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PHYSICIAN ASSISTANT PROGRAM Clinical Preceptor Handbook Through the New York State Education Department, Marist College has submitted an Application for Registration of a New Program in a Licensed Profession, for Physician Assistants. We are awaiting for the program’s proposal to be evaluated by the Professional Education Program Review (PEPR) Unit in the Office of the Professions (OP). Marist College has applied for Accreditation - Provisional from the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). Marist College anticipates matriculating its first class in May 2016, pending achieving Accreditation - Provisional status at the September 2015 ARC-PA meeting. Accreditation - Provisional is an accreditation status for a new PA program that, at the time of its initial accreditation review, demonstrated its preparedness to initiate a program in accordance with the accreditation Standards.
Transcript

PHYSICIAN ASSISTANT PROGRAM

Clinical Preceptor Handbook

Through the New York State Education Department, Marist College has submitted an Application for Registration of a New Program in a Licensed Profession, for

Physician Assistants. We are awaiting for the program’s proposal to be evaluated by the Professional Education Program Review (PEPR) Unit in the Office of the

Professions (OP).

Marist College has applied for Accreditation - Provisional from the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). Marist

College anticipates matriculating its first class in May 2016, pending achieving Accreditation - Provisional status at the September 2015 ARC-PA meeting. Accreditation - Provisional is an accreditation status for a new PA program that, at the time of its initial accreditation review, demonstrated its preparedness to

initiate a program in accordance with the accreditation Standards.

April 2015

To Our Instructional Faculty,

The Marist College Physician Assistant Program (MCPAP) would like to take this opportunity to express our sincere

gratitude to all of you for your commitment and dedication. Our local healthcare community is the foundation of our

program and the clinical experiences you offer are critical to successful student outcomes.

Attached you will find our Preceptor Handbook, a helpful guide to assist you in directing student learning. This document

provides a brief introduction to the clinical curriculum and general guidelines for MCPAP students while functioning on

clinical rotations. While it is not a definitive work, it has been developed to:

Provide a mechanism for orienting clinicians to the preceptor role

Identify program requirements for the clinical year

Introduce ideas which you may find useful as you function in the role of PA student preceptor

Thank you for your contribution to the overall success of our students and your commitment to PA education. Should you

have any suggestions that would make this document more useful, please utilize the comment page which you’ll find at

the end of this packet. As always, please feel free to contact me at any time should you have comments, questions, or

concerns.

Best Regards,

Theresa Skelly, MPT, MS, PA-C

Clinical Coordinator

Marist College

Physician Assistant Program

School of Science Physician Assistant Program Marist College Poughkeepsie, NY 12601-1387

Telephone: 845-575-3308 Fax: 845-575-3586 [email protected]

Special thanks to the MCPAP Advisory Board for their enthusiasm and commitment.

Frank Ehrlich, MD – Advisory Board Chair

Eric Amoh, PA-C, MBA, PCHM CCE/SVP

Richard Burzine, PA-C

Tom Hagerty, MD

William Heffernan, MD

Jonathan Londin, PA-C

Mara McErlean, MD

Jeff Midgley, PA-C

Al Nace, LMHC, CASAC

Bekoe Ohene-Agyei, PA-C

Daniel Perkes, MD

Steve Ritter, MD

John Sabia, MD

James Scaduto, MD

Ron Tatelbaum, MD

David Tecchio, PA-C

Jack Weeks, MD

James Wing, MD

Table of Contents

The PA Profession 1

The Marist College PA Program 1-2

The Clinical Year Basics 3-4

The Preceptor – Student Relationship 4

PA Students and Patients 4-5

Student’s Abilities 5-6

Marist College PA Program Requirements 6-7

Mid Rotation Evaluation 7-8

Final Evaluation 8

Resources 9

Conclusion 9

Summary of Preceptor Responsibilities 10

Tentative Schedule for the Class of 2018 10

Appendices

A. Request / Explanation for Student Absence 11

B. General Rotation Learning Objectives 12-14

C. Core Elements 15-16

D. Clinical Rotation Grading Table 17

E. Student Site Visit Evaluation Form 18

F. Individual Preceptor Agreement 19

G. Orientation Checklist 20

H. Student Injury / Incident Report 21

I. Mid Rotation Evaluation 22

J. Final Rotation Evaluation 23-25

K. The One Minute Preceptor 26

L. Competencies for the Physician Assistant Profession 27-29

M. Preceptor Comment Form 30

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A Brief Introduction to the PA Profession

The concept of PA’s evolved in the mid 1960’s at Duke University. The profession was

envisioned as a way to assist over-burdened physicians and as a means to provide primary care in

medically underserved areas. The first PA students were military medics who, returning from war, didn’t

fit into an existing provider role in the civilian healthcare system. The first program began in 1965 and

graduated its first class in October 1967.

According to the National Commission for the Certification of Physician Assistants (NCCPA), by

the end of 2013 there were over 95,000 certified PAs in the United States. Presently there are 190

accredited PA programs and several dozen more in development. Physician Assistants practice in all

states, and all states allow physicians to delegate prescriptive practices to PAs. The PA scope of practice

is defined by those duties delegated by the supervising physician. Physician Assistants are governed by

state and federal law, as well as by their supervising physician.

All states require PAs to pass a national exam in order to obtain state licensure. In order to be

certified, a candidate must pass a written objective examination developed by the National Commission

on Certification of Physician Assistants (NCCPA). In order to maintain certification, PAs must accrue

continuing medical education hours and pass a recertification exam every 10 years.

The Marist College PA Program

Through the New York State Education Department, Marist College has submitted an

Application for Registration of a New Program in a Licensed Profession, for Physician Assistants. We

are awaiting for the program proposal to be evaluated by the Professional Education Program Review

(PEPR) Unit in the Office of the Professions (OP).

Marist College has also applied for Accreditation - Provisional from the Accreditation Review

Commission on Education for the Physician Assistant (ARC-PA). Marist College anticipates

matriculating its first class in May 2016, pending achieving Accreditation - Provisional status at the

September 2015 ARC-PA meeting. Accreditation - Provisional is an accreditation status for a new PA

program that, at the time of its initial accreditation review, demonstrated its preparedness to initiate a

program in accordance with the accreditation Standards.

All MCPAP applicants must hold a minimum of a baccalaureate degree and have completed a

minimum of 500 hours of direct patient contact. In addition, applicants must demonstrate completed

coursework in the following areas, including the appropriate labs: General Biology (8 Cr), Microbiology

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(4 Cr), General Chemistry (8 Cr), Biochemistry (4 Cr), Organic Chemistry (4 Cr), Anatomy & Physiology

(8 Cr), and Statistics (3 Cr).

[Insert demographics for the Class of 2018 show…avg # contact hours / previous experience / GPA…]

The program is a 24 month, 90 credit, full-time, graduate level program. The first twelve months

of our program are dedicated to the didactic curriculum. Prior to entering the clinical phase, students will

have successfully completed the following: Human Anatomy (with cadaver lab), Human Physiology,

Physical Diagnostics, Medical Microbiology & Infectious Disease, and Clinical Pathology. In addition,

they will have completed courses within the social sciences/humanities including: Health Policy &

Regulation, Ethics in Healthcare Delivery, and Behavioral Medicine. Clinical topics are written into the

didactic curriculum via the many Clinical Medicine courses, in addition to Clinical Skills Labs and

Community Health. Evidence-based medicine is referenced throughout the year and a dedicated

Epidemiology/Biostatistics course is implemented just prior to the clinical year.

In addition to the foundation provided by the basic didactic courses, students will have received

education in basic procedures such as:

Testicular Exam Breast Exam Pelvic Exam

Mental Status Exam Venipuncture IV Techniques

Universal Precautions Urinalysis Finger Sticks

Basic Suturing and Wound Care Sterile Technique Splinting / Casting

Basic Life Support Infection Control Training Child Abuse Reporting

HIPAA / Privacy Training And several more…

The second twelve months of the program are reserved for the clinical and capping phases. During the

clinical year, students complete a total of nine 5-week rotations in the following specialties:

Internal Medicine Family Medicine Emergency

Medicine Pediatrics

Elective

(student’s

choice)

Ob/Gyn General Surgery Behavioral Health

Geriatrics (or

Approved Medicine

Elective)

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The Clinical Year Basics

Each rotation is 5 weeks is duration, starting on a Monday and ending on a Sunday. Students

must be available from the first Monday of the each rotation, through the last Sunday of each rotation.

Attendance is mandatory and outside work is strongly discouraged. Students are expected to maximize

the resources available to them during each clinical rotation and get as much clinical time as possible

during each week. Hours may be variable and should be assigned by the preceptor. Students are

expected to work the same schedule as their preceptor and/or the schedule that preceptors assigns to them.

This may include day, night, overnight, weekends, and holidays. All students are required to work a

minimum of 40 hours per week. Most rotations average between 50-60 hours and we encourage students

to spend as much time as possible on site. They may not accrue hours one day in order to receive time off

on another day. If for any reason the student needs to be absent from your site, it is expected that he/she

will speak with you AND contact the program directly. All anticipated absences MUST be approved by

the Program Director in order to be considered an excused absence. For all absences, students must

submit documentation to the program that identifies when they must be off site and how they plan to

make up for the missed clinical time (Appendix A). Unexcused absences are taken seriously and will be

investigated accordingly by the Program faculty.

As health care professionals, students are expected to be neatly dressed and groomed. Men must

wear a shirt and tie at all times. Women must be appropriately attired for a professional work situation.

For both men and women common sense should indicate the amount and type of jewelry worn, length of

fingernails and how to keep long hair out of harm's way. Only natural fingernails are acceptable.

Artificial nails, of any type, are not acceptable. Nail polish is acceptable if it is not chipped or cracked.

Jeans, open footwear and sneakers are unacceptable. Hospital issued scrubs are acceptable for surgical

rotations, however students are expected to wear their white coat whenever outside of the sterile area.

Scrubs are prohibited outside of patient care areas and may not be worn home. Should a site require a

dress code which differs a great deal from the above, that site should notify the Program prior to student

arrival.

The mandatory identification for students includes: short white jacket with college seal on left

shoulder, Marist College ID, and name plate which indicates they are a “Physician Assistant Student”.

Students should always identify themselves as a “Physician Assistant student” to patients, preceptors,

staff, etc. All notes written by a student should clearly indicate this status as well. In the patient record,

his/her name should be legibly written, signed, and followed by “MC/PA-S”.

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If your site requires additional site specific identification, please make the Program and student

aware. In addition, students have been instructed that they must carry equipment necessary to complete

appropriate physical examinations on patients.

Please Note: Students will never be required to solicit their own clinical rotations. All clinical

rotations will be assigned by the Clinical Coordinator at sites or with preceptors that have been vetted by

the Program. If a student requests a specific site or preceptor not previously vetted, the Program must first

approve the site and/or preceptor prior to placing the student.

The Preceptor – Student Relationship

While functioning on clinical rotations, all students will be under the supervision of a licensed

provider (attending physician, physician assistant, nurse practitioner, etc). The primary duties of a

preceptor are to impart knowledge, assist the student in refining clinical skills, and serve as a role model.

While on clinical rotations, students can be involved in several activities in and out of direct patient care.

Most of the time, preceptors will assign students to specific patients. The students should be responsible

for obtaining a complete history and physical examination. They should also develop differential

diagnoses, construct problem lists, order and interpret appropriate diagnostic tests, establish a diagnosis,

and recommend a treatment plan. Of course, all of this occurs under the review of a preceptor.

Routinely shadowing a preceptor is considered a sub-optimal experience and is not an acceptable

use of clinical time. After demonstrating proficiency, students may be permitted to undertake certain

defined activities with appropriate supervision and direction. At no time may the student take the place of

qualified medical staff. All patients must be seen and examined by a licensed provider prior to the end of

their visit.

When not seeing patients, students may attend formal demonstrations, participate in rounds, and

give presentations. At sites where other students are present, they may work in teams and participate in

group projects. This activity not only fosters medical knowledge, but also a team approach to learning.

From time to time, students may also benefit from the interdisciplinary education that comes with

spending time observing providers who have different roles within the healthcare team (i.e., PT/OT,

Speech therapy, radiology, etc.).

PA Students and Patients

The goal is to educate our PA students to provide primary care services. When possible they

should be assigned to patients who have problems commonly seen in primary care settings. While

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patients with atypical presentations or rare diseases are interesting, time spent with these patients should

be utilized judiciously.

Of course, patients should always be asked if he or she is willing to be seen by a student (with the

knowledge they will still be seen by their primary provider). On the rare occasion that there aren’t

enough patients, performing full physicals on available patients may be a meaningful use of time.

Daily notes, problem focused notes, pre/post-operative notes, and discharge summaries can all be

a part of the students daily activities. It is important to know however, that student notes alone are NOT

to serve as part of the patients’ permanent record and therefore, cannot substitute for preceptor findings.

All PA students notes must be countersigned by a preceptor, and once countersigned, may remain in the

medical record. During the call back days of every rotation, students will be submitting patient

documentation produced on site and signed by a preceptor. All demographic information should be

redacted in order to preserve patient confidentiality.

Student’s Abilities

The rigorous nature of PA programs requires students to learn a great deal of information in a

restricted amount of time. The goal is to help them learn the skills necessary to keep pace with the rapid

advances in medicine. While they will learn a great deal by activities outside of direct patient care, they

should never be viewed as “gophers”, scribes, or administrative assistants. In addition, students are never

considered contractors, agents or employees of any healthcare provider or organization. They are not

entitled to any benefits, including disability benefits or any other rights and benefits normally afforded to

employees.

In order to ensure a uniform learning experience, our students will have general learning

objectives for the clinical year (Appendix B), in addition to specific learning objectives assigned to each

rotation. The rotation specific objectives will be listed in their respective course outline. These rotation

goals and objectives have been developed with input from various sources, including practicing

physicians, and in accordance with the NCCPA. Prior to the start of the rotation, you will receive a copy

of the course outline for your rotation. The student has been instructed by the program to review these

goal and objectives with you early in the rotation. In addition, we utilize a list of “core elements” for all

rotations. This list includes daily tasks varying from site orientation to review of medical literature and

can be found in Appendix C. During elective rotations, students are required to submit their own

individual learning objectives prior to their arrival on site.

Second year PA students enter the clinical year knowing how to perform a complete history and

physical with a rudimentary knowledge of how to present a patient. On site, the speed and facility with

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which these tasks are met are a function of the number of previous rotations the student has completed.

You may see them on their first rotation or just prior to graduation. Students should show progress in

applying these skills throughout the course of this rotation. They should be able to perform these tasks on

the patient assigned to them, as well as present the patient and answer basic questions about the specific

disease process.

In any task area, it is incumbent on the student to demonstrate proficiency to you and incumbent

on you to guide the student until he/she is proficient. You may teach a student a new task, but you may

not delegate complete responsibility and authority to a student who is not competent to perform said task.

Each rotation site may require that students participate in specific learning activities in addition to the

patient care elements. These may include Grand Rounds, conferences, lectures, literature reviews, or

presentations. The other functions that a PA student can performed are governed by the PA program

policy, Marist College Policy, and New York State law. Students will decline to perform any task that is

in conflict with any of these policies.

Marist College PA Program Requirements

The following items represent a listing of the primary program requirements for 2nd year students:

1. Students are required to keep a log of their daily activities. This data includes patient

experiences, diagnoses encountered, time spent at the rotation site, board review, and procedures

performed on site. The information provided is compliant with HIPAA regulations and does not

contain any identifiable patient information, aside from an age range and sex.

2. During the course of a clinical rotation, students are expected to return to the program for the

following sessions:

a. Mandatory monthly “Call Back Day”, which falls on the third week. At that time,

students meet with their Faculty advisor to review their logs and discuss their progress to

date.

b. PA Grand Rounds: provided by students on their elective rotations, taking place during

week 5.

c. End of rotation examinations: for core rotations, taking place during week 5.

3. Depending on the rotation, the program may require a certain number of complete patient write-

ups, examinations, or case presentations to the faculty/class. The grading table for the clinical

year may be found in Appendix D. Over time, many preceptors have added assignments which

they feel are beneficial learning experiences. While these assignments may be utilized as a tool

for completing your End of Rotation Assessment (Appendix J), they will not be directly

incorporated into the student’s final grade.

4. Site visits by program faculty are conducted in order to evaluate student progress. During that

time a faculty member will spend time with the student and potentially observe a patient

encounter. He or she will also request to speak with you briefly to discuss the rotation. The

Student Visit Evaluation form utilized by faculty can be found in Appendix E.

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5. A mid-rotation and final rotation evaluation will be required of the lead preceptor for each

rotation. Details regarding this process are outlined in the next section. In addition, students are

required to evaluate each rotation site and preceptor via a secure website.

6. An individual preceptor agreement form (Appendix F) must be obtained from the preceptor for

each rotation. This should be returned to the program along with an updated CV.

7. At the start of each rotation, the student will review an “Orientation Checklist” with you

(Appendix G). When complete, both parties should sign the document and return it to the

Program.

8. Students must comply with the health requirements of each site and are instructed to be prepared

to provide evidence of compliance if requested. Updated Health Attestation Forms are collected

prior to the start of the clinical year. Copies of Health Attestation Forms and immunization

records will be kept by the Program. The student must keep copies of this information as well.

9. Students receive HIPAA refresher training prior to the start of the clinical year and must comply

with all guidelines when on site. Failure to comply with these guidelines may result in dismissal

from the program.

10. Marist College provides general liability insurance for all students and covers the duties

performed in an approved site. Preceptors must carry their own coverage.

11. All puncture wounds or blood/body fluid exposures should be reported immediately per the site

specific protocol. In addition, the student must follow the MCPAP protocol as outlined:

Protocol for blood borne pathogen exposure for Physician Assistant students off-site:

a) Follow standard procedures for the exposure – washing/flushing the site, documenting the

patient’s information, etc.

b) Notification of the preceptor.

c) The preceptor directs the student to the local site (such as the Emergency Department) and/or has

the student follow their protocol for an exposure. In some instances this means that they will

notify the PA program (845) 575-3308.

d) The student should be prepared to provide documentation to the provider of your tetanus and

hepatitis B immunization status. If the situation warrants, it is understood the student may need

to be started on treatment for HIV exposure (medication).

e) Complete a Marist College Occurrence Report (Appendix H), and fax it to the Clinical

Coordinator (845) 575-3586. The student will fill out the equivalent at the host facility.

f) Please note that the cost for any treatment and/or services rendered as a result of an exposure is

the responsibility of the student.

Mid Rotation Evaluation

Mid rotation evaluations serve as a means for both the student and preceptor to “check in” and

discuss the student’s progress (Appendix I). They do not become part of the rotation grade. Time spent

in the middle of the rotation will save time and anguish later over mismatched expectations. Please set

aside 15 minutes, about half way through the rotation to review their activities. The discussion should

take place in private, perhaps over coffee or over lunch, but never informally while on the run. Utilizing

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the evaluation form will help identify core items for discussion and expedite the process. The student is

required to complete a self-evaluation, mirroring that which is provided to the preceptor. To initiate the

conversation, you may want to ask the student how they perceive their performance and if the objectives

for the rotation are being fulfilled. It may also be helpful to ask if the student feels he/she is doing better

than two weeks ago, or to give feedback on an area the student feels might need special attention over the

remaining weeks. The program has developed resources to address any area of identified need and the

preceptor should feel free to contact the Clinical Coordinator at any time to discuss matters of concern.

All students feel good if they have learned and performed tangible skills of the trade. However

your expertise in thinking through new problems in invaluable. Is the student beginning to incorporate

your approach? Are there ways the student can more effectively tackle new problems? How is the

student’s rapport with the patients and staff?

Final Evaluation

The most useful evaluations are candid and contain concrete information regarding the student’s

performance. You will receive a copy of the Clinical Rotation Final Evaluation form in the mail

(Appendix J) or via email. If the opportunity presents itself, please review this with the student on the last

day of the rotation. When you have completed the form, please return it to the program via mail, fax, or

electronically as soon as possible. The evaluation will be scored and accounts for 60% of the student’s

final grade.

Evaluation of areas such as clinical skills, judgment, and knowledge base require that you take

into account how many rotations the student completed prior to arriving at your site. Please also consider

the progress made during the rotation.

If you are using an additional objective measure on your service, please include that information

on the attached comment form (Appendix M) and return it to the program with the completed clinical

rotation form.

Promotion and retention in the MCPAP are not automatic. At the end of each term, a committee

meets to evaluate each student’s progress. Students who have received a grade of “B” or lower, or have

otherwise failed to exhibit appropriate professional development, may be required to repeat courses or

rotations. They may also be required to complete others forms of remediation, or be dismissed from the

program. If a student is having difficulty, it is imperative that the Clinical Coordinator be alerted as early

as possible so that remediation may be initiated early. It is of no service to the student, future employer,

or most importantly future patient, to let a student slip by.

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Resources

The “One Minute Preceptor” (Appendix K) is included as an educational tool. The steps listed

provide an efficient method for evaluating and giving feedback to students.

The American Academy of Physician Assistants (AAPA), ARC-PA, and Physician Assistant

Education Association (PAEA), and NCCPA have developed the document “Competencies for

the Physician Assistant Profession” (Appendix L). Please review these at your convenience as

they were utilized in the development of program objectives.

If you have any concerns about a student, please contact the Clinical Coordinator at 845.575.3308

immediately. If a student is not making progress, please also let the Clinical Coordinator know

this information

In Conclusion

We hope that you find this orientation manual to be useful. Please let us know if you have any

suggestions for improvement via the attached comment form. We also welcome any feedback that you

may have regarding the program and its curriculum.

On behalf of the program and PA profession, thank you for serving as a preceptor for the Marist

College PA Program.

Theresa Skelly, MPT, MS, PA-C

Clinical Coordinator

Program: (845) 575 – 3308

Direct: (845) 575 – 3592

Fax: (845) 575 – 3586

[email protected]

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Summary of Preceptor Responsibilities

o As an accreditation requirement, we ask that all preceptors provide the Program with an updated

CV identifying state licensing, board certification, and clinical experience. This information must

be verified prior to student placement. For PA’s, please also provide a copy of your supervising

physician’s CV. (MCPAP verifies licensing by identifying any actions taken by OPMC and

maintains CVs for all PAs. The Clinical Coordinator will verify current status of NYS licensure,

as well as board certifications on an annual basis.)

o Provide a clinical setting with an appropriate level of supervision for the student.

o Perform the duties outlined in the orientation checklist with the student (Appendix G). Including

orientation to the site, expectations, objectives, etc.

o Provide oral or written patient assignments and responsibilities as appropriate.

o See all patients seen by the student prior to discharge/end of the day.

o Co-sign all chart notes and orders.

o Complete the mid rotation and final rotation evaluations (Appendix I and J).

o Notify the Program if there is a change in the designated preceptor.

o Contact the Clinical Coordinator immediately if there is a concern about a student’s behavior or

performance.

Tentative Clinical Schedule for the Class of 2018

Rotation I

Monday 5/22/2017 through

Sunday 6/25/2017

Rotation II

Monday 6/26/2017 through

Sunday 8/30/2017

Rotation III

Monday 8/31/2017 through

Sunday 9/3/2017

Rotation IV

Monday 9/4/2017 through

Sunday 10/8/2017

Rotation V

Monday 10/9/2017 through

Sunday 11/12/2017

Rotation VI

Monday 11/13/2017 through

Sunday 12/17/2017

Rotation VII

Monday 1/1/2018 through

Sunday 2/4/2018

Rotation VIII

Monday 2/5/2018 through

Sunday 3/11/2018

Rotation IX

Monday 3/19/2018 through

Sunday 4/22/2018

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Appendix A

Request / Explanation for Rotation Absence

Student Name: ______________________________ Today’s Date: ____________

To Clinical Coordinator: ______________________

Re: Absence from: __________________________

(rotation name / number)

I will be/was absent from the above rotation on: ________________________________________

Reason for absence: ______________________________________________________________

This is / was an:

________ anticipated absence*

________ unanticipated absence

Plan(s) for making up the hours missed on site:

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________ ___________________

Signature of Student Date

_____________________________ ___________________

Signature of Clinical Coordinator Date

Office use only:

____ Reviewed ______ Discussed with student

____ File ______ Student phoned program

*Anticipated absence requires prior approval of the Program Director

_____________________ _________

PD Signature Date

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Appendix B

General Clinical Rotation Goals and Competencies

The Competencies for the Physician Assistant Profession are utilized in the development of general course goals.

Each goal listed below is referenced to one or more of the competencies. A copy of the coded Competencies can be

found in the following pages of the Preceptor Handbook. The Competencies may also be found online at:

https://www.nccpa.net/Upload/PDFs/Definition%20of%20PA%20Competencies.pdf.

During the 5-week clinical rotation, the 2nd year PA student will:

1. obtain an accurate medical history covering all essential aspects of the history, including, but not limited to,

issues related to age, gender, and socio-economic status. (MK3, MK4, MK8, MK9, ICS2, ICS3, ICS6,

PC3, PROF7)

2. perform, in a skilled manner, a comprehensive and/or problem-oriented, organ system specific, physical

examination. (MK1, MK2, MK3, MK4, MK8, MK9, ICS2, ICS3, PC2, PC3, PROF7)

3. collect data from previous medical records, including exam findings, imaging, laboratory reports, etc.,

required of a diagnostic work-up (MK1, MK2, MK3, MK4, MK9, PC3, PC4, PBLI4).

4. identify indications for diagnostic tests and procedures, and order them appropriately. (MK1, MK2, MK3,

MK4, MK5, MK6, MK7, MK8, MK9, ICS2, PC3, PC4, PC5, PC8)

5. skillfully perform diagnostic and therapeutic procedures warranted by a patient’s condition, including but

not limited to venipuncture, suturing, common laboratory testing, and injections. (MK1, MK2, MK4, MK5,

MK6, ICS2, ICS3, PC5, PC7, PC8)

6. obtain, interpret, and manage information from laboratory and imaging studies for the formation of

diagnostic and management plans. (MK1, MK2, MK3, MK4, MK5, MK6, MK7, MK8, MK9, ICS2, ICS6,

PC3, PC4, PC5)

7. formulate a differential diagnosis in accordance with the patient assessment. (MK3, MK4, MK9, ICS2,

ICS6, PC3, PC4)

8. prepare a patient problem list (MK3, MK6, PC3, PC8).

9. implement and monitor health management plans for common, uncomplicated medical and surgical

problems. (MK1, MK3, MK6, MK7, MK8, ICS4, ICS6, PC1, PC4, PC5, PC8, SBP1, SBP9)

10. know the indications for provider referral and seek consultation from other physicians and other health

professionals when indicated. (MK3, MK6, MK7, MK8, ICS4, PC1, PC4, PC5, PROF1, PROF2, SBP3,

SBP5)

11. understand the etiology and pathogenesis (in addition to the clinical, laboratory, radiologic, and pathologic

manifestations) of the diseases or conditions clinicians are likely to encounter within a practice. (MK2,

MK3, PC4)

12. understand the scientific evidence of effectiveness for each of the therapeutic options available for patients

throughout the course of the patients’ care. (MK1, MK2, MK6, ICS3, PC4, PBLI3, PBLI4, SBP3)

13. construct diagnostic and therapeutic management strategies for patients with common acute and chronic

conditions, including medical, surgical, and psychological conditions (MK1, MK3, MK5, MK6, MK9,

PC5).

Updated: 5/29/2015 MCPAP Preceptor Handbook 13 | P a g e

14. construct a management strategy for patients requiring short- and long-term rehabilitation. (MK6, MK7,

ICS4, ICS6, PC1, PC4, PC5)

15. Recognize and assess the severity of common emergency problems and respond in a decisive manner.

(MK4, MK9, PC3, PC5, PC7, PROF4)

16. outline an initial course of management for patients with conditions requiring emergency or critical care.

(MK1, MK5, MK6, PC4, PC5, PC7, PROF4)

17. discuss management options with patients in an honest and objective fashion. (MK6, ICS1, ICS2, ICS3,

ICS5, ICS6, PC2, PC4, PC5, PC6, PC8, PROF3, PROF4, PROF7, SBP2, SBP3)

18. respond to patient needs which go beyond the scope of the immediate presenting complaint, including the

social, emotional, spiritual, and economic aspects of the patient’s problem. (ICS1, ICS2, ICS3, ICS5, PC2,

PC6, PC8, PROF3, PROF4, SBP2, SBP3, SBP4, SBP6)

19. communicate effectively, both orally and in writing, with patients, patients’ families, colleagues, and others

with whom exchange of information is required. (ICS1, ICS2, ICS3, ICS4, ICS6, PC1, PC2, PC6, PROF2)

20. interact with, educate and counsel patients at their level of comprehension, while demonstrating cultural

competency and sensitivity. (ICS1, ICS2, ICS3, ICS5, ICS6, PC2, PC6, PC8, PROF3, PROF7, PROF8).

21. demonstrate knowledge of traditional and non-traditional treatment strategies in order to provide intelligent

guidance to patients. (MK1, MK6, PC1, PC4, PC8, PROF7, PROF8, SBP1, SBP5, SBP7)

22. clearly document patient information, including admission notes, discharge summaries, progress notes,

initial comprehensive evaluations, problem-oriented notes, consult notes, surgical notes, problem lists,

orders, and prescriptions in a complete and concise manner. (ICS6, PC9, PROF1, PROF4, PBLI4, SBP1,

SBP2, SBP7)

23. provide a complete, concise and well-organized case presentation on assigned patients. (MK3, MK6, MK9,

ICS2, ICS3, ICS4, PC1)

24. review current medical literature on a continuing basis for resource and research purposes in order to

reason deductively when solving clinical problems. (MK1, MK2, PC4, PC9, PROF5, PROF8, PBLI1,

PBLI2, SBP7)

25. use evidence-based medicine protocols when possible. (MK1, MK2, PC4, PC9, PROF5, SBP7, PBLI2)

26. Implement clinical therapeutics and pharmacologic therapy in an appropriate manner. (MK1, MK2, MK6,

ICS2, PC4, PC5)

Professionalism Objectives

The 2nd year Physician Assistant student will:

1. demonstrate compassionate treatment of patients. (ICS1, ICS2, ICS3, ICS5, PC2, PC6, PROF3, PROF7)

2. demonstrate respect for patient privacy and dignity (PC2, PROF3, PROF4, PROF6).

3. demonstrate integrity in all interactions with patients, patients’ families, colleagues, and co-workers (PC1,

PC2, PROF2, PROF3, PROF4, PROF7).

4. develop an understanding and respect for the roles of other health care professionals. (PC1, ICS4, PROF2,

PROF3, PROF10)

Updated: 5/29/2015 MCPAP Preceptor Handbook 14 | P a g e

5. understand the need for collaboration with others in caring for individual patients. (ICS4, PC1, PROF1,

PROF2, PROF10, SBP5)

6. effectively function as a member of the interdisciplinary health care team. (ICS4, PC1, PROF2, PBLI1,

SBP5)

7. act as a health care professional with a positive attitude. (ICS3, ICS4, ICS5, PC1, PROF2, PROF8, PROF9)

8. recognize and accept limitations in one’s knowledge base and skill set. (ICS5, PROF8, PBLI5)

9. commit to continuously improving one’s knowledge base and abilities. (PROF5, PROF8, PBLI4, PBLI5,

SBP7)

10. carry out strategies to promote acceptance of the PA role within the professional community. (ICS4, ICS5,

ICS6, PC1, PROF1, PROF2, PROF 5, PROF10).

Updated: 5/29/2015 MCPAP Preceptor Handbook 15 | P a g e

Appendix C

Core Elements

The following is a guide to the basic tasks and procedures in which all students should participate

throughout the clinical year. It is in no way, all inclusive and subject to change at the discretion of the

Program.

o Elicit a detailed and accurate patient history, comprehensive and/or problem-oriented

o Perform a detailed and appropriate physical examination, comprehensive and/or problem

oriented, including (but not limited to): pelvic, breast, rectal, testicular, mental status exam

o Record data as would be part of a patient’s record. This includes:

Comprehensive Evaluations Admission Notes Problem Lists

Problem Oriented Notes Progress Notes Discharge Summaries

o Present patient data by developing patient management plans, participating in rounds, and

assisting a preceptor in rounds.

o Identify patient problems

o Order and interpret appropriate diagnostic procedures

o Order and evaluate the effectiveness of therapeutic procedures and medications

o Write prescriptions

o When appropriate and available, perform diagnostic procedures and tests. Including but not

limited to:

Fingerstick Venipuncture Irrigation/Debridement

Gram Stain Culture Urinalysis

Pulse oximetry Wound checks Cardiac monitoring

o When appropriate, perform therapeutic procedures. Including but not limited to:

o Participate in patient education and counseling. Discuss issues of compliance, health

maintenance, disease prevention, and health promotion.

Injections Dermal biopsy Immunizations Suturing

Surgical First Assisting Nasal Packing NG tube insertion /

removal

Cast application /

removal

Suture / Staple removal Lumbar Puncture Wound Care IV/Line insertion /

removal

Foley catheter insertion /

removal

Chest tube insertion /

removal

CPR ACLS / BLS

Slit lamp exam Fluorescein stain exam Wound debridement Endotracheal intubation

Updated: 5/29/2015 MCPAP Preceptor Handbook 16 | P a g e

o Assist in referral to preceptor, specialty care providers, health, and social service agencies.

o Review of medical literature to ensure evidence based practice.

o Some rotations have additional core requirements:

Surgical Rotations Ob/Gyn Rotations

Sterile prep procedure Assist in vaginal delivery

Staple application / removal Assist in cesarean section delivery

I & D Diaphragm and pessary fitting / care

Suture application / removal PAP smear

Cryotherapy Contraceptive counseling

Pre/Intra/Post-op notes Pre/post-natal counseling

Contraceptive insertion/removal (i.e., Norplant)

Updated: 5/29/2015 MCPAP Preceptor Handbook 17 | P a g e

Appendix D

Clinical Year Grading Table

Class of 2018

Course Number Clinical Rotation Credits Preceptor

Evaluation

EOR

exam Write-up

Grand

Rounds

Presentation

Professionalism Logs

Complete

Final

Grade

PA 701 Family Medicine 3 60% 30% Pass / Fall 10% Yes / No

PA 702 Internal Medicine 3 60% 30% Pass / Fall 10% Yes / No

PA 703 General Surgery

3 60% 30% Pass / Fall 10% Yes / No

PA 704 Pediatrics 3 60% 30% Pass / Fall 10% Yes / No

PA 705 Ob/Gyn 3 60% 30% Pass / Fall 10% Yes / No

PA 706 Behavioral Health 3 60% 30% Pass / Fall 10% Yes / No

PA 707 Emergency Medicine 3 60% 30% Pass / Fall 10% Yes / No

PA 708 Geriatrics / Elective 3 60% Pass / Fall 30% 10% Yes / No

PA 709 Elective 3 60% Pass / Fall 30% 10% Yes / No

Updated: 5/29/2015 MCPAP Preceptor Handbook 18 | P a g e

Appendix E

Site Visit – Student Evaluation Form

Student: _________________________________________________

Evaluator: _______________________________________________

Date: ___________________________________________________

Rotation / Site: ___________________________________________

Week # ____ of 5

Preceptor: _______________________________________________

Time / Pt log Review

Average # of pts seen daily

Hours

Procedure Tracking Review

Reading / Board Review:

Text

# Questions per wk / % correct

Comments:

Student Observation/Assessment:

Patient Presentation

Review of Chart Notes

History & Physical Exam

Assessment/Plan

Procedure/Skills

Patient Education / Counseling

Professionalism / Dress

Other:

Student Comments

Orientation

Level of Supervision

Teaching

Review of Objectives

Preceptor Knowledge of Objectives

Notes:

Student Perception

Strengths

Areas for Improvement

Remediation done / scheduled:

Preceptors Comments:

Overall Impression of Performance

Student Strengths

Areas for Improvement

Program Curriculum

** If you spoke or received feedback from other site personnel, please document below:

Please sign and date: _______________________________________ ___________________________________________

Evaluator Clinical Coordinator

Updated: 5/29/2015 MCPAP Preceptor Handbook 19 | P a g e

Appendix F

Agreement for Supervised Clinical Education of Marist College Physician Assistant Students

A. I, __________________, agree to provide supervised clinical education for ___________________ from the (Name of preceptor) (Name of student) Marist College Physician Assistant Program (MCPAP) while he/she is participating in clinical rotations during the

May 2017-May 2018 Clinical Year.

I also agree to provide evaluation of the student's performance throughout the rotation, and to submit a

summative evaluation to the Marist College Physician Assistant Program at the conclusion of the rotation. It is my

understanding that the student will be in good academic standing and will have written objectives identifying activities

that should be given emphasis while on rotation under my supervision. The PA Program will assist me, as necessary,

in providing the optimal environment for the student’s clinical education.

I am aware that during these clinical rotation experiences, the student will be provided professional liability

insurance coverage through Marist College. The limits of liability are $1,000,000 per occurrence and $3,000,000

aggregate ($5,000,000 cap).

I understand that I may obtain copies of the student’s immunization record and tuberculosis screening results

from the student and/or with the student’s permission but that I am not entitled to other student health records, as I

am/we are considered affiliated clinical faculty member/s of the PA program. My facility may request such

documentation from the student if needed.

Furthermore, I realize that the Marist College Physician Assistant Program prohibits its clinical preceptors

from discriminating with regard to the acceptance and education of its Physician Assistant students on the basis of

age, color, religion, creed, disability, marital status, veteran status, national origin, race, gender or sexual orientation.

B. Please describe or list the duties and responsibilities expected of this student on this rotation:

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

________________________________________ ___________________

Preceptor's Signature / Printed Name Date

________________________________________ ___________________

Program Signature Date

Marist College • 3399 North Road • Poughkeepsie, NY 12601-1387

Telephone: 845-575-3308 • Fax: 845-575-3586 • [email protected]

Updated: 5/29/2015 MCPAP Preceptor Handbook 20 | P a g e

Appendix G

Clinical Rotation Orientation Form

Student: _________________________

Dates: from ___/___/___ to ___/___/___ Rotation/Site: ____________________________________

(e.g., Emergency Medicine/MHRH)

Preceptor: _______________________________________

Student’s Orientation to Clinical Rotation Site:

Orientation to site and staff

Orientation to patient documentation and flow of patient care

Health and safety procedures and point of contact for issues on site

Review of the rotation objectives with preceptor

Review of any additional expectations outlined by preceptor (please document below)

Review midterm and end of rotation evaluation, policies and procedures

Review schedule, hours, and equipment needs

Notes: ______________________________________________________________________

____________________________________________________________________________

FEEDBACK

Please discuss how formative feedback will be given during this rotation.

Please discuss how and when the mid-rotation evaluation will be scheduled.

Please discuss and document whether or not the final evaluation will be reviewed with the student prior to

submission.

Sign and date below:

Student___________________________________________________________ Date________________

Preceptor_________________________________________________________ Date________________

Clinical Coordinator_______________________________________________ Date________________

Updated: 5/29/2015 MCPAP Preceptor Handbook 21 | P a g e

Appendix H

Student Injury & Incident Report

Person Submitting Report: Student Name: ______________________________________ Student ID #: Home address: ______________________________________ Phone Number: Date & Time of Incident: _____________________________ Location: Preceptor of Record: Source of Injury (tool, chemical, machine): Medical Treatment: Yes _____ No _____ If yes, location of treatment: Nature of Injury / Incident:

Description of Incident (attach additional page as necessary):

Corrective action that should be taken to avoid reoccurrence:

Names of Witnesses: Student’s Signature: ____________________________________________ Date: Instructor’s Name / Signature: ____________________________________ Date:

For Office Use Only: Corrective Action Taken:

Copies: Program File / Student Affairs / Risk Management

Updated: 5/29/2015 MCPAP Preceptor Handbook 22 | P a g e

Appendix I

Mid Rotation Evaluation Form

Student: ___________________________________ Rotation/Site: ___________________________

Preceptor: _______________________________ Date/Week #: ___________________________

Mid-rotation evaluations are helpful to both the student and the program in addressing areas of concern, as well as identifying

opportunities for improvement. At the midpoint of the rotation, we ask that you please take a moment to address the skills listed

below.

Your feedback is extremely important to the overall success of our students.

PLEASE FEEL FREE TO CONTACT THE CLINICAL COORDINATOR AT ANY TIME with comments, concerns, or

questions at (845) 575 – 3592.

Please check () the box that best describes the student’s performance to date, and leave any necessary comments in the space provided.

Below

Expectations Meets

Expectations Exceeds

Expectations Below

Expectations Meets

Expectations Exceeds

Expectations

History taking and physical exam

Initiative and motivation

Use of laboratory and diagnostic testing

Dependability and reliability

Application of scientific concepts

Honesty and integrity

Patient assessment and differential diagnosis

Maturity and flexibility

Patient management, plans, clinical

inventions/therapeutics

Interpersonal skills and attributes

Communication (oral/written)

Knowledge of limitations

Clinical judgment Social sensitivity and tolerance

Please email or fax the completed form to the Clinical Coordinator at (845) 575 – 3586. Thank you for your continued support of

our students.

Student Signature: ____________________________________________

Preceptor Signature: ___________________________________________

Date: ______________________________

Comments:

_________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

___

__________________________________

Clinical Coordinator Signature

________________________

Date

Updated: 5/29/2015 MCPAP Preceptor Handbook 23 | P a g e

Appendix J

Clinical Rotation Final Evaluation

STUDENT NAME: ____________________________________ ROTATION DATES: ___________________________________

PRECEPTOR: _______________________________________ ROTATION # ________________ OF _________9 _________

CLINICAL ROTATION: _________________________________ SITE: ______________________________________________

Instructions: The final evaluation of student performance covers areas of knowledge, skills, and attitudes in correlation to the

rotation objectives and goals. Please take into consideration the timing of this rotation relative to the remainder of the clinical

year. Please check the box that best correlates to the student’s performance in the following areas. Please refer to the attached

rubric (page 3) for clinical skills evaluation criteria.

Unacceptable

Clinical Skills N/A Poor Below

Average Average

Above

Average Excellent

History Taking

Physical Exam

Laboratory and Diagnostic Studies

Medical Factual Knowledge and Scientific Concepts

Problem Solving and Critical Thinking

Assessment and Differential Diagnosis

Plans, Interventions, and Management

Communication (written)

Communication (oral)

Health Maintenance

Personal Attributes and Interpersonal Skills Unacceptable Below

Expectations

Meets

Expectations

Initiative & motivation -

Demonstrates desire to learn; seeks opportunities to advance knowledge.

Honesty, integrity, & accountability -

On time; completes assigned tasks; adheres to academic honesty; ethically sound

Patient Rapport –

Able to establish and sustain sound relationships; communicate with patients /

families.

Cultural competency –

Adapts to the needs of diverse populations; sensitive and responsive to variable needs

Adaptability & flexibility –

Handles stressful situations; Able to adapt to change; demonstrates resiliency.

Emotional maturity –

Respectful of staff and patients; self-confident; behaves professionally.

Respect for patient confidentiality –

Maintains privacy of information and during patient exams; compliant with HIPAA.

Recognition of limitations –

Able to self-assess; asks for help when needed; confident in his/her practice.

Acceptance of constructive feedback –

Recognizes and implements feedback; committed to professional development

Adherence to dress code and image standards:

Wears white coat, always identifies self as PA student.

Updated: 5/29/2015 MCPAP Preceptor Handbook 24 | P a g e

STUDENT NAME: ____________________________ PRECEPTOR: ________________________________

CLINICAL ROTATION: _______________________

Please comment on the student’s level of preparedness for the clinical year: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Additional comments: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Was this evaluation discussed with the student: ________ YES ________ NO Signature: __________________________________________________ Printed Name: _______________________________________________ Date: __________________

Please return this completed evaluation via fax / email / mail to:

Marist College Physician Assistant Program

Attn: Clinical Coordinator 3399 North Road

Poughkeepsie, New York 12601 Phone (845) 575-3308

Fax (845) 575-3586 Email: [email protected]

Updated: 5/29/2015 MCPAP Preceptor Handbook 25 | P a g e

n/a 1 (Poor) 2 (Below Average) 3 (Average) 4 (Above Average) 5 (Excellent)

History Taking

Data obtained is

incomplete and

inaccurate. Routinely fails to elicit important

data. Inadequate

understanding of cases.

Occasionally fails to elicit important data.

Includes irrelevant

data. At times disorganized.

Adequate. Rarely

includes irrelevant data or misses very

minor points.

Elicits complete and

important data.

Capably done with very good

understanding of

cases.

Consistently elicits complete and

accurate data. Able

to describe findings in clear and concise

manner. Excellent

understanding of cases.

Physical Exam

Frequently incomplete. Fails to follow a logical

sequence. Deficient in

technical qualities.

Generally complete, but often fails to

follow logical

sequences. Minor technical difficulties.

Abnormalities not

always identified.

Complete and

technically accurate. Follows a logical

sequence and

recognizes abnormalities.

Thorough, logical,

and smooth

sequences. Technically reliable.

Common

abnormalities consistently

identified.

Consistently thorough and precise.

Follows logical

sequence even in difficult cases.

Technically efficient

and sound.

Laboratory/

Diagnostic

Studies

Poor knowledge of orders

and relationship of tests to

the clinical picture. Selection and

interpretation often

inappropriate.

Marginal knowledge of

routine tests. Has difficulty interpreting

results.

Average knowledge

and interpretation. Orders are clinically

appropriate.

Above average

knowledge of routine

tests. Orders and interpretations are

clinically

appropriate.

Excellent knowledge

of routine and some

specialized exams.

Orders appropriately and interprets well

Medical Factual

Knowledge/Scie

ntific Concepts

Lacks basic knowledge of

underlying processes with

frequent errors.

Needs improvement of knowledge base to

function consistently

well. Not always able to apply to cases.

Average understanding of

underlying processes

and good knowledge base.

Above average base of knowledge.

Consistently able to

relate concepts to cases.

Demonstrates a

comprehensive

understanding of processes associated

with given

conditions. Demonstrates

relevant clinical

application.

Problem Solving

/ Critical

Thinking

Faulty reasoning and

unable to solve patient

problems without significant guidance.

Requires guidance to

solve common

problems and identify diagnoses.

Able to solve

common problems. Identifies most issues

in diagnosis and

management.

Able to solve complex problems

with minimal to no

guidance. Identifies appropriate

diagnoses and plans.

Able to solve

complex problems. Concise and

thorough diagnostic

and treatment plans.

Assessment and

Differential

Diagnosis

Fails to integrate data.

Assessments often

incorrect. Avoids making decisions. Judgment is

poor.

Difficulty integrating data, identifying

problems, and setting

priorities.

Average judgment.

Assessments are appropriate.

Priorities and

differentials are appropriate.

Integrates pertinent

data. Acceptable differentials are

formulated. Very

good understanding and judgment.

Consistently correct.

Understands and

prioritizes problems. Excellent judgment

and insight.

Plans,

interventions,

and

management

Misses key components

of a plan. Unfamiliar with

clinical tasks. Unable to select appropriate

therapies, even with

guidance.

Plans are inadequate.

Requires frequent

revision. Limited understanding of

pharmacologic

properties.

Average

understanding of clinical tasks.

Formulates,

implements, and prescribes with

minimal assistance.

Formulates

acceptable plans. Selects appropriate

therapies without

guidance. Very good understanding of

pharm properties.

Consistently formulates and

implements thorough and appropriate

plans.

Comprehensive understanding of

pharmacologic

properties.

Communication

(written and

oral)

Pertinent data absent.

Disorganized.

Inappropriate and incomplete.

Sometimes incomplete or disorganized. Some

difficulty

communicating and modifying plans for

patient needs.

Capably done and

organized.

Adequately

communicates with

patients.

Concise and

organized. Timely

with documentations.

Communicates very

well with patients.

Consistently concise and organized.

Documents timely

and appropriately. Excellent patient

rapport

Health

maintenance

Poor understanding of conditions, risk factors,

screening tests, and

prevention. Frequently omits patient education.

Fair understanding of conditions, risk factors

and screening tests.

Inconsistently provides patient education.

Adequate

understanding of medical conditions,

risk factors,

screening tests. Appropriate level of

patient education..

Above average

understanding of conditions, risk

factors and screening

tests. Routinely provides patient

education.

Comprehensive understand of

medical conditions,

risk factors, screening tests and

prevention.

Consistently provides patient education.

Updated: 5/29/2015 MCPAP Preceptor Handbook 26 | P a g e

Appendix K

Updated: 5/29/2015 MCPAP Preceptor Handbook 27 | P a g e

Appendix L

Competencies for the Physician Assistant Profession

“The clinical role of PAs includes primary and specialty care in medical and surgical practice settings.

Professional competencies for physician assistants include the effective and appropriate application of

medical knowledge; interpersonal and communication skills; patient care; professionalism; practice-based

learning and improvement; systems-based practice; as well as an unwavering commitment to continual

learning, professional growth, and the physician-PA team for the benefit of patients and the larger

community being served. These competencies are demonstrated within the scope of practice, whether

medical or surgical, for each individual physician assistant as that scope is defined by the supervising

physician and appropriate to the practice setting.” (NCCPA)

At Marist College, the “Competencies for the Physician Assistant Profession” (National Commission on

Certification of Physician Assistants, 2012) are utilized as a guideline for student evaluation and

formulating course objectives. For convenience purposes, these competencies have been listed below.

In the syllabus for each clinical rotation, you will find a course objective or goal linked to one of these

codes. This method is helpful in monitoring student progress and identifying areas which require

improvement.

Medical Knowledge (MK)

Medical knowledge includes the synthesis of pathophysiology, patient presentation, differential diagnosis, patient

management, surgical principles, health promotion, and disease prevention. Physician assistants must demonstrate

core knowledge about established and evolving biomedical and clinical sciences and the application of this

knowledge to patient care in their area of practice. In addition, physician assistants are expected to demonstrate an

investigative and analytic thinking approach to clinical situations. Physician assistants are expected to understand,

evaluate, and apply the following to clinical scenarios:

MK1) evidence-based medicine

MK2) scientific principles related to patient care

MK3) etiologies, risk factors, underlying pathologic process, and epidemiology for medical conditions

MK4) signs and symptoms of medical and surgical conditions

MK5) appropriate diagnostic studies

MK6) management of general medical and surgical conditions to include pharmacologic and other

treatment modalities

MK7) interventions for prevention of disease and health promotion/maintenance

MK8) screening methods to detect conditions in an asymptomatic individual

MK9) history and physical findings and diagnostic studies to formulate differential diagnoses

Interpersonal & Communication Skills (ICS)

Interpersonal and communication skills encompass the verbal, nonverbal, written, and electronic exchange of

information. Physician assistants must demonstrate interpersonal and communication skills that result in effective

information exchange with patients, patients’ families, physicians, professional associates, and other individuals

within the health care system. Physician assistants are expected to:

ICS1) create and sustain a therapeutic and ethically sound relationship with patients

ICS2) use effective communication skills to elicit and provide information

ICS3) adapt communication style and messages to the context of the interaction

Updated: 5/29/2015 MCPAP Preceptor Handbook 28 | P a g e

ICS4) work effectively with physicians and other health care professionals as a member or leader of a

health care team or other professional group

ICS5) demonstrate emotional resilience and stability, adaptability, flexibility, and tolerance of ambiguity

and anxiety

ICS6) accurately and adequately document information regarding care for medical, legal, quality, and

financial purposes

Patient Care (PC)

Patient care includes patient- and setting-specific assessment, evaluation, and management. Physician assistants

must demonstrate care that is effective, safe, high quality, and equitable. Physician assistants are expected to:

PC1) work effectively with physicians and other health care professionals to provide patient- centered care

PC2) demonstrate compassionate and respectful behaviors when interacting with patients and their families

PC3) obtain essential and accurate information about their patients

PC4) make decisions about diagnostic and therapeutic interventions based on patient information and

preferences, current scientific evidence, and informed clinical judgment

PC5) develop and implement patient management plans

PC6) counsel and educate patients and their families

PC7) perform medical and surgical procedures essential to their area of practice

PC8) provide health care services and education aimed at disease prevention and health maintenance

PC9) use information technology to support patient care decisions and patient education

Professionalism (PROF)

Professionalism is the expression of positive values and ideals as care is delivered. Foremost, it involves prioritizing

the interests of those being served above one’s own. Physician assistants must acknowledge their professional and

personal limitations. Professionalism also requires that PAs practice without impairment from substance abuse,

cognitive deficiency or mental illness. Physician assistants must demonstrate a high level of responsibility, ethical

practice, sensitivity to a diverse patient population, and adherence to legal and regulatory requirements. Physician

assistants are expected to demonstrate:

PROF1) understanding of legal and regulatory requirements, as well as the appropriate role of the physician

assistant

PROF2) professional relationships with physician supervisors and other health care providers

PROF3) respect, compassion, and integrity

PROF4) accountability to patients, society, and the profession

PROF5) commitment to excellence and on-going professional development

PROF6) commitment to ethical principles pertaining to provision or withholding of clinical care,

confidentiality of patient information, informed consent, and business practices

PROF7) sensitivity and responsiveness to patients’ culture, age, gender, and abilities

PROF8) self-reflection, critical curiosity, and initiative

PROF9) healthy behaviors and life balance

PROF10) commitment to the education of students and other health care professionals

Practice-based Learning and Improvement (PBLI)

Practice-based learning and improvement includes the processes through which physician assistants engage in

critical analysis of their own practice experience, the medical literature, and other information resources for the

purposes of self- and practice-improvement. Physician assistants must be able to assess, evaluate, and improve their

patient care practices. Physician assistants are expected to:

Updated: 5/29/2015 MCPAP Preceptor Handbook 29 | P a g e

PBLI1) analyze practice experience and perform practice-based improvement activities using a systematic

methodology in concert with other members of the health care delivery team

PBLI2) locate, appraise, and integrate evidence from scientific studies related to their patients’ health

information on diagnostic and therapeutic effectiveness

PBLI3) apply knowledge of study designs and statistical methods to the appraisal of clinical literature and

other information on diagnostic and therapeutic effectiveness

PBLI4) utilize information technology to manage information, access medical information, and support

their own education

PBLI5) recognize and appropriately address personal biases, gaps in medical knowledge, and physical

limitations in themselves and others

Systems-based Practice (SBP)

Systems-based practice encompasses the societal, organizational, and economic environments in which health care

is delivered. Physician assistants must demonstrate an awareness of and responsiveness to the larger system of

health care to provide patient care that balances quality and cost, while maintaining the primacy of the individual

patient. PAs should work to improve the health care system of which their practices are a part. Physician assistants

are expected to:

SBP1) effectively interact with different types of medical practice and delivery systems

SBP2) understand the funding sources and payment systems that provide coverage for patient care and use

the systems effectively

SBP3) practice cost-effective health care and resource allocation that does not compromise quality of care

SBP4) advocate for quality patient care and assist patients in dealing with system complexities

SBP5) partner with supervising physicians, health care managers, and other health care providers to assess,

coordinate, and improve the delivery and effectiveness of health care and patient outcomes

SBP6) accept responsibility for promoting a safe environment for patient care and recognizing and

correcting systems-based factors that negatively impact patient care

SBP7) apply medical information and clinical data systems to provide effective, efficient patient care

SBP8) recognize and appropriately address system biases that contribute to health care disparities

SBP9) apply the concepts of population health to patient care

Updated: 5/29/2015 MCPAP Preceptor Handbook 30 | P a g e

Appendix M

Preceptor Comment Form

Please feel to leave comments or suggestions in the space below and return it with your final evaluation at

the end of the rotation.

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

Please return the form via mail, fax, or email to:

Theresa A. Skelly, MPT, MS, PA-C

Clinical Coordinator

Marist College

Physician Assistant Program

3399 North Road

Poughkeepsie, New York 12601

Fax (845) 575-3586

[email protected]

Program Telephone (845) 575-3308

Direct Line: (845) 575-3592


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