Harding University PA ProgramElective Practicum 1 & 2Page 1 of 7Updated 8/4/2015

Harding University Physician Assistant ProgramCourse Syllabus

Elective Practicum II(PAS 660) 

I. COURSE/PREFIX NUMBER & TITLE: PAS 659 - Elective Practicum 1

I. Preceptor Information :Refer to Rotation Assignment Calendar and PA Student Handbook

Responsible Faculty: Gary Hill, Clinical Director Phone: 501-279-4816Cell: 501-772-2906E-mail: ghill2@harding.edu

Office Hours:      Monday 8:00 AM – 12:00 PMTuesday 2:00 – 5:00 PMWednesday 10:00 AM – 12:00 PM, 1:00 – 5:00 PMThursday and Friday 8:00 AM – 12:00 PM, 1:00 – 5:00 PMSee rotation schedule for conference and meeting schedule.

II. Course Dates: to be arranged

III. Credit hours: 6

IV. Contact Hours: 240

V. Course Prerequisites: Completion of Didactic phase

VI. Course InformationDuring the Preclinical Phase and early portion of the Clinical Phase, PA program students consider their own clinical practice interests and needs for skill development. The student selects one or two clinical areas for the Elective Clinical Rotation(s) with the approval of program faculty. Students may select elective experiences from specialty areas not included in the required rotations, or in one of the required clinical areas. With the consultation and approval of program faculty the student develops an individualized learning plan which includes objectives for the elective rotation(s), and a method to demonstrate achievement of these objectives at the conclusion of the rotation(s). Where possible and appropriate, students participate in grand rounds, noon conferences and other clinically relevant didactic presentations.

In order to meet ARC-PA standards as well as to ensure adequate PA student training, the following minimum numbers of patient logs have been chosen. Students are encouraged to see and log more than the minimum number of each type. It is the student’s responsibility to ensure that adequate numbers of all types and settings of patients/encounters are seen and properly logged. Not meeting the minimum numbers will trigger an evaluation by the Clinical Committee. The Clinical Committee will evaluate the numbers and decide on a process of remediation. This remediation could include, but is not limited to; warning from the clinical director, failing the “logs” portion of the evaluation, being put on academic probation, repeating the rotation with a different preceptor with the loss of an elective, repeating the rotation resulting in delay of graduation, or dismissal from the program.

At the conclusion of the last rotation (Preceptorship), the student will have logged at a minimum, the following number of patients in each of the following settings:

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A. Outpatient – 300B. Emergency Department – 200C. Hospital – 50D. Operating Room – 20E. Long-term-care Facility – 15If the student has not completed these minimum numbers during the required rotations, he/she will be expected to meet them during the Clinical Electives and/or Preceptorship.

At the conclusion of the last rotation (Preceptorship), the student will have logged at a minimum, the following number of patients in each of the following Encounter Types:A. Acute Care – 150B. Chronic Care – 20C. GYN/Women’s Health – 15D. Inpatient – 20E. Post-Op – 20F. Pre-Op – 20G. Prenatal – 5H. Preventive – 10I. Psychiatric – 150J. Surgery – 20K. Well-Child – 5If the student has not completed these minimum numbers during the required rotations, he/she will be expected to meet them during the Clinical Electives and/or Preceptorship.

At the conclusion of the last rotation (Preceptorship), the student will have logged at least 15 patients in the Infant (0-1 YO) age group and 25 patients in each of the following age groups:

A. Child (1-12 YO)B. Adolescent (12-18 YO)C. Adult (18-65 YO)D. Elderly (65+ YO)It is anticipated that many of these age group requirements will be completed in the Elective rotations.

Students will review the Syllabus/Objectives with their preceptor and submit the completed Preceptor Review of Syllabus form, signed by student and preceptor to the PA Clinical Office during the first week of the rotation.

E. Learning Objectives/course organizationa. Purposes and objectivesi. The student will be able to analyze his or her own clinical interests and needs for

cognitive and clinical skill development, establish objectives in meeting these interests and goals, and identify means to measure success in achieving these goals.

ii. Based on these identified interests and needs, the student will be able to develop an Individualized Learning Plan which will identify specific cognitive and skill objectives to be achieved in the Elective Clinical Rotation(s), and identify a means to demonstrate achievement of these objectives.

iii. The student will identify resources such as texts, journals, and other materials to support meeting their Individualized Learning Plan objectives.

iv. Through the experience of self-directed Elective Clinical Rotation(s), students will develop some of the skills necessary for life long learning in clinical practice.

b. Individualized Learning Plans: i. These plans will contain both Cognitive and Skill Objectives for the proposed rotation.

Cognitive objectives would include identification of particular disorders, diagnostic techniques, therapeutic methodologies, and clinical settings about which the student plans to learn during the rotation. The skill objectives identify particular clinical skills the student plans to develop during the rotation, such as "be able to recognize

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ventricular hypertrophy on 12 lead EKGs”, "improve skills in the management of patients on oral contraceptives”, and "begin to develop skills in the harvesting of the saphenous vein for coronary revascularization”.

ii. The student will submit the Individualized Learning Plan (ILP) at least six weeks prior to the start of the rotation to allow program faculty to review it for appropriateness and provide suggestions as necessary. After any necessary revisions are complete, the student will submit one copy of the final version of the ILP to the Clinical Education Coordinator, and one copy to the preceptor at the beginning of the rotation.

iii. The preceptor and student will review the ILP and make adjustments at their discretion.

iv. Suggested outline for developing objectives in ILP:1. Obtain and document an appropriate history relevant to the

elective service, utilizing all available information sources, e.g. patient, family, community.

2. Perform and document appropriate physical examinations for the elective setting.

3. List and describe the following common problems in this elective area, including pathophysiology, diagnosis, treatment, and follow-up.

4. Interpret diagnostic tests, including laboratory results, imaging studies, and electrophysiologic studies.

5. Generate and implement an appropriate management plan, including treatment, follow-up plans and patient education and counseling.

6. Discuss the appropriate use of medication related to such issues as dosage, indications, contraindications, interactions, complications, metabolism, excretion, and mutagenicity.

7. Properly perform/assist and document any procedures under the supervision of the preceptor.

8. Special considerations:a. Identify and appropriately utilize any special

instruments.b. Describe and discuss public health issues related to

this elective.v. See sample format for the Individualized Learning Plan on page 4.

vi. Students will be given a reading assignment during the rotation and will be tested on it afterward.

F. Texts, Reference Materials, Equipment and supplies:  Essential materials and supplies:  Student will list specific tools student must have/bring (e.g. stethoscope).Epocrates Essentials Program for Mobile DevicesRequired text: Student will list Course Textbook(s) with Author’s name, which edition. A Comprehensive Review for the Certification and Recertification Examinations for Physician Assistants 5th Edition by O’ConnellRecommended reading: Student will list recommended reading

G. Evaluation and Assessment Policy a. Preceptor Evaluation – 40% of rotation grade

b. End-of-Rotation written exam – 20% of rotation gradec. Logs – 15% of rotation grade d. Case Presentations – 10%e. DXR – 10%f. Preceptor Review of Syllabus – 5%

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g. Individualized Learning Plan Proposal – Pass/Failh. Course grade determined by total of the above.

i. High Pass = 90-100% (Equivalent to letter grade of “A”)ii. Pass = 80-89% (Equivalent to letter grade of “B”)iii. Fail = < 80%

i. All assignments (A-G above) must be completed in order to receive a passing grade for the rotation, including Individualized Learning Plan approved by Clinical Director.

X. Attendance Policy: See PA Clinical Handbook

XI. Students with Disabilities: It is the policy for Harding University to accommodate students with disabilities, pursuant to federal and state law. Therefore, any student with a documented disability (e.g. physical, learning, or psychological) who needs to arrange reasonable accommodations, must contact the instructor and the Disabilities Office at the beginning of each semester. (If the diagnosis of the disability occurs during the academic year, the student must self-- identify with the Disabilities Director ‐as soon as possible in order to get academic accommodations in place for the remainder of the semester.)

The Disabilities Office is located in Room 219 in the Student Center, telephone (501) 279-- 4019‐ . Since some graduate courses are taught at different sites and students will not have access to the Disabilities Office located on Harding University’s Searcy campus, the student must self-identify with the instructor of the course and submit documentation by fax or mail to the Disabilities Office on our main campus. The necessary forms are available. Upon receiving the appropriate documentation approved by ADA Guidelines, academic accommodations may be set up by the instructor via a telephone conference with the Disabilities Director. If you have questions, please contact Teresa J. McLeod, M.Ed., Disabilities Director, at (501) 279-- 4019‐ or tmcleod@harding.edu.

XII. University Assessment: Harding University, since its charter in 1924, has been strongly committed to providing the best resources and environment for the teaching-learning process. The board, administration, faculty, and staff are wholeheartedly committed to full compliance with all criteria of the Higher Learning Commission of the North Central Association of Colleges and Schools. The university values continuous, rigorous assessment at every level for its potential to improve student learning and achievement and for its centrality in fulfilling the stated mission of Harding. Thus, a comprehensive assessment program has been developed that includes both the Academic units and the Administrative and Educational Support (AES) units. Specifically, all academic units will be assessed in reference to the following Expanded Statement of Institutional Purpose: The University provides programs that enable students to acquire essential knowledge, skills, and dispositions in their academic disciplines for successful careers, advanced studies, and servant leadership.

XIII. Credit hours: This course adheres to university guidelines regarding workload requirements per credit hour.

XIV. Academic Integrity: The Physician Assistant Program adheres to the Academic Integrity Policy as outlined in the Harding University catalog. Violations of this policy will result in penalties up to and including suspension or expulsion from the PA Program, and will be reported to the Assistant Vice President for Academic Affairs. All instances of dishonesty will be handled according to the procedures delineated in the University catalog.

XV. Disclaimer statement: The instructor has the right to change any of the components of the syllabus in the event of extenuating circumstances.

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Elective Practicum 2Individualized Learning Plan Proposal

NOTE: THIS IS A TEMPLATE TO BE ADJUSTED TO YOUR NEEDS, TYPED, AND SENT IN. PLEASE INCLUDE ALL ITEMS BELOW (INCLUDING DATE LINES) ON YOUR ILP.

Student Name______Collin Grimes________ Date Submitted_______September 27, 2015______

Rotation________Preceptorship________

Faculty Advisor________Mr. Gary Hill, PA-C_________

Dates of study_______10/12/2015-11/20/2015________

1. Overall Goals of course:A. Use dermatology terminology to effectively and accurately describe skin conditions or lesions.B. Demonstrate focused history-taking, physical examination, and oral and written presentations suitable for dermatology. C. Outline a basic approach to the diagnosis and management of common skin conditions including atopic dermatitis, psoriasis, and seborrheic dermatitis. D. Apply the basic principles and practice of oral and topical dermatologic therapy including the appropriate use of emollients, topical steroids, antipruritic therapies, and systemic immunosuppressants.E. Correctly identify common skin tumors such as basal cell carcinoma, squamous cell carcinoma, and melanoma. Outline basic management plans to include biopsies, appropriate surgical management, and patient follow up intervals.F. Recognize potentially life-threatening skin diseases, such as serious drug eruptions, toxic epidermal necrolysis, and autoimmune blistering disorders. G. Successfully demonstrate essential dermatologic diagnostic procedures including KOH examination, scabies prep, shave biopsy, and punch biopsy of the skin

2. Cognitive Objectives:A. By the end of the rotation, the PA student will demonstrate knowledge & comprehensive care of the

following: Proper approach to dermatologic diagnosis Approach to the patient with macular lesions Approach to the patient with pustular skin lesions Eczematous eruptions to include the various forms of dermatitis, dyshidrosis, and

lichen simplex chronicus Papulosquamous diseases to include dermatophyte infections (tinea versicolor, tinea

corporis/pedis), lichen planus, pityriasis rosea, and psoriasis Stevens-Johnson syndrome Keloids Erythema nodosum Bullous pemphigoid Verrucous lesions to include seborrheic keratosis & actinic keratosis Infestations to include lice, scabies, & spider bites Alopecia Onychomycosis Paronychia Viral conditions to include condyloma acuminatum, exanthems, herpes simplex,

molluscum contagiosum, verruca, varicella zoster Bacterial infections to include: cellulitis, vasculitis, erysipelas, impetigo Acanthosis nigrans Burns Decubitus ulcers Hidradenitis suppurativa

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Lipomas Urticaria Vitiligo Acne vulgaris & acne rosacea Metabolic & inherited diseases affecting the skin Syphilis Overview, screening, early detection, primary prevention, treatment & prognostic

outcomes of melanoma Overview, screening, early detection, primary prevention, treatment & prognostic

outcomes of of nonmelanoma skin cancers Overview, screening, early detection, primary prevention, treatment & prognostic

outcomes of basal cell carcinoma Overview, screening, early detection, primary prevention, treatment & prognostic

outcomes of squamous cell carcinoma USPTF Guidelines: screening for skin cancer, recommendations & rationale

B. The student will demonstrate an understanding of the various technical skills to include: removal of skin lesions, biopsies, appropriate slide staining, skin scrapings, suturing & suture removal.

C. When assigned a patient with a dermatological complaint, disease, or disorder, the PA student will perform an appropriate history & physical examination. The PA student will demonstrate their abilities, through ordering & interpreting of appropriate diagnostic studies, developing appropriate differential & final diagnosis, as well as proper treatment, management, follow-up, patient education & referral management.

D. Demonstrate the ability to work effectively with physicians, nurses and other staff members for the benefit of the patient and their families.

E. Understand & know legal & ethical health care issues in medicine, specifically dermatology. Maintain patient privacy and professionalism.

3. Skills Objectives:A. The PA student will improve on surgical skills such as understanding the duties of a first assist and perform them when necessary. Perform proper sterilization techniques, proper positioning of patients, proper technique to aid hemostasis, wound care and surgical dressings. Student will develop the skills necessary for dermatologic surgery/procedures that a PA would be performing.

4. Means of Assessment / Methods to Demonstrate Achievement of Objectives:A. Student Performance: List of objectives and goals will be discussed with the preceptor at the

beginning of the rotation that can be used to help guide the preceptor’s expectations of the student. A formal midpoint and conclusion evaluation will be given to the preceptor to monitor the student’s performance, clinical knowledge, and clinical skill. Evaluations will be discussed at the time they are completed to ensure the student is meeting objectives and to allow time for modification.

B. Preceptor Performance: Upon completion of the rotation, the student will complete a service evaluation form commenting on the experience. Evaluation will cover topics to ensure the student was given an opportunity to learn and pursue intended goals while on the dermatology rotation.

5. Resources (texts, journals, other sources):A. Materials: Clean lab coat, diagnostic tools, and notebook.B. Color Atlas & Synopsis of Clinical Dermatology , 2000 by Fitzpatrick, Johnson, Wolff, SuurmondC. Current Medical Diagnosis and Treatment , 2012 by McPhee, Papadakis, and Rabow D. Current Medical Diagnosis and Treatment: Pediatrics , 21st edition, by Hay, Levin, Deterding,

AbzugE. A Comprehensive Review for the Certification and Recertification Examinations for

Physician Assistants 5th edition by O’Connell and ZarbockF. UptoDate websiteG. Epocrates Essentials Program for Mobile Devices

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Date of initial review and approval by PA Program Office:______________________Comments:

Date final version submitted_____________________________.

Date of final review and approval by PA Program Office:_______________________________

Comments: