Lincoln Memorial University-DeBusk College of
Osteopathic Medicine
Physician Assistant Program
Clinical Year Manual
2015-2016
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Table of Contents
Introduction
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Mission .
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PA Program Goals.
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Guidelines and Program Policies for Clinical Year
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Course Descriptions
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Prerequisites for Clinical Rotations .
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End of Semester (EOS) Days
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EOS schedule .
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Student Travel Time Allowance .
Summative Evaluations .
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Student Progression During the Clinical Year.
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Rotation Procedures and Guidelines .
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Scheduling
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Clinical Sites .
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Affiliation Agreements .
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LMU-DCOM PA Program Responsibilities
Rotation Schedule and Absences .
Attendance
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Excused Absences .
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Opportunities During Clinical Rotations
Approved Clinical Rotations.
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Pregnancy
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Readmission Following Leave of Absence
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Evaluations
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Evaluation and Grading .
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Clinical Rotation Assignments
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Rotation Grading Chart .
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Evaluation Forms .
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End of Rotation Exams .
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Objective Structured Clinical Encounters (OSCE) .
Case Presentations for Elective and Selective Rotations.
Clinical Self-Reflective Essay
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Category C Professionalism Requirements .
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Revised 6/12/15
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Typhon logging of patient .
Clinical Procedure Log .
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Clinical Competency Domains
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Encounter Log Minimums .
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Procedure Log Minimums .
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Minimum Clinical Time .
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Preceptor Evaluation of the Student .
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Professionalism .
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Rotation Examination or Assignment
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How the Program will Track Clinical Student Competency Progression
Remediation of Competency Deficits
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Procedure Log Requirements
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Encounter Log Minimums .
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Rotation Site Visits
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Clinical Rotation Evaluation Discrepancies .
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Student Progress Committee (SPC) .
Committee Procedures .
Appeals Process .
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Appeals Committee
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Dismissal and Withdrawal .
Probation
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Disciplinary Procedures .
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Conduct and Professionalism
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Administrative Guidelines and Program Policies for Clinical Year
Professional Conduct
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Communication .
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Dress Code
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Proper Identification
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Student Responsibilities .
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Student Responsibilities to the Program
Student Responsibilities to the Site .
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Liability Insurance Coverage
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Preceptor Responsibilities .
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Academic Probation/Dismissal
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Student Immunizations, OSHA Requirements, & HIPAA Training
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LMU Student Health Insurance .
Waivers .
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On-campus Health Care Services
OSHA Guidelines.
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Incident Reporting
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Employment
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Assignments
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Housing, Transportation, and Meals.
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Medical Diagnostic Equipment
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Objective Structured Clinical Examination (OSCE) .
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Personal Safety and Security
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Student Background Check, Drug Screening, and Arrest Policy .
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Appendix A: Understanding of Attendance Policy
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Appendix B: Receipt of Clinical Manual
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Appendix C: Rotation Absentee Report
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Appendix D: Sample Clinical Rotation Evaluation by Student form
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Appendix E: Sample Clinical Rotation Evaluation form
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Appendix F: Needle Stick Incident Protocol .
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Incident Report .
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Introduction
The Clinical Year Manual for the Physician Assistant Program is designed to provide policies and
procedures, along with information that is pertinent to success in the clinical year. The didactic year of
education provides a broad base of knowledge, which will be developed, challenged, and solidified
through hands on clinical training during the clinical year. It is important to remember that while
Clinical Year students are rarely on campus, they are still LMU-DCOM students who are expected to
adhere to policies set forth in the LMU-DCOM Student Handbook.
The policies, procedures and requirements outlined in the following pages are designed to assist the
clinical student throughout the year. It is the student’s responsibility to read this manual. If there
are questions regarding the manual, please direct them to the Director of Clinical Education for
clarification. All students must sign a declaration of understanding prior to beginning the clinical
year stating they have read, understand, and agree to abide by the contents of this manual.
Although not specifically stated after each section, failure to comply
and/or conform to the guidelines, academic requirements, rules and
regulations of this manual could result in disciplinary action, up to and
including referral to the Student Progress Committee and dismissal
from the program.
The LMU-DCOM Physician Assistant Program reserves the right to alter, change, add to, or delete any
of the policies or procedures in the manual. Students will be notified in writing of any changes in the
clinical manual should they occur.
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MISSION OF THE LMU/DEBUSK COLLEGE OF OSTEOPATHIC MEDICINE
PHYSICIAN ASSISTANT PROGRAM
Mission Statement
The Physician Assistant (PA) Program at Lincoln Memorial University-DeBusk College of
Osteopathic Medicine recruits, educates, and mentors a diverse group of students to become physician
assistants providing quality health care.
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Emphasizes primary care and preventive medicine and seeks to interest students in providing
care to the medically underserved population within the Appalachian region and beyond;
Promotes the physician/PA team care;
Fosters an appreciation for research, leadership, and flexibility in meeting the changing needs
of the health care climate;
Empowers faculty and students to be advocates for the physician assistant profession for the
delivery of primary health care.
PA PROGRAM GOALS
Provide an academic and clinical training experience that will prepare the culturally competent PA
student to function as a nationally certified PA in a reliable and competent fashion by:
1. Teaching fundamentals of biomedical and basic sciences, clinical medicine, health policy, and
technical skills, with an emphasis upon primary care practice.
2. Providing training and experiences that enable students to perform the duties and functions of a PA
in diverse practice settings, incorporating evidence based medicine in clinical decision making and
applying medical informatics and technology.
3. Providing basic foundational skills in scholarly inquiry, medical literary analysis, medical writing,
and professional presentation.
4. Providing students with the opportunity to care for diverse patients, families, and populations in
outpatient and inpatient settings with compassion, empathy, and tact, while supervised by a physician,
PA, or nurse practitioner.
5. Inculcating basic aspects of professionalism, ethics, and other attributes required to establish and
maintain appropriate collaborative relationships with patients, families, colleagues, and the community
at large.
6. Providing medical services to underserved persons, including rural, minority, and geriatric groups,
thereby developing an awareness of social and professional responsibility.
7. Providing an understanding of the approach to care of the whole person, and emphasis on the
aspects of health care that include disease prevention and health maintenance, and an appreciation of
the role of rehabilitation care in diagnosis and disease management.
GUIDELINES AND PROGRAM POLICIES
FOR THE CLINICAL YEAR
The LMU-DCOM Physician Assistant Program policies include specific policies and guidelines for the
clinical year that includes the following:
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The clinical year is composed of several components. LMU-DCOM PA students must successfully
complete the following:
a. Two (8) eight week clinical rotations
b. Eight (4) four week clinical rotations
c. All required End of Semester (EOS) days
d. EOS Post Examinations
e. All Summative Evaluations
f. Typhon Logging of required numbers and types of patients
h. Procedure Logs
i. A patient encounter and procedure log compilation report at the end of each semester
j. A Comprehensive Written Exam
k. A Capstone Portfolio Project
l. OSCE/SIM Practicals
COURSE DESCRIPTIONS
Course description for clinical rotations and the Capstone Portfolio project are listed below. Specific
objectives are included for each rotation.
Clinical Rotation Descriptions
PAS 600
Capstone Project
4 credits
This course is designed to enable PA students to interpret research, write scholarly papers on approved
topics in clinical medicine and do various other activities, including obtaining certifications and
participation in continuing medical education which leads to professional development of the student.
Prerequisites: Successful completion of the didactic phase of the program.
PAS 610
Family Medicine Rotation
8 credits
This is a required 8 week rotation in family practice under the supervision of a clinical site preceptor.
The student will gain experience and be able to integrate the knowledge and skills learned during the
didactic phase to interact with patients and their families, order and interpret lab and diagnostic tests,
evaluate, and manage patients effectively. Students will have the opportunity to manage acute and
chronic care in addition to patient education and increase their knowledge in the use of psychoactive
pharmaceuticals. (Minimum of 240 hours for rotation) Prerequisites: Successful completion of the
didactic phase of the program.
PAS 620
Internal Medicine
Rotation
8 credits
This is a required 8 week rotation in internal medicine under the supervision of a clinical site
preceptor. The student will gain experience and be able to integrate the knowledge and skills learned
during the didactic phase to interact with patients and their families, order and interpret lab and
diagnostic tests, evaluate, educate patients about health maintenance, review patient records and
evaluate established patients for their continual medical care. Students will have the opportunity to
manage acute and chronic care in addition to patient education. With experience in both
inpatient and outpatient settings, the student will be able to recognize emergent, acute,
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and chronic diagnoses and participate in the necessary continuity of care for each. (Minimum of 240
hours for rotation) Prerequisites: Successful completion of the didactic phase of the program.
PAS 625
Behavioral Medicine Rotation
4 credits
This is a required 4 week rotation under the supervision of the site preceptor in which students will
have the opportunity to learn about behavioral health conditions and interact with patients and their
families. The student will gain experience in interviewing and assessing the behavioral health patient,
ordering and interpreting lab and diagnostic tests, evaluating, and managing patients in a behavioral
health setting. (Minimum of 120 hours for rotation) Prerequisites: Successful completion of the
didactic phase of the program.
PAS 630
Surgery Rotation
4 credits
This is a required 4 week rotation in surgery under the supervision of a clinical site preceptor. The
student will participate in pre, peri, and postoperative care. Students will gain experience in the
evaluation of acutely ill surgical patients, assist in surgery, and identify indications, contraindications,
and potential complications. (Minimum of 120 hours for rotation) Prerequisites: Successful
completion of the didactic phase of the program.
PAS 640
Emergency Medicine Rotation
4 credits
A 4 week required clinical experience under the supervision of the site preceptor in which the student
will have the opportunity to evaluate and treat a wide variety of urgent, emergent and life-threatening
conditions. The student will learn to triage patients, interact with patients’ families, and become more
proficient at taking rapid accurate histories, performing physical examinations, ordering appropriate
diagnostic tests, and formulating a treatment plan. The student will have the opportunity to improve
their oral presentations in a fast-paced environment. This rotation should give the student the
opportunity to practice many clinical procedures such as suturing, endotracheal intubation, and ACLS.
(Minimum of 120 hours for rotation) Prerequisites: Successful completion of the didactic phase of the
program.
PAS 650
Pediatric Rotation
4 credits
This is a required 4 week rotation in pediatrics under the supervision of a clinical site preceptor. The
student will refine their history taking and physical examination skills in the pediatric population,
perform well child checks, evaluate children for developmental milestones, and diagnose and treat
acute and chronic illnesses in children and adolescents. The student will have the opportunity to
educate and counsel the patient and their parent or guardian. (Minimum of 120 hours for rotation)
Prerequisites: Successful completion of the didactic phase of the program.
PAS 660
Elective Rotation
4 credits
This is a required 4 week rotation in a field chosen by the student. This experience gives the student
the opportunity to enhance their knowledge and skills in a particular specialty of medicine. The site
must be approved by the Director of Clinical Education. (Minimum of 120 hours for rotation)
Prerequisites: Successful completion of the didactic phase of the program.
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PAS 665
Selective Rotation
4 Credits
This is a required 4 week rotation in one of the core rotations that is chosen by the student. This
experience gives the student the opportunity to enhance their knowledge and skills in a particular
specialty of medicine chosen from the core rotation options. The site must be approved by the Director
of Clinical Education. (Minimum of 120 hours for rotation) Prerequisites: Successful completion of the
didactic phase of the program.
PAS 670
Women’s Health Rotation
4 credits
This is a required 4 week rotation under the supervision of the site preceptor in which students will
have the opportunity to see a wide variety of concerns related to the female reproductive system.
Students will further develop their knowledge of assessment and treatment, preventive care, and
screening recommendations of women’s health issues. The rotation will also provide the opportunity
for the student to become more familiar with women’s health exams, pregnancy, menopause, and
infertility. The student will have opportunities to participate in pre- and post-natal care. (Minimum of
120 hours for rotation) Prerequisites: Successful completion of the didactic phase of the program.
PAS 690
Orthopedics
4 credits
This is a required 4 week rotation in orthopedics under the supervision of the site preceptor. Students
will have the opportunity to develop skills to care for patients with orthopedic problems that can be
found in the primary care setting. Students will have the opportunity to participate in pre-, intra-, and
postoperative care. (Minimum of 120 hours for rotation) Prerequisites: Successful completion of the
didactic phase of the program.
Prerequisites for Clinical Rotations
A. Successful completion of all didactic courses
B. Current health insurance policy. Any student who does not maintain a current health insurance
policy during the clinical year will be removed from rotations until compliance has been established.
C. All required immunizations are up to date including the PPD (or chest x-ray for conversions).
Students who are not up to date on immunizations will not be able to start rotations.
D. Cleared the criminal background check.
E. Negative drug screen as required by the clinical site(s)
F. Contact information is up to date and on file with the program.
G. University registration for the clinical year.
H. Any additional clinical rotation site requirements (credentialing process)
End of Semester Days (EOS)
At the end of each clinical semester, students will return to campus (or other designated location) for
assessment activities.
These activities will consist of, but may not be limited to, End of Rotation Exams (EOREs), Objective
Structured Clinical Examinations (OSCEs), Case Presentations, PANCE review lectures on topics
relevant to PA practice, and Administrative issues. A calendar will be made available with the EOS
schedule. Attendance is mandatory at all EOSs. If a student is not present on an EOS day, and
it is not an excused absence (see section on excused absences to see if it is a reason to be excused),
then the student will lose one letter grade for each EOR test that was to be taken on that
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particular EOS day. Make-up exams for excused absences must be completed within one week.
(Reference Student Travel Time Allowance below)
**Requesting to be excused from an EOS at LMU-DCOM for financial reasons due to travel
from an out of state rotation is not acceptable. Personal days cannot be used on EOS days.
End of Rotation Days /(EOS schedule)
Rotation
1
2
3
4
5
Capstone
6
7
8
9
10
11
12
Pre-Graduation
Graduation
Begin
27-Jul
24-Aug
21-Sep
19-Oct
16-Nov
14-Dec
11-Jan
8-Feb
7-Mar
4-Apr
2-May
30-May
27-Jun
22-Jul
6-Aug
End
20-Aug
18-Sep
16-Oct
13-Nov
11-Dec
8-Jan
5-Feb
4-Mar
31-Mar
29-Apr
27-May
24-Jun
21-Jul
5-Aug
EOS Days
21-Aug (Friday)
EOS and Mid-year Activities (12/14-12/18)
1st & 2nd -April (Fri/Sat)
22 & 23- July (Fri/Sat)
Semesters are coded together with the same color.
Student Travel Time Allowance
NOTE – THIS TRAVEL TIME DOES NOT APPLY TO MANDATORY HOSPITAL
ORIENTATION
For the August and April EOS days, you must attend the EOS location closest to the rotation you
are on at the time of the EOS. You will not be excused to leave the rotation early for travel
except otherwise noted below.
FOR THE PURPOSES OF EOS ONLY:
Drive Time from your site to the testing location:
8 or less hours—May have 1 day for travel (example – if EOS starts on Friday you must work
through the end of the work day on Wednesday which allows 1 travel day prior to EOS)
8.5—16 hours— May have 2 days for travel
Greater than 16.5 hours— May have 3 days for travel
International—See Clinical Team.
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If Flying, the student may have 1 day for travel
Drive Time from your testing location to your next rotation site:
12 hours or less from your next rotation, you will begin the rotation on Monday
12.5—20 hours from your next rotation, you will begin the rotation on Tuesday
20.5 hours or more from your next rotation, you will begin the rotation on Wednesday
If Flying to your next rotation, the student will begin the rotation on Monday.
FOR THE PURPOSES OF END OF ROTATION TO BEGINNING OF NEXT ROTATION:
Drive Time from your current site to your next rotation site:
8 or less hours—You are required to work through the end of the rotation
8.5—16 hours—May leave the rotation 1 day early
Greater than 16.5 hours—May leave the rotation 2 days early
International—See Clinical Team.
If Flying, the student is required to work through the end of the rotation.
Students will not be allowed to leave before the days/times listed above.
*You cannot use personal days to leave your rotations early.
**These drive times must be determined using Google Maps.
*Summative Evaluations:
Prior to graduation, students will be required to participate in a summative evaluation. One part of this
evaluation will be a comprehensive written examination designed to be a summative assessment
reflecting the knowledge and skills learned throughout the program. This evaluation will also include
practical examinations in the form of Sims and OSCEs. Students will be required to pass each
component with a score of 70% or higher. These evaluations are a required component of PAS 600.
STUDENT PROGRESSION DURING THE CLINICAL YEAR
• All students must pass all first year courses before progressing to the clinical rotation year.
• Any student who does not meet the expectations of the clinical preceptor as documented on the
preceptor evaluation will automatically fail the rotation.
• If a review of the “Evaluation of Student Performance” indicates deficits in either Clinical
Performance or Professional Conduct, a change in future site(s) placement may be made
whether or not the student receives a passing grade for the rotation.
• If the conduct or performance of the student is deemed unsafe or inappropriate by the Clinical
Site or Program Faculty, the student will be removed from the rotation.
• If a student wishes to meet with the faculty for review, a written request, along with the reason,
should be submitted to the Director of Clinical Education. The Department Faculty will review
the request and determine whether or not a meeting will be convened.
• Termination of a rotation by a Preceptor or Faculty Member as a result of poor or inadequate
performance or lack of professionalism on the part of the student shall be an automatic “F” for
that rotation.
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ROTATION PROCEDURES AND GUIDELINES
Scheduling
• The Physician Assistant Program’s Director of Clinical Education with the Clinical Rotations
Coordinator will schedule students for each rotation.
• Each student’s clinical schedule will be arranged to ensure the best possible educational
experience. While students will be given the opportunity for input prior to the assignment of
rotations, please note that the Director of Clinical Education and Clinical Rotations Coordinator
reserve the right to deny a student a specific rotation based on the student’s level of skill and
knowledge.
• Sites that are not currently signed under an affiliation agreement with LMU-DCOM can be
considered for clinical rotations. However, the site must be evaluated by the clinical faculty or
designee and the required paperwork must be in place prior to the beginning of the clinical
year.
• Once the rotation schedule is completed and confirmed, no further changes will be
allowed. Changes may occur throughout the year due to various circumstances with regard to
clinical sites; therefore requiring students to be flexible. The Director of Clinical Education or
Clinical Rotations Coordinator will make assignments or substitutions which he/she feels are in
the best interest of the student, preceptor, and program.
• Students will not be allowed to be supervised by or work with relatives.
• Students should plan their personal matters and finances so that they can concentrate on the
program. Depending on the nature of the rotation, the student may be scheduled to work during
the evening, nights, weekends and/or holidays.
• Students should also plan for clinical sites that may involve travel outside the Harrogate area.
Some sites provide housing at no charge to the student, but this is very limited and may not
always be available. The Program will not pay for housing or travel.
• Students are not permitted to attend a clinical site where they are not assigned or where
appropriate legal agreements are not in place.
Clinical Sites
• The Physician Assistant Program maintains Affiliation Agreements with numerous preceptors
and clinical sites throughout the country. Throughout the year, the clinical faculty or another
member of the Clinical Team contacts the preceptors to determine their availability during a
given period of time. Those sites that are available are then utilized for rotations.
• The Program is committed to developing new relationships with preceptors and clinical
institutions. Students who know of an individual, who would like to be a clinical preceptor,
should provide the Director of Clinical Education or Clinical Rotations Coordinator with the
individual’s name, business address, and telephone/FAX numbers.
• The potential preceptor will then be contacted by the program and the site will be evaluated
before approval may be given. A student should not recommend a potential preceptor if he/she
is not willing to precept other students in the future. Students are not allowed to negotiate an
affiliation of a clinical site. The clinical faculty must evaluate the site and approve the site. If
the site is approved, the Preceptor Relations Coordinator will send out the affiliation agreement
to the site.
• Under NO circumstances should a student contact an established clinical site prior to
their assignment to that site. The Clinical Team will contact the established sites for any
required information.
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Affiliation Agreements
• Affiliation Agreements must be established between all clinical sites, long term care facilities,
hospice, hospitals/surgery centers and the university.
• This legal document addresses issues such as liability and malpractice. In addition, it helps
ensure that the student will receive a quality clinical experience.
• Students are not permitted to attend a clinical site that does not have a signed Affiliation
Agreement with the University.
• Any violation of the Affiliation Agreement policy will result in the student going before the
Student Progress Committee and given either probation or immediate dismissal from the
Program.
Approved Clinical Rotations
Students may only participate at the clinical site they are assigned to at the designated time. All clinical
training sites are sent an Affiliation Agreement that formalizes the relationship between the school and
the preceptor/site. It is unacceptable for a student to go to a clinical setting(s) in which they are not
assigned and in which there is no affiliation agreement in place.
LMU-DCOM Physician Assistant Program Responsibilities
• Serve as a resource in developing the PA role in a specific practice setting.
• Orient preceptors and students to the structure of the preceptorship and student learning
• Committed to serving the medically underserved populations.
• Provide medical malpractice insurance throughout the entire program.
• Evaluate the clinical experience through evaluations and periodic site visits and strengthen the
experience as needed.
• Student evaluations of the site will be reviewed on a monthly basis by the Director of Clinical
Education and the clinical team, any issues brought up by the students will be addressed.
• Maintain close contact with students to answer questions and to assist with any problem before
they can arise, if possible.
• Objectives for each rotation will be provided by the program, but individual learning goals may
be tailored to the student and preceptor. Objectives not met during the rotation should be
researched by the student.
• MD and PA Preceptors may be able to claim continuing medical education credit for medical
teaching during the preceptorship period, depending on what their accrediting body’s particular
rules are for precepting PA students. Category 2 credits may be claimed for teaching on an
hour for hour basis. The program will provide the documentation of the preceptorship period
for the CME credit upon request. In addition, preceptors who are PA’s may be able to claim
CME Category 1 credit. Please contact the Assistant Clinical Coordinator for details.
• The Director of Clinical Education is responsible for assigning the grade for rotation
performance. Information from all evaluations and completion of patient and procedure logs,
end of rotation exams, OSCEs, case presentations, projects, and professionalism are the basis
for the decision whether to pass the student, extend the rotation, place the student on probation,
or in some instances, dismiss the student from the program. (See grade calculations) The
performance evaluations become a permanent part of the student’s record.
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ROTATION SCHEDULE AND ABSENCES
Rotation dates are established by the university. Students are required to work full time following the
same schedule as their preceptors with a minimum of 120 hours per 4 week block. If a student
requests a day away from the rotation, he/she must discuss the absence with the preceptor and with the
program’s Director of Clinical Education. Absences must be approved by both the preceptor and the
Director of Clinical Education. In emergency situations only, students can obtain approval after they
return from their absence. Students will be required to make up the days they are absent. If the
number of days missed exceeds 2 for a four week rotation, the student may have to repeat the rotation.
Students are not to exceed a total of four days during the Family Medicine and Internal Medicine
rotations. Excused absences include days missed for illness, attending funerals of close relatives and
interview days. All missed days must be excused by completing the required form found in this
manual. Students may miss no more than 5 days in any semester. All absences must be preapproved
by the preceptor and the Director of Clinical Education and the appropriate absence request form
completed.
ATTENDANCE
A. Attendance is mandatory.
B. The work schedule will be determined by your preceptor and students are required to work full time
following the same schedule as their preceptors with a minimum of 120 hours per 4 week block.
Students will be required to take on call, nights, and weekends as designated by the preceptor.
Holidays or university breaks do not apply to the clinical year.
C. For your safety and security you must provide the Director of Clinical Education and the PA
Program with your contact information while on clinical rotations. This information would include an
emergency contact number and cell phone number. Any changes in address must also be given to the
program.
D. If a student is going to be absent from a rotation, the student must notify the preceptor or designee
at the clinical site and the Director of Clinical Education. Contact should be made by 8:00 am on the
day of the absence. Students, who have an absence, must complete the absence form (See Appendix
A) and return it to the Director of Clinical Education within 24 hours of the absence. If a student does
not follow these steps, it will be considered an unexcused absence.
a. Unexcused absences and tardiness: weddings, graduations, routine medical or dental
appointments, or any other social events or appointments are not considered to be excused
absences. Students are required to be present as scheduled by the clinical site and attend EOS.
If students request to be absent for these reasons, it will be counted toward their 5 day per
semester absence limit. Students are expected to be on time to their clinical rotations.
Tardiness is not accepted at a clinical training site or when attending an EOS. Situations in
which unexcused absences or tardiness occur will be documented in the student’s record.
Excessive tardiness reported to the program from clinical preceptors will result in a mandatory
mentor meeting.
Excused absences
Unexpected emergencies, severe illness, or injury that requires complete bed rest, attending funerals of
close family members are legitimate reasons for an absence. The student must complete the absence
form and turn the form into the Director of Clinical Education for all absences. Required
documentation regarding illness or injury may be required by the program. Students who have
legitimate absences will be required to make up the time missed for the rotation and will be given an
Revised 6/12/15
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“I” (incomplete) if the time is not made up by the completion of the rotation. Scheduling the rotation
and/or hours to be made up will depend on the availability of the site and at the discretion of the
Director of Clinical Education.
Opportunities during clinical rotations
Students will be given the opportunity to interview for jobs should the opportunity arise. The student
must first try to take a job interview on a day they have scheduled off according to their clinical
rotation schedule. If a day cannot be scheduled, the student must contact the preceptor and Director of
Clinical Education in writing to ask for the day off. The student must make up the time off for that
particular rotation.
Students will be allowed to take up to a total of 5 days off to attend a medical conference/certification
program during their Family Medicine or their Internal Medicine rotations. Up to a total of 3 days will
be allowed during the Selective or Elective rotations to attend a medical conference/certification
program , but no time off will be granted during other four week rotations. These excused absences
will require prior approval of the Director of Clinical Education and time away from the clinical
rotation should be coordinated with the preceptor in order to avoid/minimize conflicts with on-call or
other clinical duties.
A lot of time and effort are put into planning and scheduling rotations. Consideration is given to both
the student and the preceptor to make this a great learning experience. Once rotation sites are
confirmed, there will be no changes unless there are specific circumstances that would necessitate a
change. Possible circumstances would be due to a constraint at the clinical site, at the program’s
discretion, or scheduling issues. If an assignment needs to be changed, all efforts will be made to
notify the student so that there is sufficient time to make the change and also have it be an equivalent
experience.
Pregnancy
Any student, who has confirmation of pregnancy, must report the pregnancy to the PA Program
Director. Students need to obtain written documentation from their physician which must be returned
to the PA Program Director stating either the student is able to continue with their education (didactic
and/or clinical) during the pregnancy, needs a leave of absence, or has restrictions. Time off due to
pregnancy will need to be made up and will delay graduation. All requirements must be completed
successfully in order to graduate.
Readmission following Leave of Absence
A student who is returning to the program after a leave of absence due to pregnancy, illness, or injury
must submit written documentation from their physician stating they are safe to return.
EVALUATIONS
There are many characteristics that are desirable in a PA. These include comprehensive medical
knowledge, skill in applying knowledge through the provision of medical care, and professionalism in
Revised 6/12/15
15
one’s conduct. A PA must possess attention to detail, reliability, punctuality, and the ability to work as
a team player with all levels of a given organization – supervisors, peers, and subordinates.
By the second year of study, LMU-DCOM PA students are expected to demonstrate all these traits,
and at progressively higher levels as they move towards completion of clinical rotations. Thus, the
evaluation of LMU-DCOM PA students includes consideration of knowledge, skill, and
professionalism. All of these factors will be assessed at all times. However, specific forms of
evaluation are established to ensure the complete student is evaluated. Knowledge is assessed through
written testing which is carried out at EOS. Skill is assessed via clinical preceptor evaluations, and
LMU-DCOM Physician Assistant Program faculty. Professionalism is assessed through cooperation
with the program staff, attendance at mandatory functions, participation in conferences and group
exercises, and adherence to all the guidelines of this manual.
Evaluation and Grading
Evaluation and grading for the rotations will be on the following grading scale:
A=90 -100
B=80 -– 89
C=70 – 79
F= < 70
I=Incomplete
Students are required to pass each clinical rotation with a 70% or higher. Students must have
demonstrated a passing performance on their preceptor evaluations, written examinations, and by
completing end of rotation assignments, site evaluations, and Typhon patient and procedure logs that
are due at the end of each rotation. All assignments must be submitted by the end of each rotation. If
assignments are not completed by the deadline, no credit will be given. This would be considered a
matter of professionalism and the student’s grade will be affected and the student will be referred to
the Student Progress Committee.
Clinical Rotation Assignments
The program has strict deadlines for the completion of assignments for each rotation. These
include:
-Preceptor’s email address (within 1(one) week of beginning a new rotation)
-End of rotation evaluations by the preceptor (within one week of completing the rotation)
-Site evaluations (within 24 hours of the end of a rotation)
-EOS exams (during the appointed EOS meetings)
-Clinical Logs (patient and procedure) via Typhon (within 24 hours of the end of a rotation)
-End of Semester Day(s) (at LMU-DCOM or other designated location)
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ROTATION GRADING:
Evaluation and Grading
The final rotation grade consists of 3 components:
1. Performance component (Column A), and
2. Written component (Column B), and
3. Professionalism (Column C)
In order to pass the rotation as a whole, ALL components (A, B & C) must be passed.
Column A:
Performance
Column C:
Professionalism
Column B: Written
• Procedure Log
•Patient Logging
Preceptor Evaluation
End of Rotation Exam
or
Case Presentation & Clinical
Self Reflective Essay
(on elective & selective)
•
Preceptor email address
• Site Evaluation
• Conduct
• Professional Issues as laid out in
Syllabus
10% of grade
40% of grade
50% of grade
This will be determined based on
feedback from faculty, staff, and/or
personnel at your preceptor's office.
If a student fails either component A, B, or C he/she will fail the entire rotation.
Preceptor evaluations will only be accepted if received in the following manner:
1. Preceptor completes evaluation through Typhon.
Receipt of the evaluation via any other means will not be accepted and will result in an
Incomplete for the rotation grade.
Students must submit their preceptor’s email to the Assistant Clinical Coordinator within 1
(one) week of starting each new rotation. Even if you have been there before or other students
have been to this same rotation you must still communicate with the Assistant Clinical Coordinator.
If you believe the program already has your preceptor’s email address, you must still send an email
to the Assistant Clinical Coordinator with the name of your preceptor and ask if the program does
have this information.
Students will receive a grade of “F” for a rotation if the student fails to:
1) Demonstrate professionalism on the rotation
2) Participate in required EOS days
3) Pass the Preceptor evaluation and achieve a grade of 70% or higher on the EOR exam or the
elective/selective presentation.
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Students who are removed from the clinical site by a faculty member or at the preceptor’s request will
automatically receive an “F” for the rotation and will be referred to the Student Progress Committee as
indicated.
Evaluation Forms
There will be one evaluation form to be completed by the preceptor just prior to the end of the
rotation. If the student has more than one preceptor, students are encouraged to have the preceptors
collaborate and turn in only one evaluation. If this isn’t possible each preceptor can complete an
evaluation and the grade will be calculated from the average of all evaluations. Students will also
have the opportunity to provide input on their clinical experience at the end of each rotation.
1. Preceptor Evaluation of Student Performance
• All student evaluations will be done through the Typhon link which will be sent to the
preceptor via email or available to the preceptor through Typhon. Note: the student
will be responsible for verifying the current email address that the preceptor prefers to
use.
• The preceptor’s evaluation is based on demonstration of the student’s medical
knowledge and skill in the performance of developing a diagnosis and treatment plan,
history-taking, physical examination, and procedures as designated and permitted by
preceptors.
• The preceptor is encouraged to have an exit interview with the student. This evaluation
process should allow for more direct feedback between the preceptor and student
regarding the student’s performance. The student should also ask the preceptor for
feedback if it is not given. The student should also provide feedback to the preceptor
concerning the rotation in a constructive manner.
• Preceptor evaluation forms become a part of the student’s permanent record.
• The Preceptor Evaluation of Student Performance, and the Student Evaluation of
Rotation forms must be submitted at the designated time for EVERY ROTATION. It
is the student’s responsibility to ensure the Director of Clinical Education receives the
Preceptor Evaluation of Student Performance form within seven (7) days after
completion of each rotation. While the Department realizes the occasional problems
may arise, repeated offenses may lead to the lowering of a final rotation grade.
2. Student Evaluation of Rotation
a. Each student is required to complete an evaluation of the rotation site on Typhon prior
to any discussion concerning the preceptor evaluation of the student.
b. Students are encouraged to discuss the positives aspects and any areas needing
improvement on the site evaluation. Constructive comments are helpful.
c. Student evaluations of the site will be reviewed on a monthly basis by the Director of
Clinical Education and the clinical team, any issues brought up by the students will be
addressed.
End-of Rotation Exams
• During each EOS meeting, each student will be given a comprehensive exam based on
the objectives for the rotations done during that semester (with the exception of the
elective and selective rotations).
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•
•
Failure of any rotation will result in repeating the rotation and may require additional
testing specific to the rotation.
No EOR exam will be given following the elective/selective rotations. The case
presentation grade and related activities will substitute for the EOR exam grade.
Objective Structured Clinical Encounters (OSCE)
• Students will be required to pass any OSCEs given during the clinical year.
• A minimum score of 70% must be achieved on each simulation/OSCE, or the student
will be required to complete remediation on the topic that was failed. A remediation of
the SIM/OSCE will be scheduled after graduation. Students will not be considered
official graduates of the program until all coursework is successfully completed.
• If a student does not improve and pass the remediation, the student will be required to
appear before the SPC.
Case Presentations for Elective and Selective Rotations:
Submission of topic
• Two (2) weeks prior to your scheduled presentation date, submit your
desired topic (patient) of interest for the presentation to the Director of Clinical
Education. This submission must be made in writing and sent via e-mail.
• The patient submitted must be a patient on whom you completed the initial
evaluation and work-up. Therefore, you will be familiar with all aspects of the
case and should be able to give a complete presentation and answer most
questions regarding the case. Pick a patient who has a diagnosis that would be of
interest to you and you think your classmates would find interesting.
• For each patient, please include in your submission: age, gender, race and a chief
complaint. In addition, give a brief history (several sentences detailing his/her
initial presentation to you), the final diagnosis, and an explanation of your role
in the case (initial H&P, admitting H&P, first assist in the OR, consulted on the
case, etc.). Give some background on the illness or injury you are going to
present.
• The Director of Clinical Education will review your patients and once approved
you are to prepare for formal presentation utilizing PowerPoint. See the Case
Presentation Schedule for presentation and deadline dates.
One (1) week prior to your presentation, submit to the Director of Clinical Education your
PowerPoint you plan to use in your presentation. The PowerPoint should include HPI,
significant PMHx/ FHx/SHx, pertinent positives from the ROS, allergies, meds, primary
diagnosis with a differential, secondary diagnoses, and management plan (to include orders as
appropriate). Please refer to the rubric included in the selective/elective course syllabus for
grading parameters.
IF THE DEADLINES FOR SUBMISSION OF TOPICS OR OUTLINE/POWERPOINT
ARE NOT MET, THE OVERALL GRADE FOR THE PRESENTATION WILL BE
LOWERED BY ONE LETTER GRADE FOR EACH DEADLINE MISSED.
The actual case presentation (history and physical exam) should be limited to five (5) minutes. The
next five (5) minutes should consist of the patient management (orders, plan, course, prognosis,
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etc.). The last five (5) minutes are reserved for questions from classmates and the faculty
grader(s).
The presentation will be made to at least one (1) faculty member and the second year students. The
presentation will occur at a scheduled time at the EOS day (s). The presentation will be graded by
the faculty utilizing the Case Presentation Rubric.
A minimum grade of 70% is required. If the student fails the presentation, for whatever reason, the
student will be referred to SPC to discuss further options.
For each Elective and Selective rotation you will also have to turn in a Clinical Self Reflective
Essay at the time of your presentation.
Clinical Self-Reflective Essay:
You must write a self-reflective essay that focuses on a specific clinical year experience that you feel
will significantly contribute to shaping you as a practicing Physician Assistant. The experiences
should have made a significant impact on your future practice, either in a positive or negative manner.
You may cite situations that you observed or had close knowledge of or experienced directly. You
should avoid trivial events, specific and direct criticism of care provided by another provider, or
interpersonal relational issues. You should provide sufficient details as to make the essay informative
but equally mindful of protecting the identity of other role players and the location of the experience.
The essay should be no less than 600 words and be submitted as a Word© document with a New
Times Roman, size 12 font and include your name and date as a header.
In Adherence with the grading scheme, the following must be completed in order to
meet Category C Professionalism requirements (this is not meant to be an
exhaustive list of Category C requirements)
1. Preceptor Evaluation and Student Evaluation of Site forms by due date.
2. Submit Preceptor email to the Assistant Clinical Coordinator within 1 (one) week of beginning a
new rotation.
3. Submit logging of patient encounters and procedure logs in Typhon by the due date.
4. Contact the Program the same day concerning absences from rotation.
5. Mandatory attendance (without early departure) is required at all EOS days and required PA
program activities.
6. Must uphold student responsibilities to the clinical site noted on an evaluation or via other
communication with the preceptor (i.e. professional behavior/attitude, assignments, hospital
rounds, etc.).
6. Refrain from any rude, disrespectful, or derogatory remark, gesture, or act towards any instructor,
program, university faculty, or staff member, clinical preceptor, peer, patient or staff member of any
clinic or hospital, as this type of behavior is not consistent with professional behavior.
7. To represent the University in a professional manner at all times, refraining from any negative
comments toward the program, faculty/staff, course requirements, etc.
8. Must respond to all program emails within 48 hours.
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9. Must return all requested paperwork to the PA Program within 48 hours.
10. Keep all originals of your paperwork that you turn in to the program.
Typhon logging of patient encounters (subject to Category C: Professionalism)
Students will be required to maintain a patient log which gives the program an opportunity to further
evaluate the clinical experience. The patient log will show the numbers and types of patients being
seen, diagnosis, and level of participation. This is done in Typhon. This information assists in
providing information to remain in compliance with the Accreditation Review Commission on
Education for the Physician Assistant, Inc. (ARC-PA).
Clinical Procedure Log (subject to Category C: Professionalism)
The Clinical Procedure log is required to be completed by students during their clinical year. This
form will show the numbers and types of procedures performed during the rotation as well as level of
participation. The form will be logged into Typhon daily for each clinical rotation. Upon graduation,
credentialing through hospitals will require these documents. It is the student’s responsibility to
print this procedure log after graduation for credentialing purposes. These documents are
needed in order for students to get a job after graduating, so they are very important for you to
keep!
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Lincoln Memorial University-Physician Assistant Program
Clinical Competency Domains
The LMU PA Program utilizes several measurable domains drawn from the ARC-PA accreditation
standards as well as the Physician Assistant competencies in order to monitor and ensure that
individual students are progressing and meeting Program determined minimums. Deficits in particular
areas of competence can then be more effectively mentored and remediated in a timely manner as
needed.
1) Encounter Log Minimums (see page 27 of this manual):
a. Students are expected to play a direct role in patient care throughout their clinical phase
of education. The Program has established minimum patient encounter numbers for
each student per rotation, however additional minimums have been set for patient acuity
level, care setting, age, surgical settings and certain patient type encounters. As listed,
each domain corresponds with a different clinical care aspect. Each domain has a set
minimum total and sub-totals that must be achieved by every student to ensure a broad
exposure to the healthcare system.
b. Area IV, which relates to specific rotation assignments, shows the minimum number of
patient encounters students must complete within the assigned dates of that particular
rotation. These numbers cannot be logged outside of the assigned rotation.
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c. Areas I-III & V-VI cover interaction types that can be encountered and logged at any
time during the clinical phase and, as such, may be logged at any time during the
clinical phase regardless of the assigned rotation.
d. It is expected that a single patient interaction will likely meet the criteria for several
domains. For example, a thirty year old patient may present acutely to the outpatient
clinic for a Behavioral Medicine complaint to the student who is currently on a Family
Medicine rotation. In this scenario, the student will be able to log an encounter that
counts towards Areas I, II, III, IV and VI.
e. Students may only log patient interactions that occur while on site with their clinical
preceptor present. Volunteer work or working clinically in another manner will not be
counted towards the minimums in any domain so as to ensure the quality of the
interaction.
f. Clinical students should only log interactions where they played a partial or full role in
in the care of the patient. Interactions that only involve observations (or “shadowing”)
where little to no knowledge of the patient is known prior to the interaction should not
be logged towards these minimums.
2) Procedure Log Minimums:
a. “Procedures” (see Table 1) in this section will generally relate to activities that require
kinesthetic activities in addition to critical analysis of the patient interaction. Examples
will include suturing, incision and drainage of abscesses, IV access and similar.
However, other examples will include activities such as radiograph interpretation,
medication counseling and others.
b. Procedures may be logged at any time during the clinical phase when they occur and
need not be relegated to a particular rotation.
c. Logged procedures should include those where the student played an active role and
performed at least part of the activity personally. Observational learning while on the
clinical phase is considered valuable and important, however no more than ~30% of
procedures logged should be “Observation Only” type encounters.
3) Minimum Clinical Time:
a. This facet of achieving clinical competency relates to the minimum amount of time
each student is expected to be on duty/on site with their clinical preceptor per rotation.
b. The rotation minimum time requirement is distinct from the patient interaction
requirements. Completing the minimum time on rotation does not exclude the need to
see the minimum number of patients required for that rotation.
c. For all four week rotations, students must complete and log a minimum of 120 hours of
on-site/on duty time with their preceptor. A minimum of 240 hours are expected for all
eight week rotations. However it is expected that on all rotations that the student will
work their preceptors “full time” schedule to maximize learning. Students should seek
out opportunities to learn while on every rotation which may entail longer days, nights,
and weekends. A student who becomes aware that they will be unable to meet the
minimum hours should contact the program immediately so that a site re-assignment
can be made.
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d. The minimum time limit is a programmatic requirement to ensure competency and to
meet requirements for graduation. This is no different than an expected work schedule
as required by an employer.
4) Preceptor Evaluation of the Student:
a. This evaluation provides valuable feedback to the program, however, more importantly;
it provides students with the opportunity to identify areas of strength and areas needing
improvement based on their interactions with their preceptors. This is especially helpful
considering that the evaluation is based on the Physician Assistant Competencies.
b. Students must make certain that the program has the most up-to date e-mail or other
means of contacting their preceptor to make certain that they are able to complete the
evaluation in a timely manner since this evaluation is also used to determine a numeric
grade for the rotation.
5) Professionalism:
a. Professionalism is evaluated in several different ways and is considered to be more than
simply the absence of complaints or problems. A big part of this area is evaluated by the
student’s preceptor on the aforementioned Preceptor Evaluation. In addition, student
professionalism is evaluated on the timeliness of communications with the clinical
team, pro-active behaviors regarding completing required rotation, credentialing and
capstone requirements and generally ability to effectively time manage.
b. This aspect is considered when assessing a student’s clinical competence but also as
part of individual rotation grades.
6) Rotation Examination or Assignment:
a. All required clinical rotations have a written examination specific to that experience that
must be completed and passed with an acceptable grade. These exams will be scheduled
by the faculty and time set aside from rotation related duties to complete the exams in a
proctored setting. Passing these exams is not only key in determining clinical
competence but is also used to determine a rotations numeric score.
b. Assignments are required instead of exams for the clinical electives and selectives
which will generally consist of a patient-centered case, power points, and oral
presentations. These are graded by assigned faculty after the completion of the rotation
period.
7) General:
a. Students should consider their clinical phase a time to maximize their knowledge base
through application. In general, the greater the number of chances to apply knowledge
and learn from feedback and outcomes the greater the knowledge and competence.
b. The characteristics of clinical competence can be legion, however, the Program has
determined the domains listed above are pivotal in establishing an advanced level of
clinical competence that, along with other variables, will ensure a graduate’s success in
entering the healthcare field and being able to rapidly adapt to the needs of the patient
and the healthcare team.
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c. Minimum requirements listed should be considered just that, minimum requirements.
Going above and beyond these will better ensure student success.
How the Program will track Clinical Student Competency Progression
The Program will use the Typhon tracking system for students to log their patient encounters,
completed procedures, and clinical time. The Program will also use this platform to house and collect
Preceptor Evaluations of students.
As mentioned, Professionalism will be evaluated from the preceptor’s evaluation but also in the
student’s timeliness and completeness of required communication and paperwork. Frequent deficits
and lapses are communicated to the Director of Clinical Education and can, if a student is unresponsive
to mentoring, result in a referral to the Student Progress Committee for review.
The Program also utilizes the PAEA clinical exams with the exception of the Orthopedic
rotation for which a Program-designed exam is administered. The students will be required to prepare
a patient case presentation for the Elective and Selective rotations in lieu of an exam.
Remediation of Competency Deficits
All of the aforementioned components are considered to be integral parts in attaining the
advanced level of clinical competency the Program has developed and expects from all students prior
to graduation. With the exception of a few components, competency development is expected over the
course of the entire clinical phase. This is especially true since all students do not have the same
sequence of rotations from beginning to end. Minimum progression thresholds will be monitored at
the end of each semester and are dealt with proactively. Those that are not achieved will result in
communication with the student to ascertain barriers that may be interfering and to mentor strategies to
surmount these barriers. If after the completion of the Spring Semester, it is deemed that a student will
not be able to achieve a certain domain (i.e. procedure logs, patient encounter logs) then the students
elective or selective rotation may be changed in order to make certain these domains are achieved.
Failed rotation exams and preceptor evaluations are considered more serious lapses in competency
achievement and result in evaluation by the Student Progress Committee (SPC). Delays in graduation
are also considered for any competency domain that will not be achieved prior to graduation and will
be considered even when numeric scores, used for rotation/course purposes, indicate a “passing” score.
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TABLE 1
Procedure log requirements
Procedures
Adm. Of local
anesthesia
Assist in surgery
– this number
represents
actual
participation
Auscultate fetal
heart sounds
Culture
collection
(blood, throat,
wound, vaginal)
Demonstrate
aseptic
technique
EKG
interpretation
Explanation of
medication to
patients
Explanation of
procedures
Injections
Pelvic Exam
Rectal Exam
Suturing
Well-child exam
Wound care &
dressing
Radiologic
Studies
Interpretation Skeletal Films
Radiologic
Studies
Interpretation CXR
Radiologic
Studies
Interpretation -
Revised 6/12/15
Minimum to be
logged for Class
of 2016
10
30
10
15
30
20
60
40
10
10
5
20
15
20
30
20
10
CAT Scan
Casting &
splinting &
applying a sling
PAP smear
collection
10
5
26
Please see the preceding chart for the numbers and types of required procedures. You are required to
log the specific numbers of procedures in the preceding chart; however, you must log a minimum of
500 total procedures for the clinical year. For the remainder of the procedures, you can choose from
any of the other procedures listed in the Typhon procedure log.
It is expected that you should have 50% of your patient encounters and procedures completed by
the end of Fall semester and 80% completed by the end of the Spring semester. You will be
required to hand in a separate compilation report to show your progress at the EOS at the end of
the Fall semester and the EOS at the end of the Spring Semester. Your final report will be due
when you return to campus for graduation activities.
Failure to adequately log patient encounters and procedures will result in delay of graduation until it is
complete.
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Encounter Log Minimums
Area I
(B3.02)
T:1000
Area II
(B3.04)
T:820
Area III
(B3.03a)
T:920
Area IV
(B3.07)
Classification of patient encounter based on the acuity level regardless of setting, age or
rotation.
Preventative
60
Emergent
120
Acute
Chronic
400
400
Classification of patient encounter based on the setting in which it took place regardless of
acuity, age or rotation.
Outpt.
ED
600
Inpt.
90
OR
75
30
Classification based on patient age at the time of the encounter regardless of acuity,
setting or rotation.
Infants
(Birth-12
mo.)
20
Children
(1-12
yrs.)
75
Adolescents
(13-17 yrs.)
40
Adults
(18-64
yrs.)
Elderly
(65 yrs. and
above)
400
230
Classification based on the rotation in which the encounters took place.
T:920
Area V
(B3.03c)
T:110
Area VI
(B3.03b & d)
T:190
Fam.
Med
150
Peds
90
Emergency
Medicine
90
Internal
Medicine
150
Women’s
Health
70
Behav.
Med
60
General
Surgery
70
Ortho
90
Selective
90
Elective
60
Classification based on the surgical setting/timing in which the student played a role in
the patient’s care while on a surgical rotation.
Preoperative
25
Intraoperative
30
Postoperative
35
Classification based on specific type of encounter regardless of the patient demographic,
acuity or setting.
Revised 6/12/15
Women’s
Health
30PN,
40GYN
Behavioral
Health
80
28
Rotation Site Visits
Rotation sites will be visited at a minimum every two years by phone and every four years in person.
You may be visited or phoned by the clinical faculty or their designee during the clinical year.
Additional formal program evaluations of the student can be scheduled at any time as deemed
necessary by the program, student, or preceptor. The purpose of a visit is to evaluate the student’s
development in their knowledge, skills, and patient interactions. Evaluation of student performance is
important so strengths and areas of improvement can be identified and measures taken if necessary to
improve areas of deficiency. The site visit also provides an opportunity for frank and honest exchange
of information among all concerned parties. Students are also encouraged to relate their impressions of
the rotation and preceptor to the Director of Clinical Education or Faculty should they be visiting the
rotation. Visits are scheduled with the students for the clinical site by the clinical faculty at a mutually
convenient time for all parties. Students will be notified via email if a site visit needs to take place.
The student should respond to this request within 48 hours so that date/time can be confirmed and
travel arrangements made.
Utilization of the site visit includes, but will not be limited to:
• Feedback from both the preceptor and the student concerning the rotation
experience and student performance.
• Feedback from the preceptor and the student to identify and correct any
inadequacies in program training.
• Determining the safety of each clinical site.
Academic Probation/Dismissal
Any student, who receives a failing grade from the preceptor, or on the EOR test or elective/selective
presentation, will be considered to have failed the rotation.
Students who receive a failing grade from a clinical rotation may ultimately be considered for
dismissal from the program. If a student fails the same rotation twice, they will be dismissed from
the program. Students will be required to explain the failure to the student progress committee
(SPC) where the decisions for further action will be made.
Probation
All students who fail a course/rotation and appear before the SPC are placed on probation. Because
students on probation need to focus on academics, and not extracurricular activities, the following rules
apply: Students on probation may not hold any student government position, fundraisers, or any club
activities. They must stay in close communication with their faculty advisor and keep other
supervisory visits as determined by the Director of Clinical Education, and they must submit a written
plan to the Chair of the SPC summarizing how they plan to improve their academic performance.
CLINICAL ROTATION EVALUATION DISCREPANCIES
The student should meet with the preceptor for a final evaluation. If the student is dissatisfied with the
evaluation and has met with the preceptor to discuss the evaluation, the student should contact the
Director of Clinical Education by writing a statement that outlines specific reasons why he/she
disagrees with the preceptor’s final evaluation. The statement needs to be submitted within one week
Revised 6/12/15
29
of the final evaluation. The statement will be reviewed by the PA Program Director and Faculty. A
meeting with the student will take place if further information is required. If no further action is
necessary, a written decision will be sent to the student from the PA Program Director. If further
action is necessary, the Director of Clinical Education will contact the preceptor for more information.
Upon receiving the information, the PA Program Director and faculty will convene. A final written
decision will be sent to the student from the PA Program Director.
STUDENT PROGRESS COMMITTEE
The purpose of the Student Progress Committee (SPC) is to ensure that every graduate of LMUDCOM PA Program has the medical skills, knowledge, and competency as well as clinical and
professional judgment to assume the responsibilities of a physician assistant. The Committee will
monitor student progress and ensure that all students meet the academic, competency, and professional
requirements necessary for graduation. The Committee, appointed by the PA Program Director, is
composed of PA program faculty, DCOM faculty, one LMU PA alumni and the Associate Dean of
Students who serves ex-officio.
At the end of each grading period the committee reviews the academic progress of students assigned
either an “F” or “I” in a course. After reviewing the student’s file the committee may recommend one
of the following: repeat the failed course, to dismiss the student or to otherwise alter the student’s
course of study as outlined below. The Committee’s decisions are provided to the student and
forwarded to the Program Director. The SPC’s decision is the PA program’s decision.
Committee Procedures
At the end of every grading period, once the SPC chairman is given the final course grades, the
chairman sets the meeting date, provides an agenda to the members, informs the students of the
meeting and the reason(s) for being called, and convenes the meeting. The meeting will be
held as soon as possible following submission of the final course grades. Minutes will be kept
by a recording administrative assistant. All considered and discussed student cases are
submitted to a vote, with a simple majority ruling. The chair will be a non-voting member
except in the instance of a tie.
The student will be required to meet with the committee to answer questions and to submit any
information that is felt relevant to their case. Other than the student, administrative assistant,
witnesses as applicable, and the committee members, no one else will be present at the meeting.
In addition to students who failed a course, the committee may also interview students who
have: received negative comments on clinical rotations or accused of unethical behavior, such
as lack of professionalism, dishonesty, theft, and violation of patient confidentiality (See
Disciplinary Procedures in the Student Handbook).
Revised 6/12/15
30
•
Failed
Exam
First
Failure Failed
Preceptor
Eval.
Failure of
any second
Exam or
Second any second
Failure Preceptor
Eval. (same
or different
rotation)
Failure of
Exam or
Third Preceptor
Failure Eval. (same
or different
rotation)
Repeat rotation
and retake exam
Be placed on
Academic
Probation
SPC has option to dismiss student
from program
And/Or
Repeat
Rotation
and retake
exam
Pass retake exam
and Pass preceptor
Eval.
Fail retake exam
OR Preceptor
Eval.
Pass Preceptor
Eval. AND pass
retake exam
Fail either
Preceptor Eval. or
retake exam
•
Remain on
Academic
Probation
Delay of
graduation
•
Considered
Second Failure
•
Remain on
Academic
Probation
Delay of
graduation
•
•
Considered
Third Failure
• Dismissal from the Program
Students who fail to meet the standard of professionalism will appear before the SPC. The SPC
will decide one of the following:
1.
The student be mentored in professionalism.
2.
The student will be dismissed from the DCOM-PA program.
The student will be notified immediately of the SPCs decision, and a letter will be sent to the
student for documentation purposes.
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31
Appeals Process
A student wishing to appeal the SPC decision must submit a letter to the Associate Dean of
Students (Dr. Casey Bassett) within 5 working days of receiving notification of that decision.
The Associate Dean of Students will review the SPC decision and the student’s appeal, and,
after investigation, determine if the appeal should be forwarded to the Appeals Committee. The
student’s status will remain unchanged until the appeals process is finalized.
Appeals Committee
The appeals committee shall be comprised of three faculty members not involved in the original
SPC decision, including:
1. The PA program Director.
2. A PA faculty member not involved in the original SPC decision – appointed by the
Associate Dean of Students for a two-year term.
3. A DCOM faculty member not involved in the original SPC decision – appointed by the
Associate Dean of Students for a two-year term.
The committee will:
1. Accept and review a letter of appeal from the student.
2. Hear the student’s appeal in person (if requested).
3. Determine if the SPC gave the student due process and followed prescribed procedure
and pertinent precedent.
4. Forward their decision to the Associate Dean of Students within 5 working days.
The committee will NOT:
1. Meet with or consider testimony from any additional witnesses or representatives
for the student.
2. Entertain any information NOT presented to the SPC.
3. Entertain any information NOT relevant to the reason for the student being brought
before the SPC or its related decision.
4. Amend or alter the original SPC decision.
The committee may make the following recommendations:
1. The committee may confirm the SPC decision.
2. The committee may uphold the student’s appeal.
If the student’s appeal is upheld, the appeals committee will return the student to SPC for
reconsideration.
Revised 6/12/15
32
The final decision regarding the appeals process and the student’s status is made by the Dean of
DCOM based on the recommendation(s) of the Appeals committee. This final decision will be
reported to the Dean of Students who will inform the appealing student.
Dismissal and Withdrawal
The LMU-DCOM PA Program reserves the right to dismiss any PA student at any time prior to
graduation. Circumstances warranting such action may be of an academic, legal, or
professional nature. It is imperative that any student who leaves LMU-DCOM for any reason
goes through the check-out procedure before their dismissal, withdrawal, or Leave of Absence
can be said to be final. Failure to complete this exit procedure will cause LMU-DCOM and the
PA Program to withhold all records pertaining to the student’s attendance. The check-out
procedure is as follows:
1. If the student is withdrawing, he or she must supply the PA Program Director with a
letter of resignation.
2. If the student is being dismissed, the Chairperson of the Student Progress Committee
should inform the PA Program Director of the dismissal as soon as possible and
communicate with the physician assistant student who is being dismissed that a checkout is in order.
3. As soon as the Office of Admissions and Student Advancement is formally notified of
the physician assistant student leaving school, it will produce a memorandum stating the
change in the PA student’s status to all DCOM offices and the appropriate professors.
Before leaving campus, the student needs to undergo an exit interview with:
• Admissions and Student Advancement Office;
• Financial Services Office;
• Security;
• Library
4. When the student completes all of these obligations, DCOM will then release student
records upon the proper request. Dismissal and check-out forms are available in the
DCOM Office of Admissions and Student Advancement.
Probation
All students who fail a course (or courses) or appear before the SPC are placed on academic
probation. Because students on probation need to focus on academics or making modifications
to their behavior, and not extracurricular activities, the following rules apply: Students on
probation may not hold any student government position, they may not attend any local or
national medically related meetings, fundraisers, or any club activities, they must meet with
their advisor regularly, and they must submit a written plan to the Chair of the SPC or
designated advisor summarizing how they plan to improve their academic performance.
Revised 6/12/15
33
DISCIPLINARY PROCEDURES
Initial Investigation
When a report alleging student misconduct comes to the PA Program Director, the student is
immediately notified of the allegations. If the student does not respond within twenty-four hours he or
she may be immediately suspended. The Chair of the PA Program Student Progress Committee will
conduct an initial investigation by taking written and oral statements from the complainant (person
making the allegations) and any witnesses. The student who is charged will be notified of the
allegations. The student will be given a chance to present his or her case to the SPC. Once all sides
have been heard, the SPC will make a decision based on review of the allegations and the testimony
heard during the meeting. The SPC will notify the PA program Director immediately of their decision.
If the student is found guilty, he or she may be subject to immediate dismissal from the program. If the
student accepts the findings, then he or she will sign a statement acknowledging acceptance of the
findings and agreement to abide by the SPC decision. If the student is not satisfied with the findings,
then the student has the option of having the case heard by the Dean of DCOM. If the student poses a
threat to the college community, the Dean may temporarily suspend the student from attending classes
until the issue is resolved.
Student Progress Committee Hearing
Because this is not a criminal court, the level of proof for a decision shall be “substantial evidence”
and not the strict criminal law standard of “proof beyond a reasonable doubt.” If a student fails to
appear before the SPC, the matter will be resolved in his/her absence.
1. All proceedings are confidential. The meetings are closed to anyone not in the University
community. Only the committee members, the administrative assistant, and the accused student
will be allowed to attend the meeting.
2. At least three days prior to the start of the meeting the student will be notified of the specific
reasons for which they are called before the SPC.
3. If the student feels that one of the committee members is biased, then the student may request
to have this person removed and replaced with another faculty member. The request should be
made to the chair three days prior to the start of the meeting. If one of the regular members of
the SPC cannot attend the meeting then a temporary member will be appointed for the length of
the hearing.
4. The Chair will remind committee members that the hearing is confidential. The proceedings
will be recorded in writing by a secretary. Any previous disciplinary problems will not be
raised at this point.
5. The ‘plaintiff,’ if the case is due to an accusation of misconduct or unacceptable professional
behavior, will present their statements to the committee. The committee may choose to ask
questions at this point. The student will not be present for this portion of the hearing.
6. The student will be encouraged to present any information they feel is relevant to their case and
to answer questions as needed from the SPC.
7. Following the presentation of the evidence, the Chair shall request that everyone, other than the
committee members leave the room. The committee will deliberate, voice opinions, and a ballot
will be taken to decide whether the student has violated standards of acceptable conduct. A
majority vote will rule.
Revised 6/12/15
34
8. If the committee determines that a violation has occurred then the deliberations will move into
the penalty phase. At this point, any prior disciplinary problems will be provided to the
committee. After the Committee is finished deliberating it will immediately notify the student
of their conclusions, and inform the PA program Director.
9. A follow-up letter will be mailed to the student outlining the SPC decision for the purpose of
written documentation.
CONDUCT AND PROFESSIONALISM
Professionalism
An important aspect of any professional educational curriculum is the development of professional
behaviors and role identity. Evidence shows that unprofessional behavior exhibited during training is a
predictor of future problems with state regulatory boards and the need for disciplinary actions
(Papadakis, Hodgson, Teherani and Kohatsu, 2004). Since such behavior presents a potential danger
to the provision of good patient care and issues for the credibility of the profession, they share equal
importance to content knowledge and manual skills. The Physician Assistant Program considers
breeches of professional conduct as important academic deficiencies.
Recognizing the responsibility to develop appropriate professional behaviors, the LMU-DCOM
Physician Assistant program sets expectations for professional conduct and evaluates students in this
sphere to document satisfactory acquisition of these important behaviors.
The National Board of Medical Examiners has identified behaviors consistent with professionalism.
These behaviors are listed below. Each member of the Department (student and faculty) should strive
to model these behaviors as a mode to ensure quality patient care and growth of the profession. As a
mechanism to assist students in the acquisition of these professional skills, a monitoring system has
been established to identify unprofessional behaviors in both the didactic and clinical years of the
program. Students identified as exhibiting unprofessional behaviors will be provided with remediation
opportunities. Students who reflect a pattern of unprofessional behavior (deficiencies identified in two
or more courses or clinical experiences) will be placed on academic probation and will receive
documentation of these deficiencies in letters of reference provided by the department. Severe
infractions of professional behavior will be grounds for academic dismissal.
Professionalism Expectations
Altruism
1. Helps colleagues and team members who are busy
2. Takes on extra work to help the team
3. Serves as knowledge or skill resource to others
4. Advocates for policies, practices and procedures that will benefit patients
5. Endures inconvenience to accommodate patient needs
Honor and Integrity (honesty)
1. Admits errors and takes steps to prevent reoccurrence
Revised 6/12/15
35
2.
3.
4.
5.
6.
7.
Deals with confidential information appropriately
Does not misuse resources (i.e. school property)
Attributes ideas and contributions appropriately for other’s work
Upholds ethical standards in research and scholarly activity
Requests help when needed
Assumes personal responsibility for mistakes
Caring and Compassion
1. Treats the patient as an individual, considers lifestyle, beliefs, and support systems
2. Shows compassion to patients and maintains appropriate boundaries in professional
relationships
3. Responds to patient’s needs in an appropriate way
4. Optimizes patient comfort and privacy when conducting history, physical examination, and
procedures
Respect
1. Respects institutional staff and representatives; respects faculty and colleagues during teaching
sessions
2. Adheres to local dress code
3. Participates constructively as a team member
4. Adheres to institutional and departmental policies and procedures
5. Displays compassion and respect for all patients even under difficult circumstances
6. Discusses patients/faculty/colleagues without inappropriate labels or comments
Responsibility and Accountability
1. Presents self in an appropriate manner to patients and colleagues
2. Completes assignments and tasks in a timely manner
3. Responds promptly when called or when pages, emails or phone calls are sent
4. Intervenes when unprofessional behavior presents a clear and present danger
5. Uses resources effectively
6. Responds appropriately to an impaired colleague
7. Reacts to other’s lapses in conduct and performance
8. Makes valuable contributions to class, rounds, and group interactions
9. Elicits patient’s understanding to ensure accurate communication of information
10. Facilitates conflict resolution
11. Remains flexible to changing circumstances and unanticipated changes
12. Balances personal needs and patient responsibilities
13. Provides constructive feedback
Excellence
1. Has internal focus and direction, sets goals to achieve excellence
2. Takes initiative in organizing, participating, and collaborating with peer groups and faculty
3. Maintains composure under difficult situations
4. Inspires confidence in patients by proper preparation for clinical tasks and procedures
Adapted from Behaviors Reflecting Professionalism National Board of Medical Examiners.
Revised 6/12/15
36
Physician Assistant Student/Patient Relationships
The relationship between the physician assistant student and patient should always remain at a
professional level. The student is not to engage in relationships with patients that are construed as
unethical or illegal. Dating and intimate relationships with patients is never a consideration.
Unprofessional conduct will be considered improper behavior and will be grounds for disciplinary
action, including dismissal from DCOM.
ADMINISTRATIVE GUIDELINES AND PROGRAM POLICIES
FOR THE CLINICAL YEAR
The LMU-DCOM PA Program includes specific policies and guidelines for the clinical year. The
policies are as follows:
A. PROFESSIONAL CONDUCT
Behavior consistent with high professional, ethical, and moral standards is paramount in the practice of
medicine. Professional behavior refers to those acts reflecting the status, character, and standards of a
profession. Ethical behavior is that behavior which reflects the accepted principles of right and wrong
that govern a particular profession. Moral behavior refers to conforming to the acceptable standards of
behavior and conduct as practiced by a community.
Any Physician Assistant student involved in behavior which is deemed unprofessional, unethical, or
immoral is subject to disciplinary action which may include reprimand, probation, suspension, or
dismissal from the program. Any rude, disrespectful, or derogatory remark, gesture, or act
towards any instructor, the program, university faculty, or staff member, clinical preceptor,
peer, patient or staff member of any clinic or hospital is not consistent with professional
behavior.
COMMUNICATION
The program makes every attempt to keep in close contact with each student and clinical site. The
Director of Clinical Education is available for consultation with the student or site whenever necessary.
Communication between PA Faculty and PA Students is accomplished through several methods that
may include site visits, email, telephone calls, and voicemail. Students should be allowed and
encouraged to check email at least twice a day. Students must respond to all email from LMU
employees within 48 hours. Whether checking email is done at the practice site or at another nearby
facility (i.e. university/medical center or even public library) is at the discretion of the preceptor.
Problems on rotations can occur, be they academic, professional, or personal in nature. If this is not a
safety issue, students should use the following guidelines in dealing with any problems:
•
•
Revised 6/12/15
Attempt to resolve problems with the individual directly.
If this is not possible, discuss it with the preceptor or contact person.
37
•
If unable to resolve a problem for any reason, contact the Director of
Clinical Education ASAP. If the Director of Clinical Education is
unavailable, please contact the Clinical Rotations Coordinator in the PA office,
and if she cannot help you, she will put you in contact with an available faculty
member.
Main PA Program Clinical Team number: 423-869-6679
Dress Code
In keeping with the professional nature of the LMU-DCOM PA program, all PA students
are expected to dress in an appropriate manner both in the classroom and in the
clinical setting. Being neatly dressed and well groomed exemplifies a professional
appearance.
The dress code is described as Business Casual. For the PA program, business casual can also be
described as the attire appropriate for caring for patients.
EACH STUDENT IS REQUIRED TO FOLLOW THE DRESS CODE AS OUTLINED BELOW:
CLOTHING SHOULD ALLOW FOR ADEQUATE MOVEMENT DURING PATIENT CARE, AND SHOULD NOT BE
TIGHT, SHORT, LOW CUT OR EXPOSE THE TRUNK WITH MOVEMENT.
CLOTHING SHOULD NOT BE TORN OR RIPPED, AND SHOULD APPEAR WELL KEMPT.
Slacks, Pants, and Suit Pants Slacks that are similar to Dockers and other makers of cotton or
synthetic material pants, wool pants, flannel pants, dressy capris, and nice looking dress synthetic pants
are acceptable. Inappropriate slacks or pants include jeans (regardless of color), sweatpants, exercise
pants, Bermuda shorts, short shorts, shorts, bib overalls, leggings, pajama jeans, and any spandex or
other form-fitting pants such as people wear for biking or exercise.
Skirts, Dresses, and Skirted Suits Casual dresses and skirts, and skirts that are split at or below the
knee are acceptable. Dress and skirt length should be at a length at which you can sit comfortably in
public. Short, tight skirts that ride halfway up the thigh are inappropriate for work. Mini-skirts, skorts,
sun dresses, beach dresses, and spaghetti-strap dresses are inappropriate for the office.
Shirts, Tops, Blouses, and Jackets Casual shirts, dress shirts, sweaters, golf-type shirts, and
turtlenecks are acceptable attire for work. Most suit jackets or sport jackets are also acceptable attire
for the office, if they violate none of the listed guidelines. Inappropriate attire for work includes tank
tops; midriff tops; shirts with potentially offensive words, terms, logos, pictures, cartoons, or slogans;
halter-tops; tops with bare shoulders; sweatshirts, and t-shirts unless worn under another blouse, shirt,
jacket, or dress.
Shoes and Footwear Conservative athletic or walking shoes, loafers, clogs, sneakers, boots, flats,
dress heels, and leather deck-type shoes are acceptable for work. Flashy athletic shoes, thongs, flipflops, slippers are not acceptable in the office.
Revised 6/12/15
38
Jewelry, Makeup, Perfume, and Cologne Should be in good taste, with limited visible body piercing.
Remember, that some employees are allergic to the chemicals in perfumes and make-up, so wear these
substances with restraint.
Hats and Head Covering Hats are not appropriate inside. Head Covers that are traditionally required
for religious purposes or to honor cultural tradition are allowed.
JEWELRY Watches, wedding bands and/or engagement rings are permissible as appropriate. No
excessive bracelets or necklaces. Earrings - no more than two earrings per ear, no exaggerated dangling
or oversized earrings. No other visible body piercings are permitted.
NAILS Fingernails should be kept trimmed and without nail polish (on clinical sites).
TATTOOS Students may not exhibit tattoos.
PERFUME / AFTER-SHAVE No excessive or heavy perfumes or after-shaves/colognes. (No perfumes or
after-shave/colognes during clinicals).
HAIR Hair should be clean and arranged so as not to interfere with providing patient care.
NAMETAGS Which identifies you as an LMU-DCOM PA student is mandatory at all times, and must
be worn on either your lab coat or clothes while at the clinical site and in the classroom. See below.
PROFESSIONAL ATTIRE A Short, consultant style, white lab coat will be worn when out in the clinical
setting or scrubs when appropriate.
Proper Identification
All students are required to acquire an LMU Student ID Card. All students are required to have a valid
form of photo ID on them at all times while on campus (including LMU ID and license). If a faculty
member, staff member, security officer, Resident Director or Resident Assistant asks a student to
present an ID, the student must present identification immediately. Failing to provide, or refusal to
provide requested identification can result in disciplinary action, including a $25.00 fine.
PA students must always identify themselves as “physician assistant students” to faculty,
patients, clinical site staff, and never present themselves as physicians, residents, medical
students, or graduate physician assistants. While in the LMU-DCOM PA program, students may
not use previously earned titles (i.e. RN, MD, DO, EMT, Ph.D., Dr. etc.) for identification
purposes. LMU-DCOM identification badges must be worn at all times while on campus and
during clinical experiences.
*If the clinical site has established policies and practices regarding dress, the site’s policies
supersedes those of the LMU-DCOM PA Department.
CLINICAL SUPERVISORS, PRECEPTORS, OR PA DEPARTMENT FACULTY RESERVE
THE RIGHT TO ASK A STUDENT WHO IS NOT APPROPRIATELY DRESSED TO LEAVE
THE CLINICAL SITE.
Revised 6/12/15
39
CLINICAL SITE:
Students may be required to wear a separate security I.D. badge at clinical sites. The clinical site(s)
will make arrangements for you during orientation prior to beginning the rotation.
Student Responsibilities
• Maintain professional behavior at all times and dress in the manner as prescribed in the student
•
•
•
•
•
•
•
•
•
•
•
handbook. Students should wear white coat/jacket with name badge at each rotation site as it
complies with the rotation site dress code. Some sites may require additional identification.
Students must only identify themselves as PA Students.
Work the same hours as the preceptor to include all office hours/clinics, emergency calls,
nursing and hospital rounds, and meetings with a minimum or 120 hours per 4 week block.
Any charts or orders written by the student must have their name clearly written followed by
the initials “PA-S” (Physician Assistant Student). Students who possess other titles (e.g. RN,
RT, etc.), will at no time be allowed to use these designations. All charts and orders must be
signed by the preceptor immediately.
Review medical textbooks to expand knowledge of problems and procedures typically seen in
the practice setting or those that may be required by the preceptor.
Punctuality. Students should not be late to a clinical site or to rounds. The PA program must be
notified of any absence from the rotation. Students should contact the preceptor/or designee and
the Director of Clinical Education if they are going to be absent or unable to be on time.
Students must attend the rotation 100% of the time. Any absences must be excused by Director
of Clinical Education and the preceptor. If absent, the Director of Clinical Education must be
notified in writing of why the student will be absent from the site and how this rotation day
will be made up.
All students will keep a log of patient encounters and a procedure log with all the pertinent data
as required by the Director of Clinical Education. The student is encouraged to review the
procedure log with the preceptor at the end of the rotation. At the end of the rotation the logs
are to be submitted via Typhon to the Director of Clinical Education. Failure to keep logs and
to input them into Typhon will result in an Incomplete and/or possible failure for that rotation.
All final evaluations are due at the end of the rotation. The evaluation forms are to be
completed by the preceptor on Typhon. The evaluation of the site/preceptor is to be completed
by the student on Typhon.
Attendance at end of semester (EOS) days is mandatory and sign-in will be required.
Failure to complete all tests and assignments in a timely manner as prescribed by the program
will result in an Incomplete and/or Failure for a course of instruction/rotation. Students should
not receive gifts in the form of money or material goods in return for his/her assistance.
Students must work under the direct supervision of a licensed PA, physician, nurse
Midwife, or nurse practitioner. PAs, NPs, and Nurse Midwives must be supervised by a
licensed physician.
Students must always work under the direct supervision of a preceptor (assigned preceptor or
alternate). Students are at no time allowed to be in charge of a patient’s care. Students are not
allowed to provide any services without consultation and supervision of the preceptor.
Revised 6/12/15
40
• Students may perform procedures within the scope of practice as authorized by the PA
•
•
•
•
•
•
•
•
program, preceptor, and clinical site. Students are not to undertake any procedures without
consulting the preceptor.
Students cannot be under the influence of alcohol or drugs when working at a clinical site,
taking call or events at the university. Students must not compromise the safety and health of
patients, students, faculty, or hospital/clinic personnel.
Honor patient-physician confidentiality and deliver health care service to patients without
regard to their national origin, race, creed, age, sex, disease status, sexual orientation, religion,
socioeconomic status, veteran status, disability, and political beliefs.
Each student should follow universal precautions while at the clinical sites. All students
should understand when and what to use for given circumstances. If a student is not aware of
the appropriate equipment to be utilized, they need to contact the Director of Clinical Education
for additional training.
Students must maintain professionalism at all times and address the preceptor, clinical staff,
and patients appropriately.
Students should avoid disagreements with preceptors, especially in front of patients and other
health care workers.
Students are not allowed to work at any rotation site for compensation during the clinical year.
Students are not allowed to work during the clinical year and will be given no consideration to
be excused from a clinical rotation to work.
Students are required to report any safety issues to the Director of Clinical Education
immediately.
Student Responsibilities to the Program
• To review and be prepared each day at the clinical site
• To attend and fully participate
• To attend all events associated with the rotation
• To return to LMU-DCOM or other designated sites for EOS activities
• To participate in summative evaluations set up by the program
• To complete site evaluations, patient logs, and clinical procedure logs for each rotation
• To meet with the LMU Clinical Faculty or designee during a site visit
• To notify the program of any concerns or problems that may occur at the site, including but not
limited to any issues concerning safety of the site
• Uphold all standards of professionalism
Student Responsibilities to the Site
• It is the student's responsibility to contact the preceptor or his/her designated contact person at
least two weeks prior to the start of a new rotation, to determine what time, where, and to
whom the student should report for the first day of that rotation. It is required that you speak to
someone by phone at the rotation site for confirmation.
o If you cannot speak to someone at the rotation site directly to gather this
information within 48 hours contact the Clinical Rotations Coordinator
immediately for assistance.
• As this is a full time experience, students are expected to work full time following your
Revised 6/12/15
41
•
•
•
•
•
•
•
•
•
•
•
•
preceptor’s schedule, plus any on-call or weekends as scheduled by the preceptor.
Students are expected to make up any time missed while on rotation. This may be determined
by the preceptor and/or the Department.
Students will be required to make up the days they are absent. If the number of days missed
exceeds two (2) for a four week rotation, the student will have to repeat the rotation. Students
are not to exceed a total of four (4) days during the Family Medicine and Internal Medicine
rotations. Excused days missed include illness, attending funerals of close family and
interview days. All missed days must be excused by completing the required form found in
this manual.
Any student who misses two (2) days or more from an individual rotation must submit an
excuse from their health care provider on official letterhead. The excuse is to be submitted to
the Director of Clinical Education.
Students may miss no more than 5 days total per semester and all days must be cleared by both
the preceptor and the Director of Clinical Education.
Students may only take the same time off as their preceptor for a given holiday. However,
students are required to try to make up any time that they miss to ensure a good clinical
experience.
Students are not permitted to request time off from rotations without prior approval from the
Director of Clinical Education and the preceptor.
If you must be absent from the rotation for any unplanned reason, notify the rotation site as
early as possible EACH MORNING that you will be absent.
The Department and the rotation site must be notified the morning of an absence for any
reason.
Specific objectives for each rotation are provided to both the student and preceptor. End-ofrotation exams are based on the rotation objectives specific for the rotation. Clinical
experiences may vary depending on patient population and site strengths/weaknesses. It is the
student's responsibility to review the objectives and augment clinical experiences with
independent research and discussion with the preceptor as necessary.
Students are required to keep a patient log and procedure log of patient encounters.
Students are to abide by HIPAA standards.
Students are responsible for following OSHA guidelines for universal precautions at the
clinical site.
Liability Insurance coverage:
LMU-DCOM provides each student with a $2M/4M malpractice insurance policy. Students will
receive a copy of the certificate to provide to preceptors.
Preceptor Responsibilities
• The Preceptor will provide appropriate supervision of student activities, insuring the highest
standards for patient care and safety while maintaining a sound educational experience for the
student.
• Establishment of student work schedules is the responsibility of the Preceptor. LMU-DCOM
PA Program would prefer the student to experience a typical exposure to your practice. The
student is assigned to the rotation with the requirement of working full time following the
preceptor’s schedule. It is expected that the student will be on call for emergencies at any time
they occur.
Revised 6/12/15
42
• The Preceptor will take the responsibility to introduce the student and inform appropriate
•
•
•
•
•
•
•
•
•
•
personnel in the hospital and/or clinic of the student's arrival and role.
The Preceptor will orient the student to the clinical setting and discuss practice policies and
procedures.
The Preceptor will discuss “on-call” schedules and expectations.
Review the pertinent clinical preceptorship objectives.
The Preceptor will participate in evaluating the student's performance by providing verbal
and written feedback to the student and the program. At the completion of the rotation, a link
to the student evaluation will be sent to each preceptor. Based upon the Preceptor's
recommendations and other factors that can be found in the grade calculation section of this
handbook, the Director of Clinical Education will be responsible for assigning the final
rotational grade.
The Preceptor will inform the program if significant problems develop (of personality or
professional nature, etc.) which require faculty attention, knowledge, or consultation or
circumstances arise that may prevent the overall goals from being accomplished.
The student will be assigned to a specific Preceptor who will have overall responsibility for the
student during the rotation. This does not preclude the student from being assigned to another
provider within the practice during the rotation.
The Preceptor will comply with current laws, regulations, and standards of educational and
medical practice. All orders, chart entries, etc., must be countersigned by the Preceptor. The
student should not be expected to initiate or terminate patient care which is not supervised by
the physician or the hospital service algorithm (written or verbal) for the problem.
The Preceptor will not discriminate against any student because of age, creed, handicap,
national origin, race, gender or sexual orientation.
The Preceptor will directly supervise, observe, and teach in order to develop the student’s
clinical skills and to ensure patient safety.
The Preceptor will assign outside readings to promote learning, demonstrate clinical skills, and
assess oral case presentations.
Student Immunizations, OSHA Requirements & HIPAA Training
HIPAA Training
Students will receive HIPAA training prior to beginning clinical rotations. A certificate of completion
will be provided to students for proof of this training.
Health Requirements
Prior to starting clinical rotations, students are required to submit a medical history and physical
examination information form that has been completed and signed by a licensed health care provider.
Also, applicants must have their own health insurance policy and provide evidence of such. Students
who do not fulfill this requirement will not be allowed to begin clinical rotations, with no exceptions.
Revised 6/12/15
43
The PA program, in conjunction with requirements of all hospitals accredited by the Joint Commission
on Accreditation of Healthcare (JCAHO) and/or Healthcare Facilities Accreditation Program
(HFAP) requires the following immunizations:
1. Annual PPD - 1 step TB Skin test OR if positive results; provide a clear chest radiograph.
2. Hepatitis B immunization (established by three reported dates of immunization and by positive
antibody titer).
3. Tetanus, Diphtheria, and Pertussis (Tdap). Documentation of Tdap booster within the past 10
years OR a Td booster within the past 2 years.
4. Proof of immunity against measles, mumps, and rubella, MMR (Separate Requirements for
each Component with Vaccines AND Titers) Both of the following are required: 2
vaccinations AND a positive antibody titer for Measles, Mumps and Rubella.
5. Varicella immunity (established by documented history and positive antibody titer) or date of
vaccination and positive antibody titer.
6. Influenza Vaccine prior to flu season.
This documentation must be uploaded to Certified Background by the program-established due
date. Failure to provide completed documentation will prevent the student from participating in
any clinical rotations for the following year.
LMU Student Health Insurance
Lincoln Memorial University requires all students have health insurance. Students are charged the
appropriate premium on their student accounts automatically as they register for six or more credit
hours. Students registering for less than six hours are not required to show proof of coverage and will
not be charged.
WAIVERS:
All waivers are processed by the Office of Student Services. Students are required to submit proof
of insurance coverage.
PROCESS FOR WAIVER REQUEST
 Students must fax or bring a copy of their insurance card to the Office of Student
Services, Student Center, Room 308, Fax 423-869-6204.
 LMU employees should submit a copy of their insurance card. Employee IRS
dependents only need to supply a memo from the Human Resources Office stating that
they are covered under the LMU Employee medical insurance plan
• If the student’s name is not on the insurance card, the student should: 1) forward a letter from
their insurance company or Human Resources Department verifying that they are covered
under the plan; or 2) Go to carrier website and print off proof that their coverage is active.
• The student should allow at least ten business days for the account credit to be processed after
the information has been sent to the Office of Student Services. Once approved the student will
be notified via email.
Note: University personnel and insurance company personnel do not have access to personal
health information through the waiver process. No personal health information is required or
needed in the waiver process.
For Additional Information:
Office of Student Services (phone) 423-869-7166 (Fax) 423-869-6204
Revised 6/12/15
44
Students who do not have up-to-date health insurance will not be allowed to participate in any activity
that involves patient contact. This may result in the student not being able to fulfill the requirements of
certain courses and activities which could have a detrimental effect on the student’s progress.
On-campus health care services
A special feature of the plan will be no out-of-pocket costs for office visits for students who receive
care at the University Medical Clinic. For those who choose not to use this service, there is an
affordable office co-pay and annual deductible. The plan is also accepted at many area health care
providers. Please review the summary of benefits for an overview of the plan.
OSHA Guidelines:
Students are responsible for following required universal precaution guidelines at the clinical sites.
This includes the use of personal protective equipment, proper care and disposal of sharps, and
other precautionary measures. Training will be given during the didactic year and proof of training
will be provided.
Incident Reporting:
Should a student sustain an exposure at the clinical site (i.e., blood or body fluid exposure, TB
exposure, or needle stick) the student should report the incident immediately to the preceptor
and receive appropriate medical care (less than two hours from the time of exposure). An
incident report should be completed and the student is then required to contact the Director of
Clinical Education. Ultimately, the student is responsible for initiating follow up care after an
exposure at a physician’s office or at the clinic on campus (if in or near Harrogate). (See
Appendix F for updated guidelines).
Employment:
Employment is not consistent with the learning environment in the clinical year. During the clinical
year, students are expected to work full time following your preceptor’s schedule with a minimum of
120 hours per 4 week rotation. In addition, students may be required to take on call, weekends,
holiday, evenings, and/or nights. The emergency medicine rotation may require students to work 12
hour shifts. Surgery rotations will require students to be on call and to participate in any surgery that
occurs during the nights, weekends, or holidays.
Assignments:
Students are advised to keep a copy of all assignments/paperwork that they submit. The
program is not responsible for making copies or sending in paperwork for credentialing. Once an
assignment has been submitted, there will be no further acceptance of revised or additional work. Late
submissions of any assignment/paperwork will not be accepted for credit.
Revised 6/12/15
45
Housing, Transportation, and Meals
Students are responsible for all housing, transportation, and meals associated with rotations. On
occasion, clinical sites may have housing/stipends available. That information can be provided by the
site. It is the responsibility of the student to make all housing/transportation arrangements.
Medical Diagnostic Equipment
All students should bring their properly functioning medical diagnostic equipment with them to all
clinical rotations. This includes the blood pressure cuffs, stethoscope, ophthalmoscope, otoscope,
reflex hammer, and tuning forks.
Objective Structured Clinical Examination (OSCE)
Clinical encounter exams utilizing standardized patients related to competency of clinical medical
knowledge, skills, and professionalism is administered to all physician assistant students throughout
the 27 months of the program. These exams use paid actors. A student who misses a scheduled OSCE
with a paid patient actor will be charged a $50.00 remediation fee. This fee will be charged regardless
of the reason for the absence. Professional attire is mandatory for the OSCE. Unprofessional dress
will result in points being deducted from the grade.
Students not able to pass the OSCE will be able to remediate once. The remediation program is
determined by a team of full-time clinical faculty and is individualized to ensure a level of satisfaction
prior to advancement. The highest grade that can be achieved on remediation is a 70%. If the student
fails to pass the remediation, the student will be referred to the SPC.
Personal Safety and Security
A. Personal Safety
i. Program’s responsibility
1. To ensure student and faculty safety at clinical rotation sites, the program conducts and
catalogs routine site visits to evaluate the safety of the clinical site. Any clinical site deemed unsafe, is
immediately discontinued by the program.
2. The program takes seriously any student allegation or concern regarding safety, and will
investigate promptly any safety concerns.
ii.
General Safety
1. If you feel unsafe due to a patient or employee at your rotation site, immediately report this
to your preceptor, the office manager or security. If this is not handled immediately by on-site
personnel, then report it to the Director of Clinical Education.
Revised 6/12/15
46
2. If at any time during your clinical education you feel that your housing is unsafe please
contact the housing manager. If this is not taken care of immediately, then report it to the Director of
Clinical Education and alternate housing arrangements will be made to ensure safety.
3. If at any time while on clinical rotations you feel that your rotation site is unsafe, you are to
immediately contact the Director of Clinical Education by phone at 865-360-6812. If the Director of
Clinical Education is unavailable, please contact the Clinical Rotations Coordinator in the PA office,
and you will be put in contact with an available faculty member.
4. Immediately notify the Director of Clinical Education of any expected or unexpected
absences from the clinical rotation. All students must ensure that the program has the most current
contact information for you at all times.
Main PA Program Clinical Team number: 423-869-6679
If you feel your safety is in immediate jeopardy you are to call 911 and report this to the police.
iii. Student safety and security is of utmost importance, therefore certain common-sense measures
should be kept in mind as you travel to various rotation sites:
1. Don't leave valuables such as your wallet, checkbook, jewelry, or keys in open view.
2. Mark easily stolen items like portable TV's, radios, pocket organizers, and computers and
keep a list of serial numbers, model numbers, and descriptions.
3. Lock doors and windows when going out, and never prop doors open when entering/exiting
the apartment/dormitory building - it is too easy for someone paying attention to sneak in.
4. Don't store large amounts of money or credit cards in your apartment.
5. Take care of your keys; do not lend them to anyone.
6. Use the "buddy system" - go out with a friend, especially if you're headed for a late night
snack or study break.
7. Walk purposefully. Look confident. Always watch where you are going. Avoid shortcuts
through isolated areas. Be alert to your surroundings. If you still have concerns, call the health care
facility security for an escort.
8. If entrance/hallway lights are burned out after working hours, report them to maintenance.
9. If you see unusual activity or someone loitering, call hospital security immediately.
iv. Driving/Parking Safety
1. Lock all doors and close all windows when leaving your car.
2. Park in well-lit areas and try not to walk alone to/from parking areas at night.
3. Have keys ready as you approach your car. Check car for intruders before entering and lock
door immediately after getting into your car.
Revised 6/12/15
47
4. If you must store valuables in your car, store them out of sight (preferably locked in trunk).
I. Communicable illnesses / Exposure
It is the policy of the LMU-DCOM PA program that all communicable illness exposures are to be
handled according to CDC recommended guidelines. Any student on clinical rotations subject to a
communicable illness exposure should follow these steps:
1. Notify the preceptor immediately.
2. Initiate and follow the exposure protocols of the facility in which the exposure occurred.
3. Contact the Director of Clinical Education as soon as possible.
4. The Program will ensure that the student is appropriately informed and receives appropriate
CDC recommendation guideline care.
5. See specific recommendations below.
i. Influenza (Flu)
1. All students are to follow the Influenza vaccination policy found in the Student
Immunizations, OSHA Requirements & HIPAA Training section in this manual.
2. Any student displaying “flu-like” symptoms should notify their preceptor and the Director
of Clinical Education. In an effort to minimize viral spread and to promote the health and the wellbeing of the student, students with flu illness will temporarily stop all clinical activities until symptoms
are resolved. The exact timeframe of return to clinical activities will be determined by collaborative
communication with student and the Director of Clinical Education.
ii. Tuberculosis
1. All students are to follow the TB screening protocol found in the Student Immunizations,
OSHA Requirements & HIPAA Training section in this manual.
2. Students with known TB exposure during a clinical rotation are to follow the office/hospital
protocol for reporting the exposure, and are to contact the Director of Clinical Education for guidance
through the CDC exposure recommendations.
iii. Ebola, meningitis, or other highly contagious pathogens
1. Always exercise universal precautions with all patients.
2. In the event that Ebola or any other highly contagious pathogen is identified at the facility
where you are training, contact the Director of Clinical Education for further direction to determine the
safety risk and necessary actions to maintain your safety.
Revised 6/12/15
48
3. In the event of your exposure to Ebola or other highly contagious pathogen, notify your
preceptor at once. Follow the office or hospital’s exposure protocols, and notify the Director of
Clinical Education as soon as possible. The Director of Clinical Education will guide you through
CDC recommendations for such exposure.
iv. Any student absence resulting from a communicable illness or exposure will be handled on a caseby-case basis. Students are given a preset number of absences built into each semester of clinical
rotations. In the event a student exceeds this preset number of absences as a result of exposure, the
program will work with the student to determine the best course of action for continuing in the
program without being delayed. This process is generally handled by the Student Progress Committee.
Student Background Check, Drug Screening, and Arrest Policy
I. RATIONALE:
An LMU-DCOM PA student is a representative of the University and his or her profession
whether engaged in academic, research, or purely social pursuits, on or off of LMU-DCOM’s
campus. As stated in the LMU-DCOM PA Code of Student Conduct, “students are required at
all times to maintain high standards of private and public conduct on campus and at university
sponsored events.” Further, as noted in the LMU DCOM PA handbook, “The University
reserves the right to discipline students who commit certain off-campus violations of University
policies.” The protection of vulnerable patient populations is of utmost importance to LMUDCOM PA Program and the clinical sites where students complete the clinical requirements for
the student’s academic program. LMU-DCOM PA Program must be informed of any violations
of the law or school policy in order to take appropriate corrective or punitive action when
students are involved in conduct or activities that could tarnish LMU-DCOM PA Program’s
reputation.
II. POLICIES:
A. All LMU-DCOM Physician Assistant students shall submit background checks, and drug
and alcohol screening as scheduled by the PA program and as required by clinical rotation
affiliation agreements.
B. Students arrested or formally charged with any infraction of the law other than minor traffic
violations while matriculated as an LMU-DCOM PA student shall report such violation or
charges to the Assistant Dean of the LMU-DCOM PA Program within two business days
of the offense.
Students failing to report an arrest will be subject to immediate dismissal.
III. PROCEDURE:
A. Prior to matriculation into the program, and again before the clinical year, students will be
expected to submit background checks and drug and alcohol screens1. Additional
background checks and screens during the clinical year may be required for specific clinical
rotations per an affiliation agreement. Students shall be responsible for paying any and all
Revised 6/12/15
49
associated costs of urine drug screening, background checks and finger printing, including
necessary retesting for any reason. Positive findings on a background check will be subject
to review by the Assistant Dean of the LMU-DCOM PA Program. The Physician Assistant
Program reserves the right to prohibit admission or progression in the Physician Assistant
Program based upon the results of such testing or the refusal to submit to such testing.
Additionally, clinical sites reserve the right to refuse students based on the results of
background checks.
1. Students with positive findings on pre-matriculation background checks or drug screens
will meet with the program director to determine if matriculation is appropriate
(students with felony convictions or pending felony charges will not be considered for
admission. Students with prior DUI or misdemeanor convictions will be evaluated and
advised on a case by case basis). Students with new positive findings on background
checks or drug screens at any time throughout the program will be subject to the
policies as outlined above, and the procedure described below in section B.
B. Students arrested for alcohol, illegal prescription drug, or other illegal substance charges
will be recessed at the completion of the current semester pending legal outcomes1.
Students found guilty of alcohol, drug, or other illegal substance charges will be
immediately dismissed2. Students found “not guilty” of alleged charges, or students who
plead to lesser (misdemeanor) charges will be allowed to return to the program barring any
additional professional or other outstanding programmatic issues.
1. Students recessed will be expected to seek appropriate counseling, treatment or
therapies to determine if future patient safety will be compromised by the student.
2. If a student is allowed to progress, the student may be required to continue to seek
counseling, treatment, or therapies to ensure the program and public that patient safety
will not be compromised by the student’s actions.
Standing within the program for students arrested for other charges shall be at the discretion of
the Assistant Dean of the Physician Assistant Program, the Dean of Students or Administration
of DCOM or LMU, and shall be based on current policies or precedence.
The program reserves the right to immediately dismiss any student that it determines to betray
the values and integrity of the University, community, and the PA profession.
The program advises all students that graduation from the LMU-DCOM PA program does not
guarantee state licensure or hospital credentialing can be obtained, especially if the student has
any findings on a background check or drug screen.
1. Recess is defined as an immediate discontinuation of the program for a defined length of time,
with the student eligible to return with a prescribed programmatic plan.
2. Dismissal shall be defined as immediate discontinuation of the program without the eligibility
to return.
Revised 6/12/15
50
Appendix A
Lincoln Memorial University-DeBusk College of Osteopathic Medicine
Physician Assistant Program
Understanding of Attendance Policy
I, _______________________________ understand that if I am going to be
(Print Name)
absent from a rotation, I will immediately contact my Preceptor and the Director of Clinical Education
notifying her/him of the circumstances causing the absence. I also understand that to complete the
process for an excused absence, verbal notification must be followed by a written request with
sufficient documentation attesting to the reason(s) for the absence.
Failure to notify both the Director for Clinical Education and the Preceptor of any absence from
a rotation, regardless of the reason, results in an unexcused absence. A Preceptor’s absence is not
considered an excused absence for a student. If the Preceptor is going to be gone, you must
contact the PA Program. One unexcused absence requires review by the Director of Clinical
Education. Two or more unexcused absences require review by the PA Student Progress Committee
and could lead to failure of the rotation.
__________________________________________
Student’s Signature
____________
Date
__________________________________________
Director of Clinical Education’s Signature
_____________
Date
Revised 6/12/15
51
Appendix B
Receipt of Clinical Manual
I hereby acknowledge that I have received a copy of the Clinical Manual. I further acknowledge that I
am responsible for all the information contained within this manual, and I will abide by the policies,
rules and regulations set forth thereof.
I understand that failure to comply with the policies; rules and procedures set forth in these handbooks
may result in disciplinary action, suspension, or termination from the Lincoln Memorial UniversityDeBusk College of Osteopathic Medicine Physician Assistant Program.
Student Signature
Printed Name
Date
Revised 6/12/15
52
Appendix C
LMU-DCOM
PHYSICIAN ASSISTANT PROGRAM
ROTATION ABSENTEE REPORT
Student
Name_________________________________________________________________
Rotation_______________________________________________________________
Date(s) Absent__________________________________________________________
REASON FOR OCCURRENCE:
_____STUDENT ILLNESS
_____FAMILY ILLNESS
_____DEATH IN FAMILY
_____WEATHER
_____MEDICAL APPOINTMENT
_____TRANSPORTATION
_____ACCIDENT
OTHER_________________
NOTICE RECEIVED/DATE:_______________________________________
_____By Phone
_____In Person
_____Written
_____None
COMMENTS:__________________________________________________
___________________________________________________________________________
STUDENT
SIGNATURE:______________________________________________________________________
PRECEPTOR
SIGNATURE________________________________________________________DATE__________
DIRECTOR OF CLINICAL
EDUCATION:____________________________________DATE_____________
Revised 6/12/15
*This is for informational purposes only, please complete this evaluation on Typhon.
Appendix D
CLINICAL ROTATION EVALUATION BY STUDENT
Name:
Today’s Date:
Rotation:
Rotation Site(s)
I.
_____________
Concerning supervision:
1.
Who supervises you?
2.
Is every patient you see discussed with your supervisor?
3.
Do you feel you had adequate feedback and guidance from your preceptor during and at the
end of your rotation?_______________________________________________________
II.
4.
Are you receiving individual instruction in areas in which you may need help?
5.
If any areas of deficiency are identified has appropriate guidance been given?
Concerning patients seen:
1.
On average how many patients are you seeing per day?
2.
Estimated percentage of patients you have seen in the following areas:
Pediatrics including adolescents
, Adults
, Geriatrics (over 65)
3.
How many patients did you see that had some type of psychiatric disorder?____________
3.
Would it be helpful to speak Spanish here? ___Yes___No Is a translator available? ___Yes___No.
Utilizing the following scale, indicate the degree to which you agree or disagree with each statement:
SCALE:
1
Strongly Disagree
III.
3
Neutral
4
Agree
5
Strongly Agree
N/A
Not Applicable
Concerning Content, objectives, and structure:
1.
2.
3.
IV.
2
Disagree
The rotation was generally well-organized.
I was exposed to most of the rotation objectives.
I participated as a team member in the management of patients.
Concerning Rotation Outcomes:
1.
2.
3.
4.
Comments:
Revised 6/12/15
My knowledge and skills were increased.
The rotation stimulated me to work beyond what the rotation required.
My personal objectives for this course were met.
The required book(s) were helpful in meeting rotation objectives.
___
__________
Appendix E
Lincoln Memorial University-DeBusk College of Osteopathic Medicine
Physician Assistant Program
CLINICAL ROTATION EVALUATION FORM
Student’s Name:
Rotation:
Dates of Rotation:
Preceptor:
Location:
Level of interaction:
Minimum
Moderate
Extensive
Directions: Evaluate the student based on how far along they are in their clinical year. Please fill in the appropriate circle that corresponds to your response.
Patient Care
History taking; accurate and complete
Physical exam: needed components present
Complete assessment and plans
Provides quality patient education
Discusses preventative care appropriately
Case Presentation quality/clarity
Documentation complete and logical
Develops a complete differential diagnosis
Medical Knowledge
Overall problem solving ability
Anatomy and Pathophysiological knowledge
Pharmacological knowledge and usage
Appropriate selection of diagnostic tests
Appropriate analysis of findings and test results
Uses evidence-based medicine in decision making
07-06-12
Inadequate Performance
Some deficiencies,
needs
improvement
Meets
Expectations
Exceeds
Expectations
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Inadequate Performance
Some deficiencies,
needs
improvement
Meets
Expectations
Exceeds
Expectations
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
*This is for informational purposes only, please complete this evaluation on Typhon.
Practice-based Learning and Improvement
Initiative/work ethic
Responds to feedback positively
Takes initiative to improve pt. care through outside
readings
Appropriately applies scientific data
Encourages a positive learning environment
Inadequate
Performance
Some deficiencies,
needs
improvement
Meets
Expectations
Exceeds
Expectations
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Interpersonal /Communication Skills and Professionalism
Creates an effective patient/provider relationship
Creates an effective PA student/provider relationship
Communicates well with patient and team
Sensitive to cultural, age, gender and disability issues
Demonstrates caring and respectful behaviors
Works well as part of a team
Systems based practice
Demonstrates knowledge of medical delivery systems (coding,
billing, insurances)
Demonstrates appropriate referrals (specialists, PT, OT,
dietician, counseling)
Practices cost-effective medicine
2
Inadequate
Performance
Some deficiencies,
needs improvement
Meets
Expectations
Exceeds
Expectations
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Inadequate Performance
Some deficiencies,
needs improvement
Meets
Expectations
Exceeds
Expectations
0
0
0
0
0
0
0
0
0
0
0
0
*This is for informational purposes only, please complete this evaluation on Typhon.
3
Comments: (Add addendum if necessary)
Overall Performance:
(Preceptor: Please fill in the applicable circle.)
◌ Student has met expectations of the preceptor &
syllabus objectives
o I have reviewed the students procedure log
for this rotation
or
◌ Student Did Not Meet Expectations
Absences
Number of days absent
Number of days late
Preceptor
Student must also report all absences to the PA Office.
Print Name
Student
Preceptor Signature
Date
Names of others who participated in this evaluation:
Student Signature (if evaluation is reviewed with preceptor)
Date
Office Use Only:
Reviewed by:
Action Taken:
Appendix F
LMU-DCOM
Physician Assistant Program
Department of Clinical Education
Policy on Needle Stick and Blood Borne Pathogen Exposure
Detailed information on the prevention of and treatment for exposure to blood borne
pathogens is contained in the CDC brochure, “Exposure to Blood: What Healthcare Personnel
Need to Know”. Students should familiarize themselves with this information.
http://www.cdc.gov/ncidod/dhqp/pdf/bbp/Exp_to_Blood.pdf
If a student experiences a needle stick, sharps injuries or is otherwise exposed to the blood of
a patient while on a clinical rotation, the student should:
Immediately perform basic first aid. Wash needle sticks and cuts with soap and water. Flush
splashes to the nose, mouth or skin with water. If exposure is to the eyes, flush eyes with
water, normal saline solution or sterile irrigates for several minutes.
Immediately report the incident to the attending physician/preceptor. Prompt reporting is
essential. In some cases, post exposure treatment may be recommended and should be
started as soon as possible. If there is potential exposure to HIV, it is imperative to initiate
prophylactic treatment within two hours of the incident. Also, without prompt reporting, the
source patient may be released before testing for infectious disease can be conducted.
Seek post-exposure services. The student should follow this policy. If in an office contact the
Site Coordinator for instructions of how to fulfill these requirements. If in a hospital, contact
the nursing supervisor or employee health service. All clinical sites will have a policy in place
for blood borne pathogens, with a point of contact. This point of contact can help you follow
the correct procedures. If it is after hours or if the student cannot locate a person to guide
them, they should go immediately to the emergency department and identify themselves as a
student who has just sustained an exposure.
Obtain baseline laboratory tests, if indicated. The treating clinician should evaluate the type
and severity of exposure and counsel the student on the risk of transmission of HIV, HBV and
HCV. This may involve testing the student’s blood and that of the source patient and initiating
post-exposure treatment.
Complete the LMU Incident Report (attached). The student should report the incident to
Director of Clinical Education and complete the LMU Incident Report within 24 hours of the
exposure. The training site may require the student to complete a separate incident report for
their facility.
It is extremely important that students report incidents promptly to LMU-DCOM to avoid
problems that may occur later with payment for post exposure treatment.
Costs Incurred: Most training sites provide post-exposure treatment to students free of
charge. If there are charges for services, the student must file all medical claims to their
personal medical insurance first, then to the LMU intercollegiate policy.
The student should:
1. File a claim with their personal insurance policy
2. Complete the LMU intercollegiate claim form (attached)
3. Make a copy of the front and back of the insurance card
4. Collect all bills associated with the incident. Make a copy of the Explanation of Benefits
(EOB) provided by the insurance company.
5. Collect a UB4 or HCFA billing statement from the billing office of the facility where
treatment was received.
6. Return all these things via fax, e-mail, or mail to Amy Arnold ASAP.
Amy Arnold
Assistant Director of Financial Services
LMU-DCOM
6965 Cumberland Gap Parkway
Harrogate, TN 37752
Phone: 423.869-7096
FAX: 423.869.7172
amy.arnold@LMUnet.edu
copy:
1. LMU intercollegiate claim form
2. LMU Incident Report