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COURSE SYLLABUS

COURSE TITLE: CARE II TERM & YEAR: Spring-1 2018-19

COURSE NUMBER: PAS 5152

TIME & PLACE: Thursdays 8:30-12:30; Per PA weekly schedule


st
1 Class will meet on Wednesday 1/9/19 1:30-4:30p

NUMBER OF CREDIT HOURS: 2

INSTRUCTORS: Starr Newman PA-C, CLS


Dr. Emilio Vazquez
Dr. Paul Cervone

OFFICE LOCATION: PA Suite

OFFICE PHONE: 260-702-8064

EMAIL: newmans@trine.edu
vazqueze@trine.edu
cervonep@trine.edu

COURSE DESCRIPTION:

This is the second in a series of four courses where students work in teams to practice and refine
skills, employ problem-solving, participate in reflective experiences, and assume professional roles.
Students are expected to retain and apply knowledge from concurrent and previous coursework.
Examples of experiences include simulation/standardized patients, interprofessional education
opportunities, preclinical patient exposures, MAT training, IPE events, FAST U/S training, and case
studies. Professional development areas include professional communication and behavior, conflict
resolution, and stress management.

PREREQUISITES: PAS 5052 CARE I

REQUIRED TEXT/MATERIALS:

ePocrates+ subscription (2016). Available from www.epocrates.com Athenahealth.

The Health Care Handbook: A Clear and Concise Guide to the United States Health Care System.
2nd. Askin, Moore, Shankar. 2014. Washington University. ISBN: 978-0692244739

Shadow Health. (2016). Digital Clinical Experience (Version 4.0) [Software]. Available from
http://www.shadowhealth.com

PAS 5152 CARE II Syllabus p. 1


Up to Date subscription (2016). Available from www.uptodate.com Wolters Kluwer.

MAT Training Materials – provided by MAT trainers.

REFERENCE TEXT:

Evidence-Based Practice for Health Professionals: An Interprofessional Approach. Howlett, B;


Rogo, EJ; Gabiola Shelton, T. 2014. Jones and Bartlett. ISBN: 978-4496-1163-7

Introduction to the Health Professions 6th ed. Stanfield, PS; Cross, N; Hui, YH. 2012. Jones and
Bartlett. ISBN: 978-4496-0055-6

Understanding Medical Professionalism. 1st ed. Levinson. 2014. McGraw-Hill. ISBN: 978-0-07-
180743-2
Understanding Patient Safety. 2nd ed. Wachter. 2012. McGraw-Hill. ISBN: 978-0-07-176578-7

Understanding Teamwork in Health Care. 1st ed. Mosser. 2014. McGraw-Hill. ISBN: 978-
0071791953

Understanding Value-Based Healthcare. 1st ed. Moriates. 2014. McGraw-Hill. ISBN: 978-0-07-
181698-4

COURSE GOALS:
In this second course of a four-part series, the goals of the course are to continue to foster the
development of a student’s interpersonal communication skills as part of a team, to apply subjective
and objective data to improve clinical problem-solving skills, to continue professional development,
to obtain MAT training, and to complete FAST training program.

LEARNING OUTCOMES: Upon completion of this course, the student should be able to:
Medicine:
1. Begin to formulate a differential diagnosis for the cases based on information from the
medical history and physical examination and order appropriate labs and additional diagnostic
studies/procedures as indicated by the differential diagnosis to diagnose, evaluate and treat the
disorders/diseases
2. Generate pharmacologic and non-pharmacologic management plans for the diseases/disorders
based upon current clinical practice guidelines and other evidence-based resources
3. Communicate a plan for disease prevention, health promotion and patient education and
counselling including the course of illness, prognosis, and follow up care for the conditions
4. Present the patient case orally and in written format to peers and other practitioners/disciplines
in a succinct yet informative method utilizing proper medical terminology.

IPE:
5. Develop communication skills to accurately convey patient information, to solicit
different disciplines’ opinions, and to respectfully provide constructive feedback to
team members of various disciplines
6. Work together in teams during the didactic phase of educational programs to prepare for
teamwork in supervised clinical practice experiences
7. Develop values and ethics appropriate for working together to provide patient -centered
team care

PAS 5152 CARE II Syllabus p. 2


Professional Development:
8. Begin to implement your Professional Development Plan
9. Obtain MAT training
10. Obtain an NPI number
11. Complete FAST training
12. Exhibit a commitment to the life-long learner concept necessary as a Physician Assistant
13. Demonstrate appropriate moral, ethical, nonjudgmental and professional behavior when
providing care to patients of a diverse population throughout the life span

COURSE REQUIREMENTS: The student shall demonstrate professional behavior,


communication in all classroom, laboratory and clinical situations.

ATTENDANCE/PARTICIPATION: MANDATORY. Unless absent for reasons of illness or


participation in an event sanctioned by the University, attendance and punctuality are mandatory for
all classes, labs, seminars, small group discussions, field experiences, clinical rotations,
preceptorships and any other activities designed by the program staff and administration.

 If a student is absent from any course meeting, for any reason, the student is responsible for all
information, assignments, homework, handouts, discussions and any necessary additional
assignments as determined by the instructor. In addition, if a student is absent, for any reason,
the student is advised that missing classroom discussion, lab questions, assignments, check-
offs, quizzes, practical’s, exams and/or any other activities and/or missing the date the above
occur or are due, may have significant effects on the student’s grade and ability to pass the
course.
 Any examination missed during an absence due to an illness or major life event must be made
up within 24 hours of return to class or as otherwise scheduled by the instructor or academic
coordinator.
 Any absence due to illness during the didactic phase must be reported to the academic
coordinator as soon as possible. Any absences during the clinical rotation must be reported to
the clinical site and the clinical coordinator or clinical director as soon as possible.
 Students are responsible for their own attendance and, thus, take responsibility for
consequences of non-attendance.
 Decisions regarding excused absences, including those for personal reasons, are to be made by
the professor.
 Documentation verifying an illness or demonstrated participation in a sanctioned event is
required.

If there is a death in the immediate family, please contact the Academic Affairs Office or Student
Retention Office to inform Trine University of the death of an immediate family member (parent,
legal guardian, spouse, sibling and/or child). Under these circumstances a student will be excused
from class attendance for up to one week. The student shall make arrangements for completion of
course with his/her professors upon return.

Excessive unexcused absence and/or tardiness will be considered “unprofessional behavior/ conduct”
and may be subject to disciplinary action within the Physician Assistant Program.
 An unexcused absence is defined as any absence from class or clinical rotation without prior
approval from the instructor or program director.
 Unexcused absences in any class may automatically lower the final letter grade achieved in
that class as per the instructor. Three unexcused absences may result in dismissal from the
program.

PAS 5152 CARE II Syllabus p. 3


 The first two unexcused absences will require a paper covering all of the information missed
that day. The paper is to be submitted to the Academic Coordinator and course instructor.
 Any examination missed due to an unexcused absence will not be graded higher than 80%, at
the discretion of the faculty member.
 Be proactive and communicate with the faculty to avoid this situation.
The instructor has no obligation to give make-up examinations or to review other class work
missed by the student as the result of an unexcused absence.

GRADING/EVALUATION:
A Excellent 4.0 94% and above
B+ Very Good 3.5 88-93%
B Good 3.0 82-87%
C+ Average 2.5 76-81%
C Below avg (lowest passing grade) 2.0 70-75%
F Failure 0.0 69% or below
I Incomplete not figured into GPA
IP In Progress (grade deferred) not figured into GPA
W Withdrawal before completion of 80% of the semester
WP Withdrawal after completion of 80% of the semester with passing work at the time of
withdrawal

Grading Appeals and Incomplete Grade Policy


Please refer to the Trine University Student Handbook and Course Catalog for information regarding
grading appeals, incomplete grade, in progress grade, and course repeat policies.

Student Evaluation
In addition to mastery of cognitive skills and knowledge, comprehensive evaluation of student’s
performance in clinical medicine includes appraisal of performance skills and attitudes. Students are
evaluated on the following:
 Adherence to the Guidelines for Ethical Conduct for the Physician Assistant Profession
(https://www.aapa.org/WorkArea/DownloadAsset.aspx?id=815)
 Sensitivity to patient and community needs
 Ability to work with and relate to peers, faculty and other members of the healthcare team
 Attitude 
 Attendance and punctuality (including responding to emails in a timely manner)
 Professional demeanor/image/dress

1. Team Based Learning (TBL) - full participation in all phases including preparation, team
activities, assessments and debriefings
a. TBL Self and Peer Case Staffing Assessments 25 points each (8 total)
2. Individual Case Study Presentations
a. Midterm 100 points
b. Final 100 points
***These are modelled after the team based learning cases but are tested as an individual
using same rubric.
3. Shadow Health
a. Weekly assignments
i. DCE Orientation - 10 points
ii. Conversation Concept Lab – 10 points
PAS 5152 CARE II Syllabus p. 4
iii. Mental Health – 25 points
iv. HEENT – 25 points
v. Neurological – 25 points
vi. Respiratory Concept Lab – 10 points
vii. Respiratory – 25 points
viii. Cardiovascular Concept Lab – 10 points
ix. Cardiovascular – 25 points
x. Abdominal Concept Lab – 10 points
xi. Gastrointestinal – 25 points
xii. Musculoskeletal – 25 points
b. Health History Pre and Post Tests – 25 point each
c. Focused Exams
i. Cough – 50 points
ii. Chest Pain – 50 points
iii. Abdominal Pain – 50 points
d. Comprehensive Assessment – 100 points
4. Ultrasound FAST Exam Completion – 100 points
5. MAT Waiver (Live and Online) Training Completion (P/F)
6. NPI number Completion (P/F)
7. IPE- full participation in all phases including preparation, team activities, assessments and
debriefings
a. Interdisciplinary Lecture Reflections - 25 points each
b. Dr. Helfgott Lecture – 25 points
c. Attendance – 25 points each
8. Professional Development
a. Create and maintain professional development plan addressing your clinical goals,
academics, resume, service, leadership, and scholarship (P/F)
b. Meet with Professor Newman 1-2x/semester, more if needed. (P/F)
i. Discuss reflections
c. Opening Reflection: Stress Management or Conflict Management 50 points

OTHER POLICIES: Please refer to the student handbook for standard expectations. Appropriate
behavior and attire for classroom, lab or clinical setting is expected.

PAS 5152 CARE II Syllabus p. 5


COURSE CONTENT: SUBJECT TO CHANGE

Date Topic Assignment Given


1/09/19 Introduction to the course
Team Based Learning (TBL)
Create your clinical case team
(4 people per team)

How to staff an outpatient case


to your preceptor

Clinical Application Case


Scenarios
Opening Reflection (pick 1) Assignment:
1. Examine how you reacted to 1. Opening Reflection due by 1/14/19 –
final exams; including how well email to Professor Newman
you did, how well you thought newmans@trine.edu
you were going to do and how
you “managed” all of it.
2. Reflect on any PA school
experience in which you had to
face conflict and describe how
well you dealt with it and what
you might have done differently

Shadow Health Assignment:


Digital Clinical Experience - due by
1/10/19
Conversation Concept Lab - due by
1/10/19
Health History – due by 1/14/19
1/17/19 IPE 1/16/19 IPE for CARE CLASS ON 1/17/19
BARNGA 2:30-4:30 Assignment:
MUCOP 1. BARNGA reflection – due by 1/20/19
Shadow Health Mental Health – due by 1/20/19

1/24/19 MAT Live Training Successfully complete the MAT quizzes


4 hours - Dr. Emily Zarse, Area and email certificate of completion of
Chief of Addiction Psychiatry live portion to Professor Newman
Eskenazi Health

MAT Online Training Completion of 4 hours online certificate


due 2/7/19
PAS 5152 CARE II Syllabus p. 6
Shadow Health HEENT – due by 1/27/19
1/31/19 IPE 1/29/19 IPE for CARE CLASS ON 1/31/19
9-12p MUCOP
Drug Information Session DI IPE – Reflection due by 2/7/19

Shadow Health Neurological – due by 2/3/19


Clinical Application Assignment: write up case, practice
CASE 1 staffing case – Medical Case Scoring
Rubric due by 2/7/19 Self and Peer
2/7/19 2/8/19 11-12p Bring your lunch 
Intro to Integrative Medicine Parkview Regional Medical Center
With Dr. Michelle Helfgott Conference Room by Cafeteria
11141 Parkview Plaza Drive
Fort Wayne, IN 46845
Dr. Helfgott reflection due 2/10/19
Shadow Health Respiratory Concept Lab – due by
2/10/19
Respiratory – due by 2/10/19
Focused Exam: Cough due by 2/10/19
2/14/19 FWAIPEC IPE for CARE CLASS ON 2/14/19
PA Practice Act
2/12/2019 6-7:30p FWAIPEC PA Practice Act Reflection
MUCOP due by 2/17/19
PA Practice Act Handout
Shadow Health Cardiovascular Concept Lab – due by
2/17/19
Cardiovascular – due by 2/17/19
Focused Exam: Chest Pain due by
2/17/2019
Clinical Application Assignment: write up case, practice
CASE 2 staffing case – Medical Case Scoring
Rubric due by 2/21/19 Self and Peer

2/21/19 IPE Concussion Workshop IPE for CARE CLASS ON 2/21/19


Late Feb OTD, DPT Concussion Concussion Reflection due by 2/28/19
Workshop Date to be
determined (4 hrs)
Midterm Assessment Reminder: Advising meetings should be
completed by end of this week including
discussion on opening reflection
Shadow Health Abdominal Concept Lab – due by
2/24/19
Gastrointestinal – due by 2/24/19
PAS 5152 CARE II Syllabus p. 7
2/28/19 MIDTERM EXAM Focused Exam: Abdominal Pain – due by
CASE STUDY Exam (2 hrs) 3/3/19
3/07/19 Spring Break! NO CLASS 3/7/2019
3/14/19 Ultrasound Training
Dr. Joel Valinsky
SPOCUS
Shadow Health Musculoskeletal – due by 3/17/19
3/21/19 Ultrasound Training
Dr. Joel Valinsky
FAST EXAM
TBL- Meet your new team Email Professor Newman your new team
Clinical Application
CASE 3
3/28/19 TBD – PA Roundtable
Clinical Application Assignment: write up case, practice
CASE 3, cont staffing case due by 4/4/19
Shadow Health Health History Post Test – due by
3/31/19
4/04/19 Dr Cervone lecture

4/11/19 Lecture
Clinical Application Assignment: write up case, practice
CASE 4 staffing case due by 4/18/19
Final Assessments  Complete self- assessment form
 Complete peer assessment forms
Shadow Health Comprehensive Assessment – due by
4/18/19

4/18/19 Clinical Application Assignment: write up case, practice


Case 4, cont staffing case due by 4/21/19
Lecture Reminder: Advising should be completed
by end of semester
4/25/19 Clinical Year Information
5/2/19 FINAL EXAM CASE STUDY Exam (2 hrs)

Instructor reserves the right to change timing and order of material.

ADDITIONAL INFORMATION:
Students are expected to fully participate in all aspects of IPE sessions from pre and
post session assessment, the session itself, and any related debriefing. Attendance is
taken at IPE events. Be sure to sign in.

PAS 5152 CARE II Syllabus p. 8


ASSIGNMENTS
Medicine Cases Assignments:
For the cases assigned, work through the following and type the data for each step (see scoring
rubric)
For each step, identify learning gaps for maximum study strategy.
 Create a differential diagnosis (DDX) for each case based on the CC
 Obtain a medical history for each case patient
 Adjust differential diagnosis based upon medical history information
 Obtain a physical examination for each patient case
 Adjust your DDX based on the physical examination
 Order appropriate labs and additional diagnostic studies/procedures as indicated by the
differential diagnosis to diagnose, evaluate and treat the disorders/diseases.
 Use the lab studies to further adjust your differential diagnosis.
 Cite the sources for your treatment plans
 Communicate a plan for disease prevention, health promotion and patient education and
counselling including the course of illness, prognosis, and follow up care. This includes
medical documentation. (Create one document for the team)
 Describe issues of diversity and ethical issues in the case
 Describe issues of socioeconomic status
 Begin to present the patient case orally to peers and other practitioners/disciplines in a
succinct yet informative method

Reflection Assignments:
 Opening Reflection (Professional Development)
Choose one of the following and write no more than 1 page on it. Discuss both
topics with your CARE professor this semester. Due no later than Week 7.
o Examine how you reacted to the stress of final exams including how well you did and
how you “managed” it.
o Reflect on any PA school experience in which you had to face conflict including and
how and how well you dealt with it.

 Midterm (Self/Peer) Assessment Reflection


(Assessment of Individual Team Member’s Team Working Skills rubric)
o Complete the self-assessment form
o Complete the peer-assessment form for each team member

 Semester Assessment Reflection


(Assessment of Individual Team Member’s Team Working Skills rubric)
o Complete the self-assessment form
o Complete the peer-assessment form for each team member

 Interdisciplinary Lecture Reflection


Reflect on what knowledge base you had already on this topic, the information you gained,
and what surprised you the most about what you learned. Write a page about how you can
apply what you learned to culturally sensitive clinical practice.

PAS 5152 CARE II Syllabus p. 9


Professional Development
 Continue to work toward your own professional goals:
o begin to carry out your plan for distinguishing one’s self on the resume such as
through leadership, scholarship and/or service
 Carry out your ideas for class projects

PAS 5152 CARE II Syllabus p. 10


GRADING RUBRIC
Medical Cases Scoring Rubric

Student Name(s):
Reviewer (Name):
Review Type: Self, Peer, Faculty; Team, Individual
Domain to Evaluate Score
NI S E
Create a differential diagnosis DDX initially does DDX initially DDX initially
(DDX) for each case based on not include proper appropriate breadth beyond expected
the CC breadth and depth and depth breadth and depth
Captured top differentials Missed most of top Most top All top differentials
differentials; differentials were and other logical ddx
focused on noted
uncommon ddx
Obtain a medical history (Hx) Missing pertinent Hx information Hx appropriate and
for each case patient information, appropriate with w/o extraneous
extraneous, logical approach information/approach
illogical approach
Create and adjust differential DDX not adjusted, DDX adjusted; DDX adjusted with
diagnosis based upon medical not prioritized prioritized greater breadth and
history, PE and lab information depth and correctly
prioritized
Obtain a physical examination PE missing PE with appropriate PE appropriate,
(PE) for each patient case pertinent information and with logical and w/o
information, logical approach extraneous
extraneous, information/approach
illogical approach
Order appropriate labs and Labs/diagnostics Labs/diagnostics Labs/diagnostics
additional diagnostic inappropriate, appropriate with appropriate, logical
studies/procedures as indicated expensive, attention to approach, proper
by the differential diagnosis to extraneous, logic/costs utilization of health
diagnose, evaluate and treat the illogical care resources
disorders/diseases.
Communicate a patient centered Pt education plan Pt education plan Pt education plan
plan for disease prevention, absent, barely partially addressed fully addressed
health promotion and patient addressed
education and counselling
including the course of illness,
prognosis, and follow up care.
Communication in medical Medical Medical Medical
record/medical documentation. Documentation Documentation Documentation
too verbose or too mostly with Appropriate
brief, important appropriate information present
content missing information and written
succinctly
Describe ethical issues around Ethics not Ethics partially Ethics fully
the case addressed or barely addressed or N/A addressed as
addressed when applicable
applicable
PAS 5152 CARE II Syllabus p. 11
Describe issues of diversity Diversity not Diversity partially Diversity fully
seen in the case addressed or barely addressed or N/A addressed as
addressed when applicable
applicable
Describe issues of SES not addressed SES partially SES fully addressed
socioeconomic status (SES) & or barely addressed addressed or N/A as applicable
health disparities when applicable
Begin to present the patient case Oral case Oral case Oral case
orally to peers and other presentation not presentation mostly presentation
practitioners/disciplines in a succinct/not succinct/informative; succinct/informative;
succinct yet informative method informative; professional professional
showing professionalism unprofessional
Demonstrate appropriate moral, Related interactions N/A or no issues Superior attention to
ethical, nonjudgmental and to case not with case material issues surrounding
professional behavior when congruent with interactions ethics, moral,
providing care to patients of a ethics, nonjudgmental and
diverse population throughout nonjudgmental, professional behavior
the life span. professional in case material
behavior interactions

Key:
NI Needs Improvement- student is not performing to expected level at this time in the curriculum
S Satisfactory- student is performing at expected level for timing in curriculum
E Excellent- student is performing beyond expected level for timing in curriculum

PAS 5152 CARE II Syllabus p. 12


INSTRUCTIONAL OBJECTIVES for CARE II

Medicine:
 Care for virtual patients through Shadow Health. These patients will be acute, emergent,
chronic, preventive, and rehabilitative
o Solicit a relevant medical history
o Solicit a relevant physical examination
o Formulate a differential diagnosis for cases based on information from the medical
history and physical examination
o Interpret appropriate labs and additional diagnostic studies/procedures as indicated by
the differential diagnosis to diagnose, evaluate and treat the disorders/diseases
 Generate pharmacologic management plans for the diseases/disorders in the cases based upon
current clinical practice guidelines and other evidence-based resources
o Write orders for pharmacologic management plans using techniques for reducing
medical errors
 Generate non-pharmacologic plan per current clinical practice guidelines and other evidence-
based resources
o Write orders as relevant for non-pharmacologic plans
o Utilize practice guidelines for disease prevention and health promotion considering
individual health issues and public health concepts.
 Communicate a patient–centered plan for disease prevention, health promotion and patient
education and counselling including the course of illness, prognosis, and follow up care
 Describe ethical issues around the case, if present
 Describe issues of cultural diversity and other psychosocial issues
 Present the patient case orally to peers and orally to Professor Newman in a succinct yet
informative method
 Communicate accurately utilizing standard medical terminology as appropriate for situation.

IPE:
Participate fully in IPE experiential learning situations (meeting objectives below) utilizing budding
skills in communication

FWAIPEC SESSION- ROOT CAUSE ANALYSIS


Upon completion of the lecture and breakout activities on Root Cause Analysis, the learner will be
able to:
 Apply the elements of the Root Cause Analysis model retrospectively to a real patient scenario
 Utilize a fishbone diagram to delineate the issues associated with the case
 Discuss the elements of communication a patient’s family expected from health care
providers/institution
 Deliberate the issues surrounding the case, with a focus on the “why” and “how” and not the
“who”
 Create a solution to one problem associated with the case
 Present the problem and solution to other groups
 Reinforce the need for interprofessional education

PAS 5152 CARE II Syllabus Instructional Objectives p. 1


CONCUSSION WORKSHOP
Upon the completion of the concussion workshop, you should be able to:
 Define the common signs and symptoms of a concussion
 Develop a plan for concussion prevention and management
 Describe various assessment tools that can be utilized with a patient who may have a
concussion
 Prepare an assessment of a patient with a suspected concussion for a variety of settings
 Define second impact syndrome
 Compare and contrast the roles of other professionals interfacing with a patient with a
concussion
 Explain long term management strategies of a patient status post-concussion
 Summarize decisions and effectively communicate with other team members and patients
concerning return to play/learn that are consistent with state laws and athletic organizations

Professional Development/Communication skills


 Continue to explain “What is a PA?” to a patient, to team members, to a potential employer,
and to the general public.
 As a team member, provide constructive feedback to your classmates.
 Continue to work toward your own professional goals:
o through the update of your resume
o begin to carry out your plan for distinguishing one’s self on the resume such as
through leadership, scholarship and/or service
 Examine how you reacted to the stress of final exams including how well you did and how
you “managed” it.
 Reflect on any PA school experience in which you had to face conflict including and how and
how well you dealt with it.
 Carry out your ideas for class projects

Cultural Diversity Issues


 Define cultural competence in healthcare. Describe other terms utilized and the
cultural/psychosocial issues surrounding it.
 Define challenges to cultural competence.

PAS 5152 CARE II Syllabus Instructional Objectives p. 2