. Go to Canvas

2. Go to course PHA 227

3. Click on “discussion board” on left side

4. Click on “Patient Safety Institute CO 2025”

5. Click on course modules on left side and review “IHI Videos.”

6. Follow instructions for the discussion board

DEVELOPMENTAL DISABILITIES LOGGING REQUIREMENT AND REFLECTIVE JOURNALING

Logging requirement:

Although students must log specific Elective encounters during this clerkship, the below developmental disabilities logging requirement is required to be completed by the end of the clinical year, not by the end of the Elective clerkship. Throughout the clinical year, 15

patients with a history of developmental disabilities must be logged in the Exxat system. Please be sure you click on the “developmental disability” box to capture your patients in the system. These requirements may be met on any of the eight clerkships. Preceptors must sign off on the following specific patient encounters. The preceptor signature not only confirms exposure, but competence in these areas of care. The process ensures student deficiencies are identified and addressed in a timely manner. Should a student be at risk of not meeting these competencies during the clinical year, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required by the end of the clinical year and for graduation. Please follow the same process for logging patients as described under the section titled “Clerkship Specific Patient Encounter Requirements”.

Types of Clinical Encounters

Developmental Disabilities 15 encounters during clinical year

LONGITUDINAL PATIENT CASE with MEDICAL DOCUMENTATION SUBMISSION

• by session • to do list • session required documents • longitudinal patient case SOAP note. Please make sure to upload under the correct rotation.

CLERKSHIP BIBLIOGRAPHY

Please refer to the Student and Clinical Year Handbooks for additional policies related to clinical clerkships.

Student

Interesting

Case Presentation Evaluation Form

Rotation Type Site

Rotation Dates Preceptor Name ______________________________

SCORING: 0 = Not done, 1/5 = Poor, 3/5 5/5 = Excellent

TOPIC: COMMENTS

HISTORY:

History is overall representative of obtaining detailed subjective information from a patient.

PHYSICAL EXAM:

physical exam-including all components

Includes pertinent positive & negative PE findings

The PE is overall representative of the appropriate performance of a PE for the presenting complaint.

LABS/DIAGNOSTIC PROCEDURES:

MANAGEMENT:

JOURNAL:

TOTAL POINTS

Faculty Signature: _____________________________________ Date:

Elective Interesting Case Presentation Evaluation Form

Student _____________________________________ Faculty __________________________

Rotation Type __________________ Site ______________ Date________________________

Rotation Dates __________________ Preceptor Name \\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\

SCORING: 0 = Not done, 1/5 = Poor, 3/5 5/5 = Excellent

TOPIC: COMMENTS

HISTORY:

EXAM:

pertinent positive & negative PE findings

The PE is overall representative of the appropriate performance of a PE for the presenting complaint.

LABS/DIAGNOSTIC PROCEDURES:

TOTAL POINTS

Faculty Signature: Date:

Mid-Clerkship Evaluation

Please complete this evaluation by the end of the third week of the clerkship. This evaluation instrument is designed for students to facilitate a conversation with their preceptor to determine their strengths and weaknesses early so that the opportunity to identify and address deficiencies is possible in a timely manner. This tool also provides the program with feedback regarding clerkship quality. Lastly, it allows the course coordinator to identify problems with a clinical site and/or an issue with an individual student, allowing the course coordinator to follow-up with the student in a timely manner regarding the identified deficiency.

ROTATION:

1- FM 2- Med 3- WH 4- Surg 5- EM 6- BH 7- Peds 8- Elective:

ROTATION NUMBER: 12 3 4 5 6 7 8 ROTATION SITE: _________

Please rate the following learning experiences as appropriate to your rotation

5= superior 4= very good 3= good. 2= fair. 1= poor. N/A = Not Applicable Student Self-Assessment: How would you rate the following items:

1) Your ability to acclimate and acculturate to the clinical team?

2) Your professional behavior and attendance?

3) Your ability to perform histories and administer physical examinations?

4) Your ability to formulate a differential diagnosis?

5) Your ability to formulate and implement a management plan?

6) Your oral presentations?

7) Your ability to perform clinical procedures?

8) Have you discussed your performance with your preceptor and received feedback? If so, did the feedback identify a deficiency that needs correcting?

Clerkship Site Analysis: How would you rate the following items:

1) Appropriateness of supervision (i.e., is the supervisor adequately supervising patient encounters)?

2) Opportunity to perform history and physical examinations?

3) Opportunity to formulate differential diagnosis and management plans?

4) Opportunity to perform oral presentations?

5) Opportunity to perform clinical procedures?

6) Ability for this clerkship to meet the stated learning objectives?

Student Clinical Site & Preceptor Evaluation

Your feedback regarding your clinical experience is very important to the ongoing assessment and improvement process of the Hofstra Physician Assistant Studies Program. Please complete this confidential evaluation of your clinical site and preceptor on Exxat. We also ask that you provide detailed recommendations, using professional language, on how this experience may be improved. Your input is voluntary and appreciated. Your comments will not in any manner, affect your final clerkship grade.

ROTATION:

1- FM 2- Med 3- WH 4- Surg 5- EM 6- BH 7- Peds 8- Elective:

ROTATION NUMBER: 12 3 4 5 6 7 8

ROTATION SITES:

Please rate the following learning experiences as appropriate to your rotation as:

5= superior 4= very good 3= good 2= fair 1= poor N/A = Not Applicable

N/A = Not Applicable to this clinical rotation

Clinical Rotation Site Evaluation

1. The clinical site provided students with an orientation to the setting

2. The clinical site provided students with the opportunity to collaborate with/become a part of the medical team

3. The clinical site made students feel comfortable approaching staff with questions

4. The clinical site provided students with opportunities to interview and examine patient

5. The clinical site provided students with the ability to observe, learn, assist and/or perform clinical procedures

6. The clinical rotation, in conjunction with self-study, enabled the students to achieve stated learning objectives

Preceptor Evaluation

1. The preceptor provides students with the opportunity to formulate differential diagnoses and management plans

2. The preceptor provides students with the ability to observe, learn, assist and/or perform clinical procedures

3. The preceptor provides adequate supervision for the students

4. The preceptor provides students with the opportunity to present patients to them

5. The preceptor provides guidance regarding student’s clinical note writing

6. The preceptor gives the students feedback regarding their performance throughout the clinical rotation

7. The preceptor encouraged the student to ask question and was approachable

Site/Preceptor Evaluation

1. Would you recommend this site to other students?

a. Yes

b. No

c. Unsure

d. Why or why not (please be detailed and use professional language)

2. Would you recommend this preceptor to other students?

a. Yes

b. No

c. Unsure

d. Why or why not? (Please be detailed and use professional language)

STUDENT/PRECEPTOR

REVIEW OF INSTRUCTIONAL OBJECTIVES & LEARNER OUTCOMES FORM

Student ________________________________________at Hofstra University Physician (NAME)

Assistant Program has provided me with the instructional objectives and learner outcomes for this rotation. We discussed in detail the expectations involved in successfully completing this rotation.

Preceptor

Student

Date

Date of Report:

Date of Incident

Hofstra University Physician Assistant Program Exposure Incident Investigation Form

Time of Report:

Time of Incident

Name and Hofstra ID# of Student(s) involved in incident:

Name of Preceptor/Instructor at time of incident:

Location of potential exposure (classroom, Bioskills, or clinical clerkship):

If clinical clerkship, include specific site, discipline, and rotation number (ex: Woodhull, IM, rotation #4)

Exposure occurred as part of (check all that apply):

Supervised laboratory assignment

Patient care provided during clinical experience hours

Northwell Bioskills Lab

Other

Potentially Infectious Materials Involved: Type of body fluids, route, and source of exposure (ie. Needle stick, contact with open wound, etc)

Circumstance (Task being performed, where, how, and severity of the exposure):

How incident was caused? (Accident, equipment malfunction. if a device was being used include type and brand of device, whether or not it was a safety device, and when in the course of handling the device, the incident occurred):

Personal protective equipment being used: (gloves, gown, etc.):

Actions taken (decontamination, clean-up, immediate referral, reporting, etc.):

Recommendations for avoiding repetition:

If at Northwell Bioskills Lab, a copy of the Anatomy Gifts Registry specimen data sheet is attached? YES NO

Student has the Post-Exposure Evaluation and Follow-Up Checklist? circle one: YES NO

Student Signature

Name and Title of Investigator (Academic Coordinator or Clinical Coordinator): Print and Sign

Hofstra University

Department of Physician Assistant Studies

Post-Exposure Evaluation and Follow-Up Checklist

Date of Report: __________________________

Name and Hofstra ID# of Student(s) involved in incident: ____________________________

The following steps must be taken, and information transmitted, in the case of a student’s exposure to Bloodborne Pathogens:

Activity Completion Date

The Exposure Incident Investigation Form was completed

If applicable, source individual’s blood tested, and result given to exposed student.

Consent was not obtained (__________________________________)

Exposed Student’s Signature

If applicable, exposed student’s blood collected and tested. If refused, student must sign below.

Exposed Student’s Signature

If refused to see health care professional, then exposed student must sign below (_________________________________)

Exposed Student’s Signature

Name of Hofstra Student Health Services Provider – Print and Signature:

Date:

2024-2025 Clinical Year Handbook Agreement Form

Fall 2024 Edition

The 2024-2025 Physician Assistant Studies Program Clinical Handbook outlines school-wide and program-specific policies and regulations for Physician Assistant Program students in the clinical phase of the program. The clinical handbook is to be used in conjunction with the student handbook and does not supersede the student handbook. If the student is in doubt about the intent or content of any of the material in this handbook, it is his or her responsibility to initiate a discussion with their faculty advisor or the clinical coordinator.

I have read and understand the policies, rules and regulations as outlined within the Hofstra University Physician Assistant Program Clinical Year Handbook and agree, without reluctance, to abide by them.

NAME (Signature)

NAME (Print)

DATE

FAMILY MEDICINE CLERKSHIP: HEALTH PROMOTION PROJECT

Name:

Date:

The main goal of this health promotion project is to enable patients to increase control over and improve their own health. As healthcare providers, it is our responsibility to promote healthy lifestyles, along with identifying high risk patients who can develop complications from their various chronic illnesses or lifestyle risk factors. The objectives of this project are to inform patients about the prevention of a specific disease state and evaluate the effectiveness of their efforts.

Ask the patient the following questions and record and reassess the results. Please attach a current article (<5 years old) that discusses health promotion issues that relate to one of your patient’s illnesses. The assignment must be typed.

1. Identify and list this patient’s chronic illnesses and any lifestyle risk factors. Make sure to include the age, sex, and race of your patient.

2. What specific recommendations or actions did you take to enable patient selfmanagement, disease prevention and health promotion?

3. Has your patient been receiving continuous health screening from visited facility? If so, when and what was done? If no, what health care maintenance or health screening is this patient due for?

4. Reassess the patient and note if any changes were attempted or made after your initial discussions.

5. Please read your article (<5 years) that discusses one health promotion issue that relates to your patient’s illness(es). Please attach a one-page, typed, double spaced paper summarizing the article and discussing opinions regarding the article.

HEALTH PROMOTION PROJECT GRADE FORM

Student Name ____________________________

Rotation Number

Date

Content

• Identified and listed patient’s chronic illnesses and lifestyle risk factors.

• Describes specific recommendations or actions taken to enable patient selfmanagement, disease prevention and health promotion.

• Discusses whether patient is receiving continuous health screening from visited facility. If so, elaborates.

• Patient is reassessed. Discusses changes made or attempted

• States, expands, and supports main points.

• Exercises proper composition skills. (45%)

Research Article

• Research article current (<5 years)

• Research article is appropriate for topic

• Paper summarizes article

• Opinions regarding the article are discussed

• Exercises proper composition skills (45%)

Professionalism

• Submitted materials on time in a professional manner

• Student was engaged his/her audience and had good command of topic (10%)

Final Score: (100%)

DRUG CARD GRADING FORM

Name: ________________________________________ Date: _____________

Rotation Number: _________________ Rotation Discipline: ______________

Item

Student Competency

1. Class of medication Yes No

2. Mechanism of Action Yes No

3. Indications Yes No

4. Contraindications Yes No

5. Side Effects Yes No

6. Cost of medication Yes No

If “No” is circled for any item under “student competency”, the student receives a failing grade.

Circle: PASS FAIL

Comments:

Faculty signature: ________________________________________________

CLINICAL YEAR –H&P and SOAP Note GRADING FORM

Student’s Name: Date: Faculty Evaluator: _______________________________________ Grade:

SOAP/H&P:

1. Introduction (3)

2. History Components (20)

3. PE (15)

4. Assessment (20) (Includes acute, chronic, HCM)

5. Plan (20) (Patient Education, Follow Up, Preventive Care)

6. Signature (2)

7. Overall Evaluation of Note (20) (Presentation skills if student has a site visit, organization, legibility, completeness, clarity, spelling, etc.)

Total Points: _______

Comments:

DEPARTMENT OF PHYSICIAN ASSISTANT STUDIES FAMILY MEDICINE CLERKSHIP PRECEPTOR EVALUATION FORM

Student Name Rotation

Type and Site ________________

Preceptor Name

Rotation Dates

Preceptors: Please use the Likert scale below to evaluate student overall performance on clinical clerkship. Please note that 5 is the best score and 1 is the least. The student’s overall rotation grade will be determined by the total score from the Likert score below.

1 = poor

2 = below average

3 = average

4 = above average

5 = excellent

Please rate the student on their ability to achieve the following Instructional Objectives in support of the Course Learning Outcomes specific to Family Medicine.

When presented with patients with Family Medicine Conditions, please rate the student’s ability to achieve each of the following:

Formulates a management plan that uses consults appropriately for patients with a Family Medicine condition.

Provides information regarding disease prevention when caring for family medicine patients.

a pharmacological plan for patients with a Family Medicine condition.

a plan that includes non -pharmacological management for patients with a Family Medicine condition.

Formulates a plan inclusive of appropriate referrals for patients with a Family Medicine condition.

Formulates a plan that includes follow up for patients with a Family Medicine condition.

the evidence from scientific studies to Family Medicine patient cases.

effective oral presentations for patients with a Family Medicine condition.

Accurately documents patient data for patients with a Family Medicine condition.

Accurately provides preventive care to family medicine patients.

Accurately evaluates patients with acute conditions associated with Family Medicine.

Please rate the student on their ability to achieve the following Instructional Objectives in support of the Course Learning Outcomes in general and as they relate to Family Medicine.

When presented with patients with family medicine conditions, please rate the student’s ability to achieve each of the following:

Interpersonal Skills and Professional Behaviors

Clinical Reasoning and Problem -Solving Utilize

COMMENTS:

Total Points = __________ divided by 250 X 100 = _____________ (round up to nearest whole number)

Letter Grade

Total Score

Preceptor Signature:

DEPARTMENT OF PHYSICIAN ASSISTANT STUDIES

PRECEPTOR EVALUATION FORM INTERNAL MEDICINE CLERKSHIP

Student Name ____________________________

Rotation ____________________

Type and Site ________________

Preceptor Name _______________

Rotation Dates

1 = poor

2 = below average

3 = average

4 = above average

5 = excellent

Please rate the student on their ability to achieve the following Instructional Objectives in support of the Course Learning Outcomes specific to Internal Medicine.

When presented with patients with Internal Medicine Conditions, please rate the student’s ability to achieve each of the following:

Formulates a management plan that uses consults ap propriately for patients with an internal medicine condition.

Creates a pharmacological plan for patients with an internal medicine condition.

a plan that includes non -pharmacological management for patients with an internal medicine condition.

Formulates a plan inclusive of appropriate referrals for patients with an internal medicine condition.

Formulates a plan that includes follow up for patients with an internal medicine condition.

documents patient data for patients with an internal medicine condition.

Accurately evaluates patients with acute conditions associated with internal medicine.

Accurately evaluates patients with chronic conditions associated with internal medicine.

Please rate the student on their ability to achieve the following Instructional Objectives in support of the Course Learning Outcomes in general and as they relate to Internal Medicine.

When presented with patients with internal medicine conditions, please rate the student’s ability to achieve each of the following:

Interpersonal Skills and Professional Behaviors

Clinical Reasoning and Problem -Solving

Utilize appropriate clinical reasoning and problemsolving abilities to identify and manage medical conditions.

COMMENTS:

Total Points = __________ divided by 200 X 100 = _____________ (round up to nearest whole number)

Letter Grade

Total Score

Preceptor Signature:

DEPARTMENT OF PHYSICIAN ASSISTANT STUDIES

PRECEPTOR EVALUATION FORM WOMEN’S HEALTH CLERKSHIP

Student Name ____________________________

Rotation ____________________

Type and Site ________________

Preceptor Name _______________

Rotation Dates ________________

1 = poor

2 = below average

3 = average 4 = above average

5 = excellent

Please rate the student on their ability to achieve the following Instructional Objectives in support of the Course Learning Outcomes specific to women’s health.

When presented with patients with women’s health conditions, please rate the student’s ability to achieve each of the following:

Formulate

Appropriately diagnosis patients with women’s health concerns.

Formulates a management plan that uses consults appropriately for patients with women’s health concerns.

Creates a pharmacological plan for patients with women’s health concerns.

Formulates a plan that includes non -pharmacological management for patients with women’s health concerns.

Formulates a plan inclusive of appropriate referrals for patients with a women’s health concern.

Formulates a plan that includes follow up for patients with women’s health concern.

Provides effective patient education to patients with a women’s health concern.

Provides effective prenatal counseling for patients with a women’s health concern.

Emphasizes shared decision making for patients with a women’s health concern.

Provides patient education related to family planning to patients with women’s health concerns.

Applies the evidence from scientific studies to women’s health patient cases.

Accurately evaluates patients with emergent conditions associated with women’s health care.

Accurately evaluates patients with acute conditions associated with women’s health care.

Accurately evaluates patients with chronic conditions associated with women’s health care.

Accurately evaluates adult patients (18-64 y/o) with conditions associated with women’s health care.

Accurately evaluates elderly patients (65 and older) with conditions associated with women’s health care.

evaluates prenatal patients.

Accurately evaluates patient requiring gynecologic care.

Please rate the student on their ability to achieve the following Instructional Objectives in support of the Course Learning Outcomes in general and as they relate to women’s health.

When presented with patients with women’s health conditions, please rate the student’s ability to achieve each of the following:

COMMENTS:

Preceptor Signature:

Clinical Reasoning and Problem -Solving

DEPARTMENT OF PHYSICIAN ASSISTANT STUDIES

PRECEPTOR EVALUATION FORM SURGERY CLERKSHIP

Student Name ____________________________

Rotation ____________________

Type and Site ________________

Preceptor Name _______________

Rotation Dates

1 = poor

2 = below average

3 = average

4 = above average

5 = excellent

Please rate the student on their ability to achieve the following Instructional Objectives in support of the Course Learning Outcomes specific to Surgery.

When presented with patients with Surgical conditions, please rate the student’s ability to achieve each of the following:

Formulates a plan inclusive of

a plan that includes appropriate follow up for patients with a surgical condition.

Provides effective patient education to patients with a surgical condition.

Emphasizes shared decision making for patients with a surgical condition

Applies the evidence from scientific studies to surgical patient cases.

Performs effective oral presentations for patients with a surgical condition.

evaluates patients with acute conditions associated with surgical care.

evaluates patients with chronic conditions associated with surgical care.

Accurately evaluates adult patients (18-64 y/o) with surgical conditions.

Accurately evaluates elderly patients (65 and older) with surgical conditions.

assists with the care of patients requiring surgical management in the intra-operative setting.

Please rate the student on their ability to achieve the following Instructional Objectives in support of the Course Learning Outcomes in general and as they relate to surgery

When presented with patients with surgical conditions, please rate the student’s ability to achieve each of the following:

Interpersonal Skills and Professional Behaviors

COMMENTS:

Clinical Reasoning and Problem -Solving

Total Points = __________ divided by 250 X 100 = _____________ (round up to nearest whole number)

Letter Grade

Total Score

Preceptor Signature:

DEPARTMENT OF PHYSICIAN ASSISTANT STUDIES

PRECEPTOR EVALUATION FORM

EMERGENCY MEDICINE CLERKSHIP

Student Name ____________________________

Rotation ____________________

Type and Site ________________

Preceptor Name _______________

Rotation Dates ________________

1 = poor

2 = below average

3 = average

4 = above average

5 = excellent

Please rate the student on their ability to achieve the following Instructional Objectives in support of the Course Learning Outcomes specific to Emergency Medicine.

When presented with patients with Emergency Medicine Conditions, please rate the student’s ability to achieve each of the following:

Knowledge and Clinical/Technical Skills

Elicits

Formulates a plan that includes non -pharmacological management for patients with an emergency medicine condition.

Formulates a plan inclusive of appropriate referrals for patients with an emergency medicine condition.

Formulates a plan that includes follow up for patients with an emergency medicine condition.

Provides effective patient education to patients with an emergency medicine condition.

documents patient data for patients with an emergency medicine condition.

Accurately evaluates patients with emergent conditions associated with emergency medicine.

Accurately evaluates patients with acute conditions associated with emergency medicine.

Accurately evaluates adult patients (18-64 y/o) with Emergency Medicine conditions.

Please rate the student on their ability to achieve the following Instructional Objectives in support of the Course Learning Outcomes in general and as they relate to emergency medicine.

When presented with patients with emergency medicine conditions, please rate the student’s ability to achieve each of the following:

Interpersonal Skills and Professional Behaviors

COMMENTS:

Preceptor Signature:

Clinical Reasoning and Problem -Solving

DEPARTMENT OF PHYSICIAN ASSISTANT STUDIES

PRECEPTOR EVALUATION FORM

PEDIATRIC CLERKSHIP

Student Name ____________________________

Rotation ____________________

Type and Site ________________

Preceptor Name _______________

Rotation Dates ________________

1 = poor

2 = below average

3 = average

4 = above average

5 = excellent

Please rate the student on their ability to achieve the following Instructional Objectives in support of the Course Learning Outcomes specific to pediatrics.

When presented with patients with pediatric conditions, please rate the student’s ability to achieve each of the following:

Please rate the student on their ability to achieve the following Instructional Objectives in support of the Course Learning Outcomes in general and as they relate to pediatrics.

When presented with pediatric patients, please rate the student’s ability to achieve each of the following:

Exhibits

COMMENTS:

Clinical Reasoning and Problem -Solving

Total Score 100-91 90-87 86-83 82-77 76-73 72-69 68-60 59 or below

Preceptor Signature:

DEPARTMENT OF PHYSICIAN ASSISTANT STUDIES

PRECEPTOR EVALUATION FORM

BEHAVIORAL MEDICINE AND MENTAL HEALTH CARE

CLERKSHIP

Student Name

Rotation ____________________

Type and Site ________________

Preceptor Name _______________

Rotation Dates ________________

Please note that 5 is the best score and 1 is the least.

1 = poor

2 = below average

3 = average

4 = above average

5 = excellent

Please rate the student on their ability to achieve the following Instructional Objectives in support of the Course Learning Outcomes specific to behavioral medicine and mental health.

When presented with patients with behavioral and mental health conditions, please rate the student’s ability to achieve each of the following:

Medical Knowledge and Clinical/Technical Skills Elicits

Selects appropriate diagnostic tests to order for patients with behavioral and mental health conditions.

diagnostic studies for patients with behavioral and mental health conditions.

Formulate a differential diagnosis for patients with behavioral and mental health conditions.

Appropriately use the DSM V in diagnosis of patients with a behavioral and mental health condition

Formulates a management plan that uses consults appropriately for patients with behavioral and mental health conditions.

Creates a pharmacological plan for patients with a behavioral and mental health condition.

Formulates a plan that includes non -pharmacological management for patients with a behavioral and mental health condition.

Formulates a plan inclusive of appropriate referrals for patients with a behavioral and mental health condition.

Formulates a plan that includes follow up for patients with behavioral and mental health conditions.

patient education to

shared decision making for patients with a behavioral and mental health condition.

the evidence from scientific studies to behavioral and mental health patient cases.

Performs effective oral presentations for patients with a behavioral and mental health condition.

Please rate the student on their ability to achieve the following Instructional Objectives in support of the Course Learning Outcomes in general and as they relate to behavioral medicine and mental health.

When presented with patients with behavioral and mental health conditions, please rate the student’s ability to achieve each of the following:

Clinical Reasoning and Problem -Solving Utilize appropriate clinical reasoning and problemsolving abilities to identify conditions.

COMMENTS:

Preceptor Signature

DEPARTMENT OF PHYSICIAN ASSISTANT STUDIES

PRECEPTOR EVALUATION FORM

ELECTIVE CLERKSHIP

Student Name ____________________________

Rotation ____________________

Type and Site ________________

Preceptor Name _______________

Rotation Dates ________________

1 = poor

2 = below average

3 = average

4 = above average

5 = excellent

Please rate the student on their ability to achieve the following Instructional Objectives in s support of the Course Learning Outcomes specific to this Elective Clerkship.

When presented with a patient on this elective clerkship, please rate the student’s ability to achieve each of the following:

Elicits a detailed history for

elective.

this elective.

Appropriately diagnosis patients for patients specific to this elective.

Formulates a management plan that uses consults appropriately for patients specific to this elective.

Creates a pharmacological plan for patients

to this elective.

Formulates a plan that includes non -pharmacological management for patients specific to this elective.

Formulates a plan inclusive of appropriate referrals for patients specific to this elective.

Formulates a plan that includes follow up for patients specific to this elective.

Provides effective patient education to patients specific to this elective.

Emphasizes shared decision making for patients specific to this elective.

Applies the evidence from scientific studies for patients specific to this elective.

Performs effective oral presentations for patients specific to this elective.

Accurately documents patient data for patients specific to this elective.

Please rate the student on their ability to achieve the following Instructional Objectives in support of the Course Learning Outcomes in general and as they relate to this elective clerkship

When presented with a patient on this elective clerkship, please rate the student’s ability to achieve each of the following:

Interpersonal Skills and Professional Behaviors

Clinical Reasoning and Problem -Solving

Utilize appropriate clinical reasoning and problemsolving abilities.

COMMENTS:

Total Points = __________ divided by 165 X 100 = _____________ (round up to nearest whole number)

Letter Grade

Score

Preceptor Signature: