Preceptor Handbook: Fall 2022

PRECEPTOR HANDBOOK

Fall 2022

CLINICAL PATIENT

PROCEDURE

STUDENT AND CLERKSHIP MONITORING

MID CLERKSHIP EVALUATION

STUDENT EVALUATION OF PROGRAM CLERKSHIPS 35 ASSESSMENT OF CLINICAL SITES

CLINICAL YEAR SYLLABI 37

PHA 250 FAMILY MEDICINE CLERKSHIP 3 s.h.

PHA 255 INTERNAL MEDICINE CLERKSHIP 3 s.h.

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PHA 260 OBSTETRICS/GYNECOLOGY CLERKSHIP 3 s.h. 60

PHA 265 SURGERY CLERKSHIP 3 s.h 70

PHA270 EMERGENCY MEDICINE CLERKSHIP 3 s.h 82

PHA 280 PEDIATRIC CLERKSHIP 3 s.h. 93

PHA 285 PSYCHIATRY CLERKSHIP 3 s.h.

PHA 290 ELECTIVE CLERKSHIP 3 s.h.

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CLINICAL YEAR FORMS ERROR! BOOKMARK NOT DEFINED.23

Interesting Case Presentation Evaluation Form 12224 Elective Interesting Case Presentation Evaluation Form 12325 Mid Clerkship Evaluation 1246

Student Clinical Site & Preceptor Evaluation .........................................................................................................................1257

STUDENT/PRECEPTOR REVIEW OF CLINICAL OBJECTIVES FORM 1279 Exposure Incident Investigation Form 12830 Post Exposure Evaluation and Follow Up Checklist 12931

FAMILY MEDICINE CLERKSHIP: HEALTH PROMOTION PROJECT 13032 HEALTH PROMOTION PROJECT GRADE FORM 13234

END OF ROTATION GRADE FORM

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CLINICAL YEAR – CLINICAL DOCUMENTATION GRADING FORM 1357

PROGRAM IN PHYSICIAN ASSISTANT STUDIES PRECEPTOR EVALUATION FORM…………………………….138

DESCRIPTIONS OF EVALUATION CATEGORIES 1379

FACULTY AND STAFF CONTACT INFORMATION

Chair and Program Director / Assistant Professor

Academic Faculty / Assistant Professor J. Scott Gould, DMSc, PA-C

Carina Loscalzo, MS, PA-C (516) 463 4411 (516) 463 4412

Scott.Gould@hofstra.edu

Carina.Loscalzo@hofstra.edu

Gallon Wing, room 243B Gallon Wing, room 243A

Associate Director / Assistant Professor Mark L’Eplattenier, MPAS, PA-C (516) 463 1353

Mark.S.Leplattenier@hofstra.edu

Gallon Wing, room 243C

Medical Director Samuel Sandowski, MD (516) 463 4074

Ssandowski@snch.org

Gallon Wing, room 132

Academic Coordinator / Assistant Professor Amy Roberts, MS, PA-C Christine Zammit, MS, PA-C (516) 463 7728 (516) 463 4380

Academic Coordinator / Assistant Professor

Amy.Roberts@hofstra.edu

Christine.Zammit@hofstra.edu

Gallon Wing, room 130 Gallon Wing, room 137

Dual Degree Coordinator / Assistant Professor

Clinical Coordinator / Assistant Professor Mary Banahan, MS, PA-C Shannan Ricoy, MS, PA-C (516) 463 4161 (516) 463 4233

Mary.K.Banahan@hofstra.edu (516) 509 6470 (Program cellular phone) Gallon Wing, room 244 Shannan.Ricoy@hofstra.edu

Gallon Wing, room 236

Clinical Coordinator / Assistant Professor Thomas Gallo, JD, PA-C Jennifer Duperval, MS, PA-C 516 463 4382 516 463 6841

Clinical Coordinator / Assistant Professor

Thomas.Gallo@hofstra.edu

Gallon Wing, room 231

Academic Faculty/ Assistant Professor William Heuser, Pharm D, MS, EMT-P (516) 463 7008

William.Heuser@hofstra.edu

Gallon Wing, room 139

Jennifer.P.Duperval@hofstra.edu

Gallon Wing, room 237

Senior Assistant-Full Time Marie Sorrentino (516) 463 4074

Marie.Sorrentino@hofstra.edu

Gallon Wing, room 132

Clinical Secretary / Secretary - Part Time Gina Pontrelli, DHSc, PA-C

Academic Faculty / Assistant Professor

Karen Forman/Sharon Poulson (516) 463 4381 (516) 463 4074

Gina.L.Pontrelli@hofstra.edu

Gallon Wing, room 131

Karen.S.Forman@hofstra.edu

Sharon.Poulson@hofstra.edu Gallon Wing, room 132

Academic Administrator / Advisement Coordinator Analyst Gia Raponi

Adjunct Assistant Professor / Assessment and Evaluation

Eze Awgu, PhD (516) 463 4043

516 463 8543

Ezechukwu.Awgu@hofstra.edu

Gallon Wing, room 140

Academic Support Specialist

Katelyn Morgenstern, MBA

516 463 6479

Katelyn.Morgenstern@hofstra.edu

Gallon Wing, room 132A

Gia.R.Raponi@hofstra.edu

Gallon Wing, room 245

Department Main Office Phone: (516) 463-4074

Fax: (516) 463 5177

Hofstra University Physician Assistant Studies Gallon Wing, room 132 Hempstead, New York 11549 1270

Rotation 1 Fall Semester

2022 2023 Clinical Year Schedule

8/29/2022 – 10/6/2022

Students off 9/5/2022

Call Back Day 10/7/2022 Hofstra Campus

Rotation 2 Fall Semester 10/11/2022 – 11/17/2022

Rotation 3, Part #1 Fall Semester

Students off 10/10/2022

11/21/2022 - 12/16/2022

Students off 11/24/2022 11/27/2022

Winter Break- 12/19/2022 – 12/26/2022

Rotation 3, Part #2 Fall Semester 12/27/2022 1/5/2023

Rotation 4 Spring Semester 1/9/2023 – 2/15/2023

Rotation 5 Spring Semester 2/20/2023 – 3/29/2023

Spring Break 4/1/2023 – 4/9/2023

Rotation 6 Spring Semester 4/10/2023 – 5/18/2023

Rotation 7 Summer I 5/22/2023 – 6/28/2023

Rotation 8 Summer II 7/3/2023 – 8/9/2023

Students off 7/4/2023

Call Back Day 11/18/2022 Hofstra Campus

Call Back Day 1/6/2023 Hofstra Campus

Call Back Days 2/16/2023 Hofstra Campus & 2/17/2023 CLI Campus

Call Back Days 3/30/2023 Hofstra Campus & 3/31/2023 CLI Campus

Call Back Day 5/19/2023 Hofstra Campus

Call Back Days 6/29/2023 Hofstra Campus & 6/30/2023 CLI Campus

Call Back Days 8/10/2023 Hofstra Campus & 8/11/2023 CLI Campus

*Call Back Day is either on campus, at the Center for Learning and Innovation or remote via zoom.

MISSION, VISION, VALUES AND GOALS OF THE HOFSTRA NORTHWELL DEPARTMENT OF PHYSICIAN ASSISTANT STUDIES

Program Mission

The Hofstra Northwell Department of Physician Assistant Studies’ mission is to create an interprofessional environment that fosters PA leaders and scholars who deliver empathetic, patient-centered care, and promote inclusivity to the diverse populations they serve.

Program Vision

The vision of the Hofstra Northwell Department of Physician Assistant Studies aspires to be an innovative global leader in the preparation of the next generation of Physician Assistants.

Program Values

• Life-long Learning

The program is committed to promoting the ongoing professional growth and betterment of clinical practice through self-directed learning activities.

• Innovation

We facilitate learning with a multimodal approach that is creative, interprofessional, collaborative, and student-centered using the most advanced medical resources and technologies that will provide the student with the tools for life-long learning.

• Collaboration

The program is committed to fostering a learning environment where students partner with members of an interprofessional healthcare team to promote excellence in patient-centered care.

• Compassion

We embrace a patient-centered, caring, empathetic approach to the delivery of healthcare.

• Excellence

We are committed to preparing clinically competent Physician Assistants that excel in their ability to critically think and problem solve to provide comprehensive patient care.

• Leadership

We inspire our students and faculty to positively influence their professional, institutional, and patient care communities.

• Diversity

We instill awareness of and respect for individual cultures by educating our students on the importance of understanding the unique needs of a diverse patient population.

• Professionalism

We challenge our students to become exemplary Physician Assistants by exhibiting respect, integrity, honesty, and ethical behavior in all circumstances.

• Scholarship

We foster an environment that encourages the use of evidence-based medicine in clinical practice. We also promote the student and faculty’s contributions to the advancement of scientific knowledge for the betterment of the profession.

Program Goals and Objectives

• Train highly qualified PAs to enter clinical practice.

• Promote self-directed life-long learning, appreciating the significance of scholarly activities and scientific knowledge.

• Promote professionalism and leadership skills.

• Cultivate the collaborative learning and working styles necessary for participation in an interprofessional, patient-centered healthcare team.

• Empower PAs to value inclusivity and diversity, and deliver quality care to all patients, recognizing health care disparities and populations with limited access to care.

GRADUATE FUNCTIONS AND TASKS

Graduates of the Hofstra University Physician Assistant Program will be expected to demonstrate competency in the following functions and tasks:

Medical Knowledge

• Determine the normal and the abnormal in anatomy, physiology, laboratory findings, and other diagnostic data and apply the information to recognize normal and abnormal health states.

• Discern among acute, chronic, and emerging disease states.

• Determine the etiologies, risk factors, and epidemiology for medical conditions.

• Identify signs and symptoms of medical conditions.

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

• Identify and formulate an appropriate assessment and management plan.

• Select and interpret appropriate screening and diagnostic studies.

• Identify pharmacologic agents and other relevant treatment modalities as they relate to general medical conditions to include understanding the indications, contraindications, side effects, interactions, and adverse reactions.

Graduates will demonstrate competency by the successful completion of the following:

• Didactic coursework; specifically, Human Anatomy, Physiology, Physical Examination and Diagnostic Modalities I, II & III, Medicine I, II, and III, Pharmacy I, II, and III, Epidemiology, Preventative Medicine, Correlative Medicine I & II.

• Supervised clinical practice experiences in family medicine, internal medicine, surgery, psychiatry, ob/gyn, pediatrics, emergency medicine and an elective rotation.

• Successful completion of PAEA end of rotation and summative examinations.

Society and Population Health

• Recognize the principles of social-behavioral sciences as it relates to patient care, including assessing the impact of psychosocial and cultural influences on health and disease.

• Understand and apply the fundamental principles of epidemiology.

• Identify the value of quality improvement initiatives.

• Recognize the social determinants of health and understand how they apply to patient care.

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

• Use evidence-based medicine to care for individuals, families, and communities if various backgrounds

Graduates will demonstrate competency by the successful completion of the following:

• Didactic coursework; specifically, Epidemiology, Health Psychology, and Preventative Medicine.

• Supervised clinical practice experiences in family medicine, internal medicine, surgery, psychiatry, ob/gyn, pediatrics, emergency medicine and an elective rotation.

• Successful completion of summative examinations and assessments.

Interpersonal and Communication

• Use effective interviewing skills to elicit a detailed history.

• Accurately document medical information.

• Effectively complete oral presentations.

• Provide appropriate referrals.

• Participate in difficult conversations.

• 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.

• Develop relationships and effectively communicate with patients, families, physicians, and other members of the care team

Graduates will demonstrate competency by the successful completion of the following:

• Didactic coursework; specifically, Physical Examination and Diagnostic Modalities I, II and III, PA and Society, Correlative Medicine I & II and Health Psychology.

• Supervised clinical practice experiences in family medicine, internal medicine, surgery, psychiatry, ob/gyn, pediatrics, emergency medicine and an elective rotation.

• Successful completion of summative examinations.

Professional Behaviors

• Demonstrate empathetic and respectful behaviors.

• Exhibits reliability, accountability, and dependability.

• Exhibits an understanding of the physician assistant profession and the role of a PA.

• Demonstrates and identifies appropriate ethical behavior and attitudes.

• Exhibits an understanding of the laws and regulations of PA Practice.

Graduates will demonstrate competency by the successful completion of the following:

• Didactic coursework; specifically, PA and Society and Health Psychology.

• Supervised clinical practice experiences in family medicine, internal medicine, surgery, psychiatry, ob/gyn, pediatrics, emergency medicine and an elective rotation.

• Successful completion of summative examinations.

• Successful completes professional development evaluations

Clinical Reasoning and Problem-Solving Ability

• Utilize critical thinking and problem-solving skills to identify and manage medical conditions.

• Synthesize and analyze clinical data correctly.

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

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

Graduates will demonstrate competence by the successful completion of the following:

• Didactic coursework: specifically, Correlative Medicine I & II and Evidence Based Medicine

• Supervised clinical practice experiences in family medicine, internal medicine, surgery, psychiatry, ob/gyn, pediatrics, emergency medicine and an elective rotation.

• Successful completion of summative examinations.

Clinical and Technical Skills

• Performs procedures safely and at an appropriate skill level

• Identifies the indications for and contraindications of technical procedures

Graduates will demonstrate competence by the successful completion of the following:

• Didactic coursework; specifically, Physical Examination and Diagnostic Modalities I, II & III.

• Supervised clinical practice experiences family medicine, internal medicine, surgery, psychiatry, ob/gyn, pediatrics, emergency medicine and an elective rotation.

• Successful completion of summative examinations, and preceptor evaluations.

HOFSTRA UNIVERSITY DEPARTMENT OF PHYSICIAN ASSISTANT STUDIES TECHNICAL STANDARDS

A physician assistant student must possess a number of abilities and skills. The use of a trained intermediary is not acceptable in many clinical situations in that it implies that a candidate’s judgment must be mediated by someone else’s power of selection and observation. Therefore, each student must be able to:

• Observe a patient accurately, at a distance and close at hand, with or without standard medical instrumentation.

• Acquire information from written documents and to visualize information as presented in images from paper, film, slides, or video.

• Comprehend X-ray, EKG, and other graphic images with or without assistive devices.

• Speak, hear, and observe patients by sight to elicit information, describe changes in mood, activity, and posture, and perceive nonverbal communication.

• Communicate effectively with patients and their families in both written and oral modalities.

• Possess motor skills necessary to perform palpation, percussion, auscultation and other diagnostic and therapeutic maneuvers, basic laboratory tests and emergency therapeutic procedures, including airway management, placement of intravenous catheters, cardiopulmonary resuscitation, application of pressure to control bleeding, and suturing of wounds.

• Measure, calculate, reason, analyze, integrate, synthesize, and comprehend three-dimensional relationships and understand spatial relationships of structures according to standard medical care.

• Exercise good judgment and complete all responsibilities attendant to the diagnosis and care of patients promptly. Develop mature, sensitive, and effective relationships with patients.

• Tolerate physically taxing workloads, function effectively under stress, adapt to changing environments, display flexibility and learn to function in the face of uncertainties inherent in the practice of clinical medicine.

Where a candidate’s ability to observe or acquire information through sensory modalities is compromised, the candidate must demonstrate alternate means and/or abilities to acquire and demonstrate comprehension of essential information. Costs of necessary accommodations should be reasonable and will be properly borne by the University when not the responsibility of the student or otherwise funded. Students wishing to receive reasonable accommodations must first follow all registration procedures through Student Access Services.

CURRICULUM DESIGN

THE DIDACTIC PHASE

The didactic phase is comprised of classroom and laboratory instruction in areas such as: basic science, behavioral science, pharmacology, physical diagnosis, and clinical medicine. Teaching methodologies are multimodal in approach and inclusive of active learning modalities. Active learning modalities include any activity where students are actively participating in the educational process. In addition to the traditional lecture approach, instructional methods, and examples of active learning, include use of simulation, case-based learning, structure (cadaver) lab, and the use of the Northwell Bioskills Education Lab which utilizes freshfrozen human specimens for practicing skills. Each teaching modality requires significant independent study and preparation on the part of the students to successfully participate in learning opportunities. To appropriately prepare students to practice as physician assistants, the course load during the didactic year is intense. Students should expect to be in class for a minimum of 8 hours a day. Some classes may require evening, early morning, or weekend sessions. Students are expected to attend all classes. Students should have no other commitments during these hours.

At the beginning of each course, students will receive a syllabus and course outline describing the purpose of the course, the format, the objectives, and a list of required and recommended books. Students will also receive instructional learning objectives for each course, which will guide the student in studying and provide the basis for examinations. Students are responsible for each objective listed in a syllabus, regardless of whether it is covered in class. Examples of evaluation methods include simulation lab, clinical note writing, procedure skill completion, oral presentations, group work, and written exams.

Wherever possible, the curriculum is vertically integrated so that students study aspects of an organ system in several courses at the same time. For example, diseases of the lung might be studied jointly in medicine, pharmacology, and the physical examination course. The case-based courses, Correlative Medicine I and II, synthesizes and integrates previously learned material and promotes critical thinking skills. Other courses address the social aspects of medicine. Preventive Medicine and Evidence-Based Medicine help students understand the social and public health contexts of their future patients’ health, as well as how to appropriately identify and synthesize medical literature to inform their clinical decision-making. Health Psychology focuses on the formulation and improvement of student interpersonal and communication skills, especially as it relates to difficult patients or clinical encounters. The Physician Assistant and Society course explores the role of physician assistants within medicine, the legislative and legal realms. The Physical Examination and Diagnostic Modalities series provides students with an opportunity to learn skills related to physical examination, laboratory and diagnostic testing, and procedures. Examples include EKG interpretation, phlebotomy, suturing, and radiologic study interpretation.

THE CLINICAL YEAR

The clinical year is comprised of eight clerkships totaling approximately 2,000 hours of clinical training. Mandatory clerkships include internal medicine; pediatrics; obstetrics and gynecology; psychiatry; family medicine; emergency medicine; and surgery. Students are also required to complete an elective clerkship in an area of special interest of their choice. Clerkships are completed off campus in various clinical settings such as hospitals, private offices, and clinics. Clerkship locations also vary, with many, but not all, housed within the Northwell Health System. Students are not required to obtain and secure their own clinical sites or preceptors. Students are required to report to the site as instructed by their preceptors. Some rotations will require student’s attendance during weekend, a holiday, overnight, or late into the evenings. Students will

return to Hofstra campus, Northwell Center for Learning, and Innovation or remotely via Zoom onthe last dayor two of their clerkships for call back activities. These 1 -2 day-long sessions consist of oral presentations, end of rotation examinations, standardized patient encounter’s with debrief sessions, and lectures/workshops related to clinical medicine.

RESEARCH SEMESTER

The research semester includes full-time study and synthesizes didactic and clinical knowledge in the application of epidemiology, evidence-based medicine, and research design and analysis. The Epidemiology course explores issues related to health and illness within communities rather than individuals. Students will examine interventions to prevent illness in the interest of improving public health and bridge the gap between clinical medicine and the evidence-based research by which it is driven. The Research Design and Analysis course provides the framework in which data can be analyzed and presented. Students will learn how to critically read and evaluate the strengths and limitations of health research literature from a methodologic perspective.

The Research Project course provides guidance in the collection, analysis, and written presentation of data. The Research Project is a culmination of the research curriculum, and a summation of cumulative knowledge gained in medical science, health care objectives, and community-based health care. Using skills learned in Epidemiology, Research Design and Analysis, and Evidence-Based Medicine, students will complete an original research project l. Students will work in small groups to formulate a research question, perform a literature review, create a method for answering the research problem, and analyze results. The project will culminate with a formal research paper and poster presentation of significant findings. Students will present their research to their peers, professors, and the scientific community in a conference-style setting. Students may also elect to submit their manuscript for publication in the journal of their choice.

Integrated into the Research Semester students will complete a mandatory board refresher and professional series. Faculty will review topics and review questions according to the Physician Assistant National Certification Examination (PANCE) blueprint designed to help students pass the boards. The professional series is designed to begin preparing students for entrance into the workforce and includes topics such as curriculum vitae writing, contracts, and interview skills. Summative examinations and completion of the Packrat examination occurs during this semester. It is usually recommended that students maintain housing close to campus during the research semester as they are required to be on campus for the duration of the semester and attendance at all classes, activities, and examinations are mandatory.

PROGRAM CURRICULUM

First Semester 17 credits

Anatomy 4 credits PHA 223 Physical Examination and Diagnostic Modalities I 3 credits PHA 215 Pharmacology I 2 credits PHA 217 Physiology 4 credits PHA 212 Medicine I 4 credits PHA 224

Second Semester 18 credits

Health Psychology 2 credits PHA 216 Physician Assistant and Society 2 credits PHA 200 Pharmacology II 2 credits PHA 221 Physical Examination and Diagnostic Modalities II 3 credits PHA 220 Medicine II 5 credits PHA 225 Evidence-Based Medicine 2 credits PHA 202 Preventive Medicine 1 credits PHA 235 Correlative Medicine I 1 credits PHA 233

Third Semester 12 credits

Pharmacology III 2 credits PHA 234 Medicine III 7 credits PHA 227 Correlative Medicine II 1 credits PHA 233 Physical Examination and Diagnostic Modalities III 2 credits PHA 219

Fourth – Sixth Semesters (Clerkships) 24 credits

Family Medicine 3 credits PHA 250 Internal Medicine 3 credits PHA 255 OB/GYN 3 credits PHA 260 Surgery 3 credits PHA 265 Emergency Medicine 3 credits PHA 270 Pediatrics 3 credits PHA 280 Psychiatry 3 credits PHA 285 Elective 3 credits PHA 290

Seventh Semester 8 credits

Epidemiology 2 credits PHA 218 Research Design and Analysis 3 credits PHA 301 Research Project 3 credits PHA 302

Curriculum Total 79 credits

INTRODUCTION

The Preceptor Guide outlines the policies and procedures of the Hofstra University Department of Physician Assistant Studies regarding expectations for student performance in clinical clerkships. Furthermore, this handbook contains the objectives and discrete subject matter to which the student will be held responsible on a written examination. As physician assistant education is constantly evolving, this guide is reviewed and updated annually. Therefore, preceptors are encouraged to forward comments to the program on any portion of this guide that merits reexamination. Additionally, this handbook can be found on our program website at http://www.hofstra.edu/academics/colleges/nursing-physician-assistant/physician-assistant/physician-assistant handbooks.html.

The faculty of the Hofstra University Department of Physician Assistant Studies would like to take this opportunity to express our sincere gratitude to our preceptors for their hard work and dedication to this program and our physician assistant (PA) students. The clinical experiences the student will obtain in your office; clinic or institution are of critical importance to a successful learning experience in the program. The clinical setting synthesizes concepts and application of principles for quality health care delivery. You, as a clinical preceptor, are the key to successful learning experiences in the clinical setting. The PA student will work closely with you, learning from your advice and example. Through your supervision, the student will progressively develop the skills and clinical judgment necessary to become a practicing PA. Thank you for your commitment to PA education and for your support in helping to educate the next generation of health care providers.

At any time, should you have any questions, comments, or feedback regarding our students, please feel free to contact the program.

THE CLINICAL YEAR

The clinical year takes students from the theoretical classroom setting to an active, hands-on learning environment to prepare them for a lifetime of continued refinement of skills and expanded knowledge as a practicing PA. To this end, the goals of the clinical year include:

• Apply didactic knowledge to supervised clinical practice

• Develop and sharpen clinical problem-solving skills

• Expand and develop the medical fund of knowledge

• Perfect the art of history taking and physical examination skills

• Sharpen and refine oral presentation and written documentation skills

• Develop an understanding of the PA role in health care delivery

• Prepare for the Physician Assistant National Certifying Exam

• Develop interpersonal skills and professionalism necessary to function as part of a medical team

• Prepare our students to deliver high quality care to patients and individuals with developmental disabilities

THE PRECEPTOR ROLE

The preceptor is an integral part of the teaching program. Preceptors will serve as role models for the student and, through guidance and teaching, will help students perfect their skills in history taking, physical examination, communication, physical diagnosis, oral presentation, problem-solving/critical thinking, and plan development.

STUDENT LEARNING OBJECTIVES

A link to the specific minimum learning objectives for each clinical experience can be found in each discipline’s syllabus in the back of this handbook. Preceptors use the objectives by helping students accomplish basic clinical competencies. They are also used as a guide to evaluate the clinical acumen of physician assistant students when completing the Preceptor Evaluation Form, a sample of which is found at the end of each syllabus.

Students are required to review the objectives and topic list for their clerkship with the preceptor during the first week of the clerkship. In addition, students are asked to have their preceptor sign the Student/Preceptor Review of Clinical Instructional Objectives and Learner Outcomes Form so that both student and preceptor have a common understanding of what is expected during the clerkship. Once reviewed and signed, it is the students’ responsibility to assure that this form is uploaded to Exxat by the end of the first week of their clerkship. Failure of the student to upload the student/preceptor review of clinical objectives form will result in a (3) three-point reduction off the student’s overall clerkship grade. A copy of this form can be found at the end of this handbook in the “Clinical Year Forms” section.

PRECEPTOR RESPONSIBILITIES

Preceptor responsibilities include, but are not limited to the following:

• Orient students at the onset of the clerkship with the practice/site policies and procedures and review the expectations and objectives for the clerkship

• Provide ongoing and timely feedback regarding clinical performance, knowledge base, and critical thinking skills. This can be done with the student informally each week or at a designated time and can be formally reported to the clinical coordinator by submitting mid-clerkship and end-of-clerkship evaluations

• Supervise, demonstrate, teach, and observe clinical activities to aid in the development of clinical skills and ensure proper patient care

• Delegate to the student increasing levels of responsibility for clinical assessment and management as appropriate to the student’s experience and expertise

• Participate in the evaluation of clinical skills and medical knowledge base through the following mechanisms:

o Direct supervision, observation, and teaching in the clinical setting

o Direct evaluation of presentations (including both oral and written)

o Assignment of outside readings and research to promote further learning

• Dialogue with faculty during site visits to evaluate student progress and assist the learning process

• Audit and co-sign charts to evaluate the student’s ability to write appropriate and complete progress notes, histories, physical examinations, assessments, and treatment plans

• Complete and promptly return the evaluation forms provided by the program reflecting on student knowledge and skills as well as their improvement throughout the clerkship

• Promptly notify the PA program of any circumstances that might interfere with the accomplishment of

the above goals or diminish the overall training experience

• Maintain an ethical approach to the care of patients by serving as a role model for the student

• Demonstrate cultural competency through interactions with patients

• Spend a few minutes each week in a candid summary discussion with the student as to whether each is meeting the other’s needs and expectations, and what changes need to be made in the roles and relationship

• Provide timely feedback to the student and the program regarding student performance

THE PRECEPTOR STUDENT RELATIONSHIP

The preceptor should maintain a professional relationship with the PA student and always adhere to appropriate professional boundaries. Social activities and personal relationships outside of the professional learning environment should be appropriate and carefully selected so as not to put the student or preceptor in a compromising situation. Contact through web-based social networking sites (e.g., Facebook, Twitter, Instagram) should be avoided until the student fully completes the educational program. If the preceptor and student have an existing personal relationship prior to the start of the clerkship, a professional relationship must be always maintained in the clinical setting. Please consult the clinical coordinator regarding specific school or university policies regarding this issue or additional questions.

SEXUAL MISCONDUCT AND OTHER UNLAWFUL HARASSMENT

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

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

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

POLICIES REGARDING THE CLINICAL YEAR

CLINICAL SITE EVALUATION

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

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

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

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

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

• Interesting Patient Case Assignment

• Health Promotion Project

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

*Presentation can be done via Microsoft Word or PowerPoint

SECURITY AND PERSONAL SAFETY

Clinical year clerkship sites are evaluated by the clinical coordinators and deemed secure and safe for all students. If at any point a clinical year student feels that their personal safety is being compromised, the student should contact the on-site security department, the program, and alert their preceptor. If the site does not have a security department, the student is unable to reach a faculty member at the program, and the preceptor is unavailable, the student is to call 911. If a clinical year student has questions or concerns regarding site security or safety, he/she may contact the program main office at 516-463-4074 or call the emergency clinical coordinator program mobile at 516-509-6470 after office hours. All students are required to complete ilearn workplace safety modules before the start of the clinical year.

Exxat

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

Exxat PROFILE

All students will have an Exxat portfolio set-up before the start of the clinical year which contains their student profile. Student profiles will be sent to all clinical sites and preceptors via an Exxat email with the clinical year schedule. To see each student Exxat profile, please click the blue link at the bottom of your schedule that says, “click here to view student bio data, documents and other information for the students that will rotate through your department.” Then click on the orange tab “view profile” to the right of each student to review their Exxat profile. Once you are in the student’s Exxat profile please review all the “uploaded documents” on the left side of the page in green. It is this section that will house the students’ personal demographics, various certifications, background checks (if applicable), health documents, and completed ilearn modules/orientation materials.

PRECEPTOR CONTACT

Students are required to contact preceptors at least one week prior to the start of the clerkship unless the preceptor has advised otherwise. All students will contact their preceptor and site with an introductory email. Within this email is a link to see the students Exxat profile; students will also attach completed site required paperwork to this email for your review. Additionally, this email allows students an opportunity to communicate with the site and preceptors about student expectations, logistical information, and site requirements. For this process to go smoothly it is highly recommended that preceptors provide the clinical coordinators with updated and preferred contact and site information.

ORIENTATION & COMMUNICATING STUDENT EXPECTATIONS

Orientation of the student to the clerkship site serves several purposes. Orientation facilitates a quicker transition in allowing the student to become a member of the medical team. It also establishes a feeling of enthusiasm and belonging to the team as well as helping students develop the functional capability to work more efficiently.

On the first day of the clerkship (or when possible, prior to the clerkship), the student should address any administrative needs, including obtaining a name badge/security clearance and computer password, completing any necessary paperwork, EMR training, and additional site-specific training/orientation, if needed. Hofstra does initiate access and provide training on Touch works and Sunrise (Northwell clinical sites ONLY). Early in the clinical clerkship, it is recommended that the preceptor and student formulate mutual goals with regards to what they hope to achieve during the clerkship. The preceptor should also communicate his or her expectations of the student during the clerkship. Expectations can include:

• Hours

• Interactions with office and professional staff

• General attendance

•

•

•

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• Anything additional that the preceptor feels is necessary

Students are expected to communicate with preceptors any special scheduling needs they may have during the clerkship — in particular, when they may be out of the clinical setting for either personal reasons or programrequired educational activities. If students anticipate missing clinical time due to personal reasons, it needs to be discussed and approved on Exxat by the clinical team well in advance of the clinical absence.

Many sites find it helpful to create their own written orientation manual, which is given to the student prior to the first day of the clerkship. This helps the students quickly become more efficient. Creating such a sitespecific orientation/policy manual can be delegated to the students you host, with each “subsequent” student adding to a document that you as the preceptor maintain and edit

PREPARING STAFF

The staff of an office or clinic has a key role in ensuring that each student has a successful clerkship. By helping the student learn about office, clinic, or ward routines and the location of critical resources, they help a student become functional and confident. Students, like their preceptors, depend on staff for patient scheduling and assistance during a patient’s visit. Students should communicate with the staff about procedures for making appointments, retrieving medical records, bringing patients into examination rooms, ordering tests, retrieving test results, and charting.

Preceptors should not assume that receptionists, schedulers, and nursing staff automatically know what role the student will have in a practice. The preceptor should inform the staff about how the student will interact with them and with patients. Consider having a meeting or creating a memo with/for staff in advance of the student’s arrival to discuss:

1. Student’s name

2. Student’s schedule (when they will be in the office)

3. Student’s expected role in patient care

4. Expected effect of the student on office operation: Will fewer patients be scheduled? Will the preceptor be busier?

5. How patients will be scheduled for the student

SUPERVISION OF THE PA STUDENT

During a student’s time at the clinic or hospital, the preceptor must be available for supervision, consultation, and teaching, or designate an alternate preceptor. Although the supervising preceptor may not be with a student during every shift, it is important to clearly assign students to another PA, Physician, or NP who will serve as the student’s preceptor for any given time interval. Having more than one clinical preceptor has the potential to disrupt continuity for the student but also offers the advantage of sharing preceptorship duties and exposes students to valuable variations in practice style, which can help learners develop the professional personality that best fits them. In the case where supervision is not available, students may be given an assignment or may

spend time with ancillary staff (x-ray, lab, physical therapy, etc.), as these experiences can be very valuable. The preceptor should be always aware of the student’s assigned activities.

Students are not employees of the hospitals or clinics and, therefore, work entirely under the preceptor’s supervision. Students are not to substitute for paid clinicians, clerical staff, or other workers at the clinical sites. On each clerkship, it is the student’s responsibility to ensure that the supervising physician or preceptor also sees all the student’s patients. The preceptor can provide direct supervision of technical skills with gradually increased autonomy in accordance with the PA student’s demonstrated level of expertise. However, every patient must be seen, and every procedure evaluated prior to patient discharge. The preceptor must document the involvement of the PA student in the care of the patient in all aspects of the visit. The preceptor must also specifically document that the student was supervised during the entirety of the patient visit. The PA student will not be allowed to see, treat, or discharge a patient without evaluation by the preceptor.

INFORMED PATIENT CONSENT REGARDING STUDENT INVOLVMENT IN PATIENT CARE & HIPAA

The patients are essential partners in this educational endeavor as well. All efforts will be made to observe strict confidentiality, respect patient privacy and dignity, and honor their preferences regarding treatment. All students complete HIPAA training prior to their clinical year. However, patients must be informed that a physician assistant student will participate in their care, and the patient’s consent must be obtained. This may be done through standardized forms at admission or on a person-by-person basis. The students should be clearly identified as PA student and must also verbally identify themselves as such. If the patient requests a physician and refuses the PA student’s services, the request must be honored. Patients must know that they will see their regular provider, and they should have an explicit opportunity to decline student involvement.

SOCIAL MEDIA POLICY FOR STUDENTS

Maintaining professionalism is of utmost importance when using social media. It is recommended that you assume all postings are visible to program faculty, future employers, and patients. It is strictly prohibited to discuss patient related matters, take photographs of patients or cadavers, including in the operating room, even if the patient is not identified. Similarly, the posting of diagnostic images or any form of patient data on any social media platform such as YouTube, Facebook, Instagram, LinkedIn, Twitter, and blogs is strictly prohibited. Posting on Facebook or any other form of social media regarding program personnel, including faculty and fellow students is strictly prohibited. Other than LinkedIn or program and course related activities, requesting connections with preceptors, faculty, staff, and supervisors while currently a student is unacceptable.

Violation of this policy will result in being called before the Academic Standing Committee and possible dismissal from the program. Witnessing any violation of this policy should be immediately reported to the program director.

PATIENT RIGHTS AND CONFIDENTIALITY

All students have been HIPAA certified prior to entrance into clinical clerkships. All information regarding a patient’s health is privileged information. All students must strictly adhere to each institutional policy governing patient rights and confidentiality and to all federal, state, and local governances. Students must not discuss any information regarding a patient in a manner or location that might reveal the identification of the patient to individuals not directly involved in that patient’s care. For this reason, all students must complete HIPAA training and provide proof of completion before entrance to the PA Program.

Patient charts, inclusive of progress notes or lab reports, must not be removed from the clinical site by the physician assistant student. If photocopies of a patient’s record are needed for site evaluation, all information that might identify the patient must be removed, omitted, or deleted to protect patient confidentiality.

DOCUMENTATION

If allowed by the preceptor and/or facility, PA students may enter information in the medical record. Preceptors should clearly understand how different payers view student notes as related to documentation of services provided for reimbursement purposes. Any questions regarding this issue should be directed to the clinical coordinator. Students are reminded that the medical record is a legal document. All medical entries must be identified as “student” and must include the PA student’s signature with the designation PA-Student. The preceptor cannot bill for the services of a student. Preceptors are required to document the services they provide as well as review and edit all student documentation. Although student documentation may be limited for reimbursement purposes, students’ notes are legal and are contributory to the medical record. Moreover, writing a succinct note that communicates effectively is a critical skill that PA students should develop. The utilization of EMR systems (electronic medical records) presents obstacles for students if they lack a password or are not fully trained in the use of one institution’s EMR system. In these cases, students are encouraged to hand-write notes, if simply for the student’s own edification, which should be reviewed by preceptors whenever possible for feedback.

PRECEPTOR REVIEW, COUNTERSIGNATURE AND PRESCRIPTION WRITING

Preceptors must evaluate all patients seen by students. It is the responsibility of each student to ensure that the supervising preceptor evaluates each patient seen by the student. The supervising preceptor must review, critique, and countersign all notes written by the student. The student will sign each note with “PA-student” and not “PA-S” to prevent confusion. The supervising preceptor must countersign the note immediately.

The student is not authorized to initiate any orders for a patient without the consultation and the signature of the supervising preceptor. Students may transmit prescribing information for the preceptor, but the preceptor must sign all prescriptions. More specifically, the student’s name is not to appear on the prescription. For clinical clerkship sites that use electronic prescriptions, the preceptor MUST log into the system under his/her own password and personally sign and send the electronic prescription. These guidelines must not be violated by the student or the preceptor. However, students are encouraged to practice writing unofficial orders and prescriptions and present them to preceptors for review. Similarly, if hospital policy does not allow students to write clinical notes in a patient chart, unofficial notes should be reviewed by the preceptor.

EXPECTED PROGRESSION OF PA STUDENT

PA students are trained to take detailed histories, perform physical examinations, give oral presentations of findings, and develop differential diagnoses. As the year continues, they should be able to come up with an assessment and plan more effectively, though this will involve discussion with the preceptor. If the preceptor deems it necessary, students initially may observe patient encounters. However, by the end of the first week, students should actively participate in evaluating patients. As the preceptor feels more comfortable with the student’s skills and abilities, the student should be allowed progressively increasing supervised autonomy.

PRECETOR EVALUATION OF STUDENT

The preceptor evaluation comprises 50% of the grade for the clerkship. If a student fails a preceptor evaluation, the student fails the clerkship. The evaluation is designed to promote communication between preceptor and

student. Preceptors are encouraged to discuss strengths and weaknesses to encourage students about their strengths as well as provide opportunities to improve upon weaknesses. The evaluation should also reflect on student knowledge and skills as well as their improvement throughout the clerkship and assess progress in comparison to other students at the same level. The preceptor's evaluation of the student is tremendously important. On required clerkships (i.e., core clerkships required by the specific institution for all students prior to graduation), a passing evaluation from the preceptor is mandatory. If deemed “not passing,” the student will need to repeat the clerkship.

We encourage preceptors to review the preceptor evaluation with their students privately to get additional insight into the student’s performance, professionalism, and effectiveness as a team player. These comments are helpful contributions to student evaluations. Additionally, staff feedback may enhance the student experience from one clerkship to another and can help to improve efficiency and flow while also maximizing educational opportunities.

This evaluation will be sent to clinical preceptors electronically via our clinical year software program, Exxat, in the last week of the rotation. All preceptor evaluations must be submitted electronically on Exxat upon completion of the clerkship. When completing your preceptor evaluation, you have two options: “submit” or “save”. Preceptors may click “save” to go back to the evaluation and complete later. Once the evaluation is complete, preceptors must click “submit” for the program to receive the evaluation. Paper copies of the preceptor evaluation will no longer be accepted. Grades for the clerkship will not be posted until the evaluation form is received.

STUDENT FEEDBACK

While students may have only one formal evaluation during the clinical clerkship, it is imperative that they receive regular positive and constructive feedback daily from their preceptors to help improve their clinical performance. Preceptors are encouraged to provide students with feedback throughout clerkships as identification of strengths and weaknesses which is essential for student self-improvement. A planned meeting with the student midway through the clerkship may be helpful. Suggested areas of feedback include weaknesses in clinical knowledge, history taking, physical exam skills, formulation of differential diagnoses, and management/follow-up. The preceptor can provide helpful feedback on oral and written presentation skills as well as issues concerning professionalism. If a preceptor feels that a student is not meeting the expectations of the clerkship, they must notify the clinical coordinators by either phone or email prior to the end of the clerkship. It is also advised that the preceptor meet with the student directly to discuss any issues or deficiencies noted by the preceptor.

CLERKSHIP SCHEDULE

All students are required on Exxat to complete a weekly time sheet for the duration of their clerkship. Time sheets can be completed week by week or once for the entire rotation, if applicable. It is strongly recommended that students strive to be at their clinical site for a minimum of forty hours per week to get the best possible clinical experience.

A new time sheet must be submitted if a student’s schedule changes for any reason. Any planned absence or lateness requests must be submitted via Exxat a minimum of 1 week prior and approved by the clinical coordinators. The student’s request is not approved until the clinical coordinators have reviewed their submission and sent an approval via Exxat. It is the student’s responsibility to check Exxat regarding their submission status. The time used to make up absences must be similarly documented on Exxat in the “my leave” section.

Failure to submit a clerkship time sheet for the entire rotation or my leave request will result in a grade of “incomplete” until the student’s submission is received.

CME FOR PHYSICIAN ASSISTANT PRECEPTORS

The Hofstra University Department of Physician Assistant Studies can award Category 1 CME for clinical teaching. The credits are awarded by the American Academy of Physician Assistants (AAPA), made possible through collaboration with the Physician Assistant Education Association (PAEA). At this time, due to regulations from the AAPA and PAEA, this credit is limited to preceptors who are currently practicing PA’s.

The number of credits awarded is determined by the amount of time spent precepting students. Hofstra will award 2.00 AAPA Category I CME credit for each 2 weeks of clinical teaching. For the purposes of credit calculation, a week is defined as 40 hours of precepting. If a preceptor has more than one student at a time, that preceptor may be awarded an additional 2.00 CME credit for each additional student per 2 weeks of teaching. The previous limit of 20 AAPA Category 1 CME for preceptors is no longer in effect. Preceptors may now earn an unlimited number of AAPA Category 1 CME for their precepting efforts from programs accredited by AAPA to provide these CME credits. Preceptorship CME is still earned at a rate of 2 AAPA Category 1 CME credits per PA student per 40-hour week.

The preceptor must keep track of students assigned to them and the number of weeks spent clinically teaching. August 31st marks the culmination of the clinical year, at which time the preceptor is required to submit the selfevaluation form and attestation of number of weeks spent teaching. If there are multiple physician assistants precepting a single student, the PA should claim credit only for time spent actively teaching that student. If the clinical coordinator is not in receipt of these documents within one month of the end of the clinical year, credits will not be awarded.

Category 1 CME for Physician Assistant Precepting Self-Reflective Learning Evaluation

Hofstra University Department of Physician Assistant Studies

Dates of CME Activity: 9/1/22 – 8/31/23

Directions: Please complete the following evaluation form. Your written comments are greatly appreciated. For the purposes of this survey, CME activity means serving as a clinical preceptor and the self-reflective processes associated with clinical teaching of PA students which my include observing growth in student’s knowledge, skills and professionalism resulting from the student/preceptor interaction, as well as soliciting and analyzing student feedback to improve one’s own clinical knowledge, skills, and interpersonal relations that result from the teaching experience.

Preceptor Name Practice Affilication

Preceptor Learning Objectives:

Upon serving as a clinical preceptor for physician assistant studies, clincially-practicing physician assistants should be able to:

• Demonstrate core medical knowledge about medical conditions for the patients in their area of practice.

• Demonstrate critical decision-making and lifelong learning skills.

• Demonstrate effective communication with patients and their families, physicians and other health care professionals.

• Demonstate high quality health care and a commitment to patient safety.

• Demonstrate ongoing evaluation and improvement of their patient care practices

• Demonstrate the ability to effectively interact with different types of healthcare delivery systems.

1. What was your overall opinion of the CME activity related to clinical precepting? Satisfactory

2. Based on your experience of clinical precepting, please rate your relative acheivement related to the learning objectives listed above. I accomplished:

none of the above some of the above most of the above all of the above

3. What aspects of this CME activity did you find least valuable to your continued development as a physician assistant? ______________________________________________________________

4. Do you have specific suggestions as to how this CME activity might be improved? ____

5. Would you participate in this CME activity again? Yes No

6. Would you recommend clinical precepting to a colleague? Yes No

Hofstra University is approved by the American Academy of Physician Assistants to award AAPA Category 1 CME credit to eligible physician assistant preceptors. This approval is valid for one clinical year beginning 9/1/2022. This program was planned in accordance with AAPAs CME Standards. Physician assistants may earn a maximum of 20 hours of AAPA Category 1 CME credit for clinical precepting during any single calendar year.

Category 1 CME for Physician Assistant Precepting Precepting Hours Attestation Report

Hofstra University Department of Physician Assistant Studies

Dates of CME Activity: 9/1/22 – 8/31/23

Preceptor Name:

Clinical Practice Affiliation:

Student Name Clerkship Dates

Number of Weeks Spent Precepting

Total Number of CME Credits Requested: Hofstra University is approved by the American Academy of Physician Assistants to award AAPA Category 1 CME credit to eligible physician assistant preceptors. This approval is valid for one clinical year beginning 9/1/2022. This program was planned in accordance with AAPAs CME Standards.

The previous limit of 20 AAPA Category 1 CME for preceptors is no longer in effect. Preceptors may now earn an unlimited number of AAPA Category 1 CME for their precepting efforts from programs accredited by AAPA to provide these CME. Preceptorship CME is still earned at a rate of 2 AAPA Category 1 CME credits per PA student per 40-hour week.

STUDENT POLICIES

HEALTH INSURANCE

Health insurance is mandatory for all students while enrolled in the physician assistant program. All students will need to supply the program with proof of health insurance, at the beginning of the didactic, clinical, and research year. The insurance policy must cover students in the event of illness or injury including that may result from patient care. If a health condition arises during study that would in any way alter a student’s ability to perform in the clinical setting, it is the student’s responsibility to notify the Director of the Department of` Physician Assistant Studies immediately.

Domestic students who would like to purchase insurance coverage can go to the federal insurance exchange at www.healthcare.gov to find available health plans in the state where they permanently reside. If the permanent residence is outside of New York, it will be important to select a PPO plan that offers coverage throughout the United States, so that health care expenses are covered in the area near our university. International students should visit the International Student Affairs at https://www.hofstra.edu/international student/ Students should contact the Student Health and Counseling Center at SHACC@hofstra.edu or 516-463 6745 with further advice on obtaining healthcare insurance.

Students are encouraged to use the Student Health and Counseling Center at Hofstra. Services offered to enrolled students are generally free or very low cost regardless of insurance coverage.

HEALTH CLEARANCE

All students must be medically cleared as evidenced by a health care provider who has determined his/her fitness to perform physician assistant student functions. This verification must be provided at the beginning of the didactic and clinical year. Additionally, supplemental health clearance documents must be completed for students to participate in clinical year clerkships. Depending on research project location, health clearance documents may be required prior to beginning the research semester. The potential cost associated with health clearance is the responsibility of the student.

As determined by the New York State Department of Health and as per CDC requirements, students should be aware that the influenza vaccine is now required for all hospital personnel including students. If a student declines to be vaccinated against influenza, a declination form must be completed, and the student must wear a mask in all clinical arenas or comply with the policies set forth by the clinical site. Documentation of vaccination must be submitted to the PA Program main office during each influenza season (fall semester) while enrolled.

At this time, we would like to make you aware that the Northwell Health Clinical Advisory Committee and Northwell Health Executive Leadership have determined that the COVID-19 vaccination series and booster will be required for all students and faculty who are assigned to any/all Northwell Health facilities, regardless of direct patient care status. Please note Northwell Health team members may ask students or faculty to provide proof of vaccination (CDC card, New York State Excelsior Pass, etc.) upon entering a Northwell Health facility to ensure this requirement is being adhered to. Failure to produce a proof of vaccination will result in dismissal from the Northwell Health facility until vaccination proof can be provided.

Immunization requirements are in accordance with the most current Centers for Disease Control (CDC) recommendations for health care professionals. Students should be aware that some clinical or research site requirements exceed CDC recommendations. Student health records are confidential and must not be accessible to program faculty or staff except for immunization and tuberculosis screening results which are maintained and released with written permission of the student. Therefore, students are required to keep their own medical information and present it at the beginning of each clinical clerkship or research site.

IDENTIFICATION

Students must display their Hofstra University photo identification in an easily visible location while on clinical clerkships. All students must identify themselves as a “physician assistant student” to patients and medical staff. Under no circumstance should a student encourage or fail to correct the misconception that he/she is a physician or a medical student. Students answering pages or phone calls for clinical preceptors must use their title when answering. All students that have completed the Northwell Scrub class will wear a sticker on their ID badge.

LIABILITY INSURANCE

Hofstra University holds malpractice liability insurance, which covers each site with which the University has a contract. This is renewed on an annual basis. Copies of the insurance certificate can be obtained by contacting the clinical coordinators. Please allow two-four weeks to receive your certificate.

WORK POLICY

The program strongly discourages any type of outside employment during the course of studies in the program. Program responsibilities are not negotiable and will not be altered due to student work obligations. Furthermore, working has been the chief cause for academic difficulty in past years.

Students who choose to volunteer or be paid employees during their physician assistant training cannot use their affiliation with the program in any aspect of that employment. Any activity undertaken by the student, independent of the program, is not covered by the liability insurance offered for clinical work associated with physician assistant training. Furthermore, students may not be required to perform clerical or administrative work for the program.

Students may not substitute for regular clinical or administrative staff during the clinical year. Should such a request be made of a student, it should be reported to the program director immediately.

UNIVERSAL PRECAUTIONS

Students enrolled in the PA program will participate in caregiving activities. During these activities, exposure to communicable diseases, including, but not limited to, Hepatitis B (“HBV”), Tuberculosis (“TB”), Human Immunodeficiency Virus (“HIV”), SARS-Cov-2 (Covid-19), and Ebola Virus is possible. By enrolling in the PA program, students understand that they may contract a communicable disease while acting as a caregiver. Thus, healthcare professionals must understand that an infectious or environmental hazard exposure can adversely affect their overall health as well as performance in the PA Program.

There are several measures healthcare professionals, including PA students, should take to reduce the risk of exposure. All PA students must complete a training session for healthcare professionals in infection control/universal precautions approved by the New York State Department of Health before entering the program. A certificate of completion must be kept by the student and provided to any clinical site requesting a

copy. For additional information on universal precautions, please refer to www.cdc.gov.

The principle of universal precautions has been adopted to protect clinicians from exposure to infectious disease because any patient may harbor microorganisms that could cause infection if transmitted. Although bloodborne pathogens are of particular concern, all bodily fluids, secretions, and excretions are included in universal precautions. Since infected patients may be asymptomatic, it becomes necessary to use basic precautions with every patient. Observance of universal precautions will help to provide better protection for every staff member. Students must also follow the hospital/clinical site-specific policies regarding universal precautions. The material below reviews guidelines and preventative techniques.

Should any expense be incurred because of an exposure, the student is responsible for all costs related to the incident.

Universal Precautions Guidelines and Prevention Methods:

1. Avoid direct contact with blood, body fluids, secretions, excretions, mucous membranes, non-intact skin, and lesions.

2. Avoid injuries from all sharp objects such as needles or scalpels.

3. Avoid direct contact with items, objects, and surfaces contaminated with blood, body fluids, secretions, and excretions.

4. Dispose of all sharp objects promptly in special puncture resistant containers.

5. Dispose of all contaminated articles and materials in a safe manner prescribed by law.

In practice, using Universal Precautions also requires:

1. Wash hands frequently and thoroughly, especially if they become contaminated with blood, bodily fluids, secretions, and excretions.

2. Depending on job duties and risk of exposure, use appropriate barriers, which can include gloves, gowns, aprons, caps, shoe covers, leggings, masks, goggles, face shields, and resuscitation devices.

These barriers are to be used to protect:

a. Skin, especially non-intact skin (where there are cuts, chapping, abrasions, or any other break in the skin).

b. Mucous membranes, especially eyes, nose, and mouth.

NOTE: The items of protective apparel, including gloves, are to be removed after each use and are to be PROPERLY disposed of. Gloves, etc. are NOT to be worn from one patient or activity to another.

BLOOD BORNE PATHOGEN EXPOSURE POLICY

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

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

2. If the exposure occurs on a clinical clerkship, the student shall IMMEDIATELY REPORT the incident to the Preceptor or clinician student is working with. The student will follow the institutional infectious and environmental hazard policy, including completing all necessary documentation as required and

proceed to step 5. The student is required to report the incident via telephone and email to one of the clinical coordinators as soon as possible but no later than 24 hours following the incident.

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

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

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

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

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

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

CLINICAL ATTENDANCE

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

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

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

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

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

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

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

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

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

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

UNIVERSITY POLICY RELATED TO ABSENCES FOR RELIGIOUS OBSERVANCE

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

Hofstra University recognizes that students and/or faculty may, from time to time, miss class due to religious observances. Students who anticipate missing class for this reason should notify faculty members in advance

Likewise, faculty members who anticipate missing class for religious observance should notify students in their classes.

As per Faculty Policy Series 12 (B):

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

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

Additionally, in accordance with New York State Law, each student who is absent from school because of his or her religious beliefs will be given an equivalent opportunity to register for classes or make up any examination, study, or work requirements which he or she may have missed because of that absence on any particular day or days.

TENETS OF PROFESSIONAL CONDUCT

Students must always adhere to standards of professional behavior. These standards are the ethical foundation of medical practice and of our integrity as physician assistants. Professional behavior is expressed through respect for instructors, fellow students, patients, preceptors, and colleagues. Violation of one of the Tenets of Professional Conduct may result in the need to appear before the Academic Standing Committee. Professional behavior is evaluated throughout the course of study and is also formally evaluated during advisement sessions.

Examples of unprofessional behavior include but are not limited to:

• tardiness

• unexcused absences or not following program protocol for notifying program personnel of an absence

• not following program protocol for reporting lateness or leaving early

• lack of preparation

• lack of involvement

• plagiarism

• falsifying documents

• falsifying procedure or patient encounters

• inability to accept constructive criticism

• lack of respect for the rights of patients to competent, confidential service

• lack of respect for others

• failure to follow protocol, or directions of a physician, physician assistant, member of the healthcare team, or program faculty

• performing unauthorized procedures or administering services not permitted by the supervisor, the facility, or the program

• endangering the health and welfare of any patient

• utilizing illegal substances

• being under the influence of alcohol during class, while on clerkships, or completing other aspects of the program curriculum

• violation of the Health Insurance Portability and Accountability Act (HIPAA)

• failure to perform all or part of assigned tasks and responsibilities

• leaving the clinical setting without permission from the preceptor

• performing any activity which is beyond the scope of the role of a student

• failure to identify as a physician assistant student

• failure to report all observed unethical conduct by other members of the health profession, including other students

• engaging in conversation with others during a class or lecture

• leaving the classroom during lectures

• using personal e-mail, Facebook, or other social media while in class

• posting inappropriate content on social media platforms or otherwise violating the social medial policy

• connecting on social media with faculty, preceptors, or supervisors while a student in this program

• exhibiting un-truthful behavior

• lying to preceptor, faculty, or staff

• failure to submit program evaluations in a timely fashion

• neglecting to turn off cell phones, texting or talking on a cell phone during class, examinations, meetings, on the clinical site, or during any other professional functions

• unacceptable dress

• failure to submit required documents

• using scrap paper other than what is distributed by the program; and

• not replying to emails within 24 hours

DRESS REQUIREMENTS

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

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

Unacceptable clothing includes:

• Revealing clothing

• Open-toed shoes

• Tight pants or leggings

• T-shirts, sweatshirts, or sweatpants

• Any clothing made of denim

• Clothing that exposes the mid-abdomen

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

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

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

Some patients may be particularly sensitive to fragrances. Students should be sensitive to the needs of patients and avoid wearing fragrances while in the health care setting.

Only post earrings are permitted. All tattoos should be concealed. Other body piercings should not be worn during rotations.

ACADEMIC HONESTY

Cheating and plagiarism are grave infractions of academic and professional ethical behavior and are contrary to the purpose of any educational institution. They must be addressed seriously for student scholarship to have validity. Faculty are required to report all suspicions of academic dishonesty. Faculty may require students suspected of cheating or plagiarizing to confirm the originality of their work. Student breaches of academic standards may be subject to disciplinary or academic action. Please refer to URL: http://www.hofstra.edu/pdf/Senate/Senate_FPS_11G.pdf As members of Hofstra, we abide by the following honor code:

HONOR CODE

“As a member of the Hofstra community, I pledge to demonstrate integrity and ethical behavior in all aspects of my life, both inside and out of the classroom. I understand that I am accountable for everything I say and write. I will not misrepresent my academic work, nor will I give or receive unauthorized assistance for academic work. I agree to respect the rights of all members of the Hofstra community. I will be guided by the values expressed in the P.R.I.D.E Principles (http://www.hofstra.edu/studentaffairs/deanofstudents/commstandards/commstandards_prideprinciples.html. I accept the responsibility to follow this Honor Code at all times.”

Exxat TRACKING SYSTEM

For the program to ensure that each student has adequate exposure to a diverse mix of patients regarding demographics and type and severity of disorder, we use a web-based tracking system called Exxat. As each clerkship progresses, it is expected that the student’s level of involvement in patient care and the complexity of patients seen will increase as well. Students are required to log information regarding each patient seen daily. Student will print their Exxat logs at the end of their rotation for preceptors to review. All patient logs must be signed and stamped by the preceptor and should be uploaded onto session required documents on Exxat

CLERKSHIP SPECIFIC PATIENT ENCOUNTER REQUIREMENTS

Students must log specific types of patient encounters during each clerkship. It is the student’s responsibility to ensure that they satisfy all Program requirements and seek assistance from the Program/preceptor as needed to ensure that these requirements are satisfied. The minimum requirements for the clinical year are presented in the table below:

Discipline Requirements

Pediatrics 15 per week/90 per clerkship

Family Medicine 15 per week/90 per clerkship

Internal Medicine 10 per week/60 per clerkship

Psychiatry 10 per week/60 per clerkship

Ob/GYN

Prenatal Care

Gynecologic Care 10 per week/60 per clerkship 15 per clerkship 15 per clerkship

Emergency Medicine 15 per week/90 per clerkship

Surgery

Pre-op

Intra-op

Post-op 10 per week/60 per clerkship 10 per clerkship 10 per clerkship 10 per clerkship

Elective 5 per week/30 per clerkship

CLINICAL YEAR PATIENT ENCOUNTER REQUIREMENTS

Exxat also tracks the types of patient encounters seen on student clerkships. The clinical encounters below are required to be completed by the end of the clinical year. These requirements may be met on any of the eight clerkships. Preceptors must sign off on patient encounters. The preceptor’s signature not only confirms exposure, but competence in these areas of care. Competency in these areas is required for graduation. It is the student’s responsibility to ensure that they satisfy all Program requirements and seek assistance from the Program/preceptor as needed to ensure that these requirements are satisfied.

Types of Clinical Encounters

Preventative 20 encounters during clinical year

Acute 20 encounters during clinical year

Chronic 20 encounters during clinical year

Emergent 20 encounters during clinical year

Developmental Disabilities 15 encounters during clinical year

Medical Care Across the Life Span Encounters

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

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

Adults 18 y/o – 64 y/o 100 during the clinical year

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

PROCEDURE LOGGING

Students are required to perform and log a number of procedures. These procedures are tracked through the Exxat System. Please make sure the student performs rather than observes or assists as many procedures as possible, as credit is given only for those logged as “done”. Preceptors must sign off on the procedure logs. Their signature not only confirms exposure but indicates that a student can competently perform the procedure.

It is the student’s responsibility to find opportunities to meet the procedure requirements. Each clerkship syllabus will provide suggestions on procedures that may be found within that discipline; however, the requirements may be met on any of the eight clerkships. A student will not be able to graduate until competency is achieved in the items listed below. It is the student’s responsibility to ensure that they satisfy all Program requirements and seek assistance from the Program/preceptor as needed to ensure that these requirements are satisfied.

REQUIRED CLINICAL YEAR PROCEDURES/EXAMINATIONS:

Procedure Required Number

ABG 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)

STUDENT AND CLERKSHIP MONITORING

MID-CLERKSHIP EVALUATION

Students fill out a mid-clerkship evaluation at the end of the third week of the clerkship on Exxat. This tool is designed for the student to identify personal strengths and weaknesses as well as provide an opportunity to discuss his/her progress and expectations with the preceptor. Preceptors may approach the student at this time to initiate a discussion if the student has not done so This tool also provides the program with feedback regarding clerkship quality. Lastly, it allows the clinical coordinators to identify issues with a clinical site or with an individual student and provide early intervention should it be necessary. A copy of this instrument can be found at the end of this handbook in the forms section.

STUDENT EVALUATION OF PROGRAM CLERKSHIPS

Students are required to complete an evaluation of the experience at the site at the end of each clerkship on Exxat. A copy of this instrument can be found at the end of this handbook in the forms section. Data collected from these forms are compiled and analyzed at the end of each year. These results are forwarded to the preceptor either during an on-site evaluation or via email annually. This data is used to initiate a dialog with the

preceptor concerning issues regarding clerkship objectives or student experiences.

ASSESSMENT OF CLINICAL SITES

Upon acquisition of a clerkship site one of the clinical coordinators will do an initial assessment of clinical site to confirm that the site will satisfy program and accreditation standards. Periodically, but not less frequently than every two years, one of the clinical coordinators will meet with the site in person or remotely to conduct a continuous assessment of clinical site. This meeting will involve preceptors and/or site facility administrators. All parties will be contacted by one of the clinical coordinators to decide on a mutually convenient time to meet. This meeting will review the site’s ability to meet the student’s learning objectives and program expectations. Suggestions and comments by the site are highly encouraged and appreciated.

Clinical Year

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 LEARNER OUTCOMES:

Instructional Objectives Learner Outcomes

Utilized Assessment Tools

By the conclusion of the family medicine clerkship, students will be Competency for eachcompetent in the following: instructional objective is measured by successful

Upon successful completion of this clerkship, students will attain the following knowledge, interpersonal, clinical/technical skills, professional behaviors, clinical reasoning and problem solving abilities:completion of assessment tools listed below:

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

•

Preceptor evaluation

•

•

Preceptor assessment and sign off of competency on patient and procedure logs

•

Use effective interviewing skills to elicit a detailed history

•

Determine the initial assessment in acute and chronic patients

PAEA end of rotation (EOR) examination

• Preceptor evaluation

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

• Select and interpret appropriate diagnostic tests or lab studies

commonly seen in the office

• Submission of

• Synthesize and analyze clinical setting clinical data correctly documentation

• EOR examinations

• Virtual patient case assignment

Management of acute and chronic

• Preceptor evaluation

• Utilize critical thinking and illnesses that are commonly seen in

• Submission of problem solving skills to the office setting clinical documentation

• EOR examinations

• Virtual patient case assignment identify and manage a wide variety of acute and chronic conditions

• Discern among acute, chronic, and emerging disease states

Accurately document the medical

• Preceptor evaluation

• Adequately document medical care rendered for patients in primary

• Health Promotion Project information in history & care physical notes and progress notes

Develop evidence based

• Preceptor evaluation

• Use effective basic counseling recommendations regarding health

• EOR examinations and patient education skills with 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 medical documentation

• Virtual patient case assignment

• Health Promotion Project

patients and their families to empower them to participate in their care and enable shared decision making

• Locate, appraise, and apply evidence from scientific studies to enhance patient care

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

Completing technical skills

• Preceptor evaluation

• Performs procedures safely and at competently

• Competency is measured an appropriate skill level by meeting the number of

• Identifies the indications and procedures listed under contraindications of technical “Exxat Procedure Logging” procedures in conjunction with the preceptor’s signature, indicating the procedure was done competently

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.

• Preceptor evaluation

• Preceptor evaluation

• Effectively complete oral presentations

• 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

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

• Virtual patient case assignment

• Develop skills necessary for lifelong learning

• Synthesize and analyze clinical data correctly

Describe the indications,

• Drug Cards

• Identify pharmacologic agents contraindications, mechanism of and other relevant treatment action, adverse effects and drug modalities as they relate to interactions of medications various medical conditions to commonly used in primary care include understanding the indications, contraindications, side effects, interactions, and adverse reactions

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 in the family medicine link found at: https://paeaonline.org/assessment/en d-of-rotation/content

• 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

Know ways to prevent disease and utilize in patient encounters to improve patient outcomes

• Preceptor evaluation

• Identify the value of quality improvement initiatives

• 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 15%

Three Family Medicine Drug Cards P/F

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 proof of completion 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 will not be able to read from their cards. Students who do not have a site visit should upload them onto Exxat under “Session Required Documents” prior to the start of call back day. Student name, date and rotation 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 an incomplete for this clerkship.

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 in the “Student Packet” section under “Generalized Documents.”

The preceptor evaluation will be sent to the preceptor via email from Exxat towards the end of each clerkship. Students are encouraged to discuss the evaluation with their preceptor. Students are responsible for ensuring that an evaluation is completed for each clinical clerkship. Students must make every reasonable effort to follow-up with the site to ensure that the evaluation is completed in a timely fashion. 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 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.

Types of Clinical Encounters

Preventative 20 encounters during clinical year

Acute 20 encounters during clinical year

Chronic 20 encounters during clinical year

Emergent 20 encounters during clinical year

Developmental Disabilities 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 year

Geriatrics greater than 65 y/o 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 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 family medicine clerkship, it is recommended that you focus on procedures such as IM/SC/ID injections, wound care/debridement and breast 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 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.

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-and-objectives/ and apply information to the following topic list of conditions: https://paeaonline.org/assessment/end-of rotation/content. Student should also review the breakdown of the exam, which can be found through the following link: https://paeaonline.org/assessment/end-of-rotation/content These endof-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 PAEA make-up exam. A grade of 65 % or better must be achieved on the make-up exam to pass the clerkship. A grade of 65 % will be entered for this portion of the final grade, regardless of the passing grade earned for the make-up exam. Only one make up examination will be offered in any clerkship. A failure of the make-up examination will result in failure of the clerkship.

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 2023”

5. Click on course documents on left side and review “IHI Videos” at the bottom of page

6. Follow instructions for discussion board

7. See Professor Gallo with questions

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. Failure to demonstrate the required number of clinical encounters will affect the student’s ability to graduate.

REFLECTIVE JOURNALING

Chose five clinical encounters with a patient with developmental disabilities, reflect on your experiences and write them in a journal. Entries should focus on self-critique of the interaction, communication with individuals and their families and personal reactions to situations. Commenting on internal struggles or feelings, comfortability with providing care to individuals with developmental disabilities and their families/caregivers and ways of improving care are also encouraged. 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 this clerkship.

CALL BACK DAY

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

CALL BACK DAY STRUCTURE

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

Call back day activities for rotations 4, 5, 7 and 8 will be two days in length. Day one of call back day will be on campus or remote and require all students on core rotations to take their PAEA end of rotation examination. Students on their elective rotation will be required to present their interesting case to their assigned group. A guest lecture/workshop activity may also be scheduled.

Day two of call back day will be at CLI or remote and include a longitudinal patient care experience. All patients involved in the longitudinal patient care experience 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 selfreflection if the longitudinal patient care experience occurs via zoom. If a student misses a patient encounter or does not complete either the SOAP note or video self-reflection, they will receive an incomplete in the course.

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 “in house” 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:

Learner Outcomes

Upon successful completion of this clerkship, students will attain the following knowledge, interpersonal, clinical/technical skills, professional behaviors, clinical reasoning, and problem solving abilities:

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

• Select and interpret appropriate diagnostic tests or lab studies

• Synthesize and analyze clinical data correctly

Knowledge of the different

• Preceptor assessment and

• Discern among acute, types of clinical patient encounters sign off of competency on patient and procedure logs

• EOR examination

• Submission of clinical documentation chronic, and emerging disease states

Development of management plans

• Preceptor evaluation

• Utilize critical thinking for patients on the internal medicine

• Submission of and problem solving service inclusive of geriatric clinical skills to identify and patients documentation

• EOR examinations

• Virtual patient case assignment manage a wide variety of acute and chronic conditions

• Discern among acute, chronic, and emerging disease states

Accurately document the medical

• Preceptor evaluation

• Adequately document care rendered for patients on the

• Submission of medical information in internal medicine service clinical documentation history & physical notes and progress notes

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

• 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 decision making

• Provide appropriate referrals

Completing technical skills

• Preceptor evaluation

• Performs procedures safely competently

• Competency is measured and at an appropriate skill by meeting the number of level exposures listed under

• Identifies the indications “Exxat Procedure Logging” and contraindications of in conjunction with the technical procedures preceptor’s signature, indicating the procedure was done competently

Presenting patients to the preceptor or

• Preceptor evaluation

• Effectively complete other designated clinician on team in a oral presentations concise, organized way demonstrating thorough knowledge of patients on service

Identify the members of the inter

• Preceptor evaluation

• Develop relationships and professional team and the roles that effectively communicate with they play in the delivery of healthcare. 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

• Develop skills necessary problem solving to solve a virtual assignment for life long learning patient case

Application of clinical reasoning and • Virtual patient case

• Synthesize and analyze clinical data correctly

Describe the indications,

• Drug Cards

• Identify pharmacologic contraindications, mechanism of agents and other relevant action, adverse effects and drug treatment modalities as they interactions of medications commonly used in internal medicine patients inclusive of geriatric patients relate to various medical conditions to include understanding the indications, contraindications, side effects, interactions, and adverse reactions

Utilize the PAEA Core Tasks and • EOR examination

• Determine the etiologies, Functions list found at risk factors and https://paeaonline.org/assessment/c ore epidemiology for various tasks and objectives/ and apply to each medical conditions of conditions outlined at

• Identify signs and symptoms https://paeaonline.org/assessment/en of various medical conditions d-of-rotation/content

• 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 15%

Three Internal Medicine Drug Cards P/F

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

Virtual Patient Case Assignments are internet-based virtual patient programs addressing the core clerkship learning objectives. Each student will be assigned two (2) cases within the first two weeks of the clerkship. Both assigned cases need to be completed by the designated due date and proof of completion uploaded to the session required documents. Failure to complete the assigned Virtual Patient Case Assignments will result in an incomplete grade for this clerkship.

SUBMISSION OF CLINICAL DOCUMENTATION

Each student will submit one history and physical note while on their internal medicine clerkship using Microsoft to session required documents on Exxat.

Please note:

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

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

•

No identifying information may appear on any notes as this 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 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 will not be able to read from their cards. Students who do not have a site visit should upload them onto Exxat under “Session Required Documents” prior to the start of call back day. Student name, date and number must be listed on each drug card. Drug cards may be typed and submitted in word format. Should a student fail to produce these cards on a site visit or not upload onto Exxat prior to the start of call back day, they will receive an incomplete for this clerkship.

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 in the “Student Packet” section under “Generalized Documents.”

The preceptor evaluation will be sent to the preceptor via email from Exxat towards the end of each clerkship. Students are encouraged to discuss the evaluation with their preceptor. Students are responsible for ensuring that an evaluation is completed for each clinical clerkship. Students must make every reasonable effort to follow-up with the site to ensure that the evaluation is completed in a timely fashion. 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 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 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 for graduation

Types of Clinical Encounters

Preventative 20 encounters during clinical year

Acute 20 encounters during clinical year Chronic 20 encounters during clinical year Emergent 20 encounters during clinical year

Developmental Disabilities 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 year

Geriatrics greater than 65 y/o 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 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 Required Number

ABG 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

END OF CLERKSHIP EXAMINATION

To assess comprehensive knowledge of the internal 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-and-objectives/ and apply information to the following topic list of conditions https://paeaonline.org/assessment/end-of rotation/contentStudent should also review the breakdown of the exam, which can be found through the following link: https://paeaonline.org/assessment/end-of-rotation/contentThese 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 PAEA exam. A grade of 65 % or better must be achieved on the make-up exam to pass the clerkship. A grade of 65 % will be entered for this portion of the final grade, regardless of the passing grade earned for the make-up exam. Only one make up examination will be offered in any clerkship. A failure of the make-up examination will result in failure of the clerkship.

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 2023”

5. Click on course documents on left side and review “IHI Videos” at the bottom of page

6. Follow instructions for discussion board

7. See Professor Gallo with questions.

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. Failure to demonstrate the required number of clinical encounters will affect the student’s ability to graduate.

REFLECTIVE JOURNALING

Chose five clinical encounters with a patient with developmental disabilities, reflect on your experiences and write them in a journal. Entries should focus on self-critique of the interaction, communication with individuals and their families and personal reactions to situations. Commenting on internal struggles or feelings, comfortability with providing care to individuals with developmental disabilities and their families/caregivers and ways of improving care are also encouraged. 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 this clerkship.

CALL BACK DAY

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

CALL BACK DAY STRUCTURE

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

Call back day activities for rotations 4, 5, 7 and 8 will be two days in length. Day one of call back day will be on campus or remote and require all students on core rotations to take their PAEA end of rotation examination. Students on their elective rotation will be required to present their interesting case to their assigned group. A guest lecture/workshop activity may also be scheduled.

Day two of call back day will be at CLI or remote and include a longitudinal patient care experience. All patients involved in the longitudinal patient care experience 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 note or video self-reflection, they will receive an incomplete in the course.

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 CLERKSHIP

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

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

• 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 problem solving abilities:

• Elicit a detailed medical history, perform physical examination on a gynecologic patient, accurately record all data

Utilizing information obtained from

• Preceptor evaluation

• Select and interpret appropriate the history, physical and diagnostic

• EOR examinations diagnostic tests, lab studies or data to formulate differential screening tools diagnoses for obstetric and

• Synthesize and analyze all gynecologic patients clinical data correctly to aid in diagnosis

•

Knowledge of the different types of

• Preceptor assessment

• Discern among acute, chronic, clinical patient encounters and sign off of and emerging disease states competency on patient and procedure logs

• EOR examination Submission of clinical documentation

Develop evidence based, best

• Preceptor evaluation

• Utilize critical thinking and practice, patient centered

• EOR examinations problem solving skills to management plans for obstetric and identify and manage pediatric gynecologic patients care

• Locate, appraise, and apply evidence from scientific studies to enhance patient care

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

• Preceptor evaluation

• Preceptor evaluation

• EOR examinations

• Interesting patient case assignment

• Accurately and adequately 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 decision making

• Provide appropriate referrals

Completing technical skills

• Preceptor evaluation

• Performs procedures safely and at competently

• Competency is an appropriate skill level measured by meeting

• Identifies the indications and the number of contraindications of technical exposures listed under procedures “Exxat Procedure Logging” in conjunction with the preceptor’s signature, indicating the procedure was done competently

Presenting patients to the preceptor or other designated clinician on team in a concise, organized way demonstrating thorough knowledge of patient

• Preceptor evaluation

• Effectively complete oral presentations

Communicating effectively and

• Preceptor evaluation

• Work collaboratively as a respectfully with obstetric and member of an interprofessional gynecologic patients and them healthcare team families and members of the

• Exhibit reliability, interprofessional team 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

Search for relevant information,

• Preceptor evaluation

• Develop skills necessary for utilizing appropriate data sources, and life long learning critically appraise to make evidence based decisions in patient care

Describe the indications,

• Drug Cards

• Identify pharmacologic agents contraindications, mechanism of and other relevant treatment action, adverse effects, drug modalities as they relate to interactions, and pregnancy risk category of medications commonly used in obstetric and gynecologic

pediatric patients to include understanding the indications, contraindications, side effects, interactions, and adverse reactions

Utilize the PAEA Core Tasks and

• EOR examination

• Determine the etiologies, risk Functions list found at factors and epidemiology for https://paeaonline.org/assessment obstetric and gynecologic /core-tasks-and-objectives/ and conditions apply to each of the pediatric

• Identify signs and symptoms of conditions outlined at common obstetric and https://paeaonline.org/assessment/en gynecologic conditions d-of-rotation/content

• 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: One Ob/Gyn History & Physical Note 15% Three Ob/Gyn Drug Cards P/F 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

SUBMISSION OF CLINICAL DOCUMENTATION

Each student will submit one history and physical note while on their ob/gyn clerkship using Microsoft to session required documents on Exxat.

Please note:

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

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

• No identifying information may appear on any notes as this 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 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 will not be able to read from their cards. Students who do not have a site visit should upload them onto Exxat under “Session Required Documents” prior to the start of call back day. Student name, date and number must be listed on each drug card. Drug cards may be typed and submitted in word format. Should a student fail to produce these cards on a site visit or not upload onto Exxat prior to the start of call back day, they will receive an incomplete for this clerkship.

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 in the “Student Packet” section under “Generalized Documents.”

The preceptor evaluation will be sent to the preceptor via email from Exxat towards the end of each clerkship. Students are encouraged to discuss the evaluation with their preceptor. Students are responsible for ensuring that an evaluation is completed for each clinical clerkship. Students must make every reasonable effort to follow-up with the site to ensure that the evaluation is completed in a timely fashion. 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 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 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

Types of Clinical Encounters

Preventative 20 encounters during clinical year

Acute 20 encounters during clinical year

Chronic 20 encounters during clinical year

Emergent 20 encounters during clinical year

Developmental Disabilities 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 year Geriatrics greater than 65 y/o 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.

REQUIRED CLINICAL YEAR PROCEDURES/EXAMINATIONS

Procedure

ABG 4

Abscess I&D 2

Blood Cultures 2

Required Number

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 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 through the following link: https://paeaonline.org/assessment/core-tasks-and-objectives/ and apply information to: https://paeaonline.org/assessment/end-of-rotation/content Student should also review the breakdown of the exam which can be found through the following link: https://paeaonline.org/assessment/end-of-rotation/content 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 PAEA exam. A grade of 65 % or better must be achieved on the make-up exam to pass the clerkship. A grade of

65 % will be entered for this portion of the final grade, regardless of the passing grade earned for the make-up exam. Only one make up examination will be offered in any clerkship. A failure of the make-up examination will result in failure of the clerkship.

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 2023”

5. Click on course documents on left side and review “IHI Videos” at the bottom of page

6. Follow instructions for discussion board

7. See Professor Gallo with questions.

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. Failure to demonstrate the required number of clinical encounters will affect the student’s ability to graduate.

REFLECTIVE JOURNALING

Chose five clinical encounters with a patient with developmental disabilities, reflect on your experiences and write them in a journal. Entries should focus on self-critique of the interaction, communication with individuals and their families and personal reactions to situations. Commenting on internal struggles or feelings, comfortability with providing care to individuals with developmental disabilities and their families/caregivers and ways of improving care are also

encouraged. 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 this clerkship.

CALL BACK DAY

Students will return to campus and/or the Center for Learning and Innovation (CLI) at the end of each clerkship for one or two days for clinical year activities. At times call back may involve a remote clinical year activity via zoom. This is up to the discretion of the clinical team and students will be notified in advance. Call back day dates and locations can be found at the beginning of the handbook and on Exxat in the “student packet” section. Call back day activities can include lectures, case presentations, clinical skills workshops, and simulated patient encounters. All callback day activities are mandatory. Activities will vary throughout the year, however every student, except those on their elective rotations will take a Physician Assistant Education Association (PAEA) end of rotation exam on call back day. Should an absence be unavoidable, the clinical coordinator must be contacted PRIOR to the date to discuss the legitimacy of the absence.

A student leaving an on-site or remote call back day early, without notifying the clinical coordinator will result in a 5-point deduction from the overall clerkship grade. Any unexcused absence from call back day will result in a 10-point deduction from the overall clerkship grade and an incomplete will be submitted for the course until all assignments have been completed successfully.

CALL BACK DAY STRUCTURE

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

Call back day activities for rotations 4, 5, 7 and 8 will be two days in length. Day one of call back day will be on campus or remote and require all students on core rotations to take their PAEA end of rotation examination. Students on their elective rotation will be required to present their interesting case to their assigned group. A guest lecture/workshop activity may also be scheduled.

Day two of call back day will be at CLI or remote and include a longitudinal patient care experience. All patients involved in the longitudinal patient care experience 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 note or video self-reflection, they will receive an incomplete in the course.

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 265 SURGERY CLERKSHIP

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

COURSE DESCRIPTION

3 s.h.

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.

INSTRUCTIONAL OBJECTIVES AND LEARNING OUTCOMES

Instructional Objectives

By the conclusion of the surgery 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:

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

• 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 problem solving 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

• Preceptor assessment and

• Discern among acute, clinical patient encounters sign off of competency chronic, and emerging on patient encounters disease states

• EOR examination

• Submission of clinical documentation

Assessment of the pre surgical and

• Preceptor evaluation

• Elicit a detailed medical post surgical patient.

• Preceptor assessment and history, perform appropriate sign off of competency physical examination and on patient and procedure accurately record all data logs

• Identify and formulate an

• Submission of clinical appropriate assessment and documentation management plan

• EOR examination

Provide intraoperative care of

• Preceptor evaluation

• Performs procedures safely and surgical patient.

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

• EOR examinations at an appropriate skill level

• Identifies the indications and contraindications of technical procedures

Formulate assessment plans for

• Preceptor evaluation

• Select and interpret appropriate surgical patients

• Submission of clinical documentation

• EOR examinations screening and diagnostic studies

• Synthesize and analyze clinical data correctly

Develop management plans for

• Preceptor evaluation

• Utilize critical thinking and surgical patients

• Submission of clinical problem solving skills to documentation identify and manage surgical

• EOR examinations conditions

• Provide appropriate referrals

Accurately documenting surgical care in patient charts

• Preceptor evaluation

• Submission of clinical documentation

• Accurately document medical information

Providing patient education and

• Preceptor evaluation

• Use effective basic counseling counseling for surgical patients

• EOR examinations and patient education skills with

• Submission of medical documentation patients and their families to empower them to participate in their care and enable shared decision making

• Provide appropriate referrals

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

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

• Preceptor evaluation

• Performs procedures safely and at an appropriate skill level

• Identifies the indications and contraindications of technical procedures

Demonstrate clinical reasoning and problem solving ability when managing the surgical patient

• 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

• 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,

• Drug Cards

• Identify pharmacologic agents contraindications, mechanism of and other relevant treatment action, adverse effects and drug modalities as the relate to interactions of medications general surgical conditions to commonly used in surgical patients include understanding the indications, contraindications, side effects, interactions, and adverse reactions

Understand issues related to quality in a healthcare setting

• Quality Assurance & Quality Improvement Project

• 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/assessment/en d-of-rotation/content

• 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

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 Surgical clerkship is based on the following components:

One Surgical SOAP Note 15%

Three Surgical Drug Cards P/F 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 & 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 patient education.

• Photocopies are not acceptable.

• SOAP notes are not acceptable on hospital forms.

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

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 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 will not be able to read from their cards. Students who do not have a site visit should upload them onto Exxat under “Session Required Documents” prior to the start of call back day. Student name, date and number must be listed on each drug card. Drug cards may be typed and submitted in word format. Should a student fail to produce these cards on a site visit or not upload onto Exxat prior to the start of call back day, they will receive an incomplete for this clerkship.

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 in the “Student Packet” section under “Generalized Documents.”

The preceptor evaluation will be sent to the preceptor via email from Exxat towards the end of each clerkship. Students are encouraged to discuss the evaluation with their preceptor. Students are responsible for ensuring that an evaluation is completed for each clinical clerkship. Students must make every reasonable effort to follow-up with the site to ensure that the evaluation is completed in a timely fashion. 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 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 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-operative

Intra-operative

Post-operative

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.

Types of Clinical Encounters

Preventative 20 encounters during clinical year

Acute 20 encounters during clinical year

Chronic 20 encounters during clinical year

Emergent 20 encounters during clinical year

Developmental Disabilities 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 year

Geriatrics greater than 65 y/o 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 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.

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 Required Number ABG 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 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/assessment/end-of-rotation/content should also review the breakdown of the exam which can be found through the following link https://paeaonline.org/assessment/end-of-rotation/contentThese 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 PAEA exam. A grade of 65 % or better must be achieved on the make-up exam to pass the clerkship. A grade of 65 % will be entered for this portion of the final grade, regardless of the passing grade earned for the make-up exam. Only one make up examination will be offered in any clerkship. A failure of the make-up examination will result in failure of the clerkship.

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 2023”

5. Click on course documents on left side and review “IHI Videos” at the bottom of page

6. Follow instructions for discussion board

7. See Professor Gallo with questions.

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. Failure to demonstrate the required number of clinical encounters will affect the student’s ability to graduate.

REFLECTIVE JOURNALING

Chose five clinical encounters with a patient with developmental disabilities, reflect on your experiences and write them in a journal. Entries should focus on self-critique of the interaction, communication with individuals and their families and personal reactions to situations. Commenting on internal struggles or feelings, comfortability with providing care to individuals with developmental disabilities and their families/caregivers and ways of improving care are also encouraged. 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 this clerkship.

CALL BACK DAY

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

CALL BACK DAY STRUCTURE

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

Call back day activities for rotations 4, 5, 7 and 8 will be two days in length. Day one of call back day will be on campus or remote and require all students on core rotations to take their PAEA end of rotation examination. Students on their elective rotation will be required to present their interesting case to their assigned group. A guest lecture/workshop activity may also be scheduled.

Day two of call back day will be at CLI or remote and include a longitudinal patient care experience. All patients involved in the longitudinal patient care experience 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 note or video self-reflection, they will receive an incomplete in the course.

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 270 EMERGENCY MEDICINE CLERKSHIP 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:

Assessment Tools Utilized

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

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

• 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 problem solving abilities:

• Use effective interviewing skills to elicit a detailed history

• Perform problem focused physical examination

Applicable, cost effective use of laboratory tests and other diagnostic data to aid in the diagnosis of patients in the emergency room

• Preceptor evaluation

• EOR examination

• Select and interpret appropriate screening and diagnostic studies

Recognize patients who require

• Preceptor evaluation

• Synthesize and analyze all emergency medical intervention

• Preceptor assessment clinical data correctly to aid in (including but not limited to trauma, and sign off of prompt diagnosis chest pain, sepsis, CVA, shock, competency on patient

• Discern among acute, chronic, respiratory failure, surgical and procedure logs and emerging disease states abdomen),

• Submission of clinical documentation

• EOR examination

Utilize information obtained from

• Preceptor evaluation

• Elicit a detailed medical history, the H&P, laboratory and diagnostic

• EOR examinations perform patient appropriate studies to determine differential diagnoses and prioritize most likely diagnosis for patients who present

• Interesting patient case assignment physical examination, utilize appropriate diagnostic tests and accurately record all data with acute problems

Develop evidence based

• Preceptor evaluation

• Utilize critical thinking and medicine/best practice management

• EOR examinations problem solving skills to plans for patient’s seen in the emergency department

• Interesting patient case assignment manage care of psychiatric patients

• Locate, appraise and apply evidence from scientific studies to enhance patient care

• Provide appropriate referrals

Comprehensive and thorough documentation in the emergency department

• Preceptor evaluation

• Interesting patient case assignment

• Accurately document medical information

Providing patient education, to

• Preceptor evaluation

• Use effective basic counseling include follow up care, to patients

• Interesting patient case and patient education skills with in the emergency department and assignment patients and their families to their families

• Emergency Medicine Simulation Activity empower them to participate in their care and enable shared decision making

• Provide appropriate referrals

Completing technical skills

• Preceptor evaluation

• Performs procedures safely and at competently

• Competency is an appropriate skill level measured by meeting

• Identifies the indications and the number of contraindications of technical exposures listed under procedures

“Exxat Procedure Logging” in conjunction with the preceptor’s signature, indicating the procedure was done competently

Presenting patients to the preceptor or other designated clinician on team in a concise, organized way demonstrating thorough knowledge of patient

• Preceptor evaluation

• Emergency Medicine Simulation Activity

• Effectively complete oral presentations

Maintain respectful and appropriate

• Preceptor evaluation

• Develop relationships and communications with patients, • Emergency Medicine effectively communicate with families, and members of the interprofessional team in a potentially Simulation Exercise patients, families, physicians, and other members of the care team complex and stressful environment,

• Exhibit reliability, such as the emergency department 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

Demonstrate clinical reasoning and problem solving ability when managing a patient

• Preceptor evaluation

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

Search for relevant information,

• Interesting patient case • Develop skills necessary for utilizing appropriate data sources, and life long learning critically appraise to make evidence based decisions in patient care

Describe the indications,

• Drug Cards

• Identify pharmacologic agents and contraindications, mechanism of

• Emergency Medicine Simulation Activity

• Interesting patient case other relevant treatment modalities action, adverse effects and drug interactions of medications commonly used in the emergency department

as they relate to patients with emergent conditions to include understanding the indications, contraindications, side effects, interactions and adverse reactions

Understand issues related to quality in a healthcare setting

• Quality Assurance & Quality Improvement Project

• 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/assessment/e nd-of-rotation/content

• 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

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 on the following

Call Back Day Longitudinal Patient Participation, Reflective Journal Entry & Medical Documentation Submission if applicable

*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 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. 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 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 will not be able to read from their cards. Students who do not have a site visit should upload them onto Exxat under “Session Required Documents” prior to the start of call back day. Student name, date and number must be listed on each drug card. Drug cards may be typed and submitted in word format. Should a student fail to produce these cards on a site visit or not upload onto Exxat prior to the start of call back day, they will receive an incomplete for this clerkship.

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 in the “Student Packet” section under “Generalized Documents.”

The preceptor evaluation will be sent to the preceptor via email from Exxat towards the end of each clerkship. Students are encouraged to discuss the evaluation with their preceptor. Students are responsible for ensuring that an evaluation is completed for each clinical clerkship. Students must

make every reasonable effort to follow-up with the site to ensure that the evaluation is completed in a timely fashion. 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 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 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:

Types of Clinical Encounters

Preventative 20 encounters during clinical year

Acute 20 encounters during clinical year

Chronic 20 encounters during clinical year

Emergent 20 encounters during clinical year

Developmental Disabilities 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 year

Geriatrics greater than 65 y/o 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.

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 is acceptable on or at 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-emergencymed 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/emergency medicine-blueprint-20180524.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 PAEA make-up exam. A grade of 65 % or better must be achieved on the PAEA make-up exam to pass the clerkship. A grade of 65 % will be entered for this portion of the final grade, regardless of the passing grade earned for the make-up exam. 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 2023”

5. Click on course documents on left side and review “IHI Videos” at the bottom of page

6. Follow instructions for discussion board

7. See Professor Gallo with questions.

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. Failure to demonstrate the required number of clinical encounters will affect the student’s ability to graduate.

REFLECTIVE JOURNALING

Chose five clinical encounters with a patient with developmental disabilities, reflect on your experiences and write them in a journal. Entries should focus on self-critique of the interaction, communication with individuals and their families and personal reactions to situations. Commenting on internal struggles or feelings, comfortability with providing care to individuals with developmental disabilities and their families/caregivers and ways of improving care are also encouraged. 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 this clerkship.

CALL BACK DAY

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

CALL BACK DAY STRUCTURE

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

Call back day activities for rotations 4, 5, 7 and 8 will be two days in length. Day one of call back day will be on campus or remote and require all students on core rotations to take their PAEA end of rotation examination. Students on their elective rotation will be required to present their interesting case to their assigned group. A guest lecture/workshop activity may also be scheduled.

Day two of call back day will be at CLI or remote and include a longitudinal patient care experience. All patients involved in the longitudinal patient care experience 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 note or video self-reflection, they will receive an incomplete in the course.

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 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:

Assessment Tools Utilized

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

Evaluation of the pediatric patient by obtaining an accurate patient history, performing an age appropriate physical exam, obtaining, and interpreting laboratory and diagnostic studies while recognizing normal age appropriate variations

• 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 problem solving 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

Recognize normal and abnormal

• Preceptor evaluation

• Elicit a detailed medical history, patterns of pediatric growth and

• Preceptor assessment perform age appropriate physical development and milestone and sign off of examination, utilize appropriate achievement. Identify patients who require early intervention and competency on patient developmental screening tools initiate proper referral and procedure logs

and accurately record all data

• Submission of clinical documentation

• EOR examination

Formulate differential diagnoses for • Preceptor evaluation

• Submission of clinical documentation

• EOR examinations

diagnostic tests, lab studies or screening tools

• Select and interpret appropriate common complaints and presentations in the pediatric population

• Synthesize and analyze all clinical data correctly to aid in diagnosis

• Discern among acute, chronic, and emerging disease states

Develop evidence based

• Preceptor evaluation

• Utilize critical thinking and medicine/best practice, patient

• Submission of clinical problem solving skills to centered management plans for documentation identify and manage pediatric pediatric patients

• EOR examinations care

• Locate, appraise, and apply evidence from scientific studies to enhance patient care

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

• Preceptor evaluation

• Submission of clinical documentation

• Accurately and adequately document medical information

Providing patient education, to

• Preceptor evaluation

• Use effective basic counseling include health promotion and

• EOR examinations and patient education skills with disease and injury prevention (including immunizations) to pediatric patients and their families

• Submission of medical documentation patients and their families to empower them to participate in their care and enable shared decision making

• Provide appropriate referrals

Completing technical skills

• Preceptor evaluation

• Performs procedures safely and at competently

• Competency is an appropriate skill level measured by meeting

• Identifies the indications and the number of contraindications of technical exposures listed under procedures

“Exxat Procedure Logging” in conjunction with the preceptor’s signature, indicating the procedure was done competently

Presenting patients to the preceptor or other designated clinician on team in a concise, organized way demonstrating thorough knowledge of patient

• Preceptor evaluation

• Effectively complete oral presentations

Communicating effectively and

• Preceptor evaluation

• Work collaboratively as a respectfully with pediatric patients member of an interprofessional and their families and members of the healthcare team interprofessional 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.

Search for relevant information,

• Submission of medical

• Develop skills necessary for utilizing appropriate data sources, and documentation life long learning critically appraise to make evidence

• Preceptor evaluation based decisions in patient care

Describe the indications,

• Drug Cards

• Identify pharmacologic agents contraindications, mechanism of and other relevant treatment action, adverse effects, drug modalities as they relate to interactions and correct dosing pediatric patients to include parameters of medications commonly used in pediatric patients understanding the indications, contraindications, side effects, interactions and adverse reactions

Utilize the PAEA Core Tasks and • EOR examination

• Determine the etiologies, risk Functions list found at factors and epidemiology for https://paeaonline.org/assessment pediatric conditions /core tasks and objectives/ and apply

• Identify signs and symptoms of to each of the pediatric conditions common pediatric conditions outlined at https://paeaonline.org/assessment/end of rotation/content

• 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 Pediatric clerkship is based on the following components: One Pediatric SOAP Note 15%

Three Pediatric Drug Cards P/F

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 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) typed SOAP note, using Microsoft 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 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 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 will not be able to read from their cards. Students who do not have a site visit should upload them onto Exxat under “Session Required Documents” prior to the start of call back day. Student name, date and number must be listed on each drug card. Drug cards may be typed and submitted in word format. Should a student fail to produce these cards on a site visit or not upload onto Exxat prior to the start of call back day, they will receive an incomplete for this clerkship.

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 in the “Student Packet” section under “Generalized Documents.”

The preceptor evaluation will be sent to the preceptor via email from Exxat towards the end of each clerkship. Students are encouraged to discuss the evaluation with their preceptor. Students are responsible for ensuring that an evaluation is completed for each clinical clerkship. Students must make every reasonable effort to follow-up with the site to ensure that the evaluation is completed in a timely fashion. 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.

Types of Clinical Encounters

Preventative 20 encounters during clinical year

Acute 20 encounters during clinical year

Chronic 20 encounters during clinical year

Emergent 20 encounters during clinical year

Developmental Disabilities 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 year

Geriatrics greater than 65 y/o 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 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.

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 Number is acceptable on or at 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/assessment/end-of-rotation/content

Student should also review the breakdown of the exam which can be found through the following link: https://paeaonline.org/assessment/end-of-rotation/content

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 PAEA exam. A grade of 65 % or better must be achieved on the PAEA make-up exam to pass the clerkship. A grade of 65 % will be entered for this portion of the final grade, regardless of the passing grade earned for the make-up exam. 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 2023”

5. Click on course documents on left side and review “IHI Videos” at the bottom of page

6. Follow instructions for discussion board

7. See Professor Gallo with questions.

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. Failure to demonstrate the required number of clinical encounters will affect the student’s ability to graduate.

REFLECTIVE JOURNALING

Chose five clinical encounters with a patient with developmental disabilities, reflect on your experiences and write them in a journal. Entries should focus on self-critique of the interaction, communication with individuals and their families and personal reactions to situations. Commenting on internal struggles or feelings, comfortability with providing care to individuals with developmental disabilities and their families/caregivers and ways of improving care are also encouraged. 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 this clerkship.

CALL BACK DAY

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

CALL BACK DAY STRUCTURE

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

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

of rotation examination. Students on their elective rotation will be required to present their interesting case to their assigned group A guest lecture/workshop activity may also be scheduled.

Day two of call back day will be at CLI or remote and include a longitudinal patient care experience. All patients involved in the longitudinal patient care experience 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 note or video self-reflection, they will receive an incomplete in the course.

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 285 PSYCHIATRY CLERKSHIP

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

COURSE DESCRIPTION

3 s.h.

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.

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 problem solving abilities:

• Use effective and compassionate interviewing skills to elicit a detailed history

• Perform patient appropriate physical examination

Appropriate use of laboratory tests and other diagnostic data to aid in the diagnosis of patients with mental illnesses

• Preceptor evaluation

• EOR examination

• Select and interpret appropriate screening and diagnostic studies

Recognize normal and abnormal

• Preceptor evaluation

•

Elicit a detailed medical history, patterns of behavior. Identify

• Preceptor assessment perform patient appropriate patients who require admission and sign off of physical examination, utilize versus those who can be treated as competency on patient appropriate screening tools, and an outpatient and those who require and procedure logs accurately record all data specialty referral.

• Interesting patient case assignment

• EOR examination

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

• Preceptor evaluation

• EOR examinations

• Interesting patient case assignment

• Provide appropriate referral

• Discern among acute, chronic, and emerging disease states

•

Synthesize and analyze all clinical data correctly to aid in diagnosis

Develop evidence based

• Preceptor evaluation

• Utilize critical thinking and medicine/best practice, patient

• EOR examinations problem solving skills to centered management plans for patients with mental illness

• Interesting patient case assignment manage care of psychiatric patients

•

Comprehensive and thorough documentation of psychiatric H&P’s and progress notes

• Preceptor evaluation

Locate, appraise, and apply evidence from scientific studies to enhance patient care

• Accurately document medical information

Providing patient education, to

• Preceptor evaluation

• Use effective basic counseling include disease management skills

• EOR examinations and patient education skills with to patients with mental illness and their families

• Interesting patient case assignment patients and their families to empower them to participate in their care and enable shared decision making

• Provide appropriate referrals

Completing technical skills

• Preceptor evaluation

• Performs procedures safely and at competently

• Competency is an appropriate skill level measured by meeting

• Identifies the indications and the number of contraindications of technical exposures listed under procedures

“Exxat Procedure Logging” in conjunction with the preceptor’s signature, indicating the procedure was done competently

Presenting patients to the

• Preceptor evaluation

•

Effectively complete oral preceptor or other designated presentations clinician on team in a concise, organized way demonstrating thorough knowledge of patient

Communicating appropriately and • Preceptor evaluation

• Work collaboratively as a respectfully with psychiatric patients member of an interprofessional and their families and members of the healthcare team interprofessional 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

Search for relevant information,

• Interesting patient case

• Develop skills necessary for utilizing appropriate data sources, and life long learning critically appraise to make evidence based decisions in patient care

Demonstrate clinical reasoning and problem solving ability when managing the psychiatric patient

• Preceptor evaluation

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

Describe the indications,

• Drug Cards

• Identify pharmacologic agents and contraindications, mechanism of

• Interesting patient case other relevant treatment modalities action, adverse effects and drug as they relate to patients with interactions of medications mental illnesses to include commonly used in psychiatry (including but not limited to antidepressants, anxiolytics, antipsychotics, sedatives) understanding the indications, contraindications, side effects, interactions, and adverse reactions

Understand issues related to quality in a healthcare setting

• Quality Assurance & Quality Improvement Project

• Identify the value of quality improvement initiatives

• Determine the etiologies, risk Functions list found at factors and epidemiology for https://paeaonline.org/assessment psychiatric conditions /core-tasks-and-objectives/ and

Utilize the PAEA Core Tasks and • EOR examination

• Identify signs and symptoms of apply to each of the psychiatric psychiatric conditions conditions outlined at

• Utilize critical thinking and https://paeaonline.org/assessment/en problem solving skills to d-of-rotation/content manage psychiatric 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 Psychiatry clerkship is based on the following components:

Interesting Case Assignment 15%

Three Psychiatry Drug Cards P/F 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

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. 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 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 will not be able to read from their cards. Students who do not have a site visit should upload them onto Exxat under “Session Required Documents” prior to the start of call back day. Student name, date and number must be listed on each drug card. Drug cards may be typed and submitted in word format. Should a student fail to produce these cards on a site visit or not upload onto Exxat prior to the start of call back day, they will receive an incomplete for this clerkship.

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 in the “Student Packet” section under “Generalized Documents.”

The preceptor evaluation will be sent to the preceptor via email from Exxat towards the end of each clerkship. Students are encouraged to discuss the evaluation with their preceptor. Students are responsible for ensuring that an evaluation is completed for each clinical clerkship. Students must make every reasonable effort to follow-up with the site to ensure that the evaluation is completed in a timely fashion. 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 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 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 20 encounters during clinical year

Acute 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

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 year

Geriatrics greater than 65 y/o 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. 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.

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 Required Number

ABG 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 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-and-objectives/ and apply information to https://paeaonline.org/assessment/end-of-rotation/content Student should also review the breakdown of the exam which can be found through the following link: https://paeaonline.org/assessment/end-of-rotation/contentThese 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 PAEA make-up exam. A grade of 65% or better must be achieved on the make-up exam to pass the clerkship. A grade of 65% will be entered for this portion of the final grade, regardless of the passing grade earned for the make-up exam. Only one make up examination will be offered in any clerkship. A failure of the make-up examination will result in failure of the clerkship.

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 2023”

5. Click on course documents on left side and review “IHI Videos” at the bottom of page

6. Follow instructions for discussion board

7. See Professor Gallo with questions.

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. Failure to demonstrate the required number of clinical encounters will affect the student’s ability to graduate.

REFLECTIVE JOURNALING

Chose five clinical encounters with a patient with developmental disabilities, reflect on your experiences and write them in a journal. Entries should focus on self-critique of the interaction, communication with individuals and their families and personal reactions to situations. Commenting on internal struggles or feelings, comfortability with providing care to individuals with developmental disabilities and their families/caregivers and ways of improving care are also encouraged. 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 this clerkship.

CALL BACK DAY

Students will return to campus and/or the Center for Learning and Innovation (CLI) at the end of each clerkship for one or two days for clinical year activities. At times call back may involve a remote clinical year activity via zoom. This is up to the discretion of the clinical team and students will be notified in advance. Call back day dates and locations can be found at the beginning of the handbook and on Exxat in the “student packet” section. Call back day activities can include lectures, case presentations, clinical skills workshops, and simulated patient encounters. All callback day activities are mandatory. Activities will vary throughout the year, however every student, except those on their elective rotations will take a Physician Assistant Education Association (PAEA) end of rotation exam on call back day. Should an absence be unavoidable, the clinical coordinator must be contacted PRIOR to the date to discuss the legitimacy of the absence.

A student leaving an on-site or remote call back day early, without notifying the clinical coordinator will result in a 5-point deduction from the overall clerkship grade. Any unexcused absence from call back day will result in a 10-point deduction from the overall clerkship grade and an incomplete will be submitted for the course until all assignments have been completed successfully.

CALL BACK DAY STRUCTURE

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

Call back day activities for rotations 4, 5, 7 and 8 will be two days in length. Day one of call back day will be on campus or remote and require all students on core rotations to take their PAEA end of rotation examination. Students on their elective rotation will be required to present their interesting case to their assigned group. A guest lecture/workshop activity may also be scheduled.

Day two of call back day will be at CLI or remote and include a longitudinal patient care experience. All patients involved in the longitudinal patient care experience 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 note or video self-reflection, they will receive an incomplete in the course.

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 290 ELECTIVE CLERKSHIP 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:

Assessment Tools

Utilized

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

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

•

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 problem solving 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

• 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

Formulate an assessment for patients

• Preceptor evaluation

• Select and interpret appropriate in the elective discipline diagnostic tests or lab studies

• Synthesize and analyze clinical data correctly

• Discern among acute, chronic, and emerging disease states

Development of management plans for patients in the elective discipline

• Preceptor evaluation

• Utilize critical thinking and problem solving skills to identify and manage a wide variety of medical conditions seen on the elective discipline

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

• Preceptor evaluation

• Adequately document medical information in history & physical notes and progress notes

Providing patient education and

• Preceptor evaluation

• Use effective basic counseling counseling for a wide variety of

• Interesting Patient and patient education skills with medical conditions seen on the Presentation patients and their families to elective discipline empower them to participate in their care and enable shared decision making

• Provide appropriate referrals

Completing technical skills

• Preceptor evaluation

• Performs procedures safely and at competently

• 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

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

• Preceptor

• Work collaboratively as a interprofessional team the roles member of an interprofessional that they play in the delivery of healthcare team healthcare in the elective discipline

• 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

Demonstrate care that is in all patient encounters

• Preceptor evaluation

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

Appreciate the utility of

•

• Identify the value

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

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 in the “Student Packet” section under “Generalized Documents.”

The preceptor evaluation will be sent to the preceptor via email from Exxat towards the end of each clerkship. Students are encouraged to discuss the evaluation with their preceptor. Students are responsible for ensuring that an evaluation is completed for each clinical clerkship. Students must make every reasonable effort to follow-up with the site to ensure that the evaluation is completed in a timely fashion. 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 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 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.

Types of Clinical Encounters

Preventative 20 encounters during clinical year

Acute 20 encounters during clinical year

Chronic 20 encounters during clinical year

Emergent 20 encounters during clinical year

Developmental Disabilities 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 year

Geriatrics greater than 65 y/o 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 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 elective clerkship, it is recommended that you focus on the procedures

listed below, as well as procedures unique to the elective clerkship. 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 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.

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 4

Abscess I&D 2

Blood Cultures 2

Required Number

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 Learning Innovation

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 2023”

5. Click on course documents on left side and review “IHI Videos” at the bottom of page

6. Follow instructions for discussion board

7. See Professor Gallo with questions.

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. Failure to demonstrate the required number of clinical encounters will affect the student’s ability to graduate.

REFLECTIVE JOURNALING

Chose five clinical encounters with a patient with developmental disabilities, reflect on your experiences and write them in a journal. Entries should focus on self-critique of the interaction, communication with individuals and their families and personal reactions to situations. Commenting on internal struggles or feelings, comfortability with providing care to individuals with developmental disabilities and their families/caregivers and ways of improving care are also encouraged. 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 this clerkship.

CALL BACK DAY

Students will return to campus and/or the Center for Learning and Innovation (CLI) at the end of each clerkship for one or two days for clinical year activities. At times call back may involve a remote clinical year activity via zoom. This is up to the discretion of the clinical team and students will be notified in advance. Call back day dates and locations can be found at the beginning of the handbook and on Exxat in the “student packet” section. Call back day activities can include lectures, case presentations, clinical skills workshops, and simulated patient encounters. All callback day activities are mandatory. Activities will vary throughout the year, however every student, except those on their elective rotations will take a Physician Assistant Education Association (PAEA) end of rotation exam on call back day. Should an absence be unavoidable, the clinical coordinator must be contacted PRIOR to the date to discuss the legitimacy of the absence.

A student leaving an on-site or remote call back day early, without notifying the clinical coordinator will result in a 5-point deduction from the overall clerkship grade. Any unexcused absence from call back day will result in a 10-point deduction from the overall clerkship grade and an incomplete will be submitted for the course until all assignments have been completed successfully.

CALL BACK DAY STRUCTURE

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

Call back day activities for rotations 4, 5, 7 and 8 will be two days in length. Day one of call back day will be on campus or remote and require all students on core rotations to take their PAEA end of rotation examination. Students on their elective rotation will be required to present their interesting case to their assigned group A guest lecture/workshop activity may also be scheduled.

Day two of call back day will be at CLI or remote and include a longitudinal patient care experience. All patients involved in the longitudinal patient care experience 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 selfreflection if the longitudinal patient care experience occurs via zoom. If a student misses a patient encounter or does not complete either the SOAP note or video self-reflection, they will receive an incomplete in the course.

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.

CLINICAL YEAR FORMS

Interesting Case Presentation Evaluation Form Faculty

SCORING: 0 = Not done, 1/5 = Poor, 5/5 = Excellent

TOPIC: COMMENTS

HISTORY:

Descriptors included in HPI Clear & concise HPI 0 0 1 1 2 2 3 4 3 4 5 5 HPI includes pertinent positive and negatives 0 1 2 3 4 5 Includes all pertinent past medical history 0 1 2 3 4 5

PHYSICAL EXAM:

Focused physical exam including all components 0 1 2 3 4 5 Includes pertinent positive & negative PE findings 0 1 2 3 4 5

LABS/DIAGNOSTIC PROCEDURES:

Utilization of appropriate diagnostic tests 0 1 2 3 4 5 Presents pertinent findings 0 1 2 3 4 5

DIAGNOSIS:

Addresses both acute, chronic disease & HCM 0 1 2 3 4 5 Ability to formulate & eliminate differential dx 0 1 2 3 4 5 Describes pathophysiology of disease state 0 1 2 3 4 5

MANAGEMENT:

Understands pharmacologic therapy 0 2 4 6 8 10 Discusses appropriate non pharmacologic therapy 0 1 2 3 4 5 Addresses disease prevention/HCM 0 2 4 6 8 10 Provides patient with follow up instructions 0 1 2 3 4 5

JOURNAL:

Discusses or writes a summary of article Submits supporting journal article (< 5yrs old) 0 2 4 6 8 10

PROFESSIONALISM: 0 1 2 3 4 5 _

TOTAL POINTS

Faculty Signature: Date: __

Elective Interesting Case Presentation Evaluation Form

Student Faculty

Rotation Type Site Date Dates \\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\

SCORING: 0 = Not done, 1/5 = Poor, 5/5 = Excellent

TOPIC: COMMENTS

HISTORY: Descriptors included in HPI 0 1 2 3 4 5 Clear&conciseHPI 0 1 2 3 4 5 HPI includes pertinent positive and negatives 0 1 2 3 4 5 Includes all pertinent past medical history 0 1 2 3 4 5

PHYSICAL EXAM:

Focused physical exam including all components 0 1 2 3 4 5 Includes pertinent positive & negative PE findings 0 1 2 3 4 5

LABS/DIAGNOSTIC PROCEDURES:

Utilization of appropriate diagnostic tests 0 1 2 3 4 5 Presents pertinent findings 0 1 2 3 4 5

DIAGNOSIS:

Addresses both acute, chronic disease & HCM 0 1 2 3 4 5 Ability to formulate & eliminate differential dx 0 1 2 3 4 5 Describes pathophysiology of disease state 0 1 2 3 4 5

MANAGEMENT:

Understands pharmacologic therapy 0 2 4 6 8 10 Discusses appropriate non pharmacologic therapy 0 1 2 3 4 5 Addresses disease prevention/HCM 0 2 4 6 8 10 Provides patient with follow up instructions 0 1 2 3 4 5

PATIENT EDUCATION: Development of patient education materials 0 2 4 6 8 10

PROFESSIONALISM: 0 1 2 3 4 5 _

TOTAL POINTS

Faculty Signature: Date: __

Mid-Clerkship Evaluation

Please complete this evaluation by the end of the third week of the clerkship. The midclerkship evaluation is designed to have students reflect on their strengths and weaknesses at the mid-point of their clerkship. This provides the opportunity for students to obtain the best possible clinical experience and correct deficiencies before the clerkship ends. This tool also provides the program with feedback regarding clerkship quality. This allows for identification of deficiency areas at clerkship sites and early intervention should it be necessary.

ROTATION:

1-FM 2-Med 3-Ob/Gyn 4-Surg 5-EM 6-Psych 7-Peds 8-Elective:

ROTATION NUMBER: 12 3 4 5 6 7 8 ROTATION SITE:

Please rate the following learning experiences as appropriate to your rotation

5= superior 4= very good 3= good. 2= fair. 1= poor. N/A = Not Applicable

Student Self-Assessment: How would you rate the following items:

1) Your ability to acclimate and acculturate to the clinical team?

2) Your professional behavior and attendance?

3) Your ability to perform histories and administer physical examinations?

4) Your ability to formulate a differential diagnosis?

5) Your ability to formulate and implement a management plan?

6) Your oral presentations?

7) Your ability to perform clinical procedures?

Clerkship Site Analysis: How would you rate the following items:

1) Appropriateness of supervision (i.e., is the supervisor adequately supervising patient encounters)?

2) Opportunity to perform history and physical examinations?

3) Opportunity to formulate differential diagnosis and management plans?

4) Opportunity to perform oral presentations?

5) Opportunity to perform clinical procedures?

6) Ability for this clerkship to meet the stated learning objectives?

COMMENTS:

Student Clinical Site & Preceptor Evaluation

Your feedback regarding your clinical experience is very important to the ongoing assessment and improvement process of the Hofstra Physician Assistant Studies Program. Please complete this confidential evaluation of your clinical site and preceptor on Exxat. We also ask that you provide detailed recommendations, using professional language, on how this experience may be improved. Your input is voluntary and appreciated. Your comments will not in any manner, affect your final clerkship grade.

ROTATION: 1- FM 2-Med 3-Ob/Gyn 4-Surg 5-EM 6-Psych 7-Peds 8-Elective:

ROTATION NUMBER: 12 3 4 5 6 7 8 ROTATION SITES:

Please rate the following learning experiences as appropriate to your rotation as:

5= Strongly Agree 4= Agree 3= Neither Agree nor Disagree 2= Disagree 1= Strongly Disagree

N/A = Not Applicable to this clinical rotation

Clinical Rotation Site Evaluation

1. The clinical site provided students with an orientation to the setting

2. The clinical site provided students with the opportunity to collaborate with/become a part of the medical team

3. The clinical site made students feel comfortable approaching staff with questions __

4. The clinical site provided students with opportunities to interview and examine patient __

5. The clinical site provided students with the ability to observe, learn, assist and/or perform clinical procedures

6. The clinical rotation, in conjunction with self-study, enabled the students to achieve stated learning objectives

Preceptor Evaluation

1. The preceptor provides students with the opportunity to formulate differential diagnoses and management plans

2. The preceptor provides students with the ability to observe, learn, assist and/or perform clinical procedures

3. The preceptor provides adequate supervision for the students

4. The preceptor provides students with the opportunity to present patients to them

5. The preceptor provides guidance regarding student’s clinical note writing

6. The preceptor gives the students feedback regarding their performance throughout the clinical rotation

7. The preceptor encouraged the student to ask question and was approachable

Site/Preceptor Evaluation

1. Would you recommend this site to other students?

a. Yes b. No c. Unsure

d. Why or why not (please be detailed and use professional language)

2. Would you recommend this preceptor to other students?

a. Yes b. No c. Unsure

d. Why or why not? (Please be detailed and use professional language)

STUDENT/PRECEPTOR REVIEW OF INSTRUCTIONAL OBJECTIVES & LEARNER OUTCOMES FORM

Student at Hofstra University Physician (NAME)

Assistant Program has provided me the learning objectives for this rotation. We discussed in detail the expectations involved in successfully completing this rotation.

Preceptor

Student Date

Hofstra University Physician Assistant Program Exposure Incident Investigation Form

Date of Report: __________________________

Time of Report: _____________

Date of Incident _________________________ Time of Incident ____________

Name and Hofstra ID# of Student(s) involved in incident:

Name of Preceptor/Instructor at time of incident:

Location of potential exposure (classroom, Bioskills, or clinical clerkship):

If clinical clerkship, include specific site, discipline, and rotation number (ex: Woodhull, IM, rotation #4)

Exposure occurred as part of (check all that apply):

Supervised laboratory assignment

Patient care provided during clinical experience hours

Northwell Bioskills Lab

Other _______________________________________________________

Potentially Infectious Materials Involved: Type of body fluids, route, and source of exposure (ie. Needle stick, contact with open wound, etc)

Circumstance (Task being performed, where, how, and severity of the exposure):

How incident was caused? (Accident, equipment malfunction. if a device was being used include type and brand of device, whether or not it was a safety device, and when in the course of handling the device, the incident occurred):

Personal protective equipment being used: (gloves, gown, etc.):

Actions taken (decontamination, clean up, immediate referral, reporting, etc.):

Recommendations for avoiding repetition:

If at Northwell Bioskills Lab, a copy of the Anatomy Gifts Registry specimen data sheet is attached? YES NO Student has the Post Exposure Evaluation and Follow Up Checklist? circle one: YES NO

Student Signature _____________________________________________________________________

Name and Title of Investigator (Academic Coordinator or Clinical Coordinator): Print and Sign _____________________________________________________________________

Hofstra University Department of Physician Assistant Studies

Post-Exposure Evaluation and Follow-Up Checklist

Date of Report: __________________________

Name and Hofstra ID# of Student(s) involved in incident: ____________________________

The following steps must be taken, and information transmitted, in the case of a student’s exposure to Bloodborne Pathogens:

Activity Completion Date

The Exposure Incident Investigation Form was completed

If applicable, source individual’s blood tested, and result given to exposed student.

Consent was not obtained

Exposed Student’s Signature

If applicable, exposed student’s blood collected and tested. If refused, student must sign below.

Exposed Student’s Signature

If refused to see health care professional, then exposed student must sign below (_________________________________)

Exposed Student’s Signature

Name of Hofstra Student Health Services Provider – Print and Signature: Date: _____________

FAMILY MEDICINE CLERKSHIP: HEALTH PROMOTION PROJECT

Name: Date:

The main goal of this health promotion project is to enable patients to increase control over and improve their own health. As healthcare providers, it is our responsibility to promote healthy lifestyles, along with identifying high risk patients who can develop complications from their various chronic illnesses or lifestyle risk factors. The objectives of this project are to inform patients about the prevention of a specific disease states and evaluate the effectiveness of their efforts.

Ask the patient the following questions and record and reassess the results. Please attach a current article (<5 years old) that discusses health promotion issues that relates to one of your patient’s illness(es). The assignment must be typed.

1. Identify and list this patient’s chronic illnesses and any lifestyle risk factors. Make sure to include the age, sex, and race of your patient.

2. What specific recommendations or actions did you take to enable patient selfmanagement, disease prevention and health promotion?

3. Has your patient been receiving continuous health screening from visited facility? If so, when and what was done? If no, what health care maintenance or health screening is this patient due for?

4. Reassess the patient and note if any changes were attempted or made after your initial discussions.

5. Please read your article (<5 years) that discusses one health promotion issue that relates to your patient’s illness(es). Please attach a one-page, typed, double spaced paper summarizing the article and discussing opinions regarding the article.

HEALTH PROMOTION PROJECT GRADE FORM

Student Name Rotation Number Date Content

• Identified and listed patient’s chronic illnesses and lifestyle risk factors.

• Describes specific recommendations or actions taken to enable patient self management, disease prevention and health promotion.

• Discusses whether patient is receiving continuous health screening from visited facility. If so, elaborates.

• Patient is reassessed. Discusses changes made or attempted

• States, expands, and supports main points.

• Exercises proper composition skills. (45%)

Research Article

• Research article current (<5 years)

• Research article is appropriate for topic

• Paper summarizes article

• Opinions regarding the article are discussed

• Exercises proper composition skills (45%)

Professionalism

• Submitted materials on time in a professional manner

• Student was engaged his/her audience and had good command of topic (10%)

Final Score: (100%)

Faculty:

END OF ROTATION GRADE FORM

Name: Site: Final Grade:

Rotation: 1 2 3 4 5 6 7 8

Rotation Type: FM MED OB/GYN SURG EM PSYCH PEDS ELECT:

The components for Psychiatry, Pediatrics, Surgery and OB/GYN clerkships are the following:

Submitted or Completed Notes

Student Clinical Site & Preceptor Evaluation

Preceptor Evaluation

Clinical Documentation and/or 3 Pharm Cards, if applicable please see your course syllabus

Interesting Case Assignment, if applicable please see your course syllabus

Procedure Logging Requirements

Clerkship Patient Encounters Requirements

Completion of Call Back Day Activities

Developmental Disabilities Curriculum Requirements

Quality Assurance/Performance Improvement

The components for Family Medicine, Internal Medicine and Emergency Medicine clerkships are the following:

Submitted or Completed Notes

Student Clinical Site & Preceptor Evaluation

Preceptor Evaluation

Clinical Documentation and/or 3 Pharm Cards, if applicable please see your course syllabus

Sim Man or Virtual Cases

Interesting Case Assignment or Health Promotion Project, if applicable- please see your course syllabus

Procedure Logging Requirements

Clerkship Patient Encounters Requirements

Completion of Call Back Day Activities

Developmental Disabilities Curriculum Requirements

Quality Assurance/Performance Improvement

The components of the elective clerkship are the following:

Submitted or Completed Notes

Student Clinical Site & Preceptor Evaluation

Preceptor Evaluation

Elective Interesting Case Presentation

Procedure Logging Requirements

Clerkship Patient Encounters Requirements

Completion of Call Back Day Activities

Developmental Disabilities Curriculum Requirements

Quality Assurance/Performance Improvement

OVERALL GRADE: FACULTY SIGNATURE: DATE:

CLINICAL YEAR – CLINICAL DOCUMENTATION GRADING FORM

Student’s Name: Date:

Faculty Evaluator: Grade:

SOAP/H&P: Item Student Value Maximum Point Value

1. Introduction (3)

2. History Components (20)

3. PE (15)

4. Assessment (20) (Includes acute, chronic, HCM)

5. Plan (20) (Patient Education, Follow Up, Preventive Care)

6. Signature (2)

7. Overall Evaluation of Note (20) (Organization, presentation, if having a site visit, legibility, completeness, clarity, spelling, etc.)

Total Points: X 10% =

Pharmaceutical Cards:

Item Student Value Maximum Point Value

1. Class of medication (10) Mechanism of Action (20) Indications (20) Contraindications (20) Side Effects (20) Dosing & Cost of medication (10)

Total Points: X 5%=

Total Clinical Documentation Grade: + /15 = SOAP/H&P Points Pharm. Points Final Grade

Faculty Signature: Date:

PROGRAM IN PHYSICIAN ASSISTANT STUDIES PRECEPTOR EVALUATION FORM

Student Name

Rotation Type and Site

Preceptor Name

Rotation Dates

Preceptors: Please use the Likert scale below to evaluate student overall performance on clinical clerkship. (1 = poor, 2 = below average, 3 = average, 4 = good, 5 = excellent; total possible points = 100) Comments

Medical Interview

Physical Examination

Oral Case Presentation

Patient Record

Utilization of Diagnostic Tests

Interpretation of Diagnostic Tests

N/A 1 2 3 4 5

N/A 1 2 3 4 5

N/A 1 2 3 4 5

N/A 1 2 3 4 5

N/A 1 2 3 4 5

N/A 1 2 3 4 5

Technical Skills/Clinical Procedures N/A 1 2 3 4 5

Problem Solving/Clinical Thinking N/A 1 2 3 4 5

Fund of Knowledge and Application of Concepts N/A 1 2 3 4 5

Assessment/Differential Diagnoses

N/A 1 2 3 4 5

Ability to Formulate a Follow up and Management Plan N/A 1 2 3 4 5

Ability to Implement a Follow up and Management Plan N/A 1 2 3 4 5

Ability to Work Collaboratively in Interprofessional Teams N/A 1 2 3 4 5

Relating to Patients and Colleagues

N/A 1 2 3 4 5

Understanding of PA Role N/A 1 2 3 4 5

Reliability and Dependability

N/A 1 2 3 4 5

Self Confidence N/A 1 2 3 4 5

Attitude Toward Learning N/A 1 2 3 4 5

Professionalism N/A 1 2 3 4 5

Student Preparedness for Clinical Clerkship N/A 1 2 3 4 5

**For components that received an N/A, please add 5 points when calculating the total points. **

Total Points =

Overall Letter Grade = LETTER GRADE AND CIRCLE.

Overall Competency:

USE LEGEND BELOW TO CALCULATE OVERALL

Letter Grade A A B+ B B C+ C F

Row Score 100 91 90 87 86 83 82 77 76 73 72 69 68 60 59 or below

Preceptor’s signature: Date:

Student’s signature: Date: __________________

DESCRIPTIONS OF EVALUATION CATEGORIES

Medical Interview

• Conveys understanding and empathy for patient

• Obtains all pertinent information

• Follows an organized format

• Obtains history in a reasonable time

Physical Examination

• Explainsprocedure to patient before exam

• Performs examination in an orderly sequence

• Demonstrates respect for patient

• Performs appropriate and accurate exam

Oral Case Presentation

• Clear, organized, concise presentation

• Includes all major active complaints/problems

Patient Record

• Written materials are neat, legible, and appropriate

• Accurately and adequately documents patient encounters

• Electronic record, when utilized, is accurate and organized

Utilization & Interpretation of Diagnostic Tests

• Demonstrates sound knowledge of tests

• Orders appropriate test(s) for working differential diagnosis

• Uses appropriate discretion in ordering

• Demonstrates the ability to interpret diagnostic tests

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

Technical Skills/Clinical Procedures

• Performs procedures safely and at appropriate skill level

• Understands indication(s) for procedure(s)

• Explains and attains consent of patient before starting procedure

Problem Solving/Clinical Thinking

• Synthesizes and analyzes clinical data correctly

• Determines major active problem accurately and in a timely fashion

• Determines abnormal from normal

• Utilizes and evidence based approach to medicine

Fund of Knowledge and Application of Concepts

• Demonstrates application of basic and clinical sciences to patient care

• Demonstrates evidence of outside reading and studies during rotation

• Ability to apply knowledge of biomedical and psychosocial principles

• Uses information technology to support the application of knowledge

Assessment/Differential Diagnoses

• Formulates and justifies differential diagnoses

• Determine the etiologies, risk factors, and epidemiology for medical conditions

• Identify the signs and symptoms of medical conditions

Ability to Formulate and Implement a Follow-up and Management Plan

• Designs an effective and appropriate care plan

• Selects appropriate consultations and referrals

• Demonstrates an appropriate understanding of pharmacologic plan

• Implements plan consistently and appropriately

• Arranges for patient follow up

• Performs patient education at appropriate level

• Uses counseling and patienteducation skills effectively

Relating to Colleagues

• Ability to work collaboratively in inter professional teams

Relating to Patients

• Communicates effectively and appropriately with patients

• Demonstrates respect and empathy for patients

Understanding of PA Role

• Demonstrates understanding for medical conditions and situations that require an attending physician or consultation

• Understands the PA profession and the role of the PA as a team member

Reliability and Dependability

• Assumes appropriate level of responsibility

• Completes tasks thoroughly and in a timely fashion

Self-Confidence

• Demonstrates confidence in clinical competence to patient, peers, and preceptor

Attitude Toward Learning

• Demonstrates independent learning effort; undertakes supplemental readings; is inquisitive, insightful, and enthusiastic; attends conferences and lectures; and demonstrates knowledge of assigned readings

Professionalism

• Exhibits cultural awareness

• Maintains professional relationship with patients, staff, and preceptor

• Demonstrates ethical behavior and attitude in accordance with AAPA’s Guidelines for Ethical Conductfor the Physician Assistant Profession

• Respect’s patient privacy and confidentiality

• Demonstrates a positive response to constructivecriticism

• Dresses appropriately for professional role

• Maintains clean and kempt appearance

Student Preparedness for Clinical Clerkship

• Student waswell prepared to transition into clinicalclerkship