CLINICAL YEAR SYLLABI

from Preceptor Handbook: September 2021

CLINICAL YEAR FORMS

PHA 250 FAMILY MEDICINE CLERKSHIP 3 s.h.

Course Coordinator: Jennifer Duperval, MS, PA-C; Email: Jennifer.P.Duperval@hofstra.edu Office: 516-463-6841

COURSE DESCRIPTION:

This is an out-patient clinical experience where students work with family medicine preceptors to evaluate patients with a wide variety of illness in an office setting. Emphasis is placed on evaluation, management, health promotion, and preventive medicine.

COURSE GOAL:

The goal is to have students develop an approach to the evaluation and management of frequently occurring, complex, comorbid or ill-defined problems with a wide variety of acute and chronic presentations.

INSTRUCTIONAL OBJECTIVES AND LEARNING OUTCOMES:

Instructional Objectives

By the conclusion of the family medicine clerkship, students will be competent in the following:

Evaluation of the acute, chronic and well patient by obtaining an accurate history, performing a physical exam, obtaining and interpreting appropriate laboratory and diagnostic studies and developing a differential diagnosis and/or management plan

Determine the initial assessment in acute and chronic patients

Assessment Tools Utilized

Competency for each instructional objective is measured by successful completion of assessment tools listed below: • Preceptor evaluation • Preceptor assessment and sign-off of competency on patient and procedure logs • PAEA end-ofrotation (EOR) examination

Learner Outcomes

Upon successful completion of this clerkship, students will attain the following knowledge, interpersonal, clinical/technical skills, professional behaviors, clinical reasoning and problemsolving abilities: • Use effective interviewing skills to elicit a detailed history • Determine the normal and abnormal in anatomy, physiology, laboratory findings and other diagnostic data and apply the information to recognize normal and abnormal health states • Preceptor evaluation • Select and interpret appropriate diagnostic tests or lab studies

commonly seen in the office setting

Management of acute and chronic illnesses that are commonly seen in the office setting

Accurately document the medical care rendered for patients in primary care

Develop evidence-based recommendations regarding health promotion and disease prevention for the well-patient, and patient centered best practices plans for a wide variety of acute and chronic conditions

Develop and promote measures to prevent occurrence, progression, and disabling effects of acute and chronic illnesses • Submission of clinical documentation • EOR examinations • Virtual patient case assignment • Preceptor evaluation • Submission of clinical documentation • EOR examinations • Virtual patient case assignment • Synthesize and analyze clinical data correctly

• Utilize critical thinking and problem-solving skills to identify and manage a wide variety of acute and chronic conditions • Discern among acute, chronic, and emerging disease states

• Preceptor evaluation • Health Promotion Project • Adequately document medical information in history & physical notes and progress notes

• Preceptor evaluation • EOR examinations • Submission of medical documentation • Virtual patient case assignment

• Use effective basic counseling and patient education skills with patients and their families to empower them to participate in their care and enable shared decisionmaking • Locate, appraise, and apply evidence from scientific studies to enhance patient care • Health Promotion Project • Understand the principles of preventative medicine and how they apply to clinical practice.

Completing technical skills competently • Preceptor evaluation • Competency is measured by meeting the number of procedures listed under “Exxat Procedure

Logging” in conjunction with the preceptor’s signature, indicating the procedure was done competently • Performs procedures safely and at an appropriate skill level • Identifies the indications and contraindications of technical procedures

Presenting patients to the family medicine preceptor in a concise and organized way Identify the members of the interprofessional team and the roles that they play in the delivery of healthcare.

Application of clinical reasoning and problem-solving to solve a virtual patient case

Describe the indications, contraindications, mechanism of action, adverse effects and drug interactions of medications commonly used in primary care

Utilize the PAEA Core Tasks and Functions list found at https://paeaonline.org/assessment/ core-tasks-and-objectives/ and apply to each of the conditions outlined at https://paeaonline.org/wpcontent/uploads/2020/03/eorfamilymed-topiclist-20200309.pdf • Preceptor evaluation • Effectively complete oral presentations

• Preceptor evaluation • Develop relationships and effectively communicate with patients, families, physicians, and other members of the care team • Exhibit reliability, accountability, and dependability • Exhibit an understanding of the physician assistant profession and the role of a PA • Demonstrate empathetic and respectful behaviors • Demonstrates and identifies appropriate ethical behavior and attitudes • Provide appropriate referrals

• Virtual patient case assignment

• Drug Cards

• Develop skills necessary for lifelong learning • Synthesize and analyze clinical data correctly • Identify pharmacologic agents and other relevant treatment modalities as they relate to various medical conditions to include understanding the indications, contraindications, side effects, interactions, and adverse reactions • EOR examination • Determine the etiologies, risk factors and epidemiology for various medical conditions • Identify signs and symptoms of various medical conditions • Utilize critical thinking and problem-solving skills to identify and manage various medical conditions

Demonstrate care that is appropriate in all patient encounters • Preceptor evaluation • Demonstrate care that is effective, safe, equitable and high quality

Appreciate the utility of improving the quality of medical care • Quality assurance / performance improvement assignment • Identify the value of quality improvement initiatives

Know ways to prevent disease and utilize in patient encounters to improve patient outcomes • Preceptor evaluation • Understand the principles of preventative medicine and how they apply to clinical practice

ASSESSMENT/EVALUATION CRITERIA

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

Health Promotion Project & Three Drug Cards 15% Virtual Patient Case Assignment P/F Preceptor Evaluation 50% Clerkship Patient Encounter Requirement Logs P/F

Procedure Logging Requirements P/F End of Clerkship Examination 35% Developmental Disabilities Requirements- if applicable P/F Call Back Day Longitudinal Patient Participation, Reflective Journal Entry & Medical Documentation Submission - if applicable P/F Quality Assurance/Performance Improvement Assignment P/F

*All assessment and evaluation tools are in the back of the handbook

HEALTH PROMOTION PROJECT

An important element of 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. The objective of this project 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.

VIRTUAL PATIENT CASE ASSIGNMENT FOR EDUCATING STUDENTS

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 uploaded to the session required documents. Failure to complete the assigned Virtual Patient Case Assignments will result in an incomplete grade for this clerkship.

DRUG CARDS

Students are required to research three (3) pharmaceutical agents used during their family medicine clerkship and make 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 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 not upload onto Exxat

prior to the start of call back day, they will receive a grade of zero for this portion of the clerkship grade.

PRECEPTOR EVALUATION

Students will be evaluated by each Clinical Preceptor based on their general medical background, knowledge, and ability to obtain a medical history and perform an appropriate physical exam. Included in the evaluation will be the student’s ability to organize a differential, order and interpret diagnostics, propose a management plan, present cases, and demonstrate the ability to work collaboratively in an interprofessional team. Dependability, reliability, attitude toward learning, and professionalism are also part of the evaluation. A copy of this evaluation can be found at the back of your clinical handbook and is posted on Exxat under generalized documents for all students in your student packet.

The preceptor evaluation will be sent to the preceptor via email from Exxat. 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. If a preceptor evaluation is not received within 60 calendar days of the end of the clerkship, the clerkship grade will be recorded as an “F.” In some instances a resident or another attending physicianmaycomplete a preceptor evaluation form in addition to the Clinical Preceptor of record.

In those cases, additional evaluations may be submitted and averaged. A grade less than 60 on the preceptor evaluation constitutes a failure. A failing preceptor evaluation at any point during the

clerkship will result in clerkship failure. Please see the clinical handbook for additional policies.

CLERKSHIP SPECIFIC PATIENT ENCOUNTER REQUIREMENTS

Clerkship logs are designed to help the Program track student clinical experiences and is completed utilizing the Exxat system. Filling out logs thoroughly and accurately will help the program to ensure students are receiving a quality clinical education. Students are required to log information regarding each patient seen 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. Students are contacted if the weekly review shows inadequate patient care experiences. The clinical coordinators will discuss ways to maximize clinical opportunities for the remaining time in the clerkship.

The minimum family medicine 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 student’s 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. Their 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 graduation.

Family Medicine

15 encounters per week/90 per clerkship

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.

CLINICAL YEAR PATIENT ENCOUNTER REQUIREMENTS

Although students must log specific family medicine encounters during the family medicine clerkship, the below clinical 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. Their signature not only confirms exposure, but competence in these areas of care. Competency in these areas is required for graduation.

Preventative Acute Chronic Emergent Developmental Disabilities

Types of Clinical Encounters

20 encounters during clinical year 20 encounters during clinical year 20 encounters during clinical year 20 encounters during clinical year 15 encounters during clinical year

Medical Care Across the Life Span Encounters

Infants- less than 1 years of age 15 encounters during the clinical year Children- 1 y/o – 11 y/o 30 encounters during the clinical year

Adolescents- 12 y/o – 17 y/o Adults- 18 y/o – 64 y/o Geriatrics- greater than 65 y/o 30 encounters during the clinical year 100 encounters during the clinical year 100 encounters during the clinical year

PROCEDURE LOGGING REQUIREMENTS

the student’s responsibility to find opportunities to meet the procedure requirements, however, not all the requirements listed below need to be completed during the student’s

family medicine clerkship. Difficulty in meeting these requirements should be brought to the attention of the clinical coordinator and a plan for meeting competencies will be formulated.

The clinical coordinators reviews procedure logs every three months. As all procedure requirements must be completed by graduation, students receive reports every three months regarding which procedure requirements are missing. A student will not be able to graduate

until competency is achieved in the items listed below.

REQUIRED CLINICAL YEAR PROCEDURES/EXAMINATIONS

Procedure ABG Abscess I&D

Required Number 4 2 Blood Cultures 2 Cardiopulmonary Resuscitation 1-assisted is acceptable or at CLI* Foley Catheter Placement 4 IM/SC/ID-injections 10 IV Placement 10 NG Tube Placement 2 Splinting 5 Suturing 5 Venipuncture 10 Assist in Operating Room 5 Wound Care/Debridement 5 Breast Examinations 5 Pelvic Examinations 5 Rectal Examinations 5

*Center for Learning and Innovation (CLI)

END OF CLERKSHIP EXAMINATION

To assess comprehensive knowledge of the family medicine discipline, a 120-question multiplechoice 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, students must use the following Core Tasks and Objectives https://paeaonline.org/assessment/core-tasks-andobjectives/ and apply information to the following topic list of conditions: https://paeaonline.org/wp-content/uploads/2020/03/eor-familymed-topiclist-20200309.pdf Student should also review the breakdown of the exam, which can be found through the following link: https://paeaonline.org/wp-content/uploads/2018/06/family-medicine-blueprint20180524.pdf These end-of-rotation examinations have the same format as the PANCE exam and are good preparation for successfully passing 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 end-of-rotation exam, they will be given the opportunity to take a make-up exam in exam master. 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.

QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT ASSIGNMENT

The Quality Assurance/ Performance Improvement educational project is designed to help students understand issues related to quality in a healthcare setting. It is designed to increase the awareness of quality issues and help students learn how to best manage such situations. This will take place in the form of a discussion board where students and faculty will interact. 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.

As part of the clinical clerkship training, students are required to participate in a group discussion board on Blackboard. It can be found as a discussion board in the Medicine III course in blackboard. This material is from the Patient Safety Institute. Students are required to post at least twice as is 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. There are several short videos in the course documents section. Students must view these also. 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. Students are required to participate accordingly. This assignment is required for graduation. This assignment may be completed between the start of the first clerkship and prior to the completion of the eighth clinical clerkship.

Summary:

1. Go to blackboard 2. Go to course PHA 227 3. Click on “discussion board” on left side 4. Click on “Patient Safety Institute CO 2021” 5. Click on course documents on left side and review “IHI Videos” at the bottom of page 44

6. Follow instructions for discussion board 7. See Professor Gallo with questions

REFLECTIVE JOURNALING

via Exxat on call back day at the end of the 3rd clerkship, 6th clerkship and then finally, the

8th clerkship. To encourage deep-rooted, self-analysis, journal entries will only be reviewed to assure assignment completion rather than focus on a formal grade. All students will be required to submit a minimum of five reflective journal entry by call back day eight (8). Journal entries should be 1 page in length. Students can submit their reflective journal on Exxat. From the dashboard → placements → by session → to do list → session required documents → developmental disability reflective journaling. Failure to submit your reflective journaling will result in an incomplete

grade for thisclerkship.

CLINICAL ENCOUNTERS

Throughout the clinical year, 15 patients with a history of developmental disabilities must be logged in the Exxat system. Clinical encounters should focus on improving clinical management, knowledge, history and physical examination skills and communication/interpersonal skills. Please be sure you click on the “developmental disability” box to capture your patients in the system. In addition, you must write about each clinical encounter in your reflective journal (as described above). Failure to demonstrate the required number of clinical encounters will

affect the student’s ability to graduate.

CALL BACK DAY

Students return to campus, Center for Learning and Innovation (CLI) or remotely via zoom on the last day of their clerkship for a day of activities. 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. Should an absence be unavoidable, the clinical coordinator must be contacted PRIORtothedatetodiscussthelegitimacyofthe 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.

required to view their encounter remotely (on Hofstra or Northwell network) and complete a video self-reflection form assessing their performance. The video self-reflection is due 2 weeks after the callbackday.Students cansubmittheirlongitudinalpatientreflectiononExxat.Fromthedashboard → placements → by session → to do list → session required documents → longitudinal patient reflection. Please make sure to upload under your current rotation. There will be no video selfreflection if the longitudinal patient care experience occurs via zoom. If a student misses a patient

encounter or does not complete either the SOAPnotesorvideoself-reflection,theywillreceive two (2) points off their final rotation grade for each assignment not completed.

Additionally, all 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.

CLERKSHIP BIBLIOGRAPHY

During the clinical year and in clinical practice there is no set textbook or resource that will address the specific needs of the learner 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.

DISABILITY POLICY

If you believe you need accommodations for a disability, please contact Student Access Services (SAS). In accordance with Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990, qualified individuals with disabilities will not be discriminated against in any programs, or services available at Hofstra University.

Individuals with disabilities are entitled to accommodations designed to facilitate full access to all programs and services. SAS is responsible for coordinating disability-related accommodations and will provide students with documented disabilities accommodation letters, as appropriate.

Please note that accommodations may require early planning and are not retroactive; please contact SAS as soon as possible. All students are responsible for providing accommodation letters to each instructor and for discussing with him or her the specific accommodations needed and how they can be best implemented in each course. For more information on services provided by the university and for submission of documentation, please contact Student Access Services, 107 Student Center, 516-463-7075

PHA 255 INTERNAL MEDICINE CLERKSHIP 3 s.h.

Course Coordinator: Thomas Gallo, PA-C, JD; Email: Thomas.Gallo@hofstra.edu Office: 516-463-4382

COURSE DESCRIPTION

This clerkship experience provides students with a clinical experience in the in-patient setting where students will work with preceptors to evaluate and formulate treatment plans for patients with a wide variety of illnesses. This rotation allows the student to become familiar with the “inhouse” continuity of care of acute and chronic patients.

COURSE GOAL

The goal is to provide students with a working knowledge of the principles of internal medicine and to provide students with the opportunity to participate in the care of patients with multiple medical complaints.

INSTRUCTIONAL OBJECTIVES AND LEARNING OUTCOMES:

Instructional Objectives

By the conclusion of the internal medicine clerkship, students will be competent in the following:

Assessment Tools Utilized

Competency for each instructional objective is measured by successful completion of assessment tools listed below:

Formulation of assessment plans for patients on the internal medicine service inclusive of geriatric patients • Preceptor evaluation • Submission of clinical documentation • EOR examinations • Virtual patient case assignment

Learner Outcomes

Upon successful completion of this clerkship, students will attain the following knowledge, interpersonal, clinical/technical skills, professional behaviors, clinical reasoning, and problemsolving abilities: • Select and interpret appropriate diagnostic tests or lab studies • Synthesize and analyze clinical data correctly

Knowledge of the different types of clinical patient encounters

Development of management plans for patients on the internal medicine service inclusive of geriatric patients

Accurately document the medical care rendered for patients on the internal medicine service

Providing patient education and counseling for a wide variety of acute and chronic illnesses on the internal medicine service inclusive of geriatric patients

Completing technical skills competently • Preceptor assessment and sign-off of competency on patient and procedure logs • EOR examination • Submission of clinical documentation

• Preceptor evaluation • Submission of clinical documentation • EOR examinations • Virtual patient case assignment

• Preceptor evaluation • Submission of clinical documentation • Preceptor evaluation • EOR examinations • Submission of medical documentation • Virtual patient case assignment

• Preceptor evaluation • Competency is measured by meeting the number of exposures listed under

“Exxat Procedure

Logging” in conjunction with the preceptor’s signature, indicating the procedure was done competently • Discern among acute, chronic, and emerging disease states

• Utilize critical thinking and problem-solving skills to identify and manage a wide variety of acute and chronic conditions • Discern among acute, chronic, and emerging disease states • Adequately document medical information in history & physical notes and progress notes • Use effective basic counseling and patient education skills with patients and their families to empower them to participate in their care and enable shared decision-making • Provide appropriate referrals • Performs procedures safely and at an appropriate skill level • Identifies the indications and contraindications of technical procedures

Presenting patients to the preceptor or other designated clinician on team in a concise, organized way demonstrating thorough knowledge of patients on service • Preceptor evaluation • Effectively complete oral presentations

Identify the members of the interprofessional team and the roles that they play in the delivery of healthcare.

Application of clinical reasoning and problem-solving to solve a virtual patient case

Describe the indications, contraindications, mechanism of action, adverse effects and drug interactions of medications commonly used in internal medicine patients inclusive of geriatric patients

Utilize the PAEA Core Tasks and Functions list found at https://paeaonline.org/assessment/c ore-tasks-and-objectives/ and apply to each of conditions outlined at https://paeaonline.org/wpcontent/uploads/2020/03/eorinternalmed-topiclist20200309.pdf • Preceptor evaluation • Develop relationships and effectively communicate with patients, families, physicians, and other members of the care team • Exhibit reliability accountability, and dependability • Exhibit an understanding of the physician assistant profession and the role of a PA • Demonstrate empathetic and respectful behaviors • Demonstrates and identifies appropriate ethical behavior and attitudes

• Virtual patient case assignment

• Drug Cards

• Develop skills necessary for life-long learning • Synthesize and analyze clinical data correctly • Identify pharmacologic agents and other relevant treatment modalities as they relate to various medical conditions to include understanding the indications, contraindications, side effects, interactions, and adverse reactions • EOR examination • Determine the etiologies, risk factors and epidemiology for various medical conditions • Identify signs and symptoms of various medical conditions • Utilize critical thinking and problem-solving skills to identify and manage various medical conditions

Demonstrate care that is appropriate in all patient encounters • Preceptor evaluation • Demonstrate care that is effective, safe, equitable and high quality

Appreciate the utility of improving the quality of medical care • Quality assurance / performance improvement assignment • Identify the value of quality improvement initiatives

ASSESSMENT/EVALUATION CRITERIA

The grade for the internal medicine clerkship is based on the following components: Virtual Patient Case Assignment P/F One Internal Medicine History & Physical Note Three Drug Cards 15% Preceptor Evaluation 50% Clerkship Patient Encounter Requirement Logs P/F Procedure Logging Requirements P/F End of Clerkship Examination 35% Developmental Disabilities Curriculum Requirements- if applicable P/F Quality Assurance/Performance Improvement Assignment P/F Call Back Day Longitudinal Patient Participation, Reflective Journal Entry & Medical Documentation Submission - if applicable P/F *All assessment and evaluation tools are in the back of the handbook

VIRTUAL PATIENT CASE ASSIGNMENT FOR EDUCATING STUDENTS

SUBMISSION OF CLINICAL DOCUMENTATION

Each student will submit one history and physical note while on their internal medicine clerkship

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. • H&P notes cannot duplicate the interesting case patient. • No identifying information may appear on any notes as this is violates HIPAA regulations. Notes submitted with identifying information will earn a grade of zero for that note. 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). A five (5)-point deduction from the

note grade will result for each day it is tardy.

If a passing grade is not achieved, the clinical coordinator will either ask the student to fax a clinical note to the PA program office every day of the following clerkship, or the student will be asked for additional notes to be submitted on the succeeding call back day.

DRUG CARDS

Students are required to research three (3) pharmaceutical agents used during their internal medicine clerkship and make 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 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 not upload onto Exxat

prior to the start of call back day, they will receive a grade of zero for this portion of the clerkship grade.

PRECEPTOR EVALUATION

Students will be evaluated by each Clinical Preceptor based on their general medical background, knowledge and ability to obtain a medical history and perform an appropriate physical exam. Included in the evaluation will be the student’s ability to organize a differential, order and interpret diagnostics, propose a management plan, present cases, and demonstrate the ability to work collaboratively in an interprofessional team. Dependability, reliability, attitude toward learning, and professionalism are also part of the evaluation. A copy of this evaluation can be found at the back of your clinical handbook and is posted on Exxat under generalized documents for all students in your student packet.

The preceptor evaluation will be sent to the preceptor via email from Exxat during the last week of each rotation. 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. If a preceptor evaluation is not received within 60 calendar days of the end of the clerkship, theclerkship gradewillberecorded as an“F.”In someinstancesa residentoranother attendingphysicianmaycomplete a preceptor evaluation form in addition to the Clinical Preceptor of record. In those cases, additional evaluations may be submitted and averaged. A grade less than 60 on the preceptor evaluation constitutes a failure. A failing preceptor evaluation at any point

during the clerkship will result in clerkship failure. Please see the clinical handbook for additional policies.

CLERKSHIP SPECIFIC PATIENT ENCOUNTER REQUIREMENTS

The minimum internal medicine 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 student’s 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. Their 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 graduation.

Internal Medicine 10 encounters per week/60 per clerkship

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.

CLINICAL YEAR PATIENT ENCOUNTER REQUIREMENTS

Although students must log specific internal medicine encounters during the internal medicine clerkship, the below clinical 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. Their signature not only confirms exposure, but competence in these areas of care. Competency in these areas is required forgraduation

Preventative Acute Chronic Emergent Developmental Disabilities

Types of Clinical Encounters

20 encounters during clinical year 20 encounters during clinical year 20 encounters during clinical year 20 encounters during clinical year 15 encounters during clinical year

Medical Care Across the Life Span Encounters

Infants- less than 1 years of age 15 encounters during the clinical year Children- 1 y/o – 11 y/o 30 encounters during the clinical year

PROCEDURE LOGGING REQUIREMENTS

Students are required to perform and log a number of procedures. These 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”. Students must print out their “procedure list” for each rotation and have preceptors sign off on the procedure list. Their signature not only confirms exposure, but also indicates that a student can competently perform the procedure. Once your log is signed, it needs to be uploaded onto Exxat in session required documents. During your internal medicine clerkship, it is recommended that you focus on procedures such as ABG’s, I&D’s, Foley catheter placement, NG tube placement, blood cultures, rectal examinations, and wound care/debridement. It is the student’s responsibility to

find opportunities to meet the procedure requirements, however, not all the requirements listed below need to be completed during the student’s internal medicine clerkship.

Difficulty in meeting these requirements should be brought to the attention of the clinical coordinator and a plan for meeting competencies will be formulated. The clinical coordinator reviews procedure logs every three months. As all procedure requirements must be completed by graduation, students receive reports every three months regarding which procedure requirements are missing. A student will not be able to graduate

until competency is achieved in the items listed below.

REQUIRED CLINICAL YEAR PROCEDURES/EXAMINATIONS

Procedure ABG Required Number 4

Abscess I&D

2 Blood Cultures 2 Cardiopulmonary Resuscitation 1-assisted is acceptable on or at CLI* Foley Catheter Placement 4 IM/SC/ID-injections 10 IV Placement 10 NG Tube Placement 2 Splinting 5 Suturing 5 Venipuncture 10 Assist in Operating Room 5 Wound Care/Debridement 5 Breast Examinations 5 Pelvic Examinations 5

Rectal Examinations 5

*Center for Learning and Innovation (CLI)

END OF CLERKSHIP EXAMINATION

To assess comprehensive knowledge of the internal medicine discipline, 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, students must use the following Core Tasks and Objectives https://paeaonline.org/assessment/core-tasks-and-objectives/ and apply information to the following topic list of conditions https://paeaonline.org/wp-content/uploads/2020/03/eorinternalmed-topiclist-20200309.pdf Student should also review the breakdown of the exam, which can be found through the following link: https://paeaonline.org/wpcontent/uploads/2018/06/internal-medicine-blueprint-20180524.pdf These end-of-rotation examinations have the same format as the PANCE exam and are good preparation for successfully passing 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 end-of-rotation exam, they will be given the opportunity to take a make-up exam in exam master. 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

QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT ASSIGNMENT

Summary:

REFLECTIVE JOURNALING

After each clinical encounter 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. Please journal on an electronic device. Title each journal entry adhering to the following format: “Clinical Encounter”. Date each entry as well. This journal will be submitted via Exxat on call back day at the end of the 3rd clerkship, 6th clerkship and then finally, the 8th clerkship. To encourage deep-rooted, self-analysis, journal entries will only be reviewed to assure assignment completion rather than focus on a formal grade. All students will be required to submit a minimum of five reflective journal entry by call back day eight (8). Journal entries should be 12 pages in length. Students can submit their reflective journal on Exxat. From the dashboard → placements → by session → to do list → session required documents → developmental disability reflective journaling. Failure to submit your reflective journaling will result in an incomplete

grade for thisclerkship.

CLINICAL ENCOUNTERS

affect the student’s ability to graduate.

CALL BACK DAY

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 days involving the Center for Learning and Innovation will include a longitudinal patient care experience on-site or remotely via zoom. All patients are professional standardized patients, hired and trained by CLI to provide our students with a superior patient care experience. After each encounter, students will complete a SOAP note documenting the encounter. The SOAP note must be submitted on 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. In addition, after each “on-site” longitudinal patient care experience, the student will be required to view their encounter remotely (on Hofstra or Northwell network) and complete a video self-reflection form assessing their performance. 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. There will be no video self-reflection if the longitudinal patient care experience occurs via zoom. If a student misses a patient encounter or does not complete either the SOAP notes or video self-reflection, they will receive two (2) points off their final rotation grade for each assignment not completed.

rotation grade.

CLERKSHIP BIBLIOGRAPHY

During the clinical year and in clinical practice there is no set textbook or resource that will address the specific needs of the learner 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.

DISABILITY POLICY

PHA 260 OBSTETRICS/GYNECOLOGY CLERKSHIP 3 s.h.

Course Coordinator: Jennifer Duperval, MS, PA-C; Email: Jennifer.P.Duperval@hofstra.edu Office: 516-463-6841

DESCRIPTION

During clinical experience students work with obstetric and gynecologic preceptors to evaluate women’s health, throughout the reproductive and post-menopausal years. Participation in common gynecological surgical procedures along with assisting in labor and delivery may be included in this clerkship. This clerkship may take place in a hospital, clinic, or private practice setting.

COURSE GOAL

The goal of this clerkship is to provide students with general knowledge of the principles of obstetricand gynecologic care, and to prepare them to manage the healthcare needs of women, throughout their life- span.

INSTRUCTIONAL OBJECTIVES AND LEARNER OUTCOMES

Instructional Objectives

By the conclusion of the obstetrics/gynecology clerkship, students will be competent in the following:

Evaluation of the gynecologic patient by obtaining a thorough patient history, performing a physical exam, to include a breast examination and a pelvic examination and obtaining appropriate diagnostic and laboratory data

Assessment Tools Utilized

Learner Outcomes

Upon successful completion of this clerkship, students will attain the following knowledge, interpersonal, clinical/technical skills, professional behaviors, clinical reasoning, and problemsolving abilities: • Elicit a detailed medical history, perform physical examination on a gynecologic patient, accurately record all data

Utilizing information obtained from the history, physical and diagnostic data to formulate differential diagnoses for obstetric and gynecologic patients

Knowledge of the different types of clinical patient encounters

Develop evidence based, best practice, patient-centered management plans for obstetric and gynecologic patients

Accurately document pre-natal, obstetric and gynecologic care

Providing patient education, to include appropriate screening recommendations, disease prevention, family planning, prenatal care, and menopause to obstetric and gynecologic patients and their families

Completing technical skills competently • Preceptor evaluation • EOR examinations • • Select and interpret appropriate diagnostic tests, lab studies or screening tools • Synthesize and analyze all clinical data correctly to aid in diagnosis

• Preceptor assessment and sign-off of competency on patient and procedure logs • EOR examination

Submission of clinical documentation • Discern among acute, chronic, and emerging disease states

• Preceptor evaluation • EOR examinations

• Utilize critical thinking and problem-solving skills to identify and manage pediatric care • Locate, appraise, and apply evidence from scientific studies to enhance patient care • Preceptor evaluation • Accurately and adequately document medical information

• Preceptor evaluation • EOR examinations • Interesting patient case assignment

• Preceptor evaluation • Competency is measured by meeting the number of exposures listed under “Exxat

Procedure Logging” in conjunction with the preceptor’s signature, indicating the procedure was done competently • Use effective basic counseling and patient education skills with patients and their families to empower them to participate in their care and enable shared decisionmaking • Provide appropriate referrals • Performs procedures safely and at an appropriate skill level • Identifies the indications and contraindications of technical procedures

Presenting patients to the preceptor or other designated clinician on team in a concise, organized way demonstrating thorough knowledge of patient Communicating effectively and respectfully with obstetric and gynecologic patients and their families and members of the interprofessional team

Search for relevant information, utilizing appropriate data sources, and critically appraise to make evidence-based decisions in patient care Describe the indications, contraindications, mechanism of action, adverse effects, drug interactions, and pregnancy risk category of medications commonly used in obstetric and gynecologic

• Preceptor evaluation • Work collaboratively as a member of an interprofessional healthcare team • Exhibit reliability, accountability, and dependability • Exhibit an understanding of the physician assistant profession and the role of a PA • Demonstrate empathetic and respectful behaviors • Demonstrates and identifies appropriate ethical behavior and attitudes • Preceptor evaluation • Develop skills necessary for life-long learning

• Drug Cards

• Identify pharmacologic agents and other relevant treatment modalities as they relate to pediatric patients to include understanding the indications, contraindications, side effects, interactions, and adverse reactions • EOR examination • Determine the etiologies, risk factors and epidemiology for obstetric and gynecologic conditions • Identify signs and symptoms of common obstetric and gynecologic conditions • Utilize critical thinking and problem-solving skills to manage obstetric and gynecologic patients

Demonstrate care that is appropriate in all patient encounters • Preceptor evaluation • Demonstrate care that is effective, safe, equitable and high quality

Appreciate the utility of improving the quality of medical care • Quality assurance / performance improvement assignment • Identify the value of quality improvement initiatives

ASSESSMENT/EVALUATION CRITERIA

The grade for this clerkship is based on the following components: H & P & Three Drug Cards 15% Preceptor Evaluation 50% Clerkship Patient Encounter Requirement Logs P/F Procedure Logging Requirements P/F End of Clerkship Examination 35% Developmental Disabilities Curriculum Requirements- if applicable P/F Call Back Day Longitudinal Patient Participation, Reflective Journal Entry & P/F Quality Assurance/Performance Improvement Assignment Medical Documentation Submission - if applicable P/F *All assessment and evaluation tools are in the back of the handbook

DRUG CARDS

Students are required to research three (3) pharmaceutical agents used during their ob/gyn medicine clerkship and make 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 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 not upload onto Exxat

prior to the start of call back day, they will receive a grade of zero for this portion of the clerkship grade.

PRECEPTOR EVALUATION

during the clerkship will result in clerkship failure. Please see the clinical handbook for additional policies.

CLERKSHIP SPECIFIC PATIENT ENCOUNTER REQUIREMENTS

The minimum ob/gyn 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 student’s progress in each clerkship and throughout the clinical phase of the program. Students should print out a copy of their patient encounter log and have their preceptor sign off on the following specific patient encounters. Their 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 ob/gyn clerkship, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required for graduation.

Ob/GYN

Prenatal Care

Gynecologic Care

10 encounters per week/60 per clerkship 15 encounters per clerkship 15 encounters per clerkship

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.

CLINICAL YEAR PATIENT ENCOUNTER REQUIREMENTS

Although students must log specific Ob/GYN encounters during the Ob/GYN clerkship, the below clinical encounters are required to be completed by the end of the clinical year, not by the end of the obstetrics/gynecology clerkship. These requirements may be met on any of the eight clerkships. Preceptors must sign off on the following specific patient encounters. Their signature not only confirms exposure, but competence in these areas of care. Competency in these areas is required for graduation

Preventative Acute Chronic Emergent Developmental Disabilities

Types of Clinical Encounters

20 encounters during clinical year 20 encounters during clinical year 20 encounters during clinical year 20 encounters during clinical year 15 encounters during clinical year

Medical Care Across the Life Span Encounters

Infants- less than 1 years of age 15 encounters during the clinical year Children- 1 y/o – 11 y/o 30 encounters during the clinical year Adolescents- 12 y/o – 17 y/o 30 encounters during the clinical year Adults- 18 y/o – 64 y/o 100 encounters during the clinical

Geriatrics- greater than 65 y/o year 100 encounters during the clinical year

PROCEDURE LOGGING REQUIREMENTS

Students are required to perform and log a number of procedures. These 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”. Students must print out their “procedure list” for each rotation and have preceptors sign off on the procedure list. Their signature not only confirms exposure but indicates that a student can competently perform the procedure. Once your log is signed, it needs to be uploaded onto Exxat in session required documents. During your obstetrics/gynecology 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. It is the student’s

responsibility to find opportunities to meet the procedure requirements, however, not all the requirements listed below need to be completed during the student’s ob/gyn clerkship.

Difficulty in meeting these requirements should be brought to the attention of the clinical coordinator and a plan for meeting competencies will be formulated.

The clinical coordinator reviews procedure logs every three months. As all procedure requirements must be completed by graduation, students receive reports every three months regarding which procedure requirements are missing. A student will not be able to graduate

until competency is achieved in the items listed below.

Procedure ABG Required Number 4

Abscess I&D

*Center for Learning and Innovation (CLI)

END OF CLERKSHIP EXAMINATION

To assess comprehensive knowledge of the obstetrics/gynecology discipline, 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, students must use the following Core Tasks and Objectives https://paeaonline.org/assessment/core-tasks-and-objectives/ and apply information to. https://paeaonline.org/wp-content/uploads/2020/03/eor-womenshealth-topiclist-20200309.pdf Student should also review the breakdown of the exam which can be found through the following link: https://paeaonline.org/wp-content/uploads/2018/06/womens-health-blueprint20180524.pdf These end- of- rotation examinations have the same format as the Physician Assistant National Certifying Examination (PANCE) and are good preparation for successfully passing the PANCE. To pass the examinations, a student must receive a grade of no less than 65%. Should a student fail the end-of-rotation exam, they will be given the opportunity to take a make-up exam in exam master. 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.

QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT ASSIGNMENT

The Quality Assurance/ Performance Improvement educational project is designed to help students understand issues related to quality in a healthcare setting. It is designed to increase the 63

awareness of quality issues and help students learn how to best manage such situations. This will take place in the form of a discussion board where students and faculty will interact. 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.

Summary:

REFLECTIVE JOURNALING

After each clinical encounter, reflect on your experiences and write them in a journal. Entries shouldfocusonself-critiqueoftheinteraction,communicationwithindividuals 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. Please journal on an electronic device. Title each journal entry adhering to the following format: “Clinical Encounter”. Date each entry as well. This journal will be submitted via Exxat on call back day at the end of the 3rd clerkship, 6th clerkship and then finally, the 8th clerkship. To encourage deep-rooted, self-analysis, journal entrieswillonlybereviewedtoassureassignmentcompletionratherthanfocusonaformal grade. All students will be required to submit a minimum of five reflective journal entry by call back day eight (8). Journal entries should be 1 page in length. Students can submit their reflective journal on Exxat. From the dashboard → placements → by session → to do list → session required documents → developmental disability reflective journaling. Failure to submit your

reflective journaling will result in an incomplete grade for thisclerkship.

CLINICAL ENCOUNTERS

described above). Failure to demonstrate the required number of clinical encounters will

affect the student’s ability to graduate. CALL BACK DAY

Studentsreturntocampus, CenterforLearningandInnovation(CLI)or remotely via zoom onthelast day of their clerkship for a day of activities. 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. 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.

Failure to do so will result in a three-point deduction from the overall rotation grade.

CLERKSHIP BIBLIOGRAPHY

DISABILITY POLICY

PHA 265 SURGERY CLERKSHIP

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

COURSE DESCRIPTION

This course is a clinical experience where students work with their surgical preceptor to gain proficiency in treating surgical patients. The student will participate in the evaluation and monitoring of patients, perform diagnostic procedures, and assist with surgical management. The students will work as a member of the surgical team and be involved in all aspects of surgical care, to include pre- and post- op care as well as hands-on experience in the operating room setting.

COURSE GOAL

The goal is to provide students with a working knowledge of the principles of surgery and to provide students with the opportunity to participate in the care of patients with surgical complaints.

3 s.h.

INSTRUCTIONAL OBJECTIVES AND LEARNING OUTCOMES

Instructional Objectives

By the conclusion of the surgery clerkship, students will be competent in the following:

Evaluation of the potential surgical patient by obtaining an accurate history, performing a focused physical exam, obtaining, and interpreting appropriate laboratory and diagnostic studies and developing a differential diagnosis and management plan

Assessment Tools Utilized

Competency for each instructional objective is measured by successful completion of assessment tools listed below:

• Preceptor evaluation • Preceptor assessment and sign-off of competency on patient and procedure logs • PAEA end-of-rotation (EOR) examination

Learner Outcomes

Upon successful completion of this clerkship, students will attain the following knowledge, interpersonal, clinical/technical skills, professional behaviors, clinical reasoning, and problemsolving abilities: • Use effective interviewing skills to elicit a detailed history • Determine the normal and abnormal in anatomy, physiology, laboratory findings and other diagnostic data and apply the information to recognize normal and abnormal health states

Knowledge of the different types of clinical patient encounters

Assessment of the pre-surgical and post-surgical patient. • Preceptor assessment and sign-off of competency on patient encounters • EOR examination • Submission of clinical documentation • Preceptor evaluation • Preceptor assessment and sign-off of competency on patient and procedure logs • Submission of clinical documentation • EOR examination • Discern among acute, chronic, and emerging disease states

• Elicit a detailed medical history, perform appropriate physical examination and accurately record all data • Identify and formulate an appropriate assessment and management plan

Provide intraoperative care of surgical patient.

Formulate assessment plans for surgical patients • Preceptor evaluation • Preceptor assessment and sign-off of competency on patient and procedure logs • EOR examinations • Preceptor evaluation • Submission of clinical documentation • EOR examinations

Develop management plans for surgical patients • Preceptor evaluation • Submission of clinical documentation • EOR examinations

Accurately documenting surgical care in patient charts

Providing patient education and counseling for surgical patients • Preceptor evaluation • Submission of clinical documentation • Preceptor evaluation • EOR examinations • Submission of medical documentation • Performs procedures safely and at an appropriate skill level • Identifies the indications and contraindications of technical procedures

• Select and interpret appropriate screening and diagnostic studies • Synthesize and analyze clinical data correctly • Utilize critical thinking and problem-solving skills to identify and manage surgical conditions • Provide appropriate referrals • Accurately document medical information

• Use effective basic counseling and patient education skills with patients and their families to empower them to participate in their care and enable shared decisionmaking • Provide appropriate referrals

Completing technical skills competently

Presenting patients to the preceptor or other designated clinician on team in a concise, organized way demonstrating thorough knowledge of patients on service Communicating effectively and respectfully with members of the interprofessional team, patients, and their families

Demonstrate clinical reasoning and problem-solving ability when managing the surgical patient • Preceptor evaluation • Competency is measured by meeting the number of exposures listed under

“Exxat Procedure

• Preceptor evaluation • Effectively complete oral presentations

• Preceptor evaluation • Develop relations and effectively communicate with patients, families, physicians, and other members of the care team • Exhibit reliability, accountability, and dependability • Exhibit an understanding of the physician assistant profession and the role of a PA • Demonstrate empathetic and respectful behaviors • Demonstrates and identifies appropriate ethical behavior and attitudes • Preceptor evaluation • Demonstrate care that is effective, safe, equitable, and high quality

Demonstrate clinical reasoning and problem-solving ability when managing the surgical patient • Preceptor evaluation • Demonstrate care that is effective, safe, equitable, and high quality

Describe the indications, contraindications, mechanism of action, adverse effects and drug interactions of medications commonly used in surgical patients

Understand issues related to quality in a healthcare setting • Drug Cards

• Quality Assurance &

Quality Improvement

Project • Identify pharmacologic agents and other relevant treatment modalities as the relate to general surgical conditions to include understanding the indications, contraindications, side effects, interactions, and adverse reactions • Identify the value of quality improvement initiatives

Utilize the PAEA Core Tasks and Functions list found at https://paeaonline.org/assessment /core-tasks-and-objectives/ and apply to each of surgical conditions outlined at https://paeaonline.org/wpcontent/uploads/2020/03/eorgeneralsurgery-topiclist20200309.pdf Demonstrate care that is appropriate in all patient encounters • EOR examination • Determine the etiologies, risk factors and epidemiology for surgical conditions • Identify signs and symptoms of surgical conditions • Utilize critical thinking and problem-solving skills to identify and manage surgical conditions

• Preceptor evaluation • Demonstrate care that is effective, safe, equitable and high quality

Appreciate the utility of improving the quality of medical care • Quality assurance / performance improvement assignment • Identify the value of quality improvement initiatives

ASSESSMENT/EVALUATION CRITERIA

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

One surgical SOAP Note Three surgical Drug Cards Preceptor Evaluation 15%

50%

Clerkship Patient Encounter Requirement Logs P/F

Procedure Logging Requirements P/F End of Clerkship Examination 35% Developmental Disabilities Curriculum Requirements- if applicable P/F Call Back Day Longitudinal Patient Participation, Reflective Journal Entry & Medical Documentation Submission - if applicable P/F Quality Assurance/Performance Improvement Assignment P/F *All assessment and evaluation tools are in the back of the handbook

SUBMISSION OF CLINICAL DOCUMENTATION

Each student will submit one typed SOAP note while on their surgery clerkship to session required documents on Exxat. The note should be written legibly, accurately, and adequately. 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 patienteducation. • 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. All notes must be submitted to the clinical coordinator on call back day (see submitting call back day materials). A five (5) point deduction from the note grade will result for each day it is

tardy.

DRUG CARDS

Students are required to research three (3) pharmaceutical agents used during their surgery medicine clerkship and make 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 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 not upload onto

Exxat prior to the start of call back day, they will receive a grade of zero for this portion of the clerkship grade.

PRECEPTOR EVALUATION

The preceptor evaluation will be sent to the preceptor via email from Exxat during the last week of each rotation. 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. If a preceptor evaluation is not received within 60 calendar days of the end of the clerkship, the clerkship grade will be recorded as an “F.” In some instances a resident or another attending physician may complete a preceptor evaluation form in addition to the Clinical Preceptor of record. In those cases, additional evaluations may be submitted and averaged. A grade less than 60 on the preceptor evaluation constitutes a failure. A failing

preceptor evaluation at any point during the clerkship will result in clerkship failure. Please see the clinical handbook for additional policies.

CLERKSHIP SPECIFIC PATIENT ENCOUNTER REQUIREMENTS

The minimum surgery 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 student’s 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. Their 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 graduation.

Surgery Pre-op, intra-op, post-op 10 encounters per week/60 per surgical rotation 10 encounters per surgical rotation 10 encounters per surgical rotation 10 encounters per surgical rotation

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.

CLINICAL YEAR PATEINT ENCOUNTER REQUIREMENTS

Although students must log specific surgical encounters during the surgical clerkship, the below clinical encounters are required to be completed by the end of the clinical year, not by the end of the surgical clerkships. These requirements may be met on any of the eight clerkships. Preceptors must sign off on the following specific patient encounters. Their signature not only confirms exposure, but competence in these areas of care. Competency in these areas is required for graduation.

Preventative Acute Chronic Emergent Developmental Disabilities Types of Clinical Encounters 20 encounters during clinical year 20 encounters during clinical year 20 encounters during clinical year 20 encounters during clinical year 15 encounters during clinical year

Medical Care Across the Life Span Encounters Infants- less than 1 years of age Children- 1 y/o – 11 y/o Adolescents- 12 y/o – 17 y/o Adults- 18 y/o – 64 y/o Geriatrics- greater than 65 y/o 15 encounters during the clinical year 30 encounters during the clinical year 30 encounters during the clinical year 100 encounters during the clinical year 100 encounters during the clinical year

PROCEDURE LOGGING REQUIREMENTS

Students are required to perform and log several procedures. These 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”. Students must print out their “procedure list” for each rotation and have preceptors sign off on the procedure list. Their signature not only confirms exposure but indicates that a student can competently perform the procedure. Once your log is signed, it needs to be uploaded onto Exxat in session required documents. During your surgical clerkship, it is recommended that you focus on procedures such as ABG’s, I&D’s, Foley catheter placement, NG tube placement, suturing, operating room assist, rectal examinations and wound care/debridement. It is the student’s responsibility to find 73

opportunities to meet the procedure requirements, however, not all the requirements listed below need to be completed during the student’s surgical clerkship. Difficulty in meeting these requirements should be brought to the attention of the clinical coordinator and a plan for meeting competencies will be formulated.

REQUIRED CLINICAL YEAR PROCEDURES/EXAMINATIONS

Procedure ABG Abscess I&D

Required Number 4 2 Blood Cultures 2 Cardiopulmonary Resuscitation 1-assisted is acceptable on or at CLI* Foley Catheter Placement 4 IM/SC/ID-injections 10 IV Placement 10 NG Tube Placement 2 Splinting 5 Suturing 5 Venipuncture 10 Assist in Operating Room 5 Wound Care/Debridement 5 Breast Examinations 5 Pelvic Examinations 5 Rectal Examinations 5

*Center for Learning and Innovation (CLI)

END OF CLERKSHIP EXAMINATION

To assess comprehensive knowledge of the surgical discipline, 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, students must use the following Core tasks and Objectives https://paeaonline.org/assessment/core-tasks-and-objectives/ and apply information to the following topic list of conditions. https://paeaonline.org/wp-content/uploads/2020/03/eor-generalsurgerytopiclist-20200309.pdf should also review the breakdown of the exam which can be found through the following link https://paeaonline.org/wp-content/uploads/2018/06/general-surgery-blueprint20180524.pdf These end-of- examinations have the same format as the PANCE exam, and are good preparation for successfully passing 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 end-of-rotation exam, they will be given the opportunity to take a make-up exam in exam master. 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.

QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT ASSIGNMENT

Summary:

REFLECTIVE JOURNALING

via Exxat on call back day at the end of the 3rd clerkship, 6th clerkship and then finally, the 8th

clerkship. To encourage deep-rooted, self-analysis, journal entries will only be reviewed to assure assignment completion rather than focus on a formal grade. All students will be required to submit a minimum of five reflective journal entry by call back day eight (8). Journal entries should be 1 page in length. Students can submit their reflective journal on Exxat. From the dashboard → placements → by session → to do list → session required documents → developmental disability reflective

journaling. Failure to submit your reflective journaling will result in an incomplete grade for

thisclerkship.

CLINICAL ENCOUNTERS

affect the student’s ability to graduate.

CALL BACK DAY

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.

rotation grade.

CLERKSHIP BIBLIOGRAPHY

During the clinical year and in clinical practice there is no set textbook or resource that will address the specific needs of the learner 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.

DISABILITY POLICY

PHA 270 EMERGENCY MEDICINE CLERKSHIP 3 s.h.

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

COURSE DESCRIPTION

This is a clerkship that will provide the student with opportunities to see a variety of patients with urgent or emergent conditions under the supervision of the site preceptor. Students will learn how to establish priorities while diagnosing and treating critically ill patients.

COURSE GOAL

The goal of this clerkship is to teach the student how to quickly recognize and manage life threatening conditions. Students will learn to manage multiple patients in a busy emergency room. In addition, this clerkship will provide the opportunity for the student to increase and refine their procedural skills.

INSTRUCTIONAL OBJECTIVES AND LEARNER OUTCOMES

Instructional Objectives

By the conclusion of the emergency medicine clerkship, students will be competent in the following:

Timely evaluation of the patient in the emergency room by obtaining a problem-focused history, and performing an appropriate physical examination

Assessment Tools Utilized

Learner Outcomes

Applicable, cost-effective use of laboratory tests and other diagnostic data to aid in the diagnosis of patients in the emergency room Recognize patients who require emergency medical intervention (including but not limited to trauma, chest pain, sepsis, CVA, shock, respiratory failure, surgical abdomen),

Utilize information obtained from the H&P, laboratory and diagnostic studies to determine differential diagnoses and prioritize most likely diagnosis for patients who present with acute problems Develop evidence-based medicine/best practice management plans for patient’s seen in the emergency department

Comprehensive and thorough documentation in the emergency department

Providing patient education, to include follow-up care, to patients in the emergency department and their families • Preceptor evaluation • EOR examination • Select and interpret appropriate screening and diagnostic studies

• Preceptor evaluation • Preceptor assessment and sign-off of competency on patient and procedure logs • Submission of clinical documentation • EOR examination • Preceptor evaluation • EOR examinations • Interesting patient case assignment • Synthesize and analyze all clinical data correctly to aid in prompt diagnosis • Discern among acute, chronic, and emerging disease states

• Elicit a detailed medical history, perform patient appropriate physical examination, utilize appropriate diagnostic tests and accurately record all data

• Preceptor evaluation • EOR examinations • Interesting patient case assignment

• Preceptor evaluation • Interesting patient case assignment

• Preceptor evaluation • Interesting patient case assignment • Emergency Medicine

Simulation Activity • Utilize critical thinking and problem-solving skills to manage care of psychiatric patients • Locate, appraise and apply evidence from scientific studies to enhance patient care • Provide appropriate referrals • Accurately document medical information

Completing technical skills competently • Preceptor evaluation • Competency is measured by meeting the number of exposures listed under “Exxat

Procedure Logging” in conjunction with the preceptor’s signature, indicating the procedure was done competently • Performs procedures safely and at an appropriate skill level • Identifies the indications and contraindications of technical procedures

Presenting patients to the preceptor or other designated clinician on team in a concise, organized way demonstrating thorough knowledge of patient Maintain respectful and appropriate communications with patients, families, and members of the interprofessional team in a potentially complex and stressful environment, such as the emergency department

Demonstrate clinical reasoning and problem-solving ability when managing a patient • Preceptor evaluation • Emergency Medicine Simulation Activity • Effectively complete oral presentations

• Preceptor evaluation • Emergency Medicine Simulation Exercise

• Develop relationships and effectively communicate with patients, families, physicians, and other members of the care team • Exhibit reliability, accountability, and dependability • Exhibit an understanding of the physician assistant profession and the role of a PA • Demonstrate empathetic and respectful behaviors • Demonstrates and identifies appropriate ethical behavior and attitudes • Preceptor evaluation • Demonstrate care that is effective, safe, equitable, and high quality

Search for relevant information, utilizing appropriate data sources, and critically appraise to make evidence-based decisions in patient care Describe the indications, contraindications, mechanism of action, adverse effects and drug interactions of medications commonly used in the emergency department

Understand issues related to quality in a healthcare setting • Interesting patient case • Develop skills necessary for life-long learning

• Drug Cards • Interesting patient case • Emergency Medicine

Simulation Activity

• Quality Assurance &

Quality Improvement

Project • Identify pharmacologic agents and other relevant treatment modalities as they relate to patients with emergent conditions to include understanding the indications, contraindications, side effects, interactions and adverse reactions • Identify the value of quality improvement initiatives

Utilize the PAEA Core Tasks and Functions list found at https://paeaonline.org/assessment /core-tasks-and-objectives/ and apply to each of the psychiatric conditions outlined at https://paeaonline.org/wpcontent/uploads/2020/03/eoremergencymed-topiclist20200309.pdf

Demonstrate care that is appropriate in all patient encounters • EOR examination • Determine the etiologies, risk factors and epidemiology for acute and emergent conditions • Identify signs and symptoms of acute and emergent conditions • Utilize critical thinking and problem-solving skills to manage patients with acute conditions

• Preceptor evaluation • Demonstrate care that is effective, safe, equitable and high quality

Appreciate the utility of improving the quality of medical care • Quality assurance / performance improvement assignment • Identify the value of quality improvement initiatives

ASSESSMENT/EVALUATION CRITERIA

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

Interesting Case Assignment & Three Drug Cards 15%

Preceptor Evaluation 50%

Clerkship Patient Encounter Requirement Logs P/F

Procedure Logging Requirements P/F Computer Operated Adult/Child Simulators P/F End of Clerkship Examination 35% Developmental Disabilities Curriculum Requirements- if applicable P/F Quality Assurance/Performance Improvement Assignment P/F Call Back Day Longitudinal Patient Participation, Reflective Journal Entry & Medical Documentation Submission- if applicable P/F *All assessment and evaluation tools are in the back of the handbook

INTERESTING PATIENT CASE ASSIGNMENTS

The 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 a focused H&P, a written summary of the pathophysiologyof the disease state as well as one related journal article review utilizing the “Evaluating a Peer Reviewed Scientific Article” form. Journal article should be related to the chosen interesting case, current, less than 5 years old,andcomefrom anacademic,peer-reviewedmedicalpublication. Studentsthat presenttheinteresting case on a site visit should be prepared to lead a discussion with their fellow classmates and the clinical coordinator. This discussion should include all the elements of a focused H&P, related pathophysiology and review of their chosen journal article.

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 who are required to present their case may utilize an outline or notes for guidance, however 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

Students are required to research three (3) pharmaceutical agents used during their emergency medicine clerkship and make 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 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 not upload onto Exxat prior to the start of call back day, they will receive a grade of zero for this portion of the clerkship grade.

PRECEPTOR EVALUATION

The preceptor evaluation will be sent to the preceptor via email from Exxat during the last week of each rotation. 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. If a preceptor evaluation is not received within 60 calendar days of the end of the clerkship, the clerkship grade will be recorded as an “F.” In some instances a resident or another attending physician may complete a preceptor evaluation form in addition to the Clinical Preceptor of record. In those cases, additional evaluations may be submitted and averaged. A grade less than 60 on the preceptor evaluation constitutes a failure. A failing preceptor evaluation at any point during the clerkship will result in clerkship failure. Please see the clinical handbook for additional policies.

CLERKSHIP SPECIFIC PATIENT ENCOUNTER REQUIREMENTS

The minimum emergency medicine 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 student’s 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. Their 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 graduation.

Emergency Medicine 15 encounters per week/90 per clerkship

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.

CLINICAL YEAR PATIENT ENCOUNTER REQUIREMENTS

Although students must log specific psychiatric encounters during the emergency medicine clerkship, the below clinical 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. Their signature not only confirms exposure, but competence in these areas of care. Competency in these areas is required for graduation

Preventative Acute Chronic Emergent Developmental Disabilities

Types of Clinical Encounters

20 encounters during clinical year 20 encounters during clinical year 20 encounters during clinical year 20 encounters during clinical year 15 encounters during clinical year

Medical Care Across the Life Span Encounters

Infants- less than 1 years of age 15 encounters during the clinical year Children- 1 y/o – 11 y/o Adolescents- 12 y/o – 17 y/o Adults- 18 y/o – 64 y/o Geriatrics- greater than 65 y/o 30 encounters during the clinical year 30 encounters during the clinical year 100 encounters during the clinical year 100 encounters during the clinical year

PROCEDURE LOGGING REQUIREMENTS:

Students are required to perform and log a number of procedures. These 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”. Students must print out their “procedure list” for each rotation and have preceptors sign off on the procedure list. Their signature not only confirms exposure but indicates that a student can competently perform the procedure. Once your log is signed, it needs to be uploaded onto Exxat in session required documents. During your emergency medicine clerkship, it is recommended that you focus on procedures such as ABG’s, I&D’s, CPR, blood cultures, IV placement, splinting and NG tube placements. It is the student’s responsibility to find opportunities to meet the procedure requirements, however, not all the requirements listed below need to be completed during the student’s emergency medicine clerkship. Difficulty in meeting these requirements should be brought to the attention of the clinical coordinator and a plan for meeting competencies will be formulated.

REQUIRED CLINICAL YEAR PROCEDURES/EXAMINATIONS

Procedure ABG Required Number 4

Abscess I&D

2 Blood Cultures 2 Cardiopulmonary Resuscitation 1-assisted is acceptable on or at CLI* Foley Catheter Placement 4

IM/SC/ID-injections 10 IV Placement 10 NG Tube Placement 2 Splinting 5 Suturing 5 Venipuncture 10 Assist in Operating Room 5 Wound Care/Debridement 5 Breast Examinations 5 Pelvic Examinations 5 Rectal Examinations 5

*Center for Learning and Innovation (CLI)

COMPUTER-OPERATED ADULT/CHILD SIMULATORS

SimMan are computer-operated adult and child 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) 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 should be closed for any reason, all efforts will be made to make-up simulation at a later date. Failure to attend and participate in the clinical scenarios at CLI will result in an incomplete grade for this clerkship.

END OF CLERKSHIP EXAMINATION

To assess comprehensive knowledge of the discipline of the discipline of 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. To assist with preparation for the examination, students must use the following Core Tasks and Objectives https://paeaonline.org/assessment/core-tasks-and-objectives/ and apply information to https://paeaonline.org/wp-content/uploads/2020/03/eor-emergencymedtopiclist-20200309.pdf Student should also review the breakdown of the exam which can be found through the following link: https://paeaonline.org/wp-content/uploads/2018/06/emergencymedicine-blueprint-20180524.pdf

These end-ofrotation examinations have the same format as the Physician Assistant National Certifying Examination (PANCE) and are good preparation for successfully passing the PANCE. To pass the examinations, a student must receive a grade of no less than 65%. Should a student fail the end-of-rotation exam, they will be given the opportunity to take a make-up exam in exam master. 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.

QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT ASSIGNMENT

the form of a discussion board where students and faculty will interact. 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.

Summary:

REFLECTIVE JOURNALING

via Exxat on call back day at the end of the 3rd clerkship, 6th clerkship and then finally, the

grade for thisclerkship.

CLINICAL ENCOUNTERS

affect the student’s ability to graduate.

CALL BACK DAY

Students return to campus, Center for Learning and Innovation (CLI) or remotely via zoom on the last day of their clerkship for a day of activities. 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. Should an absence be unavoidable, the clinical coordinator must be contacted PRIORtothedatetodiscussthelegitimacyofthe 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.

Failure to do so will result in a three-point deduction from the overall rotation grade.

CLERKSHIP BIBLIOGRAPHY

During the clinical year and in clinical practice there is no set textbook or resource that will address the specific needs of the learner 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.

DISABILITY POLICY

PHA 280 PEDIATRIC CLERKSHIP 3 s.h.

Course Coordinator: Thomas Gallo, PA-C, JD Email: Thomas.Gallo@hofstra.edu Office: 516-463-4382

COURSE DESCRIPTION

This course is a clinical experience where students work with pediatric preceptors to 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

The goal 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, from birth through adolescence.

INSTRUCTIONAL OBJECTIVES AND LEARNER OUTCOMES

Instructional Objectives

By the conclusion of the pediatric clerkship, students will be competent in the following:

Evaluation of the pediatric patient by obtaining an accurate patient history, performing an ageappropriate physical exam, obtaining and interpreting laboratory and diagnostic studies while recognizing normal ageappropriate variations Recognize normal and abnormal patterns of pediatric growth and development and milestone achievement. Identify patients

Assessment Tools Utilized

Competency for each instructional objective is measured by successful completion of assessment tools listed below:

• Preceptor evaluation • Preceptor assessment and sign-off of competency on patient and procedure logs • PAEA end-of-rotation (EOR) examination

• Preceptor evaluation • Preceptor assessment and sign-off of

Learner Outcomes

Upon successful completion of this clerkship, students will attain the following knowledge, interpersonal, clinical/technical skills, professional behaviors, clinical reasoning, and problemsolving abilities: • Use effective interviewing skills to elicit a detailed history • Determine the normal and abnormal in anatomy, physiology, laboratory findings and other diagnostic data as applied to the pediatric population • Elicit a detailed medical history, perform ageappropriate physical examination, utilize appropriate

who require early intervention and initiate proper referral

Formulate differential diagnoses for common complaints and presentations in the pediatric population

competency on patient and procedure logs • Submission of clinical documentation • EOR examination • Preceptor evaluation • Submission of clinical documentation • EOR examinations

Develop evidence-based medicine/best practice, patientcentered management plans for pediatric patients • Preceptor evaluation • Submission of clinical documentation • EOR examinations

Accurately document pediatric care in patient H&P and SOAP notes

Providing patient education, to include health promotion and disease and injury prevention (including immunizations) to pediatric patients and their families • Preceptor evaluation • Submission of clinical documentation • Preceptor evaluation • EOR examinations • Submission of medical documentation developmental screening tools and accurately record all data

• Select and interpret appropriate diagnostic tests, lab studies or screening tools • Synthesize and analyze all clinical data correctly to aid in diagnosis • Discern among acute, chronic, and emerging disease states • Utilize critical thinking and problem-solving skills to identify and manage pediatric care • Locate, appraise, and apply evidence from scientific studies to enhance patient care • Accurately and adequately document medical information

Completing technical skills competently

Presenting patients to the preceptor or other designated clinician on team in a concise, organized way demonstrating thorough knowledge of patient • Preceptor evaluation • Competency is measured by meeting the number of exposures listed under

“Exxat Procedure

• Preceptor evaluation • Effectively complete oral presentations

Communicating effectively and respectfully with pediatric patients and their families and members of the interprofessional team

Search for relevant information, utilizing appropriate data sources, and critically appraise to make evidence-based decisions in patient care Describe the indications, contraindications, mechanism of action, adverse effects, drug interactions and correct dosing parameters of medications commonly used in pediatric patients

Utilize the PAEA Core Tasks and Functions list found at https://paeaonline.org/assessment /core-tasks-and-objectives/ and apply to each of the pediatric conditions outlined at https://paeaonline.org/wpcontent/uploads/2020/03/eorpediatrics-topiclist-20200309.pdf • Preceptor evaluation • Work collaboratively as a member of an interprofessional healthcare team • Exhibit reliability, accountability, and dependability • Exhibit an understanding of the physician assistant profession and the role of a PA • Demonstrate empathetic and respectful behaviors • Demonstrates and identifies appropriate ethical behavior and attitudes.

• Submission of medical documentation • Preceptor evaluation • Develop skills necessary for life-long learning

• Drug Cards

• Identify pharmacologic agents and other relevant treatment modalities as they relate to pediatric patients to include understanding the indications, contraindications, side effects, interactions and adverse reactions • EOR examination • Determine the etiologies, risk factors and epidemiology for pediatric conditions • Identify signs and symptoms of common pediatric conditions • Utilize critical thinking and problem-solving skills to manage pediatric patients

Demonstrate care that is appropriate in all patient encounters • Preceptor evaluation • Demonstrate care that is effective, safe, equitable and high quality

Appreciate the utility of improving the quality of medical care • Quality assurance / performance improvement assignment • Identify the value of quality improvement initiatives

ASSESSMENT/EVALUATION CRITERIA

The grade for this clerkship is based on the following components: One Pediatric SOAP Note & Three Pediatric Drug Cards 15%

Preceptor Evaluation Clerkship Patient Encounter Requirement Logs 50% P/F

Procedure Logging Requirements P/F End of Clerkship Examination 35% Developmental Disabilities Curriculum Requirements- if applicable P/F Call Back Day Longitudinal Patient P/F Quality Assurance/Performance Improvement Assignment P/F Participation, Reflective Journal Entry & Medical Documentation Submission - if applicable P/F

*All assessment and evaluation tools are in the back of the handbook

SUBMISSION OF CLINICAL DOCUMENTATION

Each student will submit to Exxat one (1) SOAP note, using ONETOUCH EMR while on their pediatric clerkship in session required documents. The note should be written legibly, accurately, and adequately. Please note:

• SOAP notes are not the same as progress notes. Progress notes will not meet 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. • No identifying information may appear on any notes, as this is violating HIPAA regulations. Notes submitted with identifying information will earn a grade of zero for that note. All notes must be submitted to the clinical coordinator on call

back day (see submitting callback day materials). A five (5) point deduction

from the note grade will result for each day it is tardy.

DRUG CARDS

Students are required to research three (3) pharmaceutical agents used during their pediatric clerkship and make 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 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 can be typed and submitted via word. Should a student fail to produce these cards on a site visit or not upload onto Exxat

prior to the start of call back day, they will receive a grade of zero for this portion of the clerkship grade.

PRECEPTOR EVALUATION

The preceptor evaluation will be sent to the preceptor via email from Exxat during the last week of each rotation. 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. If a preceptor evaluation is not received within 60 calendar days of the end of the clerkship, the clerkship grade will be recorded as an “F.” In some instances a resident or another attending physician may complete a preceptor evaluation form in addition to the Clinical Preceptor of record. In those cases, additional evaluations may be submitted and averaged. A grade less than 60 on the preceptor evaluation constitutes a failure. A failing

preceptor evaluation at any point during the clerkship will result in clerkship failure. Please see the clinical handbook for additional policies.

CLERKSHIP SPECIFIC PATIENT ENCOUNTER REQUIREMENTS

Clerkship logs are designed to help the Program track student clinical experiences and is completed utilizing the Exxat system. Filling out logs thoroughly and accurately will help the program to ensure students are receiving a quality clinical education. Students are required to log information regarding each patient seen 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 9 a.m. of the call back day. Students must log their patient experiences prior to this time. Students are contacted if the weekly review shows inadequate patient care experiences. The clinical

coordinators will discuss ways to maximize clinical opportunities for the remaining time in the clerkship.

The minimum pediatrics 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 student’s 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. Their 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 graduation.

Pediatrics

15 encounters per week/90 per clerkship

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.

CLINICAL YEAR PATEINT ENCOUNTER REQUIREMENTS

Although students must log specific pediatric encounters during the pediatric clerkship, the below clinical 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. Their signature not only confirms exposure, but competence in these areas of care. Competency in these areas is required for graduation.

Preventative Acute Chronic Emergent Developmental Disabilities

Types of Clinical Encounters

20 encounters during clinical year 20 encounters during clinical year 20 encounters during clinical year 20 encounters during clinical year 15 encounters during clinical year

Medical Care Across the Life Span Encounters

Infants- less than 1 years of age 15 encounters during the clinical year Children- 1 y/o – 11 y/o 30 encounters during the clinical year

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

Adults- 18 y/o – 64 y/o Geriatrics- greater than 65 y/o 100 encounters during the clinical year 100 encounters during the clinical year

PROCEDURE LOGGING REQUIREMENTS

Their signature not only confirms exposure but indicates that a student can competently perform the procedure. Once your log is signed, it needs to be uploaded onto Exxat in session required documents. During your pediatric clerkship, it is recommended that you focus on procedures such as blood cultures, IM/SC/ID injections, and venipuncture. It is the student’s responsibility to

find opportunities to meet the procedure requirements, however, not all the requirements

listed below need to be completed during the student’s pediatric clerkship. Difficulty in meeting these requirements should be brought to the attention of the clinical coordinator and a plan for meeting competencies will be formulated.

until competency is achieved in the items listed below.

REQUIRED CLINICAL YEAR PROCEDURES/EXAMINATIONS

Procedure ABG Abscess I&D

*Center for Learning and Innovation (CLI)

END OF CLERKSHIP EXAMINATION

To assess comprehensive knowledge of the pediatric discipline, 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, students must use the following Core Tasks and Objectives https://paeaonline.org/assessment/core-tasks-and-objectives/ and apply information to https://paeaonline.org/wp-content/uploads/2020/03/eor-pediatrics-topiclist-20200309.pdf Student should also review the breakdown of the exam which can be found through the following link: https://paeaonline.org/wp-content/uploads/2018/06/pediatrics-blueprint-20180608.pdf These end-ofrotation examinations have the same format as the Physician Assistant National Certifying Examination (PANCE) and are good preparation for successfully passing the PANCE.

To pass the examinations, a student must receive a grade of no less than 65%. Should a student fail the end-of-rotation exam, they will be given the opportunity to take a make-up exam in exam master. 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.

QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT ASSIGNMENT

Summary:

REFLECTIVE JOURNALING

page in length. Students can submit their reflective journal on Exxat. From the dashboard → placements → by session → to do list → session required documents → developmental disability reflective journaling. Failure to submit your reflective journaling will result in an incomplete

grade for thisclerkship.

CLINICAL ENCOUNTERS

affect the student’s ability to graduate.

CALL BACK DAY

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.

rotation grade.

CLERKSHIP BIBLIOGRAPHY

During the clinical year and in clinical practice there is no set textbook or resource that will address the specific needs of the learner 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.

DISABILITY POLICY

PHA 285 PSYCHIATRY CLERKSHIP 3 s.h.

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

COURSE DESCRIPTION

This is a clinical clerkship experience where students will work with psychiatrists, psychologists, and other members of the interprofessional healthcare team to evaluate and manage patients with behavioral and psychiatric illnesses.

COURSE GOAL

The goal of this clerkship is to enhance the students’ knowledge of the general principles of psychiatry and to expose them to patients with a variety of mental illnesses. Students will develop proficiency in taking a psychiatric history and performing mental status examinations and learn appropriate use of psychoactive pharmaceuticals.

INSTRUCTIONAL OBJECTIVES AND LEARNER OUTCOMES

Instructional Objectives

By the conclusion of the psychiatry clerkship, students will be competent in the following:

Comprehensive evaluation of the psychiatric patient by obtaining an accurate medical history, family and social history, a thorough psychiatric history and performance of a physical examination to include a full mental status examination. Appropriate use of laboratory tests and other diagnostic data to aid in the diagnosis of patients with mental illnesses

Assessment Tools Utilized

Competency for each instructional objective is measured by successful completion of assessment tools listed below:

• Preceptor evaluation • Preceptor assessment and sign-off of competency on patient and procedure logs • PAEA end-of-rotation (EOR) examination

• Preceptor evaluation • EOR examination

Learner Outcomes

• Select and interpret appropriate screening and diagnostic studies

Recognize normal and abnormal patterns of behavior. Identify patients who require admission versus those who can be treated as an outpatient and those who require specialty referral.

Utilize information obtained from the H&P, laboratory, and diagnostic studies to determine psychiatric differential diagnoses according to DSM-V criteria

Develop evidence-based medicine/best practice, patient-centered management plans for patients with mental illness

Comprehensive and thorough documentation of psychiatric H&P’s and progress notes Providing patient education, to include disease management skills to patients with mental illness and their families

Completing technical skills competently • Preceptor evaluation • Preceptor assessment and sign-off of competency on patient and procedure logs • Interesting patient case assignment • EOR examination

• Preceptor evaluation • EOR examinations • Interesting patient case assignment • Elicit a detailed medical history, perform patient appropriate physical examination, utilize appropriate screening tools, and accurately record all data • Provide appropriate referral • Discern among acute, chronic, and emerging disease states • Synthesize and analyze all clinical data correctly to aid in diagnosis

• Preceptor evaluation • EOR examinations • Interesting patient case assignment

• Utilize critical thinking and problem-solving skills to manage care of psychiatric patients • Locate, appraise, and apply evidence from scientific studies to enhance patient care • Preceptor evaluation • Accurately document medical information

• Preceptor evaluation • EOR examinations • Interesting patient case assignment

• Preceptor evaluation • Competency is measured by meeting the number of exposures listed under

“Exxat Procedure

Logging” in conjunction with the preceptor’s signature, indicating the procedure was done competently • Use effective basic counseling and patient education skills with patients and their families to empower them to participate in their care and enable shared decisionmaking • Provide appropriate referrals • Performs procedures safely and at an appropriate skill level • Identifies the indications and contraindications of technical procedures

Presenting patients to the preceptor or other designated clinician on team in a concise, organized way demonstrating thorough knowledge of patient Communicating appropriately and respectfully with psychiatric patients and their families and members of the interprofessional team

Search for relevant information, utilizing appropriate data sources, and critically appraise to make evidence-based decisions in patient care Demonstrate clinical reasoning and problem-solving ability when managing the psychiatric patient • Preceptor evaluation • Effectively complete oral presentations

• Preceptor evaluation • Work collaboratively as a member of an interprofessional healthcare team • Exhibit reliability, accountability, and dependability • Exhibit an understanding of the physician assistant profession and the role of PA • Demonstrate empathetic and respectful behaviors • Demonstrates and identifies appropriate ethical behavior and attitudes • Interesting patient case • Develop skills necessary for life-long learning

• Preceptor evaluation • Demonstrate care that is effective, safe, equitable, and high quality

Describe the indications, contraindications, mechanism of action, adverse effects and drug interactions of medications commonly used in psychiatry (including but not limited to antidepressants, anxiolytics, antipsychotics, sedatives) Understand issues related to quality in a healthcare setting • Drug Cards • Interesting patient case

• Quality Assurance &

Quality Improvement

Project • Identify pharmacologic agents and other relevant treatment modalities as they relate to patients with mental illnesses to include understanding the indications, contraindications, side effects, interactions, and adverse reactions • Identify the value of quality improvement initiatives

Demonstrate care that is appropriate in all patient encounters • EOR examination • Determine the etiologies, risk factors and epidemiology for psychiatric conditions • Identify signs and symptoms of psychiatric conditions • Utilize critical thinking and problem-solving skills to manage psychiatric patients

• Preceptor evaluation • Demonstrate care that is effective, safe, equitable and high quality

Appreciate the utility of improving the quality of medical care • Quality assurance / performance improvement assignment • Identify the value of quality improvement initiatives

ASSESSMENT/EVALUATION CRITERIA

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

Interesting Case Assignment & Three Psychiatry Drug Cards Preceptor Evaluation 15%

50%

Clerkship Patient Encounter Requirement Logs P/F

Procedure Logging Requirements P/F

End of Clerkship Examination 35%

Developmental Disabilities Curriculum Requirements- if applicable Quality Assurance/Performance Improvement Assignment Call Back Day Longitudinal Patient Participation, Reflective Journal Entry & Medical Documentation Submission - if applicable P/F

P/F

. *All assessment and evaluation tools are in the back of the handbook

INTERESTING PATIENT CASE ASSIGNMENTS

The interesting patient case assignment is a requirement during the psychiatry 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 a focused H&P, a written summary of the pathophysiology of the disease state as well as one related journal article review utilizing the “Evaluating a Peer Reviewed Scientific Article” form. Journal article should be related to the chosen interesting case, current, less than 5 years old, and come from an academic, peerreviewed medical publication. Students that present the interesting case on a site visit should be prepared to lead a discussion with their fellow classmates and the clinical coordinator. This

discussion should include all the elements of a focused H&P, related pathophysiology, and review of their chosen journal article.

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 who are required to present their case may utilize an outline or notes for guidance, however reading verbatim is not permitted. The interesting case patient cannot duplicate patients used for the required H & P note. Failure to

submit this project will result in a grade of zero for this portion of the clerkship grade.

DRUG CARDS

Students are required to research three (3) pharmaceutical agents used during their psychiatry medicine clerkship and make 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 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 can be typed and submitted in word format. Should a student fail to produce these cards on a site visit or not upload onto Exxat

prior to the start of call back day, they will a grade of zero for this portion of the clerkship grade.

PRECEPTOR EVALUATION

The preceptor evaluation will be sent to the preceptor via email from Exxat during the last week beginning of each rotation. 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. If a preceptor evaluation is not received within 60 calendar days of the end of the clerkship, the clerkship grade will be recorded as an “F.” In some instances a residentoranotherattendingphysicianmaycomplete a preceptor evaluation form in addition to the Clinical Preceptor of record. In those cases, additional evaluations may be submitted and averaged. A grade less than 60 on the preceptor evaluation constitutes a failure. A failing preceptor

evaluation at any point during the clerkship will result in clerkship failure. Please see the clinical handbook for additional policies.

CLERKSHIP SPECIFIC PATIENT ENCOUNTER REQUIREMENTS

Clerkship logs are designed to help the Program track student clinical experiences and is completed utilizing the Exxat system. Filling out logs thoroughly and accurately will help the program to ensure students are receiving a quality clinical education. Students are required to log information regarding each patient seen daily. All submissions are reviewed by the program each Monday at 9am. Weeklylogs 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. Students are contacted if the 103

weekly review shows inadequate patient care experiences. The clinical coordinators will discuss ways to maximize clinical opportunities for the remaining time in the clerkship.

The minimum psychiatry 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 student’s 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. Their 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 psychiatry clerkship, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required for graduation.

Psychiatry

10 encounters per week/60 per clerkship

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.

CLINICAL YEAR PATIENT ENCOUNTER REQUIREMENTS

Although students must log specific psychiatric encounters during the psychiatry clerkship, the below clinical encounters are required to be completed by the end of the clinical year, not by the end of the psychiatry clerkship. These requirements may be met on any of the eight clerkships. Preceptors must sign off on the following specific patient encounters. Their signature not only confirms exposure, but competence in these areas of care. Competency in these areas is required for graduation.

Types of Clinical Encounters

Preventative Acute Chronic

20 encounters during clinical year 20 encounters during clinical year 20 encounters during clinical year Emergent 20 encounters during clinical year Developmental Disabilities 15 encounters during clinical year

Medical Care Across the Life Span Encounters

PROCEDURE LOGGING REQUIREMENTS

print out their “procedure list” for each rotation and have preceptors sign off on the procedure list. Their signature not only confirms exposure but indicates that a student can competently perform the procedure. Once your log is signed, it needs to be uploaded onto Exxat in session required documents. Typically, psychiatry clerkships do not provide abundant opportunities to complete procedural competencies; however, they may be some opportunity to perform procedures such as venipunctures, IM/SC/ID injections and IV placement. It is the student’s responsibility to

find opportunities to meet the procedure requirements, however, not all the requirements

listed below need to be completed during the student’s psychiatry clerkship. Difficulty in meeting these requirements should be brought to the attention of the clinical coordinator and a plan for meeting competencies will be formulated.

until competency is achieved in the items listed below.

REQUIRED CLINICAL YEAR PROCEDURES/EXAMINATIONS

Procedure ABG Abscess I&D

*Center for Learning and Innovation (CLI)

END OF CLERKSHIP EXAMINATION

To assess comprehensive knowledge of the discipline of psychiatry, a 120-question multiplechoice 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, students must use the following Core Tasks and Objectives https://paeaonline.org/assessment/core-tasks-andobjectives/ and apply information to https://paeaonline.org/wp-content/uploads/2020/03/eorpsych-topiclist-20200309.pdf Student should also review the breakdown of the exam which can be found through the following link: https://paeaonline.org/wp-

content/uploads/2018/06/psychiatry-blueprint-20180608.pdf These end-ofrotation examinations have the same format as the Physician Assistant National Certifying Examination (PANCE), and are good preparation for successfully passing the PANCE. To pass the examinations, a student must receive a grade of no less than 65%. Should a student fail the end-of-rotation exam, they will be given the opportunity to take a make-up exam in exam master. 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.

QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT ASSIGNMENT

Summary:

REFLECTIVE JOURNALING

assignment completion rather than focus on a formal grade. All students will be required to submit a minimum of five reflective journal entry by call back day eight (8). Journal entries should be 1page in length. Students can submit their reflective journal on Exxat. From the dashboard → placements → by session → to do list → session required documents → developmental disability reflective journaling. Failure to submit your reflective journaling will result in an incomplete

grade for thisclerkship.

CLINICAL ENCOUNTERS

affect the student’s ability to graduate.

CALL BACK DAY

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.

lecturer evaluation. Failure to do so will result in a three-point deduction from the overall

rotation grade.

CLERKSHIP BIBLIOGRAPHY

During the clinical year and in clinical practice there is no set textbook or resource that will address the specific needs of the learner 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.

DISABILITY POLICY

PHA 290 ELECTIVE CLERKSHIP 3 s.h.

Course Coordinator: Jennifer Duperval, MS, PA-C; Email: Jennifer.P.Duperval@hofstra.edu Office: 516-463-6841

COURSE DESCRIPTION

This is a clinical experience that provides students with the opportunity to either explore a medical sub-specialty, surgical sub-specialty or to gain further experience in one of the core disciplines of medicine.

COURSE GOAL

For students to learn to provide high quality and comprehensive medical care to the patients seen on their elective clerkship.

INSTRUCTIONAL OBJECTIVES AND LEARNING OUTCOMES

Instructional Objectives

By the conclusion of the elective clerkship, students will be competent in the following:

Evaluation of the patient by obtaining an accurate history, performing a focused physical exam, obtaining, and interpreting appropriate laboratory and diagnostic studies and developing a differential diagnosis and management plan

Assessment Tools Utilized

Competency for each instructional objective is measured by successful completion of assessment tools listed below:

• Preceptor evaluation • Preceptor assessment and sign-off of competency on patient and procedure logs

Learner Outcomes

Upon successful completion of this clerkship, students will attain the following knowledge, interpersonal, clinical/technical skills, professional behaviors, clinical reasoning, and problemsolving abilities: • Use effective interviewing skills to elicit a detailed history • Determine the normal and abnormal in anatomy, physiology, laboratory findings and other diagnostic data and apply the information to recognize normal and abnormal health states • Determine the etiologies, risk factors and epidemiology for various medical and surgical conditions

Formulate an assessment for patients in the elective discipline

Development of management plans for patients in the elective discipline

Accurately document the medical care rendered for patients in the elective discipline

Providing patient education and counseling for a wide variety of medical conditions seen on the elective discipline

Completing technical skills competently • Identify signs and symptoms of various medical and surgical conditions • Utilize critical thinking and problem-solving skills to identify and manage various medical and surgical conditions

• Preceptor evaluation • Select and interpret appropriate diagnostic tests or lab studies • Synthesize and analyze clinical data correctly • Discern among acute, chronic, and emerging disease states • Preceptor evaluation • Utilize critical thinking and problem-solving skills to identify and manage a wide variety of medical conditions seen on the elective discipline • Preceptor evaluation • Adequately document medical information in history & physical notes and progress notes

• Preceptor evaluation • Interesting Patient

Presentation

• Preceptor evaluation • Competency is measured by meeting the number of exposures listed under

“Exxat Procedure

Logging” in conjunction with the preceptor’s signature, indicating the procedure was done competently • Use effective basic counseling and patient education skills with patients and their families to empower them to participate in their care and enable shared decisionmaking • Provide appropriate referrals • Performs procedures safely and at an appropriate skill level for the elective discipline • Identifies the indications and contraindications of technical procedures

Presenting patients to the preceptor or other designated clinician on team in a concise, organized way demonstrating thorough knowledge of patients seen on the elective discipline • Preceptor evaluation • Effectively complete oral presentations

Identify the members of the interprofessional team and the roles that they play in the delivery of healthcare in the elective discipline

Demonstrate care that is appropriate in all patient encounters • Preceptor evaluation • Work collaboratively as a member of an interprofessional healthcare team • Exhibit reliability, accountability, and dependability • Exhibit an understanding of the physician assistant profession and the role of a PA • Demonstrate empathetic and respectful behaviors • Demonstrates and identifies • appropriate ethical behavior and attitudes • Preceptor evaluation • Demonstrate care that is effective, safe, equitable and high quality

Appreciate the utility of improving the quality of medical care • Quality assurance / performance improvement assignment • Identify the value of quality improvement initiatives

ASSESSMENT/EVALUATION CRITERIA

Interesting Case Assignment Presentation 50% Preceptor Evaluation 50% Clerkship Patient Encounter Requirement Logs P/F Procedure Logging Requirements P/F

P/F

*All assessment and evaluation tools are in the back of the handbook

ELECTIVE INTERESTING PATIENT CASE PRESENTATION

The elective interesting patient case presentation 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 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.

When presenting students may utilize an outline or notes for guidance, however reading verbatim off their PowerPoint slides is not permitted. Failure to submit this project will result in a grade

of zero for this portion of the clerkship grade.

PRECEPTOR EVALUATION

The preceptor evaluation will be sent to the preceptor via email from Exxat during the last week of each rotation. 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. If a preceptor evaluation is not received within 60 calendar days of the end of the clerkship, the clerkship gradewill berecordedas an“F.”Insomeinstancesaresidentoranother attendingphysicianmaycomplete a preceptor evaluation form in addition to the Clinical Preceptor of record. In those cases, additional evaluations may be submitted and averaged. A grade less than 60 on the preceptor evaluation constitutes a failure. A failing preceptor evaluation at any point

during the clerkship will result in clerkship failure. Please see the clinical handbook for additional policies.

CLERKSHIP SPECIFIC PATIENT ENCOUNTER REQUIREMENTS

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 student’s 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. Their 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 graduation.

Elective 5 encounters per week/30 per clerkship

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.

CLINICAL YEAR PATEINT ENCOUNTER REQUIREMENTS

Although students must log specific elective encounters during the elective clerkship, the below clinical 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. Their signature not only confirms exposure, but competence in these areas of care. Competency in these areas is required for graduation.

Preventative Acute

Types of Clinical Encounters

20 encounters during clinical year 20 encounters during clinical year

Chronic

20 encounters during clinical year Emergent 20 encounters during clinical year Developmental Disabilities 15 encounters during clinical year

Medical Care Across the Life Span Encounters

PROCEDURE LOGGING REQUIREMENTS

responsibility to find opportunities to meet the procedure requirements, however, not all

113

the requirements listed below need to be completed during the student’s elective clerkship.

Difficulty in meeting these requirements should be brought to the attention of the clinical coordinator and a plan for meeting competencies will be formulated.

achieved in the items listed below.

REQUIRED CLINICAL YEAR PROCEDURES/EXAMINATIONS

Procedure ABG Required Number 4

Abscess I&D

2 Blood Cultures 2 Cardiopulmonary Resuscitation 1-assisted is acceptable or at CLI* Foley Catheter Placement 4 IM/SC/ID-injections 10 IV Placement 10 NG Tube Placement 2 Splinting 5 Suturing 5 Venipuncture 10 Assist in Operating Room 5 Wound Care/Debridement 5 Breast Examinations 5 Pelvic Examinations 5 Rectal Examinations 5

*Center for Learning and Innovation (CLI)

QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT ASSIGNMENT

Summary:

REFLECTIVE JOURNALING

After each clinical encounter 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, communicationwith 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. Please journal on an electronic device. Title each journal entry adhering to the following format: “Clinical Encounter”. Date each entry as well. This journal will be submitted via Exxat on call back day at the end of the 3rd clerkship, 6th clerkship and then finally, the 8th clerkship. To encourage deep-rooted, self-analysis, journal entries will only be reviewed to assure assignment completion rather than focus on a formal grade. All students will be required to submit a minimum of five reflective journal entry by call back day eight (8). Journal entries should be 1 page in length. Students can submit their reflective journal on Exxat. From the dashboard → placements → by session → to do list → session required documents → developmental disability reflective journaling.

Failure to submit your reflective journaling will result in an incomplete grade for thisclerkship.

CLINICAL ENCOUNTERS

student’s ability to graduate.

CALL BACK DAY

Studentsreturntocampus, CenterforLearningandInnovation(CLI)or remotely via zoom onthelastday of their clerkship for a day of activities. 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. Should an absence be unavoidable, the clinical coordinator must be contacted PRIOR to the date todiscussthe legitimacyof 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.

submitted on 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. In addition, after each “on-site” longitudinal patient care experience, the student will be required to view their encounter remotely (on Hofstra or Northwell network) and complete a video self-reflection form assessing their performance. 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. There will be no video self-reflection if the longitudinal patient care experience occurs via zoom. If a student misses a patient encounter or

does not complete either the SOAP notes or video self-reflection, they will receive two (2) points off their final rotation grade for each assignment not completed.

Additionally,allstudents are requiredtofill out a Call Back DayLecturer Evaluationon 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.Failureto do so will result in a three-point deduction from the overall rotationgrade.

CLERKSHIP BIBLIOGRAPHY

During the clinical year and in clinical practice there is no set textbook or resource that will address the specific needs of the learner 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.

Next Article

CLINICAL YEAR FORMS

PHA 250 FAMILY MEDICINE CLERKSHIP 3 s.h.

COURSE DESCRIPTION:

COURSE GOAL:

INSTRUCTIONAL OBJECTIVES AND LEARNING OUTCOMES:

Instructional Objectives

Assessment Tools Utilized

Learner Outcomes

ASSESSMENT/EVALUATION CRITERIA

HEALTH PROMOTION PROJECT

Exxat will result in a grade of zero for this portion of the clerkship grade.

VIRTUAL PATIENT CASE ASSIGNMENT FOR EDUCATING STUDENTS

DRUG CARDS

prior to the start of call back day, they will receive a grade of zero for this portion of the clerkship grade.

PRECEPTOR EVALUATION

clerkship will result in clerkship failure. Please see the clinical handbook for additional policies.

CLERKSHIP SPECIFIC PATIENT ENCOUNTER REQUIREMENTS

Please do not stop logging once the minimum requirement is completed, as clinical encounters will increase in complexity and level of participation as student’s progress in each clerkship

Family Medicine

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.

CLINICAL YEAR PATIENT ENCOUNTER REQUIREMENTS

Types of Clinical Encounters

Medical Care Across the Life Span Encounters

PROCEDURE LOGGING REQUIREMENTS

the student’s responsibility to find opportunities to meet the procedure requirements, however, not all the requirements listed below need to be completed during the student’s

until competency is achieved in the items listed below.

REQUIRED CLINICAL YEAR PROCEDURES/EXAMINATIONS

*Center for Learning and Innovation (CLI)

END OF CLERKSHIP EXAMINATION

QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT ASSIGNMENT

Summary:

REFLECTIVE JOURNALING

via Exxat on call back day at the end of the 3rd clerkship, 6th clerkship and then finally, the

grade for thisclerkship.

CLINICAL ENCOUNTERS

affect the student’s ability to graduate.

CALL BACK DAY

encounter or does not complete either the SOAPnotesorvideoself-reflection,theywillreceive two (2) points off their final rotation grade for each assignment not completed.

rotation grade.

CLERKSHIP BIBLIOGRAPHY

DISABILITY POLICY

PHA 255 INTERNAL MEDICINE CLERKSHIP 3 s.h.

COURSE DESCRIPTION

COURSE GOAL

INSTRUCTIONAL OBJECTIVES AND LEARNING OUTCOMES:

Instructional Objectives

Assessment Tools Utilized

Learner Outcomes

ASSESSMENT/EVALUATION CRITERIA

VIRTUAL PATIENT CASE ASSIGNMENT FOR EDUCATING STUDENTS

SUBMISSION OF CLINICAL DOCUMENTATION

note grade will result for each day it is tardy.

DRUG CARDS

prior to the start of call back day, they will receive a grade of zero for this portion of the clerkship grade.

PRECEPTOR EVALUATION

during the clerkship will result in clerkship failure. Please see the clinical handbook for additional policies.

CLERKSHIP SPECIFIC PATIENT ENCOUNTER REQUIREMENTS

Internal Medicine 10 encounters per week/60 per clerkship

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.

CLINICAL YEAR PATIENT ENCOUNTER REQUIREMENTS

Types of Clinical Encounters

Medical Care Across the Life Span Encounters

PROCEDURE LOGGING REQUIREMENTS

find opportunities to meet the procedure requirements, however, not all the requirements listed below need to be completed during the student’s internal medicine clerkship.

until competency is achieved in the items listed below.

REQUIRED CLINICAL YEAR PROCEDURES/EXAMINATIONS

*Center for Learning and Innovation (CLI)

END OF CLERKSHIP EXAMINATION

QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT ASSIGNMENT

Summary:

REFLECTIVE JOURNALING

grade for thisclerkship.

CLINICAL ENCOUNTERS

affect the student’s ability to graduate.

CALL BACK DAY

rotation grade.

CLERKSHIP BIBLIOGRAPHY

DISABILITY POLICY

PHA 260 OBSTETRICS/GYNECOLOGY CLERKSHIP 3 s.h.