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Course Name: Clinical Medicine I
Course Number: RT-220
Instructor
Phone #1
Office Location
Leeann Forsythe
503-488-6140 office
Bldg 200
E-mail
Phone #2
Class
Day/Time lforsythe@concorde.edu
602-614-2914 cell
Wednesday 0800-1300
Class Location
Semester Credit
Hours
Various as assigned
10.0 Clock hours
375 30
Total
30 315
Lecture Lab Clinical
C OURSE D ESCRIPTION
Students will learn to perform patient assessments including assessing the need for secretion removal and how to perform the appropriate procedures. Students will examine the eulogy of respiratory disease, learn to identify common pathogenic organisms and explore various isolations and sterilization techniques. Students will also learn to maintain and manage an artificial airway, and will explore the physiology of blood gases and the techniques for analyzing arterial blood gas samples. A large portion of this course will be spent in a clinical externship practicing the skills related to what has been learned, to identify, perform and assess the results of various diagnostic pulmonary function tests. (Prerequisite: RT210)
C
OURSE
O
BJECTIVES


Maintain and manage an artificial airway


Analyze blood gas samples
 Identify, perform and assess diagnostic pulmonary function tests
Perform patient assessments
Practice isolation and sterilization techniques
 Ascertain pathology of respiratory diseases and common pathogenic diseases
T EXTS
Dana Oakes, Clinical Practitioner’s Pocket Guide to Respiratory Care, 8th ed. ISBN:
0-93288-20-1, Health Educator Publications, 2013
Thomas J. Butler RRT, Laboratory Exercises for Competency in Respiratory Care, 3 rd ed.
ISBN 978 0 8036 2679 9
James R. Sills, Entry Level Exam Review for Respiratory Care, 6 th ed. ISBN: 978-0-323-
24134-2, Elsevier, Inc. via Mosby, Inc., 2016
Robert M. Kacmarek, James K. Stoller, and Albert J. Heuer, Egan's Fundamentals of
Respiratory Care, 10 th ed. with study guide. ISBN: 978-0-323-08203-7, Elsevier, Inc. via
Mosby, Inc., 2013
Robert L. Wilkins, James R. Dexter, and Albert J. Heuer, Clinical Assessment Respiratory
Care, 7 th ed. ISBN: 978-0-323-10029-8, Elsevier, Inc. via Mosby, Inc., 2014
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S TUDENT R ESOURCES
 Virtual Library: http://www.library.cengage.com
 Virtual Library: http://www.abheslibrary.com

Gale Database Resources: http://galesites.com/menu/index.php?loc=miss22358
 Evolve Resource: http://evolve.elsevier.com/Wilkins/Egans
C OMPUTER A CCESS
Some assignments in this course series require computer access. Students who do not have home access to a computer should complete computer-based activities at a Concorde computer lab, resource center, or public library. In addition there is tutorial software that can only be accessed in a Concorde computer lab. When these tutorials are assigned, it is the students ’ responsibility to schedule time to work in the lab when class time is not allotted specifically for this purpose.
L EARNING R ESOURCE C ENTER
The school maintains at least one LRC for student use. Hours are posted and you are requested to sign a log sheet each time you visit. Policies are posted in the LRC. You are expected to behave in accordance with typical library etiquette and respect the needs of other students by not talking and sharing materials/computers.
E VALUATION
Students will be evaluated on knowledge of textbook content, clinical skills, and competence on lab activities. The minimum acceptable term grade is 75% for advancement.
Refer to the Satisfactory Academic Progress Policy in the catalog for grade point expectations. Term grades are calculated as follows:
3 Unit Exams (12.5 % each)
1 Case Study
37.5 %
12.5 %
Quizzes (used for self-evaluation)
LRC/Computer labs
Lab activities / check-off stations
Homework
Class work
Q & A Cards
Clinical
FINAL EXAM
P/F
P/F
P/F
(completed) P/F
(completed) P/F
(completed) P/F
P/F
50 %
Total 100 %
90-100
80-89
=
=
A
B
70-74
69 or less
= D
= F
75-79 = C
Partial points will not be rounded Example: 79.4 = 79; however, 79.8 = 79. A letter grade of
D will be included in your CGPA but must be repeated in order to progress.
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It is very important for students to be in class for exams and performance evaluations. The student must initiate the request to reschedule on the first day the student returns to class. It is the student’s responsibility to schedule time outside the student’s regularly scheduled class hours (with program director and/or instructor) to complete any missed work. The PD will determine the method for making up required course components like labs and competencies.
Tutoring will be scheduled at the discretion of the Program Director or Academic Dean. If you want extra help, contact the instructor or program director immediately for available tutoring. If you do not show or do not call for a session that you requested, the faculty is not obligated to reschedule or to provide future assistance at your request.
The instructor and/or program director may require you attend a tutorial session if s/he believes that you need assistance on any content, skill or clinical component. If you do not show or do not call for a required session, you must meet with the Program Director before being allowed to attend class.
A course schedule outlines the due dates for all assignments, lists reading assignments, and delineates lab activities. Any homework not completed and received by the instructor prior to the applicable unit exam will receive an incomplete on the test. You have 5 business days to complete missing assignments. Any outstanding assignments after this period must be turned in by the final course day. Completion of all assigned work is required to pass the course.
Clinical Chart Exam papers, Physician Contact papers, and Clinical Time cards are due on the first class following any clinical experience. All papers must be completed to pass the course.
Calculators may NOT be used in this class. The NBRC does not allow calculators for their exam, so you must be able to work all math equations without the aid of a calculator.
Based on assigned readings, you will create at least 10 questions (each week) written on 3x5 index cards with the answer on the opposite side so you may use them as flash cards for exam preparation. You are responsible for creating cards prior to each class session. They are due at the beginning of each class session to be reviewed by the instructor. If no reading assignment has been designated for a class session, then questions are to be created from the previous class reading assignment. When multiple books are assigned, questions are to be created from each text in proportion to the amount of material gleaned from each text. Cards will typically be returned to you prior to each unit exam so you may use them for exam preparation. You are expected to carry any returned cards to class for group and class reviews throughout the course. At times, especially later courses in the program, you will be expected to bring all accumulated cards from previous program courses in preparation for the comprehensive exams.
Any cards deemed by the instructor to be incorrect or poorly written must be rewritten by the next class session for the assignment to be considered complete. Each card must have the book, page and paragraph number from which the question was generated.
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Students must earn a 75% or higher on a test for a passing grade. Due to the nature of an exam, students will be allowed up to 5 business days to take a missed exam. For any exam taken after the course’s original exam scheduled date, a 75% will be recorded for any passing score.
Class will be held for at least 2-hours on final
’s day to review and cover any remaining class items with 3-hours allotted for the exam. Not attending class for 5 hours will be documented following the attendance policy. The final exam must be made up within 5 business days as required by the incomplete grade policy in the catalog. Not taking the final exam or meeting the other retake requirements will result in failing the course.
Student will be required not only to write a case-study paper, but orally present this case-study to their class and other attendees. Students must earn a 75% or higher on a test for a passing grade. The same remediation work is required for oral as with written exams. You are expected to conduct yourself in a professional manner during the exam, simulating physician contact in a clinical setting.
Lab Grades
All labs and competencies are skills expected of professionals in the field, so a student will be required to complete labs and competencies in order to pass the course. Not successfully completing all competencies and labs/practicals will result in a failed course grade. Lab assignments may include tests, activities and practicals. Students who do not obtain the minimum requirements stated in the performance evaluation must repeat the evaluation.
Clinical Grades
Your clinical experience is a pass/fail grade. Students must demonstrate mastery and pass all clinical objectives.
M AINTAINING S ATISFACTORY A TTENDANCE S TATUS
Attendance is mandatory. All absences are unexcused. I t is also a reflection of a student’s commitment to his or her own educational success. Review your school catalog for specifics of satisfactory attendance, probation and terms of dismissal.
If you will be absent or late to a class, you must contact the program director by calling the school. If you must leave a voice message, please leave a detailed message and a return phone number where you can be reached. Notify your instructor if you plan to leave class before dismissal.
Clinical Attendance
For clinical absences, you must first contact the clinical site. You must contact the department lead therapist on shift, or designated contact at the clinical site at least one hour before your scheduled shift. Secondly, contact the Director of Clinical Education (DCE). If the DCE is not available, you must contact the program director by calling the school. If you must leave a voice message, please leave a detailed message and a return phone number where you can be reached.
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A no show, no call, is unprofessional behavior and is grounds for dismissal. A second offense is an automatic withdraw from the program. If a site requests removal, refer to the catalog for policy.
S TUDENT R ESPONSIBILITIES
Mastery of the theory and lab skills in this course is essential to your success in clinical. For that reason, in addition to class time, you should expect to spend approximately 3-hours of study for every hour of class time per week on assignments and activities to help you achieve the course objectives. Your outside class time should be spent reading the textbook materials, developing outlines and notes for exam preparation, memorizing theory, and practicing application of theory. For the remaining time complete the end of chapter activities in the textbook, investigate the web resources associated with the text, research, draft, and write papers or presentations, finish study guide or workbook activities as available, and perform any other practice as assigned by the instructor. Details of weekly activities will be in your course schedule.
C LASSROOM C ONDUCT
Refer to the catalog for details on eating, breakage, cleanliness, etc.

Food & Drinks: There will be no food or colored beverages allowed to be visible in the classroom, lab, and computer lab

Cell Phones: Cell phones are not allowed in the classroom. Upon entering the classroom, please turn off all cell phones and store away. Cell phones must not be visible at any time. If seen during quizzes or exams, the student’s paper will be collected and given a zero (0) with no option for make-up or retake.

Participation/Classwork: Each student is expected to participate in class. Class assignments, which are a part of your course grade, occur throughout the day, with or without announcement, at the instruct or’s discretion. o Classwork is defined as any competency, skill, activity, or discussion that occurs during scheduled class hours.
B
REAK
T
IMES
Break times will be at 10 minutes to the hour for 10 minutes. This can be changed per discretion of the instructor.
The syllabus is a guideline for instruction. The instructor, Program Director and/or Academic
Dean reserve the right to change, modify, or delete any item as necessary.
Abbreviations:
LECRC = Thomas J. Butler, Laboratory Exercises for Competency in Respiratory Care, 3 rd ed.
CRTER = James Sills, Comprehensive Respiratory Therapist Exam Review, 6 th ed.
Egan’s = Kacmarek et al, Egan’s Fundamentals of Respiratory Care, 10 th ed.
Egan’s SG = Egan’s Fundamentals of Respiratory Care – Study Guide, 10 th ed.
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The following pages are the proposed class schedule and subject to change to meet the goals and objectives of the term.
Monday, Oct 26, 2015 o Clinical Orientation Day (on campus) o Review professionalism, clinical do’s/don’ts & (conduct, behavior) o Adjusting to the environment and staff o Clinical paperwork (check-off form, chart exam, physician contact,
Daily, journal, time cards) electronic o Site specific parking, meals, RT department location
Homework: o Review Reading: LECRC Chapter 3 (Infection Control) o Review Reading: CRTER Chapter 2 (infection control) o Review Reading: LECRC Chapter 29 (radiology assessment) o Review Reading: CRTER Chapter 1 (patient assessment & care) o New Reading: LECRC Chapter 26 (arterial blood gas sampling) o New Reading: CRTER Chapter 3 (blood gas sampling)
Tuesday, Oct 27, 2015 o Student/instructor introductions o Review syllabus & classroom expectations o Assign Disease presentation due Nov.11,2015 o Assign Case-Study presentation due Dec.23,2015
 Use of SOAP and SBAR
Class Work: o Review Isolation (practice putting on gowns, gloves, masks) o Review types of Isolation (contact, droplet, airborne) o Review patient assessment o Review pulse-oximetry o Review chest x-ray o Begin ABG puncture lecture
Lab: Isolation precautions [LECRC page 24-33]; ABG draw [LECRC page 409-416]
Homework: o Review Reading: LECRC Chapter 30 (pulmonary function testing) o Review Reading: Egan’s Chapter 19 (pulmonary function testing) o New reading: LECRC Chapter 37 (non-invasive positive-pressure ventilation) o New reading: Egan’s Chapter 45 (noninvasive ventilation)
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Wednesday , Oct. 28, 2015 o Delmar Learning o NorthStar learning o Review medical terminology
Class Work: o Review PFTs (FEV
1
; FVC)
Discussion: NIPPV (CPAP & BiPAP)
Homework: Review Reading: LECRC Chapter 15 (respiratory pharmacology) o Review Reading: CRTER Chapter 9 (pharmacology) o New Reading: Egan’s Chapter 33 (airway management) o Egan’s – WB Chapter 33 o New Reading: LECRC Chapter 22 (emergency airway management) o New Reading: LECRC Chapter 24 (artificial airway care)
Thursday , Oct. 29, 2015
LAB: NIPPV (CPAP & BiPAP) [LECRC page 627-636] o Finish ABG lab [LECRC page 409-416] o Continue with medical terminology o Read and prepare for next week’s lab.
Wednesday, Nov. 4, 2015
Discussion first clinical experiences
Exam 1 o Review Respiratory Pharmacology o Discuss airway management
Class Work: o NT Suction o Obtaining a sputum sample o OPA, NPA o ETT Intubation o Inline (Closed) Suction o ETT Extubation
Lab:
Manual Resuscitation [LECRC Ch. 19] o NT Suction [LECRC page 320-322] o Intubation [LECRC Ch. 22] o ETT Suction [LECRC page 323-332] o Monitor Cuff Pressure [LECRC page 371-372] o Extubation [LECRC page 373-374, 383-384] o New Reading: LECRC Chapter 4 (equipment processing)
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Lab:
 Trach Care

Stoma Care
 Different types of trach devices
 Decannulation
Homework: New Reading:
Egan’s Chapter 22 (pulmonary infections)
Egan’s Chapter 23 (obstructive lung disease); Egan’s – WB Chapter 22&23 o New Reading: LECRC Chapter 4 (equipment processing)
Wednesday, Nov 11, 2015
Disease paper presentations
Plan for 15 min per presentation
Wednesday, Nov 18, 2015
Exam 2
Class Work: Discuss Chapter 23
Homework: New Reading: Egan’s Chapter 24 (interstitial lung disease) o Egan’s – WB Chapter 24
Wednesday , Nov. 25, 2015
Class Work: Discuss Chapter 24
Homework: o New Reading: Egan’s Chapter 25 (pleural diseases) o Egan’s – WB Chapter 25
Wednesday, Dec. 2, 2015
Exam 3
Class Work:Discuss Chapter 25
Homework: o New Reading: Egan’s Chapter 26 (pulmonary vascular disease) o Egan’s – WB Chapter 26 o Ne w Reading: Egan’s Chapter 27 (acute lung injury) o Egan’s – WB Chapter 27
Wednesday , Dec. 9, 2015
Class Work: Discuss Chapter 26 and Discuss Chapter 27
Homework: o Completed Case Study Papers DUE next week
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Wednesday , Dec 16, 2015
Finalize your power-point presentation
Wednesday, Dec 23, 2015 (Case Study Presentation)
Class Work:

Case study due
 Present Case Studies
Wednesday, Jan. 6, 2016
Class Work:
Review term
Final Exam Review
Friday, Jan 15, 2016 Final Exam
–Final Grades
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