Graduate Course Proposal Form Submission Detail - PAS6600
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Approved by SCNS
Submission Type: New
Course Change Information (for course changes only):
Comments: to GC 1/14/13. for MA in P.A.; needs textbook; faculty emailed 1/25/13. updated; approved. to USF Sys 2/20/13. to SCNS 2/28/13. Apprd eff 4/1/13. Nmbr 6876 apprd as 6600
- Department and Contact Information
Tracking Number Date & Time Submitted 3030 2012-11-29 Department College Budget Account Number Medicine MD HSC-10009-611600-000000-0000000 Contact Person Phone Larry Collins 813-396-9424 email@example.com
- Course Information
Prefix Number Full Title PAS 6600 Emergency Medicine Clinical Rotation Is the course title variable? N Is a permit required for registration? N Are the credit hours variable? N Is this course repeatable? If repeatable, how many times? 0 Credit Hours Section Type Grading Option 6 I - Internships (Including Practicum) R - Regular Abbreviated Title (30 characters maximum) ER MEDICINE CLINICAL ROTATION Course Online? Percentage Online C - Face-to-face (0% online) 100
This six-week rotation allows the student to develop skills in managing patients in the emergency room setting. These skills include those necessary for appropriate triage, stabilization, and initial management of patients with traumatic injuries,illness.
A. Please briefly explain why it is necessary and/or desirable to add this course.
Needed for program/concentration/certificate change
B. What is the need or demand for this course? (Indicate if this course is part of a required sequence in the major.) What other programs would this course service?
To be consistent with other Physician Assistant Degree Programs
C. Has this course been offered as Selected Topics/Experimental Topics course? If yes, how many times?
D. What qualifications for training and/or experience are necessary to teach this course? (List minimum qualifications for the instructor.)
MD, DO, PA, ARNP
- Other Course Information
Upon completion of the rotation, the student will be able to:
1. Describe and demonstrate the approach to the rapid evaluation of persons with acute life threatening, urgent, and non-urgent health problems seen in the emergency care center.
2. Identify risk factors, signs and symptoms, and pertinent historical and physical examination findings associated with each of the previous medical conditions.
3. Understand the clinical manifestations, anatomy, epidemiology, physiology, pathophysiology, and natural history associated with each of the previous medical conditions.
4. Describe the preventive care practices for children and adults according to age for injury and accident prevention.
5. Recognize the social, emotional, and physical manifestations of sexual abuse, sexual assault, elder abuse, and substance abuse along with the reporting requirements under state law.
6. Understand the indications, contraindications, complications, and cost effectiveness of various diagnostic studies and procedures associated with each of the previous medical conditions.
7. Explain normal and abnormal diagnostic results including, but not limited to, blood, urine, sputum, cerebrospinal fluid, pleural fluid, peritoneal fluid, x-ray, CT, MRI, ultrasound, and EKG associated with each of the previous medical conditions.
8. Explain the formulation of differential diagnoses based on history and physical examination findings for each of the previous medical conditions.
9. Understand therapeutic management plans for each of the previous medical conditions.
10. Understand indications, contraindications, complications, and cost-effectiveness of pharmacological treatments associated with each of the previous medical conditions.
11. Explain the indications of hospitalization for, and the appropriate inpatient and outpatient management for, each of the previous medical conditions.
12. Summarize a strategy for informing family members about the critical and noncritical nature of an individual's illness or injury.
Upon completion of the rotation, the student will be able to:
1. Perform a thorough focused, problem-oriented history and physical examination on a patient with non-urgent, urgent, and emergent illnesses/ injuries, including either a verbal or written presentation to the attending Preceptor.
2. Perform a rapid screening physical assessment survey on an acutely injured patient without moving him, with either verbal or written presentation to the attending Preceptor.
3. Recognize the signs and symptoms of the acutely ill or injured patient for triaging purpose, and assist in triage as necessary.
4. Demonstrate close monitoring and re-evaluation of a patient's condition through continuous physical examination, data collection, and analysis to determine if they are stabilizing or deteriorating.
5. Select the appropriate diagnostic studies pertinent to the problem(s) encountered.
6. Recognize abnormalities within diagnostic studies including, but not limited to, the complete blood count, routine and microscopic urinalysis, blood chemistry profiles, and radiographic studies.
7. Obtain electrocardiograms and place cardiac monitors.
8. Recognize common electrocardiographic arrhythmias and patterns with an understanding of their etiology and treatment.
9. Perform neurological checks.
10. Demonstrate ability to perform cardiopulmonary resuscitation.
11. Maintain airway through proper positioning and suctioning.
12. Administer oxygen therapy via bag, nasal cannula, or mask.
13. Recall and participate in general emergency stabilization procedures in life-threatening situations (airway obstruction, shock, MI, hemorrhage, etc.).
14. Perform venipuncture and arterial puncture.
15. Perform IV insertion and initiate I.V. fluids.
16. Perform Subcutaneous and IM injections.
17. Perform urinary catheter insertions.
18. Control hemorrhage by means of direct pressure, pressure dressings, or blood pressure cuff.
19. Perform Incision and Drainage of abscess and paronychia.
20. Perform subungual hematoma release.
21. Evaluate, clean, debride, close (steri-strips, sutures, staples), and dress wounds of varying complexity under physician direction.
22. Debride devitalized tissue.
23. Remove foreign bodies from the skin.
24. Perform Fluorescein staining of the eye.
25. Irrigation of wounds, eyes, ears, and nose.
26. Control nasal hemorrhage by direct pressure, anterior packing, or chemical coagulation.
27. Perform nasogastric intubation.
28. Assess and treat hemorrhagic shock.
29. Under direct supervision of a Preceptor, participate in performing advanced procedures, including, but not limited to:
a. Cardiopulmonary resuscitation
b. Central line placement
c. Chest tube insertion
d. Diagnostic peritoneal lavage
e. Endotracheal intubation
f. Rapid sequence intubation
g. Conscious sedation
h. Lumbar puncture
30. Perform endotracheal suctioning.
31. Support and treat patient with an anaphylactic reaction.
32. Recognize altered mental status and its common causes and treatments.
33. Treat burns to include debridement, application of dry sterile dressings, and antibiotic ointment as ordered by the physician, and evaluate percentage of burned area.
34. Participate in reducing, immobilizing, and applying traction in fractures and dislocations.
35. Apply elastic and/or plaster/fiberglass casts, with necessary modifications. (monovalve, bivalve, windows)
36. Develop understanding in completing medical records (including reimbursement, coding and billing) utilizing traditional charting and/or electronic medical record charting methods.
37. Relay collaborative discharge instructions to patients and family in a logical and accurate manner in such areas as proper administration of medications at home, preparation for diagnostic procedures, or observation of the patient with head trauma, fever, vomiting, or diarrhea.
38. Assess and recognize individual limitations and utilize proper referral (i.e.: physician, hospital, social agency) for treatment.
39. Utilize and integrate evidence-based research in medical decision making and problem solving.
40. Demonstrate sensitivity and responsiveness to the culture, age, gender and disabilities of patients and their caregivers/family.
Upon completion of the rotation, the student will be able to:
1. Demonstrate sensitivity and responsiveness to the culture, age, gender and disabilities of patients and their caregivers/family.
2. Compliance with HIPAA regulations regarding patient confidentiality.
3. Demonstrate sensitivity regarding the emotional, cultural, and socioeconomic aspects of the patient and his/her illness.
4. Exhibit effective communication skills and a professional attitude toward colleagues, staff, and consultants.
5. Willingness to seek help from others when appropriate.
6. Concern for patients care and confidentiality through appropriate record keeping.
7. Openness to receiving, considering, and appropriately acting upon constructive criticism.
8. A genuine and earnestly constructive, self-critical manner consistent with lifelong learning.
9. Respect patients and preceptors by performing assigned duties promptly, thoroughly and carefully.
10. Appreciate and recognize the ethical and legal concepts as they relate to health care and the role of the physician assistant.
B. Learning Outcomes
Course Learning Outcomes:
Upon successful completion of the supervised clinical rotation, the student will demonstrate they have developed the ability to:
1. Obtain and document a comprehensive initial, male/female annual, well child, and obstetrical history and physical examination on patients across the age continuum in the outpatient setting.
2. Demonstrate familiarity with the clinical manifestation, anatomy, epidemiology physiology, pathophysiology, and natural history associated with conditions commonly addressed in the family practice setting.
3. Obtain and document pertinent historical information and perform an appropriate physical examination in the context of managing common chronic disease processes encountered in Family Practice.
4. Obtain and document an accurate problem-focused, age appropriate, history and physical examination, on a patient presenting with an acute condition.
5. Differentiate normal developmental milestones and normal aging changes from abnormal findings in the care of the Family Practice patient.
6. Identify and counsel patients on the need for health maintenance, injury avoidance, and disease prevention through patient education on safety measures and recommendations for specific age appropriate medical screening examinations.
7. Understand the indications, limitations and costs of various laboratory tests, diagnostic studies, and procedures used in the evaluation of acute illnesses, disease risk factors, and preventative health measures.
8. Interpret the findings of laboratory tests, diagnostic studies, and procedures commonly obtained in the evaluation of the Family Practice patient.
9. Develop an initial comprehensive differential diagnosis and subsequently formulate definitive diagnosis based on the history and physical examination and available laboratory/diagnostic imaging data.
10. Formulate and implement an appropriate treatment plan in collaboration with the supervising preceptor, provide patient education, and define follow-up recommendations.
11. Identify potential therapeutic limitations, complications, and costs associated with the established treatment regimen that may affect patient compliance.
12. Demonstrate familiarity in recognizing situations where referral to other healthcare providers is necessary and to identify the appropriate referral resource.
13. Understand the components in performing a pre-operative clearance evaluation.
14. Participate in or perform necessary clinical procedures.
C. Major Topics
Recognize the clinical manifestations, assessment, and treatment of the following conditions:
I. CARDIOVASCULAR SYSTEM
1. Conduction Disorders
a. Bundle Branch Block
b. Premature beats
3. Ischemic Heart Disease
4. Vascular Disease
a. Giant cell arteritis
c. Varicose veins
5. Valvular Disease
a. Mitral valve prolapsed
6. Other Forms of Heart Disease
a. Acute pericarditis
II. PULMONARY SYSTEM
1. Infectious Disorders
a. Acute bronchitis
2. Neoplastic Disease
a. Carcinoid tumors
b. Pulmonary nodules
3. Obstructive Pulmonary Disease
c. Chronic bronchitis
4. Restrictive Pulmonary Disease
III. ENDOCRINE SYSTEM
1. Diseases of the Thyroid Gland
2. Diseases of the Pituitary Gland
3. Diabetes Mellitus
a. Type 2
4. Lipid Disorders
1. Eye Disorders
d. Corneal abrasion
2. Ear Disorders
b. Hearing impairment
c. Meniere‟s disease
e. Tympanic membrane perforation
3. Nose/Sinus Disorder
a. Acute/chronic sinusitis
b. Allergic rhinitis
d. Nasal polyps
4. Mouth/Throat Disorders
a. Acute pharyngitis
b. Acute tonsillitis
c. Aphthous ulcers
d. Dental abscess
f. Oral herpes simplex
V. GASTROINTESTINAL SYSTEM/NUTRITION
b. Motor disorders
c. Mallory-Weiss tear
a. Gastroesophageal reflux
c. Peptic ulcer disease
a. Chronic cholelithiasis
a. Acute/chronic hepatitis
5. Small Intestine/Colon
b. Inflammatory bowel disease
c. Irritable bowel syndrome
a. Anal fissure
b. Fecal impaction
d. Pilonidal disease
8. Infectious Diarrhea
9. Nutritional Deficiencies
c. Vitamin A
e. Vitamin C
f. Vitamin D
g. Vitamin K
10. Metabolic Disorders
a. Lactose intolerance
VI. GENITOURINARY SYSTEM
1. Benign Conditions of the GU Tract
a. Benign prostatic hyperplasia
b. Erectile dysfunction
2. Infectious/Inflammatory Conditions
VII. MUSCULOSKELETAL SYSTEM
1. Disorders of the Shoulder
a. Rotator cuff disorders
2. Disorders of the Forearm/Wrist/Hand
b. Carpel tunnel syndrome
c. De Quervain‟s tenosynovitis
d. Elbow tendonitis
3. Disorders of the Back/Spine
a. Ankylosing spondylitis
b. Back strain/sprain
d. Low back pain
e. Spinal stenosis
4. Disorders of the Hip
a. Aseptic necrosis
5. Disorders of the Knee
b. Meniscal injuries
6. Disorders of the Ankle/Foot
7. Neoplastic Disease
a. Ganglion cyst
10. Rheumatologic Conditions
c. Polyarteritis nodosa
e. Reiter‟s syndrome
f. Rheumatoid arthritis
g. Systemic lupus erythematous
VIII. REPRODUCTIVE SYSTEM
a. Dysfunctional uterine bleeding
5. Menstrual Disorders
c. Premenstrual syndrome
c. Fibrocystic disease
8. Pelvic Inflammatory Disease
9. Contraceptive Methods
11. Uncomplicated Pregnancy
a. Prenatal diagnosis/care
b. Normal labor /delivery
12. Complicated Pregnancy
b. Fetal distress
c. Gestational diabetes
d. Gestational trophoblastic disease
e. Molar pregnancy
f. Multiple gestation
g. Postpartum hemorrhage
h. Pregnancy-induced hypertension
i. Premature rupture of membranes
j. Rh incompatibility
IX. NEUROLOGIC SYSTEM
1. Alzheimer‟s Disease
2. Cerebral Palsy
3. Diseases of Peripheral Nerves
a. Bell‟s palsy
b. Diabetic peripheral neuropathy
c. Myasthenia gravis
a. Cluster headache
c. Tension headache
5. Movement Disorders
a. Essential tremor
b. Huntington‟s disease
c. Parkinson‟s disease
6. Multiple Sclerosis
7. Seizure Disorders
a. Generalized convulsive disorder
b. Generalized nonconvulsive disorder
X. PSYCHIATRY/BEHAVIORAL SCIENCE
1. Anxiety Disorders
a. Panic disorder
b. Generalized anxiety disorder
c. Posttraumatic stress disorder
2. Attention-Deficit Disorder
3. Eating Disorders
a. Anorexia nervosa
b. Bulimia nervosa
4. Mood Disorders
5. Personality Disorders
b. Somatoform Disorders
7. Substance Use Disorder
a. Alcohol abuse/dependence
b. Drug abuse/dependence
c. Tobacco use/dependence
8. Other Behavior/Emotional Disorders
a. Uncomplicated bereavement
XI. DERMATOLOGIC SYSTEM
1. Eczematous Eruptions
iii. Nummular eczematous
viii. Lichen simplex chronicus
2. Papulosquamous Diseases
a. Dermatophyte infections
i. Tinea versicolor
ii. Tinea corporis/pedis
b. Drug eruptions
c. Lichen planus
d. Pityriasis rosea
a. Erythema multiforme
4. Acneiform Lesions
a. Acne vulgaris
5. Verrucous Lesions
a. Seborrheic keratosis
b. Actinic keratosis
c. Spider bites
7. Hair and Nails
a. Alopecia areata
b. Androgenetic alopecia
8. Viral Diseases
a. Condyloma accuminatum
c. Herpes simplex
e. Zoster virus
a. Acanthosis nigricans
b. Hidradenitis suppurativa
c. Lipoma/epithelial inclusion cysts
XII. HEMATOLOGIC SYSTEM
a. Vitamin B12
b. Folate deficiency
c. Iron deficiency
d. G6PD deficiency
e. Sickle cell anemia
XIII. INFECTIOUS DISEASES
1. Fungal Disease
2. Bacterial Disease
d. Gonococcal infections
3. Parasitic Disease
4. Spirochetal Disease
a. Lyme borreliosis
i. Lyme disease
b. Rocky Mountain spotted fever
5. Viral Disease
a. Cytomegalovirus infections
b. Epstein-Barr virus infections
c. Herpes simplex
d. Human papillomavirus infections 96
Emergency Medicine Clerkship Primer: A Manual for Medical Students. DA Wald. Clerkship Directors in Emergency Medicine.
CURRENT Diagnosis and Treatment Emergency Medicine, Seventh Edition. C. Keith Stone, Roger Humphries. McGraw-Hill.
E. Course Readings, Online Resources, and Other Purchases
F. Student Expectations/Requirements and Grading Policy
Students are required to keep a complete record of all clinical encounters (both procedures & diagnoses) throughout the rotation. The primary tool for entering, maintaining, and tracking accurate records will be Evalue. In order for the clerkship director to monitor and facilitate clinical experiences, it will be necessary for students to keep logbooks up to date. At a minimum, students are required to update their logbooks at least once a week. A portion of the grade grade will be determined by keeping timely records. By not sufficiently documenting achievements in the required clinical experiences, students who fail to maintain timely, complete, and accurate records of their patient encounters may fail the rotation.
G. Assignments, Exams and Tests
End of Rotation Exam
H. Attendance Policy
During the clinical years, the studentís responsibilities lie within the individual clerkship. Attendance within the clerkship is a demonstration of attitude and professional behavior. This behavior impacts all members of the healthcare team including fellow students and patients. Any absence from the clerkship may have a direct impact on student performance, the broad-spectrum clinical experience, evaluation of professionalism, overall grade and the successful completion of the clerkship.
I. Policy on Make-up Work
Delinquencies will accumulate only if the student does not have a legitimate explanation such as illness or major personal difficulty. Thus, students will be given an opportunity to explain before a penalty is assessed. The Rotation Director would render a final determination. The above delineated process describes the minimum action to be taken across clerkships. Additional requirements and consequences as determined by each clinical rotation director may apply. Failure to complete the logbook can result in grade reduction.
J. Program This Course Supports
- Course Concurrence Information