Preceptor Handbook-CO 2025-Fall 2024 by Hofstra University

PRECEPTOR HANDBOOK

Fall 2024

FACULTY AND STAFF CONTACT INFORMATION

Chair and Program Director / Associate Professor

J. Scott Gould, DMSc, PA-C

Associate Director / Assistant Professor

Mark L’Eplattenier, MPAS, PA-C (516) 463-4411 (516) 463-1353

Scott.Gould@hofstra.edu

Gallon Wing, room 243B

Dual-Degree Coordinator / Assistant Professor

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

Mary.K.Banahan@hofstra.edu

Gallon Wing, room 244

Academic Coordinator / Associate Professor

Amy Roberts, PhD, PA-C

Mark.S.Leplattenier@hofstra.edu

Gallon Wing, room 243C

Medical Director

Samuel Sandowski, MD (516) 463-4074

ssandowski@snch.org

Gallon Wing, room 132

Assistant Chair/ Academic Coordinator

Christine Zammit, MS, PA-C (516) 463-7728 (516) 463-4380

Amy.Roberts@hofstra.edu

Gallon Wing, room 130

Christine.Zammit@hofstra.edu

Gallon Wing, room 137

Clinical Coordinator /Assistant Professor Director of Clinical Education /Assistant Professor

Janet Tutuyan, MPH, PA-C

Shannan Ricoy, MS, PA-C (516) 463-6841 (516) 463-4233

Janet.Tutuyan@hofstra.edu (516) 509-6470 (Program cellular phone)

Gallon Wing, room 236

Academic Faculty/ Assistant Professor

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

William.Heuser@hofstra.edu

Gallon Wing, room 139

Research Coordinator/Associate Professor

Gina Pontrelli, DHSc, PA-C

Shannan.Ricoy@hofstra.edu

Gallon Wing, room 237

Senior Assistant-Full Time

Marie Sorrentino (516) 463-4074

Marie.Sorrentino@hofstra.edu

Gallon Wing, room 132

Clinical Secretary/Secretary - Part Time

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

Gia Raponi (516) 463-4043

Gia.R.Raponi@hofstra.edu

Gallon Wing, room 245

Department Main Office, Phone: (516) 463-4074, Fax: (516) 463-5177

Hofstra University, Physician Assistant Studies

Gallon Wing, Room 132 Hempstead, New York 11549-1270

Rotation 1 Fall Semester

Rotation 2 Fall Semester

Rotation 3, Part #1 Fall Semester

2024-2025 Clinical Year Schedule

8/26/2024 – 10/3/2024

Students off 9/2/2024

10/07/2024 – 11/14/2024

Students off 10/14/2024

11/18/2024 -12/19/2024

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

Winter Break-12/23/2024– 12/29/2024

Rotation 3, Part #2 Fall Semester

Rotation 4 Spring Semester

Rotation 5 Spring Semester

Rotation 6 Spring Semester

Rotation 7

Summer I

Rotation 8

Summer II

12/30/2024 -1/2/2025

Students off 1/1/2024

1/6/2025 – 2/12/2025

2/18/2025 – 3/26/2025

Students off 2/17/2025

Spring Break-3/31/2025 – 4/6/2025

4/7/2025 – 5/15/2025

5/19/2025 – 6/25/2025

Students off 5/26/2025

6/30/2025 – 8/6/2025

Students off 7/4/2025

Call Back Day 10/4/2024

Call Back Day 11/15/2024

Call Back Day 1/3/2025

Call Back Day 2/13/2025 & 2/14/2025

Call Back Day 3/27/2025 & 3/28/2025

Call Back Day 5/16/2025

Call Back Day 6/26/2025 & 6/27/2025

Call Back Day 8/7/2025 & 8/8/2025

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 PAs

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 and Inclusivity

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

• Train highly qualified PAs to enter clinical practice.

• Promotion of 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.to quality care.

PA PROGRAM COMPETENCIES

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

Medical Knowledge (MK) (ARC-PA Standard -B4.03 d)

MK1-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.

MK2 -Discern among acute, chronic, and emerging disease states.

MK3 -Determine the etiologies, risk factors, and epidemiology for medical conditions.

MK4 -Identify signs and symptoms of medical conditions.

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

MK6 -Identify and formulate an appropriate assessment and management plan.

MK7 -Select and interpret appropriate screening and diagnostic studies.

MK8 -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 & Evidence Based Medicine, Preventative Medicine, Correlative Medicine I & II.

• Supervised clinical practice experiences in family medicine, internal medicine, surgery, behavioral and mental health care, women’s health, pediatrics, emergency medicine and an elective rotation.

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

Society and Population Health

(SPH)

SPH1 -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.

SPH2 -Understand and apply the fundamental principles of epidemiology.

SPH3 -Identify quality improvement initiatives.

SPH4 -Recognize the social determinants of health and understand how they apply to patient care.

SPH5 -Understand the principles of preventative medicine and how they apply to clinical practice.

SPH6 -Exercise cultural humility.

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

• Didactic coursework: specifically, Medicine I, II, III, Epidemiology & Evidence Based Medicine, Health Psychology, and Preventative Medicine.

• Successful completion of summative examinations and assessments.

Interpersonal and Communication (IC) (ARC-PA Standard -B4.03 c)

IC1 -Use effective interviewing skills to elicit a detailed history.

IC2 -Accurately document medical information.

IC3 -Effectively complete oral presentations.

IC4 -Provide appropriate referrals.

IC5 -Use effective basic counseling and patient education skills that enable shared decision-making.

IC6 – Understands the importance of effective communication with patients, families, physicians, and other members of the care team.

IC7 -Demonstrate understanding of diverse health care needs.

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.

• Successful completion of summative examinations

Professional Behaviors (PB) (ARC-PA Standard -B4.03 e)

PB1 -Demonstrate empathetic and respectful behaviors

PB2 -Exhibits reliability, accountability and dependability.

PB3 -Exhibits an understanding of the physician assistant profession and the role of a PA

PB4 -Demonstrates and identifies ethical behavior.

PB5 -Exhibits an understanding of the laws and regulations of PA Practice.

PB6 -Demonstrate accountability to patients, society, and the profession.

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 and Health Psychology.

• Successful completion of summative examinations.

• Successful completion of professional development evaluations.

Clinical Reasoning and problem-solving ability (CRPSA) (ARC-PA Standard -B4.03 b)

CRPSA1 -Utilize critical thinking and problem-solving skills to identify and manage medical conditions.

CRPSA2 -Synthesize and analyze clinical data correctly.

CRPSA3 -Locate, appraise, and apply evidence from scientific studies to enhance patient care.

CRPSA4 -Demonstrate care that is effective, safe, equitable, and high quality.

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

• Didactic coursework: specifically, Medicine I, II, and III, Physical Examination and Diagnostic Modalities, I, II, and III, Correlative Medicine I & II and Epidemiology and Evidence Based Medicine

• Successful completion of summative examinations.

Clinical and Technical Skills (CTS) (ARC-PA Standard B4.03 a)

CTS1 – Performs procedures safely and at an appropriate skill level.

CTS2 – Identifies the indications for and contraindications of technical procedures.

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

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

• Supervised clinical practice experiences in family medicine, internal medicine, surgery, women’s health, pediatrics, emergency medicine and elective rotation.

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 visualize information as presented in images from paper, film, slides or video.

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

• Speak, hear and observe patients by sight in order 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, online 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 PAs, 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 and Diagnostic Modalities course. The case-based courses, Correlative Medicine I and II, synthesize and integrate 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; woman’s health; behavioral & mental health care; 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 and to the Science and Innovation Center (SIC) or remotely on the last day or 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

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 a 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. 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.

First Semester

Anatomy

PROGRAM CURRICULUM

Physical Examination and Diagnostic Modalities I

Pharmacology I

Physiology

Medicine I

Second Semester

Health Psychology

Physician Assistant and Society

Pharmacology II

Physical Examination and Diagnostic Modalities II

Medicine II

Preventive Medicine

Correlative Medicine I

Third Semester

Pharmacology III

Medicine III

Correlative Medicine II

Physical Examination and Diagnostic Modalities III

Fourth – Sixth Semesters (Clerkships)

Family Medicine

Internal Medicine

Women’s Health

Surgery

Emergency Medicine

Pediatrics

Behavioral and mental healthcare

Elective

Seventh Semester

Epidemiology & Evidence Based Medicine

Research Design and Analysis

Research Project

Professional Development

Curriculum Total

PRECEPTOR INFORMATION

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-assistanthandbooks.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

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 copy of preceptor evaluations can be found at the end of this handbook in the “Preceptor Evaluations” section.

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 “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 “Forms” 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, the student 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. Students should familiarize themselves with the location and telephone number of their clinical site’s security department. If a clinical year student feels their personal safety is being compromised, they should contact the on-site security department, the program, and alert their preceptor. If the site does not have a security department, the student is unable to reach a faculty member at the program, and the preceptor is unavailable, the student is to call 911. If a clinical year student has questions or concerns regarding site security or safety, they may contact the program main office at 516-463-4074 or call the emergency clinical coordinator program mobile at 516-509-6470 after office hours. All students are required to complete the assigned safety modules on Cornerstone and download the “Hofstra SAFE” app from the following website: https://www.hofstra.edu/public-safety/ before the start of the clinical year. Once the learning modules are completed, the student will be cleared in the Northwell student portal. Students not clear in the Northwell student portal will be unable to start 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 EMR training 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

• Call schedules

• Overnight/weekend schedules

• Participation during rounds and conferences

• Expectations for clinical care, patient interaction, and procedures

• Oral presentations

• Written documentation

• Assignments

• Write-ups

• 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 clinical 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.

PRECEPTOR 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.

The preceptor 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 is highly encouraged. 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: 9/1/24 – 8/31/25

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: ____________________________________________________________

Clinical 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?

⁪Excellent ⁪Good ⁪Satisfactory ⁪Poor

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 9/1/2024. This program was planned in accordance with AAPAs CME Standards.

Category 1 CME for Physician Assistant Precepting Precepting Hours Attestation Report

Hofstra University Department of Physician Assistant Studies Dates of CME Activity: 9/1/24 – 8/31/25

Preceptor Name: ____________________________________________________________

Clinical Practice Affiliation: ___________________________________________________

Student Name Clerkship Dates

Number of Weeks Spent Precepting

Total Number of CME Credits Requested:_________________________________________

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/internationalstudent/ Students should contact the Student Health and Counseling Center at SHACC@hofstra.edu or 516-4636745 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.

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

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

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

4. If exposure occurs at the Northwell Bioskills lab, the student shall IMMEDIATELY REPORT the incident to the course instructor. The course instructor will ensure the student irrigates and cleans the affected area. The course instructor will notify Northwell staff. The course instructor will ask

Northwell staff for a copy of the Anatomy Gifts Registry specimen data sheet. The student must call Student Health Services at 516-463-6745 before reporting to Wellness and Campus Living Center and proceed to step 6.

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

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

8. http://www.hofstra.edu/StudentAffairs/StudentServices/welctr/index.html

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

As per Faculty Policy Series 12 (B):

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

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

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

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

Hofstra University places high value upon educating students about academic integrity. At the same time, the University will not tolerate dishonesty, and it will not offer the privileges of the community to the repeat offender. The academic community assumes that work of any kind--whether a research paper, a critical essay, a homework assignment, a test or quiz, a computer program, or a creative assignment in any medium--is done, entirely and without unauthorized assistance, by the individual(s) whose name(s) it bears. Students bear the ultimate responsibility for implementing the principles of academic integrity. For more information, please visit hofstra.edu/fps/11.html.

In the spring of 2012, the University community affirmed a new expression of commitment by instituting the Hofstra University Honor Code. The Honor Code is a statement of shared values.

• Hofstra University 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 Values. I accept the responsibility to follow this Honor Code at all times.”

• Honor Code Short Form: “I pledge on my honor that I have done this work with honesty and integrity, without giving or receiving unauthorized assistance.”

• Turnitin for Textual Similarity Review: “Students agree that by taking this course all required papers may be subject to submission for textual similarity review to Turnitin.com for the detection of plagiarism. All submitted papers will be included as source documents in the Turnitin.com reference database solely for the purpose of detecting plagiarism of such papers. Use of the Turnitin.com service is subject to the Usage Policy stated in the Turnitin.com site.”

Academic Dishonesty: Plagiarism and other forms of academic dishonesty are serious ethical and professional infractions. For information regarding academic integrity, examples of violations, procedures for handling violations, as well as a student’s right to appeal a charge, see Faculty Policy Series #11 or Faculty Policy Series #11G.

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

Family Medicine

Internal Medicine

15 per week/90 per clerkship

10 per week/60 per clerkship

Behavioral & Mental Health Care 10 per week/60 per clerkship

Women’s Health

Prenatal Care

Gynecologic Care

Emergency Medicine

Surgery

Pre-op

Intra-op

Post-op

10 per week/60 per clerkship

15 per clerkship

15 per week/90 per clerkship

10 per week/60 per clerkship

10 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:

Cardiopulmonary Resuscitation 1-assisted is acceptable on or at SIC*

Foley Catheter Placement 4

STUDENT AND CLERKSHIP MONITORING

MID-CLERKSHIP EVALUATION

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

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 SYLLABI

PHA 250 FAMILY MEDICINE CLERKSHIP 3 S.H. (B1.03a,

B3.04c, B3.07a)

COURSE COORDINATOR (B1.03c)

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

Office: 516-463-4233

COURSE DESCRIPTION (B1.03b)

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

COURSE GOAL (B1.03d)

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

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

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

Instructional Objectives Course Learning Outcomes Assessment Tools Program Competencies

By the conclusion of the Family Medicine Upon successful completion of this

Utilized

The instructional objectives, clerkship, students will demonstrate clerkship, students will attain the following learning outcomes, and Competency of competency in the following: (B1.01d, B1.03e, knowledge, interpersonal, clinical/technical successful completion of course instructional objectives B3.07a) skills, professional behaviors, clinical assessments guide students and learner outcomes are reasoning, and problem-solving abilities: toward the acquisition of the measured by successful (B1.01d, B1.03e, B3.07a) following Program completion of the Competencies: (B1.01b, B1.03e, following assessment B4.01a) tools: (B1.03e, B1.03g, B4.01a)

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

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

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

• Preceptor evaluation

• Clerkship specific patient encounter requirements

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

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

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

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

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

• Preceptor evaluation

• Clerkship specific patient encounter requirements

• Virtual Patient Case Assignment

• EOC Exam

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

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

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

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

• Preceptor evaluation

• Virtual Patient Case Assignment

• Clerkship specific patient

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

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

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

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

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

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

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

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

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

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

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

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

(B3.07a)

encounter requirements

• EOC Exam

• Preceptor evaluation

• Drug cards

• Health Promotion Project

• Virtual Patient Case Assignment

• Clerkship specific patient encounter requirements

• EOC Exam

•

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

• Provides appropriate referrals (IC4).

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

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

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

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

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

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

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

• Preceptor Evaluation

• Clerkship specific patient encounter requirements

• Preceptor Evaluation

• Clerkship specific patient encounter requirements

• Effectively complete oral presentations (IC3)

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

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

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

• Accurately evaluates adult patients (18-64 yo) with family medicine conditions. (B3.03b, B3.07a)

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

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

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

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

• Preceptor Evaluation

• Clerkship specific patient encounter requirements

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

• Accurately document medical information (IC2)

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

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

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

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

• Accurately evaluate patients for

• When in a family medicine setting,

• Preceptor • Elicit a detailed medical hypertension. (B3.07a) the student can appropriately Evaluation history, perform

• Accurately evaluates patients with evaluate patients with common appropriate physical congestive hyperlipidemia. (B3.07a) conditions such as hypertension, examination, and

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

hyperlipidemia, and diabetes. (B3.07a) accurately record all pertinent data. (MK5)

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

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

Instructional Objectives Course Learning Outcomes Assessment Program Tools Utilized Competencies

By the conclusion of the Family Medicine Upon successful completion of this clerkship, students will demonstrate clerkship, students will attain the following Competency of The instructional objectives, competency in the following: (B1.01d, B1.03e, knowledge, interpersonal, clinical/technical instructional objectives learning outcomes, and B3.07a) skills, professional behaviors, clinical and learner outcomes successful completion of reasoning, and problem-solving abilities: are measured by course assessments guide (B1.01d, B1.03e, B3.07a)

successful completion students toward the acquisition of the following of the following Program assessment tools: Competencies: (B1.01b, B1.03e, (B1.03e, B1.03g, B4.01a) B4.01a)

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

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

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

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

• Preceptor evaluation

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

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

• Demonstrates empathy. (B3.07a)

• When presented with a patient with a • Preceptor • Demonstrate empathetic

• Demonstrates respect. (B3.07a) family medicine condition, the evaluation and respectful behaviors.

• Demonstrates ethical behavior. (B3.07a) student demonstrates empathy, respect, and appropriate ethical behavior. (B3.07a) (PB1)

• Demonstrates reliability. (B3.07a)

• When presented with a patient with a

• Demonstrates and identifies appropriate ethical behavior. (PB4)

• Preceptor • Exhibit reliability,

• Demonstrates accountability. (B3.07a) family medicine condition, the evaluation accountability, and

• Demonstrates dependability. (B3.07a) student exhibits reliability, dependability. (PB2)

• Exhibits a positive approach to dependability, and is accountable.

• Demonstrates learning. (B3.07a)

(B3.07a) accountability to patients, society, and the profession (PB6).

• Demonstrate an understanding of

• When presented with a patient with a

• Preceptor

• Demonstrates an diverse health care needs. (B3.07a) family medicine condition, the student can understand the diverse needs of patients. (B3.07a) evaluation understanding of diverse health care needs (IC8).

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

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

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

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

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

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

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

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

• Preceptor evaluation

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

• Synthesize and analyze clinical data correctly (CRPSA2).

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

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

CARDIOVASCULAR

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

PULMONOLOGY

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

GASTROINTESTINAL/NUTRITIONAL

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

ENOT/OPHTHALMOLOGY

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

OBSTETRICS/GYNECOLOGY

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

ORTHOPEDICS/RHEUMATOLOGY

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

NEUROLOGY

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

DERMATOLOGY

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

ENDOCRINOLOGY

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

PSYCHIATRY/BEHAVIORAL MEDICINE

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

UROLOGY/RENAL

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

HEMATOLOGY

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

INFECTIOUS DISEASES

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

URGENT CARE

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

ARC-PA STANDARDS

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

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

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

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

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

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

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

a) emergency department,

b) inpatient,

c) outpatient, and

d) operating room.

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

a. family medicine,

b. emergency medicine,

c. internal medicine,

d. surgery,

e. pediatrics,

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

g. behavioral and mental health care.

STUDENT ASSESSMENT/EVALUATION (B1.03g)

Clerkship Specific Assessments

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

Health Promotion Project 15%

Drug Cards

Preceptor Evaluation 50%

End of Clerkship Examination (EOC Exam) 35%

Clerkship Specific Patient Encounter Requirements P/F

Virtual Patient Case Assignment P/F

GRADING PLAN

(B1.03h)

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

Grade Calculations

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

CLERKSHIP SPECIFIC ASSESSMENTS

HEALTH PROMOTION PROJECT

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

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

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

DRUG CARDS

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

PRECEPTOR EVALUATION

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

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

END OF CLERKSHIP EXAMINATION (EOC Exam)

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

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

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

CLERKSHIP SPECIFIC PATIENT ENCOUNTER REQUIREMENTS (Patient Logs)

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

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

Family Medicine

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

Preventive 10 encounters during the Family Medicine clerkship

Acute 10 encounters during the Family Medicine clerkship

Chronic 10 encounters during the Family Medicine clerkship

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

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

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

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

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

Emergent: Related to a medical condition requiring immediate intervention.

VIRTUAL PATIENT CASE ASSIGNMENT

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

CLINICAL YEAR REQUIRMENTS for GRADUATION

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

Clinical Year Patient Encounter Requirements P/F

Clinical Year Procedure Logging Requirements P/F

Quality Assurance/Performance Improvement Assignment P/F

Developmental Disabilities Logging Requirement and Reflective Journaling P/F

Longitudinal Patient Case with Medical Documentation Submission P/F

CLINICAL YEAR PATIENT ENCOUNTER REQUIREMENTS (Patient logs)

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

Types of Clinical Encounters

Preventative

20 encounters during clinical year

Acute 20 encounters during clinical year

Chronic 20 encounters during clinical year

Emergent 20 encounters during clinical year

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

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

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

Emergent: Related to a medical condition requiring immediate intervention.

Medical Care Across the Life Span Encounters

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

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

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

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

Elderly -65 and older 100 encounters during the clinical year

CLINICAL YEAR PROCEDURE LOGGING REQUIREMENTS

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

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

REQUIRED CLINICAL YEAR PROCEDURES/EXAMINATIONS

QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT ASSIGNMENT

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

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

Summary:

1. Go to Canvas

2. Go to course PHA 227

3. Click on “discussion board” on left side

4. Click on “Patient Safety Institute CO 2025”

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

6. Follow instructions for the discussion board

DEVELOPMENTAL DISABILITIES LOGGING REQUIREMENT AND REFLECTIVE JOURNALING

Logging requirement:

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

coordinators to meet these competencies. Competency in these areas is required by the end of the clinical year and for graduation. Please follow the same process for logging patients as described under the section titled “Clerkship Specific Patient Encounter Requirements”.

Types of Clinical Encounters

Developmental Disabilities 15 encounters during clinical year

Reflective Journal:

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

LONGITUDINAL PATIENT CASE with MEDICAL DOCUMENTATION SUBMISSION

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

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

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

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

CLERKSHIP BIBLIOGRAPHY

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

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

PHA 255 INTERNAL MEDICINE CLERKSHIP 3 S.H. (B1.03a, B3.04b, B3.07c)

COURSE COORDINATOR (B1.03c)

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

Office: 516-463-4233

COURSE DESCRIPTION (B1.03b)

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

COURSE GOAL (B1.03d)

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

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

Instructional Objectives Course Learning Outcomes Assessment Tools Program

Utilized Competencies

By the conclusion of the Internal medicine Upon successful completion of this clerkship, students will demonstrate clerkship, students will attain the following Competency of The instructional objectives, competency in the following: (B1.01d, knowledge, interpersonal, clinical/technical instructional objectives learning outcomes, and B1.03e, B3.07c) skills, professional behaviors, clinical and learner outcomes are successful completion of course reasoning, and problem-solving abilities: measured by successful assessments guide students (B1.01d, B1.03e, B3.07c)

completion of the toward the acquisition of the following assessment following Program tools: (B1.03e, B1.03g, Competencies: (B1.01b, B1.03e, B4.01a) B4.01a)

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

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

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

• Preceptor evaluation

• Clerkship specific patient encounter requirements

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

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

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

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

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

• Preceptor evaluation

• Clerkship specific patient encounter requirements

• Virtual Patient Case Assignment

• EOC Exam

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

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

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

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

• Preceptor evaluation

• Clerkship specific patient encounter requirements

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

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

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

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

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

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

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

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

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

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

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

(B3.07c)

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

• Virtual Patient Case Assignment

• EOC Exam

• Preceptor evaluation

• Drug cards

• Clerkship specific patient encounter requirements

• Virtual Patient Case Assignment

• EOC Exam

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

• Provides appropriate referrals (IC4).

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

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

• Preceptor Evaluation

• Clerkship specific patient encounter requirements

• Effectively complete oral presentations (IC3)

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

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

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

• Accurately evaluates adult patients (18-64 yo) with internal medicine conditions. (B3.03b, B3.07c)

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

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

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

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

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

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

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

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

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

• Preceptor Evaluation

• Clinical documentation assignment

• Clerkship specific patient encounter requirements

• Preceptor Evaluation

• Clerkship specific patient encounter requirements

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

• Accurately document medical information (IC2)

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

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

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

• Preceptor Evaluation

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

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

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

Instructional Objectives

Course Learning Outcomes Assessment Program

Tools Utilized Competencies

By the conclusion of the Internal Medicine Upon successful completion of this clerkship, students will demonstrate clerkship, students will attain the following Competency of The instructional objectives, competency in the following: (B1.01d, B1.03e, knowledge, interpersonal, clinical/technical instructional objectives learning outcomes, and B3.07c) skills, professional behaviors, clinical and learner outcomes successful completion of reasoning, and problem-solving abilities: are measured by course assessments guide (B1.01d, B1.03e, B3.07c)

successful completion students toward the acquisition of the following of the following Program assessment tools: Competencies: (B1.01b, B1.03e, (B1.03e, B1.03g, B4.01a) B4.01a)

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

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

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

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

• Preceptor evaluation

•

• Demonstrates empathy. (B3.07c)

• Demonstrates respect. (B3.07c)

• Demonstrates ethical behavior. (B3.07c)

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

• Preceptor evaluation

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

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

• Demonstrate empathetic and respectful behaviors. (PB1)

• Demonstrates and identifies appropriate ethical behavior. (PB4)

• Demonstrates reliability. (B3.07c)

• When presented with a patient with • Preceptor • Exhibit reliability,

• Demonstrates accountability. (B3.07c) an internal medicine condition, the evaluation accountability, and

• Demonstrates dependability. (B3.07c) student exhibits reliability, dependability. (PB2)

• Exhibits a positive approach to dependability, and is accountable.

• Demonstrates learning. (B3.07c) (B3.07c) accountability to patients, society, and the profession. (PB6)

• Demonstrates an understanding of • When presented with a patient with • Preceptor • Demonstrates an diverse health care needs. (B3.07c) an internal medicine condition, the student demonstrates the ability to understand the diverse needs of patients. (B3.07c) evaluation understanding of diverse health care needs (IC8).

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

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

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

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

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

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

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

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

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

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

• Synthesize and analyze clinical data correctly (CRPSA2).

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

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

CARDIOVASCULAR

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

PULMONOLOGY

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

GASTROINTESTINAL/NUTRITIONAL

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

ORTHOPEDICS/RHEUMATOLOGY

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

ENDOCRINOLOGY

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

NEUROLOGY

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

UROLOGY/RENAL

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

CRITICAL CARE

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

HEMATOLOGY

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

INFECTIOUS DISEASE

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

ARC-PA STANDARDS

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

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

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

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

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

e. for behavioral and mental health conditions.

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

a) emergency department,

b) inpatient, c) outpatient, and d) operating room.

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

a. family medicine,

b. emergency medicine,

c. internal medicine,

d. surgery,

e. pediatrics,

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

g. behavioral and mental health care.

STUDENT ASSESSMENT/EVALUATION (B1.03g)

Clerkship Specific Assessments

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

Clinical Documentation Assignment: H & P

of Clerkship Examination (EOC Exam)

Clerkship Specific Patient Encounter Requirements

Virtual Patient Case Assignment P/F

GRADING PLAN

(B1.03h)

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

Grade Calculations

CLERKSHIP SPECIFIC ASSESSMENTS

CLINICAL DOCUMENTATION ASSIGNMENT

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

Please note:

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

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

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

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

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

DRUG CARDS

PRECEPTOR EVALUATION

END OF CLERKSHIP EXAMINATION (EOC Exam)

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

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

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

CLERKSHIP SPECIFIC PATIENT ENCOUNTER REQUIREMENTS (Patient Logs)

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

Internal Medicine

Acute

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

10 encounters during the Internal medicine clerkship

Chronic 10 encounters during the Internal medicine clerkship

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

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

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

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

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

Emergent: Related to a medical condition requiring immediate intervention.

VIRTUAL PATIENT CASE ASSIGNMENT

CLINICAL YEAR REQUIRMENTS for GRADUATION

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

Clinical Year Patient Encounter Requirements P/F

Clinical Year Procedure Logging Requirements P/F

Quality Assurance/Performance Improvement Assignment P/F

Developmental Disabilities Logging Requirement and Reflective Journaling P/F

Longitudinal Patient Case with Medical Documentation Submission P/F

CLINICAL YEAR PATIENT ENCOUNTER REQUIREMENTS (Patient logs)

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

Types of Clinical Encounters

Preventative

Acute

Chronic

Emergent

20 encounters during clinical year

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

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

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

Emergent: Related to a medical condition requiring immediate intervention.

Medical Care Across the Life Span Encounters

Infants-less than 1 years of age

Children-1-11 y/o

Adolescents-12-17 y/o

Adults-18-64 y/o

Elderly 65 and older

15 encounters during the clinical year

30 encounters during the clinical year

100 encounters during the clinical year

CLINICAL YEAR PROCEDURE LOGGING REQUIREMENTS

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

REQUIRED CLINICAL YEAR PROCEDURES/EXAMINATIONS

QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT ASSIGNMENT

Summary:

1. Go to Canvas

2. Go to course PHA 227

3. Click on “discussion board” on left side

4. Click on “Patient Safety Institute CO 2025”

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

6. Follow instructions for the discussion board

DEVELOPMENTAL DISABILITIES LOGGING REQUIREMENT AND REFLECTIVE JOURNALING

Logging requirement:

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

Types of Clinical Encounters

Developmental Disabilities 15 encounters during clinical year

journal on Exxat. From the dashboard • placements • by session • to do list • session required documents • developmental disability reflective journaling. Title each journal entry adhering to the following format: “Clinical Encounter Number X”. Submissions will be reviewed by the program at the end of the 6th clerkship and the 8th clerkship. When submitting documents, ONLY submit at the end of these two clerkships and ensure that all journal entries are submitted as one “running” document. For example, if you submit journal entries 1, 2 and 3 at the end of rotation 6, when you submit at the end of rotation 8, you will submit one “running document” with journal entries 1 -3 and 4 & 5. This process ensures student deficiencies are identified and addressed in a timely manner. Should a student be at risk of not completing this assignment during the clinical year, students must formulate a plan with one of the clinical coordinators to assure completion. Completion is required by the end of the clinical year and for graduation. Failure of students to participate satisfactorily in this project by the end of the last clinical rotation will result in an "Incomplete" for the final clinical rotation. An incomplete remains until the student completes the requirement.

LONGITUDINAL PATIENT CASE with MEDICAL DOCUMENTATION SUBMISSION

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

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

CLERKSHIP BIBLIOGRAPHY

however, faculty encourage students to utilize more advanced resources during their clinical year such as those found through your access medicine and Up-to-Date accounts.

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

PHA 260 WOMEN’S HEALTH CLERKSHIP 3 S.H. (B1.03a, B3.03c, B3.07f)

COURSE COORDINATOR (B1.03c)

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

COURSE DESCRIPTION (B1.03b)

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

COURSE GOAL (B1.03d)

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

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

Instructional Objectives Course Learning Outcomes Assessment Program

Tools Utilized Competencies

By the conclusion of the Women’s Upon successful completion of this Health clerkship, students will clerkship, students will attain the Competency of The instructional demonstrate competency in the following knowledge, interpersonal, instructional objectives, learning following: (B1.01d, B1.03e, B3.03c, clinical/technical skills, professional objectives and outcomes, and successful B3.07f) behaviors, clinical reasoning, and learner outcomes completion of course problem-solving abilities: (B1.01d, B1.03e, are measured by assessments guide students B3.03c, B3.07f) successful toward the acquisition of completion of the following Program the following Competencies: (B1.01b, assessment tools: B1.03e, B4.01a) (B1.03e, B1.03g, B4.01a)

• Elicits a detailed history for patients presenting women’s health concerns. (B3.03c, B4.07f)

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

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

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

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

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

•

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

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

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

• Preceptor evaluation

• Clerkship specific patient encounter requirements

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

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

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

• Preceptor evaluation

• Clerkship specific patient encounter requirements

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

• Formulate a differential diagnosis for patients with women’s health concerns. (B3.03c, B4.07f)

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

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

• Creates a pharmacological plan for patients with women’s health concerns. (B3.03c, B4.07f)

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

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

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

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

• Provides effective prenatal counseling for patients with a women’s health concern. (B3.03c, B4.07f)

• Emphasizes shared decision making for patients with a women’s health concern. (B3.03c, B4.07f)

• Provides patient education related to family planning to patients with

• When presented with a patient with a women’s health concern, the student will be able to develop a differential diagnosis and determine the most likely diagnosis. (B3.03c, B4.07f)

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

• EOC Exam

• Preceptor evaluation

• Clerkship specific patient encounter requirements

• EOC Exam

• Preceptor evaluation

• Drug cards

• Clerkship specific patient encounter requirements

• EOC Exam

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

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

• Provides appropriate referrals (IC4).

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

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

women’s health concerns. (B3.03c, B4.07f)

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

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

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

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

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

• Preceptor Evaluation

• Clerkship specific patient encounter requirements

• Preceptor evaluation

• Clinical Documentation Assignment

• Clerkship specific patient encounter requirements

• Effectively complete oral presentations (IC3)

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

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

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

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

• Accurately evaluates adult patients (18-64 yo) with conditions associated with women’s health care (B3.03b, B3.07f)

• Accurately evaluates elderly patents (65 and older) with conditions

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

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

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

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

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

• Preceptor evaluation

• Clerkship specific patient encounter requirements

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

• Accurately document medical information (IC2)

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

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

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

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

associated with women’s health care (B3.03b, B3.07f)

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

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

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

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

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

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

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

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

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

Instructional Objectives

Course Learning Outcomes Assessment Program Tools Utilized Competencies

By the conclusion of the Women’s Health Upon successful completion of this clerkship, students will demonstrate clerkship, students will attain the following Competency of The instructional objectives, competency in the following: (B1.01d, B1.03e, knowledge, interpersonal, clinical/technical instructional objectives learning outcomes, and B3.03c, B3.07f) skills, professional behaviors, clinical and learner outcomes successful completion of reasoning, and problem-solving abilities: are measured by course assessments guide (B1.01d, B1.03e, B3.03c, B3.07f)

successful completion students toward the acquisition of the following of the following Program assessment tools: Competencies: (B1.01b, B1.03e, (B1.03e, B1.03g, B4.01a) B4.01a)

• Effectively communicates with • When presented with a patient with a • Preceptor • Use effective interviewing patients. (B3.03c, B3.07f) women’s health concern, the student evaluation skills to elicit a detailed

• Effectively communicates with will develop relationships that result history. (IC1) families. (B3.03c, B3.07f) in effective communication with

• Understands the

• Effectively communicates with patients, their families, and members importance of effective members of the health care team. of the interprofessional team. (B3.03c, communication with (B3.03c, B3.07f) B3.07f) patients, families,

• physicians, and other members of the care team. (IC7)

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

• When presented with a patient with a • Preceptor • Demonstrate empathetic

• Demonstrates respect. (B3.03c, B3.07f) women’s health concern, the student evaluation and respectful behaviors.

• Demonstrates ethical behavior. (B3.03c, demonstrates empathy, respect, and (PB1) B3.07f) appropriate ethical behavior. (B3.03c, B3.07f)

• Demonstrates and identifies appropriate ethical behavior. (PB4)

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

• When presented with a patient with a • Preceptor • Exhibit reliability,

• Demonstrates accountability. (B3.03c, women’s health concern, the student evaluation accountability, and B3.07f) exhibits reliability, dependability, dependability. (PB2)

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

• Demonstrates B3.07f)

• Exhibits a positive approach to learning. (B3.03c, B3.07f) accountability to patients, society, and the profession (PB6).

• Demonstrate an understanding of • When presented with a patient with a • Preceptor • Demonstrates an diverse health care needs. (B3.03c, women’s health concern, the student evaluation understanding of diverse B3.07f) demonstrates the ability to understand the diverse needs of patients. (B3.03c, B3.07f) health care needs (IC8).

• Utilize appropriate clinical reasoning

• When presented with a patient with a • Preceptor • Utilize and problem-solving abilities. (B3.03c, women’s health concern, the student evaluation appropriate B3.07f) will be able to utilize the clinical clinical

• Analyze clinical data correctly. (B3.03c, reasoning and problem-solving reasoning and B3.07f) abilities, inclusive of synthesizing and analyzing clinical data, to appropriately evaluate the patient. (B3.03c, B3.07f) problemsolving abilities to identify and manage

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

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

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

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

• When presented with a patient with a women’s health concern, the student will be able to provide effective, safe, equitable, and high-quality care.

(B3.03c, B3.07f)

medical conditions (CRPSA1).

• Synthesize and analyze clinical data correctly (CRPSA2).

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

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

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

MENSTRUATION

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

INFECTIONS

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

NEOPLASMS

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

DISORDERS OF THE BREAST

Breast abscess, Breast fibroadenoma, Fibrocystic disease, Mastitis

STRUCTURAL ABNORMALITIES

Cystocele, Ovarian torsion, Rectocele, Uterine prolapse

OTHER

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

PRENATAL CARE/NORMAL PREGNANCY

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

PREGNANCY COMPLICATIONS

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

LABOR AND DELIVERY COMPLICATIONS

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

POSTPARTUM CARE

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

ARC-PA STANDARDS

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

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

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

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

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

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

e. for behavioral and mental health conditions.

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

b. emergency medicine,

c. internal medicine,

d. surgery,

e. pediatrics,

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

STUDENT ASSESSMENT/EVALUATION

(B1.03g)

Clerkship Specific Assessments

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

Clinical Documentation Assignment 15% Drug Cards

Preceptor Evaluation 50%

End of Clerkship Examination (EOC Exam) 35%

Clerkship Specific Patient Encounter Requirements

GRADING

PLAN (B1.03h)

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

Grade Calculations

CLERKSHIP SPECIFIC ASSESSMENTS

CLINICAL DOCUMENTATION ASSIGNMENT

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

Please note:

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

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

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

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

DRUG CARDS

PRECEPTOR EVALUATION

END OF CLERKSHIP EXAMINATION (EOC Exam)

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

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

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

CLERKSHIP SPECIFIC PATIENT ENCOUNTER REQUIREMENTS (Patient Logs)

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

coordinators to meet these competencies. Competency in these areas is required for course completion and graduation and a grade of “I” incomplete will be given until all patient encounter requirements are completed.

Women’s Health

Prenatal Care

Gynecologic Care

Preventive

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

15 encounters during the Women’s Health clerkship

5 encounters during the Women’s Health clerkship

Acute 5 encounters during the Women’s Health clerkship

Chronic 5 encounters during the Women’s Health clerkship

Emergent 2 encounters during the Women’s Health clerkship

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

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

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

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

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

Emergent: Related to a medical condition requiring immediate intervention.

CLINICAL YEAR REQUIRMENTS for GRADUATION

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

Clinical Year Patient Encounter Requirements P/F

Clinical Year Procedure Logging Requirements

Quality Assurance/Performance Improvement Assignment

Developmental Disabilities Logging Requirement and Reflective Journaling

Longitudinal Patient Case with Medical Documentation Submission

CLINICAL YEAR PATIENT ENCOUNTER REQUIREMENTS (Patient logs)

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

Preventative

Types of Clinical Encounters

20 encounters during clinical year

Acute 20 encounters during clinical year

Chronic 20 encounters during clinical year

Emergent 20 encounters during clinical year

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

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

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

Emergent: Related to a medical condition requiring immediate intervention.

Medical Care Across the Life Span Encounters

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

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

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

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

Elderly-65 and older 100 encounters during the clinical year

CLINICAL YEAR PROCEDURE LOGGING REQUIREMENTS

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

REQUIRED CLINICAL YEAR PROCEDURES/EXAMINATIONS

QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT ASSIGNMENT

Summary:

1. Go to Canvas

2. Go to course PHA 227

3. Click on “discussion board” on left side

4. Click on “Patient Safety Institute CO 2025”

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

6. Follow instructions for the discussion board

DEVELOPMENTAL DISABILITIES LOGGING REQUIREMENT AND REFLECTIVE JOURNALING

Logging requirement:

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

Types of Clinical Encounters

Developmental Disabilities 15 encounters during clinical year

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

LONGITUDINAL PATIENT CASE with MEDICAL DOCUMENTATION SUBMISSION

The longitudinal patient case is completed over the clinical year. It is designed to allow students to simulate care for a patient over a prolonged period. Thus, the student begins with an initial visit with the simulated patient and then evaluates the “same patient” over the course of the clinical year. At each visit, the patient’s health care needs may change, simulating care of a patient longitudinally. Students must obtain the necessary history, perform a physical examination, order and interpret diagnostic studies, formulate an assessment, and formulate a plan in a simulated environment. After the clinical encounter, a debrief session led by faculty will focus on communication skills, clinical skills, history taking, physical exam skills, assessment and plan formulation. After each longitudinal patient encounter, students must submit a SOAP note documenting the encounter. The SOAP note must be submitted to Exxat within 72 hours of call back day. Students can submit their SOAP note on Exxat. From the dashboard • placements • by session • to do list • session required documents • longitudinal patient case SOAP note. Please make sure to upload under the correct rotation.

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

CLERKSHIP BIBLIOGRAPHY

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

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

COURSE COORDINATOR (B1.03c)

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

Office: 516-463-6841

COURSE DESCRIPTION (B1.03b)

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

COURSE GOAL (B1.03d)

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

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

Instructional Objectives Course Learning Outcomes Assessment Tools Program

Utilized Competencies

By the conclusion of the Surgery clerkship, Upon successful completion of this students will demonstrate competency in the clerkship, students will attain the following Competency of The instructional objectives, following: (B1.01d, B1.03e, B3.03d, B3.07d) knowledge, interpersonal, clinical/technical instructional objectives learning outcomes, and successful skills, professional behaviors, clinical and learner outcomes are completion of course assessments reasoning, and problem-solving abilities: measured by successful guide students toward the (B1.01d, B1.03e, B3.03d, B3.07d) completion of the acquisition of the following following assessment Program Competencies: (B1.01b, tools: (B1.03e, B1.03g, B1.03e, B4.01a) B4.01a)

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

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

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

• Preceptor evaluation

• Clerkship specific patient encounter requirements

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

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

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

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

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

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

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

• Preceptor evaluation

• Clerkship specific patient encounter requirements

• EOC Exam

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

• Formulates a management plan that uses consultations appropriately for

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

• When presented with a patient with a surgical condition, focusing on

• Preceptor evaluation

• Clerkship specific patient encounter requirements

• EOC Exam

• Preceptor evaluation

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

• Identify and formulate an appropriate assessment

patients with a surgical condition.

(B3.03d, B3.07d)

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

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

• Formulates a plan inclusive of

appropriate referrals for patients with a surgical condition. (B3.03d, B3.07d)

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

• Provides effective patient education to patients with surgical conditions.

(B3.03d, B3.07d)

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

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

• Performs effective oral presentations

shared decision making, the student will be able to formulate a management plan including the use of appropriate consults, pharmacologic plan, nonpharmacologic care, referral, follow up and patient education.

(B3.03d, B3.07d)

• Drug cards

• Clerkship specific patient encounter requirements

• EOC Exam and management plan (MK6).

• Provides appropriate referrals (IC4).

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

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

• When presented with a patient with

• Preceptor • Effectively complete oral for patients with a surgical condition. a surgical condition, the student Evaluation presentations (IC3) (B3.03d, B3.07d) will effectively orally present patients. (B3.03d, B3.07d)

• Clerkship specific patient encounter requirements

• Accurately documents patient data for

• When presented with a patient with

• Preceptor

• Elicit a detailed medical patients with a surgical condition. a surgical condition, the student Evaluation history, perform (B3.03d, B3.07d) will accurately record all data.

• Clinical appropriate physical (B3.03d, B3.07d) Documentation examination, and Assignment accurately record all

• Clerkship pertinent data. (MK5) specific patient

• Accurately document encounter medical information requirements (IC2)

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

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

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

• Accurately evaluates adult patients (18-64 yo) with surgical conditions (B3.03b, B3.07d)

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

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

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

• Accurately assists with the care of

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

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

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

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

• Preceptor Evaluation

• Clerkship specific patient encounter requirements

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

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

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

• When caring for a patient with a • Preceptor • Utilize appropriate clinical patients requiring surgical surgical condition in the operating Evaluation reasoning and problemmanagement in the intra-operative room, students can assist with patient • Clerkship solving abilities to identify setting. (B3.03d, B3.04d, B3.07d)

care during the intra-operative procedure. (B3.03d, B3.04d, b3.07d)

• Accurately evaluates patients for post-

• When in a Surgery setting, the

specific patient encounter requirements and manage medical conditions. (CRPSA1)

• Preceptor • Elicit a detailed medical operative infection. (B3.03d, B3.07d) student will be able to Evaluation history, perform

• Accurately evaluates patients with appropriately evaluate patients with appropriate physical cholecystitis. (B3.03d, B3.07d) common conditions such as examination, and

• Accurately evaluates patients with cholecystitis, intestinal obstruction, accurately record all intestinal obstruction. (B3.03d, B3.07d) and evaluates for post-operative infection. (B3.03d, B3.07d) pertinent data. (MK5)

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

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

Instructional Objectives Course Learning Outcomes Assessment Program

Tools Utilized Competencies

By the conclusion of the Surgery clerkship, Upon successful completion of this students will demonstrate competency in the clerkship, students will attain the following Competency of The instructional objectives, following: (B1.01d, B1.03e, B3.03d, B3.07d) knowledge, interpersonal, clinical/technical instructional objectives learning outcomes, and skills, professional behaviors, clinical and learner outcomes successful completion of reasoning, and problem-solving abilities: are measured by course assessments guide (B1.01d, B1.03e, B3.03d, B3.07d successful completion students toward the acquisition of the following of the following Program assessment tools: Competencies: (B1.01b, B1.03e, (B1.03e, B1.03g, B4.01a) B4.01a)

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

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

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

• When presented with a patient with a Surgical condition, the student will develop relationships that result in effective communication with patients, their families, and members of the interprofessional team. (B3.03d, B3.07d)

• Preceptor evaluation

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

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

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

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

• Preceptor evaluation

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

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

• Demonstrate empathetic and respectful behaviors. (PB1)

• Demonstrates and identifies appropriate ethical behavior. (PB4)

• Demonstrates reliability. (B3.03d, • When presented with a patient with a • Preceptor • Exhibit reliability, B3.07d) Surgical condition, the student evaluation accountability, and

• Demonstrates accountability. (B3.03d, exhibits reliability, dependability, dependability. (PB2) B3.07d)

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

• Exhibits a positive approach to and is accountable. (B3.03d, B3.07d)

• Demonstrates accountability to patients, society, and the profession learning. (B3.03d, B3.07d) (PB6).

• Demonstrate an understanding of • When presented with a patient with a • Preceptor • Demonstrates an diverse health care needs. (B3.03d, Surgical condition, the student evaluation understanding of diverse B3.07d) demonstrates the ability to understand the diverse needs of patients. (B3.03d, B3.07d) health care needs (IC8).

• Utilize appropriate clinical reasoning

• When presented with a patient with a • Preceptor • Utilize appropriate clinical and problem-solving abilities. (B3.03d, Surgical condition, the student will evaluation reasoning and problemB3.07d) be able to utilize clinical reasoning solving abilities to

• Analyze clinical data correctly. (B3.03d, and problem-solving abilities, identify and manage B3.07d) inclusive of synthesizing and analyzing clinical data, to appropriately evaluate the patient. (B3.03d, B3.07d) medical conditions (CRPSA1).

• Synthesize and analyze clinical data correctly (CRPSA2).

• Demonstrate care that is effective.

• When presented with a patient with a • Preceptor • Demonstrate care that is (B3.03d, B3.07d) Surgical condition, the student will evaluation effective, safe, equitable,

• Demonstrate care that is safe. (B3.03d, be able to provide effective, safe, and high quality B3.07d)

• Demonstrate care that is equitable. (B3.03d, B3.07d) equitable, and high-quality care. (B3.03d, B3.07d) (CRPSA4).

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

OUTLINE OF TOPICS COVERED IN THIS COURSE

(B1.03f)

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

GASTROINTESTINAL/NUTRITIONAL

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

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

CARDIOVASCULAR/VASCULAR

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

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

PULMONARY/THORACIC SURGERY

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

Pulmonary/thoracic surgery procedures: Chest tube, Thoracentesis

BREAST SURGERY

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

Breast surgery procedures: Biopsy

DERMATOLOGY

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

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

UROLOGY/RENAL

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

Urology/renal procedures: Lithotripsy, Urinary catheterization, Vasectomy

TRAUMA/ACUTE CARE

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

Trauma/acute care procedures: Transfusion

NEUROLOGY/NEUROSURGERY

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

Neurology/neurosurgery procedures: Lumbar puncture

PAIN MEDICINE/ANESTHESIA

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

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

ENDOCRINOLOGY

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

Endocrinology procedures: Fine needle biopsy

ARC-PA STANDARDS

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

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

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

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

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

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

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

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

a. family medicine,

b. emergency medicine,

c. internal medicine,

d. surgery,

e. pediatrics,

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

g. behavioral and mental health care.

STUDENT ASSESSMENT/EVALUATION (B1.03g)

Clerkship Specific Assessments

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

Clinical Documentation Assignment: SOAP Note

Cards

Evaluation

of Clerkship Examination (EOC Exam)

Specific Patient Encounter Requirements

GRADING PLAN (B1.03h)

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

Grade Calculations

CLERKSHIP SPECIFIC ASSESSMENTS

CLINICAL DOCUMENTATION ASSIGNMENT

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

Please note:

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

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

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

• Photocopies are not acceptable.

• SOAP notes are not acceptable on hospital forms.

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

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

DRUG CARDS

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

PRECEPTOR EVALUATION

END OF CLERKSHIP EXAMINATION (EOC Exam)

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

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

CLERKSHIP SPECIFIC PATIENT ENCOUNTER REQUIREMENTS (Patient Logs)

patient experiences prior to this time. More than one failure to log minimum weekly patient encounters on time will result in a three (3) point deduction from the OVERALL ROTATION GRADE. Each additional failure to log will result in a one (1) point deduction from the overall rotation grade. Students are contacted if the weekly review identifies deficiencies in patient care experiences. A clinical coordinator will discuss methods of assuring requirements are achieved and maximizing clinical opportunities for the remaining time in the clerkship.

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

Surgery

Pre-operative

Intra-operative

Post-operative

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

10 encounters during the Surgery clerkship

Acute 5 encounters during the Surgery clerkship

Chronic

Emergent

Adults-18-64 yo

Elderly -65 and older

5 encounters during the Surgery clerkship

2 encounters during the Surgery clerkship

10 encounters during the Surgery clerkship

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

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

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

Emergent: Related to a medical condition requiring immediate intervention.

CLINICAL YEAR REQUIRMENTS for GRADUATION

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

Clinical Year Patient Encounter Requirements P/F

Clinical Year Procedure Logging Requirements P/F

Quality Assurance/Performance Improvement Assignment P/F

Developmental Disabilities Logging Requirement and Reflective Journaling P/F

CLINICAL YEAR PATIENT ENCOUNTER REQUIREMENTS (Patient logs)

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

Types of Clinical Encounters

Preventative

Acute

Chronic

Emergent

20 encounters during clinical year

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

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

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

Emergent: Related to a medical condition requiring immediate intervention.

Medical Care Across the Life Span Encounters

Infants-less than 1 years of age

Children-1-11 y/o

Adolescents-12-17 y/o

Adults-18-64 y/o

Elderly -65 and older

15 encounters during the clinical year

30 encounters during the clinical year

100 encounters during the clinical year

CLINICAL YEAR PROCEDURE LOGGING REQUIREMENTS

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

REQUIRED CLINICAL YEAR PROCEDURES/EXAMINATIONS

QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT ASSIGNMENT

simply enhance student learning in quality assurance. This is pass/fail and must be completed before the end of the eight clinical clerkships. If a student fails to complete this activity, before the completion of the eighth clinical clerkship, they will be required to submit a separate document answering all the discussion boards with at least 500 words, and 2 references for each post. Completion is required by the end of the clinical year and for graduation. Failure of students to participate satisfactorily in this project by the end of the last clinical rotation will result in an "Incomplete" for the final clinical rotation. An incomplete remains until the student completes the requirement.

Summary:

1. Go to Canvas

2. Go to course PHA 227

3. Click on “discussion board” on left side

4. Click on “Patient Safety Institute CO 2025”

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

6. Follow instructions for the discussion board

DEVELOPMENTAL DISABILITIES LOGGING REQUIREMENT AND REFLECTIVE JOURNALING

Logging requirement:

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

Types of Clinical Encounters

Developmental Disabilities 15 encounters during clinical year

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

LONGITUDINAL PATIENT CASE with MEDICAL DOCUMENTATION SUBMISSION

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

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

CLERKSHIP BIBLIOGRAPHY

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

PHA 270 EMERGENCY MEDICINE CLERKSHIP 3 S.H. (B1.03a, B3.04a, B3.07b)

COURSE COORDINATOR (B1.03c)

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

Office: 516-463-4233

COURSE DESCRIPTION (B1.03b)

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

COURSE GOAL (B1.03d)

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

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

Instructional Objectives Course Learning Outcomes Assessment Program

Tools Utilized Competencies

By the conclusion of the Emergency Upon successful completion of this Medicine clerkship, students will demonstrate clerkship, students will attain the following Competency of The instructional competency in the following: (B1.01d, B1.03e, knowledge, interpersonal, clinical/technical instructional objectives, learning B3.04a, B3.07b) skills, professional behaviors, clinical objectives and outcomes, and successful reasoning, and problem-solving abilities: learner outcomes completion of course (B1.01d, B1.03e, B3.04a, B3.07b) are measured by assessments guide students successful toward the acquisition of completion of the the following Program following Competencies: (B1.01b, assessment tools: B1.03e, B4.01a) (B1.03e, B1.03g, B4.01a)

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

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

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

• Preceptor evaluation

• Interesting patient case

• Simulation Experience

• Clerkship specific patient encounter requirements

•

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

• Interpret diagnostic studies for patients with an emergency medicine condition. (B3.04a, B3.07b)

• When presented with a patient with an emergency medicine condition, the student will be able to appropriately use diagnostic studies to aid in the diagnosis. (B3.04a, B3.07b)

• Preceptor evaluation

• Interesting patient case

• Simulation Experience

• Clerkship specific patient encounter requirements

• EOC Exam

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

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

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

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

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

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

• Preceptor evaluation

• Interesting patient case

• Simulation Experience

• Clerkship specific patient encounter requirements

• EOC Exam

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

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

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

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

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

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

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

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

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

• Preceptor evaluation

• Interesting patient case

• Simulation Experience

• Drug cards

• Clerkship specific patient encounter requirements

• EOC Exam

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

• Provides appropriate referrals (IC4).

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

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

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

• Performs effective oral presentations

• When presented with a patient with

• Preceptor • Effectively complete oral for patients with an emergency an emergency medicine condition, Evaluation presentations (IC3) medicine condition. (B3.04a, B3.07b) the student will effectively orally present patients. (B3.04a, B3.07b)

• Clerkship specific patient encounter requirements

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

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

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

• Accurately evaluates adult patients (18-64 yo) with emergency medicine conditions (B3.03b, B3.07b)

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

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

• Preceptor Evaluation

• Clerkship specific patient encounter requirements

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

• Accurately document medical information (IC2)

• Accurately evaluates patients with

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

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

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

• When in an Emergency

• Preceptor Evaluation

• Clerkship specific patient encounter requirements

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

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

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

• Preceptor

• Elicit a detailed medical chest pain. (B3.04a, B3.07b)

Department setting, the student can Evaluation history, perform

• Accurately evaluates patients with appropriately evaluate patients with appropriate physical abdominal pain. (B3.04a, B3.07b) common complaints such as chest examination, and

• Accurately evaluates patients with pain, abdominal pain, and shortness accurately record all shortness of breath. (B3.04a, B3.07b) of breath. (B3.04a, B3.07b) pertinent data. (MK5)

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

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

Instructional Objectives Course Learning Outcomes Assessment Program

Tools Utilized Competencies

By the conclusion of the Emergency Upon successful completion of this Medicine clerkship, students will clerkship, students will attain the following Competency of The instructional objectives, demonstrate competency in the following: knowledge, interpersonal, clinical/technical instructional objectives learning outcomes, and (B1.01d, B1.03e, B3.04a, B3.07b) skills, professional behaviors, clinical and learner outcomes successful completion of reasoning, and problem-solving abilities: are measured by course assessments guide (B1.01d, B1.03e, B3.04a, B3.07b)

successful completion students toward the acquisition of the following of the following Program assessment tools: Competencies: (B1.01b, B1.03e, (B1.03e, B1.03g, B4.01a) B4.01a)

• Effectively communicates with patients. (B3.04a, B3.07b)

• Effectively communicates with families. (B3.04a, B3.07b)

• Effectively communicates with members of the health care team. (B3.04a, B3.07b)

• When presented with a patient with an emergency medicine condition, the student will develop relationships that result in effective communication with patients, their families, and members of the interprofessional team. (B3.04a, B3.07b)

• Preceptor evaluation

•

• Demonstrates empathy. (B3.04a, B3.07b)

• Demonstrates respect. (B3.04a, B3.07b)

• When presented with a patient with an emergency medicine condition, the student demonstrates empathy,

• Preceptor evaluation

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

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

• Demonstrate empathetic and respectful behaviors. (PB1)

• Demonstrates ethical behavior. (B3.04a, B3.07b) respect, and ethical behavior. (B3.04a, B3.07b)

• Demonstrates and identifies appropriate ethical behavior. (PB4)

• Demonstrates reliability. (B3.04a, • When presented with a patient with • Preceptor • Exhibit reliability, B3.07b) an emergency medicine condition, evaluation accountability, and

• Demonstrates accountability. (B3.04a, the student exhibits reliability, dependability. (PB2) B3.07b) dependability, and is accountable.

• Demonstrates

• Demonstrates dependability. (B3.04a, (B3.04a, B3.07b) accountability to patients, B3.07b)

• Exhibits a positive approach to learning. (B3.04a, B3.07b) society, and the profession (PB6).

• Demonstrate an understanding of • When presented with a patient with • Preceptor • Demonstrates an diverse health care needs. (B3.04a, an emergency medicine condition, evaluation understanding of diverse B3.07b) the student demonstrates the ability to understand the diverse needs of patients. (B3.04a, B3.07b) health care needs (IC8).

• Utilize appropriate clinical reasoning

• When presented with a patient with

• Preceptor • Utilize appropriate clinical and problem-solving abilities to an emergency medicine condition, evaluation reasoning and problemidentify and manage medical the student will be able to utilize the solving abilities to conditions. (B3.04a, B3.07b) clinical reasoning and problemidentify and manage

• Analyze clinical data correctly. (B3.04a, solving abilities, inclusive of medical conditions B3.07b) synthesizing and analyzing clinical data, to appropriately evaluate the patient. (B3.04a, B3.07b) (CRPSA1).

• Synthesize and analyze clinical data correctly (CRPSA2).

• Demonstrate care that is effective.

• When presented with a patient with • Preceptor • Demonstrate care that is (B3.04a, B3.07b) an emergency medicine condition, evaluation effective, safe, equitable,

• Demonstrate care that is safe. (B3.04a, the student will provide effective, and high quality B3.07b)

• Demonstrate care that is equitable. (B3.04a, B3.07b)

• Demonstrate care that is high quality. (B3.04a, B3.07b)

safe, equitable, and high-quality care. (B3.04a, B3.07b) (CRPSA4).

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

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

CARDIOVASCULAR

Acute/subacute bacterial endocarditis, Angina, Arrhythmias, Cardiac tamponade, Chest pain, Conduction disorders (atrial fibrillation/flutter, supraventricular tachycardia, bundle branch block, ventricular tachycardia/fibrillation, premature beats), Coronary heart disease (non-ST acute myocardial infarction, ST segment elevation acute myocardial infarction, angina pectoris, unstable angina, Prinz metal/variant angina), Dyspnea on exertion, Edema, Heart failure, Hypertensive emergencies, Hypotension (cardiogenic shock, orthostatic hypotension) Orthopnea, Palpitations, Pericardial effusion, Peripheral vascular disease, Syncope, Valvular disease (aortic stenosis, aortic regurgitation, mitral stenosis, mitral regurgitation), Vascular disease (aortic aneurysm/dissection, arterial occlusion/thrombosis, phlebitis)

ORTHOPEDICS/RHEUMATOLOGY

Back strain/sprain, Bursitis/tendonitis, Cauda equina, Costochondritis, Ecchymosis/erythema, Fractures/dislocations (shoulder, forearm/wrist/hand, hip, knee, ankle/foot), Gout, Herniated disk, Low back pain, Osteomyelitis, Pain, Septic arthritis, soft tissue injuries, Sprains/strains Swelling/deformity

GASTROINTESTINAL/NUTRITIONAL

Abdominal pain, Acute appendicitis, Acute cholecystitis, Acute hepatitis, Acute pancreatitis, Anal fissure/fistula/abscess, Anorexia, Change in bowel habits/diarrhea/constipation, Cholangitis, Cirrhosis, Diarrhea/constipation, Diverticular disease, Esophagitis, Gastritis, Gastroenteritis, Gastrointestinal bleeding, Giardiasis and other parasitic infections, Heartburn, Hematemesis, Hemorrhoids (thrombosed), Hernia (incarcerated/strangulated), Infectious diarrhea, Inflammatory bowel disease/toxic megacolon, Ischemic bowel disease, Jaundice, Mallory-Weiss tear, Melena; bleeding per rectum, Nausea/vomiting, Obstruction (small bowel, large bowel, volvulus), Peptic ulcer disease

PULMONOLOGY

Acute bronchiolitis, Acute bronchitis, Acute epiglottitis, Acute respiratory distress syndrome, Asthma, Croup, Foreign body aspiration, Hemoptysis, Influenza, Lung cancer, Pertussis, Pleural effusion, Pleuritic chest pain, Pneumonia (bacterial, viral, fungal, human immunodeficiency virus-related), Pneumothorax, Pulmonary embolism, Respiratory syncytial virus, Shortness of breath, Tuberculosis, Wheezing

NEUROLOGY

Altered level of consciousness/coma, Bell palsy, Encephalitis, Epidural/subdural hematoma, Guillain-Barré syndrome, Head trauma/concussion/contusion, Headache (migraine, cluster, tension), Intracerebral hemorrhage, Loss of consciousness/change in mental status, Loss of coordination/ataxia, Loss of memory, Meningitis, Numbness/paresthesia, Seizure (symptom), Seizure disorders, Spinal

cord injury, Status epilepticus, Stroke, Subarachnoid hemorrhage/cerebral aneurysm, Syncope, Transient ischemic attack, Vertigo, Weakness/paralysis

ENT/OPHTHALMOLOGY

Acute laryngitis, Acute otitis media, Acute pharyngitis (viral, bacterial), Acute sinusitis, Allergic rhinitis, Barotrauma, Blepharitis, Blowout fracture, Conjunctivitis, Corneal abrasion/ulcer, Dacryoadenitis, Dental abscess, Ear pain, Epiglottitis, Epistaxis, Foreign body (eye, ear, nose), Glaucoma (acute angle closure), Hyphemia, Labyrinthitis, Macular degeneration (wet), Mastoiditis, Nasal congestion, Optic neuritis, Orbital cellulitis, Otitis externa, Papilledema, Peritonsillar abscess, Retinal detachment, Retinal vein occlusion, Sore throat, Trauma/hematoma (external ear), Tympanic membrane perforation, Vertigo, Vision loss

UROLOGY/RENAL

Acid/base disorders, Acute renal failure, Incontinence, Nephrolithiasis, Cystitis, Dysuria, Epididymitis, Fluid and electrolyte disorders, Glomerulonephritis, Hematuria, Hernias, Orchitis, Prostatitis, Pyelonephritis, Suprapubic/flank pain, Testicular torsion, Urethritis

DERMATOLOGY

Bullous pemphigoid, Burns, Cellulitis, Dermatitis (eczema, contact), Discharge, Drug eruptions, Erysipelas, Herpes zoster, Impetigo, Itching, Lice, Pilonidal disease, Pressure sores, Rash, Scabies, Spider bites, Stevens-Johnson syndrome, Toxic epidermal necrolysis, Urticaria, Viral exanthems

ENDOCRINOLOGY

Adrenal insufficiency, Cushing disease, Diabetes insipidus, Diabetes mellitus, Diabetic ketoacidosis, Heat/cold intolerance, Hyperparathyroidism, Hyperthyroidism, Hypothyroidism, Nonketotic hyperglycemia, Palpitations, Thyroiditis, Tremors

OBSTETRICS/GYNECOLOGY

Amenorrhea, Pelvic inflammatory disease, Dysfunctional uterine bleeding, Pelvic pain/dysmenorrhea, Ectopic pregnancy, Placenta abruption, Endometriosis, Placenta previa, Fetal distress, Premature rupture of membranes, Intrauterine pregnancy, Spontaneous abortion, Mastitis/breast abscess, Vaginal discharge, Ovarian cysts, Vaginitis

PSYCHIATRY/BEHAVIORAL MEDICINE

Anxiety disorders, Bipolar and related disorders, Depressive disorders, Neurocognitive disorders, Panic disorder, Posttraumatic stress disorder, Schizophrenia, spectrum and other psychotic disorders, Spouse or partner neglect/violence, Substance use disorders, Suicide

HEMATOLOGY

Acute leukemia, Anemia, Aplastic anemia, Clotting factor disorders, Easy bruising, Fatigue, Hemolytic anemia, Hypercoagulable states, Lymphomas, Polycythemia, Sickle cell anemia/crisis, Thrombocytopenia

ARC-PA STANDARDS

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

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

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

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

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

e. for behavioral and mental health conditions.

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

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

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

a. family medicine,

b. emergency medicine,

c. internal medicine,

d. surgery,

e. pediatrics,

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

g. behavioral and mental health care.

STUDENT ASSESSMENT/EVALUATION

(B1.03g)

Clerkship Specific Assessments

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

Patient Case

GRADING PLAN (B1.03h)

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

Grade Calculations

CLERKSHIP SPECIFIC ASSESSMENTS

INTERESTING PATIENT CASE ASSIGNMENT

An interesting patient case assignment is a requirement during the Emergency Medicine clerkship. The interesting case will either be presented on a site visit or uploaded onto Exxat prior to the start of call back day. All interesting patient case assignments should include all elements of a focused H&P, a written summary of the pathophysiology of the disease state, and one related journal article review utilizing the “Evaluating a Peer Reviewed Scientific Article” form. Journal articles should be related to the chosen interesting case, current, less than 5 years old, and come from an academic, peer-reviewed medical publication. Students that present an interesting case on a site visit should be prepared to lead a discussion with their fellow classmates and a faculty member.

The interesting case assignment format can be submitted as either a word document or Power Point presentation in the same format as a focused H&P note. Students required to present their case may use an outline or notes for guidance, but reading verbatim is not permitted. Failure to submit this project will result in a grade of zero for this portion of the clerkship grade.

DRUG CARDS

PRECEPTOR EVALUATION

END OF CLERKSHIP EXAMINATION (EOC Exam)

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

CLERKSHIP SPECIFIC PATIENT ENCOUNTER REQUIREMENTS (Patient Logs)

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

Emergency Medicine

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

Emergent 2 encounters during the Emergency Medicine clerkship

Acute 10 encounters during the Emergency Medicine clerkship

Adults-18-64 y/o 10 encounters during the Emergency Medicine clerkship

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

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

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

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

Emergent: Related to a medical condition requiring immediate intervention.

SIMULATION EXPERIENCE

SimMan are computer-operated simulators that are used to create a variety of clinical education scenarios based on the core clerkship learning objectives. Students will attend a simulation session at the Center for Learning and Innovation (CLI) or at the Science and Innovation Center (SIC) while on their emergency medicine clerkship. Students will receive an email from the clinical coordinators with the date and time of your simulation session within the first two weeks of the clerkship. If CLI/SIC should be closed for any reason, a makeup simulation or similar experience will be assigned later. Failure to attend and participate in the clinical scenarios at CLI/SIC will result in

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

CLINICAL YEAR REQUIRMENTS for GRADUATION

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

Clinical Year Patient Encounter Requirements P/F

Clinical Year Procedure Logging Requirements P/F

Quality Assurance/Performance Improvement Assignment P/F

Developmental Disabilities Logging Requirement and Reflective Journaling P/F

Longitudinal Patient Case with Medical Documentation Submission P/F

CLINICAL YEAR PATIENT ENCOUNTER REQUIREMENTS (Patient logs)

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

Types of Clinical Encounters

Preventative

Acute

Chronic

Emergent

20 encounters during clinical year

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

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

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

Emergent: Related to a medical condition requiring immediate intervention.

Medical Care Across the Life Span Encounters

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

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

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

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

Elderly-65 and older 100 encounters during the clinical year

CLINICAL YEAR PROCEDURE LOGGING REQUIREMENTS

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

REQUIRED CLINICAL YEAR

QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT ASSIGNMENT

Summary:

1. Go to Canvas

2. Go to course PHA 227

3. Click on “discussion board” on left side

4. Click on “Patient Safety Institute CO 2025”

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

6. Follow instructions for the discussion board

DEVELOPMENTAL DISABILITIES LOGGING REQUIREMENT AND REFLECTIVE JOURNALING

Logging requirement:

Although students must log specific Emergency Medicine encounters during this clerkship, the below developmental disabilities logging requirement are required to be completed by the end of the clinical year, not by the end of the Emergency Medicine clerkship. Throughout the clinical year, 15 patients with a history of developmental disabilities must be logged in the Exxat system. Please be sure you click on the “developmental disability” box to capture your patients in the system. These requirements may be met on any of the eight clerkships. Preceptors must sign off on the following specific patient encounters. The preceptor signature not only confirms exposure, but competence in these areas of care. The process ensures student deficiencies are identified and addressed in a timely manner. Should a

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

Types of Clinical Encounters

Developmental Disabilities

15 encounters during clinical year

LONGITUDINAL PATIENT CASE with MEDICAL DOCUMENTATION SUBMISSION

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

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

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

CLERKSHIP BIBLIOGRAPHY

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

PHA 280 PEDIATRICS CLERKSHIP 3 S.H. (B1.03a, B3.03b, B3.07e)

COURSE COORDINATOR (B1.03c)

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

Office: 516-463-4233

COURSE DESCRIPTION (B1.03b)

This course is a supervised clinical experience where students function under the supervision of pediatric preceptors who enable students to meet learning outcomes and gain proficiency in the care of pediatric patients. Students will focus on recognizing and managing common childhood illnesses, well childcare, management of chronic conditions, assessment of growth and development, and the practice of preventive health care in this specific population.

COURSE GOAL (B1.03d)

The goal of this clerkship is to provide students with general knowledge of the principles of pediatric medicine and to allow students the opportunity to participate in the care of pediatric patients, including infants, children, and adolescents. The student will assess common medical problems by taking a medical history, performing a physical examination, ordering and interpreting diagnostic studies, and formulating management plans for infants, children, and adolescent patients.

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

PEDIATRICS

Instructional Objectives Course Learning Outcomes Assessment Tools Program

Utilized Competencies

By the conclusion of the Pediatric Upon successful completion of this clerkship, students will demonstrate clerkship, students will attain the following Competency of The instructional competency in the following: (B1.01d, knowledge, interpersonal, clinical/technical instructional objectives, learning B1.03e, B3.03b, B3.07e) skills, professional behaviors, clinical objectives and outcomes, and successful reasoning, and problem-solving abilities: learner outcomes completion of course (B1.01d, B1.03e, B3.03b, B3.07e) are measured by assessments guide students successful toward the acquisition of completion of the the following Program following Competencies: (B1.01b, assessment tools: B1.03e, B4.01a) (B1.03e, B1.03g, B4.01a)

• Elicits a detailed history of pediatric patients. (B3.03b, B3.07e)

• Perform an appropriate physical examination on pediatric patients. (B3.03b, B3.07e)

• Evaluates patients for pediatric growth and development. (B3.03b, B3.07e)

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

• Preceptor evaluation

• Clerkship specific patient encounter requirements

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

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

• Selects appropriate diagnostic studies to order for pediatric patients. (B3.03b, B3.07e)

• Interpret diagnostic studies for pediatric patients. (B3.03b, B3.07e)

• Formulate a differential diagnosis for pediatric patients. (B3.03b, B3.07e)

• Appropriately diagnose pediatric patients. (B3.03b, B3.07e)

• When presented with a pediatric patient, the student can appropriately use diagnostic studies to aid in the diagnosis. (B3.03b, B3.07e)

• Preceptor evaluation

• Clerkship specific patient encounter requirements

• EOC Exam

• When presented with a pediatric patient, the student will develop a differential diagnosis and determine the most likely diagnosis. (B3.03b, B3.07e)

• Preceptor evaluation

• Clerkship specific patient encounter requirements

• EOC Exam

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

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

• Formulates a management plan that uses consultations appropriately for pediatric patients. (B3.03b, B3.07e)

• Provides information regarding health promotion when caring for pediatric patients. (B3.03b, B3.07e)

• Provides information regarding injury prevention when caring for pediatric patients. (B3.03b, B3.07e)

• Creates a pharmacological plan for pediatric patients. (B3.03b, B3.07e)

• Formulates a plan that includes nonpharmacological management for pediatric patients. (B3.03b, B3.07e)

• Formulates a plan using appropriate referrals for pediatric patients. (B3.03b, B3.07e)

• Formulates a plan that includes appropriate follow-up for pediatric patients. (B3.03b, B3.07e)

• Provides effective patient education to patients and their families for pediatric patients. (B3.03b, B3.07e)

• Emphasizes shared decision making for pediatric patients. (B3.03b, B3.07e)

• Applies the evidence from scientific studies to pediatric patient cases. (B3.03b, B3.07e)

• Performs effective oral presentations

• When presented with a pediatric patient, focusing on shared decision making, the student will formulate a management plan including the use of appropriate consultations, pharmacologic plan, non-pharmacologic care, referral, follow up and patient education. (B3.03b, B3.07e)

• Preceptor evaluation

• Drug cards

• Clerkship specific patient encounter requirements

• EOC Exam

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

• Provides appropriate referrals (IC4).

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

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

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

• When presented with a pediatric • Preceptor • Effectively complete oral for pediatric patients (B3.03b, B3.07e) patient, the student will effectively orally present patients. (B3.03b, B3.07e)

Evaluation

• Clerkship specific patient encounter requirements presentations (IC3)

• Accurately documents patient data for

• When presented with a pediatric

• Preceptor • Elicit a detailed medical pediatric patients. (B3.03b, B3.07e) patient, the student will accurately record all data. (B3.03b, B3.07e)

Evaluation history, perform appropriate physical examination, and

• Accurately provides preventive care to pediatric patients. (B3.03a, B3.07e)

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

• Accurately evaluates pediatric patients with chronic conditions. (B3.03a, B3.07e)

• Accurately evaluates infants (less than 1) (B3.03b, B3.07e)

• Accurately evaluates children (1-11 years old) (B3.03b, B3.07e)

• Accurately evaluates adolescents (1217 years old) (B3.03b, B3.07e)

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

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

• across the life span, to include infants, children, and adolescents. (B3.03b, B3.07e)

• Clinical Documentation Assignment

• Accurately evaluates pediatric patients with a cough. (B3.03b, B3.07e)

• Accurately evaluates pediatric patients with a fever. (B3.03b, B3.07e)

• Accurately evaluates patients requiring a routine health assessment. (B3.03b, B3.07e)

• The student will be able to appropriately evaluate pediatric patients with common complaints such as cough, fever, and patients requiring a routine health assessment. (B3.03b, B3.07e)

• Clerkship specific patient encounter requirements accurately record all pertinent data. (MK5)

• Preceptor Evaluation

• Clerkship specific patient encounter requirements

• Accurately document medical information (IC2)

• Preceptor Evaluation

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

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

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

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

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

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

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

Instructional Objectives

Course Learning Outcomes Assessment Program

Tools Utilized Competencies

By the conclusion of the Pediatric clerkship, Upon successful completion of this students will demonstrate competency in the clerkship, students will attain the following Competency of The instructional objectives, following: (B1.01d, B1.03e, B3.03b, B3.07e) knowledge, interpersonal, clinical/technical instructional objectives learning outcomes, and skills, professional behaviors, clinical and learner outcomes successful completion of reasoning, and problem-solving abilities: are measured by course assessments guide (B1.01d, B1.03e, B3.03b, B3.07e)

successful completion students toward the acquisition of the following of the following Program assessment tools: Competencies: (B1.01b, B1.03e, (B1.03e, B1.03g, B4.01a) B4.01a)

• Effectively communicates with patients. (B3.03b, B3.07e)

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

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

•

• Demonstrates empathy. (B3.03b, B3.07e)

• Demonstrates respect. (B3.03b, B3.07e)

• Demonstrates ethical behavior. (B3.03b, B3.07e)

• When presented with a pediatric patient, the student will develop relationships that result in effective communication with patients, their families, and members of the interprofessional team. (B3.03b, B3.07e)

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

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

• When presented with a pediatric patient, the student demonstrates empathy, respect, and ethical behavior. (B3.03b, B3.07e)

• Preceptor evaluation

• Demonstrate empathetic and respectful behaviors. (PB1)

• Demonstrates and identifies appropriate ethical behavior. (PB4)

• Demonstrates reliability. (B3.03b, B3.07e)

• When presented with a pediatric

• Preceptor • Exhibit reliability,

• Demonstrates accountability. (B3.03b, patient, the student exhibits evaluation accountability, and B3.07e) reliability, dependability, and is dependability. (PB2)

• Demonstrates dependability. (B3.03b, accountable. (B3.03b, B3.07e)

• Demonstrates B3.07e)

• Exhibits a positive approach to learning. (B3.03b, B3.07e) accountability to patients, society, and the profession (PB6).

• Demonstrate an understanding of

• When presented with a pediatric • Preceptor • Demonstrates an diverse health care needs. (B3.03b, patient, the student can understand evaluation understanding of diverse B3.07e) the diverse needs of patients. (B3.03b, B3.07e) health care needs (IC8).

• Utilize appropriate clinical reasoning

• When presented with a pediatric

• Preceptor • Utilize appropriate clinical and problem-solving abilities. (B3.03b, patient, the student will be able to evaluation reasoning and problemB3.07e) utilize the clinical reasoning and solving abilities to

• Analyze clinical data correctly. (B3.03b, problem-solving abilities, inclusive identify and manage B3.07e) of synthesizing and analyzing clinical data, to appropriately evaluate the patient. (B3.03b, B3.07e)

medical conditions (CRPSA1).

• Synthesize and analyze clinical data correctly (CRPSA2).

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

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

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

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

• When presented with a pediatric patient, the student will provide effective, safe, equitable, and highquality care. (B3.03b, B3.07e)

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

OUTLINE OF TOPICS COVERED IN THIS COURSE

(B1.03f)

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

DERMATOLOGY

Acne vulgaris, Androgenetic alopecia, Atopic dermatitis, Burns, Contact dermatitis, Dermatitis (diaper, perioral), Drug eruptions, Erythema multiforme, Exanthems, Impetigo, Lice, Lichen planus, Pityriasis rosea, Scabies, Stevens-Johnson syndrome, Tinea, Toxic

epidermal necrolysis, Urticaria, Verrucae

ENT/OPHTHALMOLOGY

Acute otitis media, Acute pharyngotonsillitis, Allergic rhinitis, Conjunctivitis, Epiglottitis, Epistaxis, Hearing impairment, Mastoiditis, Oral candidiasis, Orbital cellulitis, Otitis externa, Peritonsillar abscess, Strabismus, Tympanic membrane perforation

INFECTIOUS DISEASE

Atypical mycobacterial disease, Epstein-Barr disease, Erythema infectiosum, Hand-foot-and-mouth disease, Herpes simplex, Influenza, Measles, Mumps, Pertussis, Pinworms, Roseola, Rubella, Varicella infection

PULMONOLOGY

Acute bronchiolitis, foreign body, Asthma, Croup, Cystic fibrosis, Hyaline membrane disease, Pneumonia (bacterial, viral), Respiratory syncytial virus

CARDIOVASCULAR

Acute rheumatic fever, Atrial septal defect, Coarctation of the aorta, Hypertrophic cardiomyopathy, Kawasaki disease, Patent ductus arteriosus, Syncope, Tetralogy of Fallot, Ventricular septal defect

GASTROINTESTINAL/NUTRIONAL SYSTEM

Appendicitis, Colic, Constipation, Dehydration, Duodenal atresia, Encopresis, Foreign body, Gastroenteritis, Gastroesophageal reflux disease, Hepatitis, Hirschsprung disease, Inguinal hernia, Intussusception, Jaundice, Lactose intolerance, Niacin deficiencies, Pyloric stenosis, Umbilical hernia, Vitamin A deficiency, Vitamin C deficiency, Vitamin D deficiency

NEUROLOGY/DEVELOPMENTAL Anticipatory guidance, Down syndrome, Febrile seizure, Immunization guidelines, Meningitis, Normal growth and development, Seizure disorders, Teething, Turner syndrome

PSYCHIATRY/BEHAVIORAL MEDICINE

Anxiety disorders, Attention-deficit/hyperactivity disorder, Autism spectrum disorder, Child abuse and neglect, Disruptive, impulsecontrol, and conduct disorders, Feeding or eating disorders, Suicide, Depressive disorders

ORTHOPEDICS/RHEUMATOLOGY

Avascular necrosis of the proximal femur, Congenital hip dysplasia, Juvenile rheumatoid arthritis, Neoplasia of the musculoskeletal system, Nursemaid elbow, Osgood-Schlatter disease, Scoliosis, Slipped capital femoral epiphysis

ENDOCRINOLOGY

Diabetes mellitus, Hypercalcemia, Hyperthyroidism, Hypothyroidism, Obesity, Short stature

HEMATOLOGY

Anemia, Bleeding disorders, Brain tumors, Hemophilia, Lead poisoning, Leukemia, Lymphoma, Neutropenia

UROLOGY/RENAL

Cryptorchidism, Cystitis, Enuresis, Glomerulonephritis, Hydrocele, Hypospadias, Paraphimosis, Phimosis, Testicular torsion, Vesicourethral reflux

ARC-PA STANDARDS

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

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

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

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

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

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

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

a. family medicine,

b. emergency medicine,

c. internal medicine,

d. surgery,

e. pediatrics,

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

g. behavioral and mental health care.

STUDENT ASSESSMENT/EVALUATION (B1.03g)

Clerkship Specific Assessments

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

Clinical Documentation Assignment: H&P

Preceptor Evaluation

End of Clerkship Examination (EOC Exam)

Clerkship Specific Patient Encounter Requirements

GRADING PLAN (B1.03h)

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

Grade Calculations

CLERKSHIP SPECIFIC ASSESSMENTS

CLINICAL DOCUMENTATION ASSIGNMENT

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

Please note:

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

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

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

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

DRUG CARDS

PRECEPTOR EVALUATION

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

END OF CLERKSHIP EXAMINATION (EOC Exam)

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

be found through the following link: https://paeaonline.org/assessment/end-of-rotation/content. The EOC examinations have a similar format to the Physician Assistant National Certifying Examination (PANCE).

CLERKSHIP SPECIFIC PATIENT ENCOUNTER REQUIREMENTS (Patient Logs)

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

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

Preventive 10 encounters during the Pediatric clerkship

Acute 5 encounters during the Pediatric clerkship

Chronic 5 encounters during the Pediatric clerkship

Infants-less than 1 years of age 15 encounters during the Pediatric clerkship

Children-1-11 y/o 30 encounters during the Pediatric clerkship

Adolescents-12-17 y/o 30 encounters during the Pediatric clerkship

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

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

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

Emergent: Related to a medical condition requiring immediate intervention.

CLINICAL YEAR REQUIRMENTS for GRADUATION

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

Clinical Year Patient Encounter Requirements P/F

Clinical Year Procedure Logging Requirements P/F

Quality Assurance/Performance Improvement Assignment P/F

Developmental Disabilities Logging Requirement and Reflective Journaling P/F

Longitudinal Patient Case with Medical Documentation Submission P/F

CLINICAL YEAR PATIENT ENCOUNTER REQUIREMENTS (Patient logs)

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

Types of Clinical Encounters

Preventative

20 encounters during clinical year

Acute 20 encounters during clinical year

Chronic 20 encounters during clinical year

Emergent 20 encounters during clinical year

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

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

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

Emergent: Related to a medical condition requiring immediate intervention.

Medical Care Across the Life Span Encounters

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

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

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

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

Elderly -65 and older 100 encounters during the clinical year

CLINICAL YEAR PROCEDURE LOGGING REQUIREMENTS

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

REQUIRED CLINICAL YEAR

QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT ASSIGNMENT

Summary:

1. Go to Canvas

2. Go to course PHA 227

3. Click on “discussion board” on left side

4. Click on “Patient Safety Institute CO 2025”

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

6. Follow instructions for the discussion board

DEVELOPMENTAL DISABILITIES LOGGING REQUIREMENT AND REFLECTIVE JOURNALING

Logging requirement:

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

required by the end of the clinical year and for graduation. Please follow the same process for logging patients as described under the section titled “Clerkship Specific Patient Encounter Requirements”.

Types of Clinical Encounters

Developmental Disabilities 15 encounters during clinical year

LONGITUDINAL PATIENT CASE with MEDICAL DOCUMENTATION SUBMISSION

The longitudinal patient case is completed over the clinical year. It is designed to allow students to simulate care for a patient over a prolonged period. Thus, the student begins with an initial visit with the simulated patient and then evaluates the “same patient” over the course of the clinical year. At each visit, the patient’s health care needs may change, simulating care of a patient longitudinally. Students must obtain the necessary history, perform a physical examination, order and interpret diagnostic studies, formulate an assessment, and formulate a plan in a simulated environment. After the clinical encounter, a debrief session led by faculty will focus on communication skills, clinical skills, history taking, physical exam skills, assessment and plan formulation. After each longitudinal patient encounter, students must submit a SOAP note documenting the encounter. The SOAP note must be submitted to Exxat within 72 hours of call back day. Students can submit their SOAP note on Exxat. From the dashboard • placements • by session • to do list • session required documents à longitudinal patient case SOAP note. Please make sure to upload under the correct rotation.

video self-reflection is due 2 weeks after the callback day. Students can submit their longitudinal patient reflection on Exxat. From the dashboard à placements à by session à to do list à session required documents à longitudinal patient reflection. Please make sure to upload under your current rotation.

CLERKSHIP BIBLIOGRAPHY

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

PHA 285 BEHAVIORAL AND MENTAL HEALTH CARE CLERKSHIP 3 S.H. (B1.03a, B3.03e, B3.07g)

COURSE COORDINATOR (B1.03c)

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

COURSE DESCRIPTION (B1.03b)

This is a supervised clinical experience where students function under the supervision of preceptors who enable them to meet learning outcomes for behavioral and mental health conditions. The student will actively participate in evaluating and managing patients with behavioral and mental health conditions.

COURSE GOAL (B1.03d)

This clerkship’s goal is to enhance students’ knowledge of the general principles of Behavioral and Mental Health Care and to expose them to patients with a variety of behavioral and mental conditions. Students will develop their psychiatric history taking skills, mental status examination skills, and learn appropriate use of psychoactive pharmaceuticals.

INSTRUCTIONAL OBJECTIVES, COURSE LEARNING OUTCOMES, AND ASSESSMENT TOOLS, SPECIFIC TO BEHAVIORAL AND MENTAL HEALTH CARE

Instructional Objectives Course Learning Outcomes Assessment Program

By the conclusion of the Behavioral and Upon successful completion of this Tools Utilized Competencies

Mental Health Care clerkship, students will clerkship, students will attain the following Competency of The instructional objectives, demonstrate competency in the following: knowledge, interpersonal, clinical/technical instructional learning outcomes, and (B1.01d, B1.03e, B3.03e, B3.07g) skills, professional behaviors, clinical objectives and successful completion of course reasoning, and problem-solving abilities: learner outcomes are assessments guide students (B1.01d, B1.03e, B3.03e)

measured by toward the acquisition of the successful following Program completion of the Competencies: (B1.01b, B1.03e, following assessment B4.01a) tools: (B1.03e, B1.03g, B4.01a)

• Elicits a detailed history of patients with behavioral and mental health conditions. (B3.03e, B3.07g)

• Evaluate the mental status of patients with behavioral and mental health conditions using a MMSE. (B3.03e, B3.07g)

• When presented with a patient with a behavioral and mental health condition, the student will use effective interviewing skills to perform a comprehensive evaluation that includes a detailed history and mental status examination. (B3.03e, B3.07g)

• Preceptor evaluation

• Interesting patient case

• Clerkship specific patient encounter requirements

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

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

• Selects appropriate diagnostic studies to order for patients with behavioral and mental health conditions. (B3.03e, B3.07g)

• Interpret diagnostic studies for patients with behavioral and mental health conditions. (B3.03e, B3.07g)

• When presented with a patient with a behavioral and mental health condition, the student will be able to appropriately use diagnostic studies to aid in the diagnosis of patients with a behavioral and mental health condition. (B3.03e, B3.07g)

• Preceptor evaluation

• Interesting patient case

• Clerkship specific patient encounter requirements

• EOC Exam

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

• Formulate a differential diagnosis for patients with behavioral and mental health conditions. (B3.03e, B3.07g)

• Appropriately use the DSM V in diagnosis of patients with behavioral and mental health conditions. (B3.03e, B3.07g)

• When presented with a patient with a behavioral and mental health condition, the student will develop a differential diagnosis and determine the most likely diagnosis. (B3.03e, B3.07g)

• Preceptor evaluation

• Interesting patient case

• Clerkship specific patient

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

• Formulates a management plan that uses consultations appropriately for patients with behavioral and mental health conditions. (B3.03e, B3.07g)

• Creates a pharmacological plan for patients with a behavioral and mental health condition. (B3.03e, B3.07g)

• Formulates a plan that includes nonpharmacological management for patients with a behavioral and mental health condition. (B3.03e, B3.07g)

• Formulates a plan inclusive of appropriate referrals for patients with a behavioral and mental health condition. (B3.03e, B3.07g)

• Formulates a plan that includes follow up for patients with behavioral and mental health condition. (B3.03e, B3.07g)

• Provides effective patient education to patients and their families for patients with behavioral and mental health conditions. (B3.03e, B3.07g)

• Emphasizes shared decision making for patients with behavioral and mental health conditions. (B3.03e, B3.07g)

• Applies the evidence from scientific studies to behavioral and mental health patient cases. (B3.03e, B3.07g)

• Performs effective oral presentations

• When presented with a patient with a behavioral and mental health condition, focusing on shared decision making, the student will be formulating a management plan including the use of appropriate consults, pharmacologic plan, nonpharmacologic care, referral, follow up and patient education.

(B3.03e, B3.07g)

encounter requirements

• EOC Exam

• Preceptor evaluation

• Interesting patient case

• Drug cards

• Clerkship specific patient encounter requirements

• EOC Exam

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

• Provides appropriate referrals (IC4).

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

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

• When presented with a patient with

• Preceptor

• Effectively complete oral for patients with behavioral and a behavioral and mental health Evaluation presentations (IC3) mental health condition. (B3.03e, B3.07g) condition, the student will effectively orally present patients.

• Clerkship specific patient

(B3.03e, B3.07g)

• Accurately documents patient data for

• When presented with a patient with

encounter requirements

• Preceptor

• Elicit a detailed medical patients with behavioral and mental a behavioral and mental health Evaluation history, perform health condition. (B3.03e, B3.07g) condition, the student will accurately record all data. (B3.03e, B3.07g)

• Accurately evaluates patients with acute behavioral and mental health conditions. (B3.03a, B307g)

• Accurately evaluates patients with chronic behavioral and mental health conditions. (B3.03a, B3.07g)

• Accurately evaluates adult patients (18-64 yo) with behavioral and mental health conditions. (B3.03b, B3.07g)

• Accurately evaluates elderly patients (65 and older) with behavioral and mental health conditions. (B3.03b, B3.07g)

• Accurately evaluates patients with depression. (B3.03e, B3.07g)

• Accurately evaluates patients with an anxiety disorder. (B3.03e, B3.07g)

• Accurately evaluates patients with bipolar disorder. (B3.03e, B3.07g)

• Accurately evaluates patients with schizophrenia. (B3.03e, B3.07g)

• Accurately evaluates patients with substance-related disorders. (B3.03e, B3.07g)

• When presented with a patient with a behavioral and mental health condition, students will be able complete a history, perform a mental status examination, formulate an assessment, and create a management plan for the following categories of patient encounters:

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

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

• When in a behavioral health setting, the student will be able to appropriately evaluate patients with common conditions such as depression, anxiety, bipolar disorder, schizophrenia, and substance related disorders. (B3.03e, B3.07g)

• Clerkship specific patient encounter requirements appropriate physical examination, and accurately record all pertinent data. (MK5)

• Accurately document medical information (IC2)

• Preceptor Evaluation

• Clerkship specific patient encounter requirements

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

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

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

• Preceptor Evaluation

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

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

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

Instructional Objectives

By the conclusion of the

Course Learning Outcomes Assessment Tools Program

Upon successful completion of this Utilized

Competencies

Behavioral and Mental clerkship, students will attain the following Competency of The instructional objectives, Health Care clerkship, knowledge, interpersonal, clinical/technical instructional learning outcomes, and students will demonstrate skills, professional behaviors, clinical objectives and successful completion of course competency in the reasoning, and problem-solving abilities: learner outcomes are assessments guide students following: (B1.01d, B1.03e, (B1.01d, B1.03e, B3.03e, B3.07g)

measured by toward the acquisition of the B3.03e, B3.07g) successful following Program completion of the Competencies: (B1.01b, B1.03e, following assessment B4.01a) tools: (B1.03e, B1.03g, B4.01a)

• Effectively communicates with patients. (B3.03e, B3.07g)

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

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

•

• Demonstrates empathy. (B3.03e)

• Demonstrates respect. (B3.03e)

• Demonstrates ethical behavior. (B3.03e)

• When presented with a patient with a behavioral and mental health condition, the student will develop relationships that result in effective communication with patients, their families, and members of the interprofessional team. (B3.03e, B3.07g)

• Preceptor evaluation

• When presented with a patient with a behavioral and mental health condition, the student demonstrates empathy, respect, and appropriate ethical behavior. (B3.03e)

• Preceptor evaluation

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

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

• Demonstrate empathetic and respectful behaviors. (PB1)

• Demonstrates and identifies appropriate ethical behavior. (PB4)

• Demonstrates reliability. (B3.03e)

• When presented with a patient with a • Preceptor • Exhibit reliability,

• Demonstrates accountability. (B3.03e) behavioral and mental health evaluation accountability, and

• Demonstrates dependability. (B3.03e) condition, the student exhibits dependability. (PB2)

• Exhibits a positive approach to reliability, dependability, and is

• Demonstrates learning. (B3.03e) accountable. (B3.03e) accountability to patients, society, and the profession (PB6).

• Demonstrate an understanding of

• When presented with a patient with a • Preceptor • Demonstrates an diverse health care needs. (B3.03e) behavioral and mental health condition, the student demonstrates the ability to understand the diverse needs of patients. (B3.03e) evaluation understanding of diverse health care needs (IC8).

• Utilize appropriate clinical reasoning and problem-solving abilities to identify conditions. (B3.03e)

• Analyze clinical data correctly. (B3.03e)

• When presented with a patient with a behavioral and mental health condition, the student will be able to utilize the clinical reasoning and problem-solving abilities, inclusive of synthesizing and analyzing clinical data, to appropriately evaluate the patient. (B3.03e)

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

• Synthesize and analyze clinical data correctly (CRPSA2).

• Demonstrate care that is effective. (B3.03e)

• Demonstrate care that is safe. (B3.03e)

• Demonstrate care that is equitable. (B3.03e)

• Demonstrate care that is of high quality. (B3.03e)

• When presented with a patient with a behavioral and mental health condition, the student will provide effective, safe, equitable, and highquality care. (B3.03e)

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

• Preceptor evaluation

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

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

DEPRESSIVE DISORDERS: BIPOLAR AND RELATED DISORDERS

Bipolar I disorder, Bipolar II disorder, Cyclothymic disorder, Major depressive disorder, Persistent depressive disorder (dysthymia)

ANXIETY DISORDERS; TRAUMA-AND STRESS-RELATED DISORDERS

Generalized anxiety disorder, Panic disorder, Phobic disorders, post-traumatic stress disorder, Specific phobias

SUBSTANCE-RELATED DISORDERS

Alcohol-related disorders, Cannabis-related disorders, Hallucinogen-related disorders, Inhalant-related disorders, Opioid-related disorders, Sedative-, hypnotic-, or anxiolytic-related disorders, Stimulant-related disorders, Tobacco-related disorders

SCHIZOPHRENIA SPECTRUM AND OTHER PSYCHOTIC DISORDERS

Delusional disorder, Schizoaffective disorder, Schizophrenia, Schizophreniform disorder

DISRUPTIVE, IMPULSE-CONTROL AND CONDUCT DISORDERS; NEURODEVELOPMENTAL DISORDERS

Attention-deficit/hyperactivity disorder, Autism spectrum disorder, Conduct disorder, Oppositional defiant disorder

PERSONALITY DISORDERS; OBSESSIVE-COMPULSIVE AND RELATED DISORDERS

Antisocial personality disorder, Narcissistic personality disorder, Avoidant personality disorder, Body dysmorphic disorder, Borderline personality disorder, Dependent personality disorder, Histrionic personality disorder, Obsessive-compulsive disorder, Obsessivecompulsive personality disorder, Paranoid personality disorder, Schizoid personality disorder, Schizotypal personality disorder

SOMATIC SYMPTOM AND RELATED DISORDERS; NONADHERENCE TO MEDICAL TREAMENT

Factitious disorder, Illness anxiety disorder, Somatic symptom disorder

FEEDING OR EATING DISORDERS

Anorexia nervosa, Bulimia nervosa

PARAPHILIC DISORDERS; SEXUAL DYSFUNCTIONS Exhibitionistic disorder, Female sexual interest/arousal disorder, Fetishistic disorder, Male hypoactive sexual desire disorder, Pedophilic disorder, Sexual masochism disorder, Voyeuristic disorder

ARC-PA STANDARDS

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

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

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

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

a. family medicine, b. emergency medicine, c. internal medicine, d. surgery, e. pediatrics, f. women’s health including prenatal and gynecological care, g. behavioral and mental health care.

STUDENT ASSESSMENT/EVALUATION

(B1.03g)

Clerkship Specific Assessments

The grade for the Behavioral and Mental Health Care clerkship is based on the following components:

Interesting Patient Case Assignment

End of Clerkship Examination (EOC Exam)

Clerkship Specific Patient Encounter Requirements

GRADING PLAN

(B1.03h)

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

Grade Calculations

CLERKSHIP SPECIFIC ASSESSMENTS

INTERESTING PATIENT CASE ASSIGNMENT

The interesting patient case assignment is a requirement during the Behavioral and Mental Health Care clerkship. The interesting case will either be presented on a site visit or uploaded onto Exxat prior to the start of call back day. All interesting patient case assignments should include all elements of a focused H&P, a written summary of the pathophysiology of the disease state, and one related journal article review utilizing the “Evaluating a Peer Reviewed Scientific Article” form. Journal articles should be related to the chosen interesting case, current, less than 5 years old, and come from an academic, peer-reviewed medical publication. Students that present an interesting case on a site visit should be prepared to lead a discussion with their fellow classmates and a faculty member.

DRUG CARDS

PRECEPTOR EVALUATION

END OF CLERKSHIP EXAMINATION (EOC Exam)

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

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

CLERKSHIP SPECIFIC PATIENT ENCOUNTER REQUIREMENTS (Patient Logs)

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

Behavioral and Mental Health Care 60 encounters during the Behavioral and Mental Health Care clerkship (approximately 10 per week)

Acute 5 encounters during the Behavioral and Mental Health Care clerkship

Chronic 5 encounters during the Behavioral and Mental Health Care clerkship

Adults-18-64 y/o 10 encounters during the Behavioral and Mental Health Care clerkship

Elderly-65 and older 10 encounters during the Behavioral and Mental Health Care clerkship

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

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

Emergent: Related to a medical condition requiring immediate intervention.

CLINICAL YEAR REQUIRMENTS for GRADUATION

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

Clinical Year Patient Encounter Requirements P/F

Clinical Year Procedure Logging Requirements P/F

Quality Assurance/Performance Improvement Assignment P/F

Developmental Disabilities Logging Requirement and Reflective Journaling P/F

Longitudinal Patient Case with Medical Documentation Submission P/F

CLINICAL YEAR PATIENT ENCOUNTER REQUIREMENTS (Patient logs)

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

formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required for clinical year completion and graduation. Please follow the same process for logging patients as described under the section titled “Clerkship Specific Patient Encounter Requirements”.

Types of Clinical Encounters

Preventative

Acute

Chronic

Emergent

20 encounters during clinical year

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

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

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

Emergent: Related to a medical condition requiring immediate intervention.

Medical Care Across the Life Span Encounters

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

Children-1-11 y/o

Adolescents-12-17 y/o

Adults-18-64 y/o

Elderly-65 and older

30 encounters during the clinical year

100 encounters during the clinical year

CLINICAL YEAR PROCEDURE LOGGING REQUIREMENTS

ensures student deficiencies are identified and addressed in a timely manner. Should a student be at risk of not meeting these competencies during the clinical year, students must formulate a plan with one of the clinical coordinators to meet these competencies. Competency in these areas is required for clinical year completion and graduation.

REQUIRED CLINICAL YEAR PROCEDURES/EXAMINATIONS

QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT ASSIGNMENT

Summary:

1. Go to Canvas

2. Go to course PHA 227

3. Click on “discussion board” on left side

4. Click on “Patient Safety Institute CO 2025”

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

6. Follow instructions for the discussion board

DEVELOPMENTAL DISABILITIES LOGGING REQUIREMENT AND REFLECTIVE JOURNALING

Logging requirement:

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

Types of Clinical Encounters

Developmental Disabilities 15 encounters during clinical year

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

LONGITUDINAL PATIENT CASE with MEDICAL DOCUMENTATION SUBMISSION

The longitudinal patient case is completed over the clinical year. It is designed to allow students to simulate care for a patient over a prolonged period. Thus, the student begins with an initial visit with the simulated patient and then evaluates the “same patient” over the course of the clinical year. At each visit, the patient’s health care needs may change, simulating care of a patient longitudinally. Students must obtain the necessary history, perform a physical examination, order and interpret diagnostic studies, formulate an assessment, and formulate a plan in a simulated environment. After the clinical encounter, a debriefing session led by faculty will focus on communication skills, clinical skills, history taking, physical exam skills, assessment and plan formulation. After each longitudinal patient encounter, students must submit a SOAP note documenting the encounter. The SOAP note must be submitted to Exxat within 72 hours of call back day. Students can submit their SOAP note on Exxat. From the dashboard à placements • by session • to do list • session required documents à longitudinal patient case SOAP note. Please make sure to upload under the correct rotation.

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

CLERKSHIP BIBLIOGRAPHY

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

PHA 290 ELECTIVE CLERKSHIP 3 S.H. (B1.03a)

COURSE COORDINATOR (B1.03c)

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

Office: 516-463-6841

COURSE DESCRIPTION (B1.03b)

This course is a supervised clinical experience where students function under the supervision of preceptors who enable students to meet learning outcomes for elective clerkship. The elective supervised clerkship is designed to provide PA students with comprehensive exposure to a field of health care they are interested in exploring. Options include medical sub-specialties, surgical sub-specialties, or to gain further experience in one of the core disciplines. The rotation involves hands-on experience, clinical application, and patient interaction under the supervision of preceptors.

COURSE GOAL (B1.03d)

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

INSTRUCTIONAL OBJECTIVES, COURSE LEARNING OUTCOMES, AND ASSESSMENT TOOLS, SPECIFIC TO THE ELECTIVE

Instructional Objectives

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

Course Learning Outcomes Assessment Tools Program Utilized Competencies

Upon successful completion of this clerkship, students will attain the following knowledge, Competency of The instructional interpersonal, clinical/technical skills, instructional objectives, learning professional behaviors, clinical reasoning, and objectives and outcomes, and successful problem-solving abilities: (B1.01d, B1.03e) learner outcomes completion of course are measured by assessments guide students successful toward the acquisition of completion of the the following Program following Competencies: (B1.01b, assessment tools: (B1.03e, B1.03g, B4.01a)

B1.03e, B4.01a)

• Elicits a detailed history for patients specific to this elective.

• Perform an appropriate physical examination on patients specific to this elective.

•

• Selects appropriate diagnostic tests to order for patients specific to this elective.

• Interpret diagnostic studies for patients specific to this elective.

• Formulate a differential diagnosis for patients specific to this elective.

• Appropriately diagnose patients for patients specific to this elective.

• When presented with a patient on the elective clerkship, the student will use effective interviewing skills to perform a comprehensive evaluation that includes a detailed history and physical examination

• Preceptor evaluation

• Interesting patient case

• Clerkship specific patient encounter requirements

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

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

• When presented with a patient on an elective clerkship, the student can appropriately use diagnostic studies to aid in the diagnosis.

• When presented with a patient on an elective clerkship, the student will be able to develop a differential diagnosis and determine the most likely diagnosis.

• Preceptor evaluation

• Interesting patient case

• Clerkship specific patient encounter requirements

• Preceptor evaluation

• Interesting patient case

• Clerkship specific patient encounter requirements

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

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

• Formulates a management plan that uses consultations appropriately for patients specific to this elective.

• Creates a pharmacological plan for patients specific to this elective.

• Formulates a plan that includes non-pharmacological management for patients specific to this elective.

• Formulates a plan inclusive of appropriate referrals for patients specific to this elective.

• Formulates a plan that includes follow-up for patients specific to this elective.

• Provides effective patient education to patients specific to this elective.

• Emphasizes shared decision making for patients specific to this elective.

• Applies the evidence from scientific studies for patients specific to this elective.

• Performs effective oral

• When presented with a patient on an elective clerkship, focusing on shared decision making, the student will be able to formulate a management plan including the use of appropriate consults, pharmacologic plan, non-pharmacologic care, referral, follow up and patient education.

• Preceptor evaluation

• Interesting patient case

• Clerkship specific patient encounter requirements

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

• Provides appropriate referrals (IC4).

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

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

(CRPSA3)

• When presented with a patient on an

• Preceptor

• Effectively complete oral presentations for patients elective clerkship, the student will Evaluation presentations (IC3) specific to this elective. effectively orally present patients.

• Clerkship specific patient encounter requirements

• Accurately documents patient data for patients specific to this elective.

• When presented with a patient on an elective clerkship, the student will accurately record all data.

• Preceptor evaluation

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

• Clinical Documentation Assignment

• Clerkship specific patient encounter requirements accurately record all pertinent data. (MK5)

• Accurately document medical information (IC2)

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

Instructional Objectives

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

Course Learning Outcomes Assessment Program Tools Utilized Competencies

Upon successful completion of this clerkship, students will attain the following Competency of The instructional objectives, knowledge, interpersonal, clinical/technical instructional objectives learning outcomes, and skills, professional behaviors, clinical and learner outcomes successful completion of reasoning, and problem-solving abilities: are measured by course assessments guide (B1.01d, B1.03e) successful completion students toward the acquisition of the following of the following Program assessment tools: Competencies: (B1.01b, B1.03e, (B1.03e, B1.03g, B4.01a) B4.01a)

• Effectively communicates with patients.

• Effectively communicates with families.

• Effectively communicates with members of the health care team.

•

• When presented with a patient on an elective clerkship, the student will develop relationships that result in effective communication with patients, their families, and members of the interprofessional team.

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

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

• Demonstrates empathy.

• When presented with a patient on an • Preceptor • Demonstrate empathetic

• Demonstrates respect. elective clerkship, the student evaluation and respectful behaviors.

• Demonstrates ethical behavior. demonstrates empathy, respect, and appropriate ethical behaviors. (PB1)

• Demonstrates and identifies appropriate ethical behavior. (PB4)

• Demonstrates reliability.

• Demonstrates accountability.

• Demonstrates dependability.

• Exhibits a positive approach to learning.

• When presented with a patient with an elective clerkship, the student exhibits reliability, dependability, and is accountable.

• Preceptor evaluation

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

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

• Demonstrate an understanding of

• When presented with a patient on an

• Preceptor

• Demonstrates an diverse health care needs. elective clerkship, the student demonstrates the ability to understand the diverse needs of patients. evaluation understanding of diverse health care needs (IC8).

• Utilize appropriate clinical reasoning

• When presented with a patient on an

• Preceptor

• Utilize and problem-solving abilities. elective clerkship, the student will be evaluation appropriate

• Analyze clinical data correctly. able to utilize the clinical reasoning and problem-solving abilities, inclusive of synthesizing and analyzing clinical data, to appropriately evaluate the patient. clinical reasoning and problemsolving abilities to identify and manage medical conditions (CRPSA1).

• Synthesize and analyze clinical data correctly (CRPSA2).

• Demonstrate care that is effective.

• Demonstrate care that is safe.

• Demonstrate care that is equitable.

• When presented with a patient on an elective clerkship, the student will

• Preceptor evaluation

• Demonstrate care that is effective, safe, equitable,

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

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

The elective clerkship is designed to supplement the other seven mandatory clerkships which cover all necessary topics, including meeting ARC-PA standards related to clinical setting, care across the life span, types of patient encounters (ie preventive, emergent, acute etc.), and clerkship discipline (ie surgery, EM, IM etc.) Therefore, this clerkship focuses on student interests, rather than mandatory competencies. Thus, there are no set topics addressed in the elective clerkship.

STUDENT ASSESSMENT/EVALUATION (B1.03g)

Clerkship Specific Assessments

The grade for the Elective Care clerkship is based on the following components: Interesting Patient Case

Preceptor Evaluation

Clerkship Specific Patient Encounter Requirements

GRADING PLAN (B1.03h)

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

Grade Calculations

CLERKSHIP SPECIFIC ASSESSMENTS

INTERESTING PATIENT CASE ASSIGNMENT

The interesting patient case assignment is a requirement during the elective clerkship. The interesting case will be presented on call back day. All interesting patient case presentations should be in a PowerPoint format and include a focused H&P, a summary of the pathophysiology of the disease state. In addition to this, students must create a unique plan to educate their patients on this topic. Examples include a poster, pamphlet, or lesson plan. Students should be prepared to lead a discussion with their fellow classmates and the clinical coordinator. This presentation can be no longer than twenty minutes in length and submitted to Exxat in session required documents prior to the start of call back day. If your file is too large to submit on Exxat, please send it to the clinical team via email. All topics are to be submitted to the clinical coordinators a minimum of two weeks prior to call back day for approval. Students should have a grade sheet and copy of their elective presentation for the instructor.

Students required to present their case may use an outline or notes for guidance, but reading verbatim is not permitted. Failure to submit this project will result in a grade of zero for this portion of the clerkship grade.

PRECEPTOR EVALUATION

CLERKSHIP SPECIFIC PATIENT ENCOUNTER REQUIREMENTS (Patient Logs)

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

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

Elective 30 encounters during the Elective clerkship (approximately 5 per week)

CLINICAL YEAR REQUIRMENTS for GRADUATION

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

Clinical Year Patient Encounter Requirements

Clinical Year Procedure Logging Requirements

Quality Assurance/Performance Improvement Assignment

Developmental Disabilities Logging Requirement and Reflective Journaling

Longitudinal Patient Case with Medical Documentation Submission

CLINICAL YEAR PATIENT ENCOUNTER REQUIREMENTS (Patient logs)

P/F

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

Preventative

Types of Clinical Encounters

20 encounters during clinical year

Acute 20 encounters during clinical year

Chronic 20 encounters during clinical year

Emergent 20 encounters during clinical year

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

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

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

Emergent: Related to a medical condition requiring immediate intervention.

Medical Care Across the Life Span Encounters

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

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

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

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

Elderly-65 and older 100 encounters during the clinical year

CLINICAL YEAR PROCEDURE LOGGING REQUIREMENTS

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

QUALITY ASSURANCE/PERFORMANCE IMPROVEMENT ASSIGNMENT

Summary:

1. Go to Canvas

2. Go to course PHA 227

3. Click on “discussion board” on left side

4. Click on “Patient Safety Institute CO 2025”

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

6. Follow instructions for the discussion board

DEVELOPMENTAL DISABILITIES LOGGING REQUIREMENT AND REFLECTIVE JOURNALING

Logging requirement:

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

Types of Clinical Encounters

Developmental Disabilities 15 encounters during clinical year

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

LONGITUDINAL PATIENT CASE WITH MEDICAL DOCUMENTATION SUBMISSION

The longitudinal patient case is completed over the clinical year. It is designed to allow students to simulate care for a patient over a prolonged period. Thus, the student begins with an initial visit with the simulated patient and then evaluates the “same patient” over the course of the clinical year. At each visit, the patient’s health care needs may change, simulating care of a patient longitudinally. Students must obtain the necessary history, perform a physical examination, order and interpret diagnostic studies, formulate an assessment, and formulate a plan in a simulated environment. After the clinical encounter, a debrief session led by faculty will focus on communication skills, clinical skills, history taking, physical exam skills, assessment and plan formulation. After each longitudinal patient encounter, students must submit a SOAP note documenting the encounter. The SOAP note must be submitted to Exxat within 72 hours of call back day. Students can submit their SOAP note on Exxat. From the dashboard • placements • by session • to do list • session required documents à longitudinal patient case SOAP note. Please make sure to upload under the correct rotation.

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

CLERKSHIP BIBLIOGRAPHY

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

CLINICAL YEAR FORMS

INTERESTING CASE PRESENTATION EVALUATION FORM

Student Faculty____________________________

Rotation Type ___________________ Site ______________ Date_________________________

Rotation Dates _____________________ Preceptor Name ______________________________ \\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\

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

TOPIC: ___________________________________________________ COMMENTS

HISTORY:

detailed subjective information from a patient.

EXAM: Focused physical exam-including all components

findings

performance of a PE for the presenting complaint. Includes pertinent positive & negative PE

LABS/DIAGNOSTIC PROCEDURES:

MANAGEMENT:

JOURNAL: Discusses and completes journal article form Submits supporting journal article (<

PROFESSIONALISM:

TOTAL POINTS

ELECTIVE INTERESTING CASE PRESENTATION EVALUATION FORM

Student _____________________________________ Faculty __________________________

Rotation Type __________________ Site ______________ Date________________________

Rotation Dates __________________ Preceptor Name _________________________________

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

of obtaining

detailed subjective information from a patient.

EXAM: Focused physical exam-including all components

findings

appropriate performance of a PE for the presenting complaint. Includes pertinent positive & negative PE

LABS/DIAGNOSTIC

MANAGEMENT:

JOURNAL:

Discusses and completes journal article form

Submits supporting journal article

PROFESSIONALISM:

TOTAL POINTS

Faculty Signature: _____________________________________ Date: _____________________________

MID-CLERKSHIP EVALUATION

Please complete this evaluation by the end of the third week of the clerkship. This evaluation instrument is designed for students to facilitate a conversation with their preceptor to determine their strengths and weaknesses early so that the opportunity to identify and address deficiencies is possible in a timely manner. This tool also provides the program with feedback regarding clerkship quality. Lastly, it allows the course coordinator to identify problems with a clinical site and/or an issue with an individual student, allowing the course coordinator to follow-up with the student in a timely manner regarding the identified deficiency.

ROTATION:

1-FM 2-Med 3- WH 4-Surg 5-EM 6-BH 7-Peds 8-Elective:

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

Please rate the following learning experiences as appropriate to your rotation

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

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

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

2) Your professional behavior and attendance?

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

4) Your ability to formulate a differential diagnosis?

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

6) Your oral presentations?

7) Your ability to perform clinical procedures?

8) Have you discussed your performance with your preceptor and received feedback? If so, did the feedback identify a deficiency that needs correcting? _____

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

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

2) Opportunity to perform history and physical examinations?

3) Opportunity to formulate differential diagnosis and management plans?

4) Opportunity to perform oral presentations?

5) Opportunity to perform clinical procedures?

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

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- WH 4-Surg 5-EM 6-BH 7-Peds 8-Elective:

ROTATION NUMBER: 12 3 4 5 6 7 8

ROTATION SITES:

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

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

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

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

Completion Date

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

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 selfmanagement, disease prevention and health promotion.

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

• Patient is reassessed. Discusses changes made or attempted

• States, expands, and supports main points.

• Exercises proper composition skills.

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:

Faculty:

DRUG CARD GRADING FORM

Name: ________________________________________ Date: _____________

Rotation Number: _________________ Rotation Discipline: ______________

Item

Student Competency

1. Class of medication Yes No

2. Mechanism of Action Yes No

3. Indications Yes No

4. Contraindications Yes No

5. Side Effects Yes No

6. Cost of medication Yes No

If “No” is circled for any item under “student competency”, the student receives a failing grade.

Circle: PASS FAIL

Comments:

Faculty signature: ________________________________________________

CLINICAL YEAR –H&P AND SOAP NOTE GRADING FORM

Student’s Name: _______________________________________ Date: _______________

Faculty Evaluator: _______________________________________ Grade: ______________

SOAP/H&P: Item

Introduction (3)

History Components (20)

PE (15)

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

Plan (20)

(Patient Education, Follow Up, Preventive Care)

Signature (2)

Overall Evaluation of Note (20)

(Presentation skills if student has a site visit, organization, legibility, completeness, clarity, spelling, etc.)

Total Points: _______

Comments:

DEPARTMENT OF PHYSICIAN ASSISTANT STUDIES

FAMILY MEDICINE CLERKSHIP PRECEPTOR EVALUATION FORM

Student Name ____________________________

Rotation ____________________

Type and Site ________________

Preceptor Name _______________

Rotation Dates ________________

Preceptors: Please use the Likert scale below to evaluate student overall performance on clinical clerkship. Please note that 5 is the best score and 1 is the least. The student’s overall rotation grade will be determined by the total score from the Likert score below.

1 = poor

2 = below average

3 = average

4 = above average

5 = excellent

Please rate the student on their ability to achieve the following Instructional Objectives in support of the Course Learning Outcomes specific to Family Medicine.

When presented with patients with Family Medicine Conditions, please rate the student’s ability to achieve each of the following:

Medical Knowledge and Clinical/Technical Skills

Elicits

Formulates a plan inclusive of appropriate referrals for patients with a Family Medicine condition.

Formulates a plan that includes follow up for patients with a Family Medicine condition.

effective patient education to patients with a Family Medicine condition.

Emphasizes shared decision making for patients with a Family Medicine condition.

Applies the evidence from scientific studies to Family Medicine patient cases.

Performs effective oral presentations for patients with a Family Medicine condition.

Accurately documents patient data for patients with a Family Medicine condition.

Accurately provides preventive care to family medicine patients.

Accurately evaluates patients with acute conditions associated with Family Medicine.

Accurately evaluates patients with chronic conditions associated with Family Medicine.

Accurately evaluates adult patients (18-64 yo) with Family Medicine conditions.

Accurately evaluates elderly patients (65 and older) with Family Medicine conditions.

Please rate the student on their ability to achieve the following Instructional Objectives in support of the Course Learning Outcomes in general and as they relate to Family Medicine.

When presented with patients with family medicine conditions, please rate the student’s ability to achieve each of the following:

Interpersonal Skills and Professional Behaviors

Clinical

Reasoning and Problem-Solving

Utilize appropriate clinical reasoning and problemsolving abilities.

COMMENTS:

Total Points = __________ divided by 250 X 100 = _____________ (round up to nearest whole number)

Letter Grade

Total Score

Preceptor Signature: _______________________________

DEPARTMENT OF PHYSICIAN ASSISTANT STUDIES

INTERNAL MEDICINE CLERKSHIP PRECEPTOR EVALUATION FORM

Student Name ____________________________

Rotation ____________________

Type and Site ________________

Preceptor Name _______________

Rotation Dates ________________

1 = poor

2 = below average

3 = average

4 = above average

5 = excellent

Please rate the student on their ability to achieve the following Instructional Objectives in support of the Course Learning Outcomes specific to Internal Medicine.

When presented with patients with Internal Medicine Conditions, please rate the student’s ability to achieve each of the following:

Medical Knowledge and Clinical/Technical Skills

Elicits

Formulates a plan that includes follow up for patients with an internal medicine condition.

patient education to patients with an internal medicine condition.

shared decision making for patients with an internal medicine condition

Applies the evidence from scientific studies to internal medicine patient cases.

Performs effective oral presentations for patients with an internal medicine condition.

Accurately documents patient data for patients with an internal medicine condition.

Accurately evaluates patients with acute conditions associated with internal medicine.

associated with internal medicine.

evaluates adult patients (18-64 yo) with internal medicine conditions.

Accurately evaluates elderly patients (65 and older) with internal medicine conditions.

evaluates patients for hypertension.

Accurately evaluates patients with congestive heart failure

Please rate the student on their ability to achieve the following Instructional Objectives in support of the Course Learning Outcomes in general and as they relate to Internal Medicine.

When presented with patients with internal medicine conditions, please rate the student’s ability to achieve each of the following:

Clinical Reasoning and Problem-Solving

appropriate clinical reasoning and problemsolving abilities

identify and manage medical conditions.

Demonstrates care that is of high quality. 1 2 3 4 5 COMMENTS:

Total Points = __________ divided by 200 X 100 = _____________ (round up to nearest whole number)

Letter Grade

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

Preceptor Signature: _______________________________

DEPARTMENT OF PHYSICIAN ASSISTANT STUDIES

WOMEN’S HEALTH CLERKSHIP PRECEPTOR EVALUATION FORM

Student Name ____________________________

Rotation ____________________

Type and Site ________________

Preceptor Name _______________

Rotation Dates ________________

1 = poor

2 = below average

3 = average

4 = above average

5 = excellent

Please rate the student on their ability to achieve the following Instructional Objectives in support of the Course Learning Outcomes specific to women’s health.

When presented with patients with women’s health conditions, please rate the student’s ability to achieve each of the following:

Elicits

Medical Knowledge and Clinical/Technical Skills

Formulates a plan that includes non-pharmacological management for patients with women’s health concerns.

Formulates a plan that includes follow up for patients with women’s health concern.

Provides effective patient education to patients with a women’s health concern.

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

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

Provides patient education related to family planning to patients with women’s health concerns.

Applies the evidence from scientific studies to women’s health patient cases.

Performs effective oral presentations for patients with a women’s health concern.

Accurately documents patient data for patients with a women’s health concern.

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

Accurately evaluates patients with emergent conditions associated with women’s health care.

Accurately evaluates patients with acute conditions associated with women’s health care.

Accurately evaluates patients with chronic conditions associated with women’s health care.

Accurately evaluates adult patients (18-64 y/o) with conditions associated with women’s health care.

Accurately evaluates elderly patients (65 and older) with conditions associated with women’s health care.

Please rate the student on their ability to achieve the following Instructional Objectives in support of the Course Learning Outcomes in general and as they relate to women’s health.

When presented with patients with women’s health conditions, please rate the student’s ability to achieve each of the following:

Interpersonal Skills and Professional Behaviors

Demonstrates an understanding of diverse health care needs.

Clinical Reasoning and Problem-Solving

COMMENTS:

Preceptor Signature: _______________________________

DEPARTMENT OF PHYSICIAN ASSISTANT STUDIES

SURGERY CLERKSHIP PRECEPTOR EVALUATION FORM

Student Name ____________________________

Rotation ____________________

Type and Site ________________

Preceptor Name _______________

Rotation Dates ________________

1 = poor

2 = below average

3 = average

4 = above average

5 = excellent

Please rate the student on their ability to achieve the following Instructional Objectives in support of the Course Learning Outcomes specific to Surgery.

When presented with patients with Surgical conditions, please rate the student’s ability to achieve each of the following:

Elicits

shared

effective oral presentations for patients with a surgical condition.

Accurately documents patient data for patients with a surgical condition.

evaluates patients with emergent conditions associated with surgical care.

Accurately evaluates patients with acute

associated with surgical care.

evaluates adult patients (18-64 y/o) with surgical conditions.

evaluates elderly patients (65 and older) with surgical conditions.

evaluates pre-operative patients requiring surgical management.

Accurately evaluates post-operative patients requiring surgical management.

Accurately assists with the care of patients requiring surgical management in the intra-operative setting.

Please rate the student on their ability to achieve the following Instructional Objectives in support of the Course Learning Outcomes in general and as they relate to surgery.

When presented with patients with surgical conditions, please rate the student’s ability to achieve each of the following:

Interpersonal Skills and Professional Behaviors

Clinical Reasoning and Problem-Solving

appropriate clinical reasoning and problem-solving abilities.

clinical data correctly.

COMMENTS:

Total Points = __________ divided by 250 X 100 = _____________ (round up to nearest whole number)

Letter Grade

Total Score

Preceptor Signature: _______________________________

DEPARTMENT OF PHYSICIAN ASSISTANT STUDIES

EMERGENCY MEDICINE CLERKSHIP PRECEPTOR EVALUATION FORM

Student Name ____________________________

Rotation ____________________

Type and Site ________________

Preceptor Name _______________

Rotation Dates ________________

1 = poor

2 = below average

3 = average

4 = above average

5 = excellent

Please rate the student on their ability to achieve the following Instructional Objectives in support of the Course Learning Outcomes specific to Emergency Medicine.

When presented with patients with Emergency Medicine Conditions, please rate the student’s ability to achieve each of the following:

Elicits

Medical Knowledge and Clinical/Technical Skills

Formulates a management plan that uses consults appropriately for patients with an emergency medicine condition.

Creates a pharmacological plan for patients with an emergency medicine condition.

Formulates a plan that includes non-pharmacological management for patients with an emergency medicine condition.

Provides effective patient education to patients with an emergency medicine condition.

shared decision making for patients with an emergency medicine condition

Applies the evidence from scientific studies to emergency medicine patient cases.

Performs effective oral presentations for patients with an emergency medicine condition.

Accurately documents patient data for patients with an emergency medicine condition.

Accurately evaluates patients with emergent conditions associated with emergency medicine.

Accurately evaluates patients with acute conditions associated with emergency medicine.

Accurately evaluates adult patients (18-64 y/o) with Emergency Medicine conditions.

Accurately evaluates elderly patients (65 and older) with Emergency Medicine conditions.

Accurately evaluates patients for chest pain.

Accurately evaluates patients with abdominal pain.

Accurately evaluates patients with shortness of breath.

Please rate the student on their ability to achieve the following Instructional Objectives in support of the Course Learning Outcomes in general and as they relate to emergency medicine.

When presented with patients with emergency medicine conditions, please rate the student’s ability to achieve each of the following:

Interpersonal Skills and Professional Behaviors

Clinical Reasoning and Problem-Solving

appropriate clinical reasoning and problemsolving abilities.

Total Points = __________ divided by 200 X 100 = _____________ (round up to nearest whole number)

Letter Grade

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

Preceptor Signature: _______________________________

DEPARTMENT OF PHYSICIAN ASSISTANT STUDIES PEDIATRIC CLERKSHIP PRECEPTOR EVALUATION FORM

Student Name ____________________________

Rotation ____________________

Type and Site ________________

Preceptor Name _______________

Rotation Dates ________________

1 = poor

2 = below average

3 = average

4 = above average

5 = excellent

Please rate the student on their ability to achieve the following Instructional Objectives in support of the Course Learning Outcomes specific to pediatrics.

When presented with patients with pediatric conditions, please rate the student’s ability to achieve each of the following:

Medical Knowledge and Clinical/Technical Skills

Please rate the student on their ability to achieve the following Instructional Objectives in support of the Course Learning Outcomes in general and as they relate to pediatrics.

When presented with pediatric patients, please rate the student’s ability to achieve each of the following:

Clinical Reasoning and Problem-Solving

Utilize appropriate clinical reasoning and problemsolving abilities.

COMMENTS:

Total Points = __________ divided by 225 X 100 = _____________ (round up to nearest whole number)

Letter Grade

Total Score

Preceptor Signature: _______________________________

DEPARTMENT OF PHYSICIAN ASSISTANT STUDIES

BEHAVIORAL MEDICINE AND MENTAL HEALTH CARE CLERKSHIP PRECEPTOR EVALUATION FORM

Student Name ____________________________

Rotation ____________________

Type and Site ________________

Preceptor Name _______________

Rotation Dates ________________

Please note that 5 is the best score and 1 is the least.

1 = poor

2 = below average

3 = average

4 = above average

5 = excellent

Please rate the student on their ability to achieve the following Instructional Objectives in support of the Course Learning Outcomes specific to behavioral medicine and mental health.

When presented with patients with behavioral and mental health conditions, please rate the student’s ability to achieve each of the following:

mental

using a MMSE.

appropriate diagnostic tests to order for patients with behavioral and mental health conditions.

diagnostic studies for patients with behavioral and mental health conditions.

Formulate a differential diagnosis for patients with behavioral and mental health conditions.

Appropriately use the DSM V in diagnosis of patients with a behavioral and mental health condition

Formulates a management plan that uses consults appropriately for patients with behavioral and mental health conditions.

Creates a pharmacological plan for patients with a behavioral and mental health condition.

Formulates a plan that includes non-pharmacological management for patients with a behavioral and mental health condition.

Formulates a plan inclusive of appropriate referrals for patients with a behavioral and mental health condition.

Formulates a plan that includes follow up for patients with behavioral and mental health conditions.

Provides effective patient education to patients with a behavioral and mental health condition.

Emphasizes shared decision making for patients with a behavioral and mental health condition.

Applies the evidence from scientific studies to behavioral and mental health patient cases.

Performs effective oral presentations for patients with a behavioral and mental health condition.

Accurately documents patient data for patients with a behavioral and mental health condition.

Accurately evaluates patients with acute behavioral and mental health conditions.

Accurately evaluates patients with chronic behavioral and mental health conditions.

Accurately evaluates adult patients (18-64 y/o) with behavioral and mental health conditions.

evaluates elderly patients (65 and older) with behavioral and mental health conditions.

Please rate the student on their ability to achieve the following Instructional Objectives in support of the Course Learning Outcomes in general and as they relate to behavioral medicine and mental health.

When presented with patients with behavioral and mental health conditions, please rate the student’s ability to achieve each of the following:

COMMENTS:

Clinical Reasoning and Problem-Solving

Preceptor Signature________________________________

DEPARTMENT OF PHYSICIAN ASSISTANT STUDIES

ELECTIVE CLERKSHIP PRECEPTOR EVALUATION FORM

Student Name ____________________________

Rotation ____________________

Type and Site ________________

Preceptor Name _______________

Rotation Dates ________________

1 = poor

2 = below average

3 = average

4 = above average

5 = excellent

Please rate the student on their ability to achieve the following Instructional Objectives in s support of the Course Learning Outcomes specific to this Elective Clerkship.

When presented with a patient on this elective clerkship, please rate the student’s ability to achieve each of the following:

Medical Knowledge and Clinical/Technical Skills

Elicits a detailed history for patients

this elective.

a differential diagnosis for patients specific to this elective.

Appropriately diagnosis patients for patients specific to this elective.

Formulates a management plan that uses consults appropriately for patients specific to this elective.

Creates a pharmacological plan for patients specific to this elective.

Formulates a plan that includes non-pharmacological management for patients specific to this elective.

Formulates a plan inclusive of appropriate referrals for patients specific to this elective.

Formulates a plan that includes follow up for patients specific to this elective.

Provides effective patient education to patients specific to this elective.

Emphasizes shared decision making for patients specific to this elective.

Applies the evidence from scientific studies for patients specific to this elective.

Performs effective oral presentations for patients specific to this elective.

Accurately documents patient data for patients specific to this elective.

Please rate the student on their ability to achieve the following Instructional Objectives in support of the Course Learning Outcomes in general and as they relate to this elective clerkship.

When presented with a patient on this elective clerkship, please rate the student’s ability to achieve each of the following:

Interpersonal Skills and Professional Behaviors

Effectively communicates with patients.

Effectively communicates with families.

Effectively communicates with members of the health care team.

needs.

an understanding of diverse

Clinical Reasoning and Problem-Solving

appropriate clinical reasoning and problemsolving abilities.

COMMENTS: Total Points = __________ divided by 165 X 100 = _____________ (round up to nearest whole