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Barry University Physician Assistant Program Technical and Professional Standards

  1. Introduction

    Physician Assistant (PA) training is recognized as a broad-based process that requires the acquisition of general knowledge in all fields of medicine and of the basic skills required for the practice of medicine, regardless of specialty. The education of a PA in the Barry University Physician Assistant Program (BUPAP) requires assimilation of knowledge, acquisition of skills, and development of judgment through patient care experience in preparation for semi-autonomous and appropriate decisions required in medical practice. The current practice of medicine emphasizes collaboration among physicians, other allied health care professionals such as PAs, patients and families.

  2. Technical and Professional Standards

    1. The BUPAP Technical and Professional Standards (Standards), as distinguished from academic standards, refer to those physical, cognitive, and behavioral abilities necessary for satisfactory completion of all aspects of the BUPAP curriculum. This includes the development of professional attributes required by the faculty of all BUPAP students by the time of graduation and for future practice as a certified and licensed PA.
    2. The BUPAP standards and essential functions of medical education shape the requirements for admission, retention, and graduation of applicants and students, respectively, at BUPAP. All graduates are expected to be qualified to enter a field of PA practice of their choice.
    3. Students applying to the BUPAP are selected on the basis of academic achievement, faculty evaluations, evidence of maturity, motivation, leadership, integrity, and compassion. Students must be capable of meeting the Standards described herein.
    4. The medical education process involved in the BUPAP focuses largely on the care of patients, and differs markedly from postsecondary education in fields outside of the health sciences. The primary responsibility for the selection of students and for the content of the curriculum rests with the BUPAP and its faculty.
    5. The PA role is, and must remain, a broad, undifferentiated role that produces graduates capable of supporting the full range of physician practice and patient needs. The BUPAP credentials awarded must attest to the acquisition of general knowledge in all fields of medicine and the basic skills requisite for the practice of medicine under physician supervision.
    6. Applicants are assessed without regard to sex, race, religion, color, national or ethnic origin, age, physical disability, or sexual preference. Admission to the BUPAP is competitive and is based on individual merit and performance within each applicant pool for a given academic year, and not on personal convictions, preferences, or happenstance of birth unrelated to academic performance.
    7. The Standards, along with the BUPAP policies, procedures and process for the admission and education of PA students, parallel, to some extent, those set forth by the Physician Assistant Competencies published by the ARC-PA, AAPA, NCCPA and PAEA, and inform and guide the decisions of the BUPAP faculty. All students of medicine, including PA students, must possess those intellectual, ethical, physical and emotional capabilities required to undertake the full curriculum and to achieve the levels of competence required by the faculty.
    8. The Standards are as follows.

      1. Observation

        The BUPAP curriculum requires essential abilities in information acquisition.

        1. The student must have the ability to master the course work presented in the form of lectures, written material and projected images. For many required tasks, observation necessitates the functional and mixed use of the sense of vision and other sensory modalities.
        2. Learning is enhanced by the functional use of the senses of smell and touch. The candidate must possess adequate sensation of vision, hearing, equilibrium, smell, taste, touch, pain, temperature, position, pressure, movement, stereognosis, and vibration, particularly when gross and/or subtle changes in symmetry are present.
        3. The student must have the cognitive abilities necessary to master relevant content in basic science and clinical courses at a level and pace deemed appropriate by the faculty.
        4. These skills may be described as the ability to comprehend, memorize, analyze, and synthesize material.
        5. The student must also be able to discern and comprehend dimensional and spatial relationships of structures and to develop reasoning and decision-making skills appropriate to the practice of medicine.
        6. Students must be able to perceive, by the use of senses and mental abilities, the presentation of information through small group discussions and presentations, large-group lectures, one-on-one interactions, demonstrations, laboratory experiments, patient encounters (at a distance and close at hand), diagnostic findings, procedures, and written material and audiovisual materials.
        7. Representative examples of materials/occasions requiring perceptual abilities in the first year include, but are not limited to: books, diagrams, discussions, photographs, x-rays, clinical case presentations, patient interviews and physical examinations, completion of cognitive and skills requirements for ACLS and PALS certification, and performance of suturing, casting, splinting, gowning, gloving, surgical scrubbing and establishing/maintaining sterile fields in the operating room setting.
        8. Additional examples from the second (clinical) year include, but are not limited to: physical exams; rectal and pelvic exams; examinations with stethoscopes, otoscopes, fundoscopes, sphygmomanometers, and refl ex hammers; verbal communication and non-verbal cues (as in taking a patient’s history or working with a medical team); live and televised surgical procedures; assisting at surgery and childbirth; x-rays, MRIs, and other diagnostic findings; online computer searches; and, responding to a wide variety of urgent and/or emergent patient presentations.
      2. Communication

        The student must have the ability to take a medical history and perform a physical examination. Such tasks require the ability to communicate with the patient.

        1. The student must be capable of perceiving the signs of disease or distress as manifested through the physical examination so these findings can be communicated verbally or in writing or both. Such information is derived from viewing and touching the body surfaces, palpable changes in various organs, and auditory information (patient voice, heart tones, bowel, and lung sounds).
        2. The student must be able to communicate effectively (in English) with patients and family, physicians, and other members of the health care team.
        3. These communication skills require the ability to assess all information, including the recognition of the significance of non-verbal responses and immediate assessment of information provided to allow for appropriate, well-focused follow-up inquiry.
        4. The student must be capable of responsive, empathetic listening to establish rapport in a way that promotes openness on issues of concern and sensitivity to potential cultural differences, and includes interacting therapeutically with psychiatric patients. In essence, this requires that the student be able to function, often in a fast paced environment, in order to:

          • * Elicit information
          • * Convey information
          • * Clarify information
          • * Create rapport
          • * Develop therapeutic relationships
          • * Demonstrate competencies
        5. The student must be able to skillfully process and communicate information regarding the patient’s status accurately and in a timely manner to the physician supervisors and all other members of the health care team. Complete, accurate information then needs to be communicated in a succinct, yet comprehensive manner, in settings in which the time available is limited. This may include, but is not limited to, participating in clinical rounds and conferences, oral presentations to physicians or other members of the healthcare team, written or dictated patient assessments and writing prescriptions.
        6. Appropriate communication may also depend on the student’s ability to make a correct judgment in seeking supervision and consultation in a timely manner, particularly in urgent and emergent situations.
      3. Sensory and Motor Function

        The student must have sufficient sensory and motor function to elicit information from patients by palpation, auscultation, percussion, and other diagnostic maneuvers.

        1. The student will be required to coordinate both gross and fine muscular movements, equilibrium, and functional use of the senses of hearing, touch and vision.
        2. More specifically, the student must be able to exercise such fine motor skill as to adequately perform laboratory tests, including but not limited to, wet mount, urinalysis and gram stain.
        3. The student must exercise such level of dexterity, sensation and visual acuity as to competently and accurately complete such processes as administering intravenous medication, making fine measurements of angles and size, measuring blood pressure, respiration and pulse, performing physical examinations, and performing therapeutic procedures such as phlebotomy, EKGs, reading radiographs, suturing and casting.
        4. The student must be able to hear sufficiently to accurately differentiate percussive notes and auscultory findings, including but not limited to heart, lung, and abdominal sounds, as well as discern normal and abnormal findings using instruments such as tuning forks, stethoscopes, sphygmomanometers, and Doppler devices.
        5. A student must be able to transport himself or herself in a manner which provides timely response in both general and emergency care situations. Moving patients and engaging in some procedures requires the level of skill, strength and endurance necessary to perform the procedure(s) quickly, safely, effectively and for a reasonable period of time, often in a stressful environment.
        6. Examples of emergency treatment reasonably required of a PA are cardiopulmonary resuscitation, the administration of intravenous medication, application of pressure to stop bleeding, the opening of obstructed airways, the suturing of simple wounds, and the performance of simple obstetrical maneuvers. Such actions often require simultaneous coordination of gross and fine muscular movements, equilibrium and functional use of the senses of touch and vision.
      4. Intellectual-Conceptual, Integrative and Quantitative Abilities

        Students must be able to demonstrate higher-level cognitive abilities, which include:

        • * Rational thought
        • * Measurement
        • * Calculation
        • * Visual-spatial comprehension
        • * Conceptualization
        • * Analysis
        • * Synthesis
        • * Organization
        • * Representations (oral, written, diagrammatic, three dimensional)
        • * Memory
        • * Application
        • * Clinical reasoning
        • * Ethical reasoning
        • * Sound judgment
        1. Examples of applied cognitive abilities in the first year include, but are not limited to: understanding, synthesizing, and recalling material presented in classes, labs, small groups, patient interactions, and meetings with preceptors; understanding 3-dimensional relationships, such as those demonstrated in the anatomy lab; successfully completing oral, written, and laboratory exams; understanding ethical issues related to the practice of medicine; engaging in problem solving, alone and in small groups; interpreting the results of patient examinations and diagnostic tests; analyzing complicated situations, such as cardiac arrest, and determining the appropriate sequence of events to effect successful treatment; working through genetic problems.
        2. Additional examples of required cognitive abilities in year two include, but are not limited to: integrating historical, physical, social, and ancillary test data into differential diagnoses and treatment plans; understanding indications for various diagnostic tests and treatment modalities - from medication to surgery; understanding methods for various procedures, such as lumbar punctures and inserting intravenous catheters; being able to think through medical issues and exhibit sound judgment in a variety of clinical settings, including emergency situations; identifying and understanding classes of psychopathology and treatment options; making concise, prompt, cogent, and thorough presentations based on various kinds of data collection, including web-based research; knowing how to organize information, materials, and tasks in order to perform efficiently on service; understanding how to work and learn independently; understanding how to function effectively as part of a healthcare team.
      5. Behavioral and Social Attributes

        A candidate must possess the emotional health required for full utilization of his or her intellectual abilities, the exercise of good judgment, the prompt completion of all responsibilities attendant to the diagnosis and care of patients, and the development of mature, sensitive, and effective relationships with patients.

        1. Candidates must be able to tolerate physically taxing workloads and to function effectively under stress.
        2. They must be able to adapt to changing environments, to display fl exibility, and to learn to function in the face of uncertainties inherent in the clinical problems of many patients.
        3. Compassion, integrity, concern for others, interpersonal skills, interest, and motivation are all personal qualities that are assessed during the admissions and throughout the education processes.
        4. The student must be able to understand the basis and content of medical ethics.
        5. The student must possess attributes that include compassion, empathy, altruism, integrity, responsibility, and tolerance. (See Professional Behaviors, below)
        6. The student must have the emotional stability to function effectively under stress and to adapt to an environment that may change rapidly, without warning, and/or in unpredictable ways.
      6. Professional Standards

        All students of the BUPAP program must consistently display integrity, honesty, empathy, caring, fairness, respect for self and others, diligence, and dedication. Students must:

        1. Promptly complete all assignments and responsibilities attendant to the diagnosis and care of patients (beginning with study in the first year);
        2. Develop mature, sensitive, and effective relationships, not only with patients but with their peers, all members of the BUPAP and university community and healthcare teams;
        3. Tolerate physically, emotionally, and mentally demanding workloads;
        4. Function effectively under stress, and proactively make use of available resources to help maintain both physical and mental health;
        5. Adapt to changing environments, display fl exibility, and be able to learn in the face of uncertainty;
        6. Take responsibility for themselves and their behaviors.

        Examples of professional behavior in year one include, but are not limited to: attending required experiences on time and prepared; displaying good personal hygiene and dressing according to program requirements; refraining from the abuse of alcohol and/or prescription drugs, and the use of illicit drugs; handing in assignments on time; refraining from plagiarizing or cheating; treating faculty, staff, and other students with respect; making an effort to understand prejudices and preconceptions that might affect patient interactions or collegial relationships (especially in the areas of race and ethnicity, sexual orientation, gender, disability, age, and religious difference); developing successful working relationships with preceptors, staff, and peers by accepting constructive feedback and modifying their behavior accordingly.

        Additional examples of professional behavior in year two include, but are not limited to: maintaining a professional appearance and demeanor on service (e.g. white coat, name tag, appropriate attire, neat appearance, respectful speech, sobriety); representing oneself accurately; appreciating and preserving patient confidentiality; responding sensitively to patients’ social and psychological issues; developing empathic listening skills; understanding social biases and stigmas, and not reinforcing them; advocating for patients when appropriate; using hospital/clinic resources responsibly; showing up prepared and on time for rounds, lectures, conferences, and procedures; getting advice when handling ethical dilemmas; taking constructive feedback from attending physicians and residents with open-mindedness and the intention to improve; contributing to the effectiveness, efficiency, and collegiality of healthcare teams.

Applicants are assessed without regard to sex, race, religion, color, national or ethnic origin, age, physical disability, or sexual preference. A strong affirmative action program is maintained in all of the admission entry routes. Applications are encouraged from students of medically-underrepresented minority groups.

The medical education process involved in the BUPAP focuses largely on the care of patients, and differs markedly from postsecondary education in fields outside of the health sciences. The primary responsibility for the selection of students and for the content of the curriculum rests with the BUPAP and its faculty.

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